CN106955314A - 活血清热川黄散 - Google Patents
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Abstract
本发明公开了一种外用中药方剂活血清热川黄散，其按质量比的配方为：芙蓉叶1‑3份、水鬼蕉1‑3份、大青叶1‑3份、大黄1‑3份、黄柏1‑3份、黄芩1‑3份、当归1‑3份、白芷1‑3份、天花粉1‑3份。该活血清热川黄散在治疗骨折与伤筋早期、掀红作热及热痹、热毒肿痛等疾病时，在有活血化瘀作用的同时还有清热凉血作用，具有疗效好、毒副作用小的特点。
Description
技术领域
本发明涉及中药配方，具体涉及治疗骨折、伤筋早期、掀红作热及热痹、热毒肿痛的外用中药方剂活血清热川黄散。
背景技术
骨折与筋伤是骨伤科临床的常见疾病，一般都是由于外伤引起，临床辨证多为瘀血阻滞，外用药膏多为活血化瘀之品为主，如三七、川芎、乳香、没药等，并增加部分温经之品如肉桂、丁香，再添加少量冰片、樟脑或薄荷脑等中和温热之品。如用川芎、川牛膝、白芷、延胡索、红花、肉桂、丁香、薄荷脑、冰片配制而成的万通筋骨贴，以及用乳香没药各150克血竭90克香油10千克三七90克冰片90克樟脑90克东丹5千克配制而成的跌打膏，等等。存在的缺陷是：这类药膏温热有余而寒凉不足，忽视了离经之血易化热的规律，在温经药物过多情况下，易增加早期骨折及筋伤的瘀血之症，并加重其热象。
发明内容
本发明的目的是提供一种在治疗骨折与伤筋早期、掀红作热及热痹、热毒肿痛等疾病时同时具有活血化瘀与清热凉血作用、疗效好、毒副作用小的外用中药方剂活血清热川黄散。
为实现以上目的，本发明活血清热川黄散按质量比的配方为：芙蓉叶1-3份、水鬼蕉1-3份、大青叶1-3份、大黄1-3份、黄柏1-3份、黄芩1-3份、当归1-3份、白芷1-3份、天花粉1-3份。
更优选的配方按质量比为：芙蓉叶、水鬼蕉、大青叶、大黄各2份，黄柏、黄芩、当归、白芷、天花粉各1份。
使用方法：按上述配方将调好的散或膏摊平于纸棉或纱布，敷于患处，用外用胶布或绷带包扎。连续使用1-2天后取下药膏，让皮肤休息5小时后可更换新药再次使用。
副作用：在使用时间过长时，可能出现皮肤过敏；患处呈虚寒现象时，疼痛可能加重。
禁忌：皮肤过敏、表皮擦破或开放伤口。
本发明活血清热川黄散的方解：本方用天花粉、芙蓉叶、水鬼蕉清热解毒，消肿排脓；用黄柏、黄芩、白芷清泄湿热，凉血祛风；用大黄、当归、大青叶活血祛瘀，疗疮止痛。全方具有清热解毒、活血祛瘀、凉血止痛和排脓疗疮功能；可治疗骨折、伤筋早期、肿胀积血和瘀斑青紫，治疗痛风、风湿热痛、肢体掀红剧痛之热痹症，治疗瘀血蕴结、气机阻滞、血脉闭塞、血流不通、肢体坏死等急重瘀血症。
上述配方的具体方解如下：
1、芙蓉叶
性味归经：辛、微苦，凉，归肺、肝经。
功效：清肺凉血，解毒消肿。
主治：用于肺热咳嗽，目赤肿痛，痈疽肿毒，恶疮，缠身蛇丹，脓疱疮，肾盂肾炎，水火炎伤，毒蛇咬伤，跌打损伤。
2、水鬼蕉
性味归经：辛，温，归肝、肾经。
功效：舒筋活血，消肿止痛。
主治：用于风湿关节痛，跌打肿痛，痈疽疮肿，痔疮。
3、大青叶
性味归经：苦、咸，大寒，归心、肺、胃经。
功效：清热解毒，凉血消斑。
主治：用于热入营血，温毒发斑；用于喉痹口疮，丹毒痈肿。
4、大黄
性味归经：苦，寒，归脾、胃、大肠、肝、心经。
功效：泻下攻积，清热泻火，止血，解毒，活血祛瘀。
主治：用于大便秘结，胃肠积滞；用于血热妄行之吐血、咯血，以及火邪上炎所致的目赤、咽喉肿痛、牙龈肿痛等证；用于热毒疮疡，烧烫伤；用于瘀血证。
5、黄柏
性味归经：苦，寒，归肾、膀胱、大肠经。
功效：清热燥湿，泻火解毒，退热除蒸。
主治：用于湿热带下，热淋脚气，泻痢黄疸；用于疮疡肿痛，湿疹湿疮；用于阴虚发热，盗汗遗精。
6、黄芩
性味归经：苦，寒，归肺、胃、胆、大肠经。
功效：清热燥湿，泻火解毒，凉血止血，除热安胎。
主治：用于湿温暑湿湿热痞闷，黄疸泻痢；用于肺热咳嗽，热病烦渴；用于痈肿疮毒，咽喉肿痛；用于血热吐血。用于胎热不安。
7、当归
性味归经：甘、辛、温，归肝、心、脾经。
功效：补血，活血，调经，止痛，润肠。
主治：用于心肝血虚，面色萎黄，眩晕心悸等；用于血虚或血虚兼有瘀滞的月经不调、痛经、经闭等症；用于血虚，血滞兼有寒凝，以及跌打损伤，风湿痹阻的疼痛证；用于痈疽疮疡；用于血虚肠燥便秘。
8、白芷
性味归经：辛，温，归肺、胃经。
功效：解表散风，通窍，止痛，燥湿止泻，消肿排脓。
主治：用于外感风寒，头痛、鼻塞；用于阳明头痛，齿痛，鼻渊，风湿痹痛；用于带下过多。用于疮疡肿毒。
9、天花粉
性味归经：甘、微苦，微寒，归肺、胃经。
功效：清热生津，清肺润燥，解毒消痈。
主治：用于热病口渴，消渴多饮；用于肺热燥咳；用于痈肿疮疡。
本发明活血清热川黄散主治骨折与伤筋早期、掀红作热及热痹、热毒肿痛，具有活血祛瘀、清热消肿之功效，其技术特点和有益效果如下：
本发明在使用水鬼蕉、当归、大黄等活血化瘀之品后，又配了芙蓉叶、大青叶、黄芩、黄柏、天花粉等清热凉血之品，故临床疗效较好，且对于治疗痛风性关节炎、风湿性关节炎、类风湿性关节炎等疾病时，急性发作期以热象为主，对关节掀红作热者亦有良效。此外，本发明制作工艺简便，容易取材，毒副作用小，且给药方便，药剂易于制造，成本低廉。
具体实施方式
下面结合临床研究和具体实施例对本发明活血清热川黄散作进一步详细说明。
实施例1
本发明活血清热川黄散配方：芙蓉叶、水鬼蕉、大青叶、大黄、黄柏、黄芩、当归、白芷、天花粉各1份。
使用方法：将按配方调好的散或膏摊平于纸棉或纱布后敷于患处，用外用胶布或绷带包扎。连续使用1-2天后取下药膏，让皮肤休息5小时后，可更换新药再次使用。
实施例2
本发明活血清热川黄散配方：芙蓉叶、水鬼蕉、大青叶、大黄各3份、黄柏、黄芩、当归、白芷、天花粉各1份。
使用方法同实施例1。
实施例3
本发明活血清热川黄散配方：芙蓉叶、水鬼蕉、大青叶、大黄各2份、黄柏、黄芩、当归、白芷、天花粉各1份。
使用方法同实施例1。
实施例1为最小剂量，实施例2为最大剂量，实施例3为最佳剂量。实施例3在增加君臣药的情况下，适当控制佐使药的用量，使其符合君臣佐使的药量要求，既发挥了全方的最大良效，又避免了药物的毒副作用。临床使用中也证明实施例3取得了最佳疗效。
临床试验及疗效观察结论：
1、纳入标准：符合骨折、伤筋早期，掀红作热及热痹、热毒肿痛的辨证要点。
2、排除标准：鉴别后不符合纳入标准；未能按治疗方案用药或中断试验者。
3、入选病历：此次入选病历均为龙岩市中医院骨伤科门诊外伤及痹症患者。
4、用药及观察方法：外用，用法用量：每贴药膏外用2天，休息5小时后再贴新药膏2天，2周为一个疗程。
疗效判定及治疗结果如下所示：
如表所示：本发明治疗骨折与伤筋早期、掀红作热及热痹、热毒肿痛等疾病疗效好，在整个临床治疗观察过程中，有少量病例出现局部皮肤瘙痒皮疹等过敏现象，经外用肤轻松后症状消失。本发明活血清热川黄散主要有活血祛瘀清热消肿的作用，最终试验结论表明本发明用于治疗骨折与伤筋早期、掀红作热及热痹、热毒肿痛等疾病具有较好疗效。此外，本发明制作工艺简便，毒副作用小，且给药方便，药剂易于制造，成本低廉。
典型病例
病例1：患者姓名：王××，性别：女，年龄：31岁；扭伤致右踝肿痛、活动受限2天。查体：右外踝肿胀、压痛，局部皮温略高，主动屈伸活动受限；右踝正侧位片见右外踝尖小片状撕脱骨碎片。中医诊断：右外踝撕脱性骨折；证候诊断：瘀血阻滞。治疗给以本发明活血化瘀消肿，一个疗程后痊愈。
病历2：患者姓名：林*，男性，50岁；突发左膝红肿热痛1天。既往痛风病史10年，发病前有饮用啤酒及食用海鲜史。查体：左膝关节皮肤发红，皮温高，关节肿胀、压痛明显，活动明显受限，舌质红苔黄腻，脉滑数；血尿酸：610mmol/L。诊断：痛风病(湿热痹阻)；治疗以本发明一个疗程后康复。
病历3：患者，张**，女性，25岁；扭伤致腰痛、活动受限1小时。查体：腰椎活动受限，左侧L3横突压痛；舌淡苔薄白，脉弦。诊断：急性腰扭伤(瘀血阻络)；治疗以本发明治疗，一个疗程后治愈。
Claims (2)
1.一种活血清热川黄散，其特征是：按质量比的配方为芙蓉叶1-3份、水鬼蕉1-3份、大青叶1-3份、大黄1-3份、黄柏1-3份、黄芩1-3份、当归1-3份、白芷1-3份、天花粉1-3份。
2.如权利要求1所述活血清热川黄散，其特征是：所述按质量比的配方为芙蓉叶、水鬼蕉、大青叶、大黄各2份，黄柏、黄芩、当归、白芷、天花粉各1份。
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