CN109432364A - 用于产后恢复的参芪益母中药组合物及其制备方法与应用 - Google Patents
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Abstract
本发明公开了一种用于产后恢复的参芪益母中药组合物,包括以下重量份的组分:人参900~1600份、黄芪900~1600份、当归900~1600份、川芎400~800份、麦冬900~1600份、通草100~500份、路路通100~500份、王不留行100~500份、益母草900~1600份、丹参400~800份、香附400~800份、延胡索(醋制)100~500份、炮姜100~500份、蒲黄(生)100~500份、甘草(制)100~500份。本发明具有益气养血,通络下乳,活血袪瘀、理气止痛等功效,补气血而不留瘀,袪瘀而不伤正,可有效改善气血虚弱所致之产后乳迟乳少,产后恶露不绝,产后腹痛等症状,促进产妇康复,增加乳汁分泌,同时能够有效改善妇女经期腹痛,经量过多等症状,且使用安全可靠,无毒副作用。
Description
技术领域
本发明涉及药品领域,具体涉及一种用于产后恢复的参芪益母中药组合物及其制备方法与应用。
背景技术
分娩虽是自然生理现象,但可对产妇造成持久且强烈的应激反应。每个产妇经生产完后其生理和心理均会发生显著的变化,生产完后身体多处于搞度虚弱状态,如不能及时进行有效的康复,不管是心理还是机体体力、功能恢复均需较长时间。产后虚损是指产妇生产后或产褥期发生的与分娩或产褥有关的一种产后体虚疾病,患者临床常表现为神疲乏力、心悸气短、腰膝酸软等症状,若不及时调理,易引发产后缺乳、发热、恶露不尽等病症,常导致患者出现生殖周期紊乱、焦虑情绪,严重影响产妇生活质量及新生儿母乳喂养。产褥期不但是产妇分娩后机体器官恢复的关键时期,亦是新生儿健康发育、成长的重要环节。现代社会由于环境污染,生活节奏加快等原因,致使越来越多的产妇产后恢复差,产后无乳可喂,而越来越多地使用各种代用品,影响了两代人的健康。据资料统计我国每年有2000余万产妇,在产后自然恢复的过程中,约有70%的妇女不同程度的存在着产褥缩复不良的情况。因此,产褥期康复的必要性和重要性越来越受到重视。由于产妇及新生儿特殊的生理性质,产后恢复中需选择安全有效的治疗方式。在产妇产后恢复临床应用中,目前常应用缩宫素类西药或益母草类中药制剂来促进子宫收缩,用抗生素预防或治疗切口感染,但临床实践已证明以上方法虽然能起到一定的临床效果,但其剂量及方法应用均有较大的局限性,且不能缓解患者体虚的根本,副作用还相对较大。
中医认为,产后虚损归属祖国医学“产后病”范畴,其基本病机为亡血失津、瘀血壅滞,因大量失血耗气加之外邪入侵导致气血两虚及脉络不通,使得气血运化失常,进而导致恶露下行缓慢、恶露不尽等症状;因此,临床治疗应以“益气养血、疏经通络、活血化瘀”为根本原则。临床研究发现中医药浴或擦浴、中药药物疗法、经络疗法、针灸、推拿治疗、穴位埋线疗法等,在产妇产后恢复中的应用效果较好,其中以口服给药的中药药物疗法最为简便且疗效显著而深受产妇的欢迎。
本发明人认为产后恶露不绝、腹痛、乳迟乳少,虽然临床表现各异,但其病因相同,均乃多因元气虚弱,亡血伤津,瘀血内阻而致。本着促进产妇康复,增加乳汁分泌,从而利于两代人的健康的理念,利用“辨证求因,按因施治”的祖国医学的治疗原则,施以益气养血,活血祛瘀之法治疗产后虚损,取得满意疗效。
(1)人参,为五加科植物人参Pana ginseng C.A.Mey.的干燥根和根茎。收载于《中国药典》2015年版:【性昧与归经】甘、微苦,微温。归脾、肺、心、肾经。【功能与主治】大补元气,复脉固脱,补脾益肺,生津养血,安神益智。用于体虚欲脱,肢冷脉微,脾虚食少,肺虚喘咳,津伤口渴,内热消渴,气血亏虚,久病虚羸,惊悸失眠,阳痿宫冷。
(2)黄芪,为豆科植物蒙古黄芪Astragalus membranaceus(Fisch.)Bge.var.mongholicus(Bge.)Hsiao或膜荚黄芪Astragalus membranaceus(Fisch.)Bge.的干燥根。收载于《中国药典》2015年版:【性昧与归经】甘,微温。归肺、脾经。【功能与主治】补气升阳,固表止汗,利水消肿,生津养血,行滞通痹,托毒排脓,敛疮生肌。用于气虚乏力,食少便溏,中气下陷,久泻脱肛,便血崩漏,表虚自汗,气虚水肿,内热消渴,血虚萎黄,半身不遂,痹痛麻木,痈疽难溃,久溃不敛。
(3)当归,为伞形科植物当归Angelica sinensis(Oliv.)Diels的干燥根。收载于《中国药典》2015年版:【性昧与归经】甘、辛,温。归肝、心、脾经。【功能与主治】补血活血,调经止痛,润肠通便。用于血虚萎黄,眩晕心悸,月经不调,经闭痛经,虚寒腹痛,风湿痹痛,跌扑损伤,痈疽疮疡,肠燥便秘。
(4)麦冬,为百合科植物麦冬Ophiopogon japonicus(L.f)Ker-GawL的干燥块根。收载于《中国药典》2015年版:【性昧与归经】甘、微苦,微寒。归心、肺、胃经。【功能与主治】养阴生津,润肺清心。用于肺燥干咳,阴虚痨嗽,喉痹咽痛,津伤口渴,内热消渴,心烦失眠,肠燥便秘。
(5)通草,为五加科植物通脱木Tetra panax papyrifer(Hook.)K.Koch的干燥茎髓。收载于《中国药典》2015年版:【性昧与归经】甘、淡,微寒。归肺、胃经。【功能与主治】清热利尿,通气下乳。用于湿热淋证,水肿尿少,乳汁不下。
(6)路路通,为金缕梅科植物枫香树Liquidambar formosana Hance的干燥成熟果序。收载于《中国药典》2015年版:【性昧与归经】苦,平。归肝、肾经。【功能与主治】祛风活络,利水,通经。用于关节痹痛,麻木拘挛,水肿胀满,乳少,经闭。
(7)王不留行,为石竹科植物麦蓝菜Vaccaria segetalis(Neck.)Garcke的干燥成熟种子。收载于《中国药典》2015年版:【性昧与归经】苦,平。归肝、胄经。【功能与主治】活血通经,下乳消肿,利尿通淋。用于经闭,痛经,乳汁不下,乳痈肿痛,淋证涩痛。
(8)川芎,为伞形科植物川芎Ligusticum chuanxiong Hort.的干燥根茎。收载于《中国药典》2015年版:【性昧与归经】辛,温。归肝、胆、心包经。【功能与主治】活血行气,祛风止痛。用于胸痹心痛,胸胁刺痛,跌扑肿痛,月经不调,经闭痛经,癥瘕腹痛,头痛,风湿痹痛。
(9)益母草,为唇形科植物益母草Leonurus japonicus Houtt.的新鲜或干燥地上部分。收载于《中国药典》2015年版:【性昧与归经】苦、辛,微寒。归肝、心包、膀胱经。【功能与主治】活血调经,利尿消肿,清热解毒。用于月经不调,痛经经闭,恶露不尽,水肿尿少,疮疡肿毒。
(10)蒲黄(生),即生蒲黄,为蒲黄经揉碎结块,过筛的炮制加工品。蒲黄为香蒲科植物水烛香蒲Typha angustifolia L.、东方香蒲Typha orientalis Presl或同属植物的干燥花粉,收载于《中国药典》2015年版:【性昧与归经】甘,平。归肝、心包经。【功能与主治】止血,化瘀,通淋。用于吐血,衄血,咯血,崩漏,外伤出血,经闭痛经,胸腹刺痛,跌扑肿痛,血淋涩痛。
(11)丹参,为唇形科植物丹参Salvia miltiorrhiza Bge.的干燥根和根茎。收载于《中国药典》2015年版:【性昧与归经】苦,微寒。归心、肝经。【功能与主治】活血祛瘀,通经止痛,清心除烦,凉血消痈。用于胸痹心痛,脘腹胁痛,癥瘕积聚,热痹疼痛,心烦不眠,月经不调,痛经经闭,疮疡肿痛。
(12)炮姜,为干姜的炮制加工品,干姜为姜科植物姜Zingiber officinale Rose.的干燥根茎。收载于《中国药典》2015年版:【性昧与归经】辛,热。归脾、胃、肾经。【功能与主治】温经止血,温中止痛。用于阳虚失血,吐衄崩漏,脾胃虚寒,腹痛吐泻。
(13)香附,为莎草科植物莎草Cyperus rotundus L.的干燥根茎。收载于《中国药典》2015年版:【性昧与归经】辛、微苦、微甘,平。归肝、脾、三焦经。【功能与主治】疏肝解郁,理气宽中,调经止痛。用于肝郁气滞,胸胁胀痛,疝气疼痛,乳房胀痛,脾胃气滞,脘腹痞闷,胀满疼痛,月经不调,经闭痛经。
(14)延胡索(醋制),即醋延胡索,为延胡索照醋炙法或醋煮法的炮制加工品。延胡索为罂粟科植物延胡索Corydalis yanhusuo W.T.Wang的干燥块茎,收载于《中国药典》2015年版:【性昧与归经】辛、苦,温。归肝、脾经。【功能与主治】活血,行气,止痛。用于胸胁、脘腹疼痛,胸痹心痛,经闭痛经,产后瘀阻,跌扑肿痛。
(15)甘草(制),即炙甘草,为甘草的炮制加工品。甘草为豆科植物甘草Glycyrrhiza inflata Bat.或光果甘草Glycyrrhiza glabra L.的干燥根和根茎。炙甘草收载于《中国药典》2015年版:【性昧与归经】甘,平。归心、肺、脾、胃经。【功能与主治】补脾和胃,益气复脉。用于脾胃虚弱,倦怠乏力,心动悸,脉结代。
发明内容
本发明的目的在于提供一种促进产妇康复,增加乳汁分泌的中药组合物,用于治疗妇女产后乳迟乳少,产后腹痛,恶露不绝等症,疗效好且安全无毒副作用。
本发明所采用的技术方案如下:
一种用于产后恢复的参芪益母中药组合物,包括以下重量份的组分:人参900~1600份、黄芪900~1600份、当归900~1600份、川芎400~800份、麦冬900~1600份、通草100~500份、路路通100~500份、王不留行100~500份、益母草900~1600份、丹参400~800份、香附400~800份、延胡索(醋制)100~500份、蒲黄(生)100~500份、炮姜100~500份、甘草(制)100~500份。
进一步的,以上所述的用于产后恢复的参芪益母中药组合物,优选包括以下重量份的组分:人参1100~1400份、黄芪1100~1400份、当归1100~1400份、川芎500~700份、麦冬1100~1400份、通草200~400份、路路通200~400份、王不留行200~400份、益母草1100~1400份、丹参500~700份、香附500~700份、延胡索(醋制)200~400份、蒲黄(生)200~400份、炮姜200~400份、甘草(制)200~400份。
进一步的,以上所述的用于产后恢复的参芪益母中药组合物,更优选包括以下重量份的组分:
人参1250份、黄芪1250份、当归1250份、川芎625份、麦冬1250份、通草250份、路路通250份、王不留行250份、益母草1250份、丹参625份、香附625份、延胡索(醋制)375份、蒲黄(生)250份、炮姜250份、甘草(制)250份;
或人参1250份、黄芪1250份、当归1250份、川芎625份、麦冬1250份、通草250份、路路通250份、王不留行375份、益母草1250份、丹参625份、香附625份、延胡索(醋制)250份、蒲黄(生)250份、炮姜250份、甘草(制)250份;
或人参1400份、黄芪1400份、当归1400份、川芎500份、麦冬1400份、通草250份、路路通250份、王不留行250份、益母草1400份、丹参500份、香附500份、延胡索(醋制)250份、蒲黄(生)250份、炮姜250份、甘草(制)250份;
或人参1100份、黄芪1100份、当归1100份、川芎700份、麦冬1100份、通草375份、路路通375份、王不留行375份、益母草1100份、丹参700份、香附700份、延胡索(醋制)375份、蒲黄(生)375份、炮姜375份、甘草(制)375份。
以上所述的用于产后恢复的参芪益母中药组合物,可按照常规工艺加入常规辅料制备成药品领域可接受的任意内服制剂,优选制备成片剂、胶囊剂、颗粒剂、丸剂、散剂、口服液、糖浆剂、膏剂。
以上所述的用于产后恢复的参芪益母中药组合物的制备方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用50~99%的乙醇作溶剂,浸渍6~72小时后,以0.5~6ml/min·kg的速度进行渗漉,收集渗漉液2000~20000ml,药渣与其余黄芪等八味加水煎煮1~4次,每次加水4~15倍量,每次煎煮0.5~3小时,煎液滤过,滤液浓缩至在80℃时相对密度为1.05~1.30,放冷,加乙醇使含醇量达50~80%,静置6~72小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.10~1.35的清膏,按照常规工艺加入常规辅料制备成药品领域可接受的任意内服制剂,包括片剂、胶囊剂、颗粒剂、丸剂、散剂、口服液、糖浆剂、膏剂。
进一步的,以上所述的中药组合物的制备方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用70%乙醇作溶剂,浸渍24小时后,以1.5ml/min·kg的速度进行渗漉,收集渗漉液5000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.10~1.13,放冷,加乙醇使含醇量达63%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.25~1.27的清膏,按照常规工艺加入常规辅料制备成内服制剂,包括片剂、胶囊剂、丸剂、散剂、口服液、糖浆剂、膏剂。
更进一步的,以上所述的中药组合物的制备方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用70%乙醇作溶剂,浸渍24小时后,以1.5ml/min·kg的速度进行渗漉,收集渗漉液5000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.10~1.13,放冷,加乙醇使含醇量达63%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.25~1.27的清膏,加入蔗糖粉和糊精各适量,混匀,制成颗粒剂。
以上所述的用于产后恢复的参芪益母中药组合物,在制备治疗妇女产后乳迟乳少,产后腹痛,恶露不绝等症的药品中的应用。
妇女产后恶露不绝、腹痛、乳迟乳少等,虽病症不同,但多因元气虚弱,亡血伤津,瘀血内阻而致。产后病的发病机理,与产前体弱、产后气血耗损及产后调养失宜有关。孕期阴血本已不足,产后失血致产后亡血伤津;孕期元气不足,复因产时耗气过极,致元气虚弱;产后胞宫余血浊液因寒而凝,因热所灼,因肝郁而滞,因气虚失运,则瘀血内阻,败血妄行。此外,六淫、七情所伤、饮食不节、房事所伤均可加重亡血伤津,元气虚弱,瘀血内阻而变症多端。产后恶露不绝、腹痛、乳迟乳少,虽然临床表现各异,但其病因相同。“辨证求因,按因施治。”这是祖国医学的治疗原则,也是祖国医学“异病(症)同治”的根据。以上病症若是气血亏虚,瘀血内阻型,则治疗方法均可用益气养血,活血祛瘀法。
本发明方中人参、黄芪大补元气,生津安神,其补肺脾之气,以资生血之源,为君药。辅以当归、川芎补血活血,阳生阴长,气旺血生;甘草(制)补脾益气加强君药功效;麦冬润肺养阴,益胃生津,共为臣药。配以路路通、王不留行、通草活血、通络,下乳;益母草、蒲黄(生)、丹参、炮姜、香附、延胡索(醋制)活血祛瘀、止血止痛,共为佐药。甘草(制)又有缓急止痛,缓和药性功能为使药。诸药合用,补气血而不留瘀,袪瘀而不伤正,共凑益气养血,通络下乳,活血袪瘀、理气止痛之功效。用于产后乳迟乳少,产后腹痛,产后恶露不绝,也可用于妇女经期腹痛,经量过多。
本发明的有益效果是:
1.本发明用于产后恢复的参芪益母中药组合物,组方严谨,药少力专,具有益气养血,通络下乳,活血袪瘀、理气止痛等功效,补气血而不留瘀,袪瘀而不伤正,可有效改善气血虚弱所致之产后乳迟乳少,产后恶露不绝,产后腹痛等症状,促进产妇康复,增加乳汁分泌,同时能够有效改善妇女经期腹痛,经量过多等症状。经药效学研究试验表明,具有显著的止血、镇痛、解痉、催乳作用。经临床试验表明,用于产后恢复治疗,对缺乳、产后腹痛和恶露不绝的总有效率分别为94.3%、96.9%、和100%。
2.既克服了西药不能缓解患者体虚的根本且副作用大的缺点,又发扬了中药副作用小,不易产生耐药性的优点,从根本上改善患者体虚的症状,标本兼治,提高了产妇的生活质量,促进了新生儿母乳喂养。
3.原料来源广泛,且使用安全可靠,无明显不良反应和毒副作用。
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、用于产后恢复的参芪益母中药组合物的制备
实施例1散剂
人参1400g、黄芪1400g、当归1400g、川芎500g、麦冬1400g、通草200g、路路通200g、王不留行200g、益母草1400g、丹参500g、香附500g、延胡索(醋制)200g、蒲黄(生)200g、炮姜200g、甘草(制)200g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用60%乙醇作溶剂,浸渍60小时后,以5ml/min·kg的速度进行渗漉,收集渗漉液15000ml,药渣与其余黄芪等八味加水煎煮3次,第一次加12倍量水,煎煮3.5小时,第二次加9倍量水,煎煮2.5小时,第三次加5倍量水,煎煮0.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.25~1.28,放冷,加乙醇使含醇量达55%,静置60小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.30~1.32的清膏,加入糊精、滑石粉制成散剂。每瓶含相当生药量10g。
实施例2片剂
人参1250g、黄芪1250g、当归1250g、川芎625g、麦冬1250g、通草250g、路路通250g、王不留行250g、益母草1250g、丹参625g、香附625g、延胡索(醋制)375g、蒲黄(生)250g、炮姜250g、甘草(制)250g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用75%乙醇作溶剂,浸渍36小时后,以3ml/min·kg的速度进行渗漉,收集渗漉液10000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加11倍量水,煎煮3小时,第二次加7倍量水,煎煮2小时,第三次加4倍量水,煎煮1小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.13~1.15,放冷,加乙醇使含醇量达65%,静置36小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.28~1.30的清膏,加入淀粉、糊精制成片剂。每片含相当生药量3.33g。
实施例3颗粒剂
人参1250g、黄芪1250g、当归1250g、川芎625g、麦冬1250g、通草250g、路路通250g、王不留行375g、益母草1250g、丹参625g、香附625g、延胡索(醋制)250g、蒲黄(生)250g、炮姜250g、甘草(制)250g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用70%乙醇作溶剂,浸渍24小时后,以1.5ml/min·kg的速度进行渗漉,收集渗漉液5000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.10~1.13,放冷,加乙醇使含醇量达63%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.25~1.27的清膏,加入蔗糖粉和糊精各适量,混匀,制成颗粒剂。每袋含相当生药量10g。
实施例4丸剂
人参1100g、黄芪1100g、当归1100g、川芎700g、麦冬1100g、通草375g、路路通375g、王不留行375g、益母草1100g、丹参700g、香附700g、延胡索(醋制)375g、蒲黄(生)375g、炮姜375g、甘草(制)375g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用85%乙醇作溶剂,浸渍18小时后,以1.2ml/min·kg的速度进行渗漉,收集渗漉液4000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.14~1.16,放冷,加乙醇使含醇量达78%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.28~1.30的清膏,加入蜂蜜制成丸剂。每8丸含相当生药量10g。
实施例5胶囊剂
人参1400g、黄芪1400g、当归1400g、川芎500g、麦冬1400g、通草250g、路路通250g、王不留行250g、益母草1400g、丹参500g、香附500g、延胡索(醋制)250g、蒲黄(生)250g、炮姜250g、甘草(制)250g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用80%乙醇作溶剂,浸渍48小时后,以4ml/min·kg的速度进行渗漉,收集渗漉液12000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加13倍量水,煎煮2小时,第二次加8倍量水,煎煮1小时,第三次加5倍量水,煎煮1小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.15~1.18,放冷,加乙醇使含醇量达70%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.30~1.32的清膏,加入糊精、硬脂酸镁制成胶囊剂。每粒含相当生药量3.33g。
实施例6口服液
人参900g、黄芪900g、当归900g、川芎800g、麦冬900g、通草500g、路路通500g、王不留行500g、益母草900g、丹参800g、香附800g、延胡索(醋制)500g、蒲黄(生)500g、炮姜500g、甘草(制)500g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用90%乙醇作溶剂,浸渍12小时后,以1.0ml/min·kg的速度进行渗漉,收集渗漉液3000ml,药渣与其余黄芪等八味加水煎煮2次,第一次加14倍量水,煎煮3小时,第二次加9倍量水,煎煮2小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.08~1.10,放冷,加乙醇使含醇量达75%,静置12小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.12~1.15的清膏,加入蜂蜜、蔗糖、苯甲酸制成口服液。每支含相当生药量10g。
实施例7膏剂
人参1100g、黄芪1100g、当归1100g、川芎700g、麦冬1100g、通草400g、路路通400g、王不留行400g、益母草1100g、丹参700g、香附700g、延胡索(醋制)400g、蒲黄(生)400g、炮姜400g、甘草(制)400g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用99%乙醇作溶剂,浸渍6小时后,以0.5ml/min·kg的速度进行渗漉,收集渗漉液2000ml,药渣与其余黄芪等八味加15倍量水煎煮3小时,滤过,滤液浓缩至在80℃时相对密度为1.05~1.08,放冷,加乙醇使含醇量达80%,静置6小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.10~1.13的清膏,加入庶糖、苯甲酸制成膏剂。每1ml含相当生药量2g。
实施例8糖浆剂
人参1600g、黄芪1600g、当归1600g、川芎400g、麦冬1600g、通草100g、路路通100g、王不留行100g、益母草1600g、丹参400g、香附400g、延胡索(醋制)100g、蒲黄(生)100g、炮姜100g、甘草(制)100g;
将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用50%乙醇作溶剂,浸渍72小时后,以6ml/min·kg的速度进行渗漉,收集渗漉液20000ml,药渣与其余黄芪等八味加水煎煮4次,第一次加15倍量水,煎煮4小时,第二次加12倍量水,煎煮3小时,第三次加8倍量水,煎煮2小时,第四次加4倍量水,煎煮1小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.28~1.30,放冷,加乙醇使含醇量达50%,静置72小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.33~1.35的清膏,加入庶糖、苯甲酸制成糖浆剂。每1ml含相当生药量1g。
二、药理试验
(一)主要药效学试验
目的:根据新药申报要求,考察本发明产品(实施例3制备过程中所得的在80℃时相对密度为1.25~1.27的清膏,以下称“参芪益母膏”,1g膏=4g生药材)的止血、镇痛、促进子宫复原及催乳作用,为临床用药提供实验依据。
1试验材料
样品:取参芪益母膏,同时以市面销售的通乳冲剂、盐酸吗啡注射液、垂体后叶素注射液、己烯雌酚注射液、凝血酶、田七粉、母婴乐冲剂作为阳性对照。
动物:NIH系小鼠,雌雄兼有,由广西医科大学动物室提供,普通级;昆明种小鼠,雌雄兼有,购自广西中医药研究所动物室,普通级;白色豚鼠,雌性,由广西医科大学动物室提供,普通级;Wistar系大鼠,由广西肿瘤防治研究所动物室提供。
2方法与结果
2.1止血作用
2.1.1对小鼠断尾出血的影响
选取体重18~22g健康NIH系小鼠60只,按性别、体重分层均匀分为6组,每组10只,雌雄各半。第1组给予生理盐水(NS)10ml/kg,第2组给予通乳冲剂20g/kg,第3组给予田七粉1g/kg,第4~6组分别给予参芪益母膏,剂量分别为30g生药材/kg、6g生药材/kg、1.2g生药材/kg,给药体积均为0.1ml/10g,BW,每ig给药一次,连用7天。末次给药1h后,将小鼠固定,以利剪将尾尖3mm处横断,血自行流出时计算时间,每隔30s用滤纸吸血1次,直至滤纸吸附无血为止,记录其出血时间,所得数据与空白对照组(NS)进行显著性测定。结果见表1。
表1对小鼠断尾出血的影响
组别 | 动物数(只) | 药量(g/kg) | 停止出血时间(min)(X±SD) |
生理盐水 | 10 | 12.90±5.80 | |
通乳冲剂 | 10 | 20.0 | 5.17±2.07<sup>***</sup> |
田七粉 | 10 | 1.0 | 4.97±3.44 |
参芪益母膏(高) | 10 | 30.0 | 5.19±5.07<sup>**</sup> |
参芪益母膏(中) | 10 | 6.0 | 7.65±4.21<sup>*</sup> |
参芪益母膏(低) | 10 | 1.2 | 9.23±9.05 |
注:与空白对照组比较,*P<0.05 **P<0.01 ***P<0.001(以下同)
由表1可见,参芪益母膏高、中剂量能显著缩短小鼠断尾出血时间,与空白对照组比较,组间差异有显著性意义(P<0.01~P<0.05),且有明显的显效关系,表明参芪益母膏对小鼠出血时间的影响随剂量增加而明显缩短,止血效果显著。
2.1.2对小鼠凝血时间的影响(玻片法)
选取体重18~22g健康NIH系小鼠60只,雌雄各半。动物分组、给药剂量及方法同2.1.1.末次给药后1h,摘除小鼠一侧眼球,滴血于载玻片两端各1滴(直径≈5mm),立即计时,每隔30S用洁净针头自一血滴边缘向里轻轻挑一次,每次均同一方向,直至有血丝形成即为凝血时间,另一滴血供最后复检,所得数据与空白对照组(NS)进行显著性测定。结果见表2。
表2对小鼠凝血的影响
组别 | 动物数(只) | 停止出血时间(min)(X±SD) |
生理盐水 | 10 | 2.36±1.09 |
通乳冲剂 | 10 | 1.09±0.20<sup>**</sup> |
田七粉 | 10 | 0.81±0.29<sup>***</sup> |
参芪益母膏(高) | 10 | 1.00±0.24<sup>**</sup> |
参芪益母膏(中) | 10 | 0.79±0.23<sup>***</sup> |
参芪益母膏(低) | 10 | 0.92±0.21<sup>***</sup> |
由表2可见,参芪益母膏各剂量均能明显缩短凝血时间,与空白对照相比较,均有非常显著性差异,表明参芪益母膏具有明显的促进凝血的作用。
2.1.3对豚鼠全血浆凝块溶解的影响
选取体重200±20g的豚鼠48只,随机分成6组,每组8只,雌雄各半。给药剂量及方法同2.1.1。末次药后1h,分别抽取各豚鼠心脏血1ml,加至盛有3.8%枸椽酸钠溶液0.2ml的试管内,混匀,3000rpm×10min离心,分离血浆。吸取血浆0.1ml加入小试管中,于37℃水浴中加入凝血酶0.1ml(相当于10μg),使之凝固并开始计时,每隔1h观察1次血浆块溶解情况,记录血浆块完全溶解所需时间,比较各药组与空白对照组之间差异。结果见表3。
表3对豚鼠全血浆凝块溶解的影响
组别 | 动物数(只) | 药量(g/kg) | 停止出血时间(min)(X±SD) |
生理盐水 | 8 | 4.75±0.30 | |
通乳冲剂 | 8 | 20.0 | 8.50±0.40<sup>***</sup> |
田七粉 | 8 | 1.0 | 11.50±0.70<sup>***</sup> |
参芪益母膏(高) | 8 | 30.0 | 8.70±0.30<sup>***</sup> |
参芪益母膏(中) | 8 | 6.0 | 8.60±0.20<sup>***</sup> |
参芪益母膏(低) | 8 | 1.2 | 8.70±0.30<sup>***</sup> |
由表3可见,参芪益母膏各剂量组均能非常明显延长血浆凝块的溶解时间,与空白对照组(NS)相比较,均具有非常显著性差异,表明参芪益母膏具有明显的延长凝血溶解的作用。
2.2止痛作用
2.2.1对小鼠热板致痛的影响(热板法)
选取经初筛合格(痛阈在10~30S间)小鼠60只,体重18~22g,随机分为6组,每组10只,雌性。第1组给予蒸馏水,第2组给予通乳冲剂20g/kg,第3组给予盐酸吗啡10mg/kg,第4~6组分别给予参芪益母膏,剂量分别为30g生药材/kg、6g生药材/kg、1.2g生药材/kg,给药体积均为0.2ml/10g,BW。除第3组于第7天一次皮下给药外,其余各组均每ig给药一次,连用7天。各组均于末次药后30min进行测痛试验,计算痛阈、痛阈提高率%,比较各给药组与空白对照组之间的差异。结果见表4。
表4对小鼠热板致痛的影响(n=10,X±SD)
由表4可见,参芪益母膏大剂量组药后30min到药后150min均可明显提高痛阈;中剂量组在药且60min至90min均可明显提高痛阈;低剂量组药后虽有提高痛阈的趋向,但经统计学处理,其痛阈与空白对照组相比较,差异无显著性意义。结果表明,参芪益母膏高、中剂量具有明显的镇痛作用。
2.2.2对小鼠化学性(冰醋酸)致痛的影响(扭体法)
选取昆明种小鼠60只,体重18~22g。动物分组、给药方法和剂量同2.2.1。末次药后1h,每鼠i p 0.6%冰醋酸0.1ml/10g,BW,记录各鼠扭体潜伏期(S),计算30min内扭体动物数及每鼠扭体次数,比较各给药组与空白对照组之间的差异,结果见表5。
表5对冰醋酸致痛的影响(n=10,X±SD)
由表5可见,参芪益母膏高、中剂量组在药后10min、30min内均能明显减少冰醋酸ip引起小鼠疼痛反应(扭体)次数,与空白对照组相比较,均有非常显著性差异,表明参芪益母膏具有明显的镇痛作用。
2.2.3对小鼠光热刺激致痛的影响
先取体重20±2g的昆明种小鼠,分别置于小鼠固定器内,使其不能自由活动而鼠尾自然下垂,以光电刺激器(12V,50W电影放映灯泡)刺激鼠尾1/3处,以甩尾时间作为痛阈指标,药前测2次,痛阈在2~4min内为初筛合格动物备用。取初筛合格的小鼠60只,雌雄兼用,动物、给药方法和剂量同2.2.1。末次药后30min作致痛试验,每隔30min测痛阈一次。观察记录药前、药后痛阈的改变。结果见表6。
表6对光热刺激致痛的影响(n=10,X±SD)
注:与蒸馏水组比较,*P<0.05 **P<0.01 ***P<0.001
药前、后自身比较,△P<0.05 △△P<0.01 △△△P<0.001
由表6可见,参芪益母膏高、中剂量于药后30~120min及低剂量于药后90~120min均能明显提高光热刺激致痛的痛阈,表明参芪益母膏具有显著的镇痛作用。
2.3对子宫平滑肌的作用
2.3.1对豚鼠离体子宫平滑肌的影响
取白色豚鼠体重250g,雌性,未孕。实验前48h给予二丙酸己烯雌酚0.1mg/kg,SC,人为造成动情期以提高子宫对药物敏感性。实验时,将鼠击毙,迅速剖腹取出子宫并置于盛有洛氏液的玻璃皿中。轻轻剥离子宫上附着的结缔组织和脂肪组织。然后将一侧子宫角的两端以线结扎,一端挂于麦氏浴槽挂钩上,另一端连接记录仪。麦氏槽内浴液温度31±0.5℃,通氧气(每秒通2个小气泡),待收缩平稳后,描记子宫平滑肌的正常收缩曲线,再滴加实验室试的药物,剂量由小逐渐加大,在更换药液时用洛氏液冲洗3次。加垂体后叶素3mu/ml于浴槽中,子宫明显收缩,换液后加入通乳冲剂3mg/ml,不引起子宫收缩,换液后加入参芪益母膏剂量为3mg/ml时,对子宫平滑肌收缩活动亦无明显影响,在此基础上,加垂体后叶素3mu/ml,发现垂体后叶素收缩子宫平滑肌的作用明显减弱。为证实参芪益母膏拮抗垂体后叶素兴奋子宫平滑肌的作用,另取一子宫标本作试验,滴加垂体后叶素3mu/ml,子宫收缩明显,加入参芪益母膏后,其收缩作用强度明显降低。若先加参芪益母膏,后加垂体后叶素,则垂体后叶素兴奋子宫平滑肌的作用几乎表现不出来。若先加垂体后叶素,引起子宫平滑肌持久,强烈的收缩,再加参芪益母膏,子宫平滑肌很快松驰,收缩作用的曲线下降。
以上试验所见,参芪益母膏对豚鼠离体子宫平滑肌的兴奋具有抑制作用,即对抗垂体后叶素的兴奋子宫平滑肌的作用。
2.3.2对豚鼠在体子宫平滑肌的影响
取体重250g,雌性,未孕豚鼠,用戊巴比妥钠30mg/kg,iv,麻醉,仰位固定,在下腹部切4~5cm长的切口,打开腹腔,找出右侧子宫角,轻轻剥离周围组织并用温暖的洛氏液冲洗干净,在其中点缝一线穿过特制玻璃筒与描记装置相连,再将子宫角阴道端和近卵巢端分别缝合在玻璃筒底部两端的支点上,将切口处的腹壁绕玻璃筒用线做荷包缝合以固定之。待描记曲线稳定后,给动物ig参芪益母膏1.2g/kg,BW,观察并记录给药后60、90、120及180min的子宫平滑肌收缩情况。给药前,子宫呈节律性收缩,每分钟收缩8次,药后60min至180min,子宫仍然呈节律性收缩,但收缩频率减慢,每分钟收缩5次,其收缩的强度(振幅)及肌张力无显著改变。结果表明,给豚鼠ig参芪益母膏1.2g/kg可明显减少子宫收缩的频率,但对振幅、张力无明显的影响。
2.4催乳作用试验
2.4.1对哺乳期母鼠体重、乳汁量及乳腺组织学的影响
取产仔4天后的母鼠,体重216.58±10090g,随机分成5组,每组5只,单笼饲养,普通饲料喂养。受试样品高、中、低剂量分别为15g、7.5g及0.75g生药/kg(相当于临床拟用日剂量的25、12.5及1.25倍),阳性对照给予母婴乐冲剂1g生药/kg(人用剂量为1g生药/kg),上述药物均配成溶液,置饮水器中,动物饮完药液后才允许饮用常水,空白对照组给常水,给药容积均为2ml/100g,BW,连续给药5天,停药后第4H及第10天,称各母鼠体重,以微量注射器测各母鼠乳汁量,以神速林氏法测乳汁中蛋白含量,在末次测定乳汁量后24h,取各鼠乳腺作组织学检查。结果给药后第5天,各试验组动物体重与空白对照组间无显著差异;给药后第10天,受试药高、中剂量组动物体重增长明显高于空白对照组,见表7。给药第10天,受试药高、低剂量组动物乳汁量分别为0.48±0.08ml和0.32±0.07ml,与空白对照组的0.18±0.09ml相比较,均有非常显著性差异,P<0.01,但受试药中剂量对动物乳汁无明显影响,见表8。
表7对母鼠体重的影响(n=10,X±SD)
组别 | 药量(g/kg) | 药前体重(g) | 药后5天体重净增值(g) | 药后10天体重净增值(g) |
参芪益母膏(高) | 15.0 | 330±50.6 | 5.0±2.4 | 11.0±3.6** |
参芪益母膏(中) | 7.5 | 302±48.3 | 7.1±3.1 | 9.0±3.3** |
参芪益母膏(低) | 0.75 | 320±55.7 | 2.2±2.0 | 7.2±2.7 |
母婴乐冲剂 | 1.0 | 300±61.5 | 5.2±3.4 | 9.3±3.8** |
空白对照 | / | 314±76.7 | 3.0±2.3 | 3.0±1.9 |
由表7可见,参芪益母膏连续给药5天,能增加动物体重,表明参芪益母膏具有明显的增重作用。
表8对母乳汁及乳腺组织学的影响(n=10,X±SD)
组别 | 药量(g/kg) | 乳汁量(ml | 蛋白含量(mg/ml) | 乳腺组织学 |
参芪益母膏(高) | 15.0 | 0.48±0.08** | 121.93±18.16** | +++ |
参芪益母膏(中) | 7.5 | 0.17±0.09 | 98.71±11.83 | ++ |
参芪益母膏(低) | 0.75 | 0.32±0.08** | 113.0±13.98** | +++ |
母婴乐冲剂 | 1.0 | 0.41±0.06** | 116.22±13.39** | +++ |
空白对照 | / | 0.18±0.09 | 89.45±7.19 | ++ |
由表8可见,参芪益母膏可增加排乳量及乳汁中蛋白含量,提示参芪益母膏具有增加乳汁量,提高乳汁质量的作用。
乳腺组织学检查分级标准:乳腺上皮呈柱状,腺泡扩张不明显,无乳汁分泌者为静止期乳腺,以(-)表示。若乳腺上皮呈矮柱状,1/3以上腺泡扩张,少数腺泡内有乳汁者为妊娠期乳腺,以(+)表示。若乳腺上皮变成扁平,超过2/3的腺泡扩张,1/3以上的腺泡含乳汁者即为授乳期乳腺,以(++)表示;若乳腺上皮变得更扁平,且间质变窄,几乎全部乳腺腺泡明显扩张,2/3以上的腺泡充满乳汁,则以(+++)表示。结果,受试药高、低剂量组动物乳腺具有授乳期特征,判为(+++),提示参芪益母膏具有催乳作用。见表8。
2.4.2对仔鼠体重的影响
取出生第4天仔鼠,分成5组,即受试药高、中、低剂量组,阳性对照组及空白对照组,每组30只,雌雄兼有。各组仔鼠每日自由吸食接受不同药物、剂量处理的母鼠乳汁,于实验第4、10天称仔鼠体重,结果见表9。
表9对仔鼠体重的影响(n=10,X±SD)
组别 | 药量(g/kg) | 药前体重(g) | 药后4天体重净增值(g) | 药后10天体重净增值(g) |
参芪益母膏(高) | 15.0 | 13.46±1.98 | 10.95±2.01 | 38.61±3.46* |
参芪益母膏(中) | 7.5 | 12.59±2.34 | 10.22±1.89 | 34.82±4.05 |
参芪益母膏(低) | 0.75 | 14.48±2.00 | 8.38±3.02 | 34.73±4.12 |
母婴乐冲剂 | 1.0 | 13.91±2.26 | 10.63±3.17 | 38.57±3.5* |
空白对照 | / | 13.53±2.05 | 9.51±2.60 | 36.64±3.93 |
由表9可见,药后第10天,参芪益母膏高剂量组与母婴乐冲剂阳性对照组动物体重净均值相近,与空白对照相比较,均有显著性差异,P<0.05,提示参芪益母膏通过增加乳汁形成、提高乳汁质量,从而使仔鼠体重增加。表明参芪益母膏具有催乳作用。
2.5结论
本研究试验表明,参芪益母膏能显著缩短小鼠断尾的出血时间,且呈明显的量效关系;能显著促进血液凝固及非常明显延长血浆凝块的溶解时间;能显著提高小鼠热板致痛的痛觉阈,显著减少小鼠醋酸性致痛(扭体次数,显著提高小鼠光热刺激致痛(甩尾)的痛觉阈;可显著抑制垂体后叶素对豚鼠离体子宫平滑肌的兴奋作用,可减少豚鼠在体子宫平滑肌节律性收缩频率;可增加大鼠体重,延长大鼠乳腺授乳期,使乳汁生成增多,乳汁量增加,乳汁中蛋白含量增加,提高乳汁质量,从而使仔鼠体重增加。表明参芪益母膏具有显著的止血、镇痛、解痉、催乳作用。
(二)动物急性毒性试验
给小白鼠灌服参芪益母膏,12h内给药3次,总剂量为270g药材/kg,BW.(成人(按50kg计)服用剂量为0.6g生药材/kg.d),给药7d内动物均健存,食欲、粪便正常,体重增加26±1.2%,限于药物浓度及体积,未能没出LD50,故其LD50必大于270g生药材/kg,BW。按改良寇氏法测得小鼠ip参芪益母膏时的LD50为21.9±0.97g生药材/kg(P=0.95)。表明参芪益母膏口服的安全性很大。
(三)动物长期毒性试验
给大鼠按1.2g生药材/kg,30g生药材/kg及60g生药材/kg(分别为临床拟用日剂量的2倍、50倍及100倍)连续灌服参芪益母膏28天,结果动物外观、行为、体重增长正常,血常规、血液生化、肝肾功能以及脑垂体、乳腺、胸腺、心、肺、肝、脾、肾、肾上腺、子宫、卵巢11种组织学检查未见异常。表明按拟定剂量、途径和疗程服用参芪益母膏是安全的。
三、临床试验
1.一般资料
选择20~37岁女性患者,治疗组148例,对照组64例。治疗组和对照组年龄分布和病程、病情比较均无显著差异(P>0.05),资料具有可比性,见表10。
表10治疗组(A)与对照组(B)年龄分布和病程、治前病性比较
注:两组比较,P值均>0.05
2.病例选择
2.1纳入标准:凡符合下列情况之一者均可纳入观察对象:
(1)中医辩证属于气血虚弱证之缺乳患者;
(2)中医辩证属于气虚证之产后恶露不绝患者;
(3)中医辩证属于血虚证之产后腹痛患者。
2.2排除标准(包括不适应症及剔除标准):
(1)经检查证实由乳腺发育不良,乳痈及其他乳腺疾病所致,或有消化道疾病史之产后无乳或少乳患者。
(2)经检查证实由盆腔器质性病变或由全身性疾病引起的经量过多患者,以及由蜕膜剥离不全,胎盘或胎膜残留,子宫肌瘤,剖腹产子宫疤痕等因素引起的产后恶露不绝及产后腹痛患者。
(3)年龄18岁以下或50岁以上者,对本发明产品过敏者。
(4)合并有心血管系统,肝、肾、造血系统等严重原发性疾病,精神病患者。
(5)不符合纳入标准,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。
3.诊断标准
(1)缺乳:妇女产后排出的乳汁量少,甚或全无,不够喂养婴儿者。
气血虚弱证:产后乳少,甚或全无,乳汁清稀,乳房柔软无胀感,面色少华,神疲食少,舌淡少苔,脉虚细。
(2)产后恶露不绝:产后恶露持续20天以上,人工流产术后恶露持续14天以上仍淋漓不断者。
气虚证:产后恶露过期不止,量多,或淋漓不断,色淡红,质稀薄,无臭气。小腹宫坠,神倦懒言,面色苍白。舌淡,脉缓弱。
(3)产后腹痛:产后以小腹疼痛为主证者,多为阵发性,不伴寒热等症。
血虚证:产后小腹隐隐作痛,喜按,恶露,量少色淡,头晕耳鸣,大便干燥,舌质淡红,苔薄,脉虚细。
4.观察方法
共观察212例,随机分为2组。其中治疗组148例,使用本发明实施例3样品(参芪益母颗粒),每次1袋,每日3次。对照组64例,缺乳者使用市面销售的乳母乐冲剂,每次1袋(包),每日3次;产后恶露不绝和产后腹痛者使用生化丸,每次1丸,每日3次。疗程:缺乳和产后腹痛者连用3天;产后恶露不绝者连用7天。试验前常规对受试者作详细体格检查,符合病例选择标准者即纳入观察对象。试验后缺乳和产后腹痛者每天随诊1次,月经过多和产后恶露不绝者第3、5、7天各随诊1次,询问服药情况,记录病情及副作用。疗效判断直接由观察者作出。观察期间停用其他类似药物。
5.疗效评定标准
5.1缺乳:
(1)痊愈:乳汁分泌正常,能满足婴儿喂养。
(2)显效:乳汁分泌明显增多,基本能满足婴儿喂养。
(3)有效:乳汁分泌增加,但仍不能满足婴儿喂养。
(4)无效:乳汁分泌无增加。
5.2产后恶露不绝(主要观察近期止血效果):
(1)痊愈:服药5天内完全止血或恶露完全消失。
(2)显效:服药5天内出血或恶露明显减少(较原来减少2/3以上)。
(3)有效:服药7天内出血或恶露明显减少。
(4)无效:服药7天出血或恶露无明显减少。
5.3产后腹痛:
(1)痊愈:服药3天内腹痛完全消失。
(2)显效:服药3天内腹痛明显减轻。
(3)有效:服药3天内腹痛有所减轻。
(4)无效:服药3天腹痛无明显改善。
6.结果
6.1不良反应和安全性评价
观察期间,两组患者均未发现明显不良反应和毒作用。
6.2见证积分治疗前后比较
本试验所纳入之观察对象均为气血虚弱证缺乳患者,或血虚证之产后腹痛患者,或气虚证之产后恶露不绝患者,治疗后患者产后乳少、神疲乏力、产后腹痛、头晕耳鸣以及恶露量多等症均有明显改善(P<0.01),见表11。提示本发明实施例3样品(参芪益母颗粒)具有益气养血、通络下乳、活血祛瘀、理气止痛之功效。
表11见证积分治疗前后比较(X±SD)
注:治疗前后比较,P值均<0.01
6.3临床疗效比较
治疗组148例,对缺乳、产后腹痛和恶露不绝的总有效率分别为94.3%、96.9%和100%。对照组64例,对缺乳、产后腹痛和恶露不绝的总有效率分别为93.3%、96.7%和100%。治疗组与对照组比较均无明显差异(P>0.05),见表12。提示本发明实施例3样品(参芪益母颗粒)治疗气血虚弱证缺乳疗效与乳母乐冲剂一致;治疗产后腹痛和产后恶露不绝疗效与生化丸一致。
表12临床疗效比较(Ridit分析)(例)
7.结论
以上临床试验结果表明,本发明实施例3样品(参芪益母颗粒)具有益养血、通络下乳、活血祛瘀、理气止痛之功效。适用于气血虚弱所致之乳迟乳少、产后腹痛和产后恶露不绝等症,且服用安全可靠,无不良反应副作用。以下为几个典型病例:
例1:卢某,女性,25岁。剖宫产分娩,产后3天仍觉疲乏,食少,乳汁稀少,婴儿大部分依靠库乳喂养。查见:双乳房松软,只能挤出10~15ml乳汁,乳汁清稀,舌质淡,脉细弱。诊断:缺乳(气血虚弱证)。予本发明实施例3样品治疗(参芪益母颗粒),每次1包,每日3次,连服3天。服药2天后乳汁明显增多,自感奶胀,每次挤乳量达100~120ml,满足了母乳喂养。疗效评定:痊愈。
例2:甘某,女性,30岁。自然分娩后即出现小腹部阵发性疼痛,伴有头晕、耳鸣。查见:舌质淡红,苔薄,脉细虚,恶露少,色淡。诊断:产后腹痛(血虚证)。予本发明实施例3样品(参芪益母颗粒)治疗,每次1包,每日3次,连服3天。服药2天后腹痛明显减轻,3天后腹痛及其它症完全消失。疗效评定:痊愈。
例3:马某,女性,24岁。因人流术后恶露不绝20天,自述人流术后已20天,恶露仍淋漓不断,伴有神疲体倦。查见:面色苍白,舌质淡,苔薄白,脉细弱。诊断:产后恶露不绝(气虚证)。予本发明实施例3样品(参芪益母颗粒)治疗,每次1包,每日3次,连服7天。服药3天后恶露明显减少,精神好转。5天后恶露干净,无神疲乏力,面色转红润。疗效评定:痊愈。
Claims (10)
1.一种用于产后恢复的参芪益母中药组合物,其特征在于,包括以下重量份的组分:人参900~1600份、黄芪900~1600份、当归900~1600份、川芎400~800份、麦冬900~1600份、通草100~500份、路路通100~500份、王不留行100~500份、益母草900~1600份、丹参400~800份、香附400~800份、延胡索(醋制)100~500份、蒲黄(生)100~500份、炮姜100~500份、甘草(制)100~500份。
2.根据权利要求1所述的用于产后恢复的参芪益母中药组合物,其特征在于,包括以下重量份的组分:人参1100~1400份、黄芪1100~1400份、当归1100~1400份、川芎500~700份、麦冬1100~1400份、通草200~400份、路路通200~400份、王不留行200~400份、益母草1100~1400份、丹参500~700份、香附500~700份、延胡索(醋制)200~400份、蒲黄(生)200~400份、炮姜200~400份、甘草(制)200~400份。
3.根据权利要求1所述的用于产后恢复的参芪益母中药组合物,其特征在于,包括以下重量份的组分:
人参1250份、黄芪1250份、当归1250份、川芎625份、麦冬1250份、通草250份、路路通250份、王不留行250份、益母草1250份、丹参625份、香附625份、延胡索(醋制)375份、蒲黄(生)250份、炮姜250份、甘草(制)250份;
或人参1250份、黄芪1250份、当归1250份、川芎625份、麦冬1250份、通草250份、路路通250份、王不留行375份、益母草1250份、丹参625份、香附625份、延胡索(醋制)250份、蒲黄(生)250份、炮姜250份、甘草(制)250份。
4.根据权利要求1所述的用于产后恢复的参芪益母中药组合物,其特征在于,包括以下重量份的组分:
人参1400份、黄芪1400份、当归1400份、川芎500份、麦冬1400份、通草250份、路路通250份、王不留行250份、益母草1400份、丹参500份、香附500份、延胡索(醋制)250份、蒲黄(生)250份、炮姜250份、甘草(制)250份;
或人参1100份、黄芪1100份、当归1100份、川芎700份、麦冬1100份、通草375份、路路通375份、王不留行375份、益母草1100份、丹参700份、香附700份、延胡索(醋制)375份、蒲黄(生)375份、炮姜375份、甘草(制)375份。
5.根据权利要求1~4任一所述的用于产后恢复的参芪益母中药组合物,其特征在于,所述中药组合物按照常规工艺加入常规辅料制备成药品领域可接受的任意内服制剂。
6.根据权利要求1~4任一所述的用于产后恢复的参芪益母中药组合物,其特征在于,所述中药组合物按照常规工艺加入常规辅料制备成片剂、胶囊剂、颗粒剂、丸剂、散剂、口服液、糖浆剂、膏剂。
7.根据权利要求1~3任一所述的用于产后恢复的参芪益母中药组合物的制备方法,其特征在于该方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用50~99%的乙醇作溶剂,浸渍6~72小时后,以0.5~6ml/min·kg的速度进行渗漉,收集渗漉液2000~20000ml,药渣与其余黄芪等八味加水煎煮1~4次,每次加水4~15倍量,每次煎煮0.5~3小时,煎液滤过,滤液浓缩至在80℃时相对密度为1.05~1.30,放冷,加乙醇使含醇量达50~80%,静置6~72小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.10~1.35的清膏,按照常规工艺加入常规辅料制备成药品领域可接受的任意内服制剂,包括片剂、胶囊剂、颗粒剂、丸剂、散剂、口服液、糖浆剂、膏剂。
8.如权利要求7所述的中药组合物的制备方法,其特征在于该方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用70%乙醇作溶剂,浸渍24小时后,以1.5ml/min·kg的速度进行渗漉,收集渗漉液5000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.10~1.13,放冷,加乙醇使含醇量达63%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.25~1.27的清膏,按照常规工艺加入常规辅料制备成内服制剂,包括片剂、胶囊剂、丸剂、散剂、口服液、糖浆剂、膏剂。
9.如权利要求7所述的中药组合物的制备方法,其特征在于该方法为:将人参、当归、川芎、丹参、炮姜、香附、路路通粉碎成粗粉,用70%乙醇作溶剂,浸渍24小时后,以1.5ml/min·kg的速度进行渗漉,收集渗漉液5000ml,药渣与其余黄芪等八味加水煎煮三次,第一次加水10倍量,煎煮2小时,第二、三次加水各8倍量、7倍量,煎煮1.5小时,合并煎液,滤过,滤液浓缩至在80℃时相对密度为1.10~1.13,放冷,加乙醇使含醇量达63%,静置24小时,取上清液与上述渗漉液合并,回收乙醇,浓缩至在80℃时相对密度为1.25~1.27的清膏,加入蔗糖粉和糊精各适量,混匀,制成颗粒剂。
10.根据权利要求1~9中任一所述的用于产后恢复的参芪益母中药组合物,其特征在于,所述中药组合物在制备治疗妇女产后乳迟乳少,产后腹痛,恶露不绝等症的药品中的应用。
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