CN109674874A - 一种治疗老年糖尿病性周围神经病变的中药足浴护理液 - Google Patents
一种治疗老年糖尿病性周围神经病变的中药足浴护理液 Download PDFInfo
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Abstract
本发明涉及一种治疗老年糖尿病性周围神经病变的中药足浴护理液，由包含如下重量份的中药材制备而成：丝瓜络8‑15份、松叶10‑15份、路路通8‑10份、延胡索2‑10份、透骨草5‑15份、红花7‑15份、地龙2‑10份、五加皮7‑10份、蜈蚣8‑12份、花椒8‑15份、土鳖虫7‑15份、艾叶10‑20份；本发明中药的药物君臣佐使，共奏祛风除湿、舒筋通络、益气补虚、活血化瘀的功效。可以通过局部中药足浴能够有效的改善糖尿病患者周围神经的病变，加快神经的传导速度，达到较好的临床效果。
Description
技术领域
本发明属于中医护理技术领域，具体涉及一种治疗老年糖尿病性周围神经病变的中药足浴护理液。
背景技术
糖尿病周围神经病变是糖尿病常见并发症之一。近年来，随着经济和社会的发展，人群生活方式的改变、人口结构的老龄化，临床检验的普及化，糖尿病尤其是2型糖尿病的发病率日益增多，检出率大大提高。随之而来的糖尿病周围神经病并发症也在逐年增加。其中，糖尿病周围神经病变中的末梢神经病变，主要表现为手足感觉异常如冷凉、麻木、疼痛、灼热等，是糖尿病神经并发症研究的焦点。临床表现是①感觉多是从足趾开始，经数月或数年逐渐向上发展，通常达到膝盖时出现上肢症状，亦是从手指向腕部发展。后期可伴有胸、腹部的感觉异常。②突出的症状是自发性感觉异常，从很轻的不适感、表浅的“皮痛”到难以忍受的不适感或深部的“骨痛”。典型的疼痛可为灼痛、钝痛、压榨样痛、刺痛、痉挛痛或撕裂样疼痛，下肢比上肢重，夜间加重。多数患者除疼痛外，还会有麻木、发冷感。足底出现轻触摸的不适感变为疼痛或强烈不适感，是本病的一个特征性症状。③体检时患者常常有麻木、疼痛等感觉，在双手呈“手套”样分布，而在双足这些不良的感觉呈“袜子”样分布的，并且从手指尖、脚趾尖向上逐渐加重的疼痛、麻木、温度觉减退或消失。发病早期呈相对可逆性，后期发展为顽固性难治性神经损伤。发病机制目前尚未完全清楚，普遍认为其发生与血管病变、代谢紊乱、神经生长因子减少、遗传因素、自身免疫功能及血液流变性改变等多种因素相互作用有关。临床上一般以血糖控制、营养神经、改善微循环等综合治疗，但对部分病程长久，并发症严重患者疗效较差，不能明显缓解症状。
目前国内外尚无特殊疗法，西医除控制血糖外，多采用B族维生素、血管扩张剂、镇痛药及抗氧化、补充神经营养因子等治疗，实践中发现其治疗效果并不理想，且有副作用，而且西药普遍工艺复杂，成本高昂，普通家庭难以承受。
中药足浴是用中药煎煮取汁泡脚的一种保健治疗方法，通过中药足浴和足部按摩刺激，促使全身血液循环改善，调节各脏腑器官的功能，改善内脏产生的病理变化，提高机体自我防御及免疫力，达到治病防病的目的。
发明内容
为了解决现有西药对糖尿病周围神经病变的疗效较差的问题，本发明提供一种治疗老年糖尿病性周围神经病变的中药足浴护理液。本发明根据传统中医理论，经过对药物组分的大量筛选、重组、尝试、又通过大量动物实验研究作出，中药组合物在治疗糖尿病周围神经病变上具有独特的优势，弥补了西药治疗该病的不足，无副反应，成本低，改善了患者的生活质量，减轻了社会和家庭巨大的经济负担。
本发明的目的是这样实现的：
一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络8-15份、松叶10-15份、路路通8-10份、延胡索2-10份、透骨草5-15份、红花7-15份、地龙2-10份、五加皮7-10份、蜈蚣8-12份、花椒8-15份、土鳖虫7-15份、艾叶10-20份；按重量份数计，分别称取上述中药组合物，混合后得混合提取物；将所述混合提取物在超微粉碎机中粉碎至300～500目；对粉碎至300～500目的混合提取物进行梯度升温杀菌处理，所述梯度升温杀菌处理工艺为：杀菌温度为75-85℃，升温速率为5～10℃/min，杀菌时间为5～10min；然后杀菌温度为105-108℃，升温速率为5～10℃/min，杀菌时间为15～30min；然后杀菌温度为135-145℃，升温速率为3～6℃/min，杀菌时间为10～15min；包装得到药粉包；使用时煮沸15-20min或者用沸水浸泡药粉包15-30min，即得中药足浴护理液。
优选的是：由包含如下重量份的中药材制备而成：丝瓜络8份、松叶10份、路路通8份、延胡索10份、透骨草15份、红花7份、地龙2份、五加皮10份、蜈蚣8份、花椒8份、土鳖虫15份、艾叶10份。
优选的是：由包含如下重量份的中药材制备而成：丝瓜络15份、松叶15份、路路通10份、延胡索2份、透骨草5份、红花7份、地龙10份、五加皮10份、蜈蚣12份、花椒8份、土鳖虫7份、艾叶20份。
优选的是：由包含如下重量份的中药材制备而成：丝瓜络10份、松叶10份、路路通10份、延胡索6份、透骨草10份、红花10份、地龙6份、五加皮8份、蜈蚣10份、花椒10份、土鳖虫10份、艾叶15份。
使用方法：待药液温度降至35℃～4O℃时开始泡足，水面至踝关节10cm以上，每次浸泡30min～40min，每天1次，连续3d～5d，4周为1个疗程。
本发明中，丝瓜络有通行经络和凉血解毒的作用，脚上穴位和经络丰富，可以起到加快血液循环的功效；松叶泡脚可以调节内分泌系统，促进胰岛细胞陕复功能，达到控制血糖目的；路路通活血化瘀，延胡索行气、活血、止痛，透骨草祛风除湿，舒筋通络，活血止痛；红花促进血液循环，祛淤止痛，缓解疼痛；地龙清热息风、通络；五加皮促进血液循环；蜈蚣熄风镇痉,解毒散结,通络止痛；花椒水泡脚舒缓疲劳，促进睡眠、祛除五脏六腑的寒气，能够通血脉，帮助调节关节的湿气寒气；土鳖虫逐瘀、通经络；艾叶驱火祛寒。
本发明中药的药物君臣佐使，共奏祛风除湿、舒筋通络、益气补虚、活血化瘀的功效。足部有着非常多的穴位和反射区，通过温热对其反射区进行刺激能够有效的扩张血管、加速经络的传递和吸收的作用，药物经皮肤和黏膜等多种途径乘热而行，直达病灶。中药能够起到双重的作用，其治疗没有痛苦，没有创伤，并且经济，患者的接受程度较高，可以通过局部中药足浴能够有效的改善糖尿病患者周围神经的病变，加快神经的传到速度，达到较好的临床效果。
具体实施方式
实施例1
一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：由包含如下重量份的中药材制备而成：丝瓜络8份、松叶10份、路路通8份、延胡索10份、透骨草15份、红花7份、地龙2份、五加皮10份、蜈蚣8份、花椒8份、土鳖虫15份、艾叶10份；按重量份数计，分别称取上述中药组合物，混合后得混合提取物；将所述混合提取物在超微粉碎机中粉碎至300～500目；对粉碎至300～500目的混合提取物进行梯度升温杀菌处理，所述梯度升温杀菌处理工艺为：杀菌温度为75-85℃，升温速率为5～10℃/min，杀菌时间为5～10min；然后杀菌温度为105-108℃，升温速率为5～10℃/min，杀菌时间为15～30min；然后杀菌温度为135-145℃，升温速率为3～6℃/min，杀菌时间为10～15min；包装得到药粉包；使用时煮沸15-20min或者用沸水浸泡药粉包15-30min，即得中药足浴护理液。
实施例2
一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络15份、松叶15份、路路通10份、延胡索2份、透骨草5份、红花7份、地龙10份、五加皮10份、蜈蚣12份、花椒8份、土鳖虫7份、艾叶20份；按重量份数计，分别称取上述中药组合物，混合后得混合提取物；将所述混合提取物在超微粉碎机中粉碎至300～500目；对粉碎至300～500目的混合提取物进行梯度升温杀菌处理，所述梯度升温杀菌处理工艺为：杀菌温度为75-85℃，升温速率为5～10℃/min，杀菌时间为5～10min；然后杀菌温度为105-108℃，升温速率为5～10℃/min，杀菌时间为15～30min；然后杀菌温度为135-145℃，升温速率为3～6℃/min，杀菌时间为10～15min；包装得到药粉包；使用时煮沸15-20min或者用沸水浸泡药粉包15-30min，即得中药足浴护理液。
实施例3
一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络10份、松叶10份、路路通10份、延胡索6份、透骨草10份、红花10份、地龙6份、五加皮8份、蜈蚣10份、花椒10份、土鳖虫10份、艾叶15份；按重量份数计，分别称取上述中药组合物，混合后得混合提取物；将所述混合提取物在超微粉碎机中粉碎至300～500目；对粉碎至300～500目的混合提取物进行梯度升温杀菌处理，所述梯度升温杀菌处理工艺为：杀菌温度为75-85℃，升温速率为5～10℃/min，杀菌时间为5～10min；然后杀菌温度为105-108℃，升温速率为5～10℃/min，杀菌时间为15～30min；然后杀菌温度为135-145℃，升温速率为3～6℃/min，杀菌时间为10～15min；包装得到药粉包；使用时煮沸15-20min或者用沸水浸泡药粉包15-30min，即得中药足浴护理液。
应用例1临床试验
糖尿病性周围神经病变患者58例，其中男性25例，女性23例，年龄(50-65)岁，平均年龄(56±1.2)岁，糖尿病病程为(8.3±1.3)年，糖尿病并发糖尿病性周围神经病变病程(2.4±0.8)。
为了试验的公平性，随机将所有患者分为试验组和对照组各29例，两组患者性别，年龄，病程等方面比较差异无统计学意义，具有可比性。
试验组进行本发明中药足浴治疗，中药足浴的方剂为实施例1的组方。使用方法：待药液温度降至35℃～4O℃时开始泡足，水面至踝关节10cm以上，每次浸泡30min～40min，每天1次，连续5d，4周为1个疗程。
对照组不加药液，采用温水足浴，1日1次，连续5d，所有患者治疗4周为1个疗程。
治疗4周后按以下指标进行评定：
①症状及体征：麻木、刺痛、冷感、灼热、瘙痒感、足部触觉、振动感觉、踝反射。
②神经传导速度：运动神经传导速度是测定冲动在快速运动纤维上传导的一种方法，能直接测定运动神经的兴奋性和传导性。
测定运动神经传导速度，采用间距为20-30mm的双电极，选择神经干近、远两点作为刺激点。
临床疗效评定：
症状、体征完全消失，肌电图显示神经传导速度接近正常人为治愈；
症状、体征明显缓解，肌电图显示神经传导速度有2项增加≥5m/s为显效；
症状、体征有所改善，肌电图显示神经传导速度至少有1项增加≥5m/s或有2项增加且＜5m/s者为有效；
症状、体征和肌电图无任何变化甚至加重者为无效。
试验结束后，比较两组患者治疗后的总有效率和无效率。
试验组患者的总有效率(96.6％)明显高于对照组患者的总有效率(48.3％)，见表1。
该结果证明本发明的一种治疗老年糖尿病性周围神经病变的中药足浴护理液干预治疗老年糖尿病性周围神经病变是安全有效的，可以通过局部中药足浴能够有效的改善糖尿病患者周围神经的病变，加快神经的传导速度，达到较好的临床效果，非常适合现代老年患者使用。
表1两组患者的临床疗效比较[例(％)]
| 组 | 病例 | 无效 | 有效 | 显效 | 治愈 |
| 试验组 | 29 | 1 | 8 | 12 | 8 |
| 对照组 | 29 | 15 | 8 | 6 | 0 |
典型病例
病例1
王某，男，58岁，青岛人，于2016年4月23日就诊。糖尿病病史4年，主诉夜尿频繁，双下肢麻木，大便正常。舌质红，苔薄，脉沉细。查体见BP135/76mmHg，心肺听诊无异常，双足背动脉波动减弱。
目前自服消渴丸以降糖，血糖控制差。查空腹血糖9.8mmol/L，糖化血红蛋白8.9％，双下肢肌电图显示：右侧腓总神经感觉传导损害，胫神经脱髓鞘性损害。诊断为糖尿病性周围神经损害。以本发明实施例1足浴1日1次，连续5天，1周后复查空腹血糖7.9mmol/L，患者自诉双下肢麻木感觉减轻，继续足浴1月后，患者自诉无双下肢麻木症状。
病例2
刘某，男，59岁，济南人，于2017年5月1日就诊。糖尿病病史11年，主诉视物模糊、双下肢自觉发凉，触之温暖，夜尿多，大便干，2～3日1次，舌质红，苔薄，脉细。
现采用胰岛素治疗控制血糖，血糖控制可，查空腹血糖(指尖血)6.9mmol/L，肝功能、肾功能正常，糖化血红蛋白9.2％，双下肢肌电图示：双下肢多发神经损害。根据临床表现及辅助检查诊断为糖尿病周围神经损害，予以本发明实施例1足浴1日1次，连续5天，1月后患者自诉双下肢自觉发凉减轻。
病例3
李某，男，65岁，青岛人，于2015年6月1日就诊。糖尿病病史15年，主诉双下肢麻木、疼痛、瘙痒，大便正常，舌质暗，苔薄白，脉细。
现采用二甲双胍治疗控制血糖，血糖控制可，查空腹血糖(指尖血)6.8mmol/L，肝功能、肾功能正常，糖化血红蛋白9.0％，双下肢肌电图示：双下肢多发神经损害。根据临床表现及辅助检查诊断为糖尿病周围神经损害，予以本发明实施例1足浴1日1次，连续5天，1月后患者自诉麻木、疼痛、瘙痒减轻。
Claims (4)
1.一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络8-15份、松叶10-15份、路路通8-10份、延胡索2-10份、透骨草5-15份、红花7-15份、地龙2-10份、五加皮7-10份、蜈蚣8-12份、花椒8-15份、土鳖虫7-15份、艾叶10-20份；按重量份数计，分别称取上述中药组合物，混合后得混合提取物；将所述混合提取物在超微粉碎机中粉碎至300～500目；对粉碎至300～500目的混合提取物进行梯度升温杀菌处理，所述梯度升温杀菌处理工艺为：杀菌温度为75-85℃，升温速率为5～10℃/min，杀菌时间为5～10min；然后杀菌温度为105-108℃，升温速率为5～10℃/min，杀菌时间为15～30min；然后杀菌温度为135-145℃，升温速率为3～6℃/min，杀菌时间为10～15min；包装得到药粉包；使用时煮沸15-20min或者用沸水浸泡药粉包15-30min，即得中药足浴护理液。
2.根据权利要求1所述的一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络8份、松叶10份、路路通8份、延胡索10份、透骨草15份、红花7份、地龙2份、五加皮10份、蜈蚣8份、花椒8份、土鳖虫15份、艾叶10份。
3.根据权利要求2所述的一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络15份、松叶15份、路路通10份、延胡索2份、透骨草5份、红花7份、地龙10份、五加皮10份、蜈蚣12份、花椒8份、土鳖虫7份、艾叶20份。
4.根据权利要求2所述的一种治疗老年糖尿病性周围神经病变的中药足浴护理液，其特征在于：由包含如下重量份的中药材制备而成：丝瓜络10份、松叶10份、路路通10份、延胡索6份、透骨草10份、红花10份、地龙6份、五加皮8份、蜈蚣10份、花椒10份、土鳖虫10份、艾叶15份。
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