CN109260415A - 一种用于治疗急性脑梗死的中药组合物 - Google Patents

一种用于治疗急性脑梗死的中药组合物 Download PDF

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CN109260415A
CN109260415A CN201811174473.8A CN201811174473A CN109260415A CN 109260415 A CN109260415 A CN 109260415A CN 201811174473 A CN201811174473 A CN 201811174473A CN 109260415 A CN109260415 A CN 109260415A
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吴蔚清
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Abstract

本发明提供一种治疗急性脑梗死的中药组合物，一种用于治疗急性脑梗死的中药组合物，其特征在于，方剂组成：黄芪50g、白术15g、防风6g、法半夏10g、钩藤10g后下、石决明12g先煎、水蛭5g、僵蚕10g、全蝎6g、蜈蚣1条、女贞子12g、杜仲12g、川牛膝12g、黄芩10g、冰片3g、绞股蓝9g、淮山12g、桑枝10g、灵芝10g、川芎9g、姜黄10g、当归9g、葛根12g、甘草10g。本中药具有改善循环，抗凝及抗血液黏稠性，抗血小板聚集作用，可抑制和延缓脑梗死的发生，从而达到加速患者康复进程，降低病残率之功效，值得推广。

Description

一种用于治疗急性脑梗死的中药组合物
技术领域
本发明涉及一种中药组合物及其制备方法，特别是涉及用于急性脑梗死的中药组合物。
背景技术
急性脑梗死（Acute cerebral infarct）是指脑血供突然中断后导致的脑组织坏死。通常主要是由于供应脑部血液的动脉出现粥样硬化和血栓形成，使管腔狭窄甚至闭塞，导致局灶性急性脑供血不足而发病；也有因异常物体（固体、液体、气体）沿血液循环进入脑动脉或供应脑血液循环的颈部动脉，造成血流阻断或血流量骤减而产生相应支配区域的脑组织软化、坏死。
而中医认为脑梗死属于中医的中风病范畴，传统认为，中风病机不外风、火、痰、虚、气、血六端，主要在于患者素体气血不足或肝肾阴亏，在忧思脑怒，饮酒饱食或房劳过度或外邪侵袭，诱因作用下，致使肝阳暴张，阳化风动，气随血逆，内风时起，内风夹痰，夹火，横窜经络，蒙闭清窍，因此，风、火、痰是中风急性期的主要病理改变。
目前，对于脑梗死治疗国内外尚未有特效的治疗方法出现，但中医药在治疗该疾病的方面有一定疗效，中医从整体观念出发进行辩证施治，药物组方经过合理配伍，标本兼治，几乎无毒副作用，因此研制疗效确切的治疗急性脑梗死的中药组合物很有必要。
发明内容
本发明的一个目的是提供一种治疗急性脑梗死的中药组合物。
本发明的技术方案是：
一种用于治疗急性脑梗死的中药组合物，其特征在于，方剂组成：黄芪50g、白术15g、防风6g、法半夏10g、钩藤10g后下、石决明12g先煎、水蛭5g、僵蚕10g、全蝎6g、蜈蚣1条、女贞子12g、杜仲12g、川牛膝12g、黄芩10g、冰片3g、绞股蓝9g、淮山12g、桑枝10g、灵芝10g、川芎9g、姜黄10g、当归9g、葛根12g、甘草10g。
脑梗死属于中医的中风病范畴，传统认为，中风病机不外风、火、痰、虚、气、血六端，主要在于患者素体气血不足或肝肾阴亏，在忧思脑怒，饮酒饱食或房劳过度或外邪侵袭，诱因作用下，致使肝阳暴张，阳化风动，气随血逆，内风时起，内风夹痰，夹火，横窜经络，蒙闭清窍，因此，风、火、痰是中风急性期的主要病理改变。
本中药组合物重用黄芪为君药，配伍白术、淮山、法半夏、灵芝为臣药，益气健脾化痰；全蝎、蜈蚣熄风止痉、通络止痛；钩藤、白僵蚕、石决明、水蛭平肝熄风通络；黄芩、桑枝、川牛膝、女贞子、杜仲滋阴补肾清火；当归、葛根、姜黄、川芎活血化瘀，为佐药；防风、冰片、绞股蓝、甘草调和诸药解百毒，为使药。现代医学研究发现，脑梗死发病的根本原因是供应脑部血液的颅内或颅外动脉中闭塞性病变，而未能获得及时充分的侧支循环，使局部脑组织代谢得不到相应的血液供应，导致血液成份中脂蛋白、胆固醇、纤维蛋白原等含量增加，使血液粘度增高和红细胞表面电荷降低，使血流速度减慢，最终发生脑梗死。方中姜黄、川芎的有效成分有活血化瘀之功效；冰片开窍醒神、清热止痛，助水蛭、白僵蚕活血化瘀通经络、抑制凝血；黄芪、白术、淮山配伍防风，益气健脾、养血祛风、鼓舞胃气，以防水蛭、全蝎、蜈蚣耗伤正气；绞股蓝、葛根、姜黄，降脂、降压；灵芝降糖、防高血脂中风；当归活血补血，治气滞血瘀；川芎行气活血，其生物碱具有抑制血小板聚集的作用。
本中药具有改善循环，抗凝及抗血液黏稠性，抗血小板聚集作用，可抑制和延缓脑梗死的发生，从而达到加速患者康复进程，降低病残率之功效，值得推广。
具体实施方式
自2015年7月-2018年9月来，采用中药组合物加丹参川芎嗪治疗急性脑梗死102例，并与单用西药治疗比较，现总结如下：
1、临床资料
1.1 一般资料102例急性脑梗死患者均为住院病例，西医诊断符合全国第四次脑血管病会议的诊断标准，并经CT扫描确诊，随机分治疗组和对照组，治疗组102例，其中男性58例，女性44例，年龄33-69岁，对照组102例，其中男性56例，女性46例，年龄30-68岁，所有患者均首次发生脑梗死，64例无意识障碍，60例无明显颅内压增高，8例大面积脑梗死，72例有定位体征的腔隙性脑梗死。肌力0-1级（重型）28例，2-3级（普遍型）52例，4级或接近5级（轻型）124例。
1.2 中医证候分析，依据中华人民共和国中医药行业标准，《中医病症诊断疗效标准》进行分例，其中治疗组肝阳暴亢证17例，痰热腑实证17例，风痰组络证12例，气虚血瘀证18例，阴虚风动证12例，风火闭窍证8例，痰火闭窍证12例，痰湿蒙窍证6例，对照组分别为17例、16例、17例、18例、12例、10例、8例、4例。
1.3 治疗方法：
治疗组用中药组合物以益气健脾化痰，平肝潜阳通络，滋阴补肾清火为法，方剂组成，黄芪50g、白术15g、防风6g、法半夏10g、钩藤10g后下、石决明12g先煎、水蛭5g、僵蚕10g、全蝎6g、蜈蚣1条、女贞子12g、杜仲12g、川牛膝12g、黄芩10g、冰片3g、绞股蓝9g、淮山12g、桑枝10g、灵芝10g、川芎9g、姜黄10g、当归9g、葛根12g、甘草10g，水煎温服，2次/日，3周为一疗程。西药用吉林四长制药有限公司生产的注射用丹参川芎嗪10ml稀释于250ml生理盐水中静滴，3周为一疗程。对照组同治疗组所用西药，2组基础用药相同，（脱水：甘露醇或甘油果糖；护脑：清开灵注射液；抗凝剂（双抗）：肠溶阿司匹林、氯吡格雷；脑自由基清除剂：依达拉奉；神经细胞活化剂：维生素E等），高血压，糖尿病患者适当加降压，降糖药并早期康复介入。
禁忌症：（1）对注射用丹参川芎嗪有过敏史者；
（2）有出血倾向患者（PT、APTT较正常延长）；
（3）高钠血症、低血压患者慎用。
1.4 测定指标：两组治疗后第25天进行临床神经功能缺损评分，停药第二周进行临床疗效评定，全部病例首诊时均作头颅CT扫描有48例患者未发现责任病灶，入院第2天或第3天复查CT，治疗满4周后再次复查头颅CT。
1.5 统计学处理：计量资料采用配对t检验，计数资料采用X2检验。
2、结果
2.1 疗效标准：临床疗效及临床神经功能缺损程度评分评定，根据1996年全国第四届脑血管病学术会议通过的标准。基本治愈，神功能缺损评分减少>90%，病残程度0级。显著进行：神经功能缺损评分减少46%-89%病残程度1-3级。进步：神经功能缺损减少18%-45%。无变化：神经功能缺损评分减少或增加<18%。恶化：神经功能缺损评分增加>18%。基本治愈加显著进步为显效、显效加进步为有效，两组治疗前后临床疗效见表（1）
两组患者临床疗效比较（例 %）
注：与对照组比较P<0.05
治疗组显效率62.7%，对照组显效率42.1%，两组比较差异有显著性（P<0.01）
治疗组有效率87.2%，对照组有效率70.5%，两组比较差异有显著性（P<0.05）
2.2 两组治疗前后神经功能缺损评分表（2）
两组治疗前后神经功能缺损评分情况（分、x±s）
注：与本组治疗前比较，P<0.05，P<0.01，与治疗组的治疗后比较△<0.05。两组治疗后神经功能缺损均有改善(P<0.05，P<0.01)，治疗组改善更加明显（P<0.05）
2.3 两组治疗梗塞灶变化比较见表（3）
两组患者治疗前后CT梗塞灶体积比较（cm3, x±s）
注：与本组治疗前比较，P<0.05，P<0.01
两组入院时（治疗前）和停药2周末（治疗后）CT检查梗塞灶体积，治疗组和对照组梗塞体积比治疗前缩小。

Claims (1)

1.一种用于治疗急性脑梗死的中药组合物，其特征在于，方剂组成：黄芪50g、白术15g、防风6g、法半夏10g、钩藤10g后下、石决明12g先煎、水蛭5g、僵蚕10g、全蝎6g、蜈蚣1条、女贞子12g、杜仲12g、川牛膝12g、黄芩10g、冰片3g、绞股蓝9g、淮山12g、桑枝10g、灵芝10g、川芎9g、姜黄10g、当归9g、葛根12g、甘草10g。
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