CN110448625B - 一种治疗缺氧性肾损伤疾病的中药组合物、制备方法及其应用 - Google Patents
一种治疗缺氧性肾损伤疾病的中药组合物、制备方法及其应用 Download PDFInfo
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Abstract
本发明涉及一种治疗缺氧性肾损伤疾病的中药组合物,所述中药组合物由以下重量份的原料药制成:党参12份、仙灵脾12份、炮附子9份、丹参15份、制大黄9份、紫苏叶9份、桃仁12份、虫草菌丝6份、生蒲黄12份、炙升麻9份、五灵脂12份。本发明还包括所述中药组合物在制备治疗缺氧性肾损伤疾病的药物中的应用。其优点表现在:1、所选取的各原料药之间符合“君臣佐使”配伍原则,协同奏效,疗效佳,且各原料药之间经过试验筛选得到最佳配比,具有效果显著的优点。2、本发明的药物制备方法简便,各原料药来源广泛。3、本发明为患有缺氧性肾损伤疾病类的患者提供了新的治疗方案,提高了该类患者的生存率,具有很好的应用前景。
Description
技术领域
本发明涉及中药技术领域,具体地说,是一种治疗缺氧性肾损伤疾病的中药组合物、制备方法及其应用。
背景技术
慢性肾功能衰竭(以下简称慢性肾衰竭)是在各种慢性肾脏病的基础上缓慢出现肾功能进行性减退直至衰竭的一种临床综合征,其主要病理改变为肾小球硬化和肾间质纤维化,是各种原因的慢性肾脏病进展至终末期肾病的主要病理基础。据中国流行病学调查显示,慢性肾衰竭患病率高达10.8%,并且随着继发性肾脏病发病率的不断上升,慢性肾衰竭的发病率还在不断升高,给家庭和社会带来沉重的经济负担。
随着对慢性肾衰竭发病机制的深入研究,肾内缺血—缺氧扮演着重要的角色。肾脏占人体重的0.4%-0.5%,而肾氧耗却占人体的7%左右,肾脏代谢活动高耗氧过程的生理特点使肾脏易于受缺氧微环境的影响。慢性肾衰竭过程中,由于受贫血、血管病变、间质纤维化、残余肾单位高灌注等因素的影响,肾内缺血—缺氧成为其病情进展的重要病理因素,因此,慢性肾衰竭是一个低氧疾病。
通过建立合适的慢性肾衰竭动物模型,有助于人们了解慢性肾衰竭的病理发生和进展机制,帮助理解与慢性肾衰竭有关的病理学因素,建立临床上的诊断指标,为慢性肾衰竭的治疗提供实验依据,对慢性肾衰竭药物的筛选具有重大意义。
肾内缺血—缺氧是大多数慢性肾衰竭患者疾病进展的重要病理基础。现有慢性肾衰竭动物模型的不足在于未能充分体现肾内缺血-缺氧重要病理因素,不能充分契合慢性肾衰竭疾病进展的病程和病理特点,给慢性肾衰竭疾病的深入研究带来一定困难。因此,目前急需建立一套有效、稳定、制备方法简单、契合慢性肾衰竭病理特点的动物模型,以便开展进一步的研究。
中国专利:CN106310146B,公开了一种具有防治慢性肾衰功效的中药组合物,它由黄蜀葵花10份,黄芪3-30份,虎杖3-15份,姜黄0.3-3份制成。
中国专利:CN100355445C,公开了一种治疗脾虚湿热型慢性肾衰的药物复合物。本发明以中医的健脾益气,清热化湿理论为依据,选用党参(或太子参)、生黄芪(或白术)、草果仁(或砂仁)、苍术(或川扑)、黄连(或车前子)、制大黄(或生大黄)中药为原料制成。
但是关于本发明一种治疗缺氧性肾损伤疾病的中药组合物、制备方法及其应用目前还未见报道,本发明的中药组合物具有疗效佳的优点。
发明内容
本发明的第一个目的是针对现有技术的不足,提供一种治疗缺氧性肾损伤疾病的中药组合物。
本发明的第二个目的是针对现有技术的不足,提供如上所述中药组合物的用途。
本发明的第三个目的是针对现有技术的不足,提供一种治疗缺氧性肾损伤疾病的药物。
本发明的第四个目的是针对现有技术的不足,提供如上所述药物的制备方法。
为实现上述第一个目的,本发明采取的技术方案是:
一种治疗缺氧性肾损伤疾病的中药组合物,所述中药组合物由以下重量份的原料药制成:党参9-15份、仙灵脾9-15份、炮附子6-12份、丹参10-20份、制大黄6-12份、紫苏叶6-12份、桃仁9-15份、虫草菌丝4-8份、生蒲黄9-15份、炙升麻3-12份、五灵脂9-15份。
作为本发明的一个优选实施方案,所述中药组合物由以下重量份的原料药制成:党参12份、仙灵脾12份、炮附子9份、丹参15份、制大黄9份、紫苏叶9份、桃仁12份、虫草菌丝6份、生蒲黄12份、炙升麻9份、五灵脂12份。
作为本发明的一个优选实施方案,按照中药常规制备方法制备成临床上可接受的药物制剂。
作为本发明的一个优选实施方案,所述药物制剂为汤剂、颗粒剂、散剂、胶囊剂、片剂、合剂或口服液。
为实现上述第二个目的,本发明采取的技术方案是:
如上任一所述的中药组合物在制备治疗缺氧性肾损伤疾病的药物中的应用。
作为本发明的一个优选实施方案,所述缺氧性肾损伤疾病包括慢性肾衰竭。
为实现上述第三个目的,本发明采取的技术方案是:
一种治疗缺氧性肾损伤疾病的药物,所述的药物由上任一所述的中药组合物和医药行业上可接受的载体配制而成。
作为本发明的一个优选实施方案,所述药物的活性成分是采用水提或40—80%体积百分浓度的乙醇提取制备而成的。
为实现上述第四个目的,本发明采取的技术方案是:
如上所述药物的制备方法,包括如下步骤:
按照以上任一所述重量份配比取各原料药,加水提取2-3次,每次加水量相当于药材总重量的6-12倍,每次提取时间为1-3小时,合并提取液,滤过,滤液浓缩至70-80℃时相对密度为1.10-1.25的清膏,即得药物活性成分。
作为本发明的一个优选实施方案,包括如下步骤:
按照以上任一所述重量份配比取各原料药,加水提取2-3次,每次加水量相当于药材总重量的6-12倍,每次提取时间为1-3小时,合并提取液,滤过,滤液浓缩至70-80℃时相对密度为1.05-1.20的清膏,加入乙醇,使含醇量为40-70%,静置12-24小时,滤过,滤液浓缩至70-80℃时相对密度为1.10-1.25的浸膏,即得药物活性成分。
方解:
方中党参与丹参配伍益气活血通脉,通补兼施,共为君药;仙灵脾温肾祛湿,炮附子温阳散寒,合用则振奋三焦阳气,泄浊散邪,配制大黄推陈致新,逐瘀通络,三药相伍寒温并用,阴阳平调,共为臣药;桃仁破血行瘀,生蒲黄止血化瘀利尿,合五灵脂活血泄浊,合党参活血而不伤正,炙升麻升阳解毒,鼓清气上行,浊邪下消,虫草菌丝补肾益肺,上下同治,共为佐药;紫苏叶解毒散邪,为使药。
本发明优点在于:
1、方中各原料药之间符合“君臣佐使”配伍原则:党参与丹参配伍益气活血通脉,通补兼施,共为君药;仙灵脾温肾祛湿,炮附子温阳散寒,合用则振奋三焦阳气,泄浊散邪,配制大黄推陈致新,逐瘀通络,三药相伍寒温并用,阴阳平调,共为臣药;桃仁破血行瘀,生蒲黄止血化瘀利尿,合五灵脂活血泄浊,合党参活血而不伤正,炙升麻升阳解毒,鼓清气上行,浊邪下消,虫草菌丝补肾益肺,上下同治,共为佐药;紫苏叶解毒散邪,为使药。
各原料药之间协同奏效,疗效佳;
且各原料药之间经过试验筛选得到最佳配比,具有效果显著的优点。
2、本发明的各原料药来源广、药物制备方法简便,为缺氧性肾损伤疾病患者提供了新的治疗方案,提高了该类患者的生存率,具有很好的应用前景。
附图说明
附图1是灌胃60天后各组大鼠肾内血流和氧耗的比较,注:*P<0.05,**P<0.01。
附图2是治疗后各组肾功能的比较,注:*P<0.05,**P<0.01。
附图3是各组大鼠HE和Masson染色结果比较,注:A为假手术组;B为模型组;C为中药组;D为西药组。
附图4是各组大鼠缺氧标志性蛋白HIF-1α表达的比较,注:**P<0.01。
具体实施方式
下面结合具体实施方式,进一步阐述本发明。应理解,这些实施例仅用于说明本发明而不用于限制本发明的范围。此外应理解,在阅读了本发明记载的内容之后,本领域技术人员可以对本发明作各种改动或修改,这些等价形式同样落于本申请所附权利要求书所限定的范围。
实施例1中药组合物(一)
按照以下重量份配比取原料药:党参9份、仙灵脾9份、炮附子6份、丹参10份、制大黄6份、紫苏叶6份、桃仁9份、虫草菌丝4份、生蒲黄9份、炙升麻3份、五灵脂9份。
实施例2中药组合物(二)
按照以下重量份配比取原料药:党参15份、仙灵脾15份、炮附子12份、丹参20份、制大黄12份、紫苏叶12份、桃仁15份、虫草菌丝8份、生蒲黄15份、炙升麻12份、五灵脂15份。
实施例3中药组合物(三)
按照以下重量份配比取原料药:党参9份、仙灵脾15份、炮附子6份、丹参20份、制大黄6份、紫苏叶12份、桃仁9份、虫草菌丝8份、生蒲黄9份、炙升麻12份、五灵脂9份。
实施例4中药组合物(四)
按照以下重量份配比取原料药:党参15份、仙灵脾9份、炮附子12份、丹参10份、制大黄12份、紫苏叶6份、桃仁15份、虫草菌丝4份、生蒲黄15份、炙升麻3份、五灵脂15份。
实施例5中药组合物(五)
按照以下重量份配比取原料药:党参9份、仙灵脾9份、炮附子6份、丹参10份、制大黄6份、紫苏叶12份、桃仁15份、虫草菌丝8份、生蒲黄15份、炙升麻12份、五灵脂15份。
实施例6中药组合物(六)
按照以下重量份配比取原料药:党参15份、仙灵脾15份、炮附子12份、丹参20份、制大黄12份、紫苏叶6份、桃仁9份、虫草菌丝4份、生蒲黄9份、炙升麻3份、五灵脂9份。
实施例7中药组合物(七)
按照以下重量份配比取原料药:党参12份、仙灵脾12份、炮附子9份、丹参15份、制大黄9份、紫苏叶9份、桃仁12份、虫草菌丝6份、生蒲黄12份、炙升麻9份、五灵脂12份。
实施例8胶囊剂
分别取实施例1-7所述配比原料药,加入胶囊剂常用辅剂,按照常规制药方法制备即得。
实施例9合剂
分别取实施例1-7所述配比原料药,加入合剂常用辅剂,按照常规制药方法制备即得。
实施例10口服液
分别取实施例1-7所述配比原料药,溶解后净化、浓缩,加入口服液常用辅剂,按照常规制药方法制备即得。
实施例11动物实验
一、实验材料
1、动物:SPF级健康成年雄性SD大鼠,8周龄,体重190-210g,购买于西普尔-必凯实验动物有限公司(上海),合格证编号:SCXK(沪)2008-0016,饲养于上海中医药大学实验动物中心,温度(22±2)℃,12h光照,相对湿度(55±2)%。饲料为市售固体普通饲料,饮用水均为自来水,自由饮用水及摄食。
2、药物组成:党参12g,仙灵脾12g,炮附子9g,丹参15g,制大黄9g,紫苏叶9g,桃仁12g,虫草菌丝6g,生蒲黄12g,炙升麻9g,五灵脂12g:上海曙光医院制剂科制备;氯沙坦钾(科素亚,100mg,杭州默沙东制药有限公司,合格批号:H20030654)。西药蒸馏水制备混悬液(5.5mg/ml)。
二、方法
1、造模及分组
随机选取65只大鼠采用5/6CRF大鼠模型,适应性喂养一周后,用2%戊巴比妥钠(0.2ml/100g)进行腹腔注射麻醉,局部剃毛常规消毒,于左肋弓下0.5cm处,脊柱向左旁开1cm处切开一垂直于脊柱长约1.5cm切口。在无菌条件下经过后腹膜选取左肾并暴露肾脏,将肾包膜分离后,把左肾动脉的2/3分支结扎(单个结扎后支及前降支),缝合,一周后摘除右肾。30天后,目内眦采血测定肾功能及血红蛋白指标。剔除造模失败和死亡大鼠后,造模成功存活45只,采用完全随机原则分为三组,即模型组(B组)、中药组(C组)、西药组(D组),每组15只,另取15只大鼠为假手术组。
2、干预方法
按成人标准体重(60kg)常规用量的20倍给药,D组给予氯沙坦钾混悬液2ml(5.5mg/ml)灌胃,C组给予中药组合物浓煎药液2ml进行灌胃,A组、B组则予生理盐水2ml模拟。各组每天干预一次,连续60d。干预期间自由摄食和饮水。
3、肾血流和氧耗检测
经2个月灌胃治疗后,大鼠经2%戊巴比妥钠(0.2ml/100g)腹腔麻醉,放于手术台上维持体温37℃,局部剪毛常规消毒后,气管切开用聚乙烯导管(PE-240)插入保持呼吸道通畅,沿腹白线从胸骨下纵行切开长约7cm切口,无菌条件下暴露左肾,仔细剥离肾动静脉包膜,并分离左肾动脉和静脉,利用周围血管超声波血流检测仪(美国TransonicSystemInc,型号:T206U)的检测探头,轻轻钩住肾静脉(注意不能钩住肾动脉),待血流稳定后(约10分钟后),读取肾血流指数并记录。
血气测量方法:测量肾血流量读数之后,移走血流探头,用1ml血气针从肾静脉中抽取约0.2ml静脉血,拔出针头后压迫血管止血。接着分离腹主动脉外血管包膜,充分暴露腹主动脉,用1ml血气针平行于腹主动脉进针,抽取0.2ml动脉血,拔出针头后局部压迫血管止血。采用i-STAT血气分析仪分别检测肾静脉和腹主动脉血气的O2Hb%、PO2。
肾动脉、肾静脉氧含量计算公式:
AQO2(ml/ml blood)=(1.39×tHb×O2Hb%+PO2×0.003)÷100
VQO2(ml/ml blood)=(1.39×tHb×O2Hb%+PO2×0.003)÷100
左肾总氧耗(QO2)(ml/min)=肾血流量(RBF)×(动脉O2ct-静脉O2ct)
肾内氧耗根据以下公式计算:肾内氧耗应用钠吸收的氧耗(QO2/TNa)=左肾总氧耗(QO2)与钠吸收(TNa)的比值(ml/mmol)。
4、样本采集与处理大鼠用2%戊巴比妥钠(0.2ml/100g)腹腔注射麻醉,打开腹腔,下腔静脉采血,4℃离心,收集血清。摘取左肾,将左肾横切为二,一半置10%中性缓冲福尔马林液中固定24h经石蜡包埋后制成3um的石蜡切片行常规HE、Masson染色观察肾组织病理形态;一半分装后放入液氮送至-80℃保存用于western印迹法检测。
三、实验结果
1、各组大鼠肾内血流和氧耗的比较见图1。
实施效果:验证5/6(A/I)慢性肾衰大鼠肾血流量降低及肾内氧耗加,中药组合物可以改善慢性肾衰模型大鼠残余肾血流量,降低肾内氧耗。
2、治疗后各组肾功能的比较见图2。
5/6(A/I)慢性肾衰大鼠血肌酐和血尿素氮水平升高,内生肌酐清除率降低,肾功能恶化。中药组合物可以明显降低血肌酐和血尿素氮水平,升高内生肌酐清除率,改善肾功能。
3、各组大鼠HE和Masson染色结果比较见图3。
假手术组肾小球结构正常,管腔无扩张,包曼氏囊囊腔清晰,无扩张,肾间质无炎性细胞浸润,无纤维组织增生。模型组肾小球结构紊乱,系膜重度增生,毛细血管管腔严重受压闭塞,肾小球呈弥漫性硬化、硬化区系膜基质增生,与包曼氏囊粘连,肾小球周围纤维化,肾间质大量炎性细胞浸润。中药组肾小球病变轻微,包曼氏囊存在,未及明显球囊粘连。管腔无明显扩张,间质有少量炎性细胞浸润。西药组肾小球结构较模型组清晰,小球内仍有轻度分叶,系膜增生减少、炎性物质亦明显减少,肾小球系膜基质增生减轻,囊腔结构较模型组完整,肾小球纤维化较模型组有所减轻。
4、各组大鼠缺氧标志性蛋白HIF-1α表达的比较见图4。
实施效果:5/6(A/I)慢性肾衰大鼠缺氧标志性蛋白HIF-1α表达升高,中药组合物可以明显降低HIF-1α蛋白的表达,改善肾内缺氧。
方中各原料药之间符合“君臣佐使”配伍原则:党参与丹参配伍益气活血通脉,通补兼施,共为君药;仙灵脾温肾祛湿,炮附子温阳散寒,合用则振奋三焦阳气,泄浊散邪,配制大黄推陈致新,逐瘀通络,三药相伍寒温并用,阴阳平调,共为臣药;桃仁破血行瘀,生蒲黄止血化瘀利尿,合五灵脂活血泄浊,合党参活血而不伤正,炙升麻升阳解毒,鼓清气上行,浊邪下消,虫草菌丝补肾益肺,上下同治,共为佐药;紫苏叶解毒散邪,为使药。各原料药之间协同奏效,疗效佳,应用前景好。
以上所述仅是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员,在不脱离本发明原理的前提下,还可以做出若干改进和补充,这些改进和补充也应视为本发明的保护范围。
Claims (9)
1.一种治疗缺氧性肾损伤疾病的中药组合物,其特征在于,所述中药组合物由以下重量份的原料药制成:党参12份、仙灵脾12份、炮附子9份、丹参15份、制大黄9份、紫苏叶9份、桃仁12份、虫草菌丝6份、生蒲黄12份、炙升麻9份、五灵脂12份。
2.根据权利要求1所述中药组合物,其特征在于,按照中药常规制备方法制备成临床上可接受的药物制剂。
3.根据权利要求2所述的中药组合物,其特征在于,所述药物制剂为汤剂、颗粒剂、散剂、胶囊剂、片剂、合剂或口服液。
4.权利要求1所述的中药组合物在制备治疗缺氧性肾损伤疾病的药物中的应用。
5.根据权利要求4所述应用,其特征在于,所述缺氧性肾损伤疾病包括慢性肾衰竭。
6.一种治疗缺氧性肾损伤疾病的药物,其特征在于,所述的药物由权利要求1所述的中药组合物和医药行业上可接受的载体配制而成。
7.根据权利要求6所述药物,其特征在于,所述药物的活性成分是采用水提或40—80%体积百分浓度的乙醇提取制备而成的。
8.权利要求6所述药物的制备方法,其特征在于,包括如下步骤:
按照权利要求1所述重量份配比取各原料药,加水提取2-3次,每次加水量相当于药材总重量的6-12倍,每次提取时间为1-3小时,合并提取液,滤过,滤液浓缩至70-80℃时相对密度为1.10-1.25的清膏,即得药物活性成分。
9.权利要求6所述药物的制备方法,其特征在于,包括如下步骤:
按照权利要求1所述重量份配比取各原料药,加水提取2-3次,每次加水量相当于药材总重量的6-12倍,每次提取时间为1-3小时,合并提取液,滤过,滤液浓缩至70-80℃时相对密度为1.05-1.20的清膏,加入乙醇,使含醇量为40-70%,静置12-24小时,滤过,滤液浓缩至70-80℃时相对密度为1.10-1.25的浸膏,即得药物活性成分。
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