CN106491974B - Traditional Chinese medicine composition and traditional Chinese medicine decoction for treating enteroparalysis - Google Patents

Traditional Chinese medicine composition and traditional Chinese medicine decoction for treating enteroparalysis Download PDF

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CN106491974B
CN106491974B CN201610953888.XA CN201610953888A CN106491974B CN 106491974 B CN106491974 B CN 106491974B CN 201610953888 A CN201610953888 A CN 201610953888A CN 106491974 B CN106491974 B CN 106491974B
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陈英杰
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/88Liliopsida (monocotyledons)
    • A61K36/898Orchidaceae (Orchid family)
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    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/23Apiaceae or Umbelliferae (Carrot family), e.g. dill, chervil, coriander or cumin
    • A61K36/233Bupleurum
    • AHUMAN NECESSITIES
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    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/28Asteraceae or Compositae (Aster or Sunflower family), e.g. chamomile, feverfew, yarrow or echinacea
    • A61K36/288Taraxacum (dandelion)
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    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/28Asteraceae or Compositae (Aster or Sunflower family), e.g. chamomile, feverfew, yarrow or echinacea
    • A61K36/289Vladimiria
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    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/48Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/482Cassia, e.g. golden shower tree
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/48Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/484Glycyrrhiza (licorice)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/53Lamiaceae or Labiatae (Mint family), e.g. thyme, rosemary or lavender
    • A61K36/537Salvia (sage)
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    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/57Magnoliaceae (Magnolia family)
    • A61K36/575Magnolia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/66Papaveraceae (Poppy family), e.g. bloodroot
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/70Polygonaceae (Buckwheat family), e.g. spineflower or dock
    • A61K36/708Rheum (rhubarb)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/75Rutaceae (Rue family)
    • A61K36/752Citrus, e.g. lime, orange or lemon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2236/00Isolation or extraction methods of medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicine
    • A61K2236/30Extraction of the material
    • A61K2236/33Extraction of the material involving extraction with hydrophilic solvents, e.g. lower alcohols, esters or ketones
    • A61K2236/331Extraction of the material involving extraction with hydrophilic solvents, e.g. lower alcohols, esters or ketones using water, e.g. cold water, infusion, tea, steam distillation, decoction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2236/00Isolation or extraction methods of medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicine
    • A61K2236/30Extraction of the material
    • A61K2236/39Complex extraction schemes, e.g. fractionation or repeated extraction steps

Abstract

The invention relates to a traditional Chinese medicine composition and a traditional Chinese medicine decoction for treating enteroparalysis. The traditional Chinese medicine composition comprises the following traditional Chinese medicine raw materials in parts by mass: 20-40 parts of raw rhubarb, 20-40 parts of mirabilite, 5-20 parts of folium sennae, 10-20 parts of dandelion, 5-15 parts of radix aucklandiae, 5-15 parts of mangnolia officinalis, 5-15 parts of dried orange peel, 5-20 parts of radix bupleuri, 10-20 parts of immature bitter orange, 10-20 parts of rhizoma corydalis, 5-15 parts of salvia miltiorrhiza, 5-15 parts of bletilla striata and 5-10 parts of honey-fried licorice root. The traditional Chinese medicine decoction has a reasonable formula, has the effects of promoting qi circulation, clearing heat, promoting diuresis, removing blood stasis and detoxifying, can effectively treat acute pancreatitis, and has the advantages of high content of effective medicinal components, no obvious toxic or side effect, stable effect, convenience in taking and the like; the traditional Chinese medicine decoction can effectively improve the enteroparalysis, promote the recovery of gastrointestinal functions, relieve inflammatory reaction, protect the barrier function of intestinal mucosa, improve physicochemical indexes, promote the recovery of diseases, reduce the incidence rate of adverse reactions and fully exert the characteristic and advantageous effects of the traditional Chinese medicine.

Description

Traditional Chinese medicine composition and traditional Chinese medicine decoction for treating enteroparalysis
(I) technical field
The invention relates to a traditional Chinese medicine composition and a traditional Chinese medicine decoction for treating enteroparalysis.
(II) background of the invention
Acute pancreatitis refers to pancreatic enzyme activation caused by various causes, and is mainly characterized by local inflammation reaction of pancreas, and about 80 percent of patients have light and medium pancreatic injuries, and the disease course is self-limiting; about 20% of patients develop severe illness, rapid progress of pathological changes, many complications and high mortality. The disease belongs to the categories of abdominal pain and pancreatic fever in traditional Chinese medicine, and pathogenesis evolution is mainly dysfunction of spleen-stomach ascending and descending and transmission caused by dampness, heat, stasis and toxin accumulation in middle-jiao, and liver dysfunction and liver catharsis. The traditional Chinese medicine and the Chinese and western medicine combined therapy for treating acute pancreatitis can play a role in treating acute pancreatitis by inhibiting the release of cytokines, improving microcirculation, removing oxygen radicals, inhibiting the secretion of pancreatin, protecting damaged organs and other multi-target and multi-link medicines, shorten the course of diseases, reduce the occurrence of complications and improve the cure rate, are proved by clinical practice, are widely accepted in clinic, and are the characteristics and advantages of treating acute pancreatitis in China. Guo's clear pancreas decoction is the proved recipe of the third group of old Chinese medicine experts' academic inheritance in Fujian province for instructing the teacher Guoneren chief and ren physicians, has the functions of promoting the circulation of qi and clearing the hollow viscera, clearing heat and promoting diuresis, and removing blood stasis and detoxifying, and has better clinical curative effect on acute pancreatitis.
Disclosure of the invention
The invention aims to provide a traditional Chinese medicine composition and a traditional Chinese medicine decoction for treating acute pancreatitis, which have definite curative effect, no obvious toxic or side effect, stable effect and convenient taking.
The technical scheme adopted by the invention is as follows:
a traditional Chinese medicine composition for treating enteroparalysis is prepared from the following traditional Chinese medicine raw materials in parts by mass:
20-40 parts of raw rhubarb, 20-40 parts of mirabilite, 5-20 parts of folium sennae, 10-20 parts of dandelion, 5-15 parts of radix aucklandiae, 5-15 parts of mangnolia officinalis, 5-15 parts of dried orange peel, 5-20 parts of radix bupleuri, 10-20 parts of immature bitter orange, 10-20 parts of rhizoma corydalis, 5-15 parts of salvia miltiorrhiza, 5-15 parts of bletilla striata and 5-10 parts of honey-fried licorice root.
Preferably, the composition comprises the following components in percentage by mass: 30 parts of raw rhubarb, 30 parts of mirabilite, 10 parts of senna leaf, 15 parts of dandelion, 10 parts of vladimiria root, 10 parts of magnolia officinalis, 10 parts of dried orange peel, 10 parts of radix bupleuri, 15 parts of immature bitter orange, 15 parts of corydalis tuber, 10 parts of salvia miltiorrhiza, 10 parts of bletilla striata and 6 parts of honey-fried licorice root.
The invention also relates to a traditional Chinese medicine decoction for treating enteroparalysis (namely Guo's clear pancreas decoction), which is prepared from the following traditional Chinese medicine raw materials in parts by mass: 20-40 parts of raw rhubarb, 20-40 parts of mirabilite, 5-20 parts of folium sennae, 10-20 parts of dandelion, 5-15 parts of radix aucklandiae, 5-15 parts of mangnolia officinalis, 5-15 parts of dried orange peel, 5-20 parts of radix bupleuri, 10-20 parts of immature bitter orange, 10-20 parts of rhizoma corydalis, 5-15 parts of salvia miltiorrhiza, 5-15 parts of bletilla striata and 5-10 parts of honey-fried licorice root; the preparation method of the traditional Chinese medicine decoction comprises the following steps:
(1) weighing the traditional Chinese medicine raw materials according to the formula amount, and cleaning the raw materials except mirabilite for later use;
(2) soaking the raw materials except the raw rhubarb, the mirabilite and the senna leaves in water, namely soaking the raw materials except the raw rhubarb, the mirabilite and the senna leaves in the water, burying the water in the medicine surface for 1-2 cm, and decocting and extracting the raw materials for 2 times after soaking for 0.5-1 hour: decocting the medicines with slow fire for the first time until the medicines are fully expanded, boiling the medicines, adding raw rhubarb and senna leaves, keeping the boiling for 15-30 minutes, and filtering dregs of a decoction to obtain first medicine juice; adding water into the medicine residues for the 2 nd time, burying the water for 1-2 cm above the medicine surface, decocting with slow fire until the medicine is fully expanded, boiling again, keeping boiling for 15-30 minutes, and filtering the medicine residues to obtain a second medicine juice; mixing the two decoctions, adding Natrii sulfas, and dissolving in the decoctions;
(3) and (3) sealing and subpackaging the medicinal juice obtained in the step (2) by using special Chinese medicinal bags, wherein each bag is 150-200ml, and thus obtaining the Chinese medicinal decoction.
Preferably, the traditional Chinese medicine decoction is prepared from the following traditional Chinese medicine raw materials in parts by mass: 30 parts of raw rhubarb, 30 parts of mirabilite, 10 parts of senna leaf, 15 parts of dandelion, 10 parts of vladimiria root, 10 parts of magnolia officinalis, 10 parts of dried orange peel, 10 parts of radix bupleuri, 15 parts of immature bitter orange, 15 parts of corydalis tuber, 10 parts of salvia miltiorrhiza, 10 parts of bletilla striata and 6 parts of honey-fried licorice root.
The invention has the following beneficial effects: (1) the traditional Chinese medicine composition is reasonable in formula, has the effects of promoting qi circulation, clearing heat, promoting diuresis, removing blood stasis and detoxifying, and can effectively treat acute pancreatitis. (2) The invention has the advantages of high content of effective medicinal components, no obvious toxic or side effect, stable effect, convenient taking and the like, the Guoshi clear pancreas decoction is prepared into bags, each bag is 150 plus 200ml, the storage is convenient, the decoction can be taken at any time in clinical application, and the clinical practice is more met. (3) The traditional Chinese medicine decoction can effectively improve the enteroparalysis, promote the recovery of gastrointestinal functions, relieve inflammatory reaction, protect the barrier function of intestinal mucosa, improve physicochemical indexes, promote the recovery of diseases, reduce the incidence rate of adverse reactions and fully exert the characteristic and advantageous effects of the traditional Chinese medicine.
(IV) detailed description of the preferred embodiments
The invention will be further described with reference to specific examples, but the scope of the invention is not limited thereto:
example 1: preparation of Guoshi clear pancreas soup
The formula is as follows: 30g of raw rhubarb (added later), 30g of mirabilite (added later), 10g of senna leaf (added later), 15g of dandelion, 10g of radix aucklandiae, 10g of magnolia officinalis, 10g of dried orange peel, 10g of radix bupleuri, 15g of immature bitter orange, 15g of corydalis tuber, 10g of salvia miltiorrhiza, 10g of bletilla striata and 6g of honey-fried licorice root.
The preparation method comprises the following steps:
(1) weighing the raw materials according to the formula ratio, and cleaning the raw materials except the mirabilite for later use.
(2) Soaking the raw materials except the raw rhubarb, the mirabilite and the senna leaf in the step (1) in water, burying the water in the medicine surface for 1-2 cm, and decocting and extracting for 2 times after soaking for 1 hour; decocting with slow fire for the first time 1 until the materials are fully expanded, boiling, adding radix et rhizoma Rhei and folium sennae, boiling for 30 min, and filtering the residue to obtain decoction of the first time 1; adding water for the 2 nd time, burying the water 1-2 cm above the surface of the medicine, decocting with slow fire until the medicine is fully expanded, boiling again and keeping boiling for 30 minutes, and filtering the residue to obtain the 2 nd time decoction; mixing the above 2 decoctions, adding Natrii sulfas, and dissolving in the decoctions.
(3) And (3) sealing and subpackaging the medicinal juice obtained in the step (2) by using special Chinese medicinal bags, wherein each bag is 150-200ml, and thus obtaining the Chinese medicinal decoction (Guoshi clear pancreas soup).
Example 2: clinical research of Guoshi Qingshi decoction for treating acute pancreatitis
1 purpose of study:
the curative effect of the Guo's clear pancreas decoction on treating acute pancreatitis and the influence of inflammatory factors and intestinal mucosa barrier function are observed.
2 research data and methods
2.1 general data
And selecting cases meeting the research standard from inpatients in 3 months to 2015 11 months in 2014.
The control group and the observation group are divided into 75 cases according to a random number method. In the control group, 44 men and 31 women aged 20-63 years, with the average (41.7 +/-15.2) years; the time from onset to admission is 5-42 h, and the average time is (17.6 +/-15.1) h; the etiology is as follows: the medicine is prepared from 48 of bile origin, 27 of alcoholic nature and other 10 of the alcoholic nature. Grading by CT imaging: 26 cases of B stage, 36 cases of C stage and 13 cases of D stage; acute physiological and chronic health status (APACHE ii) score: (14.8. + -. 3.5) minutes. In the observation group, 46 men and 29 women are aged 20-65 years, and the average age is (42.4 +/-14.7); the time from onset to admission is 6-48 h, and the average time is (19.4 +/-14.8) h; the etiology is as follows: 45 examples of bile origin, 29 examples of alcoholic activity, and 11 other examples. Grading by CT imaging: 24 cases of B-stage, 38 cases of C-stage and 13 cases of D-stage; APACHE II score (15.1. + -. 3.8). The comparison between the two groups of baseline data has no statistical significance and is comparable.
2.2 diagnostic Standard acute pancreatitis diagnostic Standard, in accordance with the Chinese guidelines for acute pancreatitis (2013, Shanghai) set by the gastroenterology group of the Chinese medical society, pancreas disease group. The main symptoms are: acute, sudden, continuous and severe upper abdominal pain, which is usually reflected in the back by radiation, and the activity of serum amylase and/or lipase is at least 3 times higher than the normal upper limit value; enhanced CT/MRI or abdominal ultrasound presents an acute pancreatitis imaging change. The secondary symptoms are as follows: the Ranson score is more than or equal to 3 points; the APACHE II score is more than or equal to 8 points; the Bedside Index (BISAP) score of the severity of acute pancreatitis is more than or equal to 3 points; the CT severity index (MCTSI) score is more than or equal to 4. The diagnosis can be made by adding 2 main symptoms and 1 secondary symptom.
2.3, bringing the pancreatitis into the standard, namely meeting the Western diagnosis standard of acute pancreatitis; ② hospitalization treatment is carried out within 72h after the onset of the disease; no treatment with traditional Chinese medicine and somatostatin; age 18-65 years old, male and female without limitation; and fourthly, signing an informed consent.
2.4 excluding standard (I) patients with serious liver and kidney dysfunction; ② patients with serious complications; ③ patients with abnormal blood coagulation and obvious bleeding tendency, such as digestive tract hemorrhage, hematopathy, malignant tumor, hepatopathy, oral anticoagulant drug, etc.; fourthly, pregnant women or women in lactation period; the fifth step is to combine serious diseases of other systems of the whole body, tumor patients and psychopath patients. Sixthly, judging the curative effect by adopting other traditional Chinese medicines at the same time; and (c) removing the solvent. Patients with poor treatment compliance and medication contraindications.
2.5 treatment method the control group is given western medicine treatments of fasting, gastrointestinal decompression, limited fluid resuscitation, spasmolysis, pain relief, correction of water electrolysis alkali balance, pancreatic secretion inhibition, systemic inflammatory response syndrome inhibition, nutrition support, intestinal tract dredging, infection prevention and control and the like.
And (3) an observation group, which is treated by adding Guo's clear pancreas soup on the basis of the treatment of a control group: (1) placing spiral jejunum nasal jejunum tube of Fuerkai produced by Nutriaca of the Netherlands by bare hands, and administering the Guo's clear pancreas decoction through the nasal jejunum tube, wherein the Chinese medicinal decoction pieces are provided by a Chinese pharmacy in a hospital, and each dose of the decoction is decocted by the decoction room in the hospital for 2 times according to the method of the embodiment 1, and 400ml of the decoction is taken; 150 ml/time, dropping through a nasal jejunum tube, and controlling the dropping speed by using a dropping pump to be 50-100 ml/hour, 1 time/4-6 hours.
Both groups of patients were treated continuously for 7 days.
2.6 observation indexes are that the recovery evaluation of the intestinal function records the time of abdominal pain, abdominal distension relief, recovery of bowel sound and ventilation and defecation; monitoring blood routine, blood and urine amylase, blood sugar and blood calcium by physical and chemical indexes, and evaluating 1 time before and after treatment; ③ the inflammation factors comprise serum interleukin-1 (IL-1), serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), which are detected by adopting an enzyme-linked immunosorbent assay, and the kit is provided by Nanjing Biotechnology Limited company, and has the batch number of 20150361. And fourthly, evaluating the intestinal barrier function, namely detecting the D-lactic acid in the serum by adopting a spectrophotometry method according to 3 indexes of D-lactic acid, endotoxin and urolactulose/mannitol (L/M) values, detecting the endotoxin by adopting a limulus kit produced by Shanghai medical assay, and respectively detecting the L/M values by adopting a high performance liquid chromatography according to reference documents. Each was evaluated 1 time before and after treatment.
2.7 the standard of curative effect is formulated according to the opinion on the consensus of experts in diagnosis and treatment of acute pancreatitis, formulated by the division of spleen and stomach diseases of the Chinese medical society. And (3) healing: the symptoms and physical signs of the patient disappear completely, the laboratory indexes are all restored to normal levels, and no pseudopancreatic cyst is formed. The effect is shown: the symptoms and signs are obviously improved or recovered to be normal, and the laboratory index is more than 75 percent to recover to be normal. The method has the following advantages: the symptoms and physical signs are obviously improved, and the laboratory index is more than 50 percent to recover the normal level. And (4) invalidation: the symptoms and signs are not obviously improved, and the disease condition is worsened or died.
2.8 statistical processing data management and statistical analysis adopts SPSS 18.0 statistical analysis software, metering data adopts x + -s representation, comparison adopts t test, grade data adopts Ridit analysis, counting data comparison adopts chi2Inspection with P<A difference of 0.05 is statistically significant.
3 results
3.1 comparison of clinical efficacy of two groups of patients through Ridit analysis, clinical efficacy of the observed group is superior to that of the control group (P <0.05), see Table 1.
Table 1: clinical efficacy comparison of two groups of patients
3.2 comparison of the intestinal function improvement results of the two groups, the indexes (abdominal pain, abdominal distension relief time, bowel sound recovery time and first defecation time) of the observed group reflecting the intestinal paralysis are all shorter than those of the control group (P <0.01), which is shown in Table 2.
Table 2: comparison of the two groups of intestinal function improvement (
Figure BDA0001142181800000074
d)
Figure BDA0001142181800000071
Note: comparing with control group1)P<0.01。
3.3 comparing the change conditions of the physicochemical indexes before and after treatment with those before treatment, wherein the White Blood Cells (WBC), blood, urine amylase and fasting blood glucose in the two groups after treatment are all reduced, and the reduction in the observation group is more obvious (P is less than 0.01); the serum calcium levels were elevated in both groups, and the observed group was more significantly elevated (P <0.01), as shown in table 3.
Table 3: comparison of physicochemical index changes before and after treatment in two groups (
Figure BDA0001142181800000075
n=75)
Figure BDA0001142181800000072
Note: comparison with before treatment1)P<0.01, compared with a control group2)P<0.01 (same in tables 4 and 5).
3.4 comparing the levels of IL-1, IL-6 and TNF-alpha in serum before and after treatment in two groups with that before treatment, the IL-1, IL-6 and TNF-alpha levels in the two groups are obviously reduced after treatment (P is less than 0.01); the IL-1, IL-6 and TNF-. alpha.levels in the post-treatment observation groups were lower than in the control group (P <0.01) compared to the control group, see Table 4.
Table 4: comparison of serum IL-1, IL-6 and TNF- α levels before and after treatment in both groups: (
Figure BDA0001142181800000076
n=75)pg·mL-1
Figure BDA0001142181800000081
3.5 comparing the change conditions of D-lactic acid, endotoxin and urine L/M values before and after treatment with those before treatment, wherein the D-lactic acid and urine L/M values are reduced after treatment, and the D-lactic acid and urine L/M values of an observed group after treatment are lower than those of a control group (P is less than 0.01); endotoxin levels increased in both groups after treatment, and the observed group had lower endotoxin than the control group after treatment (P <0.01), as shown in table 5.
Table 5: comparison of the changes in D-lactic acid, endotoxin and urine L/M values before and after treatment in two groups (
Figure BDA0001142181800000083
n=75)
Discussion 4
The pathogenesis of acute pancreatitis is a complex and multi-factor involved pathophysiological process, which is still not completely understood up to now. The traditional view is limited to enzyme abnormal activation, pancreatic enzyme self-digestion and the like, and with the research, the release of inflammatory mediators and cytokines, the occurrence of apoptosis and pancreatic microcirculation disturbance are also important factors involved in the occurrence and development of AP and are important mechanisms for the progress of acute pancreatitis. The excessive production of inflammatory mediators triggers a "cascade-like reaction" of inflammatory mediators through a "trigger-like action", eventually leading to the rapid development of localized lesions into Systemic Inflammatory Response Syndrome (SIRS) and Multiple Organ Failure (MOF). The intestinal mucosa barrier damage and intestinal tract bacterial translocation cause that bacteria and endotoxin can pass through the damaged intestinal mucosa to enter blood circulation, and can stimulate mononuclear and macrophage to generate inflammatory cytokines, thereby causing bacteremia and toxemia, and the bacteria and endotoxin can shift to important organs and tissues, causing secondary strike to organisms, and accelerating or aggravating the occurrence or development of SIRS, sepsis and MOF.
The traditional Chinese medicine considers that the disease is caused by damp-heat accumulation in the middle-jiao, abnormal ascending and descending of the spleen and stomach, adverse qi circulation of the liver and gallbladder, obstruction of qi movement and mutual accumulation of stagnant heat due to improper diet, internal accumulation of worm stones, traumatic injury, uncomfortable emotion and feeling of exogenous pathogenic factors. The disease property is mainly caused by interior, excess and heat syndromes, and the disease location is in spleen, stomach, liver and gallbladder, and the qi obstruction of fu-organs leads to pain. The traditional Chinese medicine can exert curative effects by inhibiting the release of cytokines, improving microcirculation, removing oxygen free radicals, inhibiting pancreatin secretion, protecting multiple targets and multiple links of damaged organs and the like in the course of treating acute pancreatitis, shorten the course of disease, reduce the occurrence of complications and improve the cure rate.
Aiming at the symptoms of abdominal distension, abdominal pain and the like which appear in pancreatitis, the traditional Chinese medicine distinguishes according to the syndrome differentiation that the diseases are caused by the damp-heat in the middle-jiao, the damp-heat is retained in the gastric cavity, the qi stagnation and the blood stasis, and the heat toxin is accumulated internally, so that the diseases are distended and painful. For the treatment of damp-heat clearing, qi-moving, blood stasis removing, fu-qi clearing and toxicity removing, in Guo's Qing pancreas decoction formula, Da Huang, Mirabilite and senna leaf are used to purge fu-organs for removing heat and toxic pathogen, and Pu Gong Ying helps Huang and Mirabilite to clear heat and toxicity; aucklandia root, magnolia bark and immature bitter orange are used for promoting qi circulation and eliminating stagnation, bupleurum root is used for soothing liver and relieving depression, dried orange peel is used for resolving dampness and regulating the middle warmer, rhizoma corydalis, salvia miltiorrhiza and bletilla striata are used for removing blood stasis, bletilla striata has the function of inhibiting exudation, and liquorice is used for regulating the effects of the medicines and preventing excessive purgation and injuring healthy qi.
Early enteral nutrition is one of important means for treating AP, but attention is paid to whether pancreatic juice secretion is increased or not so as to aggravate the disease, so that the aim of letting pancreas rest can be achieved by clinically recommending and directly infusing nutrient solution through jejunum, and the nasojejunal tube placed by blind vision has the advantages of simplicity, practicability, safety, small invasiveness, no special requirements on equipment, one-time positioning, good tolerance of a conscious patient and the like. Researches of scholars show that compared with injection through a stomach tube, rhubarb is administrated through a nasojejunal tube way to treat severe AP, the active ingredients of rhubarb directly act on intestinal mucosa, stimulation to pancreas is reduced, and systemic inflammatory reaction can be controlled more effectively and illness state can be relieved. The study adopts Guo's clear pancreas decoction to be administered for many times at a slow speed through nasojejunal tube so as to reduce the stimulation of the Guo's clear pancreas decoction on pancreas and fully exert the sustained effect.
Research shows that the abdominal pain, the abdominal distension relieving time, the bowel sound recovery time and the first defecation time of an observation group after treatment are all shorter than those of a control group, and the research suggests that the use of the Guo's clear pancreas decoction can quickly improve the enteroparalysis of patients with acute pancreatitis and promote the recovery of intestinal function. The leucocyte, blood, urine amylase and fasting blood glucose in the observation group are averagely lower than those in the control group after treatment, the serum calcium level is higher than that in the control group, and through Ridit analysis, the clinical curative effect of the observation group is better than that of the control group, which all indicates that the Guoshi Qingpancreas decoction can relieve symptoms, improve physical and chemical indexes and promote the recovery of diseases when used for treating acute pancreatitis.
As mentioned above, the inflammatory response is an important mechanism of acute pancreatitis, IL-1, IL-6 and TNF-alpha are important proinflammatory factors, which are higher than normal level in patients with acute pancreatitis of different severity, and 3 factors can be used as important indexes of acute pancreatitis prediction system. The research shows that the IL-1, IL-6 and TNF-alpha levels of an observation group are lower than those of a control group after treatment, and the Guo's clear pancreas decoction can effectively control the inflammatory reaction of patients with acute pancreatitis, control the progress of diseases, prevent the occurrence of SIRS, sepsis, MOF and the like, and has important clinical significance.
Almost all D-lactic acid in blood comes from intestinal tracts, and D-lactic acid in early stage with damaged intestinal mucosa barrier function of patients with acute pancreatitis is increased and can accurately reflect the barrier function of intestinal mucosa; the urine L/M value is used for determining an ideal index of intestinal mucosa permeability, the intestinal mucosa mechanical barrier of a patient suffering from acute pancreatitis is damaged, lactulose can be absorbed in a large amount through a paracellular route, and the absorption amount of mannitol is not changed greatly, so that the urine L/M value is increased; when the barrier function of the intestinal mucosa is damaged, endotoxin passes through the intestinal mucosa and enters the blood circulation to form endotoxemia, so that monitoring the endotoxin level in peripheral blood becomes one of important means for understanding the barrier function of the intestinal mucosa. The research shows that the levels of D-lactic acid, endotoxin and urine L/M values of an observed group after treatment are all lower than those of a control group, and the Guo's clear pancreas decoction has a good protective effect on the intestinal mucosa barrier function of patients with acute pancreatitis, so that the Guo's clear pancreas decoction has a certain control effect on the development of diseases.
5 conclusion
The experimental research shows that the traditional Chinese medicine decoction (Guoshi Qingshi decoction) prepared from the traditional Chinese medicine composition disclosed by the invention can be used for treating patients with acute pancreatitis, and can be used for effectively improving enteroparalysis, promoting gastrointestinal function recovery, relieving inflammatory reaction, protecting intestinal mucosa barrier function, improving physicochemical indexes and promoting disease recovery.

Claims (3)

1. A traditional Chinese medicine composition for treating enteroparalysis is prepared from the following traditional Chinese medicine raw materials in parts by mass:
20-40 parts of raw rhubarb, 20-40 parts of mirabilite, 5-20 parts of folium sennae, 10-20 parts of dandelion, 5-15 parts of radix aucklandiae, 5-15 parts of mangnolia officinalis, 5-15 parts of dried orange peel, 5-20 parts of radix bupleuri, 10-20 parts of immature bitter orange, 10-20 parts of rhizoma corydalis, 5-15 parts of salvia miltiorrhiza, 5-15 parts of bletilla striata and 5-10 parts of honey-fried licorice root.
2. The traditional Chinese medicine composition of claim 1, wherein the composition comprises the following components by mass: 30 parts of raw rhubarb, 30 parts of mirabilite, 10 parts of senna leaf, 15 parts of dandelion, 10 parts of vladimiria root, 10 parts of magnolia officinalis, 10 parts of dried orange peel, 10 parts of radix bupleuri, 15 parts of immature bitter orange, 15 parts of corydalis tuber, 10 parts of salvia miltiorrhiza, 10 parts of bletilla striata and 6 parts of honey-fried licorice root.
3. A traditional Chinese medicine decoction for treating enteroparalysis is prepared from the following traditional Chinese medicine raw materials in parts by mass: 30 parts of raw rhubarb, 30 parts of mirabilite, 10 parts of senna leaf, 15 parts of dandelion, 10 parts of vladimiria root, 10 parts of magnolia officinalis, 10 parts of dried orange peel, 10 parts of radix bupleuri, 15 parts of immature bitter orange, 15 parts of corydalis tuber, 10 parts of salvia miltiorrhiza, 10 parts of bletilla striata and 6 parts of honey-fried licorice root; the preparation method of the traditional Chinese medicine decoction comprises the following steps:
(1) weighing the traditional Chinese medicine raw materials according to the formula amount, and cleaning the raw materials except mirabilite for later use;
(2) soaking the raw materials except the raw rhubarb, the mirabilite and the senna leaves in water, namely soaking the raw materials except the raw rhubarb, the mirabilite and the senna leaves in the water, burying the water in the medicine surface for 1-2 cm, and decocting and extracting the raw materials for 2 times after soaking for 0.5-1 hour: decocting the medicines with slow fire for the first time until the medicines are fully expanded, boiling the medicines, adding raw rhubarb and senna leaves, keeping the boiling for 15-30 minutes, and filtering dregs of a decoction to obtain first medicine juice; adding water into the medicine residues for the 2 nd time, burying the water for 1-2 cm above the medicine surface, decocting with slow fire until the medicine is fully expanded, boiling again, keeping boiling for 15-30 minutes, and filtering the medicine residues to obtain medicine juice for the 2 nd time; mixing the medicinal juices, adding Natrii sulfas, and dissolving in the medicinal juices;
(3) sealing and subpackaging the medicinal juice obtained in the step (2) by using special Chinese medicinal bags, wherein each bag is 150-200ml,
thus obtaining the traditional Chinese medicine decoction.
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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN101099784A (en) * 2007-07-09 2008-01-09 济南康众医药科技开发有限公司 Traditional Chinese medicine suppository and preparation method thereof

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Publication number Priority date Publication date Assignee Title
CN101099784A (en) * 2007-07-09 2008-01-09 济南康众医药科技开发有限公司 Traditional Chinese medicine suppository and preparation method thereof

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内镜结合中医疗法治疗重症急性胰腺炎对细胞因子的影响;赖少彤等;《中国中西医结合消化杂志》;20060625;第14卷(第03期);141-143 *
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