CN111870628B - 治疗慢性乙肝的药物 - Google Patents
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Abstract
本发明涉及中药领域,尤其涉及一种治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份。本发明的柴胡既能清解肝胆邪热,又能疏肝解郁,本草言之“主心腹寒热邪聚,推陈致新”,为方中君药;白芍和枳实壳协助柴胡疏肝理气,白芍兼有柔肝滋阴之效,两者共为臣药;蚕沙、茵陈、鸡骨草、田基黄和垂盆草祛湿、清热、解毒,五味子和女贞子益肝养阴,为佐助药;山楂和鸡内金化瘀、消食、健胃,为使药;本发明诸药合力,具有疏肝解郁、清热利湿兼扶正益阴之功效。
Description
技术领域
本发明涉及中药领域,尤其涉及一种治疗慢性乙肝的药物。
背景技术
乙肝是乙型肝炎病毒引起的消化道传染病,中医称之为“黄疸”、“肝郁”、“瘕积”。乙肝有急性和慢性之分,急性乙肝病程在半年之内,慢性乙肝病程在半年之上。乙型病毒性肝炎的发病原因多由多由饮食不节、七情内伤使湿热蕴蒸脾胃,肝气失于疏泄,热毒内陷所致。临床症状有乏力、食欲减退、恶心、厌油、腹胀、便溏、肝区痛、尿黄、发热、轻度脾肿大、黄疸、肝功能异常等体征,若不及时治疗,则可能发展成肝硬化。
慢性乙肝是危害比较严重的一种传染病,慢性乙肝久治不愈可发展为肝硬化、肝癌。慢性病毒性乙型肝炎发病率较高,极大的损害人民身体健康,影响了人民的正常生活与工作。我国是病毒性肝炎的高发区,是肝胆系统疾病中的常见病、多发病。平均发病率为120~ 140/10万,其中以乙型肝炎最为突出,我国乙型肝炎病毒(HBV)感染率高达57.63%,全国至少有6亿人感染过HBV。
目前的主要治疗:西医方面,有血液置换,卧床休息,抗病毒,抗感染,补液打针,口服用药,还没有针对乙型肝炎的特效药,基本上是根据乙型肝炎的表面症状进行治标不治本的治疗,只能缓解乙肝的症状。中医药在认识乙肝疾病方面有独到的见解,也出现许多治疗乙肝的中成药,如常用方剂茵陈五苓散、龙胆泄肝汤、乙肝扶正胶囊等。茵陈五苓散和龙胆泄肝汤专于清热利湿,忽略了疏肝解郁、阻断和清除乙肝病毒、提高机体免疫力,因而难以完全清除乙肝病毒、使病毒标记转阴而达到治愈的目的,并且忽略了对肝脏的保护。
在治疗方面需要辩证诊治,不同的病症和病例使用不同的药物,因此必须辩证地使用中药,即治疗慢性乙肝中药组合物既有概括性,又有针对性。临床研究发现,湿热阻滞是慢性乙型肝炎最主要的中医临床证型,此外,功能损害比较严重和乙肝表面抗原持续阳性且症状体征不明显的临床证型也是存在的。目前,虽然临床常用的中成药品种非常多,但对于具体不同慢性乙肝临床证型治疗尚无特效药物,现有技术中的药物的疗效和针对性仍不能令人满意。
发明内容
(一)解决的技术问题
针对现有技术的不足,本发明提供了一种治疗慢性乙肝的药物,解决了上述背景技术中提到的问题。
(二)技术方案
为实现以上目的,本发明通过以下技术方案予以实现:
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份。
优选地,包括以下重量配比的中药:柴胡12份,白芍10份,枳实8份,蚕沙15份,茵陈25份,山楂肉25份,鸡骨草33份,田基黄26份,鸡内金4份,五味子8份,女贞子10份,垂盆草33份。
优选地,包括以下重量配比的中药:柴胡10份,白芍12份,枳实10份,蚕沙12份,茵陈30份,山楂肉30份,鸡骨草30份,田基黄30份,鸡内金6份,五味子6份,女贞子12份,垂盆草27份。
优选地,包括以下重量配比的中药:柴胡8份,白芍15份,枳实12份,蚕沙10份,茵陈33份,山楂肉35份,鸡骨草16份,田基黄33份,鸡内金8份,五味子4份,女贞子14份,垂盆草30份。
如上述治疗慢性乙肝的药物,还包括以下重量配比的中药:蒲公英5~35份,板蓝根 5~35份,白花蛇舌草15~45份,虎杖5~30份,土茯苓5~30份,薏米5~25份,槟榔5~25份,厚朴5~30份。
如上述治疗慢性乙肝的药物,还包括以下重量配比的中药:露蜂房5~35份,虎杖5~ 30份,丹皮5~25份,赤芍5~25份,丹参5~30份,白茅根2~15份,生地2~25份,水红花子2~25份。
如上述治疗慢性乙肝的药物,还包括以下重量配比的中药:麦冬5~30份,玉竹2~15份,沙参5~25份,百合5~25份,旱莲草5~20份。
如上述治疗慢性乙肝的药物,还包括以下重量配比的中药:白豆蔻2~20份,陈皮2~ 15份,苍术2~15份,白扁豆2~15份,山药2~20份,黄芪2~20份,党参2~20份,茯苓2~15份,白术2~15份。
中药药效如下:
柴胡,味辛、苦,性微寒;归肝、胆、肺经;具有和解表里、疏肝升阳之功效。柴胡总挥发油中的丁香酚、己酸、γ-十一酸内酯和对-甲氧基苯二酮是其解热的主要成分;柴胡挥发油可能作用于下丘脑体温调节中枢,抑制该部位cAMP的产生或释放,从而抑制体温调定点的上移,使体温下降。柴胡保肝机制在于:柴胡皂苷对生物膜(如线粒体膜)有直接保护作用;柴胡皂苷促进脑垂体分泌ACTH,进而升高血浆皮质醇;拮抗外源性甾体激素对肾上腺的萎缩作用,提高机体对非特异性刺激的抵抗能力;促进肝细胞DNA合成,抑制细胞外基质的合成。
白芍,味苦、酸,性微寒;归肝、脾经;具有养血、敛阴止汗、柔肝止痛、平抑肝阳之功效。对四氯化碳、黄曲霉毒素B1、D-半乳糖胺所致肝损伤有明显保护作用;白芍对肝脏有保护作用,对胃液分泌有抑制作用。
枳实,苦、辛、酸,微寒;归脾、胃经;具有破气消积、化痰散痞之功效。枳实中的黄酮类成分含量较高,约占5%~28%,是枳实理气行滞,祛痰消积的重要组成成分。
蚕沙,味辛、甘,性温;归胃、脾、肝经;具有祛风除湿、和胃化浊、活血通经之功效。
茵陈,味苦、辛,性微寒;归脾、胃、肝、胆经;具有清利湿热、利胆退黄之功效。茵陈色原酮、甲基茵陈色原酮等均有促进胆汁分泌与排出作用,煎剂对四氯化碳所致肝损害有一定的保肝作用,肝细胞肿胀、脂肪病变与坏死有不同程度的减轻。
山楂肉,具有肝调、滋阴食谱、健脾、开胃之功效。山楂含维生素C、维生素B2、胡萝卜素及多种有机酸,口服能增加胃中消化酶的分泌,并能增强酶的活性,促进消化,其中所含的脂肪酶能直接帮助消化脂肪类食物,且能加强胃脂肪酶、蛋白酶的活性。
鸡骨草,味甘、微苦,性凉;归肝、胃经;具有利湿退黄、清热解毒、疏肝止痛之功效。鸡骨草主要有效活性成分为黄酮类和生物碱类物质;鸡骨草对四氯化碳造成的急性肝损伤有明显降低作用。
田基黄,甘、苦,凉;归肺,肝,胃经;具有清热利湿、解毒、散瘀消肿之功效。田基黄的化学成分主要有两大类,分别为黄酮、黄烷醇及其苷类和间苯三酚衍生物;黄烷醇类主要有槲皮素、槲皮甙、白前甙B,它为抗炎有效成分之一;间苯三酚类衍生物具有抗菌、抗疟等活性。
鸡内金,甘,平;归脾、胃、小肠、膀胱经;具有健胃消食、涩精止遗、通淋化石之功效。鸡内金中含有胃激素、蛋白质、少量胃蛋白酶、淀粉酶和各种氨基酸;鸡内金能显著增加蛋白酶排出量;鸡内金能增强小肠推进作用。
五味子,味酸、甘,性温;归肺、心、肾经;具有收敛固涩、益气生津、补肾宁心之功效。五味子醇提取物能降低四氯化碳,硫代乙醇胺等引起的谷丙转氨酶升高;γ-五味子素具有护肝损伤的作用。
女贞子,甘、苦,凉;归肝、肾经;具有滋阴益寿、补益肝肾、清热明目、乌须黑发等功效。女贞子所含齐墩果酸为广谱抗生素,对金黄色葡萄球菌、溶血性链球菌、大肠杆菌、弗氏痢疾杆菌、伤寒杆菌,特别是对伤寒杆菌、金黄色葡萄球菌作用比氯霉素强。女贞子的保肝、免疫调节作用最强,OLA含量最高,降SGPT作用最强。
垂盆草,味甘、淡,性凉;归肝、胆、小肠经;具有利湿退黄、清热解毒之功效。垂盆草主要含有蛋白质、氨基酸、糖类、黄酮类、三萜类及垂盆草苷类;垂盆草苷(2-氰基 -4-O-B-D-葡萄糖反丁烯-2-醇),为抗肝炎活性成分;垂盆草苷对四氯化碳性肝损伤有明显保护作用,可使肝细胞内糖元和葡萄糖-6-磷酸酶,乳酸脱氢酶含量增加,肝细胞内琥珀酸脱氢酶和ATP酶活性增强;垂盆草对滤过性毒菌引起的肝癌细胞有抑制作用,可以通过抑制其增殖来延长肝癌患者寿命。
蒲公英,苦甘,寒;入肝、胃经;具有清热解毒之效。
板蓝根,味苦,性寒;归心、胃经;具有清热解毒、利咽之功效。
白花蛇舌草,味苦、淡,性寒;具有清热解毒、消痈、利湿之功效。
虎杖,味微苦,性微寒;归肝、胆、肺经;具有利湿退黄、清热解毒、散瘀止痛之功效。
土茯苓,甘、淡,平;归肝、胃经;具有解毒、除湿、通利关节之功效。
薏米,除富含优质蛋白质、碳水化合物、脂肪、矿质元素和维生素外,还具有丰富的多糖、脂肪酸与其酯类化合物、黄酮类化合物、三萜类化合物等多种活性成分;具有抗氧化、抗炎症、抗癌、和止痛之功效。
槟榔,具有杀虫、破积、降气行滞、行水化湿之功效。
厚朴,味苦、辛,性温;归脾、胃、肺、大肠经;具有化湿导滞、化食消痰、驱风镇痛之效,其种子有明目益气功效。
露蜂房,甘,平;归肝、胃、肾经;具有祛风、攻毒、止痛、抗过敏之功效。
丹皮,具有镇静、降温、解热、镇痛、抗溃疡之作用。
赤芍,味苦,性微寒;归肝经;具有清热凉血、活血祛瘀的功效。
丹参,味苦,微寒;归心、肝经;具有活血祛瘀、通经止痛之功效,凉血消痈之功效。
白茅根,甘,寒;归肺、胃、膀胱经;具有凉血止血、清热解毒之功效。
鲜地黄,味甘、苦,性寒;归心、肝、肾经;为清热凉血药,熟地黄则为补益药。
水红花子,具有散血消症,消积止痛之功效。
麦冬,甘,微苦,微寒;归心、肺、胃经;具有养阴生津、润肺止咳之功效。
玉竹,具有养阴润燥,生津止渴之功效。
沙参,味甘,微苦,性微寒;归肺、胃经;具有养阴清热、润肺化痰、益胃生津之功效。
百合,甘,微苦,微寒;心,肺经;具有养阴润肺、清心安神之功效。
旱莲草,甘酸,凉;《滇南本草》:“性寒,味咸。”入肝、肾经;具有止血、补肾、益阴之功效。
豆蔻,用于化湿消痞、行气温中、开胃消食。
陈皮,味苦、辛,性温;归肺、脾经;具有理气健脾、燥湿化痰之功效。
苍术,味辛、苦,性温;归脾、胃、肝经;具有燥湿健脾、祛风散寒、明目之功效。
白扁豆,甘,微温;归脾、胃经;具有健脾、化湿之功效。
山药,甘,温、平;具有益肾气、健脾胃之功效。
黄芪,味甘,性微温;归脾、肺经;具有补气固表、托毒排脓、生肌之功效。
党参,《本经逢原》:甘,平;《中国药典》:归脾、肺经;具有补中益气、止渴、健脾益肺、养血生津之功效。
茯苓,味甘、淡,性平;归心、肺、脾、肾经;具有利水渗湿、健脾、宁心之功效。
白术,苦、甘,温;具有健脾益气之功效。
(三)有益效果
本发明提供了一种治疗慢性乙肝的药物,具备以下有益效果:
本发明的药物包括柴胡、白芍、枳实、蚕沙、茵陈、山楂肉、鸡骨草、田基黄、鸡内金、五味子、女贞子和垂盆草,组成本发明治疗慢性乙肝的基础方;其中,柴胡既能清解肝胆邪热,又能疏肝解郁,本草言之“主心腹寒热邪聚,推陈致新”,为本申请的君药;白芍和枳实壳协助柴胡疏肝理气,白芍兼有柔肝滋阴之效,两者共为臣药;蚕沙、茵陈、鸡骨草、田基黄和垂盆草祛湿、清热、解毒,五味子和女贞子益肝养阴,为佐助药;山楂和鸡内金化瘀、消食、健胃,为使药;诸药合力,起到疏肝解郁、清热利湿兼扶正益阴之功效。
对于湿热之毒较重的乙肝患者,治疗时重在清化湿热解毒兼和胃理气疏肝,在上述基础方上加用蒲公英、板蓝根、白花蛇舌草、虎杖、土茯苓、薏米、槟榔、厚朴。
对于于乙肝表面抗原持续阳性,但症状体征不明显的患者,在上述基础方上加用露蜂房、虎杖、丹皮、赤芍、丹参、白茅根、生地、水红花子,与解毒法配伍得当,有利改善肝功能,促进抗原的转阴。
对于肝功能损害比较严重,病程较长的患者,治疗宜滋补肝肾兼清肝解毒,在基础方上加用甘寒养阴、柔而不腻之品,如麦冬、玉竹、沙参、百合、旱莲草,乙肝病毒易损耗肝阴,只有注意滋阴养血柔肝,才有助肝功能的恢复。
“见肝之病,知肝传脾,当先实脾”因此治疗乙肝的始终都要注意保护脾胃功能,一般选用芳香化浊、利湿解毒、健脾补气之品,如白豆蔻、陈皮、苍术、白扁豆、山药、黄芪、党参、茯苓、白术等,如有肾阳不足,则配合温补肾阳,可选枸杞、菟丝子、仙灵脾、巴戟天等温而不燥之品。
本发明诸药合力,起到疏肝解郁、清热利湿兼扶正益阴之功效;用于治疗慢性乙肝,尤其是治疗肝郁气滞,湿热之毒较重,乙肝表面抗原持续阳性且症状体征不明显,肝功能损害比较严重且病程较长具有显著疗效;本发明也可用于各种脂肪肝、急慢性肝炎、肝功能损害等症状。
具体实施方式
下面将对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅仅是本发明一部分实施例,而不是全部的实施例。
实施例1
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡12克,白芍10克,枳实8克,蚕沙15克,茵陈25克,山楂肉25克,鸡骨草33克,田基黄26克,鸡内金4克,五味子8克,女贞子10克,垂盆草33克。
实施例2
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克。
实施例3
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡8克,白芍15克,枳实12克,蚕沙10克,茵陈33克,山楂肉35克,鸡骨草16克,田基黄33克,鸡内金8克,五味子4克,女贞子14克,垂盆草30克。
实施例4
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡12克,白芍10克,枳实8克,蚕沙15克,茵陈25克,山楂肉25克,鸡骨草33克,田基黄26克,鸡内金4克,五味子8克,女贞子10克,垂盆草33克,蒲公英15克,板蓝根20克,白花蛇舌草18克,虎杖18克,土茯苓8克,薏米15克,槟榔8克,厚朴15克。
实施例5
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,蒲公英10克,板蓝根15克,白花蛇舌草22 克,虎杖15克,土茯苓12克,薏米10克,槟榔12克,厚朴7克。
实施例6
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,露蜂房15克,虎杖10克,丹皮7克,赤芍10 克,丹参20克,白茅根6克,生地15克,水红花子8克。
实施例7
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡8克,白芍15克,枳实12克,蚕沙10克,茵陈33克,山楂肉35克,鸡骨草16克,田基黄33克,鸡内金8克,五味子4克,女贞子14克,垂盆草30克,露蜂房10克,虎杖15克,丹皮10克,赤芍7克,丹参15克,白茅根10克,生地10克,水红花子6克。
实施例8
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡12克,白芍10克,枳实8克,蚕沙15克,茵陈25克,山楂肉25克,鸡骨草33克,田基黄26克,鸡内金4克,五味子8克,女贞子10克,垂盆草33克,麦冬15克,玉竹5克,沙参10克,百合20克,旱莲草10克。
实施例9
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,麦冬10克,玉竹8克,沙参15克,百合15 克,旱莲草10克。
实施例10
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,白豆蔻10克,陈皮8克,苍术7克,白扁豆5 克,山药10克,黄芪10克,党参15克,茯苓10克,白术8克。
实施例11
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,蒲公英10克,板蓝根15克,白花蛇舌草22 克,虎杖15克,土茯苓12克,薏米10克,槟榔12克,厚朴7克,白豆蔻8克,陈皮10 克,苍术10克,白扁豆7克,山药15克,黄芪5克,党参10克,茯苓8克,白术5克。
实施例12
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,露蜂房15克,虎杖10克,丹皮7克,赤芍10 克,丹参20克,白茅根6克,生地15克,白豆蔻5克,陈皮15克,苍术12克,白扁豆 5克,山药10克,黄芪12克,党参8克,茯苓5克,白术10克。
实施例13
治疗慢性乙肝的药物,包括以下重量配比的中药:柴胡10克,白芍12克,枳实10克,蚕沙12克,茵陈30克,山楂肉30克,鸡骨草30克,田基黄30克,鸡内金6克,五味子6克,女贞子12克,垂盆草27克,麦冬10克,玉竹8克,沙参15克,百合15 克,旱莲草10克,白豆蔻6克,陈皮12克,苍术5克,白扁豆6克,山药8克,黄芪8 克,党参5克,茯苓12克,白术12克。
临床观察报告
1.临床资料
收集门诊就诊的慢性乙肝患者540例,均符合慢性乙肝诊断标准。
以随机数字表法分为第一、第二、第三、第四、第五治疗组和对照组,每组90例。
第一治疗组包括:男性病例54例,女性病例36例,年龄在23~60之间,平均年龄为35.6±2.2;第二治疗组包括:男性病例57例,女性病例33例,年龄在25~58之间,平均年龄为33.8±2.5;第三治疗组包括:男性病例52例,女性病例38例,年龄在23~55之间,平均年龄为28.9±3.2;第四治疗组包括:男性病例57例,女性病例33例,年龄在26~ 63之间,平均年龄为31.9±3.2;第五治疗组包括:男性病例50例,女性病例40例,年龄在21~56之间,平均年龄为32.2±2.4;对照组包括:男性病例55例,女性病例35例,年龄在28~60之间,平均年龄为30.6±3.1。
第一、第二、第三、第四、第五治疗组和对照组患者人口信息比较中,性别、身高、年龄、体重、病史、治疗史、过敏史和体格检查各项差别无统计学意义(P>0.05)。
排除标准:(1)近3个月曾参加其它临床试验者;(2)育龄期准备生育者;(3) 西医确诊为重型肝炎(含急性、亚急性及慢性重型肝炎);(4)有其它肝炎病毒感染及各种原因引起的肝硬化;(5)合并有心、肾、肺、内分泌、血液等严重原发病,或精神病患者。
剔除终止标准:(1)纳入后发现不符合纳入标准的病例;(2)对本发明所用中药过敏的患者;(3)受试者自主性过强者;(4)病情较治疗前明显恶化,或者医生认为必须退出者;(5)发生严重不良事件、发生并发症或特殊生理变化不宜继续接受试验、自行退出者等均为脱落病例。
2.治疗方法
第一、第二、第三、第四和第五治疗组分别采用实施例1、实施例5、实施例6、实施例9和实施例10中的中药组成,每日1剂,水煎服。
对照组:每日以甘利欣30mL,清开灵1 200mg。分别加入5%GS 250mL中静滴;口服立平脂200mg,每日1次。
以上治疗4周为1个疗程,连续治疗2个疗程。上述患者均于治疗前7天停用所有影响血脂代谢的药物。治疗前1天晚上不进食高脂饮食,不饮酒,治疗期间均停服其它药物。
3.疗效标准
3.1整体疗效评定参照《中药新药临床研究指导原则》相关标准:
(1)痊愈:症状和体征消失或基本消失,B超检查肝胆形态结构正常,实验室检查肝功能及HBV-DNA结果正常,随访无复发。
(2)显效:自觉症状基本消失,肝脾肿大稳定或改善I级以上,肝功能检查正常,以上各项指标稳定半年以上者。
(3)有效:主要症状消失,或基本消失,肝脾肿大稳定不变或缩小;肝功能指标检查正常或较原值下降50%以上,并持续3个月者。
(4)无效:疗程结束后,未达上述疗效标准者。
3.2中医证候疗效判定计分标准
慢性乙型肝炎证候疗效,根据主要症状轻重程度不同,采用三级计分,分轻(+),中(++),重(+++)。
表1 中医证候疗效判定计分标准
4.治疗结果与分析
表2 临床治疗效果统计表
由表2数据分析,第二、第三、第四和第五治疗组总有效率明显优于对照组,可见本发明用于治疗慢性乙肝痊愈率高且不易复发,具有推广应用的价值。
表3 治疗前后病例的证候积分统计表
治疗后,第一、第二、第三、第四和第五治疗组积分较治疗前大幅减少,与对照组相比,说明第一、第二、第三、第四和第五治疗组得效果明显优于对照组。治疗后,第二、第三、第四治疗组积分略低于第一治疗组治疗后的积分,说明实施例5、实施例6、实施例9提供的配伍又增加了其他疗效,与实施例1提供的基础方相比。
表4 不同症状疗效比较
由表4可知,实施例1、实施例5、实施例6、实施例9和实施例10的配伍对肝郁气滞均有很好的治疗效果,说明本发明提供的基础方(包括柴胡、白芍、枳实、蚕沙、茵陈、山楂肉、鸡骨草、田基黄、鸡内金、五味子、女贞子和垂盆草)对于治疗肝郁气滞具有很好的治疗效果;实施例5提供的配方对于治疗肝郁湿热具有良好的治疗效果,实施例9适合用于治疗乙肝表面抗原持续阳性,但症状体征不明显的患者;而实施例10适合用于治疗肝功能损害比较严重,病程较长,见肝痛隐隐,稍有劳作则加重,伴头晕目眩、形体消瘦、精神疲倦、眼目干涩、失眠多梦,口干,面色黯黑,舌红少苔,脉细数等症状的患者。
综上所述,对于湿热之毒较重的乙肝患者,临床表现为肝区或两胁下胀满疼痛,或兼脘腹不适、恶心呕吐、食欲不振,厌油,口粘口苦口臭,偶有低热,大便不成形,尿黄,舌苔黄腻厚浊,治疗时重在清化湿热解毒兼和胃理气疏肝,在基础方上加用蒲公英、板蓝根、白花蛇舌草、虎杖、土茯苓、薏米、槟榔、厚朴。
对于于乙肝表面抗原持续阳性,但症状体征不明显的患者,常用露蜂房、虎杖、丹皮、赤芍、丹参、白茅根、生地、水红花子等,与解毒法配伍得当,有利改善肝功能,促进抗原的转阴。
对于肝功能损害比较严重,病程较长,见肝痛隐隐,稍有劳作则加重,伴头晕目眩、形体消瘦、精神疲倦、眼目干涩、失眠多梦,口干,面色黯黑,舌红少苔,脉细数等症状的患者,治疗宜滋补肝肾兼清肝解毒,在基础方上加用甘寒养阴、柔而不腻之品,如麦冬、玉竹、沙参、百合、旱莲草,乙肝病毒易损耗肝阴,只有注意滋阴养血柔肝,才有助肝功能的恢复。
本发明诸药合力,起到疏肝解郁、清热利湿兼扶正益阴之功效;用于治疗慢性乙肝,尤其是治疗肝郁气滞,湿热之毒较重,乙肝表面抗原持续阳性且症状体征不明显,肝功能损害比较严重且病程较长具有显著疗效;本发明也可用于各种脂肪肝、急慢性肝炎、肝功能损害等症状。
以上所述,仅为本发明较佳的具体实施方式,但本发明的保护范围并不局限于此,任何熟悉本技术领域的技术人员在本发明揭露的技术范围内,根据本发明的技术方案及其发明构思加以等同替换或改变,都应涵盖在本发明的保护范围之内。
Claims (8)
1.治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份。
2.根据权利要求1所述的治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡12份,白芍10份,枳实8份,蚕沙15份,茵陈25份,山楂肉25份,鸡骨草33份,田基黄26份,鸡内金4份,五味子8份,女贞子10份,垂盆草33份。
3.根据权利要求1所述的治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡10份,白芍12份,枳实10份,蚕沙12份,茵陈30份,山楂肉30份,鸡骨草30份,田基黄30份,鸡内金6份,五味子6份,女贞子12份,垂盆草27份。
4.根据权利要求1所述的治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡8份,白芍15份,枳实12份,蚕沙10份,茵陈33份,山楂肉35份,鸡骨草16份,田基黄33份,鸡内金8份,五味子4份,女贞子14份,垂盆草30份。
5.一种治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份,蒲公英5~35份,板蓝根5~35份,白花蛇舌草15~45份,虎杖5~30份,土茯苓5~30份,薏米5~25份,槟榔5~25份,厚朴5~30份。
6.一种治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份,露蜂房5~35份,虎杖5~30份,丹皮5~25份,赤芍5~25份,丹参5~30份,白茅根2~15份,生地2~25份,水红花子2~25份。
7.一种治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份,麦冬5~30份,玉竹2~15份,沙参5~25份,百合5~25份,旱莲草5~20份。
8.一种治疗慢性乙肝的药物,其特征在于,由以下重量配比的中药组成:柴胡5~20份,白芍5~20份,枳实5~25份,蚕沙5~25份,茵陈25~45份,山楂肉25~45份,鸡骨草25~45份,田基黄25~45份,鸡内金2~15份,五味子2~15份,女贞子~25份,垂盆草25~45份;白豆蔻2~20份,陈皮2~15份,苍术2~15份,白扁豆2~15份,山药2~20份,黄芪2~20份,党参2~20份,茯苓2~15份,白术2~15份。
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