CN114652797A - 用于骨折患者养血补气的中药配方及其中药液的制备方法 - Google Patents
用于骨折患者养血补气的中药配方及其中药液的制备方法 Download PDFInfo
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- CN114652797A CN114652797A CN202210443775.0A CN202210443775A CN114652797A CN 114652797 A CN114652797 A CN 114652797A CN 202210443775 A CN202210443775 A CN 202210443775A CN 114652797 A CN114652797 A CN 114652797A
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Abstract
本发明涉及一种用于骨折患者养血补气的中药配方按照重量分数包括如下组分:养血祛瘀中药组分,健脾益气中药组分,接骨生新中药组分。中药液的制备方法为称取药材,清洗,浸泡,三次煎煮,过滤,合并三次提取液,得用于骨折患者养血补气的中药配方的中药液。本发明的中药配方,更符合骨伤患者的身体恢复阶段的需求,散去瘀血,养血补气,能够从自身体质上为骨折病人提供动力,促进患者痊愈。同时,本发明制备方法采用低温浸泡,且多次提取液合并的方式,可以最大程度的保持药物中有效成分的活性。
Description
技术领域
本发明涉及中药药剂技术领域,尤其涉及一种用于骨折患者养血补气的中药配方及其中药液的制备方法。
背景技术
中医骨伤学是中医学的重要组成部分,但对于中医骨伤疾病的诊治,其病因病机、治则治法,又有别于其他中医诸科,是一门相对独立的中医专科。
“辨证论治”现代概念的倡导者任应秋先生明确提出:“了解和掌握辨证论治这一方法,就成为继承和发扬祖国医药学遗产的一个非常重要的问题。”他的用意是高度概括中医理论与临床特色,找到阐述中医诊疗有别于西医的理论根基。在当前手术占比居高的骨伤科,如何发扬中医临床特色,关键在于辨证方法。
国家级名老中医叶海叶老认为:中医骨伤科施治首在辨证,需通过“望、闻、问、切、动、量”六诊和一些特殊查体,收集到症状、体征等临床资料,再通过综合分析,辨清局部病痛的原因、部位、性质、程度,以及与患者整体气血脏腑经络盛衰的关系,概括为能涵盖全貌的某种证,根据辨证结果确定相应治则治法。
叶老认为关于骨折治疗应该根据患者的自身情况份不同的阶段以不同的药物进行治疗。叶老认为骨折治疗内调法应气血兼顾。损伤不论在脏腑、经络(脉),或在皮肉、筋骨,都离不开气血,故伤科理论主要建立在“气血并重”基础之上,不能专主血,或专主气,“以气为主”是常法,“以血为先”是变法。因此,养血补气是为骨折病人治疗之重。
发明内容
本发明设计了一种用于骨折患者养血补气的中药配方、中药液制备方法及其应用,其解决的技术问题是:(1)提供一种气血兼顾、接骨效果良好的用于骨折患者养血补气的中药配方。(2)提供一种可以高效提取药物有效成分,且操作简单的制备方法。(3)提供一种用于热敷的设备,使用便捷,疗效更好。(4)为气血兼顾的用于骨折患者养血补气的中药配方提供新的应用思路。
为了解决上述存在的技术问题,本发明采用了以下方案:
一种用于骨折患者养血补气的中药配方,其特征在于,包括如下组分:养血祛瘀中药组分,健脾益气中药组分,接骨生新中药组分。
进一步,按照重量分计,所述的养血祛瘀中药组分包括生黄芪18-25份,当归7-12份,炒白芍12-20份,赤芍12-20份,熟地黄12-18份,红花2-5份,苏木8-11份,丹参13-17份;
所述的健脾益气中药组分包括枳壳15-30份、白术15-30份、茯苓15-30份、谷芽8-15份;
所述的接骨生新中药组分包括杜仲13-16份,续断8-12份,巴戟天7-13份,骨碎补12-18份,自然铜9-11份。
一种用于骨折患者养血补气的中药配方中药液的制备方法,其特征在于:
按比例称取各种药材,将称好的药材清洗两遍除去泥沙杂质,将清洗后的药材组合物进行浸泡,用文火煎煮30分钟,过滤得第一提取液和药渣;将药渣加水煮沸后再用文火煎煮20分钟,过滤得第二提取液;将药渣加水煮沸后再用文火煎煮5分钟,过滤得第三提取液;合并第一提取液、第二提取液、第三提取液,得所述用于骨折患者养血补气的中药配方的中药液。
进一步,所述的浸泡时水温为15-20℃,时间为1-2h。
进一步,煎煮之后剩余的药渣可以用于骨折患处的热敷。
进一步,所述的热敷是将煎煮之后的药渣收集,烘干加热,之后放入热敷包中置于患处进行热敷每日1-3次。
进一步,所述热敷包的结构包括热敷包本体和设置于热敷包本体两侧的两根绑带;
所述热敷包本体为一长方形袋状结构,所述热敷包本体由下至上包括设置于下方的热传导层,设置于中间的热敷药物包层和设置于上方的保温层;
所述的热敷药物包层的一侧设置有加药口,所述加药口上设置有密封设备,用于加入热敷药物之后实现密封;
所述的保温层一侧设置有保温材料放入口,所述的加药口和保温材料放入口设置在热敷包本体的同一侧。
进一步,加药口上所述的密封设备为拉链;所述保温层内放入的保温材料为小型热水袋或可以发热的贴剂,所述热传导层内的材料为保温棉。
进一步,所述的两根绑带分别与下方的热传导层和上方保温层相连接。
本发明还保护上述的中药配方在制备治疗骨折药物中的应用。
本发明中养血散淤药物作用机理:
生黄芪补肺脾之气,使“有形之血,生于无形之气”;当归、炒白芍、熟地黄滋阴补血;赤芍、红花、丹参活血化瘀;苏木行血破瘀,消肿止痛。以上八味,共奏益气活血,祛瘀生新之效。
生黄芪:性甘,微温。归脾、肺经。有补脾升阳,益肺固表,利尿消肿,脱毒生肌的同时有益气活血的之功,有常用于气虚血瘀之痹证,且常与祛风湿、活血药物配伍。本品补气以生血,又有一定的补血之功,为气血双补之品。
当归:性甘、辛、温,归心、肝经。有补血,活血、调经,止痛润肠功效。本品为补血要药,适用于血虚诸证。因又能活血,对血虚且血滞之证有兼顾之效。本品又为活血化瘀要药,兼能止痛,长于补血,故尤宜伴有疼痛的瘀血证及瘀滞与血虚并存者。
炒白芍:性甘、酸、苦、微寒。归肝、脾、心经。有养血敛阴,柔肝止痛,平抑肝阳之功效。本品有补血之功,血虚肝失所养,筋脉拘急所致拘急疼痛者,本品既能补血以柔肝,又能缓急,常与甘草、当归等缓急养血之品同用。
熟地黄:性甘、微温。归肝、心、肾经。有补阴血,益肾精的功效。为补血要药,当归补血而兼动,本品补血而宁静,对阴血俱虚者有兼顾之效,两者补血常相须为用。本品又能补益肾精,肾精亏虚者往往关系于肾阴、肾阳不足或阴阳俱虚,治疗方面常首先顾护肾精,广泛用于肾精不足及肾阴虚、肾阳虚诸证。
赤芍:性苦、微寒。归肝、心经。有清热凉血、祛瘀止痛、清泻肝火之功。有活血通经、祛瘀止痛之效,用于跌打损伤,且长于散瘀止痛,凡血瘀所致诸证均可使用。
红花:性辛、温。归心、肝经。有活血祛瘀,通经止痛之功效。本品辛散温通,为活血通经止痛之要药,通过活血祛瘀而达消癥,通畅血脉,消肿止痛之效。瘀肿作痛时常配伍苏木、乳香、没药等活血疗伤之品。
丹参:性苦、微寒。归心、肝经。有活血祛瘀,凉血消痈,除烦安神之功效。本品功擅活血祛瘀,作用平和,能去瘀生新,活血不伤正,前有人“一味丹参,功同四物”之说,广泛用于瘀血所致的各种病症。本品凉血又活血,又清瘀热消痈肿之功。
苏木:性成、辛、平。归心、肝经。有活血疗伤,祛瘀通经之功效。本品味辛能散,成入血分,功能活血散瘀,消肿止痛而疗伤,治跌打损伤,瘀滞肿痛或骨折,既可内服、也可外用。
本发明中的健脾药物作用机理:
以上述养血散淤之方配合“枳壳、白术、茯苓、白术、谷芽”,固护脾胃,气血查化生
之源。
枳壳,味苦、辛,性凉。入肺、脾、大肠经。辛散苦降,善走肺胃气分。功擅破气、行痰、消积。临床常用于治胸膈痰滞、胁胀食积、噫气呕逆、下痢后重、脱肛脱宫等。白术,味苦、甘,性温。入脾、胃经。功擅补脾益胃、燥湿和中、止汗安胎。治疗脾胃气弱、不思饮食、倦怠少气、虚胀水肿、小便不利、表虚自汗。炒后增强燥湿作用。
枳壳辛散苦降,行于气分,善走肺胃气分,擅长行气消胀、宽胸快膈;白术甘温性缓,守而不走,善于补脾益气,补多于散。二药配伍应用,枳壳理气行滞,白术健脾益气,补泄结合,可使气机补而不滞、走而不泄。
白术,味甘、苦、微辛,性温。入脾,胃经。功擅益气生血、和中消滞、固表止汗。临床应用有生,炒之别。生用健脾而少燥气,炒用增强燥湿之力。茯苓,味甘,性平。入心、肺、脾、胃、肾经。功专益心脾、利水湿,且补而不峻、利而不猛,为健脾渗湿之要药。
白术甘温补中,健脾燥湿;茯苓甘淡渗湿,健脾安神。白术以健脾燥湿为主;茯苓以利水渗湿为要。二药配伍,一燥一渗,诸湿皆有出路。风寒湿邪闭阻经络为痹,其中湿盛者为着痹,湿盛则困脾,脾虚则湿无以化。常以白术与茯苓为药对,治疗着痹,以达健脾益气、化湿除痹之效。
谷芽,味甘,性温。归脾、胃经。功擅消食和中、健脾开胃。主治食积不消、腹胀口臭、脾胃虚弱、不饥食少。炒谷芽偏于消食,而焦谷芽善化积滞。加强健脾开胃、消食化积之功,主治饮食停滞不消、脘腹胀满、食欲不振。
本发明接骨生新药物作用机理:益气活血,祛瘀生新;固护脾胃,气血有化生之源;之后即入接骨生新之药物配方,更进一步补肝肾而生新骨,接骨疗伤,促伤向愈。
杜仲味甘,性温。入肝、肾经。本品补益肝肾、固经安胎。肝主筋,肾主骨,肝充则筋健,肾充则骨强,故乃治疗肝肾不足、腰膝酸痛之要药。
续断,味苦,性温。入肝、肾经。本品补而能宣,行而不泄,能补肝益肾、活络止痛、续筋接骨、固经止带。
杜仲补肝肾、强筋骨,善走经络关节之中;续断通利血脉、续筋接骨,在于筋节气血之间。二药相须为用,名曰杜仲丸,补肝肾、壮筋骨、通血脉力强,常用于肝肾不足之腰膝酸软、行走无力等症。
巴戟天、骨碎补补肝肾,强筋骨,肾精足则髓充,肝血充则筋坚,补骨脂、益智仁补肾壮阳,其中骨碎补续伤止痛为续筋接骨良药,活血续伤,补肾强骨,与散瘀止痛、接骨疗伤之自然铜同用,为伤科常用药对。
骨折治疗内调法应气血兼顾。损伤不论在脏腑、经络(脉),或在皮肉、筋骨,都离不开气血,故伤科理论主要建立在“气血并重”基础之上,不能专主血,或专主气,“以气为主”是常法,“以血为先”是变法。
骨折中后期是瘀凝之血化而未尽,肿痛消而未净,而正气随损伤而损耗,若继续采用祛瘀之法会进一步伤正气,当以顾护正气,此时以“和”之,则意为“养血活血”为治疗要点。气血治而未顺,瘀血祛而未净,遣方之中当以配伍养血活血之品,使治血同时化血有源,祛瘀而兼顾正气,扶正以祛邪。配伍以补气血之药物,以扶正气,气血充则余瘀得祛,另配伍祛瘀之药物以净余瘀,用量宜少,以免耗伤正气,使得邪留不祛。三期分治内治法,中期强调合营止痛,《素问·阴阳应象大论》“阴在内,阳之守也,阳在外,阴之使也”,营卫调和,血液化生有源,气血脏腑正常生理活动得以恢复。
血滞成瘀,停积而不能散去,阻于筋骨经络之间,不但失去正常血液的濡养作用,且可导致新的病变发生。瘀血致病的病理特性:其一,易于阻滞气机。气为血帅,血为气母,血瘀必兼气滞。瘀血一旦形成,局部气血不畅,气行受阻,不通则痛,出现刺痛或胀痛。其二,影响正常血液运行。瘀血阻塞于脉道内,或脉络受损,阻滞气机运行,引起正常血液流动障碍,新骨而不得生。其三,阻碍新的血液生化。“瘀血不去,新血不生”,瘀血虽然由血液演化,但失去了血液的基本生理功能,失去了濡养滋润机体的作用。饮食水谷为生化之源,由脏腑运化吸收后,变化为红色血液,行于脉中周而不休,营养全身。瘀血产生,日久阻滞不化,影响气血运行,脏腑机能失常,势必影响新血的生成,使四肢百骸、皮肉筋骨失去濡养,故见骨折延迟愈合或不愈合等表现。
临床中骨折损伤后分早、中、后三期,不同阶段有各自治疗特点。骨折损伤初期治宜止(血)宜活(血),损伤中期治宜和宜续,损伤后期宜补宜温。骨折中期:一般指伤后3-6周,此时筋骨开始接续,瘀血散而未尽,气血仍未调和。治疗一方面继续固定,一方面适当活动关节。用药以调和气血、舒筋和络为主。骨折后期,气血亏虚,瘀血留滞者而至骨折延期愈合或不愈合者。骨折后期期间适宜使用本发明的药物配方。
本发明具有以下有益效果:
(1)本发明遵从国家级名老中医叶海叶老师的中医治疗骨折的理论,在治疗上重视气血,滋养肝肾,健脾益胃,培补先后天,同时加补肾接骨之品,通过标本兼治,局部与整体兼顾。这样能达到更有效的促进骨折愈合的目标。
(2)本发明提供一种气血兼顾的用于骨折患者养血补气的中药配方,更符合骨伤患者的身体恢复阶段的需求,散去瘀血,养血补气。本发明的促进骨伤的药理在于三重:
第一重:生黄芪补肺脾之气,使“有形之血,生于无形之气”;当归、炒白芍、熟地黄滋阴补血;赤芍、红花、丹参活血化瘀;苏木行血破瘀,消肿止痛。以上八味,共奏益气活血,祛瘀生新之效。
第二重:“枳壳、白术、茯苓、白术、谷芽”,固护脾胃,气血有化生之源。
第三重:“杜仲、续断、巴戟天、骨碎补、自然铜”补肝肾而生新骨,接骨疗伤,促伤向愈。
三重药理的药物同时奏效,能够从患者自身体质上为骨折病人提供动力,促进患者痊愈。
(3)本发明提供一种药物的制备方法,该方法可以高效提取药物有效成分,使用效果更加,且操作简单,行之有效。本发明采用低温浸泡,且多次提取液合并的方式,可以最大程度的保持药物中有效成分的活性,且可以最大限度的提取其有效成分作用的患者,其效果更加显著。同时本发明中既利用的中药液本身的药效又充分引导利用药渣热敷发挥双重配合的药效,其合理利用药材又内外兼治。
(4)本发明的用于中药热敷的设备中热传导层内的材料为保温棉的设计可以实现热传导的均匀分布且具有热传导的缓冲作用。使得患者热敷时受热均匀,且不容易被烫伤,同时,还可以实现对于患处的保护,以避免被比较硬的药渣伤到。加药口的拉链设计,方便药渣的放入和取出,又能快速实现热敷药物包层的密封。保温层的设计,可以用最快速方便,和家庭容易实现的方式提供保温材料,可以是小型的热水袋,也可以是发热的贴剂等等,在安全的情况下,不限于上述可保温的材料。本发明的设备设计科学合理,操作简单方便,配合内服中药,加之以外敷,也能更好的配合药渣发挥功效,治疗效果加倍。
(5)本发明为气血兼顾的用于骨折患者养血补气的中药配方提供新的应用思路。
附图说明
图1:本发明用于中药药渣热敷的热敷包结构示意图。
具体实施方式
下面结合实施例和附图,对本发明做进一步说明:
实施例1
本发明用于骨折患者养血补气的中药配方包括如下组分,养血祛瘀中药组分,健脾益气中药组分,接骨生新中药组分。
其中,养血中药组分包括生黄芪20g,当归10g,炒白芍15g,赤芍15g,熟地黄15g,红花3g,苏木10g,丹参15g;
健脾益气中药组分包括枳壳20g、白术20g、茯苓20g、谷芽10g;
接骨生新中药组分包括杜仲15g,续断10g,巴戟天10g,骨碎补15g,自然铜10g。
上述实施例中中药配方的中药液的制备方法如下:
按比例称取各种药材,将称好的药材清洗两遍除去泥沙杂质,将清洗后的药材组合物进行浸泡,浸泡时水温为20℃,时间为2h。用文火煎煮30分钟,过滤得第一提取液和药渣;将药渣加水煮沸后再用文火煎煮20分钟,过滤得第二提取液;将药渣加水煮沸后再用文火煎煮5分钟,过滤得第三提取液;合并第一提取液、第二提取液、第三提取液,得所述用于骨折患者养血补气的中药配方的中药液。
实施例2
本发明用于骨折患者养血补气的中药配方包括如下组分,养血祛瘀中药组分,健脾益气中药组分,接骨生新中药组分。
其中,养血祛瘀中药组分包括生黄芪18g,当归7g,炒白芍12g,赤芍12g,熟地黄12g,红花2g,苏木8g,丹参13g;
健脾益气中药组分包括枳壳15g、白术15g、茯苓15g、谷芽8g;
接骨生新中药组分包括杜仲13g,续断8g,巴戟天7g,骨碎补12g,自然铜9g。
上述实施例中中药配方的中药液的制备方法如下:
按比例称取各种药材,将称好的药材清洗两遍除去泥沙杂质,将清洗后的药材组合物进行浸泡,浸泡时水温为15℃,时间为2h。用文火煎煮30分钟,过滤得第一提取液和药渣;将药渣加水煮沸后再用文火煎煮20分钟,过滤得第二提取液;将药渣加水煮沸后再用文火煎煮5分钟,过滤得第三提取液;合并第一提取液、第二提取液、第三提取液,得所述用于骨折患者养血补气的中药配方的中药液。
实施例3
本发明用于骨折患者养血补气的中药配方包括如下组分,养血祛瘀中药组分,健脾益气中药组分,接骨生新中药组分。
其中,养血祛瘀中药组分包括生黄芪25g,当归12g,炒白芍20g,赤芍20g,熟地黄18g,红花5g,苏木11g,丹参17g;
健脾益气中药组分包括枳壳30g、白术30g、茯苓30g、谷芽15g;
接骨生新中药组分包括杜仲16g,续断12g,巴戟天13g,骨碎补18g,自然铜11g。
上述实施例中中药配方的中药液的制备方法如下:
按比例称取各种药材,将称好的药材清洗两遍除去泥沙杂质,将清洗后的药材组合物进行浸泡,浸泡时水温为20℃,时间为1h。用文火煎煮30分钟,过滤得第一提取液和药渣;将药渣加水煮沸后再用文火煎煮20分钟,过滤得第二提取液;将药渣加水煮沸后再用文火煎煮5分钟,过滤得第三提取液;合并第一提取液、第二提取液、第三提取液,得所述用于骨折患者养血补气的中药配方的中药液。
上述各实施例中,煎煮之后剩余的药渣可以用于骨折患处的热敷。热敷是将煎煮之后的药渣收集,烘干加热,之后放入热敷包中置于患处进行热敷每日1-3次。
如图1所示,本发明中用于实现热敷的热敷包具有如下结构:
热敷包的结构包括热敷包本体1和设置于热敷包本体两侧的两根绑带2;两根绑带2分别与下方的热传导层11和上方保温层13相连接。
热敷包本体为一长方形袋状结构,热敷包本体由下至上包括设置于下方的热传导层11,设置于中间的热敷药物包层12和设置于上方的保温层13;热敷药物包层12的一侧设置有加药口121,加药口121上设置有拉链,用于加入热敷药物之后实现密封;保温层13一侧设置有保温材料放入口131,加药口121和保温材料放入口131设置在热敷包本体1的同一侧。保温层13内放入的保温材料为小型热水袋或可以发热的贴剂,热传导层内11的材料为保温棉。
热传导层内的材料为保温棉的设计可以实现热传导的均匀分布且具有热传导的缓冲作用。使得患者热敷时受热均匀,且不容易被烫伤,同时,还可以实现对于患处的保护,以避免被比较硬的药渣伤到。
加药口的拉链设计,方便药渣的放入和取出,又能快速实现热敷药物包层的密封。
保温层的设计,可以用最快速方便,和家庭容易实现的方式提供保温材料,可以是小型的热水袋,也可以是发热的贴剂等等,在安全的情况下,不限于上述可保温的材料。使用方便简单,又能保证热敷的时间和温度,从而保证治疗效果。
对于本方的适用患者分析:
其一、临床中骨折损伤后分早、中、后三期,不同阶段有各自治疗特点。骨折损伤初期治宜止(血)宜活(血),损伤中期治宜和宜续,损伤后期宜补宜温。骨折中期:一般指伤后3-6周,此时筋骨开始接续,瘀血散而未尽,气血仍未调和。治疗一方面继续固定,一方面适当活动关节。用药以调和气血、舒筋和络为主。此期间适宜使用本发明的药物配方。
其二,气虚血瘀为主型的患者适宜本发明的药物配方,一般表现为患肢肿明显,且多为虚肿,指压凹陷,间有肢体红紫或瘀班水疱,局部疼痛,疲乏无力,动则气喘,纳呆便秘,舌质淡胖或边有瘀斑,苔白腻,脉细弱或细涩。辨证为气虚血瘀,筋骨失养,治宜益气通经、接骨续断。
典型案例1
左腓骨远端及距骨骨折、左踝骨折
谢某,男,19岁,未婚,学生,居住环境良好。
初诊日期:2017年7月2日。发病节气:小暑前5天。
主诉:左踝关节肿胀、疼痛,活动受限一月半。
一般情况:患者一月半前外伤致左侧腓骨远端及距骨颈骨折,行切开复位内固定术,术后对位好,于小腿及踝关节支具外固定下扶拐不负重活动,近仍有患处肿痛、关节活动受限。夜寐欠安,纳可二便调。查体:左踝关节肿胀,压痛(+),主动跖屈角度约10度,主动背伸约5度。苔薄白质淡红,脉细。
辅助检查:X线(术前):左外踝及距骨骨折,下胫腓关节间隙增宽。
诊断:中医诊断(证型):左踝骨折(骨断筋离型)
西医诊断:左腓骨远端及距骨骨折
辨证分析与立法:患者外伤致腓骨远端及距骨颈骨折,该处骨折影响踝关节稳定性,易并发距骨脱位,并引发距骨缺血性坏死、创伤性踝关节炎、背伸或内翻畸形愈合等后遗症。为避免以上情况发生,骨科对患侧踝关节及时行切开复位内固定术,并予以支具外固定。术后X片复查,对位良好,但伤后骨断筋离,术中复位难免再行拉筋拨骨,又以3枚螺钉串行骨折断端,虽已术后40余日,仍有患处肿痛、关节活动受限,为骨折中期气滞血瘀、筋骨不连之象。治拟标本兼治,益气养血、接骨续筋以治本,通络利水、消肿止痛以治标。
治疗方法和用量:使用上方实施例1药物按照要求浸泡后,水煎至300ml,分早晚两次温服,2周为1疗程,治疗8疗程。期间配合使用本发明的热敷包,用药渣加热进行热敷每天3次。治疗8疗程之后无疼痛,行动便捷,基本痊愈,获得了较好的临床效果。
典型案例2
左侧肱骨中段骨折不愈合
陈某,女,71岁,已婚,退休,居住环境良好。
初诊日期:2017年3月6日,发病节气:惊蛰。
主诉:外伤致左肱骨骨折,术后5月不愈。
一般情况:2016年10月2日,患者因不慎外伤致左肱骨中段骨折,于市中医院行切开复位内固定手术治疗,术后给予石膏托外固定制动一周,去石膏后进行适当功能锻炼。2017年2月15日,患者上臂仍疼痛明显,伴肿胀、压痛,活动受限,行X线复查示:骨折端骨折线明显,内固定在位,对位对线欠佳,骨痂少许。刻诊,患者左上肢仍有疼痛,肿胀,活动受限,活动时疼痛呈钝性,自觉骨折处“咯咯”作响。发病以来无畏寒发热,夜寐及胃纳尚可,小便次数多,大便溏薄。
查体:左上臂压痛明显,活动受限,左上肢肿胀,未触及异常活动,可触及轻微骨擦感,肢体远端血运及活动可。舌质淡红苔薄白,脉弦辅助检查:X线(2017年2月15日)示:骨折端骨折线明显,内固定在位,对位对线欠佳,骨痂少许。
诊断:中医诊断(证型):骨不愈(肝肾亏虚证)
西医诊断:左侧肱骨中段骨折不愈合
辨证分析与立法:患者5月前不慎外伤,暴力直击左上臂,致骨断筋离、气血损伤。气机紊乱,瘀血內停,筋肉损伤,恐其不能固复骨骼,故行切开复位内固定手术。术后,患者因年老体弱,肝肾亏虚、气血不足,不能濡养筋骨,久久不见愈合。筋未愈骨不连,气血通畅受阻,仍见肿胀疼痛、活动受限。舌质淡红苔薄白,脉弦,为标实本虚,肝肾气血亏虚为本,气滞血瘀为标。治则应为补虚为主,标本兼治。采用补肝益肾、活血祛瘀、续筋接骨。
治疗方法和用量:使用上方实施例1药物按照要求浸泡后,水煎至300ml,分早晚两次温服,2周为1疗程,治疗8疗程。期间配合使用本发明的热敷包,用药渣加热进行热敷每天3次。治疗8疗程之后无疼痛,上臂活动便捷,基本痊愈,获得了较好的临床效果。
临床实验:
2016年1月-2017年12月,经医院门诊临床观察60例病例。具体情况如下:
(1)临床基本资料
门诊患者符合中医辨证为气滞血瘀、筋骨失养类型骨折。治拟标本兼治,益气养血、接骨续筋以治本,通络利水、消肿止痛以治标。
临床症状患处肿痛、气血通畅受阻、活动受限、舌质淡红、苔薄白,脉弦等。
共观察病例60例,其中,治疗组(30例):男性25岁-55岁者10例,≥55岁者8例;女性25岁-55岁者7例,≥55岁者5例。
对照组(30例):男性25岁-55岁者11例,≥55岁者7例;女性25岁-55岁者8例,≥55岁者4例。
(2)治疗及观察方法
病例采用开放、随机、对照的方法进行分组和观察。
治疗组服用本发明实施例1中药液,1日1剂,水煎至300毫升,分早晚饭后温服,每次150毫升。2周为1疗程。期间配合使用本发明的热敷包,用药渣加热进行热敷每天3次。
对照组服用成药跌打生骨颗粒一次1袋,分早晚饭后温开水兑服。14天为一个疗程,1个疗程后进行疗效性和安全性评价。
(3)综合疗效评定
关于总疗效评定:
显效:用药14天以内症状、体征明显改善。
有效:用药14天以内症状、体征均有好转。
无效:用药14天以内症状及体征均无明显改善,甚或加重。
关于安全性评价:
1级:安全,无任何不良反应。
2级:比较安全,如有不良反应,不需做任何处理可继续给药。
3级:有安全性问题,有中等程度的不良反应,做处理后可继续给药。
4级:因不良反应中止治疗。
(4)治疗结果
两组患者治疗效果比较:治疗14天后,治疗组显效人数为23人,有效人数为6人,总的有效率达到96.7%。对照组显效人数为16人,有效人数为8人,总的有效率达到80%。
总有效率为显效人数与有效人数之和占总人数的百分比。
(5)安全性评价结果
临床观察中,未发现不良反应,也没有因不良反应而终止治疗的情况发生,安全等级均在1级,安全性好。
本发明实施例提供的用于骨折患者养血补气的中药对于上述骨折患者具有良好的治疗效果,且优于跌打生骨颗粒对照组。
综上所述,本发明用于治疗骨折患者养血补气的中药配方治疗效果显著,配合以外敷治疗的方法更是提高治疗效率,快速缓解患者的症状。
本发明的促进骨伤的药理在于三重:
第一重:生黄芪补肺脾之气,使“有形之血,生于无形之气”;当归、炒白芍、熟地黄滋阴补血;赤芍、红花、丹参活血化瘀;苏木行血破瘀,消肿止痛。以上八味,共奏益气活血,祛瘀生新之效。
第二重:“枳壳、白术、茯苓、白术、谷芽”,固护脾胃,气血有化生之源。
第三重:“杜仲、续断、巴戟天、骨碎补、自然铜”补肝肾而生新骨,接骨疗伤,促伤向愈。
三重药理的药物同时奏效,能够从患者自身体质上为骨折病人提供动力,促进患者痊愈。结合上述具体病例可见之。
上面结合附图和实施例对本发明进行了示例性的描述,显然本发明的实现并不受上述方式的限制,只要采用了本发明的方法构思和技术方案进行的各种改进,或未经改进将本发明的构思和技术方案直接应用于其它场合的,均在本发明的保护范围内。
Claims (10)
1.一种用于骨折患者养血补气的中药配方,其特征在于,包括如下组分:
养血祛瘀中药组分,
健脾益气中药组分,
接骨生新中药组分。
2.根据权利要求1所述的用于骨折患者养血补气的中药配方,其特征在于:按照重量分计,所述的养血祛瘀中药组分包括生黄芪18-25份,当归7-12份,炒白芍12-20份,赤芍12-20份,熟地黄12-18份,红花2-5份,苏木8-11份,丹参13-17份;
所述的健脾益气中药组分包括枳壳15-30份、白术15-30份、茯苓15-30份、谷芽8-15份;
所述的接骨生新中药组分包括杜仲13-16份,续断8-12份,巴戟天7-13份,骨碎补12-18份,自然铜9-11份。
3.一种权利要求1-2所述的用于骨折患者养血补气的中药配方中药液的制备方法,其特征在于:
按比例称取各种药材,将称好的药材清洗两遍除去泥沙杂质,将清洗后的药材组合物进行浸泡,用文火煎煮30分钟,过滤得第一提取液和药渣;将药渣加水煮沸后再用文火煎煮20分钟,过滤得第二提取液;将药渣加水煮沸后再用文火煎煮5分钟,过滤得第三提取液;合并第一提取液、第二提取液、第三提取液,得所述用于骨折患者养血补气的中药配方的中药液。
4.根据权利要求3所述的制备方法,其特征在于:所述的浸泡时水温为15-20℃,时间为1-2h。
5.根据权利要求3所述的制备方法,其特征在于:煎煮之后剩余的药渣可以用于骨折患处的热敷。
6.根据权利要求5所述的制备方法,其特征在于:所述的热敷是将煎煮之后的药渣收集,烘干加热,之后放入热敷包中置于患处进行热敷每日1-3次。
7.根据权利要求6所述的制备方法,其特征在于:
所述热敷包的结构包括热敷包本体和设置于热敷包本体两侧的两根绑带;
所述热敷包本体为一长方形袋状结构,所述热敷包本体由下至上包括设置于下方的热传导层,设置于中间的热敷药物包层和设置于上方的保温层;
所述的热敷药物包层的一侧设置有加药口,所述加药口上设置有密封设备,用于加入热敷药物之后实现密封;
所述的保温层一侧设置有保温材料放入口,所述的加药口和保温材料放入口设置在热敷包本体的同一侧。
8.根据权利要求7所述的制备方法,其特征在于:加药口上所述的密封设备为拉链;所述保温层内放入的保温材料为小型热水袋或可以发热的贴剂,所述热传导层内的材料为保温棉。
9.根据权利要求7所述的制备方法,其特征在于:所述的两根绑带分别与下方的热传导层和上方保温层相连接。
10.一种权利要求1-2所述的中药配方在制备治疗骨折药物中的应用。
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