CN106729939B - 一种治疗褥疮的敷料 - Google Patents
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Abstract
本发明公开了一种治疗褥疮的敷料,包括内层、外层和中间浸膏层,所述内层为无纺布,与所述中间浸膏层粘合连接;所述无纺布上涂有渗透剂;所述外层为聚氨基甲酸酯薄膜层,包括中间面和四周侧臂,中间面与所述中间浸膏层固定连接;所述中间浸膏层为含有中药浸膏的纤维膜层;所述渗透剂为烷基磺酸钠。本发明提供的敷料各层直接彼此衔接,相互配合,既有很好的治疗效果,又兼具良好的具有通风、透气功能。
Description
技术领域
本发明涉及医药,特别是一种治疗褥疮的敷料。
背景技术
长期卧床患者,由于皮肤组织,甚至肌肉,因持续受压,局部缺氧,血管栓塞、组织坏死腐脱而形成的溃疡,称为褥疮。褥疮具有发病率高,病程发展快,难以治愈,治愈后易复发的特点。
目前,临床上治疗褥疮常用的方法包括手术治疗方法,药物治疗方法和外敷方法。手术治疗主要是采用彻底清创后皮瓣转移修复,但该方法对于许多病人并不适合;药物疗法,包括内服药和外用药,也普遍存在效果不够明显的缺点由于外敷方法简单易操作,且对病人的伤害最小,因此,许多临床研究也给以极大关注。传统创伤敷料包括棉纱绷带、卷装绷带、专用敷料、浸渍棉纱、豁合条带制品以及应急处理敷料杂品等,主要体现止血、防菌、防止伤口粘连和简单的包扎功能。显然,传统创伤敷料在褥疮治疗中无法满足要求。
发明内容
针对现有的治疗褥疮过程中存在的问题,为解决现有技术的缺陷,本发明提供一种治疗褥疮的敷料,可有效解决目前因西医药尚无针对性特效疗法、个体反应性差异明显的缺点。
为达到上述目的,本发明采用以下技术方案:
一种治疗褥疮的敷料,包括内层、外层和中间浸膏层,所述内层为无纺布,与所述中间浸膏层粘合连接;所述无纺布上涂有渗透剂;所述外层为聚氨基甲酸酯薄膜层,包括中间面和四周侧臂,中间面与所述中间浸膏层固定连接;所述中间浸膏层为含有中药浸膏的纤维膜层;所述渗透剂为烷基磺酸钠。
作为本发明的优选方案,所述侧臂数量为个或者个,所述侧臂上与中间浸膏层同侧一面,设置有沾粘结构。
作为本发明的优选方案,所述中间浸膏层3包括如下组份:按质量份计,抗菌剂0.3-0.5份、成膜剂1-4份、致孔剂1-3份、助悬剂0.1-0.2份和中药浸膏50-60份;
所述抗菌剂为HFXZ-881;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;所述致孔剂为二甘醇双马来酸酯;所述助悬剂为海藻酸钠。
作为本发明的优选方案,所述中药浸膏包括如下重量份数的中药:黄芪(生)120-150g、党参100-120g、白术100-120g;熟地100-120g、当归尾6-10g,白芍5-8g;地龙、川芎、红花、桃仁各3-5g;乳香、白芷、没药各10-15g;黄连10-15g,生大黄100-120g;五倍子100-130g;铜绿1.5-2g;斑蝥0.03-0.06g;茯苓15-20g,生姜10-15g,炙甘草6-8g,轻粉1-3g和冰片2-4g。
作为本发明的优选方案,所述中药浸膏包括如下重量份数的中药:黄芪(生)130-140g、党参110-115g、白术110-115g;熟地110-115g、当归尾7-9g,白芍6-7g;地龙、川芎、红花、桃仁各3-4g;乳香、白芷、没药各11-14g;黄连12-14g,生大黄110-115g;五倍子110-120g;铜绿1.5-1.8g;斑蝥0.04-0.05g;茯苓17-19g,生姜11-14g,炙甘草6-7g,轻粉1-2g和冰片2-3g。
作为本发明的优选方案,所述中药浸膏包括如下重量份数的中药:黄芪(生)135g、党参110g、白术110g;熟地110g、当归尾8g,白芍6g;地龙、川芎、红花、桃仁各4g;乳香、白芷、没药各12g;黄连12g,生大黄110g;五倍子115g;铜绿1.8g;斑蝥0.04g;茯苓18g,生姜12g,炙甘草7g,轻粉2g和冰片3g。
作为本发明的优选方案,所述中药浸膏包括如下重量份数的中药:下肢为主者,加牛膝、杜仲各15-20g。
作为本发明的优选方案,日久效果不显著者,加水蛭、虻虫各5-8g。
作为本发明的优选方案,偏寒者,加熟附子1-3g。
所述中药浸膏的制备方法为:将生大黄加水300-500毫升,煎沸20-50分钟,过滤;再加水300-500毫升,煎沸15-20分钟,过滤;两次滤液浓缩至100-150毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
需要指出的是,本发明中,所述的治疗褥疮的敷料的制备方法,包括如下步骤:
A、取粉碎细度为20目的鲨鱼皮与鲨鱼软骨,所述鲨鱼皮与鲨鱼软骨细粉的重量比为6.7:3.4的混合物干品,加入15倍重量份的0.1N/L NaOH溶液,8℃浸泡5小时,取出沥干;加入10倍重量份的石油醚,8℃温度下浸泡12小时,用蒸馏水洗涤后沥干;再加10倍重量份的质量分数为2.5wt%的乙酸溶液,在8℃,搅拌速度300rpm的条件下搅拌48小时,40000r/min的条件下离心;取上清液加入1mol/L硫酸钠,经过沉淀、过滤、蒸馏水洗涤,再加10倍重量份的2.5wt%的乙酸溶液溶解,采用北京陶氏超滤膜公司供应的截留分子量为100kDa的超滤膜超滤,滤液冷冻干燥,获得鲨鱼皮和软骨混合胶原蛋白,再取2wt%乙酸溶液溶解配成含混合胶原蛋白浓度为0.3wt%的溶液;
B、取A步骤制备的溶液,在搅拌速度300rpm的条件下,加入海藻酸钠、聚丙烯酸钠和猪皮胶原蛋白,搅拌20分钟;
C、以乙醇为溶剂,取碱性成纤维细胞生长因子(bFGF),在搅拌速度300rpm的条件下,配制壳聚糖季铵盐和生长因子复合溶液,溶液中壳聚糖季铵盐含量为0.3wt%,bFGF生长因子含量为0.001wt%,搅拌10分钟;
D、以步骤B中所得到的海藻酸盐复合溶液作为纺丝的外层溶液,以步骤C中所得到的含壳聚糖季铵盐和生长因子复合溶液作为纺丝的内层溶液,进行同轴静电纺丝,在接收板上得到淡黄色、带有核壳结构的纤维丝并由纤维丝构成的海藻酸盐纤维膜;
E、以蒸馏水为溶剂,采用氯化钙和氯化锌,配制含3wt%氯化钙与0.5wt%氯化锌的氯化物混合液,将D步骤所得的纳米纤维膜浸入混合液中,加入抗菌剂,然后取出干燥,浸入放置时间为20分钟,在35℃的热空气干燥,干燥时间为2小时;
F、向E步骤制得的交联海藻酸盐复合物浸入中药浸膏然后取出干燥,35℃热空气干燥,干燥时间为2小时,得复合物;
G、取聚氨基甲酸酯,溶解在四氢呋喃中,配制成1wt%溶液,加入致孔剂,然后通过流延法涂布在洁净不粘纸上,经过68℃的热空气干燥,干燥时间为2小时,获得聚氨基甲酸酯薄膜;
H、复合
将步骤F获得的复合物与步骤G获得的聚氨基甲酸酯薄膜复合,再将无纺布与内层粘贴于所述中药浸膏的另一侧,将侧臂设置于中间面四周恰当的位置,即得到所述治疗褥疮的敷料。
本方生黄芪用量独重,但开始可先用小量,效果不明显时,再逐渐增加。
使用时将内层无纺布面,贴于创面,靠侧臂沾粘结构域固定,每12小时更换1次。
本发明中所用中药:
黄芪
性味归经:甘,微温;归脾、肺经。
功效:益卫固表,补气升阳,托毒生肌,利水消肿。
主治:用于气虚乏力、食少便溏,中气下陷,久泻脱肛,自汁盗汗,血虚萎黄,阴疽漫肿,气虚水肿,内热消渴。
党参
性味归经:甘,平。归脾、肺经。
功效:补中益气,生津养血。
主治:用于中气不足,食少便溏,咳喘气短,津伤口渴,血虚萎黄,心悸头晕。
白术
性味归经:苦、甘,温;归脾、胃经。
功效:补气健脾,燥湿利水,止汗,安胎。
主治:用于脾气虚弱,食少便溏,痰饮水肿,表虚自汗,胎动不安。
熟地黄
性味归经:甘,微温。归肝、肾经。
功效:养血滋阴,补精益髓。
主治:用于血虚萎黄,眩晕心悸,月经不调,潮热盗汗,消渴,腰酸耳鸣。
当归
性味归经:甘、辛,温。归肝、心、脾经。
功效:活血止痛,补血调经,润肠通便。
主治:用于血虚眩晕,月经不调,经闭,痛经,面色萎黄,虚寒腹痛,跌打损伤,风湿痹痛,痈疽疮疡,肠燥便秘。
白芍
性味归经:苦、酸,微寒。归肝、脾经。
功效:养血敛阴,柔肝止痛,平抑肝阳。
主治:用于月经不调,崩漏,虚汗,脘腹急痛,胁肋疼痛,四肢挛痛,头痛眩晕。
地龙
性味归经:咸,寒。归肝、脾、膀胱经。
功效:清热熄风,平喘,通络,利尿。
主治:用于壮热惊风,手足抽搐,肺热喘咳,关节痹痛,半身不遂,热结尿闭。
川芎
性味归经:辛,温。归肝、胆、心包经。
功效:活血行气,祛风止痛。
主治:用于月经不调、胁痛、胸痹、疮疡肿痛、跌打损伤、头痛、风湿痹痛。
红花
性味归经:辛、温。归心、肝经。
功效:活血化瘀,通经。
主治:用于血滞经闭,产后瘀阻,癥瘕积滞,跌打伤痛,麻疹不透。
桃仁
性味归经:苦,平。归心、肝、肺、大肠经。
功效:活血祛瘀,润肠通便。
主治:用于经闭,痛经,产后瘀阻,跌打伤痛,肺痈,肠痈,肠燥便秘。
乳香
性味归经:辛、苦,温。归心、肝、脾经。
功效:活血止痛,消肿生肌。
主治:用于痛经闭经,胃脘疼痛,风湿痹痛,跌打伤痛,痈肿疮疡。
白芷
性味归经:辛、温。归肺、胃经。
功效:散寒解表,祛风燥湿,消肿排脓,止痛。
主治:用于风寒表证,头痛,牙痛,痈疮肿痛,寒湿带下。
没药
性味归经:苦,平。归心、肝、脾经。
功效:活血止痛,消肿生肌。
主治:用于经闭腹痛,胃脘疼痛,跌打伤痛,痈肿疮疡。
黄连
黄连性味归经:苦,寒。归心、胃、肝、大肠经。
黄连功效:清热燥湿,泻火解毒。
黄连主治:用于胃肠湿热,呕吐,泻痢,高热神昏,心烦不寐,血热吐衄,疮疡肿毒,脓耳,湿疮,胃火牙痛。
大黄
性味归经:苦,寒。归脾、胃、大肠、肝、心包经。
功效:泻下攻积,清热泻火,凉血解毒,活血祛瘀。
主治:用于肠道积滞,大便秘结,血热吐衄,目赤,咽痛,牙龈肿痛,热毒疮疡,水火烫伤,血瘀经闭,跌打损伤,湿热黄疸,热淋。
五倍子
性味归经:酸、涩,寒。归肺、大肠、肾经。
功效:敛肺降火、涩肠,固精,敛汗,止血。
主治:用于肺虚久咳,久泻久痢,遗精、滑精、自汗、盗汗、崩漏下血。
铜绿
性味:酸;涩;寒;平;有毒;
归经:肝;胆经;
功能主治:明目退翳;涌吐风痰;解毒祛腐;杀虫止痒。主目翳;眼睑糜烂;中风痰壅;痈疽;鼻息肉;喉痹;牙疳;臁疮;狐臭;顽癣;
斑蝥
性味、归经:辛,热;有大毒,归肝、胃、肾经;
功效:破血逐瘀消漱,攻毒散结。
生姜
性味归经:辛,微温。归肺、脾经。
功效:发汗解表,温中止吐,温肺止咳。
主治:用于风寒表证,胃寒呕吐,风寒咳嗽。
轻粉
归经:味辛、寒,有毒。归大肠、小肠经。
功能与主治:外用攻毒杀虫;内服逐水退肿。用于疥癣,梅毒,水肿,二便不利之实证。
冰片
性味归经:辛、苦,微寒。归心、脾、肺经。
功效:开窍醒神,清热止痛。
主治:用于窍闭神昏,疮疡,咽喉肿痛,口舌生疮。
甘草
性味归经:甘,平。归心、脾、肺、胃经。
功效:补脾益气,润肺止咳,清热解毒,缓解止痛,缓和药性。
主治:用于脾胃虚弱,气短乏力,心悸怔忡,咳嗽痰少,热毒疮疡,药食中毒,脘腹急痛,四肢挛痛。
本发明的有益效果为:
1.本发明提供了一种多层敷料,各层直接彼此衔接,相互配合,既有很好的治疗效果,又兼具良好的具有通风、透气功能。
2.本发明将新型敷料与传统中药药效相结合,提供了一种有效治疗褥疮的敷料;其中所述辅料的中药浸膏成分,运用传统中药理论结合多年临床经验,以独特的理论为立方指导:其中,黄芪补气有良好的托毒生肌之功,与当归同用,补气生血有益气养血、托毒生肌收口之功,黄芪长于补脾肺之气且能升举阳气与白术、党参同用,可增强补气健脾作用;黄芪与白术既能补气,又可利水消肿;黄芪、芍药同用用于气虚血滞所致的肢体麻木效果显著,党参能补气养血与熟地黄、当归补血药同用,熟地黄甘温滋润入肝,与当归、白芍同用长于补血。当归与白芍、生姜同用,祛瘀止痛,配伍没药桃仁、红花祛瘀生新与熟地黄、白芍补血作用增强、与川芎、白芍同用,既善补血,又善活血止痛,地龙有通利经络作用,与黄芪、当归尾、川芎,治气虚血滞,经络不利所致的半身不遂;红花与桃仁、当归、川芎同用辛散温通,入血分,活血祛瘀、通调经脉,活血祛瘀以化滞;
没药与乳香共研细末能消肿生肌,乳香与白芷同用活血止痛,消肿生肌;白芷与白术,山药同用辛温行散,既能止痛,又能消肿排脓;黄连大苦大寒,配冰片泻火解毒力强,大黄寒沉降性能,可引热下行,使之上炎之火邪,得以下泄、清泄热毒,又能清泄血分之热,凉血解毒、配白芷、亦取其解毒之效;本发明以补气为主,活血通络为辅,气血双补,托毒生肌;清热解毒,祛腐排脓,敛疮生肌、补气,活血,通络;滋阴养血,燥湿止痒;可刺激皮肤和患处血管的扩张,促进新陈代谢和再生,有利于病变的康复。重用补气药与活血药相伍,使气旺血行以治本,祛瘀通络以治标,标本兼顾;且补气而不壅滞,活血又不伤正,同时添加解表药、燥湿药、去腐生肌药,合而用之,则气旺、瘀消、络通,腐肉去新肉生诸症向愈;本方重用生黄芪、党参、白术培土生金、补益元气,意在气旺则血行,瘀去络通,同时为君药;熟地、当归尾、白芍、川芎、红花、桃仁、乳香、没药、斑蝥、以行气以活血祛瘀、活血通络、攻毒散结不伤血,用为臣药;白芷、生姜助地龙通经活络,力专善走,周行全身,以行药力,黄连、大黄、燥湿去分泌物,五倍子、铜绿、轻粉、冰片、解毒祛腐;杀虫止痒亦为佐药;炙甘草既善解毒,又可清热,增强清热解毒药疗效,与大黄、,能缓和大黄、与党参、熟地黄等补虚药同用,能使作用缓慢而持久;与黄连等热药寒药同用,又可以起协调作用为使药。
3.本发明疗效神奇,且不开刀不打针不吃药,就能迅速减轻患者痛苦,并克服了常规治疗方法不能解决的问题,避免口服、注射西药对身体的副作用,所以为广大患者所接受,是当今绿色自然疗法的理想选择!
附图说明
图1为本发明的内部结构示意图:
图2为本发明的实施例1结构示意图:
图3为本发明的实施例2结构示意图:
附图中:内层-1、外层-2、中间浸膏层-3、中间面-21和四周侧臂-22,沾粘结构23。
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
如图1、2所示,一种治疗褥疮的敷料,包括内层1、外层2和中间浸膏层3,所述内层1为无纺布,与所述中间浸膏层3粘合连接;所述无纺布上涂有适量烷基磺酸钠;所述外层2为聚氨基甲酸酯薄膜层,包括中间面21和四周侧臂22,侧臂22数量为2个,所述侧臂22上与中间浸膏层同侧一面,设置有沾粘结构23;中间面21与所述中间浸膏层3固定连接;所述中间浸膏层3为含有中药浸膏的纤维膜层;
中间浸膏层3包括如下组份:按质量份计,抗菌剂HFXZ-881 0.3份、成膜剂1份、二甘醇双马来酸酯1份、海藻酸钠0.1份和中药浸膏50份;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;
中药浸膏包括如下重量份数的中药:黄芪(生)120g、党参100g、白术100g;熟地100g、当归尾6g,白芍5g;地龙、川芎、红花、桃仁各3g;乳香、白芷、没药各10g;黄连10g,生大黄100g;五倍子100g;铜绿1.5g;斑蝥0.03g;茯苓15g,生姜10g,炙甘草6g,轻粉1g和冰片2g;
中药浸膏的制备方法为:将生大黄加水300毫升,煎沸20分钟,过滤;再加水300毫升,煎沸15分钟,过滤;两次滤液浓缩至100毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
其中,所述适量烷基磺酸钠,为医药领域渗透剂的常规用量。
实施例2
如图1、3所示,一种治疗褥疮的敷料,包括内层1、外层2和中间浸膏层3,内层1为无纺布其上涂有适量烷基磺酸钠,与所述中间浸膏层3粘合连接;外层2为聚氨基甲酸酯薄膜层,包括中间面21和四周侧臂22,所述侧臂22数量为4个,侧臂22上与中间浸膏层同侧一面,设置有沾粘结构23;中间面21与中间浸膏层3固定连接;所述中间浸膏层3为含有中药浸膏的纤维膜层;
中间浸膏层3包括如下组份:按质量份计,HFXZ-881 0.5份、成膜剂4份、二甘醇双马来酸酯3份、海藻酸钠0.2份和中药浸膏60份;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;
中药浸膏包括如下重量份数的中药:黄芪(生)150g、党参120g、白术120g;熟地120g、当归尾10g,白芍8g;地龙、川芎、红花、桃仁各5g;乳香、白芷、没药各15g;黄连15g,生大黄120g;五倍子130g;铜绿2g;斑蝥0.06g;茯苓20g,生姜15g,炙甘草8g,轻粉3g和冰片4g;
中药浸膏的制备方法为:将生大黄加水500毫升,煎沸50分钟,过滤;再加水500毫升,煎沸20分钟,过滤;两次滤液浓缩至150毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
实施例3
一种治疗褥疮的敷料,其结构与组成与实施例1基本相同;其不同之处在于:
中间浸膏层3包括如下组份:按质量份计,HFXZ-881 0.4份、成膜剂2份、二甘醇双马来酸酯2份、海藻酸钠0.15份和中药浸膏55份;
所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;
所述中药浸膏包括如下重量份数的中药:黄芪(生)135g、党参110g、白术110g;熟地110g、当归尾8g,白芍6g;地龙、川芎、红花、桃仁各4g;乳香、白芷、没药各12g;黄连12g,生大黄110g;五倍子115g;铜绿1.8g;斑蝥0.04g;茯苓18g,生姜12g,炙甘草7g,轻粉2g和冰片3g;
中药浸膏的制备方法为:将生大黄加水400毫升,煎沸35分钟,过滤;再加水400毫升,煎沸18分钟,过滤;两次滤液浓缩至110毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
实施例4
一种治疗褥疮的敷料,其结构与组成与实施例2基本相同;其不同之处在于:
中间浸膏层3包括如下组份:按质量份计,HFXZ-881 0.3份、成膜剂3份、二甘醇双马来酸酯1份、海藻酸钠0.1份和中药浸膏52份;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;
所述中药浸膏包括如下重量份数的中药:黄芪(生)132g、党参112g、白术113g;熟地111g、当归尾7g,白芍6g;地龙、川芎、红花、桃仁各3g;乳香、白芷、没药各11g;黄连12g,生大黄112g;五倍子112g;铜绿1.6g;斑蝥0.04g;茯苓17g,生姜11g,炙甘草6g,轻粉1g和冰片2g;
中药浸膏的制备方法为:将生大黄加水350毫升,煎沸30分钟,过滤;再加水350毫升,煎沸16分钟,过滤;两次滤液浓缩至110毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
实施例5
一种治疗褥疮的敷料,其结构与组成与实施例1基本相同;其不同之处在于:
中间浸膏层3包括如下组份:按质量份计,HFXZ-881 0.5份、成膜剂4份、二甘醇双马来酸酯2份、海藻酸钠0.1份和中药浸膏58份;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;
所述中药浸膏包括如下重量份数的中药:黄芪(生)140g、党参115g、白术115g;熟地115g、当归尾9g,白芍7g;地龙、川芎、红花、桃仁各4g;乳香、白芷、没药各14g;黄连14g,生大黄115g;五倍子120g;铜绿1.8g;斑蝥0.05g;茯苓19g,生姜14g,炙甘草7g,轻粉2g和冰片3g;
中药浸膏的制备方法为:将生大黄加水400毫升,煎沸40分钟,过滤;再加水400毫升,煎沸19分钟,过滤;两次滤液浓缩至140毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
实施例6
一种治疗褥疮的敷料,其结构与组成与实施例3基本相同;其不同之处在于:
对于以下肢为主的褥疮患者进行治疗,所述中药浸膏还包括如下重量份数的中药:牛膝、杜仲各15-20g。
实施例7
一种治疗褥疮的敷料,其结构与组成与实施例3基本相同;其不同之处在于:
对于日久效果不显著的褥疮患者进行治疗,所述中药浸膏还包括如下重量份数的中药:水蛭、虻虫各5-8g。
实施例8
一种治疗褥疮的敷料,其结构与组成与实施例3基本相同;其不同之处在于:
对于体质偏寒的褥疮患者进行治疗,所述中药浸膏还包括如下重量份数的中药:加熟附子1-3g。
并经临床资料得到了充分证明,有关临床资料如下:
(一)病例选择:
随机筛选中风、偏瘫或者意外事故造成的肢体活动能力丧失,因长期卧床、压迫髋关节部形成褥疮患者600人,男300人,女300人,年龄35-75岁(患者个体间差异性可忽略不计),褥疮直径约2-3CM深度1-2CM,为轻度褥疮,直径6-8CM深度3-5CM为重度褥疮,轻度为180人,重度为420人;随机分为6组,每组轻度褥疮患者30,重度褥疮患者70人,分别以本发明实施例1-5所得治疗褥疮的敷料和市售康乐宝褥疮贴,进行治疗。
(二)治疗方案
对各组患者,定期清洗创面,以所选药贴或者敷料进行贴敷治疗,12个小时,更换一次;十天为一个疗程。
(三)疗效评定标准:
治愈:患者创面干燥、创口开始修复,创口明显缩小、创口不再疼痛;
有效:患者创面基本干燥、不再流血化脓,创面不再扩大。
无效:患者创面基本不再扩大,但是效果不明显。
(四)统计学处理:
按上述治疗方案,经过用药一个疗程,结果显示,本发明实施例1-5中,轻度褥疮患者的痊愈人数达24人以上,其中实施例3达到28人;重度褥疮患者的痊愈人数达50人以上,实施例3组达到60人;而对比例中,轻度褥疮患者的痊愈人数为22人,重度褥疮患者的痊愈人数为45人;及至第三个疗程,实施例组中,轻度褥疮患者的痊愈人数达28人以上,且全部都见疗效;重度褥疮患者的痊愈人数达61人以上,且实施例3的痊愈人数达67人;而对比例中,轻度褥疮患者的痊愈人数为28人,亦全部见疗效;重度褥疮患者的痊愈人数为45人;还有8人无效。
由上述统计结果可知,本发明提供的治疗褥疮的敷料在治疗褥疮的临床药效上,特别是针对重度褥疮患者的疗效上显著优于市售康乐宝褥疮贴。进一步,本发明实施例3提供的技术方案,在相同条件下,其疗效效果,明显优于其他实施例组,是最佳配方组合。
(五)结论
本发明的提供的治疗褥疮的敷料,经长期实验总结制成,疗效在此组方范围达到最佳。
典型病例:
周某,男,下肢瘫痪,长期卧床,臀部长有褥疮,创面不断有扩大的趋势,流血、流脓,使用本发明实施例6所得褥疮敷料进行治疗,外用,敷料每12小时更换一次,用药5天,患者创面流血、流脓症状消失,用药15天患者创面开始缩小,用药20天,患者创口痊愈。
梁某,男,79岁,患半身不遂,卧床5年,背部及臀部长有褥疮,创面大且深,流血、流脓症状严重,使用其他褥疮贴药物,疗效不理想;使用本发明实施例7所得褥疮敷料,前三天,每6个小时更换一次,更换药物过程中,注意创面的清洗和消炎,流血、流脓症状有所减轻,改为每12小时更换一次敷料,15天后,,患者创面流血、流脓症状消失,用药25天患者创面开始缩小,用药35天,患者创口痊愈。
李某,女,65岁,下肢瘫痪,卧床3年,体质偏寒,阴虚脾虚;背部及臀部长有褥疮,伴有流血、流脓的症状,使用本发明实施例8所得褥疮敷料,外用,敷料每12小时更换一次,用药3天,患者创面流血、流脓症状消失,用药10天患者创面开始缩小,用药15天,患者创口痊愈,体寒状况有所改善。
最后说明的是,以上实施例仅用以说明本发明的技术方案而非限制,本领域普通技术人员对本发明的技术方案所做的其他修改或者等同替换,只要不脱离本发明技术方案的精神和范围,均应涵盖在本发明的权利要求范围当中。
Claims (7)
1.一种治疗褥疮的敷料,其特征在于,包括内层(1)、外层(2)和中间浸膏层(3),所述内层(1)为无纺布,与所述中间浸膏层(3)粘合连接;所述无纺布上涂有渗透剂;所述外层(2)为聚氨基甲酸酯薄膜层,包括中间面(21)和四周侧臂(22),中间面(21)与所述中间浸膏层固定连接;所述中间浸膏层(3)为含有中药浸膏的纤维膜层;所述渗透剂为烷基磺酸钠;
所述侧臂(22 )数量为2个或者4个,所述侧臂(22 )上与中间浸膏层同侧一面,设置有沾粘结构(23);
所述中间浸膏层(3)包括如下组份:按质量份计,抗菌剂0.3-0.5份、成膜剂1-4份、致孔剂1-3份、助悬剂0.1-0.2份和中药浸膏50-60份;
所述抗菌剂为HFXZ-881;所述成膜剂为聚丙烯酸钠、鲨鱼胶原蛋白、猪皮胶原蛋白、壳聚糖季铵盐和碱性成纤维细胞生长因子,其重量比为聚丙烯酸钠:鲨鱼胶原蛋白:猪皮胶原蛋白:壳聚糖季铵盐:碱性成纤维细胞生长因子=100:40:8:75:0.25;所述致孔剂为二甘醇双马来酸酯;所述助悬剂为海藻酸钠;
所述中药浸膏包括如下重量份数的中药:生黄芪120-150g、党参100-120g、白术100-120g;熟地100-120g、当归尾6-10g,白芍5-8g;地龙、川芎、红花、桃仁各3-5g;乳香、白芷、没药各10-15g;黄连10-15g,生大黄100-120g;五倍子100-130g;铜绿1.5-2g;斑蝥0.03-0.06g;茯苓15-20g,生姜10-15g,炙甘草6-8g,轻粉1-3g和冰片2-4g。
2.根据权利要求1所述的治疗褥疮的敷料,其特征在于,所述中药浸膏包括如下重量份数的中药:生黄芪130-140g、党参110-115g、白术110-115g;熟地110-115g、当归尾7-9g,白芍6-7g;地龙、川芎、红花、桃仁各3-4g;乳香、白芷、没药各11-14g;黄连12-14g,生大黄110-115g;五倍子110-120g;铜绿1.5-1.8g;斑蝥0.04-0.05g;茯苓17-19g,生姜11-14g,炙甘草6-7g,轻粉1-2g和冰片2-3g。
3.根据权利要求1所述的治疗褥疮的敷料,其特征在于,所述中药浸膏包括如下重量份数的中药:生黄芪135g、党参110g、白术110g;熟地110g、当归尾8g,白芍6g;地龙、川芎、红花、桃仁各4g;乳香、白芷、没药各12g;黄连12g,生大黄110g;五倍子115g;铜绿1.8g;斑蝥0.04g;茯苓18g,生姜12g,炙甘草7g,轻粉2g和冰片3g。
4.根据权利要求3所述的治疗褥疮的敷料,其特征在于,所述中药浸膏包括如下重量份数的中药:下肢为主者,加牛膝、杜仲各15-20g。
5.根据权利要求3所述的治疗褥疮的敷料,其特征在于,日久效果不显著者,加水蛭、虻虫各5-8g。
6.根据权利要求3所述的治疗褥疮的敷料,其特征在于,偏寒者,加熟附子1-3g。
7.根据权利要求1-6任一项所述的治疗褥疮的敷料,其特征在于,所述中药浸膏的制备方法为:将生大黄加水300-500毫升,煎沸20-50分钟,过滤;再加水300-500毫升,煎沸15-20分钟,过滤;两次滤液浓缩至100-150毫升,得大黄煎出液;然后每100克凡士林中加人30毫升大黄浓缩液,混合均匀,成为大黄膏,再将各中药组分粉碎、研成细末,掺入大黄膏内,即为中药浸膏。
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