CN108888692A - 一种治疗慢性心力衰竭的中药配方及其制备方法 - Google Patents

一种治疗慢性心力衰竭的中药配方及其制备方法 Download PDF

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CN108888692A
CN108888692A CN201811080112.7A CN201811080112A CN108888692A CN 108888692 A CN108888692 A CN 108888692A CN 201811080112 A CN201811080112 A CN 201811080112A CN 108888692 A CN108888692 A CN 108888692A
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冯骏霞
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Abstract

本发明公开了一种治疗慢性心力衰竭的中药配方，按重量份数是包括以下中药成分：熟附片18g，红参8g，桂枝13g，大腹皮13g，白术11g，茯苓28g，楮实子28g，甘草6g。本发明中药组合物的制备和使用方法：先将除红参之外的药材用清水浸泡1小时，将药放在火上，用大火熬开，沸腾后改用小火煎煮50分钟，将药液倒出，红参另炖，共煎取药汁200ml，每天1剂，早晚温服，14天为1个疗程，服药期间，停用洋地黄制剂和利尿制剂。

Description

一种治疗慢性心力衰竭的中药配方及其制备方法
技术领域
本发明属于中药组合物，具体地说，是涉及一种用于慢性心力衰竭治疗的中药配方及其制备方法。
背景技术
心力衰竭简称心衰，是指由于心脏的收缩功能和(或)舒张功能发生障碍，不能将静脉回心血量充分排出心脏，导致静脉系统血液淤积，动脉系统血液灌注不足，从而引起心脏循环障碍症候群。而慢性心力衰竭(CHF)则是持续存在的心力衰竭状态，可以稳定、恶化或失代偿，是一种自行进展(self-perpetuating)、不断恶化的疾病。慢性心力衰竭(慢性心衰)并不是一个独立的疾病，而是各种心血管疾病发展的终末阶段。欧洲心脏病协会(ESC)《急、慢性心力衰竭诊断和治疗指南》指出，心力衰竭是一种临床综合征，其特征是存在由于心脏结构和/或功能异常，引起静息或负荷时心输出量减少和/或心内压力增高，从而导致的典型症状(如呼吸困难、踝部水肿和疲乏)，也可伴有体征(如颈静脉压升高、肺部啰音和外周水肿)。其作为一种进展性的临床综合征，病情复杂、预后不良，有着极高的病死率。
慢性心力衰竭是由于神经体液激素和心脏重构造成的恶性循环的病理生理过程,最终导致死亡。而心肌重塑是则心脏应对压力负荷、维持心脏正常输出的所做出的适应性反应，其涉及心肌细胞的凋亡和肥大、血管新生及细胞外基质相关改变的多个病理生理过程。在神经内分泌系统的代偿机制启动后，短期内病理性心肌肥厚为代偿性反应,可以维持心输出量,平衡室壁压力,消除初始刺激的影响，同时心肌的成纤维细胞在损伤区域合成分泌大量以胶原为主的细胞外基质，取代损伤的心肌组织，使心功能维持在相对正常范围；然而在系统长期被激活后，心肌肥厚使心功能失代偿，已受损的心肌细胞再次受到了损伤，同时细胞外基质的过度沉积引起了心肌纤维化，心室基本组成成份受损，使得心室顺应性降低，导致心脏的收缩舒张功能遭到严重的破坏，致使心肌细胞凋亡、心肌扩张，最终造成心力衰竭。
祖国医学虽无与慢性心力衰竭相应的病名，但根据慢性心衰的临床表现，可将其归属于肺胀、心悸、水肿等范畴，并与痰饮、血瘀等内生之邪壅积心肺脉络相关，正如张仲景所说“咳逆倚息短气不得卧，其形为肿”。中医在治疗慢性心衰方面，遵循古理，顺其药性，吸取西医之治疗方法。
发明内容
本发明的目的在于：针对上述存在的问题，提供一种治疗慢性心力衰竭的中药组合物及其制备方法，配伍精当，具有补气阴，通道路，温阳利水的功效，且在治疗过程中疗效好、见效快、毒副作用小。
为了实现上述发明目的，本发明制成该药物有效成分的原料组成及其重量配比为：熟附片18g，红参8g，桂枝13g，大腹皮13g，白术11g，茯苓28g，楮实子28g，甘草6g。
本发明中药组合物的制备和使用方法：先将除红参之外的药材用清水浸泡1小时，将药放在火上，用大火熬开，沸腾后改用小火煎煮50分钟，将药液倒出，红参另炖，共煎取药汁200ml，每天1剂，早晚温服，14天为1个疗程，服药期间，停用洋地黄制剂和利尿制剂。
发明用于治疗慢性心力衰竭的中药配方，选择天然药物，针对慢性心力衰竭病因病机，各味药材各具其效，互相协调，红参补心益气，温血通脉；白术益气健脾，利湿行水；附子大辛大热，温肾助阳；桂枝化水温阳，平冲降逆；茯苓健脾利湿，以利水邪；楮实子化湿利水而不伤阴；大腹皮行气化湿；甘草调和诸药。
具体实施方式
实施例1：一种治疗慢性心力衰竭的中药配方，按重量份数包括以下中药成分：熟附片18g，红参8g，桂枝13g，大腹皮13g，白术11g，茯苓28g，楮实子28g，甘草6g。
实施例2：如果患者兼痰阻，在上述组分中加瓜蒌13g，薤白11g，贝母11g，半夏11g。
实施例3：如果患者兼气滞重，在上述组分中加郁金11g，乌药13g，降香13g。
实施例4：如果患者血瘀明显，在上述组分中加三七13g，白及13g，红花11g，益母草13g，丹参8g。
先将除红参之外的药材用清水浸泡1小时，将药放在火上，用大火熬开，沸腾后改用小火煎煮50分钟，将药液倒出，红参另炖，共煎取药汁200ml，每天1剂，早晚温服，14天为1个疗程，服药期间，停用洋地黄制剂和利尿制剂。
以下通过实用例来阐明本发明所述用于慢性心力衰竭护理的中药配方的临床治疗效果。
1、临床资料
慢性心力衰竭病例120例，参照《中药新药临床研究指导原则》制定，阳虚水泛兼血瘀证，主症：心悸，气喘，下肢浮肿，畏寒肢冷；次症：乏力，胸闷，脘腹胀满，尿少，面色晦黯，口唇紫暗，颈部青筋暴露，胁下痞块；相应舌、脉象：舌质紫暗或暗红或有瘀点、瘀斑，苔白滑，脉细促、脉涩或结代。
2、疗效标准
显效：心衰基本控制或心功能提高2级以上者；
有效：心功能提高1级，但不及2级者；
无效：心功能提高不足1级者；
恶化：心功能恶化1级或以上者。
3、治疗结果
治疗效果：该临床观察病例中，显效85例，有效30例，无效5例，总有效率93.83％，中药品不良反应（ADR）评价，未发生不良反应和毒副作用。
典型案例：
患者李某，女69岁，18年前查体发现高血压，血糖高，一直未服用降压药物，间断服用降糖药，收缩压维持在160mmHg，血糖控制不稳定，2006年查体发下“血糖高(16mmol/L)”，在内分泌科住院治疗，诊断为糖尿病，高血压病等，行药物治疗，好转出院，出院后一直服药治疗，患者于10年前出现胸闷，夜间不能平卧等症状，后因旅游后感冒，上述症状加剧，并出现憋闷、心慌、恶心、发热、血弹，以“冠心病、心功能IV级(NYHA分级)、高血压病、糖尿病”入急诊科治疗，待病情缓解后注入心内科治疗，服用本发明配方，每日2次，2周一个疗程，连续服用4个疗程，病情明显好转，进一步服用4个疗程，治愈。

Claims (5)

1.一种治疗慢性心力衰竭的中药配方，其特征在于：该中药配方按重量份数包括以下中药成分：熟附片18g，红参8g，桂枝13g，大腹皮13g，白术11g，茯苓28g，楮实子28g，甘草6g。
2.如权利要求1所述的一种治疗慢性心力衰竭的中药配方，其特征在于：该中药配方还包括瓜蒌13g，薤白11g，贝母11g，半夏11g。
3.如权利要求1所述的一种治疗慢性心力衰竭的中药配方，其特征在于：该中药配方还包括郁金11g，乌药13g，降香13g。
4.如权利要求1所述的一种治疗慢性心力衰竭的中药配方，其特征在于：该中药配方还包括三七13g，白及13g，红花11g，益母草13g，丹参8g。
5.如权利要求1所述的一种治疗慢性心力衰竭的中药配方的制备方法，其特征在于：先将除红参之外的药材用清水浸泡1小时，将药放在火上，用大火熬开，沸腾后改用小火煎煮50分钟，将药液倒出，红参另炖，共煎取药汁200ml，每天1剂，早晚温服，14天为1个疗程，服药期间，停用洋地黄制剂和利尿制剂。
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