CN111870670B - 一种治疗粉刺的中药汤剂 - Google Patents

一种治疗粉刺的中药汤剂 Download PDF

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CN111870670B
CN111870670B CN202010874781.2A CN202010874781A CN111870670B CN 111870670 B CN111870670 B CN 111870670B CN 202010874781 A CN202010874781 A CN 202010874781A CN 111870670 B CN111870670 B CN 111870670B
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赵艳
段浩博
王艳艳
段素社
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Abstract

一种治疗粉刺的中药汤剂，属于治疗皮肤疾病的中药制剂领域，按重量份数计，包括以下原料：鱼腥草20份，黄芩12份，桑白皮10份，地骨皮10份，牡丹皮10份，当归10份，丹参20份，赤芍15份，生山楂30份，泽泻10份，茵陈10份，黄柏12份，白花蛇舌草20份，夏枯草15份，陈皮10份，枇杷叶15份，砂仁9份，桔梗10份，白芷10份。本发明中药汤剂，通过清热解毒、活血通络治疗粉刺，有效率高，见效快。

Description

一种治疗粉刺的中药汤剂
技术领域
本发明属于治疗皮肤疾病的中药制剂领域，涉及一种治疗粉刺的中药汤剂，通过清热解毒、活血通络治疗粉刺，有效率高，见效快。
背景技术
粉刺又称痤疮。好发于面部、颈部、前胸及后背，以粉刺、丘疹、脓疮、结节等多行型皮损为特点。粉刺在青少年多见，80％-90％罹患此病，因此，该病对青少年群体的心理和社交影响很大，如不及时有效治疗，可能出现瘢痕、色素沉着、持久性红斑，影响美观。
目前，教科书将其辩证分型为：肺经风热证、肠胃湿热证、痰湿瘀滞证。详细介绍如下：
1.肺经风热证
证候:丘疹色红，或有痒痛，或有脓疱，或伴口渴喜饮，大便秘结，小便短赤。舌质红苔薄黄，脉弦滑。
治法:疏风清肺。
方药:枇杷清肺饮加减。常用枇杷叶(去毛蜜炙)、生甘草、黄连、桑白皮、黄柏等。
伴口渴喜饮者，加生石膏、天花粉；大便秘结者，加生大黄；脓疱多者，加紫花地丁、白花蛇舌草；经前加重者，加香附、益母草、当归。
2.肠胃湿热证
证候:颜面、胸背部皮肤油腻，皮疹红肿疼痛，或有脓疱。伴口臭、便秘、溲黄。舌红，苔黄，脉滑数。
治法:清热除湿解毒。
方药:茵陈蒿汤加减。常用茵陈、栀子、大黄。伴腹胀，舌苔厚腻者，加生山楂、鸡内金、枳实、薏苡仁；脓疱较多者，加白花蛇舌草、野菊花、金银花。
3.痰湿瘀滞证
证候:皮疹颜色黯红，以结节、脓肿、囊肿、瘢痕为主，或见窦道，经久难愈。伴纳呆腹胀。舌质黯红，苔黄腻或白腻，脉弦滑。
治法:除湿化痰，活血散结。
方药:二陈汤合桃红四物汤加减。常用陈皮、半夏、茯苓、甘草、当归、赤芍、生地黄、川芎、桃仁、红花。伴囊肿成脓者，加贝母、皂角刺、野菊花、连翘；伴结节、囊肿难消者，加三棱、莪术、皂角刺、夏枯草。
从以上分型可以看出，该分型及治法复杂，特别是青少年身体健壮，很少有兼证，当仅有粉刺表现，而无其它症状时，往往令医生陷入无证可辨的地步。
发明内容
本发明未解决上述问题，提供了一种治疗粉刺的中药汤剂，特别是当仅有粉刺出现，无其他症状时，达到很好的治疗效果。
本发明按照抓主症体现治病求本的原则，首先辨出粉刺当归属于中医痈疽的范畴，这一点在粉刺的外观表现就可以确定。通过“望而知之谓之神”，粉刺的外在表现通过望诊可见丘疹、脓疱、结节等。粉刺多见于青年男女，故也称青春痘，西医称为痤疮。青年人血气方刚，素体阳热偏盛，营血偏热，血热外壅，体表气血瘀滞；过食辛辣、鱼腥海鲜肥腻之品；或外感风热，积热循肺胃二经上熏胸面，皮肤气血瘀滞，经络失畅，玄府不通，蕴成疮毒。“面疱者，为面上有风热气生疮，头如米大，亦如谷大”。因此判断粉刺当为中医之疮痈。根据中医“痈疽原是火毒生，经络阻滞气血凝”，可以确定粉刺是火毒为病而致气血凝滞；治疗上当以“清热解毒活气血，更看部位属何经”用药以清上焦火，解上焦毒，配以活血通络的治则。在清热解毒，活血通络的治则下遣方用药，所创清热解毒通络治方，本发明为实现其目的采用的技术方案是：
一种治疗粉刺的中药汤剂，按重量份数计，包括以下原料：鱼腥草20份，黄芩12份，桑白皮10份，地骨皮10份，牡丹皮10份，当归10份，丹参20份，赤芍15份，生山楂30份，泽泻10份，茵陈10份，黄柏12份，白花蛇舌草20份，夏枯草15份，陈皮10份，枇杷叶15份，砂仁9份，桔梗10份，白芷10份。
所述中药汤剂由下述方法制备：
(1)准备原料：鱼腥草20g，黄芩12g，桑白皮10g，地骨皮10g，牡丹皮10g，当归10g，丹参20g，赤芍15g，生山楂30g，泽泻10g，茵陈10g，黄柏12g，白花蛇舌草20g，夏枯草15g，陈皮10g，枇杷叶15g，砂仁9g，桔梗10g，白芷10g；
(2)将原料用水浸泡1小时，控制煎药时水没过药物2cm，水沸腾后，煎煮30分钟，煎煮结束后，取出煎汁150ml，然后向煎锅中加水，控制水没过药物1cm，水沸腾后，煎煮20分钟，取出煎汁150ml，两煎混匀。分两次早晚各服药一次，两次服药间隔8小时。
本发明的有益效果：
针对火毒蕴结，循经上蒸，气血凝滞的病机施治，是治本之策，故避免了《教科书》虽列出每型的主症和兼证，但往往是兼证不足无证可辨；或是同一病人，不同的医生会辨出不同的结果，所用方药差异很大，疗效难以保证的局面。在抓主症体现治病求本思路下所组方药治疗粉刺，符合中医主证辨治的原则，临床疗效突出且可重复性强。每日1剂，一般1周控制新增粉刺。随着继续服用厚皮损逐渐恢复，4周一疗程。
本发明中鱼腥草入肺经，清热解毒、消痈排脓为主药，肺居上焦，主皮毛，肺经郁热，热盛肉腐，身之上部皮肤发生疮疡肿毒，非鱼腥草热毒不能清，故《中药学》把鱼腥草列为治疗肺痈的要药。黄芩虽善清上焦肺热，但无排脓之作用，故不能作为主药，而与具有清泻肺火，且有排脓作用的桑白皮、地骨皮共为辅药，辅助主药清肺火，解热毒，消肿排脓。粉刺为痈疽，痈疽有气血凝滞的病机，治当还应活血通络，有助于粉刺的消散，故用丹皮、当归、丹参、赤芍、山楂以活血通经为佐药；泽泻、茵陈、黄柏利湿清热，白花蛇舌草、夏枯草散结以消疮毒，亦为佐药。以上主、辅、佐药均多寒凉，恐有寒凉伤胃之嫌，用陈皮、枇杷叶、砂仁温化行气，以防寒凉太过而伤胃共为佐药。使药桔梗、白芷，载药上行且引药入肺经，且二药均有排脓作用，诸药合用，药多而不杂，突出了集中针对肺经火热的病机，达到清热解毒，排脓通经散结的作用，制方要素与病机要素高度对应。
具体实施方式
下面结合具体实施例对本发明做进一步的说明。
一、具体实施例
实施例1
一种治疗粉刺的中药汤剂，原料如下：鱼腥草20g，黄芩12g，桑白皮10g，地骨皮10g，牡丹皮10g，当归10g，丹参20g，赤芍15g，生山楂30g，泽泻10g，茵陈10g，黄柏12g，白花蛇舌草20g，夏枯草15g，陈皮10g，枇杷叶15g，砂仁9g，桔梗10g，白芷10g。
所述的汤剂由下述方法制备：将原料用水浸泡1小时，控制煎药时水没过药物2cm，水沸腾后，煎煮30分钟，煎煮结束后，取出煎汁150ml，然后向煎锅中加水，控制水没过药物1cm，水沸腾后，煎煮20分钟，取出煎汁150ml，两煎混匀。分两次早晚各服药一次，两次服药间隔8小时。
二、临床实验
1.临床资料全部90例均为石家庄长城中西医结合医院门诊病例，随机分为2组，治疗组45例，男20例，女25例，年龄18-35岁，病程3-24个月。对照组45例，男21例，女24例，年龄17-35岁，病程3-22个月。2组一般资料比较差异无统计学意义，具有可比性。
2.诊断标准
1.西医诊断标准(参考Pill Sburv及国际改良痤疮分级法，赵辨所著《临床皮肤病学》，第二版，江苏科技出版社)
(1)寻常痤疮诊断标准青春期开始发病，好发于面部、上胸及背部等皮脂腺发达部位，对称分布。皮损为毛囊性丘疹、黑头粉刺、脓疱、结节、囊肿和疤痕，伴有皮脂溢出，呈慢性经过。
3.纳入标准：(1)符合诊断标准，(2)受试者年龄在16到35岁者.
4.排除标准，(1)年龄在16岁以下及大于35岁者，(2)有其他疾病，正在用药治疗者，(3)近两周内用过内服或外治法治疗过痤疮(粉刺)者，(4)怀孕或哺乳期的女性。
5.治疗方法
治疗组用自拟“粉刺通络方”方药组成即实施例1，分2次口服，早晚各服药一次，两次服药间隔8小时，4周为一疗程。
对照组用克林霉素磷酸酯凝胶，国药准字H10970006苏州第四制药厂。取适量凝胶在患处涂一薄层，早晚各一次，四周为一疗程。
6.疗效标准：
参照《中药新药临床研究指导原则(试行)》中有关痤疮的疗效标准。痊愈:皮损消退90％以上或仅留有色素沉着，无新发皮疹；显效:皮损消退70％～90％，新发皮疹＜5个；有效:皮损消退40％～69％，新发皮疹＜10个；无效:皮损消退40％以下，消退不明显。有效率＝(痊愈+显效+有效)/总治疗人数×100％。
结果：2组疗效比较见表1。
表1由表1可见，2组有效率比较差异有统计学意义，(P＜0.05)治疗组疗
组别 例数 痊愈 显效 有效 无效 总有效率
治疗组 45 26 11 5 3 93.3％
对照组 45 14 10 11 10 77.7％
效优于对照组。

Claims (2)

1.一种治疗粉刺的中药汤剂，其特征在于，按重量份数计，由以下原料制成：鱼腥草20份，黄芩12份，桑白皮10份，地骨皮10份，牡丹皮10份，当归10份，丹参20份，赤芍15份，生山楂30份，泽泻10份，茵陈10份，黄柏12份，白花蛇舌草20份，夏枯草15份，陈皮10份，枇杷叶15份，砂仁9份，桔梗10份，白芷10份。
2.根据权利要求1所述的一种治疗粉刺的中药汤剂，其特征在于，所述汤剂由下述方法制备：
（1）准备原料：鱼腥草20g，黄芩12g，桑白皮10g，地骨皮10g，牡丹皮10g，当归10g，丹参20g，赤芍15g，生山楂30g，泽泻10g，茵陈10g，黄柏12g，白花蛇舌草20g，夏枯草15g，陈皮10g，枇杷叶15g，砂仁9g，桔梗10g，白芷10g；
（2）将原料用水浸泡1小时，控制煎药时水没过药物2cm，水沸腾后，煎煮30分钟，煎煮结束后，取出煎汁150ml，然后向煎锅中加水，控制水没过药物1cm，水沸腾后，煎煮20分钟，取出煎汁150ml，两煎混匀。
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