CN107158287A - 缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药 - Google Patents

缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药 Download PDF

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CN107158287A
CN107158287A CN201710185042.0A CN201710185042A CN107158287A CN 107158287 A CN107158287 A CN 107158287A CN 201710185042 A CN201710185042 A CN 201710185042A CN 107158287 A CN107158287 A CN 107158287A
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许进秀
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Abstract

本发明涉及一种缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药，由下述中药原料组成：护心草5‑8g，地笋3‑7g，海松子5‑10g，密蒙花10‑15g，剪刀草3‑7g，茅草叶5‑8g，楮叶10‑15g，牛尾菜10‑15g，枸橘叶3‑10g，丝瓜络5‑15g，素兴花3‑7g，东风菜根5‑15g，水泽兰8‑12g，柠檬根5‑10g，辟汗草3‑5g，松蒿8‑10g。能有效降低EGFRIs相关皮肤毒性，总有效率高。

Description

缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药
技术领域
本发明属于医药领域，具体涉及一种缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法。
背景技术
吉非替尼，又名易瑞沙，是一种选择性表皮生长因子受体(EGFR)酪氨酸激酶抑制剂，适用于治疗既往接受过化学治疗或不适于化疗的局部晚期或转移性非小细胞肺癌(NSCLC)。EGFRIs所致的皮肤毒性的根本在"肺热血療"，因为肺合皮毛、肺居于上焦，肺热则头部W及躯干上部的皮肤易发丘疹、干燥；热邪生风则皮肤脱屑壌痒。皮肤毒性不限于气分，血热血疲更可出现红斑或化疮。皮疹从来不是人体在外割裂之症状，必须配合整体病机，司外察内，要将"肺热血療"与癌症患者本身之辨病辨证有机结合，才可贯彻治疗。
发明内容
本发明的目的在于提供一种有效率高的缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法。
本发明解决其技术问题所采用的技术方案是：缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法，包括中药治疗和耳穴贴压治疗；所述中药治疗为口服中药制剂，隔日一剂，早晚分服；所述耳穴贴压治疗的步骤为：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替；嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。
具体地，所述中药治疗中所用的中药由下述中药原料组成：护心草5-8g，地笋3-7g，海松子5-10g，密蒙花10-15g，剪刀草3-7g，茅草叶5-8g，楮叶10-15g，牛尾菜10-15g，枸橘叶3-10g，丝瓜络5-15g，素兴花3-7g，东风菜根5-15g，水泽兰8-12g，柠檬根5-10g，辟汗草3-5g，松蒿8-10g。
优选的，所述中药治疗中所用的中药由下述中药原料组成：护心草7g，地笋5g，海松子8g，密蒙花10g，剪刀草5g，茅草叶5g，楮叶12g，牛尾菜15g，枸橘叶8g，丝瓜络10g，素兴花5g，东风菜根10g，水泽兰10g，柠檬根7g，辟汗草5g，松蒿8g。
具体地，所述耳穴贴压治疗的主穴为肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。
中药治疗中所用中药原料的药理活性如下：
护心草，为莎草科植物旋鳞莎草的全草，味辛，淡，性平，归肝、脾经，行气养血；调经。主月经不调；痛经。
地笋，为唇形科植物地瓜儿苗的根茎，甘、辛，温，化瘀止血；益气利水。主衄血；吐血；产后腹痛；黄疸；带下；气虚乏力。
海松子，为松科植物红松的种子，甘，性微温，归肝、肺、大肠经，润燥，养血，祛风，主肺燥干咳，大便虚秘，诸风头眩，骨节风，风痹。并有润泽皮肤，敷荣毛发的功能。
密蒙花，为马钱科植物密蒙花的干燥花或花蕾，甘，微寒，归肝经，清热养肝，明目退翳。用于目赤肿痛，多泪羞明，眼生翳膜，肝虚目暗，视物昏花。
剪刀草，为唇形科植物光风轮或瘦风轮的全草，苦辛，凉，祛风清热；行气活血；解毒消肿。主感冒发热；食积腹痛；呕吐；泄泻；痢疾；白喉；咽喉肿痛；痈肿丹毒；荨麻疹；毒虫咬伤；跌打伤出血。
茅草叶，为禾本科植物白茅的叶片，辛，微苦，平，祛风除湿。主风湿痹痛；皮肤风疹。
楮叶，为桑科植物构树的叶，甘，性凉，凉血止血；利尿解毒。主吐血；衄血；崩血；金疮出血；水肿；疝气；痢疾；毒疮。
牛尾菜，为百合科植物牛尾菜的根及根茎，甘苦，平，补气活血，舒筋通络。治气虚浮肿，筋骨疼痛，偏瘫，头晕头痛，咳嗽吐血，骨结核，白带。
枸橘叶，为芸香科植物枸橘的叶片，辛，温，归肺、胃、大肠经，理气止呕；消肿散结。主噎膈；反胃；呕吐；梅核气；疝气。
丝瓜络，为葫芦科植物丝瓜老熟果实的网状纤维或粤丝瓜的枯老果实，味苦，性凉，归肺、肝、胃经，通经活络；解毒消肿。主胸胁疼痛；风湿痹痛，经脉拘挛，乳汁不通，肺势咳嗽。
素兴花，为木犀科植物多花素馨的全株及花，苦，微辛，性凉，行气；活血；止痛；清热散结。主胸胁脘腹胀痛；血滞痛经；月经不调；睾丸肿痛；淋巴结核。
东风菜根，为菊科植物东风菜的根，辛，温，疏风，行气，活血，止痛。治肠炎腹痛，骨节疼痛，跌打损伤。
水泽兰，为虎耳草科植物扯根菜的全草，味苦、微辛，性寒，归肝、肾经，利水除湿，活血散瘀，止血，解毒。主水肿，小便不利，黄疸，带下，痢疾，闭经，跌打损伤，尿血，崩漏，毒蛇咬伤。
柠檬根，为芸香科植物黎檬或洋柠檬的根，辛，苦，微温，归肝、肾经，行气止血；止痛；止咳。主胃痛；疝气痛；跌打损伤；咳嗽。
辟汗草，为豆科植物草木犀的全草，清热，解毒，化湿，杀虫。治暑热胸闷，疟疾，痢疾，淋病，皮肤疮疡。
松蒿，为玄参科植物松蒿的全草，味微辛，性凉，归肺、脾、胃经，清热利湿；解毒。主黄疸；水肿；风热感冒；口疮；鼻炎；疮疖肿毒。
本发明具有以下有益效果：本发明采用口服中药及耳穴贴压治疗方法干预EGFRIs相关皮肤毒性，能有效降低EGFRIs相关皮肤毒性，总有效率高。
具体实施方式
以下是本发明的具体实施例，对本发明的技术方案做进一步描述，但是本发明的保护范围并不限于这些实施例。凡是不背离本发明构思的改变或等同替代均包括在本发明的保护范围之内。
实施例1
缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法，包括中药治疗和耳穴贴压治疗；所述中药治疗为口服中药制剂，隔日一剂，早晚分服；所述耳穴贴压治疗的步骤为：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替；嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。所述耳穴贴压治疗的主穴为肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。
所述中药治疗中所用的中药由下述中药原料组成：护心草7g，地笋5g，海松子8g，密蒙花10g，剪刀草5g，茅草叶5g，楮叶12g，牛尾菜15g，枸橘叶8g，丝瓜络10g，素兴花5g，东风菜根10g，水泽兰10g，柠檬根7g，辟汗草5g，松蒿8g。
实施例2
缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法，包括中药治疗和耳穴贴压治疗；所述中药治疗为口服中药制剂，隔日一剂，早晚分服；所述耳穴贴压治疗的步骤为：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替；嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。所述耳穴贴压治疗的主穴为肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。
所述中药治疗中所用的中药由下述中药原料组成：护心草5g，地笋7g，海松子5g，密蒙花15g，剪刀草3g，茅草叶6g，楮叶13g，牛尾菜10g，枸橘叶3g，丝瓜络15g，素兴花7g，东风菜根5g，水泽兰8g，柠檬根5g，辟汗草5g，松蒿10g。
实施例3
缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法，包括中药治疗和耳穴贴压治疗；所述中药治疗为口服中药制剂，隔日一剂，早晚分服；所述耳穴贴压治疗的步骤为：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替；嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。所述耳穴贴压治疗的主穴为肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。
所述中药治疗中所用的中药由下述中药原料组成：护心草6g，地笋3g，海松子6g，密蒙花12g，剪刀草6g，茅草叶7g，楮叶15g，牛尾菜12g，枸橘叶5g，丝瓜络5g，素兴花6g，东风菜根8g，水泽兰12g，柠檬根8g，辟汗草4g，松蒿9g。
实施例4
缓解吉非替尼/厄洛替尼引起的皮肤毒性的方法，包括中药治疗和耳穴贴压治疗；所述中药治疗为口服中药制剂，隔日一剂，早晚分服；所述耳穴贴压治疗的步骤为：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替；嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。所述耳穴贴压治疗的主穴为肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。
所述中药治疗中所用的中药由下述中药原料组成：护心草8g，地笋6g，海松子10g，密蒙花13g，剪刀草7g，茅草叶8g，楮叶10g，牛尾菜13g，枸橘叶10g，丝瓜络8g，素兴花3g，东风菜根15g，水泽兰9g，柠檬根10g，辟汗草3g，松蒿8g。
选择我院门诊及住院应用吉非替尼、厄洛替尼的恶性肿瘤患者200例，随机分成四组，观察组1、观察组2、观察组3及对照组各入组非小细胞肺癌(NSCLC)患者50例，给予常规EGFRIs治疗，用药两月以上，进行相关观察指标评价。
纳入标准：
1)临床确诊为Ⅲ-Ⅳ期NSCLC，具有实性病灶可测量；
2)采用表皮生长因子受体抑制剂吉非替尼、厄洛替尼治疗；
3)EFGR突变阳性：或女性、非吸烟、腺癌EPGR突变未知，拒绝化疗的一线治疗；或晚期NSCLC二、三线治疗，符合表皮生长因子受体抑制剂治疗适应证；
4)身体状况评分ECOG1-3级，预计生存期>3月；
5)距末次放化疗时间间隔>4周；
6)未合并心、肝、肾等器官功能障碍，无严重感染；
7)血常规、肝肾功能、血凝、血脂等血液生化检查，心电图等辅助检查基本正常；
治疗方法：
1)对照组：EGFRIs(吉非替尼/厄洛替尼)连续使用至少两个月；
2)观察组1：EGFRIs联合中药、耳穴贴压；
3)观察组2：EGFRIs联合耳穴贴压；
4)观察组3：EGFRIs联合中药；
耳穴贴压主穴：肺、脾、肾上腺、内分泌、神门、交感、肿瘤区。操作方法：用75％酒精棉球擦洗耳廓皮肤，将粘有王不留行珠的小胶布(0.6*0.6cm)对准相应的穴位贴紧，以食指和拇指指腹相对按压，两耳交替。嘱患者每日按压4-6次，每次3-5min，隔日按压，3日更换王不留行珠籽。
中药：护心草5-8g，地笋3-7g，海松子5-10g，密蒙花10-15g，剪刀草3-7g，茅草叶5-8g，楮叶10-15g，牛尾菜10-15g，枸橘叶3-10g，丝瓜络5-15g，素兴花3-7g，东风菜根5-15g，水泽兰8-12g，柠檬根5-10g，辟汗草3-5g，松蒿8-10g，制成水煎剂，隔日一剂，早晚分服，药渣煎水可配合外洗。
疗效判断标准：
治愈：无感染征象，无主观症状，皮疹消失，可正常生活工作；
有效：皮肤毒性分级下降一级及以上，主观症状减轻或消失，皮疹由广泛变为局部分布或明显减少，生活质量改善；
无效：皮肤毒性分级上升一级及以上，出现主观症状或加重，皮疹无变化、皮疹由局部变为全身广泛分布或明显增多，生活质量恶化。
结果比较：治疗结果对比如下表：
组别 治愈 有效 无效 治愈率/％ 总有效率/％
对照组 0 19 31 0 38
观察组1 39 10 1 78 98
观察组2 29 13 8 58 84
观察组3 33 10 7 66 86
由此可见，采用本发明的中药及耳穴贴压治疗方法能有效降低EGFRIs相关皮肤毒性，总有效率高。

Claims (2)

1.缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药，其特征在于，由下述中药原料组成：护心草5-8g，地笋3-7g，海松子5-10g，密蒙花10-15g，剪刀草3-7g，茅草叶5-8g，楮叶10-15g，牛尾菜10-15g，枸橘叶3-10g，丝瓜络5-15g，素兴花3-7g，东风菜根5-15g，水泽兰8-12g，柠檬根5-10g，辟汗草3-5g，松蒿8-10g。
2.如权利要求1所述的缓解吉非替尼/厄洛替尼引起的皮肤毒性的中药，其特征在于，由下述中药原料组成：护心草7g，地笋5g，海松子8g，密蒙花10g，剪刀草5g，茅草叶5g，楮叶12g，牛尾菜15g，枸橘叶8g，丝瓜络10g，素兴花5g，东风菜根10g，水泽兰10g，柠檬根7g，辟汗草5g，松蒿8g。
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