CN106492105A - 一种治疗风痰上扰型眩晕的中药 - Google Patents

一种治疗风痰上扰型眩晕的中药 Download PDF

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CN106492105A
CN106492105A CN201710022807.9A CN201710022807A CN106492105A CN 106492105 A CN106492105 A CN 106492105A CN 201710022807 A CN201710022807 A CN 201710022807A CN 106492105 A CN106492105 A CN 106492105A
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rhizoma
medicine
fructus amomi
phlegm
dizziness
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CN106492105B (zh
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刘向哲
王新志
段春天
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Henan University of Traditional Chinese Medicine HUTCM
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Abstract

本发明涉及治疗风痰上扰型眩晕的中药,可有效解决眩晕风痰上扰型的用药问题,解决的技术方案是,该中药是由以下重量计的原料药物制成:姜半夏9‑15g、天麻10‑20g、白术10‑20g、茯苓15‑30g、陈皮9‑15g、砂仁6‑15g、菖蒲10‑20g、丹参15‑20g、川芎10‑20g、谷精草15‑30g、荷叶10‑20g、白芷10‑20g和炙甘草3‑6g,发明组方科学合理,原料丰富,服用方便,成本低,具有熄风化痰之功效,治疗风痰上扰型眩晕效果显著,疗效确切,用药安全,是治疗风痰上扰型眩晕药物上的创新。

Description

一种治疗风痰上扰型眩晕的中药
技术领域
本发明涉及医药领域,特别是一种治疗风痰上扰型眩晕的中药。
背景技术
风痰上扰型眩晕是一种常见证型,临床以眩晕,或伴视物旋转,恶心呕吐,头重昏蒙,胸闷,舌苔白腻,脉弦滑等为其证候特点,并常伴有神疲倦怠,反应迟钝,食少多寐,耳鸣重听,头痛头胀等症。
汉代张仲景认为痰饮是眩晕的重要致病因素之一;金元时期,朱丹溪强调“无痰不作眩”,都指出了痰饮对于眩晕致病的重要性。而风为百病之长,常兼他邪合而伤人,风邪终岁常在,风痰相合,上扰清窍,发为眩晕。眩晕病位在头窍,与肝脾肾三脏相关,证属本虚标实,具有发病率高、复发率高的特点,严重影响患者身心健康及工作、学习和生活。目前虽有治疗眩晕病的多种中成药,但缺乏针对风痰上扰型眩晕的药物,个别药物其疗效和使用并不尽人意,因此,研制新的治疗风痰上扰型眩晕的药物势在必行。
发明内容
针对上述情况,为克服现有技术之缺陷,本发明之目的就是提供一种治疗风痰上扰型眩晕的中药,可有效解决眩晕风痰上扰型的用药问题。
根据中医药学原理,风痰上扰型眩晕表现为眩晕,或伴视物旋转,恶心呕吐,头重昏蒙,胸闷,舌苔白腻,脉弦滑等为其证候特点,并常伴有神疲倦怠,反应迟钝,食少多寐,耳鸣重听,头痛头胀等症。因此,以熄风化痰为治疗原则,据此,本发明解决的技术方案是,该中药是由以下重量计的原料药物制成:姜半夏9-15g、天麻10-20g、白术10-20g、茯苓15-30g、陈皮9-15g、砂仁6-15g、菖蒲10-20g、丹参15-20g、川芎10-20g、谷精草15-30g、荷叶10-20g、白芷10-20g和炙甘草3-6g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡30-60min,武火煎沸,再文火煎40-60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40-60min,过滤,得第二次药液;合并两次药液,混匀,即得。
本发明组方科学合理,原料丰富,服用方便,成本低,具有熄风化痰之功效,治疗风痰上扰型眩晕效果显著,疗效确切,用药安全,是治疗风痰上扰型眩晕药物上的创新。
具体实施方式
以下结合实施例对本发明的具体实施方式作进一步详细说明。
实施例1
本发明在具体实施时,可由以下重量计的原料药物制成:姜半夏11-13g、天麻13-17g、白术13-17g、茯苓18-23g、陈皮11-13g、砂仁8-10g、菖蒲15-18g、丹参17-19g、川芎13-17g、谷精草18-27g、荷叶13-17g、白芷13-17g和炙甘草4-5g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡30-60min,武火煎沸,再文火煎40-60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40-60min,过滤,得第二次药液;合并两次药液,混匀,即得。
实施例2
本发明在具体实施时,还可由以下重量计的原料药物制成:姜半夏10g、天麻11g、白术11g、茯苓16g、陈皮10g、砂仁7g、菖蒲11g、丹参16g、川芎11g、谷精草16g、荷叶11g、白芷11g和炙甘草4g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡40min,武火煎沸,再文火煎60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎60min,过滤,得第二次药液;合并两次药液,混匀,即得。
实施例3
本发明在具体实施时,还可由以下重量计的原料药物制成:姜半夏12g、天麻15g、白术15g、茯苓23g、陈皮12g、砂仁10g、菖蒲15g、丹参18g、川芎15g、谷精草22g、荷叶15g、白芷15g和炙甘草4g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡40min,武火煎沸,再文火煎50min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎50min,过滤,得第二次药液;合并两次药液,混匀,即得。
实施例4
本发明在具体实施时,还可由以下重量计的原料药物制成:姜半夏14g、天麻18g、白术18g、茯苓28g、陈皮14g、砂仁13g、菖蒲18g、丹参18g、川芎18g、谷精草28g、荷叶18g、白芷18g和炙甘草5g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡60min,武火煎沸,再文火煎40min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40min,过滤,得第二次药液;合并两次药液,混匀,即得。
中医认为眩晕多为痰扰所致,且现代随着生活水平的提高,多食肥甘厚味,而酿生痰湿。且风为百病之长,常兼他邪合而伤人,风邪终岁常在,风挟痰湿,上蒙清窍,发为眩晕。“风痰”为眩晕的主要病因病机,风痰上扰型为临床最常见证型。有学者研究表明,眩晕证型中“风证”占33.6%,“痰证”占32.6%,说明证候要素“风”和“痰”在眩晕证型中占较大比例。
方中半夏燥湿化痰,降逆止呕;天麻平肝熄风而止头眩,两者合用为治风痰眩晕之要药。李杲在《脾胃论》中说:“足太阴痰厥头痛,非半夏不能疗,眼黑头眩,风虚内作,非天麻不能除。”故本方以此两味为君药;白术、茯苓健脾祛湿,以治生痰之源。洁古云:“非白术不能去湿”。茯苓渗湿,走而不守,白术补中,守而不走。二药配伍,治在脾胃,共奏健脾燥湿、淡渗利水之效。菖蒲醒神开窍、和胃化湿,砂仁化湿行气,陈皮理气化痰,以使气顺则痰消,共为臣药;痰瘀相关,痰湿之邪易黏滞血分,阻碍血液的正常运行,瘀血反过来又可生痰,故除痰有助于活血,活血有助于除痰。所以,方中丹参、川芎活血化瘀兼行气祛滞。痰浊之邪最易阻遏阳气,而头为诸阳之会,方中谷精草、荷叶、白芷升阳开窍、清利头目,同为佐药;甘草调和诸药,为使药。诸药合用,使浊痰得消、清阳得升,共奏熄风化痰之效,眩晕自愈。熄风化痰方取得了非常满意的治疗效果,并经临床资料得到了充分证明,有关临床试验资料如下:
一、选择病例的标准
参照国家中医药管理局医政司2010年颁布的《眩晕诊疗方案》制定。临床以眩晕,或伴视物旋转,恶心呕吐,头重昏蒙,胸闷,舌苔白腻,脉弦滑等为其证候特点,并常伴有神疲倦怠,反应迟钝,食少多寐,耳鸣重听,头痛头胀等症。
凡具有上述症状者,均作为选择病例的标准。
二、诊断标准、纳入及排除标准
1、西医诊断标准参照中华医学会神经病学分会2010年发布的《眩晕诊治专家共识》制定
2、中医诊断标准参照国家中医药管理局医政司2010年颁布的《眩晕诊疗方案》制定
3、中风病脾肾两虚证辨证标准依据国家中医药管理局医政司2010年颁布的《眩晕诊疗方案》制定
4、病例纳入标准①符合西医诊断标准及中医病证诊断标准;②年龄≧16岁且≦80岁,性别不限;③签署知情同意书。
5、病例排除标准①近6个月来发生过严重脑血管意外、外伤等导致严重残疾的患者;②合并严重心肝肾、内分泌等疾病,以及遗传、精神疾病等影响治疗和评估的患者;③合过敏体质者,妊娠期及哺乳期妇女;④4周之内参加其他临床试验的患者及仍坚持服用其他中药的患者;⑤判定依从性差的患者。
6、病例脱落标准①在研究期间中自然脱离、失访者,使临床资料不全等对疗效和安全性判断造成影响者;②在研究期间发生不良事件与并发症,或者严重不良反应,不适合接受后续试验者。
三、治疗方案
对照组:基础治疗,参照《眩晕诊治专家共识》进行。
治疗组:基础治疗同时,服用本发明中药,每日1剂,早晚分服,每次200ml。
疗程:连续治疗14天;合并症均按照指南给予对症处理。
治疗前后评定疗效积分及血尿便常规、肝肾功能、心电图等安全性指标。
四、疗效评定标准
参照《眩晕诊疗方案》制定。主要从主证、伴随症状和发作频率三个方面进行评价。
痊愈:眩晕等症状消失,疗效指数≧90%;显效:眩晕等症状明显减轻,头微有昏沉或头晕目眩但不伴有自身及景物的旋转、晃动感,可正常生活及工作,疗效指数≧70%,同时<90%;有效:头晕或眩晕减轻,仅伴有轻微的自身或景物的旋转、晃动感,虽能坚持工作,但工作和生活受到影响,疗效指数≧30%,同时<70%;无效:头昏沉及眩晕等症状无改善或加重,疗效指数<30%。
疗效指数:[(治疗前积分-治疗后积分)÷治疗前积分]×100%
五、统计学处理
本研究连续性纳入符合标准的2015年9月-2016年6月的200例在河南中医药大学第一附属医院就诊的门诊眩晕病风痰上扰型患者,按照患者就诊时间的顺序,釆用随机数字表法对纳入患者分为治疗组和对照组各100例。治疗组男性43例,女性57例,治疗中脱落6例(3名男性,3名女性),完成病例数94例。年龄48.38±9.58岁,病程4小时-20年,其中后循环缺血占47.87%、良性位置性眩晕17.02%、高血压10.63%、颈椎病8.51%、神经官能症3.19%、其他2.12%、不明原因10.63%。对照组男性46例,女性54例,治疗中脱落9例(其中男性5例,女性4例),完成病例数91例。年龄46.90±11.43岁,病程6小时-20年,其中后循环缺血占45.05%、良性位置性眩晕16.48%、高血压10.98%、颈椎病9.89%、神经官能症2.19%、其他3.29%、不明原因12.08%。两组患者年龄、性别、病程、西医诊断均无统计学差异(P>0.05),具有可比性。
统计分析采用SPSS13.0软件处理,采用χ2检验进行数据分析,所有结果分析以P<0.05具有统计学意义。
两组总有效率比较,治疗组明显优于对照组,差异具有统计学意义(P<0.05)结果如下表所示:
两组临床疗效比较(n,%)
注:与对照组相比,P<0.05
六、结论
风痰上扰型眩晕为临床常见证型,熄风化痰为风痰上扰型眩晕的基本治疗原则,由上述试验表明,本发明中药可有效用于风痰上扰型眩晕的治疗,能显著改善风痰上扰型眩晕的临床症状及日常生活能力,疗效确切,用药安全,无毒副作用,是目前理想的治疗中风的中药制剂,具有实际的临床意义和很好的推广应用价值,经济和社会效益巨大。

Claims (5)

1.一种治疗风痰上扰型眩晕的中药,其特征在于,该中药是由以下重量计的原料药物制成:姜半夏9-15g、天麻10-20g、白术10-20g、茯苓15-30g、陈皮9-15g、砂仁6-15g、菖蒲10-20g、丹参15-20g、川芎10-20g、谷精草15-30g、荷叶10-20g、白芷10-20g和炙甘草3-6g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡30-60min,武火煎沸,再文火煎40-60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40-60min,过滤,得第二次药液;合并两次药液,混匀,即得。
2.据权利要求1所述的治疗风痰上扰型眩晕的中药,其特征在于,由以下重量计的原料药物制成:姜半夏11-13g、天麻13-17g、白术13-17g、茯苓18-23g、陈皮11-13g、砂仁8-10g、菖蒲15-18g、丹参17-19g、川芎13-17g、谷精草18-27g、荷叶13-17g、白芷13-17g和炙甘草4-5g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡30-60min,武火煎沸,再文火煎40-60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40-60min,过滤,得第二次药液;合并两次药液,混匀,即得。
3.据权利要求1所述的治疗风痰上扰型眩晕的中药,其特征在于,由以下重量计的原料药物制成:姜半夏10g、天麻11g、白术11g、茯苓16g、陈皮10g、砂仁7g、菖蒲11g、丹参16g、川芎11g、谷精草16g、荷叶11g、白芷11g和炙甘草4g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡40min,武火煎沸,再文火煎60min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎60min,过滤,得第二次药液;合并两次药液,混匀,即得。
4.据权利要求1所述的治疗风痰上扰型眩晕的中药,其特征在于,由以下重量计的原料药物制成:姜半夏12g、天麻15g、白术15g、茯苓23g、陈皮12g、砂仁10g、菖蒲15g、丹参18g、川芎15g、谷精草22g、荷叶15g、白芷15g和炙甘草4g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡40min,武火煎沸,再文火煎50min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎50min,过滤,得第二次药液;合并两次药液,混匀,即得。
5.据权利要求1所述的治疗风痰上扰型眩晕的中药,其特征在于,由以下重量计的原料药物制成:姜半夏14g、天麻18g、白术18g、茯苓28g、陈皮14g、砂仁13g、菖蒲18g、丹参18g、川芎18g、谷精草28g、荷叶18g、白芷18g和炙甘草5g,将上述原料药物除砂仁外混合在一起,加水浸没,浸泡60min,武火煎沸,再文火煎40min,最后10min加入砂仁,然后过滤,得第一次药液;药渣再加水浸没,武火煎沸,再文火煎40min,过滤,得第二次药液;合并两次药液,混匀,即得。
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