CN109224000A - 一种延缓糖尿病肾病的灌肠中药液 - Google Patents

一种延缓糖尿病肾病的灌肠中药液 Download PDF

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CN109224000A
CN109224000A CN201811402584.XA CN201811402584A CN109224000A CN 109224000 A CN109224000 A CN 109224000A CN 201811402584 A CN201811402584 A CN 201811402584A CN 109224000 A CN109224000 A CN 109224000A
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diabetic nephropathy
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李晓冰
谢亚丹
任玉梅
刘林昌
刘胜利
王晓
李智勇
王帆
王一帆
吴效通
孟志勇
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Henan University of Traditional Chinese Medicine HUTCM
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Abstract

本发明涉及一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄5‑40份、赤芍10‑25份、川芎3‑20份、倒扣草5‑25份、蒲公英6‑30份、紫花地丁10‑30份、茯苓6‑20份、泽泻5‑12份、玉米须10‑50份、猫须草20‑60份、绵萆薢6‑20份、莱菔子3‑20份、陈皮3‑15份和甘草3‑9份；本发明原料丰富，制备方法简单，组分配伍科学合理，具有活血祛瘀，燥湿化痰，降浊解毒的功效，疗效稳定，患者依从性好，副作用小，成本低，是防治糖尿病肾病的药物上的创新，经济和社会效益显著。

Description

一种延缓糖尿病肾病的灌肠中药液
技术领域
本发明涉及中药，特别是一种延缓糖尿病肾病的灌肠中药液。
背景技术
糖尿病肾病(diabetic nephropathy，DN)是糖尿病最主要的微血管并发症，是糖尿病患者死亡的主要原因，也是导致慢性肾功能衰竭的主要原因之一，严重影响着人们的生活，近年来， DN 的发病率呈上升趋势，虽然西医在 DN 治疗方面方法很多，但疗效不明显，尤其在蛋白尿的抑制方面，目前应用较多的ACEI及ARB类药物，存在价格昂贵，患者依从性差、有副作用的问题，其使用效果并不尽人意，因此，治疗糖尿病肾病的药物上的改进和创新是目前亟需解决的技术问题。
发明内容
针对上述情况，为克服现有技术之缺陷，本发明之目的是提供一种延缓糖尿病肾病的灌肠中药液，可有效解决糖尿病肾病治疗上的用药价格昂贵、依从性差，效果差，有副作用问题。
本发明解决的技术方案是，一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄5-40份、赤芍10-25份、川芎3-20份、倒扣草5-25份、蒲公英6-30份、紫花地丁10-30份、茯苓6-20份、泽泻5-12份、玉米须10-50份、猫须草20-60份、绵萆薢6-20份、莱菔子3-20份、陈皮3-15份和甘草3-9份；将上述原料药物混合在一起，加水浸没，武火主沸，改为文火煎煮30-45min，过滤，得第一滤液，滤渣加水浸没，武火煮沸，改为文火煎煮30-45min，过滤，得第二滤液，合并两次滤液，混匀，即成。
本发明原料丰富，制备方法简单，组分配伍科学合理，具有活血祛瘀，燥湿化痰，降浊解毒的功效，疗效稳定，患者依从性好，副作用小，成本低，是防治糖尿病肾病的药物上的创新，经济和社会效益显著。
具体实施方式
以下结合实施例和具体情况对本发明的具体实施方式做详细说明。
本发明可由以下实施例给出。
实施例1：本发明一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄15-30份、赤芍15-20份、川芎10-13份、倒扣草10-20份、蒲公英10-25份、紫花地丁15-25份、茯苓10-15份、泽泻8-10份、玉米须20-40份、猫须草35-45份、绵萆薢10-15份、莱菔子8-15份、陈皮8-10份和甘草4-7份；将上述原料药物混合在一起，加水浸没，武火主沸，改为文火煎煮30-45min，过滤，得第一滤液，滤渣加水浸没，武火煮沸，改为文火煎煮30-45min，过滤，得第二滤液，合并两次滤液，混匀，即成。
实施例2：本发明一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄5份、赤芍10份、川芎3份、倒扣草5份、蒲公英6份、紫花地丁10份、茯苓6份、泽泻5份、玉米须10份、猫须草20份、绵萆薢6份、莱菔子3份、陈皮3份和甘草3份。
实施例3：本发明一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄40份、赤芍25份、川芎20份、倒扣草25份、蒲公英30份、紫花地丁30份、茯苓20份、泽泻12份、玉米须50份、猫须草60份、绵萆薢20份、莱菔子20份、陈皮15份和甘草9份。
实施例4：本发明一种延缓糖尿病肾病的灌肠中药液，由以下重量份数计的原料药物制成：大黄22份、赤芍17份、川芎11份、倒扣草15份、蒲公英18份、紫花地丁20份、茯苓13份、泽泻8份、玉米须30份、猫须草40份、绵萆薢13份、莱菔子11份、陈皮9份和甘草6份。
在上所述药物，其中：
大黄:性味苦，寒。归经归脾、胃、大肠、肝、心包经。功能主治泻热通肠，凉血解毒，逐瘀通经。用于实热便秘，积滞腹痛，泻痢不爽，湿热黄疸，血热吐衄，目赤，咽肿，肠痈腹痛，痈肿疔疮，瘀血经闭，跌打损伤，外治水火烫伤；上消化道出血。
赤芍 :性味苦，微寒。归经归肝经。功能主治清热凉血，散瘀止痛。用于温毒发斑，吐血衄血，目赤肿痛，肝郁胁痛，经闭痛经，症瘕腹痛，跌扑损伤，痈肿疮疡。
川芎:性味辛，温。归经归肝、胆、心包经。功能主治活血行气，祛风止痛。用于月经不调，经闭痛经，症瘕腹痛，胸胁刺痛，跌扑肿痛，头痛，风湿痹痛。
倒扣草:性味苦；酸；性微寒。归经肝；肺；膀胱经。功能主治活血化瘀；利尿通淋；清热解表。主经闭；痛经；月经不调；跌打损伤；风湿关节痛；淋病；水肿；湿热带下，外感发热；疟疾；咽痛；疔疮痈肿。
蒲公英：性味苦、甘，寒。归经归肝、胃经。功能主治清热解毒，消肿散结，利尿通淋。用于疔疮肿毒，乳痈，瘰疠，目赤，咽痛，肺痈，肠痈，湿热黄疸，热淋涩痛。
紫花地丁：性味苦、辛，寒。归经归心、肝经。功能主治清热解毒，凉血消肿。用于疔疮肿毒，痈疽发背，丹毒，毒蛇咬伤。
茯苓：性味甘、淡，平。归经归心、肺、脾、肾经。功能主治利水渗湿，健脾宁心。用于水肿尿少，痰饮眩悸，脾虚食少，便溏泄泻，心神不安，惊悸失眠。
泽泻：性味甘，寒。归经归肾、膀胱经。功能主治利小便，清湿热。用于小便不利，水肿胀满，泄泻尿少，痰饮眩晕，热淋涩痛；高血脂。
玉米须：性味味甘；淡；性平。归经肾；胃；肝；胆经。功能主治利尿消肿；清肝利胆。主水肿；小便淋沥；黄疸；胆囊炎；胆结石；高血压；糖尿病；乳汁不通。
猫须草：性味甘、微苦，凉。功能主治清热祛湿，排石利尿。用于急慢性肾炎，膀胱炎，尿路结石，胆结石。
绵萆薢：性味苦，平。归经归肾、胃经。功能主治利湿去浊，祛风通痹。用于淋病白浊，白带过多，湿热疮毒，腰膝痹痛。
莱菔子：性味辛、甘，平。归经归肺、脾、胃经。功能主治消食除胀，降气化痰。用于饮食停滞，脘腹胀痛，大便秘结，积滞泻痢，痰壅喘咳。
陈皮：性味苦、辛，温。归经归肺、脾经。功能主治理气健脾，燥湿化痰。用于胸脘胀满，食少吐泻，咳嗽痰多。
甘草：性味甘，平。归经归心、肺、脾、胃经 。功能主治：补脾益气，清热解毒，祛痰止咳，缓急止痛，调和诸药。用于脾胃虚弱，倦怠乏力，心悸气短，咳嗽痰多，脘腹、四肢挛急疼痛，痈肿疮毒，缓解药物毒性、烈性。
由上述药物可知，大黄凉血解毒，逐瘀通经；茯苓利水渗湿，共为君药；赤芍、川芎、倒扣草活血化瘀，助大黄化瘀通经；蒲公英、紫花地丁清热解毒，助大黄下泄浊毒，泽泻淡渗利水，玉米须、猫须草利尿去湿，绵萆薢利湿去浊，共助茯苓利水渗湿，共为臣药；陈皮、莱菔子燥湿理气化痰，共为佐药；甘草调和诸药，为使药。
本发明诸药相伍，具有活血祛瘀，燥湿化痰，降浊解毒的功效，可有效用于糖尿病肾病的治疗，疗效稳定，并经临床应用，取得了良好的疗效，有关试验资料如下：
1、选择病例标准
糖尿病肾病是糖尿病病人最重要的合并症之一，以慢性高血糖、蛋白尿为主要临床表现，发生糖尿病肾病时也往往同时合并其他器官或系统的微血管病如糖尿病视网膜病变和外周神经病变，凡具有上述症状者，均作为选择病例的标准。
2、诊断标准：
DN 分期按照《现代糖尿病诊断治疗学》相关标准。Ⅲ期: 糖尿病早期肾病期，肾小球滤过率基本正常; 尿蛋白排泄率(UAE) 持续为 20 ～ 200 μg /min，或 24 h 尿蛋白定量为30 ～ 300 mg /24 h; 6 个月内至少连续检查尿清蛋白 3 次，如有 2 次均达到或其平均值达到诊断标准即可诊断。
3、病例选择：
经确诊患有糖尿病肾病患者100例，均为糖尿病肾病Ⅲ期患者，随机分为本发明组和对照组，每组50人，两组在性别、年龄及病况等方面比较，差异无统计学意义，具有可比性。
4、治疗方案 ：
对照组给予常规治疗，包括宣教、运动、必需氨基酸、优质低蛋白饮食，控制血糖、血压及血脂。本发明组在对照组基础上加用本发明灌肠制剂，每日灌肠1次，每次用量100-150ml，每次保留时间1h，于睡前灌肠。30天为一疗程，两个疗程后统计疗效。
5、疗效评价 ：
按照《糖尿病肾病诊断、辨证分型及疗效评定标准》制订。显效: 临床症状消失，血糖、糖化血红蛋白下降 1 /3 或恢复正常，24 h 尿蛋白定量下降1 /2 以上; 肾功能正常。有效: 临床症状较治疗前好转，血糖、糖化血红蛋白有所下降，但不足显效标准，24 h 尿蛋白定量较治疗前下降不到 1 /2; 肾功能指标正常。无效: 临床症状未改善或恶化，实验室指标无变化或升高。
6、统计学处理：
实验结束后临床疗效比较，治疗组显效 29 例、有效 20 例，无效 1 例，总有效率98%，对照组显效 21 例、有效 19 例、无效 10 例，总有效率80%，本发明组有效率明显高于对照组，在试验期间为发现有任何不良反应和毒副作用。有效者随访一周，未见复发。
结论
本发明原料丰富，制备方法简单，易生产制备，组分互相支持，协同增效，具有活血祛瘀，燥湿化痰，降浊解毒之功效，有效率高达98%，而且疗效稳定可靠，无毒副作用，具有很好的使用价值，易于推广应用，是糖尿病肾病药物上的创新，可有效延缓糖尿病肾病，具有良好的治疗效果，经济和社会效益显著。

Claims (5)

1.一种延缓糖尿病肾病的灌肠中药液，其特征是：由以下重量份数计的原料药物制成：大黄5-40份、赤芍10-25份、川芎3-20份、倒扣草5-25份、蒲公英6-30份、紫花地丁10-30份、茯苓6-20份、泽泻5-12份、玉米须10-50份、猫须草20-60份、绵萆薢6-20份、莱菔子3-20份、陈皮3-15份和甘草3-9份；将上述原料药物混合在一起，加水浸没，武火主沸，改为文火煎煮30-45min，过滤，得第一滤液，滤渣加水浸没，武火煮沸，改为文火煎煮30-45min，过滤，得第二滤液，合并两次滤液，混匀，即成。
2.根据权利要求1所述的延缓糖尿病肾病的灌肠中药液，其特征是：由以下重量份数计的原料药物制成：大黄15-30份、赤芍15-20份、川芎10-13份、倒扣草10-20份、蒲公英10-25份、紫花地丁15-25份、茯苓10-15份、泽泻8-10份、玉米须20-40份、猫须草35-45份、绵萆薢10-15份、莱菔子8-15份、陈皮8-10份和甘草4-7份。
3.根据权利要求1所述的延缓糖尿病肾病的灌肠中药液，其特征是：由以下重量份数计的原料药物制成：大黄5份、赤芍10份、川芎3份、倒扣草5份、蒲公英6份、紫花地丁10份、茯苓6份、泽泻5份、玉米须10份、猫须草20份、绵萆薢6份、莱菔子3份、陈皮3份和甘草3份。
4.根据权利要求1所述的延缓糖尿病肾病的灌肠中药液，其特征是：由以下重量份数计的原料药物制成：大黄40份、赤芍25份、川芎20份、倒扣草25份、蒲公英30份、紫花地丁30份、茯苓20份、泽泻12份、玉米须50份、猫须草60份、绵萆薢20份、莱菔子20份、陈皮15份和甘草9份。
5.根据权利要求1所述的延缓糖尿病肾病的灌肠中药液，其特征是：由以下重量份数计的原料药物制成：大黄22份、赤芍17份、川芎11份、倒扣草15份、蒲公英18份、紫花地丁20份、茯苓13份、泽泻8份、玉米须30份、猫须草40份、绵萆薢13份、莱菔子11份、陈皮9份和甘草6份。
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