CN106511574A - 治疗风寒湿型颈椎病的中药外敷贴 - Google Patents

治疗风寒湿型颈椎病的中药外敷贴 Download PDF

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CN106511574A
CN106511574A CN201611159893.XA CN201611159893A CN106511574A CN 106511574 A CN106511574 A CN 106511574A CN 201611159893 A CN201611159893 A CN 201611159893A CN 106511574 A CN106511574 A CN 106511574A
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迟俊婷
王波
刘滢
吴玉绒
余珊
张大新
俞华
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Abstract

治疗风寒湿型颈椎病的中药外敷贴。本发明属于治疗颈椎病的中药领域，具体涉及一种治疗风寒湿型颈椎病的中药外敷贴。本发明的中药外敷贴含有以下各种药物，沙苑子、川草乌、红藤、荆芥、防风、当归尾、鸡血藤、海桐皮、透骨草、红花、细辛、花椒、桂枝、芍药、艾叶、威灵仙和乌梢蛇的醇提液。本发明配方较简单，选用药物的配合合理，对治疗外感风、寒、湿所致的风寒湿型颈椎病疗效明显。

Description

治疗风寒湿型颈椎病的中药外敷贴
技术领域
本发明属于治疗颈椎病的中药领域，具体涉及一种治疗风寒湿型颈椎病的中药外敷贴。
背景技术
颈椎病(Cervical spondylopathy) 又称颈椎综合征，是指颈椎间盘退行性变及颈椎骨质增生，刺激或压迫了周围的脊髓、神经根、血管及交感神经，从而引起颈部强直、僵硬、双上肢麻木、头晕眼花、恶心呕吐、听力下降、上臂肢体酸胀等临床症状的疾病,称为颈椎病，是我国常见慢性疾病之一。近年来，国内外医院纷纷采用颈前路椎间盘切除椎体融合术、手术治疗、颈椎牵引、针灸和推拿等方法来综合治疗颈椎病,取得了较好的疗效，但是存在治疗疗效不佳、价格昂贵、使用成本高等问题。因此，寻求一种有效方法来缓解患者主要症状，减轻疼痛，提高患者生活质量，对解决临床治疗颈椎病难点具有重要意义。
颈椎病是退变性质的疾病，其发病机制较复杂，部分病理机制尚未完全清楚。国内外学者从病因和发病机制等各个角度对颈椎病进行了大量的基础和临床研究，目前被认为颈椎病的发病机制主要与机械压迫、交感神经受刺激、横突孔狭窄、颈后软组织病变、体液因子及微循环障碍等有关。主要原因是颈椎的退行性变，发育性颈椎椎管狭窄，慢性劳损和颈椎的先天性畸形等，严重的会引起患者出现吞咽障碍、视力障碍、颈心综合征、高血压颈椎病、胸部疼痛以及植物神经紊乱等并发症等，如不及时治疗会造成患者出现下肢瘫痪，给患者以及家属带来严重的后果。
颈椎病属于祖国医学“痹症”、“痉证”、“眩晕”等范畴，病机属于本虚标实，标实包括风寒、痰湿、血瘀及肝风内动等；本虚包括气血亏虚、肝肾亏虚、肾阴阳两虚等。中医分别从六经辩证、肝脾肾论治、气血论治三个维度对病因病机进行详细的阐述：一、六经辩证论治，认为是由于外感风、寒、湿三邪侵入足太阳膀胱经，由表入里，使机体营卫失调，气血失调，经脉不畅，气滞血瘀，肢体失去濡养而导致活动不利；二、气血辩证论治，认为是由于气虚血瘀是本病的病机之关键，而劳倦内伤是气虚血瘀的主要原因，瘀血阻脉,不通则痛；瘀血之不除,新血不可生,气虚无援,血运不畅,荣养失职,引起了不荣则痛和肢麻等症状；三、肝脾肾辩证论治，金元医家李东恒《脾胃论·大肠小肠五脏皆属于胃虚则俱病论》云：“胃虚则五脏六腑、十二经、十五络、四肢皆不得营运之气而百病生”，由此可知，脾胃为气血生化之源，脾胃虚弱，气血亏虚，肢体失去濡养。
目前中医对颈椎病的外用药治疗多采用膏药，如中国专利申请号201610513616.8、201510059185.8等公开的外用药物，这些药物主要以治疗颈椎和颈部肌肉劳损出发来进行治疗，因此在短时的止痛方面效果是很好的，但是这类膏药很难消除患者的眩晕和恶心现象，对于由于外感风、寒、湿三邪侵入所致的风寒湿型颈椎病则效果更是不好，其原因就是发病原因、药物的选用以及治疗方法的选用不合理，所以治疗效果不佳。
发明内容
本发明的目的在于提供一种治疗风寒湿型颈椎病的中药外敷贴，其配方较简单，选用药物的配合合理，对治疗外感风、寒、湿所致的风寒湿型颈椎病疗效明显。
实现本发明上述目的所采用的技术方案是：中药外敷贴含有以下各种药物，沙苑子、川草乌、红藤、荆芥、防风、当归尾、鸡血藤、海桐皮、透骨草、红花、细辛、花椒、桂枝、芍药、艾叶、威灵仙和乌梢蛇，其中各药物的醇提物重量比为，沙苑子1～30份、川草乌1～20份、红藤1～30份、荆芥1～30份、防风1～30份、当归尾1～40份份、鸡血藤1～30份、海桐皮1～20份、透骨草1～30份、红花1～20份、细辛1～10份、花椒1～15份、桂枝1～10份份、芍药1～15份、艾叶1～15份、威灵仙1～20份和乌梢蛇1～30份。
中药外敷贴的各药物的醇提物为各药物用体积浓度95%乙醇分别浸泡一个月，采用提取、分离、浓缩和干燥工艺流程分别提取浸膏，再按各药物的配比混合，采用体积浓度为70%酒精按照1∶15的配比制作而成的醇提物混合液。
该中药外敷贴的各药物的醇提物混合液是与含低聚物为载体的壳聚糖医用生物膜和医用发热贴组合而成的外敷贴。
沙苑子为温补肝肾、固精、缩尿及益肝明目的传统中药。现代药理研究表明沙苑子具有直接扩张血管作用、抑制血小板聚集作用、抗炎作用和镇痛作用，能有效缓解疼痛。
红藤具有清热解毒、活血化瘀、消炎及祛风湿等功能，与当归尾、鸡血藤合用具有活血止痛，祛风除湿之功效，对风寒湿型颈椎病具有良好的疗效；
荆芥、防风均有祛风湿、止痛功效，现代药理研究表明两药联合应用增强的抗炎，解热镇痛作用。海桐皮、透骨草、花椒和威灵仙舒筋活络，祛风除湿，痛痹止痛之功效；现代药理研究表明海桐皮中含有刺桐灵碱、氨基酸和有机酸等，具有能够有效地改善局部微循环和抗炎的作用；透骨草药理活性为抗过敏、抗炎、抗真菌等；花椒具有抗肿瘤,抗炎,镇痛,抗病毒,抗血小板凝结,抗菌和抗氧化等活性；威灵仙具有镇痛抗炎、免疫抑制和抗肿瘤等作用。以上诸药合用，共奏祛风除湿、温经通络、活血止痛之功。
桂枝温通筋脉、通阳化气，芍药具有镇痉、镇痛、通经作用，加艾叶可达温经散寒止痛之功。
乌梢蛇干具有祛风湿、通经络的功效，是治疗风湿性关节炎、中风、口眼歪斜、半身不遂等顽固性疾病的首选天然药材；乌梢蛇肉治病早在李时珍的《本草纲目》中就有记载，主治“诸风顽痹，皮肤不仁，风骚湿疹、疥癣热毒、须眉脱落”等症。
该中药外敷贴的工作原理及有益效果是：
①贴于体表的外敷贴药物配伍合理，可刺激神经末梢，通过反射，扩张血管，促进局部血液循环，改善周围组织营养，达到消肿，消炎和镇痛的目的；
②同时药物在患处通过皮肤渗透达皮下组织，在局部产生药物浓度的相对优势，从而发挥较强的药理作用；
③因外敷药中有些刺激性强的药物，强刺激通过神经反射，可以调节肌体功能促进抗体形成，提高人体免疫力。药物穿通皮肤及黏膜后，经过血管或淋巴管进入体循环，也可产生全身性药物作用；
④配合了医用发热贴可促进肌肤对药物的渗透，使药物直达靶向器官，进一步增强了治疗效果；
⑤肌肤表面喷洒医用生物膜，可起到防止药液外渗和杀菌的作用。
以下是本中药外敷贴的临床治疗资料：
临床资料：选取寻甸县中医院2014年2月～2015年12月收治的颈椎病患者46例作为研究对象，随机分为治疗组和对照组，其中治疗组23例，对照组23例。治疗组23例患者中男性14例，女性患者9例，患者年龄42～62岁，平均年龄（43.2±3.4）岁；对照组23例患者中男性11例，女性患者12例，患者年龄46～68岁，平均年龄（48.2±2.4）岁；病程2月～5年，平均2.4年。两组患者在年龄、性别、 病程等一般情况比较无统计学差异(P<0．05)，具有可比性。
诊断标准：根据1994年国家中医药管理局颁布的《中医病证诊断疗效标准》中的相关诊断标准，风寒湿型：颈、肩、上肢串痛麻木，以痛为主，头有沉重感，颈部僵硬，活动不利，恶寒畏风。舌淡红，苔薄白，脉弦紧。颈椎X线示：椎体增生，钩椎关节增生明显，椎间隙变窄，椎间孔变小。CT可见椎体后赘生物及神经根管变窄。
纳入标准为：符合上述风寒湿型颈椎病的诊断标准；意识清楚，能配合采集临床资料者；年龄18岁以上，66岁以下。
排出标准为：研究者认为无法配合完成本研究的患者；合并各系统严重疾病；孕妇或哺乳期妇女；颈部皮肤有破溃者；颈椎骨实质病变，包括结核、肿瘤等；胸廓出口(上口)综合症、肩周炎、腕管症候群、网球肘、尺桡神经核正中神经损伤、肱二头肌腱鞘炎等引起的上肢疼痛为主的患者。
治疗方法对照组采用传统针灸推拿手法治疗，每天治疗1次，10 d为1个疗程。
在传统针灸推拿治疗基础上给予中药外敷贴结合超导离子靶向导入治疗仪治疗，每天治疗1次，10 d为1个疗程。中药外敷方如下：红藤、荆芥、元胡、防风、当归、鸡血藤、海桐皮、乳香、没药、透骨草、川断、红花、花椒、伸筋草、威灵仙、甘草等16味中药各30 g使用超细粉碎机粉碎，用体积分数为95%乙醇浸泡一个月，采用提取、分离、浓缩和干燥等工艺流程提取浸膏；采用体积分数为70%酒精按照1∶15的配比制作；将配比完成的10 mL药液浸入药垫中。采用超导离子靶向导入治疗仪，调到药导档，选择“治疗颈椎病”处方项，将药垫放在正极，用绷带绑住两个极，然后根据患者的承受能力调节大小，电流强度 应有麻、颤、震动感为宜。取穴：患肢内外膝眼。每次20 min。
观察指标为：肩背疼痛、双上肢酸麻、重着及屈伸不利等临床症状及其血液动力学的改变。
疗效标准:
①治愈：原有各型病症消失，肌力正常，颈、肢体功能恢复正常，能参加正常劳动和工作；
②好转：原有各型症状减轻，颈、肩背疼痛减轻，颈、肢体功能改善；3)未愈：症状无改善。
统计学分析采用SPSS17.0软件分析，数据以x±s表示，采用单因素方差分析，组间两两比较采用Tukey检验，P＜0.05为差异有统计学意义。
治疗组与对照组疗效观察比较结果:
治疗组23名患者在进行治疗后，有效率明显高于对照组，对比两组患者的治疗总有效率，差异有统计学意义（P＜0.05），见表1。
表1 治疗组与对照组疗效观察比较(x±s)
分组 例数 治愈 好转 未愈 总有效率/%
治疗组 23 13 8 2 91.3
对照组 23 9 10 4 82.6
两组患者治疗前后血流动力学变化情况：
两组治疗后血流速度(Vs)、平均血流速度(Vd)、舒张末期血流速度(Vm)均较治疗前升高(P＜0．05)，其中治疗组升高幅度较对照组明显(P＜0．05)。见表2。
表2 两组患者治疗前后血流动力学变化情况(x±S）
。
具体实施方式
实施例：取沙苑子、川草乌、红藤、荆芥、防风、当归尾、鸡血藤、海桐皮、透骨草、红花、细辛、花椒、桂枝、芍药、艾叶、威灵仙和乌梢蛇使用超细粉碎机粉碎，按以下重量比混合均匀，沙苑子1～30份、川草乌1～20份、红藤1～30份、荆芥1～30份、防风1～30份、当归尾1～40份份、鸡血藤1～30份、海桐皮1～20份、透骨草1～30份、红花1～20份、细辛1～10份、花椒1～15份、桂枝1～10份份、芍药1～15份、艾叶1～15份、威灵仙1～20份和乌梢蛇1～30份。用体积分数为95%乙醇分别浸泡一个月，采用提取、分离、浓缩和干燥等工艺流程分别提取浸膏； 按各药物的配比，采用体积分数为70%酒精按照1∶15的配比制作成各药物混合的提取液；将配比完成的10 mL药液浸入药垫中。采用超导离子靶向导入治疗仪，调到药导档，选择“治疗颈椎病”处方项，将药垫放在正极，用绷带绑住两个极，然后根据患者的承受能力调节大小，电流强度 应有麻、颤、震动感为宜。取穴：患肢内外膝眼。每次20 min。

Claims (3)

1.一种治疗风寒湿型颈椎病的中药外敷贴，其特征是含有以下各种药物：沙苑子、川草乌、红藤、荆芥、防风、当归尾、鸡血藤、海桐皮、透骨草、红花、细辛、花椒、桂枝、芍药、艾叶、威灵仙和乌梢蛇，各药物的醇提物重量比为，沙苑子1～30份、川草乌1～20份、红藤1～30份、荆芥1～30份、防风1～30份、当归尾1～40份份、鸡血藤1～30份、海桐皮1～20份、透骨草1～30份、红花1～20份、细辛1～10份、花椒1～15份、桂枝1～10份份、芍药1～15份、艾叶1～15份、威灵仙1～20份和乌梢蛇1～30份。
2.按权利要求1所述的治疗风寒湿型颈椎病的中药外敷贴，其特征是：中药外敷贴的各药物的醇提物为各药物用体积浓度95%乙醇分别浸泡一个月，采用提取、分离、浓缩和干燥工艺流程分别提取浸膏，再按各药物的配比混合，采用体积浓度为70%酒精按照1∶15的配比制作而成的醇提物混合液。
3.按权利要求2所述的治疗风寒湿型颈椎病的中药外敷贴，其特征是：该中药外敷贴的各药物的醇提物混合液是与含低聚物为载体的壳聚糖医用生物膜和医用发热贴组合而成的外敷贴。
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CN105343225A (zh) * 2015-11-25 2016-02-24 天津雪赢世纪专利技术有限公司 一种中药熏蒸治疗颈椎病药包

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