CN108619473A - 一种治疗糖尿病周围神经病变的中药熏洗剂 - Google Patents
一种治疗糖尿病周围神经病变的中药熏洗剂 Download PDFInfo
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Abstract
本发明涉及一种治疗糖尿病周围神经病变的中药熏洗剂,属于中药技术领域,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香28‑32份、制没药25‑35份、当归15‑22份、川芎18‑23份、鸡血藤27‑35份、伸筋草28‑32份、透骨草28‑32份、桂枝10‑18份、黑附子8‑12份、干姜18‑22份、制川乌12‑18份和细辛8‑12份。该中药熏洗剂对于治疗糖尿病周围神经病变具有补气活血、通络止血的功效,既可活血通络治其标,又可益气养阴治其本,且治疗效果明显,无明显副作用,价格低廉,使用方便。
Description
技术领域
本发明属于中药技术领域,具体地,涉及一种治疗糖尿病周围神经病变的中药熏洗剂。
背景技术
糖尿病周围神经病变(diabetie peripheral neuropathy,DPN)是指在排除其他原因的情况下,糖尿病患者出现与周围神经功能障碍相关的症状和(或)体征,是糖尿病常见的慢性并发症之一,也是糖尿病患者主要的致残因素,它是一种以阶段性脱髓鞘为主的多发性神经病变,病发率高。糖尿病周围神经病变属中医“消渴病痹证”。在脾运失健、气阴两伤基础上出现久病入络、络脉瘀阻的病变表现,正如叶天士所云:“病久气血推行不力,血络之中,必有瘀凝,故治病气缠绵不去。”又云:“久发、频发之恙,必伤及络。”瘀滞之邪,久存脉络,络中气血阻滞不通,心卒然而痛,脉络中气血阴阳不足,营卫不调,不能滋濡温养气络,络虚不荣,“不荣则痛”。“其不痛不仁者,痛久入深”,后期阴损及阳可致阴阳两虚,更加重淤血阻络,进而形成恶性循环。糖尿病周围神经病变以手足麻木、疼痛、感觉障碍、甚至运动障碍为主要特点,其重要病机为气虚血滞,因虚致瘀,瘀阻脉络,气虚为本,血瘀为标,本虚标实。此病起病缓慢,隐匿性强,使得治疗难度加大,给生活和家庭带来沉重的负担。目前现有技术中存在采用西药针对发病机制中的某一环节进行针对性治疗,鉴于治疗疗程较长,不仅价格昂贵,且副作用明显,虽然能起到一定的治疗作用,但在改善患者全身症方面疗效并不理想。中药作为一门伟大的学科,其在糖尿病周围神经病变方面有着巨大的潜力,目前也存在一些治疗糖尿病周围神经病变的中药制剂,采取补气活血、通络止血为治原则,疗效较好,不良反应少,因此,继续开发具有显著疗效的新药物,越来越受到中医学界的关注,也具有十分重大的社会意义。
发明内容
针对上述问题,本发明的目的在于提供一种治疗糖尿病周围神经病变的中药熏洗剂。该中药熏洗剂对于治疗糖尿病周围神经病变具有补气活血、通络止血的功效,既可活血通络治其标,又可益气养阴治其本,且治疗效果明显,无明显副作用,价格低廉,使用方便。
一种治疗糖尿病周围神经病变的中药熏洗剂,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香28-32份、制没药25-35份、当归15-22份、川芎18-23份、鸡血藤27-35份、伸筋草28-32份、透骨草28-32份、桂枝10-18份、黑附子8-12份、干姜18-22份、制川乌12-18份和细辛8-12份。
作为对上述方案的进一步优化,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香30份、制没药30份、当归20份、川芎20份、鸡血藤30份、伸筋草30份、透骨草30份、桂枝15份、黑附子10份、干姜20份、制川乌15份和细辛10份。
作为对上述方案的更进一步优化,所述中药熏洗剂是分别称取净选后的各种原料药混合,粉碎过筛,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为200-300W,时间为3-4min,得药物粉末;然后将药物粉末分装入药袋制得。
作为对上述方案的更进一步优化,所述中药熏洗剂使用时,首先取药剂,向药剂中加200-250倍药剂质量的水浸泡30-40min,武火加热至沸腾,文火继续煎煮30-40min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入100-150倍滤渣Ⅰ质量的水,中火加热20-30min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
一、本发明各种原料药的药理作用如下:
1、乳香:辛、苦、温,归肝、心、脾经。功效:活血行气,消肿生肌。乳香主要含有五环三萜、四环三萜和大环而萜等化合物,具有良好的抗炎、抗氧化、抗肿瘤、镇痛的作用。
2、没药:苦、辛、平,归心、肝、脾经。功效:活血行气,消肿生肌。现代研究表明,没药中含有树脂、树胶、挥发油和苦味素等成分,具有镇痛、抗炎、降血脂、抗肿瘤、粘膜保护等多种作用。
3、当归:甘、辛、温,归肝、心、脾经。功效:补血,活血,调经,止痛,润肠。当归中含有挥发油,油中主要成分为藁本内酯、正厅烯酜内酯、当归酮、香荆芥酚等。另外含水溶性成分阿魏酸、厅二酸等。尚含有当归多糖、多种氨基酸、维生素A、B12、E,及多种人体必需元素等。具有抑制平滑肌收缩、抗血小板聚集、促进血红蛋白及红细胞的生成、抗心肌缺血和扩血管作用,改善外周循环、镇静、镇痛、抗炎、抗氧化及体外抗菌等作用。
4、川芎:辛、温,归肝、胆、心包经。功效:活血行气,祛风止痛。川芎含有挥发油、生物碱、酚性物质、有机酸、苯酚内酯等物质,具有镇静、镇痛、扩张冠状动脉、降低血粘度、抗血小板聚集等作用。
5、鸡血藤:苦、甘、温,归肝经。功效:行血补血,调经,舒筋活络。鸡血藤含有黄酮类、萜类、淄醇类、蒽醌类、内酯类、苷类及其它类型化合物,具有促进造血功能、抗肿瘤、抗病毒、免疫调节、对了酪氨酸酶双向调节、抗炎、抗氧化、镇静催眠等作用。
6、伸筋草:苦、辛、温,归肝经。功效:祛风湿,舒筋活络。伸筋草含有三萜类、生物碱类、挥发油及蒽醌类等多种化学成分,具有抗炎、镇痛、抑制胆碱酯酶、抗菌等多种药理作用。
7、透骨草:甘、辛,温。归肺、肝经。功效:祛风湿,活血通络。透骨草含有黄酮、萘醌、甾醇、多肽、香豆素等多种化学成分,具有抗炎、抗过敏、抗真菌等作用。
8、 桂枝:辛、甘、温,归心、肺、膀胱经。功效:发汗解肌,温通经脉,助阳化气。桂枝含有桂皮醛、有机酸、多糖类、香豆素及鞣质类等多种化学成分,具有缓和胃肠刺激、强心、改善微循环、抗炎、抗血小板聚集等作用。
9、附子:辛、甘、热,有毒,归心、肾、脾经。功效:回阳救逆,助阳补火,散寒止痛。附子含有生物碱、附子脂酸、附子磷脂酸钙、β-谷甾醇、脂肪酸酯及附子苷、尿嘧啶等多种成分,具有正性肌力、抗心律失常、舒张血管、镇痛、抗衰老、抗肿瘤、免疫调节、毒性等多种作用。
10、干姜:辛、热,归脾、胃、心、肺经。功效:温中散寒,回阳通脉,温肺化饮。干姜含有挥发油、姜辣素、二苯基庚烷等多种化学成分,具有抗炎杀菌、镇痛、抗氧化、抗血小板聚集、抗肿瘤等多种作用。
11、川乌:辛、苦、温,有大毒,归心、脾、肝、肾经。功效:祛风除湿,散寒止痛。乌头含有二萜生物碱及黄酮、香豆素、酚性类化合物、酰胺、尿嘧啶等多种成分。具有抗炎、镇痛、免疫调节、扩张血管、强心、抗肿瘤等多种作用。
12、细辛:辛、温,有小毒,归肺、肾、心经。功效:祛风散寒,通窍,止痛,温肺化饮。细辛含有甲基丁香油酚、α-蒎烯、β-蒎烯、细辛醚、月桂烯等多种化学成分,具有抗菌抗炎、抗病毒、镇咳、抗癌、降血脂等作用。
有益效果:
1、 采用本发明所述中药复方熏洗剂治疗,能起到温煦、通经、活血、通络、止痛的作用。方义:当归、川芎共为君药,当归甘、辛、温,补血,活血,止痛。《景岳全书·本草正》:“当归,其味甘而重,故专能补血;其气轻而辛,故又能行血。补中有动,行中有补,诚血中之气药,亦血中之圣药也。”川芎辛、温,活血行气,祛风止痛。本草汇言》:“芎穹,上行头目,下调经水,中开郁结,血中气药……味辛性阳,气善走而无阴凝粘滞之态,虽入血分,又能去一切风,调一切气。”二药合用,共奏补血活血,祛风止痛之功。制乳香、制没药、鸡血藤、干姜、黑附子共为臣药。 乳香辛、苦、温,活血行气,消肿生肌。 没药苦、辛、平,活血行气,消肿生肌。乳香偏于行气,伸筋;没药偏于散血化瘀。《医学衷中参西录》:“乳香、没药,二药并用,为宣通脏腑,流通经络之要药,故凡心胃腹肢体关节诸疼痛皆能治之。又善治女子行经腹痛,产后淤血作痛,月事不能时下。其通气活血之力,又善治风寒湿痹,周身麻木,四肢不遂及一切疮疡肿疼,或其疮硬不疼。。。虽为开通之品,不至耗伤气血,诚良药也。” 鸡血藤苦、甘、温,行血补血,调经,舒筋活络。《本才纲目拾遗》:“其藤最活血,暖腰膝已风痰。”藤胶“壮筋骨,已酸痛……治老人气血虚弱,手足麻木瘫痪等症……妇人经血不调……”附子辛、甘、热,有毒,回阳救逆,助阳补火,散寒止痛。《本经》:“主风寒咳逆邪气,温中,金疮,破癥坚积聚血瘕,寒湿痿躄,拘挛膝痛,不能行走。”干姜辛、热,温中散寒,回阳通脉,温肺化饮。《本草纲目》:“元素曰,干姜……其用有四:通心助阳,一也;去脏腑沉寒痼冷,二也;发诸经寒气,三也;治感寒腹痛,四也。”《本草求真》:“干姜大热无毒,守而不走,凡胃中虚冷,元阳欲绝,合附子同投,则能回阳立效,故书有附子无姜不热之句。”五药合用,相得益彰,共奏补血活血,温经止痛之功。方中以伸筋草、透骨草、桂枝、制川乌、细辛为佐使,五药合用即可祛风除痹、通络止痛。
2、 本发明所述中药熏洗剂治疗糖尿病周围神经病变有明显优势,具有从整体调节、副反应少、临床治疗稳定和可以长期服用的特点,其在中医理论的指导下,辨证论治,理法兼备,配伍科学,药效显著,安全性好,无明显不良反应及毒副作用,使用方便,经济成本低,有利于临床推广应用。
3、 本发明所述中药熏洗剂的制备较为简单,将经净选后的原料药混合后粉碎后过筛,为保证充分发挥药效并尽可能减少有效成分损失,进行了微波处理,在此基础上,熏洗时,加水经过两次不同的煎煮处理,使得熏洗效果达到最佳。
具体实施方式
下面通过具体的实施例地本发明做进一步的解释说明。
实施例1
一种治疗糖尿病周围神经病变的中药熏洗剂,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香30份、制没药30份、当归20份、川芎20份、鸡血藤30份、伸筋草30份、透骨草30份、桂枝15份、黑附子10份、干姜20份、制川乌15份和细辛10份。
按上述比例称取净选后的各种原料药混合,粉碎机粉碎,过筛100目,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为300W,时间为3min,得药物粉末;然后将药物粉末分装入药袋,每袋20g。使用时,将药袋放入锅中,加水4000ml,浸泡30min,武火加热至沸腾,文火继续煎煮40min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入1000ml的水,中火加热20min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
采用微波处理,加热较为均匀,并且加温速度快,热效率高,药材中的水分因吸收较多能量而迅速汽化,而固体药材因吸收微波的能力较小,温度不会升温过高,有效成分不置于受破坏,有利于保证中药制剂的药效;同时该处理对中药制剂起到杀菌作用。
实施例2
一种治疗糖尿病周围神经病变的中药熏洗剂,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香32份、制没药25份、当归22份、川芎18份、鸡血藤35份、伸筋草28份、透骨草28份、桂枝10份、黑附子8份、干姜18份、制川乌14份和细辛10份。
按上述比例称取净选后的各种原料药混合,粉碎机粉碎,过筛100目,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为260W,时间为4min,得药物粉末;然后将药物粉末分装入药袋,每袋20g。使用时,将药袋放入锅中,加水5000ml,浸泡35min,武火加热至沸腾,文火继续煎煮38min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入1200ml的水,中火加热25min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
实施例3
一种治疗糖尿病周围神经病变的中药熏洗剂,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香32份、制没药28份、当归15份、川芎23份、鸡血藤27份、伸筋草30份、透骨草32份、桂枝14份、黑附子10份、干姜22份、制川乌18份和细辛8份。
按上述比例称取净选后的各种原料药混合,粉碎机粉碎,过筛100目,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为240W,时间为4min,得药物粉末;然后将药物粉末分装入药袋,每袋20g。使用时,将药袋放入锅中,加水4500ml,浸泡38min,武火加热至沸腾,文火继续煎煮34min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入1400ml的水,中火加热28min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
实施例4
一种治疗糖尿病周围神经病变的中药熏洗剂,所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香29份、制没药35份、当归18份、川芎22份、鸡血藤33份、伸筋草32份、透骨草30份、桂枝18份、黑附子12份、干姜20份、制川乌12份和细辛12份。
按上述比例称取净选后的各种原料药混合,粉碎机粉碎,过筛100目,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为200W,时间为3min,得药物粉末;然后将药物粉末分装入药袋,每袋20g。使用时,将药袋放入锅中,加水4000ml,浸泡40min,武火加热至沸腾,文火继续煎煮30min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入1500ml的水,中火加热30min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
临床资料:
1、疗效评价标准:
a、有效:熏洗3次,麻木症状减轻,熏洗10次,麻木症状好转。
b、显效:熏洗5次,麻木症状减轻,熏洗20次,麻木症状好转。
c、无效:熏洗15次,麻木无改善减。
2、治疗效果:本发明所治疗的150例患者,其中有效100,显效46例,无效4例,治疗有效率达97.3%。结果表明,本发明中药配方组方合理,对治疗糖尿病血管神经病变疗效显著。
3、 典型病例
一:李某某,男,79岁,汝州市蟒川乡人,患糖尿病15年,双下肢麻木,伴有双下肢乏力、发凉,查体:双下肢皮肤菲薄、毳毛脱落,双侧足背动脉搏动减弱,双下肢踝反射正常,针刺痛觉、振动觉、压力觉、温度觉均略减低。查四肢肌电图提示:重度神经病变,诊断为糖尿病周围神经病变。用胰岛素及口服降糖药控制血糖达标,配合上述中药治疗糖尿病神经病变。
将含有原料药的药袋入热水中浸泡,在水温下降至37℃左右时开始泡脚,每次泡30分钟左右,连续治疗5次,症状减轻,泡20次症状基本缓解。
二:宋某某,男,70岁,汝州市小屯镇朝川街人,患糖尿病20年合并神经病变2年,双下肢麻木、刺痛、发凉。用胰岛素及口服降糖药控制血糖达标,配合局部治疗糖尿病足病。
上述中药熏洗剂使用时,入热水中浸泡,在水温下降至37℃左右时开始泡脚,每次泡30分钟左右,连续治疗20次,症状减轻,泡40次症状基本缓解。
需要说明的是,以上所述实施例仅为本发明的较佳实施方式,并不用以限制本发明,凡在本发明的精神和原则之内,所作的任何修改、等同替换、改进等,均应包含在本发明的保护范围之内。
Claims (4)
1.一种治疗糖尿病周围神经病变的中药熏洗剂,其特征在于:所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香28-32份、制没药25-35份、当归15-22份、川芎18-23份、鸡血藤27-35份、伸筋草28-32份、透骨草28-32份、桂枝10-18份、黑附子8-12份、干姜18-22份、制川乌12-18份和细辛8-12份。
2.如权利要求1所述的一种治疗糖尿病周围神经病变的中药熏洗剂,其特征在于:所述中药熏洗剂的原料药由以下重量份数的组分组成:制乳香30份、制没药30份、当归20份、川芎20份、鸡血藤30份、伸筋草30份、透骨草30份、桂枝15份、黑附子10份、干姜20份、制川乌15份和细辛10份。
3.如权利要求1或2所述的一种治疗糖尿病周围神经病变的中药熏洗剂,其特征在于:所述中药熏洗剂是分别称取净选后的各种原料药混合,粉碎过筛,得粉碎后物料;将粉碎后物料进行微波干燥,微波频率为200-300W,时间为3-4min,得药物粉末;然后将药物粉末分装入药袋制得。
4.如权利要求3所述的一种治疗糖尿病周围神经病变的中药熏洗剂,其特征在于:所述中药熏洗剂使用时,首先取药剂,向药剂中加200-250倍药剂质量的水浸泡30-40min,武火加热至沸腾,文火继续煎煮30-40min后过滤,得滤液Ⅰ和滤渣Ⅰ;向滤渣Ⅰ中再加入100-150倍滤渣Ⅰ质量的水,中火加热20-30min,过滤得滤液Ⅱ和滤渣Ⅱ,弃滤渣Ⅱ;合并滤液Ⅰ和滤液Ⅱ,混合均匀,备用熏洗,熏洗过程中水温控制在38-40℃。
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| CN112691143A (zh) * | 2021-02-07 | 2021-04-23 | 新乡医学院第一附属医院 | 一种用于防治化疗导致周围神经损伤的外用中药熏洗剂及其制备方法 |
| CN116898941A (zh) * | 2023-07-21 | 2023-10-20 | 首都医科大学附属北京中医医院 | 一种中药组合物及其应用、中药制剂及其制备方法和应用 |
| CN116898941B (zh) * | 2023-07-21 | 2024-04-30 | 首都医科大学附属北京中医医院 | 一种中药组合物及其应用、中药制剂及其制备方法和应用 |
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