CN109663131A - 润肠通便的组合物 - Google Patents
润肠通便的组合物 Download PDFInfo
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- CN109663131A CN109663131A CN201910106471.3A CN201910106471A CN109663131A CN 109663131 A CN109663131 A CN 109663131A CN 201910106471 A CN201910106471 A CN 201910106471A CN 109663131 A CN109663131 A CN 109663131A
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Abstract
本发明涉及一种润肠通便的组合物,其包括火麻仁3~15份、黄芪2~30份、枳实1~10份、当归1~12份、麦冬2~12份、沙棘1~10份、蒺藜3~10份、山葡萄3~30份、补肾组分2~6份、调理脾胃组分1~5份、动物油脂1~6份以及籽实类组分0.5~10份;本发明的润肠通便组合物旨在健脾养胃,养血生津,补肾益气,疏肝解郁、润肠导滞,用料作用温和,从根本上调理脾肝胃肠,平衡身体,调动身体各器官机能恢复元气,增强润肠通便、调节肠胃道的功能,彻底改善肠胃,实现泻中有补,彻底解决便秘问题,而且无毒副作用,能够防止和减少通便药物所可能导致的不良反应。
Description
技术领域
本发明属于药食组合物领域,特别涉及一种润肠通便的组合物。
背景技术
便秘是临床上常见的疾病,以大便秘结、排便的周期延长或者周期不长,但是粪便干结、排出困难,又或者是粪便不硬但是排便不畅为主要临床表现。便秘虽然不是直接致命的疾病,但是因为便秘带来的一系列后果则可以对整个人体产生严重的影响:(1)易导致痔疮、肛裂;(2)使胃肠道功能紊乱;(3)可以诱发肿瘤或加重心脑血管疾病;(4)长期便秘还可以使心脏负荷增加,心衰的发生率也随之增高;(5)对于老年患者来说,排便用力的过程中,颅内血压升高,持续的颅内高压可能诱发脑血管破裂,导致中风的发生。我国慢性便秘发病率为6%~14.3%,甚至地区发病率可达17.6%;且发病人群年轻化。因此,防治大便秘结,对于保持健康,提升生活质量,建设健康中国等具有十分重要的意义。
《内经》认为,便秘与脾、胃、肾、大肠密切相关,其病机变化为脾虚气逆,胃肠留热,肾水枯涸,并将大便不适列为“五实”,属肾实的范畴。肝气郁结,舒泄不畅,通降失调,大肠不能正常传化,另一方面肝气横逆犯脾,使脾失其运,糟粕内停而致便秘,因此,肝郁气滞也是引起便秘的一个主要原因。
便秘目前主要通过食疗和药物治疗为主,食疗仅能缓解症状,药物治疗则多采用泻药。研究表明泻药大黄酚酞中的蒽醌类物质对肠壁肌间神经丛有损伤作用。目前治疗便秘的药物多采用大黄、黄连、番泻叶。大黄、黄连大苦大寒,过服久服易伤脾胃,拉肚子,影响到肠胃的运化功能,从而影响食欲,导致消化不良。除非体内有实热,否则慎用,对于脾胃虚寒的人不宜服用,枯燥伤津,阴虚津伤者慎用。番泻叶含有蒽醌类物质,这种物质对肠道黏膜有刺激作用,长期服用会造成肠道黏膜病理性改变,即结肠黑变病。结肠黑变病目前被认为是一种癌前病变,可引起结肠癌。
因此,需要研究一种温和有效的能够从根本上调理肠胃的彻底解决便秘问题的组合物。
发明内容
本发明的目的之一是提供一种药性温和、泻中有补,能够调理肠道、脾胃,润肠导滞的润肠通便组合物。
本发明的目的之二提供了上述润肠通便组合物作为主要成分在润肠通便药物或保健品或茶饮料中的应用。
为了实现上述目的,本发明所采用的技术方案是:
一种润肠通便组合物,其按质量份数计,所述组合物包括火麻仁3~15份、黄芪2~30份、枳实1~10份、当归1~12份、麦冬2~12份、沙棘1~10份、蒺藜3~10份、补肾组分2~6份、山葡萄3~30份、调理脾胃组分1~5份、动物油脂1~6份以及籽实类组分0.5~10份。
进一步限定,所述润肠通便组合物还包括水溶性膳食纤维组分0.5~3份和不溶性膳食纤维组分1~15份,水溶性膳食纤维:水溶性膳食纤维结构中含有更多亲水性基团,有很强的吸水能力和与水结合的能力,此作用可使肠道中粪便体积增大,加快其转运速度;另一方面,水溶性膳食纤维在大肠内经细菌发酵会产生较多的水、短链脂肪酸、氢气甲烷,可以增加肠道排气、促进肠胃蠕动,从而有效缓解或解决便秘问题。而不溶性膳食纤维具有很强的保水能力,不被消化道所吸收,但在大肠内能吸收大量水分而膨胀,软化粪便,增强肠蠕动,刺激肠壁产生便意感,加速粪便的排出,达到润肠通便的目的。
进一步限定,所述补肾组分选自动物肾脏、广东虫草子实体、鹿肉、鹿茸、覆盆子、磁石、制首乌、女贞子、山茱萸、菟丝子、沙苑子以及五味子中的一种或任意组合。在生理条件下,肾精的滋养是大肠保持精津润泽的基础,肾气的温通作用是保持精津布散的动力,肾经阴阳元气的正常气化保证了二便的正常,若肾精不足,阴阳气化失常,大肠精津失布而干涩不畅。通过补肾组分,解决大肠精津失布的问题。
进一步限定,所述调理脾胃组分包括显脉旋覆花、泥鳅、黄鳝、桂鱼、党参、茯苓、山药、人参、黄精、白术、鸡内金、苍术、厚朴以及砂仁中的一种或任意组合。
进一步限定,所述籽实类组分包括乌桕籽、西蓝花籽、乐昌含笑种籽、霹雳果、奇亚籽、芹菜籽、木瓜籽、火龙果籽、萝卜籽、香菜籽、韭菜籽、生菜籽、紫苏籽、秋葵籽、杜仲籽、车前子、菠菜籽、葡萄籽、油菜籽、松籽、核桃、开心果、夏威夷果、大杏仁、腰果、银杏仁、板栗、榛子中的一种或任意组合,籽实类含有丰富的油脂和膳食纤维,有助胃肠蠕动,达到润肠效果。
进一步限定,所述不溶性膳食纤维组分包括车前子壳粉、燕麦膳食纤维、藜麦膳食纤维、小麦麸膳食纤维、荞麦膳食纤维、大麦苗粉、香菇粉、芹菜粉、菠菜粉、西兰花粉、猴头菇粉、苹果粉等脱水果蔬粉中的一种或任意组合。
进一步限定,所述水溶性膳食纤维组分包括抗性糊精、魔芋粉、低聚木糖、低聚果糖、菊粉、聚葡萄糖、水苏糖、低聚异麦芽糖、异麦芽酮糖、低聚乳糖、大豆低聚糖、琼脂粉、羧甲基纤维素、壳聚糖中的一种或任意组合。
上述的润肠通便组合物可以制成胶囊、片剂、颗粒剂或者茶汤。
上述的润肠通便组合物作为主要成分在润肠通便药物或保健品或茶饮料中的应用。
本发明的润肠通便组合物以下述中药成分为主要原料,其分别具有如下功效:
火麻仁:甘,平。归脾、胃、大肠经。润肠通便。现代药理研究表明,火麻仁能刺激肠黏膜,使分泌增加,蠕动加快,减少大肠吸收水分,从而起到润肠通便的作用。
黄芪:甘,微温。归肺、脾经。补气升阳,固表止汗,利水消肿,生津养血,行滞通痹。现代药理研究表明黄芪可促进机体新陈代谢,增强小肠运动和平滑肌紧张度,从而达到缓解便秘的疗效。
枳实:苦、辛、酸,微寒。归脾、胃经。破气消积,化痰散痞。枳实可通过提高P物质、血管活性肠肽的含量,以及促进胃泌素分泌提高胃的收缩力,促进胃排空等促进排便。
当归:甘、辛,温。归肝、心、脾经。补血活血,调经止痛,润肠通便。现代药理研究表明当归可明显改善血虚便秘症候,增加结肠和粪便含水量、软化粪便、改善结肠粘液的分泌,促进粪便排出,发挥其“润肠通便”功效。
麦冬:甘、微苦,微寒。归心、肺、胃经。养阴生津,润肺清心。现代药理研究表明,麦冬能加快胃肠道的推进作用,其富含的粘多糖可促进大肠黏液的分泌,进而发挥通便效能。
沙棘:酸、涩,温。归脾、胃、肺、心经。健脾消食,止咳祛痰,活血散瘀。沙棘可消积化食,其含有的活性营养物质能增加胃肠蠕动,促进肠内有益菌群繁殖,达到通便的目的。
蒺藜:辛、苦,微温。归肝经。平肝解郁,活血祛风。用于肝郁气滞引起的便秘。
山葡萄:苦,凉。具有消积,行血、活血,改善由积食和血虚引起的便秘。
调脾胃:脾主运化,脾气虚弱,脾为胃传输津液的功能受到制约,则肠道津亏,大便干燥而难解;胃中有热,即消谷引食,大便必坚。
动物油脂:滑腻,入大肠经,可以“润滑”肠道,使人排便通畅。
本发明的润肠通便组合物以火麻仁、黄芪、当归、枳实、麦冬、沙棘、蒺藜、山葡萄、补肾组分和调脾胃益气血组分配伍,旨在健脾养胃,养血生津,补肾益气,疏肝解郁、润肠导滞,用料作用温和,从根本上调理脾肝胃肠,平衡身体,调动身体各器官机能恢复元气;再通过添加动物油脂、籽实类和水溶性膳食纤维和不溶性膳食纤维,进一步增强润肠通便、调节肠胃道的功能,彻底改善肠胃,实现泻中有补,从根本上对病理部位进行调节,彻底解决便秘问题,而且无毒副作用,能够防止和减少通便药物所可能导致的不良反应。
具体实施方式
现结合实施例和实验对本发明的技术方案进行进一步说明,但是本发明不仅限于下述的实施情形。
本发明的润肠通便组合物,按质量份数计,包括蒺藜3~10份、水溶性膳食纤维组分0.5~3份、不溶性膳食纤维组分1~15份、补肾组分2~6份、调理脾胃组分1~5份、动物油脂1~6份、籽实类组分0.5~10份。
除了上述组分之外,还可以包含火麻仁3~15份、黄芪2~30份、枳实1~10份、当归1~12份、麦冬2~12份、沙棘1~10份、山葡萄3~30份。
进一步说明,上述补肾组分可以选自动物肾脏(如牛肾脏、羊肾脏、猪肾脏、狗肾脏等)、广东虫草子实体、鹿肉、鹿茸、覆盆子、磁石、制首乌、女贞子、山茱萸、山药、菟丝子、沙苑子以及五味子等中的一种或任意组合。
进一步说明,上述调理脾胃组分可以选自显脉旋覆花、泥鳅、黄鳝、桂鱼、党参、茯苓、山药、人参、黄精、白术、鸡内金、苍术、厚朴以及砂仁等中的一种或任意组合。
进一步说明,上述籽实类组分可以选自乌桕籽、西蓝花籽、乐昌含笑种子、霹雳果、奇亚籽、芹菜籽、木瓜籽、火龙果籽、萝卜籽、韭菜子、香菜籽、韭菜子、生菜籽、紫苏籽、秋葵籽、杜仲籽、车前子、菠菜籽、葡萄籽、油菜籽、松籽、核桃、开心果、夏威夷果、大杏仁、腰果、银杏仁、板栗、榛子等中的一种或任意组合。
进一步说明,上述不溶性膳食纤维组分可以选自车前子壳粉、燕麦膳食纤维、藜麦膳食纤维、小麦麸膳食纤维、荞麦膳食纤维、大麦苗粉、香菇粉、芹菜粉、菠菜粉、西兰花粉、猴头菇粉、苹果粉等脱水果蔬粉中的一种或任意组合。
进一步说明,上述水溶性膳食纤维组分可以选自抗性糊精、魔芋粉、低聚木糖、低聚果糖、菊粉、聚葡萄糖、水苏糖、低聚异麦芽糖、异麦芽酮糖、低聚乳糖、大豆低聚糖、琼脂粉、羧甲基纤维素、壳聚糖中的一种或任意组合。
进一步说明,上述组合物可以作为有效成分在润肠通便药物或保健食品或茶饮料中的应用,制成胶囊、粉剂、颗粒剂或者茶饮料等。
实施例一
本实施例制备胶囊型润肠通便药物,具体的制备方法如下:
(1)称取火麻仁6g、黄芪5g、当归4g、麦冬4g、枳实2g、沙棘1.5g、蒺藜3g、山葡萄5g、制何首乌3g、显脉旋覆花3g,加12倍水浸泡1.5个小时,煎煮2次,每次提取2小时,每次煎煮后分离药液,滤过,合并两次煎煮滤液,静止后分取上清液。
(2)将得到的上清液减压浓缩(-0.06MPa,温度为55℃)至50℃时相对密度为1.22,向浓缩液中加入相对浓缩液质量2.5倍体积浓度为95%的乙醇,充分搅拌,静置48h滤过,得滤液,药渣用体积浓度为60%的乙醇洗涤,洗液与滤液合并,减压浓缩(-0.06MPa,温度为55℃)至50℃时相对密度为1.35的清膏,加入3g猪油,搅拌均匀,减压干燥(-0.085Mpa,60℃),粉碎至干膏粉,加入奇亚籽粉1g、抗性糊精2g,混匀,过80目筛,加入60%(w/w)乙醇制粒;将制好的湿颗粒55℃干燥至水分5%以下,整粒,得干颗粒,装入胶囊,即得成品(1g/粒)。
实施例二
本实施例制备片剂型润肠通便保健食品,具体的制备方法如下:
(1)称取火麻仁6g、黄芪4g、当归3g、麦冬3g、枳实3g、沙棘3g、蒺藜4g、山葡萄10g、鸡内金2g、覆盆子3g,加12倍水浸泡2个小时,煎煮2次,每次提取2小时,每次煎煮后分离药液,滤过,合并两次煎煮滤液,静止后分取上清液;
(2)将得到的上清液减压浓缩(-0.07MPa,温度为60℃)至50℃时相对密度为1.22,向浓缩液中加入相对浓缩液质量3倍体积浓度为95%的乙醇,充分搅拌,静置后(静置时间48h)滤过,得滤液,药渣用体积浓度为60%的乙醇洗涤,洗液与滤液合并,减压浓缩(-0.07MPa,温度为60℃)至50℃时相对密度为1.35的清膏,加入3g羊油,搅拌均匀,减压干燥(-0.085Mpa,60℃),粉碎至干膏粉,加入鹿肉冻干粉0.5g、黄鳝冻干粉1g、车前子壳粉1g、乌桕籽粉1g,混匀,过80目筛,加入干膏粉量的1%的羧甲基纤维素钠和2%的羧甲基淀粉钠,混合均匀,加入60%(w/w)乙醇制粒;将制好的湿颗粒55℃干燥至水分5%以下,整粒,得干颗粒;加入干颗粒总量1%的硬脂酸镁,混合,得总混物经压片制成片剂(1g/片)。
实施例三
本实施例制备颗粒剂型润肠通便保健品,具体的制备方法如下:
(1)称取火麻仁7g、黄芪3g、当归3g、麦冬2g、枳实3g、沙棘4g、蒺藜3g、山葡萄3g、广东虫草子实体3g,加12倍水浸泡2个小时,煎煮2次,每次提取2小时,每次煎煮后分离药液,滤过,合并两次煎煮滤液,静止后分取上清液;
(2)将得到的上清液减压浓缩(-0.07MPa,温度为60℃)至50℃时相对密度为1.22,向浓缩液中加入相对浓缩液质量3倍体积浓度为95%的乙醇,充分搅拌,静置后(静置时间48h)滤过,得滤液,药渣用体积浓度为60%的乙醇洗涤,洗液与滤液合并,减压浓缩(-0.07MPa,温度为60℃)至50℃时相对密度为1.35的清膏,加入2g牛油,搅拌均匀,减压干燥(-0.085Mpa,60℃),粉碎至干膏粉;加入桂鱼冻干粉3g、乐昌含笑种子粉2g、车前子壳粉1g、燕麦膳食纤维2g,混匀,过80目筛,备用。将干膏粉、抗性糊精3g混合均匀,用14目筛制粒,55-60℃干燥,12、20目双筛选粒,分装,检验,包装,即得成品(6g/袋)。
实施例四
本实施例制备润肠通便茶饮料,具体的制备方法如下:
步骤(1):按质量配比分别称取以下原料:火麻仁15g、黄芪2g、枳实10g、当归1g、麦冬12g、沙棘1g、蒺藜5g、山葡萄30g、羊鞭3g、覆盆子2g、苍术1g、厚朴2g、砂仁2g、西蓝花籽5g、杜仲籽5g。
步骤(2):向步骤(1)称取的原料中加入原料总质量12倍的水,煎煮2小时后过滤,向滤渣中加入原料总质量8倍的水,煎煮2小时后过滤,合并两次煎煮得到的滤液;
步骤(3):向步骤(2)两次煎煮得到的滤液中加入滤液总质量0.03%的液体果胶酶酶解6h后热沸10min灭酶,待滤液冷却至室温,加入澄清剂并搅拌均匀,澄清剂为ZTC1+1天然澄清剂,其A组分、B组分加入量均为滤液总质量的1.5%,静置40min后过滤除去沉淀,得到酶解后的澄清药液;
步骤(4):将步骤(3)得到的澄清药液,减压浓缩(-0.06MPa,温度为55℃)至500ml,加入猪油6g、低聚异麦芽糖3g、苹果粉5g等,高压均质,精滤即得。
实施例五
与上述实施例一的区别之处在于本实施例的原料配比是:
火麻仁3g、黄芪30g、枳实1g、当归12g、麦冬5g、沙棘10g、蒺藜10g、山葡萄9g、女贞子2g、山茱萸1g、五味子2g、菟丝子1g、党参4g、霹雳果0.5g、羊油1g、魔芋粉1g、低聚木糖1g、低聚果糖1g、藜麦膳食纤维0.5g。
实施例六
与上述实施例二的区别之处在于本实施例的原料配比是:
火麻仁12g、黄芪12g、枳实5g、当归2g、麦冬5g、沙棘3g、蒺藜5g、山葡萄4g、磁石3g、制首乌3g、泥鳅1g、人参0.5g、黄精0.6g、白术2g、芹菜籽2g、木瓜籽2g、火龙果籽2g、羊油2g、菊粉2g、聚葡萄糖1g、车前子壳粉2g、燕麦膳食纤维3g。
实施例七
与上述实施例三的区别之处在于本实施例的原料配比是:
火麻仁12g、黄芪12g、枳实5g、当归2g、麦冬5g、沙棘3g、蒺藜5g、山葡萄7g、羊肾脏5g、茯苓2g、山药3g、萝卜籽1g、韭菜子2g、香菜籽1g、生菜籽1g、紫苏籽1g、秋葵籽2g、牛油2g、水苏糖1g、异麦芽酮糖1g、低聚乳糖1g、小麦麸膳食纤维3g、荞麦膳食纤维4g、大麦苗粉3g。
实施例八
与上述实施例四的区别之处在于本实施例的原料配比是:
火麻仁5g、黄芪12g、枳实1g、当归3g、麦冬10g、沙棘9g、蒺藜3g、山葡萄4g、猪肾脏3g、广东虫草子实体3g、显脉旋覆花3g、苍术2g、菠菜籽1g、葡萄籽2g、油菜籽1g、松籽1g、核桃1g、开心果2g、夏威夷果0.5g、大杏仁0.5g、牛油5g、大豆低聚糖1g、琼脂粉1g、羧甲基纤维素1g、藜麦膳食纤维2g。
为了验证本发明的润肠通便组合物的通便效果,现以下述动物实验和人体实验为例进行说明。
试验例一
(一)动物实验
采用小鼠作为受试动物,取100只小鼠,雌雄各半,体重为18~22g,将小鼠分为小肠运动试验和排便试验两个大组,再根据小鼠体重水平将每个大组分为空白对照组、模型对照组和三个剂量组共5个小组,每小组10只,共100只,进行小肠运动、排首粒黑便时间、排粪便粒数、粪便重量及形状的测定实验。
将实施例三制备的样品,按相当于人体推荐量的10倍、20倍、30倍确定小鼠的低、中、高剂量,即小鼠每日食用量分别为3g/kg·bw、6g/kg·bw、12g/kg·bw,用去离子水溶解受试样品。
经口每日一次灌胃给予小鼠受试物,灌胃体积按0.2ml/10g·bw计。低、中、高剂量组中受试物溶液的浓度分别为15%、30%、60%,空白对照组和模型对照组以等体积的去离子水代替受试物溶液灌胃。连续给予15d后测通便功能的各项指标。
1、小肠运动试验
末次给予受试物后,各组小鼠禁食不禁水16h后。除正常对照组外,其余各组灌胃复方地芬诺酯(5mg/kg·bw),空白对照组给予蒸馏水。给复方地芬诺酯片后0.5h后,剂量组分别给予含相应受试样品的墨水(含5%的活性炭粉、10%阿拉伯树胶),阴性和模型对照组给墨汁灌胃,25分钟后立即脱颈椎处死动物,打开腹腔分离肠系膜,剪取上端自幽门、下端至回盲部的肠管,置于托盘上,轻轻将小肠拉成直线,测量肠管长度为“小肠总长度”,从幽门至墨汁前沿为“墨汁推进长度”。按下式计算墨汁推进率(P)后进行统计分析。
墨汁推进率(%)=墨汁推进长度(cm)/小肠总长度(cm)×100%
排首粒黑便时间、粪便粒数和粪便重量的测定:末次给予受试样品后各组小鼠禁食不禁水16小时后,模型对照组和三个剂量组灌胃给予复方地芬诺酯(10mg/kg·bw),空白对照组给予等量的蒸馏水。给复方地芬诺酯0.5h后,模型对照组和空白对照组小鼠给予墨汁灌胃,三个剂量组给予含相应受试样品的墨汁,同时开始计时。每只动物均单独饲养,正常饮水、进食,观察记录每只小鼠首次黑便时间、5小时内排便粒数及重量。实验所得数据均为数值变量资料。所有数据均经SPSS统计软件进行方差分析。方差齐用方差分析,方差不齐用秩和检验。
1.1对小鼠体重的影响
表1对小肠运动实验小鼠的初始体重和结束体重的影响
由表1可见,各组动物的体重无显著性差异(P>0.05)
表2对排便实验小鼠的初始体重和结束体重的影响
由表2可见,各组动物的体重无显著性差异(P>0.05)。
1.2对小肠运动实验的影响
表3对小鼠小肠运动的影响
由表3可见,经墨汁推进率统计分析,模型对照组小鼠的墨汁推进率显著低于空白对照组(P<0.01),说明便秘模型成立;高剂量组小鼠的墨汁推进率显著高于模型对照组(P<0.05)。
1.3对小鼠首粒黑便时间、粪便粒数和粪便重量的影响
表4对小鼠首粒黑便时间的影响
由表4可见,经口给予样品后,模型对照组的小鼠首粒黑便时间显著大于空白对照组(P<0.01),说明便秘模型成立;高剂量组的首粒黑便时间显著性短于模型对照组(P<0.01)。
表5对小鼠粪便粒数的影响
由表5可见,经口给予样品后,模型对照组的小鼠粪便粒数显著低于空白对照组(P<0.05),说明便秘模型成立;高剂量组粪便粒数也明显多于模型对照组(P<0.05)。
表6对小鼠粪便质量的影响
由表6可见,经口给予样品后,模型对照组的小鼠粪便重量显著低于空白对照(P<0.01),说明便秘模型成立;高剂量组粪便重量也明显多于模型对照组(P<0.01)。
由上述实验表明,经口给予小鼠不同剂量的本发明的样品后,对小鼠体重增长无不良影响,能促进便秘小鼠的小肠推进运动;缩短便秘小鼠的首粒黑便时间,增加所排粪便的粒数和重量,即本发明的润肠通便组合物具有通便功能。
(二)通便功能人体试食试验
1、试验方法
1.1试验样品:实施例三制备的样品
人体推荐量:口服,每次1袋,每日3次,服用量为18g/日。
1.2受试对象:按自愿原则在填写知情同意书后,选择符合下述标准者作为受试者。
纳入标准受试者:排便次数减少和粪便硬度增加者。大便一周少于3次者。无器质性便秘者。习惯性便秘者。
受试者排除标准:不能进口进食者或不能按规定服用受试样品者。主诉不清者。体质虚弱无法进行试验者。30天内进行过外科手术引起便秘症状发生者,因严重器质病变引起的近期排便困难者。结肠癌,严重的肠炎、肠梗阻,炎症性肠病等。便秘困难并拌有疼痛者。30天内发生过急性胃肠道疾病者。孕期及经期妇女。合并有心血管、肝、肾和造血系统等严重全身疾病患者。有其它伴随疾病正在治疗者。短期内服用与受试功能有关的物品,影响到对结果的判断者。
1.3试验设计与分组要求:采用自身和组间对照两种试验设计。按受试者的便秘症状(排便次数、粪便性状、症状持续时间等)随机分为试食组和对照组,尽可能考虑到影响结果的主要因素如年龄、性别、日常饮食、便秘原因、病程等,进行均衡性检验,以保证组间的可比性。每组受试者不少于50例。
1.4试食剂量及时间:受试者在受试期间保持平时的生活和饮食习惯。试食组口服,每次1袋,每日3次。连续服用15天。对照组为空白对照。
2、观察指标:
2.1一般情况:受试者在试食期间的精神、饮食、睡眠、大小便、血压、心率等。
2.2安全性指标
2.2.1血、尿、便常规检查:红细胞计数(RBC)、血红蛋白(Hb)、白细胞计数(WBC),尿、大便常规检查。
2.2.2肝、肾功能检查:谷草转氨酶、谷丙转氨酶、血清总蛋白、白蛋白、尿素氮、肌肝、甘油三酷、总胆固醇、血糖。
2.2.3胸透、心电图、腹部B超检查(仅在试验开始前检查一次)。
2.3功效性指标:每日对受试者进行询问并记录,同时记录受试者服用受试样品前6天及试验时的情况。
2.3.1每日排便次数记录受试者试食前后排便次数的变化。
2.3.2排便状况
根据排便困难程度(腹痛或肛门烧灼感、下坠感、不适感,有否便频但排便困难而量少等症状)分为I一Ⅳ级,统计积分值。
I级(0分):排便正常
II级(1分):仅有下坠感、不适感
III级(2分):下坠感、不适感明显,或有便频但排便困难而量少,较少出现腹痛或肛门烧灼感
Ⅳ级(3分):经常出现腹痛或肛门烧灼感,影响排便
2.3.3粪便性状
根据布里斯托(Bristol)粪便性状分类法将粪便性状分为I-III级。
I级(0分):像香肠或蛇,平滑而且软;像香肠,但在它的表面有裂痕;软的团块,有明显的边缘(容易排出)
II级(1分):香肠形状,但有团块;松散的块状,边缘粗糙,像泥浆状的粪便
III级(2分):分离的硬团,像果核(不易排出)
2.3.4日常饮食情况:纤维素类食物的比例。
2.3.5记录有无不良反应(恶心、胀气、腹泻、腹痛及粪便异常等)。
2.4功效性观察的质量控制:70%调查表格复核;电话提示和面对面咨询进行随访,人均1-2次/周;膳食调查采用统一规格的食物估重图片,减少食物估重的误差。
3、数据处理和结果判定
3.1数据处理:试验数据为计量资料,可用t检验进行分析。凡自身对照资料可以采用配对t检验,两组均数比较采用成组t检验,后者需进行方差齐性检验,对非正态分布或方差不齐的数据进行适当的变量转换,待满足正态方差齐性后,用转换的数据进行t检验;若转换数据仍不能满足正态方差齐性要求,改用t’检验或秩和检验:但变异系数太大(>50%)的资料应用秩和检验。
3.2结果判定:试食前后试食组自身比较排便次数明显增加,排便状况和粪便性状二项指标中一项指标积分明显下降,差异有显著性;试食后试食组与对照组比较,排便次数、排便状况和粪便性状任一项明显改善,差异有显著性,可判定该受试样品具有通便功能的作用。
4、试验结果
4.1一般资料:纳入受试者116人,随机分为试食组和对照组。对照组脱失受试者2人,有效受试者为114人,试食组57人,对照组57人,年龄在25-65岁。按年龄、性别、病程。
试食期间受试者精神正常,饮食、睡眠、小便、血压、心率均无异常表现;X-胸透、心电图、腹部B超未见异常:受试者在试食期间无恶心、胀气、腹泻、腹痛及粪便异常不良反应;
试食前两组一般情况、便秘程度情况见表7、表8。
表7试食前一般情况比较
表8试食前后心率和血压变化比较
从表7、表8中可见,试食组和对照组试食前的性别、年龄、病程及血压、心率均无显著差异(P>0.05)。说明两组具有可比性。
表9试食前后两组便秘程度的组间比较
由表9中可见,试食组和对照组试食前的排便次数、排便状况和粪便性状差异均无显著性(P>0.05)。说明两组具有可比性。
4.2对便秘人群功效指标的影响
4.2.1试食前后试食组便秘程度的自身比较
表10试食前后试食组与对照组便秘程度的自身比较
表10表明,试食前后自身比较,试食组的排便次数增加(P<0.001)、排便状况、粪便性状均有改善(P<0.001)。对照组的排便次数、排便状况、粪便性状均无显著性差异(P>0.05)。
4.2.2试食后两组便秘程度的组间比较
表11试食后两组便秘程度的组间比较
表11结果表明:试食后与对照组比较,试食组排便次数增加,差异有显著性(P<0.001),排便状况及粪便性状也均有改善,显著差异(P<0.001)。
4.2.3试食前后两组纤维素类食物摄入量的自身比较
表12试食前后两组纤维素类食物摄入情况
由表12可见,试食组和对照组纤维素类食品摄入量试食前后自身比较及两组间比较均无显著差异(P>0.05)。
4.3对便秘人群安全指标的影响
4.3.1试食前后两组血、尿、便常规的自身比较
表13试食前后两组血尿常规的自身比较
从表13可见两组受试者的红细胞、白细胞、血红蛋白、血小板均处于正常范围,且两组试食前后自身比较差异无显著(P>0.05);两组受试者尿、便常规试食前后均基本正常。
4.3.2试食前后血液生化指标的自身比较
表14试食前后血液生化指标的自身比较
明两组受试者的血清总蛋白、白蛋白、谷丙转氨酶、吞草转氨酶、甘油三酯、总胆固醇、肌酐、尿素氮、血糖均基本处于正常范围内;且两组试食前后自身比较差异均无显著性(P>0.05)。
4.4受试者脱失率
纳入受试者116例,试食组57例、对照组57例,对照组有2例未按规定参加体格检测,符合受试者排除标准,有效受试者试食组57例、对照组57例。试食组、对照组受试者脱失率均为1.7%。
4.5不良反应观察:未见过敏及其他不良反应
表15食后两组在试食期间过敏及其他不良反应情况
5、结论
5.1采用自身与组间两种对照设计。114例符合要求的有效受试者,其中试食组57人、对照组57人。对照组为空白对照。试食组按要求服用,口服,每次1袋,每日3次。服用15天后试食组试食前后自身比较排便次数明显增加(P<0.001)、排便状况和粪便性状两项指标积分明显下降(P<0.001);试食后试食组与对照组比较,排便次数明显增加(P<0.001)、排便状况和粪便性状两项指标积分明显改善(P<0.001);根据《保健食品检验与评价技术规范》(2003年版)功能学评价检验方法中二十六通便功能检验方法人体试食试验的判定标准,结果显示本发明的润肠通便组合物具有通便功能。
5.2试食前后三天膳食调查结果显示试食组和对照组纤维素类食品摄入量试食前后自身比较和组间比较差异均无显著性;试食前后纤维素类食物的比例均无改变,说明饮食因素对试验结果无影响。
5.3试食者胸透、腹部B超、心电图均基本在正常范围。试食本发明的润肠通便组合物前后,除试食后大便性状改善外,血、尿、大便及肝肾功能各项检测指标均基本在正常范围,说明本品对试食者身体健康无不良影响。
5.4在试食本发明的润肠通便组合物过程中未观察到过敏及不良反应(恶心、胀气、腹泻、腹痛等)。
试验例二
选择年龄55岁以上的便秘患者;病程在一年以上;大便干结,排便费力;纤维肠镜排除结肠、直肠品质性病变。
临床实验分组:采取随机对照试验方法,分为两组,治疗组52例,对照组52例。治疗前两组在年龄、性别、病程等方面的比较,均经过统计学分析,具有可比性。
方法:对照药品为麻仁软胶囊,每日3次,每次2粒。
治疗组用本发明实施例一的胶囊剂,每天3次,每次2粒。
疗效评定标准:
治愈:2天排便1次,便质转润,解时通畅,短期无复发;
有效:3天排便1次,便质转润,排便欠畅;
无效:症状无改善。
结果:见表16
表16两组患者疗效比较
上述临床试验结果表明本发明组合物与对照组相比具有很好的润肠通便疗效,总有效率达98.08%。
试验例三
将实施例四所得润肠通便茶饮料与纯山葡萄水按照试验例二的方法进行通便功效对比。
上述山葡萄水的制备是将30g山葡萄用清水浸泡30分钟,洗净,放入砂锅中,倒入500ml清水,盖锅盖大火煮滚15分钟,过滤,用水补足500ml,即得。
食用量:实施例4所得润肠通便组合物制成茶饮料与山葡萄水均为500ml/次,每天一次。
对比结果如下表17所示:
表17实施例4所得润肠通便组合物制成茶饮料与山葡萄水的功效对比
组别 | 总例数 | 治愈 | 有效 | 无效 | 治愈率(%) | 总有效率(%) |
山葡萄水 | 50 | 4 | 8 | 38 | 8.00 | 24.00 |
本发明的茶饮料 | 50 | 35 | 13 | 2 | 70.00 | 96.00 |
上述试验结果表明本发明组合物与山葡萄水相比具有很好的润肠通便疗效,总有效率达96.00%。
Claims (9)
1.一种润肠通便的组合物,其特征在于,包括火麻仁3~15份、黄芪2~30份、枳实1~10份、当归1~12份、麦冬2~12份、沙棘1~10份、蒺藜3~10份、山葡萄3~30份、补肾组分2~6份、调理脾胃组分1~5份、动物油脂1~6份以及籽实类组分0.5~10份。
2.根据权利要求1所述的润肠通便的组合物,其特征在于还包括水溶性膳食纤维组分0.5~3份和不溶性膳食纤维组分1~15份。
3.根据权利要求2所述的润肠通便的组合物,其特征在于,所述补肾组分选自动物肾脏、羊鞭、广东虫草子实体、鹿肉、覆盆子、磁石、制何首乌、女贞子、山茱萸、菟丝子、沙苑子以及五味子中的一种或任意组合。
4.根据权利要求3所述的润肠通便的组合物,其特征在于,所述调理脾胃组分包括显脉旋覆花、泥鳅、黄鳝、桂鱼、党参、茯苓、山药、人参、黄精、白术、鸡内金、苍术、厚朴以及砂仁中的一种或任意组合。
5.根据权利要求3所述的润肠通便的组合物,其特征在于,所述籽实类组分包括乌桕籽、西蓝花籽、乐昌含笑种籽、霹雳果、奇亚籽、芹菜籽、木瓜籽、火龙果籽、萝卜籽、香菜籽、韭菜籽、生菜籽、紫苏籽、秋葵籽、杜仲籽、车前子、菠菜籽、葡萄籽、油菜籽、松籽、核桃、开心果、夏威夷果、大杏仁、腰果、银杏仁、板栗、榛子中的一种或任意组合。
6.根据权利要求3所述的润肠通便的组合物,其特征在于,所述不溶性膳食纤维组分包括车前子壳粉、燕麦膳食纤维、藜麦膳食纤维、小麦麸膳食纤维、荞麦膳食纤维、大麦苗粉、香菇粉、芹菜粉、菠菜粉、西兰花粉、猴头菇粉、苹果粉等脱水果蔬粉中的一种或任意组合。
7.根据权利要求3所述的润肠通便的组合物,其特征在于,所述水溶性膳食纤维组分包括抗性糊精、魔芋粉、低聚木糖、低聚果糖、菊粉、聚葡萄糖、水苏糖、低聚异麦芽糖、异麦芽酮糖、低聚乳糖、大豆低聚糖、琼脂粉、羧甲基纤维素、壳聚糖中的一种或任意组合。
8.根据权利要求1~7任一项所述的润肠通便的组合物,其特征在于,所述组合物制成胶囊、粉剂、颗粒剂或者茶饮料。
9.权利要求1~7任一项所述的润肠通便的组合物作为主要成分在润肠通便药物或保健品或茶饮料中的应用。
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