CN112535702A - Traditional Chinese medicine composition for nursing arteriovenous internal fistula and preparation method thereof - Google Patents
Traditional Chinese medicine composition for nursing arteriovenous internal fistula and preparation method thereof Download PDFInfo
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Abstract
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to a traditional Chinese medicine composition for nursing arteriovenous internal fistula and a preparation method thereof. The traditional Chinese medicine composition for nursing arteriovenous internal fistula comprises 80-90 parts of gallnut, 0.1-1 part of centella extract, 0.1-1 part of centipede, 0.1-1 part of borneol, 1-3 parts of dragon's blood, 10-30 parts of honey and 200-300 parts of mature vinegar. The traditional Chinese medicine composition for nursing arteriovenous internal fistula disclosed by the invention has a good effect on nursing of hemodialysis arteriovenous internal fistula (AVF).
Description
Technical Field
The invention belongs to the technical field of traditional Chinese medicines, and particularly relates to a traditional Chinese medicine composition for nursing arteriovenous internal fistula and a preparation method thereof.
Background
Arteriovenous internal fistula is one of surgical operations and is mainly used for hemodialysis treatment. The arteriovenous internal fistula is a small operation for blood vessel anastomosis, wherein an artery at the part of a forearm close to a wrist and an adjacent vein are sutured, so that arterial blood flows in the anastomosed vein to form an arteriovenous internal fistula. The arteriovenous internal fistula blood vessel can provide sufficient blood for hemodialysis treatment, and guarantee is provided for the sufficiency of the hemodialysis treatment.
The existing hemodialysis arteriovenous internal fistula (AVF) nursing medicine has certain limitation on the protection effect of the arteriovenous internal fistula, and is specifically embodied as follows: (1) no significant relief of the proliferation of surrounding connective tissue; (2) the repair effect after trauma is not obvious; (3) has uncertain protective effect on vascular endothelium.
Disclosure of Invention
The invention aims to provide a traditional Chinese medicine composition for nursing arteriovenous internal fistula.
The invention also aims to provide a preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula.
The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to the specific embodiment of the invention is prepared from the following raw materials in parts by weight: 80-90 parts of gallnut, 0.1-1 part of centella extract, 0.1-1 part of centipede, 0.1-1 part of borneol and 1-3 parts of dragon's blood.
The traditional Chinese medicine composition also comprises 10-30 parts of honey and 200-300 parts of mature vinegar.
The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to the specific embodiment of the invention is prepared from the following raw materials in parts by weight: 80 parts of gallnut, 0.1 part of asiaticoside, 0.1 part of centipede, 0.1 part of borneol, 1 part of dragon's blood, 10 parts of honey and 200 parts of mature vinegar.
The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to the specific embodiment of the invention is prepared from the following raw materials in parts by weight: 90 parts of gallnut, 1 part of asiaticoside, 1 part of centipede, 1 part of borneol, 3 parts of dragon's blood, 30 parts of honey and 300 parts of mature vinegar.
The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to the specific embodiment of the invention is prepared from the following raw materials in parts by weight: 86 parts of Chinese gall, 0.3 part of asiatic centella total glycosides, 0.5 part of centipede, 0.3 part of borneol, 1.5 parts of dragon's blood, 18 parts of honey and 250 parts of mature vinegar.
The preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula according to the specific embodiment of the invention is prepared by the method comprising the following steps of:
(1) pulverizing Galla chinensis and Scolopendra respectively;
(2) adding the crushed gallnut into 50% of mature vinegar according to the formula amount, and soaking for 20-40 hours;
(3) boiling the rest of mature vinegar, adding the rest of mature vinegar into the gallnut soaked by the mature vinegar obtained in the step (2), heating the mixture for 30-50 min by strong fire, and heating the mixture for 1-3 h by mild fire;
(4) adding boiling honey;
(5) cooling to 35-40 ℃, adding the asiatic pennywort herb extract, dragon's blood, centipede and borneol, and uniformly stirring to obtain the traditional Chinese medicine.
According to the preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula, in the step (1), gallnut is crushed and then sieved by a 120-mesh sieve.
According to the preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula, in the step (1), centipedes are crushed and then sieved by a 200-mesh sieve.
According to the preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula, in the step (4), honey is boiled for 2 times and then used.
The Chinese medicinal composition for nursing arteriovenous internal fistula according to the embodiment of the invention is in the form of paste.
Gallnut, a gall on leaves of Rhus chinensis Mill, Rhus potaninii Maxim, a Rhus chinensis Mill, a Rhus chinensis, or Rhus chinensis punjabensis Stew.var.sinica (Diels) Red. et Wils. mainly formed by parasitizing the gall aphid Melaphosis chinensis (Bell) Baker. Sour, astringent and cold in nature. It enters lung, large intestine and kidney meridians. Has the effects of astringing lung, reducing pathogenic fire, relieving diarrhea with astringents, arresting sweating, stopping bleeding, astringing dampness and healing sore. Can be used for treating chronic cough due to lung deficiency, chronic diarrhea, spontaneous perspiration, night sweat, diabetes, hemafecia, hemorrhoidal bleeding, traumatic hemorrhage, carbuncle, sore, and skin ulcer.
Centella asiatica (L.) Urban is a perennial herb of Centella asiatica of Umbelliferae, Centella asiatica, and is used as a whole herb. Is cold in nature, bitter and pungent in flavor, has the effects of clearing heat, promoting diuresis, removing toxic substances and relieving swelling, and is clinically used for treating damp-heat jaundice, carbuncle sore pyogenic infections, traumatic injury, arsenic poisoning, sterility poisoning, summer-heat relieving, infectious hepatitis, epidemic cerebrospinal meningitis and the like.
The extract of centella asiatica is obtained by water extraction: extracting herba Centellae with water for 2 times, extracting with 10 times of water for 2 hr for the first time, and extracting with 8 times of water for 1.5 hr for the second time. The optimal conditions of the purification process are as follows: the dosage of chitosan is 0.4mL/g, and the concentration proportion of the liquid medicine is 1.2: 1, the flocculation temperature is 70 ℃.
The extract of centella asiatica may also be extracted by enzymatic extraction, preparative high performance liquid chromatography, AB-8 macroporous resin separation, and other methods known in the art.
The centella asiatica extract contains asiaticoside and madecassoside as main components. Wherein, the method for extracting the asiaticoside is heating reflux, ultrasonic extraction and flash extraction, and mainly uses 75 percent ethanol for extraction.
The centella asiatica extract in the invention can be directly obtained from commercial products, or can be extracted from centella asiatica, or can be directly added with main components in the centella asiatica extract, such as asiaticoside, madecassoside and the like.
Borneolum, named as Borneolum, pericarpium Citri Tangerinae, folium Artemisiae Argyi, Borneolum Syntheticum, Serissa, Borneolum Syntheticum, and Borneolum Syntheticum, is prepared from stems and leaves of blumea balsamifera of Compositae or branches and leaves of Cinnamomum camphora of Lauraceae by steam distillation and recrystallization. Fragrant smell, pungent and cool taste. It enters heart, spleen and lung meridians. Can be used for treating block syndrome of unconsciousness, conjunctival congestion, swelling and pain, sore throat, aphtha, sore and ulcer, swelling and pain, and unhealing ulcer.
Sanguis Draxonis is prepared from resin exuded from fruit of daemonorops draco of Palmaceae. Sweet, salty and mild in nature and taste. It enters heart and liver meridians. Promoting blood circulation, relieving pain, removing blood stasis, stopping bleeding, healing sore, and promoting granulation. Can be used for treating traumatic injury, heart and abdomen blood stasis and pain, traumatic hemorrhage, and unhealed skin and external diseases.
Scolopendra is dried product of Scolopendra subspinipes mutilans L.Koch of Scolopendra family. Pungent and warm in nature and flavor. It enters liver meridian. Has effects of calming endogenous wind, relieving spasm, dredging collaterals, relieving pain, removing toxic substance, and resolving hard mass. Can be used for treating the internal stirring of the liver wind,spasm, convulsions, infantile convulsions and apoplexy
Hemiplegia, tetanus, stubborn rheumatism, migraine, sore and ulcer, scrofula, snake and insect bite.
The invention has the beneficial effects that:
the traditional Chinese medicine composition for nursing arteriovenous internal fistula disclosed by the invention adopts gallnut, centella extract, centipede, borneol, dragon's blood, honey and mature vinegar, and the combination of the medicines can effectively improve local trauma caused by puncture; can obviously inhibit the proliferation of connective tissue around the wound; can effectively inhibit vascular endothelial hyperplasia and improve AVF blood flow.
The Chinese gall in the blood-activating and stasis-dissipating paste of the invention is mainly used for treating ulcerative gingivitis, rheumatic tinea and infantile facial eczema by external treatment, and is used for astringing, detoxifying and reducing swelling. Wu Gong, the most rapid moving force, enters viscera, externally, along meridians and collaterals, can be used to treat the stagnation of qi and blood, and has its effect on the swelling and hard mass caused by repeated puncture. Centella asiatica has the effects of clearing heat, promoting diuresis, reducing swelling and detoxifying, and dragon's blood has the functions of removing toxicity, dissipating stagnation, promoting blood circulation and arresting convulsion. The internal fistula is similar to the incised wound, but the internal fistula injures blood vessels, and the centella and the dragon's blood together play the roles of clearing heat, resolving masses, detoxifying and removing blood stasis. Borneol, the damage of needle, can help the penetration of all the drugs under the skin. The vinegar and honey can soften hard masses, detoxify, moisten dryness, relieve pain and harmonize the medicines, and the two are used as the medicine base. The medicines are used together, and have good curative effects on subcutaneous edema, connective tissue hyperplasia, vascular endothelial injury and the like caused by long-term puncture of internal fistula.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be described in detail below. It is to be understood that the described embodiments are merely exemplary of the invention, and not restrictive of the full scope of the invention. All other embodiments, which can be derived by a person skilled in the art from the examples given herein without any inventive step, are within the scope of the present invention.
Example 1
The traditional Chinese medicine composition (blood circulation promoting and stasis removing paste) for nursing arteriovenous internal fistula comprises 80g of Chinese gall, 0.1g of centella extract (asiaticoside), 0.1g of centipede, 0.1g of borneol, 1g of dragon's blood, 10g of honey and 200mL of mature vinegar.
The preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula comprises the following steps:
(1) pulverizing Galla chinensis, sieving with 120 mesh sieve, pulverizing Scolopendra, and sieving with 200 mesh sieve;
(2) adding 100mL of crushed gallnut into mature vinegar, soaking for 20 hours, stirring at regular time, boiling the rest half of mature vinegar in a marmite for 1 hour, adding the gallnut soaked in the vinegar when the color is deep and the taste is strong, heating for 30 minutes by strong fire, heating for 1 hour by slow fire, stirring by a wood stick in the same direction, picking up a sheet, dropping and transmitting light, and keeping the paste black and purple;
(3) adding heated and boiled Mel, and removing from fire (the Mel should be boiled for 2 times);
(4) cooling to 35 deg.C, adding sanguis Draxonis, Scolopendra, Borneolum Syntheticum, and herba Centellae total glycosides, and stirring.
Example 2
The traditional Chinese medicine composition (blood circulation promoting and stasis removing paste) for nursing arteriovenous internal fistula comprises 90g of Chinese gall, 0.5g of centella extract, 1g of centipede, 1g of borneol, 3g of dragon's blood, 30g of honey and 300mL of mature vinegar.
The preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula comprises the following steps:
(1) pulverizing Galla chinensis, sieving with 120 mesh sieve, pulverizing Scolopendra, and sieving with 200 mesh sieve;
(2) adding 150mL of mature vinegar into the crushed Chinese gall and the asiatic pennywort herb, soaking for 40 hours, stirring at regular time, boiling the rest half of the mature vinegar in an earthenware pot for 1 hour, adding the vinegar-soaked Chinese gall when the color is dark and the taste is strong, heating for 50 minutes with strong fire, heating for 3 hours with slow fire, stirring with a stick in the same direction, picking up the sheet, dropping off and transmitting light, and keeping the paste black and purple;
(3) adding heated and boiled Mel, and removing from fire (the Mel should be boiled for 2 times);
(4) cooling to 38 deg.C, adding sanguis Draxonis, Scolopendra, Borneolum Syntheticum, and herba Centellae extract, and stirring.
Example 3
The invention relates to a traditional Chinese medicine composition (blood circulation promoting and stasis removing paste) for nursing arteriovenous internal fistula, which comprises the following components in part by weight: 86g of Chinese gall, 33g of asiatic centella extract (asiaticoside cream ointment, the specification is 10 g: 0.25g (calculated by asiaticoside)), 0.5g of centipede, 0.3g of borneol, 1.5g of dragon's blood, 18g of honey and 250mL of mature vinegar.
The preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula comprises the following steps:
(1) sieving Galla chinensis with 120 mesh sieve, pulverizing Scolopendra, and sieving with 200 mesh sieve;
(2) adding pulverized Galla chinensis and herba Centellae into old vinegar 125ml, soaking for 24 hr, stirring at regular time, adding vinegar-soaked Galla chinensis when the color is dark and the taste is strong, heating with strong fire for 40 min, heating with slow fire for 2 hr, stirring with wood bar in the same direction, picking up the sheet, peeling, and transmitting light, when the paste is black and purple;
(3) adding heated and boiled Mel, and removing from fire (the Mel should be boiled for 2 times);
(4) cooling to 40 deg.C, adding sanguis Draxonis, Scolopendra, Borneolum Syntheticum, and herba Centellae extract, and stirring.
The application method of the blood-activating stasis-removing paste
After hot compress is carried out for 20-30 minutes by warm water at 40-50 ℃, the blood circulation promoting and stasis removing paste is coated on the arms on the internal arteriovenous fistula side, the coating thickness is 2-3 mm, the paste is kept for more than 2 hours, and the paste is clean by warm water.
Can be sealed by a preservative film, and the absorption can be promoted by gently massaging the large thenar along the blood vessel from artery to vein during the period.
Example 4 examination of the Effect of the composition of the present invention
The patients who are involved in the period from 1 month to 6 months in 2018 to perform regular hemodialysis in a dialysis room of Dongdong department hospital of Beijing university of traditional Chinese medicine are 60 patients, wherein 34 patients are male patients and 26 patients are female patients, the age of the patients is 30-80 years, the using time of arteriovenous internal fistula is more than 6 months, the primary diseases are 25 patients with diabetic nephropathy, 6 patients with glomerulonephritis, 9 patients with hypertensive renal injury and other 20 patients. The study was reviewed by the ethical committee of the hospital (2018KY-008-1), and all subjects voluntarily participated in the study and signed an informed consent.
The study included 60 subjects, 4 cases of the traditional Chinese medicine and 3 cases of the control group during the study period, and finally 53 cases of the study were completed. 26 cases of the traditional Chinese medicine and 27 cases of the control group. The difference between two groups of general data (age, sex, primary disease, dialysis age) is not statistically significant (P > 0.05).
Dividing a subject meeting the inclusion exclusion standard into two groups at random by adopting a random digital table method, applying Xiliaotai ointment to the outside of 30 cases in a control group, avoiding a puncture point when using, applying 2g of Xiliaotai ointment to the arm on the side of the internal fistula before starting dialysis on the morning of dialysis, massaging the arm from the far end to the near end of the internal fistula, applying 2g of Xiliaotai ointment to the arm on the side of the internal fistula before sleeping at night after dialysis, packaging a food preservative film for 2 hours, not massaging, applying the food preservative film to the arm twice a day on a non-dialysis day, performing hot compress for 30 minutes at 40-50 ℃ firstly, and then applying 2g of Xiliaotai ointment to the arm after massaging; in 30 experimental groups, the blood circulation promoting and stasis removing ointment of the invention in example 3 was applied externally, and the operation method was the same as that of the control group.
No adverse reactions occurred in both groups during the treatment period. Before and after treatment, hemoglobin, erythrocytes, neutrophils, platelets, reticulocytes, ALT and AST have no statistical difference in comparison between the two groups (P > 0.05).
All data were imported into the SPSS 25 software for statistics. Counting data utilization rate and percentage description, and adopting X2 for inspection; the measured data is averaged + -SD
Or a median (interquartile range) representation; scar scoring does not conform to normal distribution, two related sample nonparametric tests are adopted for comparison in groups, independent sample nonparametric tests are adopted for comparison among groups, and repeated measurement variance analysis is adopted for repeated measurement of hard junction areas. The incidence rate of the complications of the internal fistula and the incidence rate of the adverse reactions are classified variables, and chi-square test is adopted; all data were examined bilaterally with P<A difference of 0.05 is statistically significant.
4.1 hemodialysis patients scar score comparison
Compared with the experimental group and the control group, the experimental group and the control group have no statistical difference in the aspects of scar blood vessel distribution, thickness, softness and total score and have comparability. The results of comparison of scar scores in two groups of hemodialysis patients after 24 weeks of treatment are shown in table 1:
table 1 comparison of scar scores in two groups of hemodialysis patients (score,
)
note:*represents the comparison of the experimental group with the control group P before treatment<0.05，#Represents the post-treatment versus pre-treatment ratio of P in the experimental group<0.05. Significant level was 0.05 as P<0.05 is statistically significant.
The results are shown in table 1, and after 24 weeks of treatment, the control group showed a decrease in scar colour, vascularity, thickness, softness and total score compared to 0 weeks before treatment, but the differences were not statistically significant (P > 0.05).
The color and luster of scars (Z-2.714, P-0.007), the softness of scars (Z-2.070, P-0.038) and the total scar score (Z-2.809, P-0.005) of the experimental group after 24 weeks of treatment are obviously reduced compared with the total scar score of 0 week before treatment, and the difference has statistical significance; the decrease in scar vascularity (Z-577, P-0.564) and scar thickness (Z-1.732, P-0.083) is not statistically significant.
Scar scores were calculated for 24 weeks after treatment by comparing the two groups of scar score groups, and scar vascularity (P ═ 0.197), thickness (P ═ 0.790), softness (P ═ 0.354), and total score (P ═ 0.168) were statistically insignificant. Therefore, the effect of the experimental group is equivalent to that of the control group.
4.2 comparison of induration area of two groups of hemodialysis patients
The hard area of two groups of hemodialysis patients is compared, and the reduction of the hard area at 8 th, 16 th and 24 th weeks of the test is compared with that at 0 th week of the test by applying a repeated measurement analysis of variance method. See table 2 for details.
TABLE 2 Experimental groups and pairsComparison of hard area according to group (mm)2，
)
As shown in table 2, there was a statistical difference in time effect (P0.002 <0.05), indicating that the overall induration area decreased with increasing treatment time; while there was no statistical difference in effect between the two groups (P ═ 0.669>0.05), indicating that there was no statistical difference in comparison between the two groups after treatment. Therefore, the effect of the experimental group is equivalent to that of the control group.
4.3 comparison of incidence rates of complications of internal fistula of two groups of hemodialysis patients
The results of comparing the incidence rate of red skin, swollen skin, narrow internal fistula and embolism in the experimental group and the control group are shown in the table 3:
TABLE 3 comparison of the number of complications in two groups of hemodialysis patients
Note:*denotes comparison with the control group, P<0.05. Significant level was 0.05 as P<0.05 is statistically significant.
The results are shown in table 3, and there was no statistical difference (P >0.05) between the two groups in terms of incidence of red skin, swollen skin, narrow internal fistula and embolism; the experimental group was less than the control group in the number of subcutaneous blood stasis occurrences, and the difference was statistically significant (P ═ 0.027< 0.05).
The above description is only for the specific embodiments of the present invention, but the scope of the present invention is not limited thereto, and any person skilled in the art can easily conceive of the changes or substitutions within the technical scope of the present invention, and all the changes or substitutions should be covered within the scope of the present invention. Therefore, the protection scope of the present invention shall be subject to the protection scope of the appended claims.
Claims (10)
1. The traditional Chinese medicine composition for nursing arteriovenous internal fistula is characterized by being prepared from the following raw materials in parts by weight: 80-90 parts of gallnut, 0.1-1 part of centella extract, 0.1-1 part of centipede, 0.1-1 part of borneol and 1-3 parts of dragon's blood.
2. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 1, wherein the traditional Chinese medicine composition further comprises 10-30 parts of honey and 200-300 parts of mature vinegar.
3. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 1, wherein the centella asiatica extract comprises asiaticoside.
4. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 1, wherein the centella asiatica extract comprises asiaticoside and madecassoside.
5. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 3, which is prepared from the following raw materials in parts by weight: 80 parts of gallnut, 0.1 part of asiaticoside, 0.1 part of centipede, 0.1 part of borneol, 1 part of dragon's blood, 10 parts of honey and 200 parts of mature vinegar.
6. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 3, which is prepared from the following raw materials in parts by weight: 90 parts of gallnut, 1 part of asiaticoside, 1 part of centipede, 1 part of borneol, 3 parts of dragon's blood, 30 parts of honey and 300 parts of mature vinegar.
7. The traditional Chinese medicine composition for nursing arteriovenous internal fistula according to claim 3, which is prepared from the following raw materials in parts by weight: 86 parts of gallnut, 0.3 part of asiaticoside, 0.5 part of centipede, 0.3 part of borneol, 1.5 parts of dragon's blood, 18 parts of honey and 250 parts of mature vinegar.
8. The preparation method of the traditional Chinese medicine composition for nursing arteriovenous internal fistula of claim 1, which is characterized by being prepared by a method comprising the following steps of:
(1) pulverizing Galla chinensis and Scolopendra respectively;
(2) adding the crushed gallnut into 50% of mature vinegar according to the formula amount, and soaking for 20-40 hours;
(3) boiling the rest of mature vinegar, adding the rest of mature vinegar into the gallnut soaked by the mature vinegar obtained in the step (2), heating the mixture for 30-50 min by strong fire, and heating the mixture for 1-3 h by mild fire;
(4) adding boiling honey;
(5) cooling to 35-40 ℃, adding the asiatic pennywort herb extract, dragon's blood, centipede and borneol, and uniformly stirring to obtain the traditional Chinese medicine.
9. The preparation method of the traditional Chinese medicine composition for nursing arteriovenous fistula according to claim 8, wherein in the step (1), gallnut is crushed and then sieved by a 120-mesh sieve.
10. The preparation method of the traditional Chinese medicine composition for nursing arteriovenous fistula as claimed in claim 8, wherein in the step (1), centipedes are crushed and then sieved by a 200-mesh sieve.
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| CN105770186A (en) * | 2016-04-13 | 2016-07-20 | 徐州市中心医院 | Gallnut scar unguent and preparation method thereof |
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| CN105770186A (en) * | 2016-04-13 | 2016-07-20 | 徐州市中心医院 | Gallnut scar unguent and preparation method thereof |
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