CN107998235A - 治疗踝关节扭伤的复方壮药物及其制备方法 - Google Patents
治疗踝关节扭伤的复方壮药物及其制备方法 Download PDFInfo
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Abstract
本发明公开了一种治疗踝关节扭伤的复方壮药物及其制备方法。该药物包括以下重量份的原料:宽筋藤10‑50份、地锦10‑50份、豆豉姜10‑50份、透骨草10‑50份、千年健10‑50份、两面针10‑50份、穿破石10‑50份、大黄10‑50份、艾叶10‑50份。本发明制剂具有祛风除湿凉血、活血消肿止痛等功效,能有效治疗踝关节扭伤,具有标本兼治,价廉,使用方便,对皮肤无刺激性,安全、无毒副作用等优点。本发明制备方法简单,对生产设备无特殊要求、容易操作、耗能低、省时、生产成本低,容易实现工业化生产。
Description
技术领域
本发明属于药品领域,涉及一种药物制剂及其制备方法,特别涉及一种治疗踝关节扭伤的复方壮药物及其制备方法。
背景技术
急性踝关节扭伤,也称为闭合性踝关节软组织急性损伤,是日常生活以及运动当中一种十分常见的损伤,可发生于各个年龄段,其中主要为运动损伤,其发生率约占所有运动损伤的40%,其中外侧副韧带扭伤最为常见(约占90%)。踝关节扭伤是骨科门急诊中在疾病诊治过程中最多见的,大多数患者能提早引起关注,并进行治疗;但也有相当部分患者认为仅仅为软组织损伤并未伤及骨骼,故不予以及时治疗,继续负重下地走动或运动,导致病情由急性逐渐变为慢性,踝关节疼痛反反复复,缠绵难愈,随着疾病的发展,甚至会发生慢性踝关节不稳,更容易发生扭伤,后期出现创伤性关节炎等并发症。若这个时候才开始就医诊治,其疗效远比刚扭伤时就诊治疗疗效差,疗程长。因此,这些年来,随着人们的关注度加大,关于急性踝关节扭伤的诊治慢慢引起了众多医学从事者的关注。
关于急性踝关节扭伤,西医治疗暂无统一标准和规范,其治疗方式可分为手术方式和非手术方式两种。非手术方式为包含功能治疗、固定、给予镇痛消炎药物治疗等方式。手术治疗方式一般针对较为严重的开放性损伤和韧带损伤,给予手术治疗方式稳定性良好,但存在恢复时间长,病人痛苦大、费用高等问题,因此,临床中多采用口服药物+康复训练方式促进患者康复。西医治疗具有见效快、临床症状改善明显等优势,可有效控制伤情,虽取得一定的临床效果,但西药治疗往往存在毒副作用大,易产生耐药性,而且不能从根本上治愈。中医学理论认为踝关节扭伤属于“筋伤”范畴。主要致病机理为外因损伤经脉,致使患处气机阻滞,血瘀伤筋引发肿胀、疼痛等症,其治疗的关键在于活血化瘀,疏通经络,消肿止痛。中医治疗能从根本上改善患者损伤部位的血供,从而达到根治的目的。
发明人致力于壮医理论与临床应用,认为急性踝关节扭伤,在中药外敷在机体受到损伤的情况下,提高血小板活性,加快血小板黏附聚集速度,限制血液渗出进程,同时能使血管张力性增大,加快局部组织血液循环,降低血液粘稠度,以阻止血栓形成。通过体外微量给药而阻止炎性组织的外渗、浸润,控制炎性分子的生成与分泌,最终达到消炎镇痛的效果。发明人发现了一些疗效独特的治疗各类急性踝关节扭伤的壮药复方,这些壮药复方既克服了西药副作用大、容易产生耐药性,治标不治本的缺点,又发扬了中药副作用小、不易产生耐药性,标本兼治的优点,同时还其自身民族特色的特点。广西有着丰富的壮药资源,其中不乏具有祛风除湿凉血、活血消肿止痛功效的健筋骨壮药,以此开发出适用于各种早期骨折、软组织扭挫伤壮药方,具有独特的疗效,市场前景广阔。
(1)宽筋藤,为防己科植物中华青牛胆Tinospora sinensis(Lour.)Merr.的干燥藤茎。收载于《广西中药材标准》(1990年版):【性味】微苦,凉。【功能与主治】舒筋活络,祛风止痛。用于风湿痹痛,腰肌劳损,坐骨神经痛,跌打损伤。
(2)地锦,又名爬山虎,为葡萄科植物的爬山虎(Parthenocissus tricuspidata(Sieb.etZucc.)Planch.)藤茎或根。收载于《中华本草》第5册,第十三卷:【药性】味辛、微涩,性温。【功能与主治】祛风止痛,活血通络。主治风湿痹痛,中风半身不遂,偏正头痛,产后血瘀,腹生结块,跌打损伤,痈肿疮毒,溃疡不敛。《广西本草选编》:祛风止痛,去腐生肌。
(3)豆豉姜,樟草科植物山鸡根Lirsea cubeba(Lour.)Pers.的干燥根和根茎。收载于《广西中药材标准》(第二册):【性味】辛,温。归肾、膀胱经。【功能与主治】祛风除湿,理气止痛。用于感冒,风湿痹痛,胃寒痛,脚气,跌打损伤肿痛。
(4)透骨草,为毛莨科植物黄花铁线莲ClemaSis inSricaSa Bunge的干燥全草。收载于《广西中药材标准(1997年版第二册)》【性味】辛、苦,温。【功能与主治】散风祛湿,解毒止痛。用于筋骨拘挛,风湿关节痛,疮疡,风湿肿毒。
(5)千年健,为天南星科植物千年健Homalomena occulta(Lour.)Schott的干燥根茎。收载于《中国药典》2015年版:【性味与归经】苦、辛,温。归肝、肾经。【功能与主治】祛风湿,壮筋骨。用于风寒湿痹,腰膝冷痛,拘挛麻木,筋骨痿软。
(6)两面针,为芸香科植物两面针Zanthoxylum nitidum(Roxb)DC.的干燥根。收载于《中国药典》2015年版:【性味与归轻】苦、辛,平;有小毒。归肝、胃经。【功能与主治】活血化瘀,行气止痛,祛风通铬,解毒消肿。用于跌扑损伤,胃痛,牙痛,风湿痹痛,毒蛇咬伤;外治烧烫伤。
(7)穿破石,为桑科植物构棘Gudrania cocbinchinensis(Lour.)Kudo et Masam.或拓树Gudrania tricuspta(Garr.)Bur.的干燥根。收载于《中国药典》1977年版:【性味】微苦,凉。【功能与主治】止咳,退黄,活血,通络。用于肺结核,湿热黄疸,胁肋疼痛,跌扑瘀痛,风湿痹痛。
(8)大黄,为寥科植物掌叶大黄Rheum palmatum L.、唐古特大黄Rheumtanguticum Maxim.ex Balf.或药用大黄Rheum officinale Baill.的干燥根和根茎,收载于《中国药典》2015年版:【性味与归经】苦,寒。归脾、胃、大肠、肝、心包经。【功能与主治】泻下攻积,清热泻火,凉血解毒,逐瘀通经,利湿退黄。用于实热积滞便秘,血热吐衄,目赤咽肿,痈肿疔疮,肠痈腹痛,瘀血经闭,产后瘀阻,跌打损伤,湿热痢疾,黄疸尿赤,淋证,水肿;外治烧烫伤。
(9)艾叶,为菊科植物艾Artemisia argyi Levl.et Vant.的干燥叶。收载于《中国药典》2015年版:【性味与归经】辛、苦,温;有小毒。归肝、脾、肾经。【功能与主治】温经止血,散寒止痛;外用祛湿止痒。用于吐血,衄血,崩漏,月经过多,胎漏下血,少腹冷痛,经寒不调,宫冷不孕;外治皮肤瘙痒。
以上背景技术内容的公开仅用于辅助理解本发明的发明构思及技术方案,其并不必然属于本专利申请的现有技术,在没有明确的证据表明上述内容在本专利申请的申请日已经公开的情况下,上述背景技术不应当用于评价本申请的新颖性和创造性。
发明内容
本发明的目的是针对现有技术中西医治疗踝关节扭伤的存在的不足而提供一种具有民族特色的治疗踝关节扭伤的壮药制剂及其制备方法,该壮药制剂具有祛风除湿凉血、活血消肿止痛功效,且疗效显著、价廉、使用方便和毒副作用小,制备工艺简单等特点。
本发明的技术方案如下:
一种治疗踝关节扭伤的复方壮药物,包括以下重量份的原料:宽筋藤10-50份、地锦10-50份、豆豉姜10-50份、透骨草10-50份、千年健10-50份、两面针10-50份、穿破石10-50份、大黄10-50份、艾叶10-50份。
以上所述的治疗踝关节扭伤的复方壮药物,优选包括以下重量份的原料:宽筋藤20-40份、地锦20-40份、豆豉姜20-40份、透骨草20-40份、千年健20-40份、两面针20-40份、穿破石20-40份、大黄20-40份、艾叶20-40份。
以上所述的治疗踝关节扭伤的复方壮药物,最佳优选包括以下重量份的原料:宽筋藤30份、地锦30份、豆豉姜30份、透骨草30份、千年健30份、两面针30份、穿破石30份、大黄30份、艾叶30份。
以上所述的治疗踝关节扭伤的复方壮药物,可制备成药学上可接受的任何外用制剂,最佳优选制备成搽剂。
以上所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤10-50份、地锦10-50份、豆豉姜10-50份、透骨草10-50份、千年健10-50份、两面针10-50份、穿破石10-50份、大黄10-50份、艾叶10-50份;
S3.取步骤S2称量好的药材,加水煎煮,过滤,滤液浓缩,加适量防腐剂,分装,即得。
进一步的,以上所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,步骤S3项下的加水煎煮加为加5-15倍量的水煎煮1-3次,每次1-3小时;滤液浓缩至相对密度在60℃时为1.11-1.14的清膏。
进一步的,以上所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,步骤S3项下所述的防腐剂为尼泊金乙酯与苯甲酸、苯甲酸钠、山梨酸、山梨酸钾中的一种或一种以上组合。
以上所述的治疗踝关节扭伤的复方壮药物的用途,在制备用于治疗踝关节扭伤的药物中的应用。
与现有技术相比,本发明具有以下有益效果:
1.本发明治疗踝关节扭伤的复方壮药物,通过现代科学理论配制而成。方中宽筋藤舒筋活络,祛风止痛;地锦祛风止痛,活血通络;豆豉姜祛风除湿,理气止痛;透骨草散风祛湿,解毒止痛;千年健祛风湿,壮筋骨;两面针活血化瘀,行气止痛,祛风通铬,解毒消肿;穿破石活血,通络;大黄凉血解毒,逐瘀通经;艾叶温经止血,散寒止痛。诸药合用共奏祛风除湿凉血、活血消肿止痛之功,能有效治疗踝关节扭伤,治疗总有效率达95%。
2.本发明所用各药味通过科学合理配方,组方严谨,药少力专,具有疗效显著,价廉,使用方便,对皮肤无刺激性,安全、无毒副作用等优点,既克服了西药副作用大、容易产生耐药性,治标不治本的缺点,又发扬了中药副作用小、不易产生耐药性的优点,同时还具有壮族民族特色,达到标本兼治的目的。
3.本发明制备方法简单,对生产设备无特殊要求、容易操作、耗能低、省时、生产成本低,容易实现工业化生产。
具体实施方式
下面结合具体实施例对本发明作进一步描述,但不限制本发明的保护范围和应用范围:一、治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法
实施例1
治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤100g、地锦100g、豆豉姜100g、透骨草100g、千年健100g、两面针100g、穿破石100g、大黄100g、艾叶100g;
S3.取步骤S2称量好的药材,加水15倍量水煎煮3小时,过滤,滤液浓缩至相对密度在60℃时为1.11的清膏,0.06%苯甲酸和0.06%尼泊金乙酯,混匀,分装,即得。
实施例2
治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤500g、地锦500g、豆豉姜500g、透骨草500g、千年健500g、两面针500g、穿破石500g、大黄500g、艾叶500g;
S3.取步骤S2称量好的药材,加水煎煮3次,第一次加15倍量水煎煮2小时,第一次加10倍量水煎煮1小时,第一次加5倍量水煎煮1小时,过滤,合并滤液,浓缩至相对密度在60℃时为1.14的清膏,加入0.08%苯甲酸钠和0.06%尼泊金乙酯,混匀,分装,即得。
实施例3
治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤200g、地锦200g、豆豉姜200g、透骨草200g、千年健200g、两面针200g、穿破石200g、大黄200g、艾叶200g;
S3.取步骤S2称量好的药材,加水煎煮2次,第一次加12倍量水煎煮2小时,第二次加8倍量水煎煮1小时,过滤,合并滤液,滤液浓缩至相对密度在60℃时为1.12的清膏,加入0.04%山梨酸和0.05%尼泊金乙酯,分装,即得。
实施例4
治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤400份、地锦400份、豆豉姜400份、透骨草400份、千年健400份、两面针400份、穿破石400份、大黄400份、艾叶400份;
S3.取步骤S2称量好的药材,加水煎煮2次,第一次加13倍量水煎煮2.5小时,第二次加9倍量水煎煮1.5小时,过滤,合并滤液,滤液浓缩至相对密度在60℃时为1.13的清膏,加入0.05%山梨酸钾和0.05%尼泊金乙酯,分装,即得。
实施例5
治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤300g、地锦300g、豆豉姜300g、透骨草300g、千年健300g、两面针300g、穿破石300g、大黄300g、艾叶300g;
S3.取步骤S2称量好的药材,加水煎煮2次,每次加10倍量水煎煮2小时,过滤,合并滤液,滤液浓缩至相对密度在60℃时为1.13的清膏,加入0.03%山梨酸、0.05%苯甲酸和0.05%尼泊金乙酯,分装,即得。
二、临床试验
1.病历资料
1.1选取单侧踝关节扭伤患者80例,其中男41例,女39例,平均年龄43.25±10.35岁,受伤至就诊时间≤48h,平均23±9.38h。
1.2诊断标准
参照国家中医药管理局1994年发布的《中医病证诊断疗效标准》、《中医筋伤学》中关于踝关节扭伤的诊断标准制定:
(1)有明确的踝部外伤史,损伤时间不超过一周;
(2)损伤后踝关节即出现疼痛,局部肿胀,皮下瘀斑,跛行步或不能着地步行;
(3)损伤局部压痛明显;
(4)x线片检查未见骨折。
1.3病例纳入标准
(1)符合踝关节扭伤诊断标准;
(2)无韧带完全断裂;
(3)损伤后未经过任何治疗;
(4)签署知情同意书者。
1.4病例排除标准(参照2002年卫生部《中药新药临床研究指导原则》中中药新药治疗急性软组织损伤的临床研究指导原则):
(1)踝关节韧带损伤时间超过7天者;
(2)局部有皮肤破损或皮肤病者;
(3)妊娠及哺乳期妇女;
(4)合并心脑血管、肝、肾及造血系统等严重原发性疾病,精神病患者。
1.5退出试验病例标准
(1)发生严重不良事件或过敏反应,不宜继续接受试验者;
(2)病情恶化,根据医师判断应停止临床试验者;
(3)试验过程中自行停药或中断治疗、随访者;
(4)未按规定用药,无法判断疗效,或资料不全等影响疗效或安全性判断者;
(5)因其他各种原因疗程未结束退出试验、失访的病例。以上均作无效病例处理。
2.方法
2.1治疗方法
将上述80例患者随机分成2组,每组40人:
(1)实施例组:给予本发明实施例5样品,外用涂擦于患处,一日3次,7天为一疗程;
(2)对照组:给予市售双氯芬酸钠搽剂,外用涂擦于患处,一日3次,7天为一疗程;
以上两组患者治疗期间饮食宜清淡,忌辛辣刺激食物;禁服一切可能干扰研究结果的药物。
2.2观察指标及评分标准
参考卫生部2002年制定的《中药新药临床研究指导原则》中的临床症状及体征分级计分标准,其中疼痛采用采用模糊视觉疼痛量表(VAS本量表):从无痛至最痛分0到10级,治疗前后由病人依其疼痛程度自行划分;肿胀、压痛、活动功能障碍均采取ASI评估(见表1)。用药前以及用药后的第3天、第7天为观察日,治疗前后各记录一次,同时注意记录不良反应。
表1 肿胀、压痛、活动功能障碍分级计分标准
2.3疗效判定标准
《参照中药新药临床研究指导原则》,痊愈:疼痛、肿胀均消失,活动功能正常;显效:疼痛、肿胀和关节功能同时下降6个分值以下;有效:疼痛、肿胀和活动功能同时下降3~5个分值;无效:疼痛、肿胀和活动功能无改善或改善不明显,下降3个分值以下。
2.4数据处理
采用SPSS 24.0软件包进行统计学分析。计量资料采用t检验,计数资料采用卡方检验,等级资料采用Ridit检验。P大于0.05为无显著性差异,P小于0.05为差异有显著性,P小于0.01差异极显著。
3结果
3.1观察指标的比较
治疗后第7天两组患者的临床各观察指标症状均可见有效改善(与治疗前对比,P<0.05或P<0.01),实施例组患者治疗后各观察指标症状评估结果优于对照组(与对照组对比P<0.01),均可见统计学差异,见表2、表3。
表2 治疗前后不同时间VAS比较
注:与治疗前对比,☆P<0.05,☆☆P<0.01;与对照组对比,★P<0.05,★★P<0.01
表3 治疗前后不同时间肿胀、压痛、活动功能障碍程度比较
注:与治疗前对比,☆P<0.05,☆☆P<0.01;与对照组对比,★P<0.05,★★P<0.01
3.2临床疗效
实施例组的临床疗效优于对照组,两组总有效率比较差异有统计学意义(P<0.05),见表4。
表4 临床疗效的比较
注:与对照组比较,★P<0.05
3.3不良反应与副作用
在试验过程中,实施例组无患者出现不良反应,而对照组有5例患者出现局部皮肤发红、水肿、瘙痒等不良反应。
以上临床试验结果表明,本发明治疗踝关节扭伤的复方壮药物能有效改善急性踝关节扭伤后各项临床症状,且效果明显优于对照组,治疗总有效率达95%,而且使用安全,无毒副作用。以下为几个典型案例。
王某某,女,35岁,南宁市人,患者因下楼不慎扭伤左脚,有“裂帛”样撕裂感,疼痛明显,患足不能负重行走,临床诊断为急性踝关节扭伤,给予本发明实施例5样品治疗1个疗程后,患处疼痛、局部肿胀、皮下瘀斑均消失,痊愈,一年不复发。
张某某,男,24岁,百色市人,患者因打篮球,扭伤右踝,疼痛明显,压痛,临床诊断为急性踝关节扭伤,给予本发明实施例5样品治疗1个疗程后,疼痛消失,痊愈,一年不复发。
廖某,男,38岁,桂林市人,患者因跑步不慎踩至石仔至右踝扭伤,临床诊断为急性踝关节扭伤,给予本发明实施例5样品治疗1个疗程后,症状消失,痊愈,一年不复发。
以上内容不能认定本发明的具体实施只局限于这些说明,对于本发明所属技术领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干简单推演或替换,都应当视为属于本发明由所提交的权利要求书确定的专利保护范围。
Claims (10)
1.一种治疗踝关节扭伤的复方壮药物,其特征在于,包括以下重量份的原料:宽筋藤10-50份、地锦10-50份、豆豉姜10-50份、透骨草10-50份、千年健10-50份、两面针10-50份、穿破石10-50份、大黄10-50份、艾叶10-50份。
2.根据权利要求1所述的治疗踝关节扭伤的复方壮药物,其特征在于,包括以下重量份的原料:宽筋藤20-40份、地锦20-40份、豆豉姜20-40份、透骨草20-40份、千年健20-40份、两面针20-40份、穿破石20-40份、大黄20-40份、艾叶20-40份。
3.根据权利要求1所述的治疗踝关节扭伤的复方壮药物,其特征在于,包括以下重量份的原料:宽筋藤30份、地锦30份、豆豉姜30份、透骨草30份、千年健30份、两面针30份、穿破石30份、大黄30份、艾叶30份。
4.根据权利要求1-3中任一项所述的治疗踝关节扭伤的复方壮药物,其特征在于,所述药物制备成药学上可接受的任何外用制剂。
5.根据权利要求1-3中任一项所述的治疗踝关节扭伤的复方壮药物,其特征在于,所述药物制备成搽剂。
6.一种如权利要求4所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,其特征在于,包括以下步骤:
S1.分别取宽筋藤、地锦、豆豉姜、透骨草、千年健、两面针、穿破石、大黄、艾叶,净选,干燥;
S2.按以下重量份称取原料:宽筋藤10-50份、地锦10-50份、豆豉姜10-50份、透骨草10-50份、千年健10-50份、两面针10-50份、穿破石10-50份、大黄10-50份、艾叶10-50份;
S3.取步骤S2称量好的药材,加水煎煮,过滤,滤液浓缩,加适量防腐剂,分装,即得。
7.根据如权利要求6所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,其特征在于,步骤S3项下的加水煎煮加为加5-15倍量的水煎煮1-3次,每次1-3小时。
8.根据如权利要求6所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,其特征在于,步骤S3项下滤液浓缩至相对密度在60℃时为1.11-1.14的清膏。
9.根据如权利要求6所述的治疗踝关节扭伤的复方壮药物制备成搽剂的制备方法,其特征在于,步骤S3项下所述的防腐剂为尼泊金乙酯与苯甲酸、苯甲酸钠、山梨酸、山梨酸钾中的一种或一种以上组合。
10.如权利要求1所述的治疗踝关节扭伤的复方壮药物的用途,其特征在于,在制备用于治疗踝关节扭伤的药物中的应用。
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