CN113144012A - 一种用于治疗骨关节炎的药物组合物及其制备方法和用途 - Google Patents

一种用于治疗骨关节炎的药物组合物及其制备方法和用途 Download PDF

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CN113144012A
CN113144012A CN202010015126.1A CN202010015126A CN113144012A CN 113144012 A CN113144012 A CN 113144012A CN 202010015126 A CN202010015126 A CN 202010015126A CN 113144012 A CN113144012 A CN 113144012A
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党万太
徐丹
周京国
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Chengdu Medical College
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Abstract

本发明提供了一种药物组合物,它是由下述重量配比的原料制备而成:骨碎补5‑50份、补骨脂5‑50份、淫羊藿5‑50份、杜仲10‑40份、狗脊10‑30份、桑寄生10‑45份、秦艽10‑30份、川牛膝10‑25份、独活10‑35份、红花5‑25份、甘草5‑30份、土鳖虫1‑10份、伸筋草10‑100份、威灵仙10‑30份、鸡血藤10‑50、海风藤5‑35份、乳香5‑25份、没药5‑25份、菟丝子10‑30份、白芍10‑35份、川木香5‑35份。本发明提供了所述药物的制备方法和用途。本发明组合物治疗骨关节炎疗效显著,临床应用前景优良。

Description

一种用于治疗骨关节炎的药物组合物及其制备方法和用途
技术领域
本发明涉及医药领域,具体涉及一种用于治疗骨关节炎的药物组合物及其制备方法和用途。
背景技术
骨关节炎(Osteoarthritis,OA)是多种因素引起关节软骨纤维化、皲裂、溃疡、脱失而导致的关节疾病,病因尚不明确,可能与年龄、肥胖、性别、种族、营养、骨密度、骨骼形态、运动、免疫、遗传及关节软骨代谢情况等多种因素有关。其特征性病理改变为关节软骨的变性破坏。由于疾病的痛苦及其所导致的残疾,严重降低了患者的生存质量。据报道,到2020年,全世界范围内OA将成为第四大致残性疾病。
OA的发病关节多在膝、髋、手、肩等部位,最常患病的是膝关节,即膝骨关节炎(Knee osteo-arthritis,KOA)。目前我国症状性KOA的患病率为8.1%,50岁以下人群发病率为5.2%,60岁以上已达11%,女性的患病率明显高于男性,本病的致残率可高达53%。OA患者的全球伤残调整生命年在非传染疾病中位居前十。
中医学认为,OA属“痹证”“骨痹”范畴,其中KOA被称为“膝痹”。骨痹的病因多考虑为外感风邪,遇寒或受热,加之湿邪偏盛,诸邪裹结,合而为痹。而素体骨髓亏虚,肌腠不能抵御邪气,外邪乘隙入侵,是导致骨痹发生的内在因素。《素问·长刺节论篇》曰:“病在骨,骨重不可举,骨髓酸痛,寒气至,名曰骨痹。”根据患者平素体质的偏性,邪气滞留于四肢,导致经脉不通,出现疼痛、肿胀等临床表现。病程初期以邪实为主,正气未虚,正邪交争,疼痛肿胀较甚;病情日久,缠绵不愈,劳伤气血津液,损及内脏,病情以虚为主,虚实夹杂。中医治疗骨痹讲究辨证论治,旨在通过中草药的配伍,以达到通络止痛、补虚泻实之功效。
治疗OA的常用方药包括:①以补肾活血为主的药物,如补骨脂、桑寄生、黄芪、制川乌、制草乌、红花、桃仁、川牛膝等;②以温补肾阳为原则的方剂,如独活寄生汤、右归饮等。
中医外治法是将药物外用于患处或穴位,通过局部用药及经络连结,起到局部以及全身的治疗作用。外治法治疗OA的历史悠久,应用广泛。外用剂多由温经散寒、祛湿消肿、活血化瘀、通络止痛的药物组成。
目前市面上有外用药神农镇痛膏,可以活血散瘀,消肿止痛。用于跌打损伤,风湿关节痛,腰背酸痛。其为三七、胆南星、白芷、狗脊、羌活、石菖蒲、防风、升麻、红花、土鳖虫、川芎、当归、血竭、马钱子、没药、樟脑、重楼、薄荷脑、乳香、水杨酸甲酯、冰片、丁香罗勒油、人工麝香、颠茄流浸膏、熊胆粉再加上辅料制成的外用膏药。
开发更多、更有效的中药组合物,制备成外用制剂,用于治疗骨关节炎,是亟待解决的问题,在临床上具有优良的应用前景。
发明内容
本发明的目的在于提供了一种治疗骨关节炎的药物组合物,也提供了所述组合物的制备方法和用途。
本发明提供一种治疗骨关节炎的药物组合物,它是由下述重量配比的原料制备而成:
骨碎补5-50份、补骨脂5-50份、淫羊藿5-50份、杜仲10-40份、狗脊10-30份、桑寄生10-45份、秦艽10-30份、川牛膝10-25份、独活10-35份、红花5-25份、甘草5-30份、土鳖虫1-10份、伸筋草10-100份、威灵仙10-30份、鸡血藤10-50份、海风藤5-35份、乳香5-25份、没药5-25份、菟丝子10-30份、白芍10-35份、川木香5-35份。
优选地,它是由下述重量配比的原料制备而成:
骨碎补40份、补骨脂40份、淫羊藿25份、杜仲25份、狗脊15份、桑寄生20份、秦艽20份、川牛膝18份、独活18份、红花12份、甘草18份、土鳖虫8份、伸筋草50份、威灵仙20份、鸡血藤38份、海风藤18份、乳香15份、没药15份、菟丝子20份、白芍15份、川木香24份。
进一步地,所述的组合物是由所述原料的原生粉末,加入可接受的辅料或者辅助性成分制备成常用的制剂。
进一步地,所述辅料为凡士林。
进一步地,所述制剂是外用制剂。
进一步地,所述外用制剂是贴膏剂、酊剂、膏药、凝胶剂、软膏剂、露剂、搽剂、洗剂、涂膜剂、气雾剂、喷雾剂
本发明提供一种制备所述的组合物的方法,它包括如下步骤:
a)称取各重量配比的原料;
b)烘干、粉碎、过筛,拌匀;
c)取药,加入水煎煮即得。
优选地,
步骤b中,筛的型号为80目;
步骤c中,加入水的同时加入凡士林,水:凡士林:药物=1.5:0.5:8,煎煮时间为2-5分钟。
本发明还提供所述组合物在制备治疗骨关节炎的药物中的用途。
本发明提供了所述组合物在制备具有活血通络,消肿散结、行气止痛、强筋壮骨的药物中的用途。
骨关节炎可表现为:痹证日久,关节酸楚肿痛,痛处固定,双膝关节疼痛,行路困难,筋肉萎缩,肢体麻木,腰膝疼痛,遇劳加重且反复发作。
本发明人在研究中认为骨关节炎的病因为:肝肾亏虚日久,气血虚少,肢节血少气血运行不畅,故见腰膝疼痛,久则肢节屈伸不利,或麻木不仁、手足拘挛,气血凝滞,肢节肿胀疼痛。
因此,用药根据为:活血通络,消肿散结、行气止痛、强筋壮骨。
本发明药物组合物中重用骨碎补、补骨脂、淫羊藿、红花、菟丝子、川木香、杜仲为君,以辛、甘、苦、温补肾强骨、活化行气止痛。臣以独活、土鳖虫、威灵仙、海风藤祛风止痛、通络。佐以乳香、没药、狗脊、桑寄生、秦艽、川牛膝活血化瘀止痛,同时兼以强壮腰脊。方中以甘草、伸筋草、鸡血藤、白芍为使药,协助调和药性,同时化瘀袪风止痛缓解肢节麻木挛紧。
使用本发明药物组合物治疗后,可以降低患者ESR、CRP水平,降低患者骨关节炎指数,患者Lysholm评分显著升高,VAS疼痛评分也显著降低。同时,与对照组相比,治疗有效率更高。
本发明药物组合物对骨关节炎患者具有较好的治疗作用,对骨关节炎患者的疼痛症状具有较好的缓解作用。该药物组合物没有传统激素和非甾体抗炎药治疗骨关节炎的毒副作用。该药物通过外敷治疗,与同类药物相比有效率更高,临床应用前景优良。
除非有特别的说明,用于本发明中药组合物的药材均如中国药典所述。
显然,根据本发明的上述内容,按照本领域的普通技术知识和惯用手段,在不脱离本发明上述基本技术思想前提下,还可以做出其它多种形式的修改、替换或变更。
附图说明
图1骨关节炎药物组合物治疗前后骨关节炎相关分析表;A:ESR;B:CRP;C:WOMAC指数;D:Lysholm评分;E:VAS疼痛评分分析;
注:ESR(红细胞沉降率);CRP(C反应蛋白);WOMAC(西安大略和麦克马斯特大学骨关节炎指数);Lysholm评分(膝关节评分量表);VAS(视觉模拟评分法)。
具体实施方式
以下通过实施例形式的具体实施方式,对本发明的上述内容再作进一步的详细说明。但不应将此理解为本发明上述主题的范围仅限于以下的实例。凡基于本发明上述内容所实现的技术均属于本发明的范围。
实施例1本发明组合物的制备
1.原料:骨碎补40g、补骨脂40g、淫羊藿25g、杜仲25g、狗脊15g、桑寄生20g、秦艽20g、川牛膝18g、独活18g、红花12g、甘草18g、土鳖虫8g、伸筋草50g、威灵仙20g、鸡血藤38g、海风藤18g、乳香15g、没药15g、菟丝子20g、白芍15g、川木香24g。
2.制备方法:
a)称取各重量配比的原料;
b)烘干、粉碎、过80目筛,拌匀;
c)取药,加入水、凡士林,水:凡士林:药物=1.5:0.5:8,煎煮4分钟,使药液浓稠,状如膏状,置冷待用,即得。
实施例2本发明组合物的制备
1.原料:骨碎补5g、补骨脂5g、淫羊藿5g、杜仲10g、狗脊10g、桑寄生10g、秦艽10g、川牛膝10g、独活10g、红花5g、甘草5g、土鳖虫1g、伸筋草10g、威灵仙10g、鸡血藤10g、海风藤5g、乳香5g、没药5g、菟丝子10g、白芍10g、川木香5g。
2.制备方法:
a)称取各重量配比的原料;
b)烘干、粉碎、过80目筛,拌匀;
c)取药,加入水、凡士林,水:凡士林:药物=1.5:0.5:8,煎煮2分钟,使药液浓稠,状如膏状,置冷待用,即得。
实施例3本发明组合物的制备
1.原料:骨碎补20g、补骨脂20g、淫羊藿20g、杜仲20g、狗脊15g、桑寄生20g、秦艽15g、川牛膝15g、独活15g、红花10g、甘草15g、土鳖虫5g、伸筋草40g、威灵仙15g、鸡血藤20g、海风藤15g、乳香10g、没药10g、菟丝子15g、白芍15g、川木香15g。
2.制备方法:
a)称取各重量配比的原料;
b)烘干、粉碎、过80目筛,拌匀;
c)取药,加入水、凡士林,水:凡士林:药物=1.5:0.5:8,煎煮3分钟,使药液浓稠,状如膏状,置冷待用,即得。
实施例4本发明组合物的制备
1.原料:骨碎补40g、补骨脂40g、淫羊藿40g、杜仲30g、狗脊25g、桑寄生30g、秦艽20g、川牛膝20g、独活20g、红花15g、甘草20g、土鳖虫8g、伸筋草80g、威灵仙20g、鸡血藤40g、海风藤20g、乳香20g、没药20g、菟丝子20g、白芍25g、川木香25g。
2.制备方法:
a)称取各重量配比的原料;
b)烘干、粉碎、过80目筛,拌匀;
c)取药,加入水、凡士林,水:凡士林:药物=1.5:0.5:8,煎煮3分钟,使药液浓稠,状如稀膏状,置冷待用,即得。
实施例5本发明组合物的制备
1.原料:骨碎补50g、补骨脂50g、淫羊藿50g、杜仲40g、狗脊30g、桑寄生45g、秦艽30g、川牛膝25g、独活35g、红花25g、甘草30g、土鳖虫10g、伸筋草100g、威灵仙30g、鸡血藤50g、海风藤35g、乳香25g、没药25g、菟丝子30g、白芍35g、川木香35g。
2.制备方法:
a)称取各重量配比的原料;
b)烘干、粉碎、过80目筛,拌匀;
c)取药,加入水、凡士林,水:凡士林:药物=1.5:0.5:8,煎煮3分钟,使药液浓稠,状如膏状,置冷待用,即得。
试验例1本发明组合物疗效
1临床资料
1.1一般资料选取2019年1月至2019年10月在成都医学院第一附属医院风湿免疫科就诊的骨关节炎患者140例,按照随机数字表法分为治疗组和对照组,每组70例。治疗组男34例,女36例;年龄38~81岁,平均(49.77士5.21)岁;病程0.5~9年,平均(3.39士0.24)年。对照组男29例,女41例;年龄39~79岁,平均(50.38+5.82)岁;病程0.5~17年,平均(6.21士2.09)年。2组患者在性别、年龄、病程等方面比较,差异无统计学意义(P>0.05),具有可比性。
1.2诊断标准按照美国风湿病协会1995年修订的骨关节炎诊断(分类)标准。
1.3纳入标准(1)符合上述诊断标准;(2)年龄38~85岁,性别不限;(3)未使用激素或非甾体抗炎药;(4)同意接受抽血等相关检查及治疗者;(5)同意签署知情同意书并能完成随访者。
1.4排除标准(1)妊娠或哺乳期妇女;(2)合并其他免疫系统疾病者;(3)合并肝、肾、心血管、造血系统等严重疾病者;(4)关节皮肤溃疡或严重关节外表现者,如高热、中枢神经系统病变等;(5)对本研究中药物成分过敏者。
2方法
2.1治疗方法对照组给予神农镇痛膏(广东湛江吉民药业股份有限公司)外贴治疗(早晚各一贴,一贴4-6h)。观察组给予本发明实施例1所制备的药物组合物,涂于沙布,外敷于疼痛部位,(早晚各一贴,一贴4-6h)。
2.2观察指标(1)比较两组患者治疗有效率;(2)比较观察组治疗前与治疗72h、1周、2周后红细胞沉降率(ESR)、C反应蛋白(CRP)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、膝关节评分量表(Lysholm评分)。
3结果
经本发明药物组合物治疗2周后ESR与治疗前相比显著降低(P<0.05)(A);
经本发明药物组合物治疗1、2周后CRP与治疗前相比均显著降低(P<0.05)(B);
经本发明药物组合物治疗2周后WOMAC指数与治疗前相比显著降低(P<0.05)(C);
经本发明药物组合物治疗2周后Lysholm评分与治疗前相比显著升高(P<0.05)(D);
经本发明药物组合物治疗1、2周后VAS评分与治疗前相比均显著降低(P<0.05)(E),结果见图1。
经本发明药物组合物治疗后观察组(观察组患者脱失7例,最终入组患者为63例)有效率显著高于对照组(对照组患者脱失21例,最终入组患者为49例),(P<0.05)(表1)。
表1 本发明药物组合物的临床治疗有效率
Figure BDA0002358583380000061
4结论
使用本发明药物组合物治疗后,可以降低患者ESR、CRP水平,降低患者骨关节炎指数,患者Lysholm评分显著升高,VAS疼痛评分也显著降低。同时,与对照组相比,治疗有效率更高。
综上所述,本发明药物组合物对骨关节炎患者具有较好的治疗作用,对骨关节炎患者的疼痛症状具有较好的缓解作用。该药物组合物没有传统激素和非甾体抗炎药治疗骨关节炎的毒副作用。该药物通过外敷治疗,与同类药物相比有效率更高,临床应用前景优良。

Claims (10)

1.一种治疗骨关节炎的药物组合物,其特征在于:它是由下述重量配比的原料制备而成:
骨碎补5-50份、补骨脂5-50份、淫羊藿5-50份、杜仲10-40份、狗脊10-30份、桑寄生10-45份、秦艽10-30份、川牛膝10-25份、独活10-35份、红花5-25份、甘草5-30份、土鳖虫1-10份、伸筋草10-100份、威灵仙10-30份、鸡血藤10-50份、海风藤5-35份、乳香5-25份、没药5-25份、菟丝子10-30份、白芍10-35份、川木香5-35份。
2.根据权利要求1所述的组合物,其特征在于:它是由下述重量配比的原料制备而成:
骨碎补40份、补骨脂40份、淫羊藿25份、杜仲25份、狗脊15份、桑寄生20份、秦艽20份、川牛膝18份、独活18份、红花12份、甘草18份、土鳖虫8份、伸筋草50份、威灵仙20份、鸡血藤38份、海风藤18份、乳香15份、没药15份、菟丝子20份、白芍15份、川木香24份。
3.根据权利要求1或2所述的组合物,其特征在于:它是由所述原料的原生粉末,加入可接受的辅料或者辅助性成分制备成常用的制剂。
4.根据权利药物3所述的药物组合物,其特征在于:所述辅料为凡士林。
5.根据权利要求3所述的组合物,其特征在于:所述制剂为外用制剂。
6.根据权利要求5所述的外用制剂,其特征在于:所述外用制剂是贴膏剂、酊剂、膏药、凝胶剂、软膏剂、露剂、搽剂、洗剂、涂膜剂、气雾剂、喷雾剂。
7.一种制备权利要求1-6任意一项所述的组合物的方法,其特征在于:它包括如下步骤:
a)称取各重量配比的原料;
b)烘干、粉碎、过筛,拌匀;
c)取药,加入水煎煮即得。
8.根据权利要求7所述制备方法,其特征在于:
步骤b中,筛的型号为80目;
步骤c中,加入水的同时加入凡士林,水:凡士林:药物=1.5:0.5:8,煎煮时间为2-5分钟。
9.权利要求1-6任意一项所述组合物在制备治疗骨关节炎的药物中的用途。
10.权利要求1-6任意一项所述组合物在制备具有活血通络,消肿散结、行气止痛、强筋壮骨的药物中的用途。
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CN103393840A (zh) * 2013-07-24 2013-11-20 赵世明 一种治疗骨性关节炎的中药组合物
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