CN110404020B - Externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury and preparation method thereof - Google Patents
Externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury and preparation method thereof Download PDFInfo
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Abstract
The invention discloses an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury, which comprises the following raw materials in parts by weight: 10-15 parts of prepared aconite root, 10-15 parts of cinnamon, 10-15 parts of rhizoma alismatis, 10-15 parts of plantain seed, 6-10 parts of platycodon grandiflorum, 15-20 parts of semen vaccariae, 10-15 parts of medicinal cyathula root, 10-15 parts of fistular onion stalk and 3-5 parts of honey. The invention also provides a preparation method of the externally applied traditional Chinese medicine. According to the pathogenesis of urinary retention after spinal cord injury, the traditional Chinese medicines for warming yang, tonifying the kidney, promoting blood circulation and removing dampness are selected, and the traditional Chinese medicines for warming yang, tonifying the kidney, promoting blood circulation and removing dampness are selected, so that the used medicines are simple and easy to find, and have small toxic and side effects; the medicines have synergistic effect and are reasonably compatible; the medicine can be absorbed by human body by applying on Shenque acupoint and Guanyuan acupoint, and has remarkable therapeutic effect in treating urinary retention after spinal cord injury.
Description
Technical Field
The invention relates to the technical field of traditional Chinese medicines, in particular to an external traditional Chinese medicine for treating urinary retention after spinal cord injury and a preparation method thereof.
Background
In recent years, with the improvement of the living standard of people and the increase of urban construction, spinal cord injury caused by traffic accidents, falling at high places, smash injury and other reasons has shown a tendency of high incidence, high disability rate, high consumption and great vigor. Worldwide, the incidence rate of spinal cord injury is 10.4/100 ten thousand-83/100 ten thousand, and about 50 ten thousand patients are increased each year. The neurogenic bladder is one of the common complications after spinal cord injury, and is often mainly clinically manifested by abnormal urination functions such as frequent urination, urgent urination, urinary incontinence and the like, difficult urination, weakness, incomplete urination, prolonged urination time and the like. Urination disorders not only cause great trouble to patients and families, but also cause urinary tract infection, calculus and hydronephrosis due to increased cystocele, and may progress to uremia, leading to death of the patients. Therefore, effective measures are taken to treat urinary retention after spinal cord injury, reduce related clinical complications, promote recovery of bladder function, and have important clinical significance for improving the life quality of patients and improving prognosis.
The pathogenesis of neurogenic bladder after spinal cord injury is complex, the treatment method is various, and the treatment process is long. Because of the continuous efforts of students at home and abroad in the aspects of researches of protecting upper urinary tract functions, reconstructing bladder functions, preventing urinary tract infection and the like, the treatment of neurogenic bladder is also mature day by day, wherein the comprehensive treatment such as intermittent urethral catheterization, bladder function training, drug treatment, physical factor treatment and the like can be matched with psychological intervention to achieve a certain curative effect. But all have the problems of long treatment period, stimulation of toxic and side effects, poor long-term curative effect and the like with different degrees. In contrast, the traditional Chinese medicine rehabilitation technology has remarkable clinical application effect on neurogenic bladder urinary retention after spinal cord injury.
The theory of traditional Chinese medicine holds that urinary retention after spinal cord injury belongs to the category of urine retention in traditional Chinese medicine. "Su Wen. Xuan Ming Wu Qi" is: the urinary bladder disorder is urine retention, which is not about enuresis. Urine is produced by body fluids, and is produced by kidney qi transformation and descending into the urinary bladder. Urine can be discharged from the body automatically when the urine is retained in the bladder to a certain extent. "Neijing" is: the bladder, the body fluids are stored and qi transformation is sufficient. The urinary storage and drainage functions of the bladder depend on the kidney's qi transformation function. The "Su Wen & Yi Hui Lun" means kidney-qi consuming water and governing body fluids. The distribution and excretion of water in the body are mainly based on the kidney qi transformation function, and the kidney qi transformation is normal, so that the body is opened and closed to a certain degree. If the kidney qi fails to function properly, the closing and opening of the door is unfavorable, and urine retention can occur. So the "su Mi and Shu-thermal theory" refers to "kidney-qi", the stomach is also closed. The door is not closed, so water is collected and the like. "
Under physiological conditions, water enters the kidneys through the reception of the stomach, the transportation of the spleen and the descending of the lung, and then enters the kidneys through the qi transformation action of the kidneys, so that clear people go up to the lungs to spread the whole body, turbid people go down to the bladder and drain out of the body, and the balance of the water metabolism of the human body is maintained. "Su Wen, jing Mai Bien Lun" is: the decoction is drunk in the stomach, overflows essence and qi, is infused in the spleen, and the spleen and qi dispel essence, and is infused in the lung, the water channel is communicated, the bladder is infused downwards, four water essence flows and five meridians are parallel. The distribution and excretion of body fluids can be seen and the metabolic balance is maintained. Depends on the coordination and balance of a series of physiological functions of a plurality of viscera, wherein the physiological functions of lung, spleen and kidney play a main role in regulating and balancing. Therefore, many viscera dysfunction can affect distribution and excretion of body fluids and maintain metabolic balance. If lung fails to descend, the gold is not in the state; spleen failing to transport and ascend and descend; deficiency of kidney yang, abnormal qi, etc. can affect the excretion of water and cause urine retention.
Urinary retention after spinal cord injury is due to traumatic injury, blood stasis, damaged governor vessel, kidney yang deficiency, bladder qi failure, and urination disorder; for a long time, kidney yang deficiency, essence and qi failing to warm the body, together with stagnant blood blocking its transportation and transformation, cause retention of urine; spleen is a junction of water metabolism, and is a serious problem for urine retention due to spleen impairment due to long-term sleep, spleen loss of transportation, ascending and descending.
The acupoint application method is based on the theory of meridian theory of traditional Chinese medicine, and comprises grinding the medicinal materials into fine powder, concocting with water, vinegar, wine, egg white, mel, vegetable oil, essential oil, medicinal liquid and even saliva into paste, or making into ointment, pill or cake with coagulated oil (such as vaseline, etc.), yellow vinegar, rice and fructus Jujubae mud, or decocting the Chinese medicinal decoction into paste, or dispersing the medicinal powder on plaster, and directly applying onto acupoint and affected part (Ashi acupoint) to treat diseases. The Chinese medicine is an important component of Chinese medicine therapeutics, is a set of unique and effective therapeutic method summarized by the laborers in China in long-term fight against diseases, and has very long development history after undergoing numerous practical, cognitive, re-practical and re-cognitive development processes. The acupoint application can make the medicine property from the exterior to the interior through skin striae and striae, so as to achieve the aim of treating diseases; he can improve local blood circulation, increase tissue metabolism, strengthen local nutrition, improve tissue regeneration capacity and improve the immunity of the organism, so the design of the externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury is necessary.
Disclosure of Invention
The invention aims to solve the defects of the technology and provides an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury and a preparation method thereof. According to the pathogenesis of urinary retention after spinal cord injury, the traditional Chinese medicine is selected to warm yang, benefit kidney, activate blood and promote diuresis, the used medicine is simple and easy to find, the toxic and side effects are small, the medicines act synergistically, and the medicines are reasonably compatible; the medicine can be absorbed by human body by applying on Shenque acupoint and Guanyuan acupoint, and has remarkable therapeutic effect in treating urinary retention after spinal cord injury.
In order to achieve the above purpose, the invention adopts the following technical scheme:
an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury is prepared from the following raw materials in parts by weight:
10-15 parts of prepared aconite root, 10-15 parts of cinnamon, 10-15 parts of rhizoma alismatis, 10-15 parts of plantain seed, 6-10 parts of platycodon grandiflorum, 15-20 parts of semen vaccariae, 10-15 parts of medicinal cyathula root, 10-15 parts of fistular onion stalk and 3-5 parts of honey.
Preferably, the external application traditional Chinese medicine for treating urinary retention after spinal cord injury is prepared from the following raw materials in parts by weight:
10 parts of prepared aconite root, 10 parts of cinnamon, 10 parts of rhizoma alismatis, 10 parts of plantain seed, 6 parts of platycodon grandiflorum, 15 parts of semen vaccariae, 10 parts of medicinal cyathula root, 10 parts of fistular onion stalk and 5 parts of honey.
The invention also provides a preparation method of the externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury, which comprises the following steps:
step one, weighing the following raw material medicines in parts by weight: 10-15 parts of prepared aconite root, 10-15 parts of cinnamon, 10-15 parts of rhizoma alismatis, 10-15 parts of plantain seed, 6-10 parts of platycodon grandiflorum, 15-20 parts of semen vaccariae, 10-15 parts of medicinal cyathula root, 10-15 parts of fistular onion stalk and 3-5 parts of honey for standby;
mashing and deslagging the fistular onion stalk weighed in the first step to obtain fistular onion stalk juice;
pulverizing the prepared aconite, cinnamon, rhizoma alismatis, semen plantaginis, platycodon grandiflorum, semen vaccariae and radix cyathulae weighed in the first step into 100 meshes, and mixing to obtain mixed medicinal powder;
and thirdly, mixing the mixed medicinal powder and the fistular onion stalk juice obtained in the second step with the honey weighed in the first step, uniformly blending, and obtaining the external application traditional Chinese medicine in a thick paste form.
Compared with the prior art, the invention has the following beneficial effects:
1. under the summary of the traditional Chinese medical theory and clinical practice experience, the invention selects the raw materials and strictly mixes the raw materials, has precise and appropriate formula, follows the principles of 'dialectical treatment' and 'four-qi five-flavor' of traditional Chinese medicine, and cuts off the pathogenesis of urinary retention after spinal cord injury; the external traditional Chinese medicine adopts a traditional Chinese medicine comprehensive conditioning method, provides a yang-warming kidney-tonifying and blood-activating diuresis-promoting method, and provides a yang-warming and spleen-activating side acupoint application method for treating urinary retention caused by spinal cord injury, and can effectively reduce the residual urine volume of the bladder of a patient and improve the safety capacity of the bladder of the patient, thereby effectively improving the clinical rehabilitation level of the neurogenic urinary retention of the bladder after spinal cord injury;
2. the traditional Chinese medicine composition provided by the invention has reasonable compatibility of monarch, minister, assistant and guide medicines, wherein prepared aconite is monarch, warm kidney yang and invigorate spleen yang; cinnamon is ministerial, and helps aconite root to warm yang and promote blood circulation; the alisma and plantain seed excrete dampness and promote diuresis, the semen vaccariae and the radix cyathulae invigorate blood circulation and promote menstruation, and the radix platycodi is used for lifting the pot to uncover, ventilating lung and promoting diuresis, and the fistular onion stalk is used for publishing and activating yang and promoting urination together as an assistant guide. The medicines are combined together to play the roles of warming yang, tonifying kidney, promoting blood circulation and promoting diuresis. Kidney yang is warm, spleen yang is tonifying, lung qi is ventilating, meridians are communicating, bladder is open and close to a degree, and urine retention is healed when water is flowing down;
3. the invention selects and applies external application to Shenque acupoint and Guanyuan acupoint, wherein Shenque acupoint is congenital vital pedicle, acquired qi will be between middle and lower energizer and in the middle part of abdomen, the acupoint can regulate body channel qi, and can be applied to viscera, six fu organs, limbs and bones and muscles through channel qi operation of any pulse. Guanyuan point is located three cun below the umbilicus and is indicated for deficiency of primordial qi. The Shenque acupoint is located at the umbilical region, the umbilical region is the final closure position of abdominal wall during embryo development, the epidermis stratum corneum is thinnest, the barrier function is weakest, and the navel is easiest to penetrate and disperse; and no adipose tissue exists under the umbilicus, and the skin is directly connected with fascia and peritoneum, so the characteristics of the umbilical skin structure are most favorable for drug absorption.
Detailed Description
In order that those skilled in the art will better understand the technical scheme of the present invention, the present invention will be further described with reference to specific examples, but the present invention should not be construed as being limited thereto. The experimental procedures, which are not identified as specific conditions in the examples below, were performed according to methods and conditions conventional in the art.
The technical scheme of the invention is further described below with reference to some specific embodiments.
Example 1
The embodiment provides an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury, which is prepared from the following raw materials in parts by weight: prepared aconite root 10g, cinnamon 10g, alismatis rhizome 10g, plantain seed 10g, balloonflower root 6g, vaccaria seed 15g, cyathula root 10g, fistular onion stalk 10g and bee honey 5g.
The implementation also provides a preparation method of the externally applied traditional Chinese medicine, which comprises the following steps:
step one, weighing the following raw material medicines in parts by weight: prepared aconite root 10g, cinnamon 10g, alismatis rhizome 10g, plantain seed 10g, balloonflower root 6g, vaccaria segetalis 15g, cyathula root 10g, fistular onion stalk 10g, bee honey 5g for standby;
mashing the fistular onion stalk weighed in the first step in a mortar, and removing residues to obtain fistular onion stalk juice;
pulverizing the prepared aconite, cinnamon, rhizoma alismatis, semen plantaginis, platycodon grandiflorum, semen vaccariae and radix cyathulae weighed in the first step into 100 meshes, and mixing to obtain mixed medicinal powder;
and thirdly, mixing the mixed medicinal powder obtained in the second step, the fistular onion stalk juice and the honey weighed in the first step, and uniformly blending by using a fine rod to form thick paste, thereby obtaining the external application traditional Chinese medicine.
Example 2
The embodiment provides an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury, which is prepared from the following raw materials in parts by weight: prepared aconite root 15g, cinnamon 15g, alismatis rhizome 15g, plantain seed 15g, balloonflower root 10g, vaccaria 20g, cyathula root 15g, fistular onion stalk 15g and bee honey 5g.
Example 3
The embodiment provides an externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury, which is prepared from the following raw materials in parts by weight: prepared aconite root 12.5g, cinnamon 12.5g, alisma rhizome 12.5g, plantain seed 12.5g, balloonflower root 8g, vaccaria seed 18.5g, cyathula root 12.5g, fistular onion stalk 12.5g and bee honey 3g.
The external application traditional Chinese medicine for treating urinary retention after spinal cord injury is provided in all of the examples 1-3, and the effects of the invention are described below by taking the external application traditional Chinese medicine prepared in the example 1 as an example because the traditional Chinese medicine composition provided in the examples 1-3 is basically parallel in treatment effect.
1. Clinical trial
1. Test subjects
83 patients with neurogenic bladder urinary retention after spinal cord injury meeting inclusion criteria were selected for diagnosis in Henan province middle hospital (Henan Chinese medical institute second affiliated hospital) from 6 th year of 2016 to 2018 th year of 12 th month. All patients were signed with informed consent, and randomized into trial 42 and control 41. After the study is finished, the test group drops off 2 cases, and the control group drops off 1 case; the test group accords with 40 cases of the scheme, the control group accords with 40 cases of the scheme, the table 1 is a general data comparison of two groups of patients before treatment, and as can be seen from the table 1, the sex composition, average age, bladder residual urine quantity and bladder safety capacity comparison difference among the two groups of patients have no statistical significance (P is more than 0.05) and are comparable.
Table 1 comparison of general data prior to treatment for two groups of patients
Note that: (P>0.05)
2. Inclusion and exclusion criteria
2.1 inclusion criteria:
(1) the diagnosis of SCI in accordance with international standards for neurological classification of spinal cord injury and the diagnosis is confirmed by CT/MRI;
(2) meets the diagnosis of urine retention in the traditional Chinese medicine disease diagnosis curative effect standard;
(3) the spinal shock period is over, and the disease is stable;
(4) the American spinal injury Association (AISA) nerve function was graded as grade B and grade C with residual urine volume > 100mL;
(5) age 18-65 years, disease course less than or equal to 24 months;
(6) informed consent was given to the treated subjects.
2.2 exclusion criteria:
(1) unstable vital signs or worsening;
(2) severe heart, brain and kidney, etc. important visceral diseases;
(3) bladder dysfunction due to mechanical obstruction of urethral outlet;
(4) infection, unconsciousness, speech impairment and uncooperative researchers;
(5) other clinical trials are being enrolled to influence the evaluation of the results of this study.
3. Therapeutic method
Both groups of patients performed routine intermittent catheterization and bladder function training, the intermittent catheterization being performed according to the neurogenic bladder care guidelines (2011 edition); bladder function training refers to the guide for urinary system management and clinical rehabilitation of spinal cord injury patients (2013 edition), and a doctor selects to use behavioral skill training, anus stretch training, compensatory urination training and the like according to the condition of the patients. On the basis of the treatment, the traditional Chinese medicine acupoint application treatment in the embodiment 1 is added to the patients in the test group. The Chinese medicine acupoint application is applied to Shenque acupoint and Guanyuan acupoint for 4-6 hr each time, 1 time a day.
4. Efficacy assessment
The curative effect assessment method adopts a bladder scanner to measure the residual urine volume of the bladder of the patient, and adopts a bladder pressure capacity assessment system to measure the bladder safety capacity of the patient. Statistical analysis and efficacy assessment were performed on the data of residual urine volume of bladder, safe bladder capacity, etc. before and after treatment for both groups of patients.
5. Statistical analysis
Statistical analysis was performed using SPSS22.0 statistical software. Age of patient, residual urine of bladder, and safe bladder capacityThe method is characterized in that the comparison between groups adopts two independent sample t-tests, and the comparison in the groups adopts paired sample t-tests; patient gender composition ratio comparison uses x 2 And (5) checking. Let α=0.05 be the check level.
6. Results
6.1 Table 2 shows the comparison of the bladder residual urine levels before and after treatment for two groups of patients, and Table 2 shows that the bladder residual urine levels after treatment for two groups of patients are compared with those before treatment, the bladder residual urine levels of the test group and the control group of patients are obviously reduced (P < 0.01) after treatment, and the reduction of the bladder residual urine levels of the test group and the control group is more obvious (P < 0.01) compared with the control group.
Table 2 residual urine volume of bladder before and after treatment for two groups of patients
Note that: (P>0.05)
6.2 Table 2 shows the bladder safety capacity before and after treatment of two groups of patients, and as can be seen from Table 3, the bladder safety capacity of two groups of patients is obviously increased (P < 0.01) compared with that of the two groups of patients before treatment, the bladder safety capacity difference of the test group of patients after treatment has no statistical significance (P > 0.05), and the bladder safety capacity difference of the control group of patients after treatment has no statistical significance (P > 0.05).
Table 3 two groups of patients had a safe bladder capacity before and after treatment
The results of this study showed that: the application of the acupoint plaster for treating neurogenic bladder urinary retention after spinal cord injury has the effects of reducing the residual urine volume of the bladder of a patient and improving the safe capacity of the bladder of the patient, and has the advantages of safety, strong operability, convenient popularization and application, and improvement of the clinical rehabilitation level of neurogenic bladder urinary retention after spinal cord injury.
2. Typical cases
1. The patient pays something, female, 45 years old. The hospital is admitted by 5 months and 11 days in 2018 with quadriplegia accompanied by dysuria for more than 1 year. Four limbs paralysis, dysuria and unconsciousness loss occur after a traffic accident of the patient in 2018, 3 and 25 days. Sending to the first affiliated hospital of Zhengzhou university for diagnosis and treatment, and checking cervical vertebra magnetic resonance prompt: 1. cervical 3-7 horizontal intraspinal abnormalities signal, considering bruise; 2. abnormal signals of the cervical vertebrae 4, 5, 6, taking into account oedema; 3. the cervical 4, 5, 6 vertebral body attachments show poor; 4. anterior cervical vertebral body slipping; 5. cervical 4, 5, 6 around the vertebral bodies and cervical 2-thoracic 2 level anterior soft tissue edema. The following day of treatment of 'cervical spine posterior spinal canal expansion decompression slipping reduction nail rod internal fixation surgery + cervical spine anterior discectomy cage implantation bone grafting fusion internal fixation surgery', hormone impact, circulation improvement, vegetative nerve and the like, and after 1 month, the disease is stably transferred into the rehabilitation treatment of our hospital. The admission symptoms are as follows: paralysis of limbs, cough, difficulty in urination, urine retention and anorexia. A pale tongue with white coating and a deep and weak pulse. The diagnosis of traditional Chinese medicine is as follows: flaccidity disease, syndrome type: deficiency of kidney-yang and blood stasis. Western diagnosis: spinal cord injury, grade C5, B (quadriplegia; neurogenic bladder; neurogenic rectum). Treatment: the external application traditional Chinese medicine of the example 1 is applied to the traditional Chinese medicine acupoints for treatment by implementing a drinking plan, conventional intermittent catheterization and bladder function training. The Chinese medicine acupoint application is applied to Shenque acupoint and Guanyuan acupoint for 4-6 hr each time, 1 time a day.
For 10 days, patients have urine leakage, and for 5 times, the lower abdomen can be massaged or tapped for urination, and the color Doppler ultrasound of the urinary system is checked: the residual urine was less than 50ml.
It should be noted that, when numerical ranges are referred to in the claims of the present invention, it should be understood that two endpoints of each numerical range and any numerical value between the two endpoints are optional, and since the adopted steps are the same as those of the embodiments, the preferred embodiments of the present invention are described for preventing redundancy, and although the preferred embodiments of the present invention have been described, further variations and modifications can be made to these embodiments once the basic inventive concept is known to those skilled in the art. It is therefore intended that the following claims be interpreted as including the preferred embodiments and all such alterations and modifications as fall within the scope of the invention.
The foregoing is merely a preferred embodiment of the present invention and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the present invention, which are intended to be comprehended within the scope of the present invention.
Claims (2)
1. The externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury is characterized by being prepared from the following raw materials in parts by weight:
10-15 parts of prepared aconite root, 10-15 parts of cinnamon, 10-15 parts of rhizoma alismatis, 10-15 parts of plantain seed, 6-10 parts of platycodon grandiflorum, 15-20 parts of semen vaccariae, 10-15 parts of medicinal cyathula root, 10-15 parts of fistular onion stalk and 3-5 parts of honey;
the preparation method of the externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury comprises the following steps:
step one, weighing the following raw material medicines in parts by weight: 10-15 parts of prepared aconite root, 10-15 parts of cinnamon, 10-15 parts of rhizoma alismatis, 10-15 parts of plantain seed, 6-10 parts of platycodon grandiflorum, 15-20 parts of semen vaccariae, 10-15 parts of medicinal cyathula root, 10-15 parts of fistular onion stalk and 3-5 parts of honey for standby;
mashing and deslagging the fistular onion stalk weighed in the first step to obtain fistular onion stalk juice;
pulverizing the prepared aconite, cinnamon, rhizoma alismatis, semen plantaginis, platycodon grandiflorum, semen vaccariae and radix cyathulae weighed in the first step into 100 meshes and mixing to obtain mixed medicinal powder;
mixing the mixed medicinal powder obtained in the step two and the fistular onion stalk juice with the honey weighed in the step one, uniformly blending, and obtaining the external application traditional Chinese medicine in a thick paste form;
the topical parts are SHENQUE acupoint and GUANYUAN acupoint.
2. The externally applied traditional Chinese medicine for treating urinary retention after spinal cord injury according to claim 1, wherein the traditional Chinese medicine is characterized by comprising the following raw material medicines in parts by weight:
10 parts of prepared aconite root, 10 parts of cinnamon, 10 parts of rhizoma alismatis, 10 parts of plantain seed, 6 parts of platycodon grandiflorum, 15 parts of semen vaccariae, 10 parts of medicinal cyathula root, 10 parts of fistular onion stalk and 5 parts of honey.
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