CN114984127B - 一种治疗伤筋骨病的壮骨伸筋丸 - Google Patents

一种治疗伤筋骨病的壮骨伸筋丸 Download PDF

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CN114984127B
CN114984127B CN202210791429.1A CN202210791429A CN114984127B CN 114984127 B CN114984127 B CN 114984127B CN 202210791429 A CN202210791429 A CN 202210791429A CN 114984127 B CN114984127 B CN 114984127B
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CN114984127A (zh
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王卫国
刘谟桐
陈儒
傅阳
刘美辰
黄旭东
赵明华
李琦
徐小东
傅永升
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Affiliated Hospital of Shandong University of Traditional Chinese Medicine
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Abstract

本发明公开了一种治疗伤筋骨病的壮骨伸筋丸，涉及中医药物技术领域，由以下原料组成：当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没各、水蛭、苧麻根炭、牛蹄筋和甘草。本发明通过设置当归11～12％、牛蹄筋11～12％以及甘草3～4％制成的药丸能够舒筋活血，通络止痛，骨正筋柔。用于骨折、脱臼整复后或伤筋、骨痹、腰痛症等筋骨断而未续、骨质疏松症、骨无菌性坏死，且对于脱臼复位后患者活动功能障碍的改善及疼痛情况，能起到较好的临床疗效，对复位的再次脱臼有很好的的改善作用，从而解决了现今脱臼治疗进行复位后固定期间极易导致肩、肘关节黏连、僵硬，严重影响患者生活水平的问题。

Description

一种治疗伤筋骨病的壮骨伸筋丸
技术领域
本发明涉及一种中药经验药物，特别涉及一种治疗伤筋骨病的壮骨伸筋丸。
背景技术
脱位是指构成关节的关节面之间失去正常的对应关系，古人很早就对脱位有所认识，汉墓马王堆出土的医籍《阴阳十一脉灸经》记载了“肩以脱”，讲述了肩关节脱位，葛洪《肘后救卒方》记载了“失欠颌车”，即颞颌关节脱位，其中创制的口腔内复位法是世界首创，至今仍被采用，蔺道人所著《仙授理伤续断秘方》首次描述了髋关节脱位，利用手牵足蹬法进行复位，并介绍了“肩胛骨出”(肩关节脱位)的椅弱松弛，但也正是这种解剖结构导致肩关节的稳定性较差，易于脱位，肩关节脱位通常手法复位即可达到复位效果，复位后常将患肢内收、内旋、屈肘90°悬吊于胸前，肩关节是人体各关节中最灵活、活动范围最大的关节，其中盂肱关节主要由肩胛盂及肱骨头构成，肩胛盂小且浅，只占肱骨头关节面的1/3-1/4，而且周围关节囊松弛而薄弱，前方尤为明显，这种结构一方面为增大肩关节的活动度提供了有利条件，另一方面也导致了肩关节的不稳定性，肩关节脱位分为前脱位和后脱位，临床上比较多见的是肩关节前脱位，占肩关节脱位的97％以上，临床上肩关节脱位治疗原则是尽早复位，一方面可以及时减轻患者的痛苦，另一方面还能减少肩关节局部软组织肿胀、出血及肌肉痉挛，有益于尽快恢复肩关节的稳定性且尽快恢复肩关节功能，目前治疗肩关节前脱位的最常用的方法是手牵足蹬复位法，其次还有椅背复位法、外展外旋法等等，对于患者而言手法整后的功能恢复情况尤为重要，由于肩关节脱位往往伴随着或轻或重的肩关节周围肌腱、韧带、关节囊等软组织损伤，如若复位后未及时进行固定，或者在固定期间依旧进行剧烈运动极易造成二次脱位，其次复位后固定期间极易导致肩、肘关节黏连、僵硬，严重影响患者生活水平，因此提出了一种治疗伤筋骨病的壮骨伸筋丸来解决上述问题。
发明内容
本发明的目的在于提供一种治疗伤筋骨病的壮骨伸筋丸，以解决上述背景技术中提出的现今脱臼治疗进行复位后固定期间极易导致肩、肘关节黏连、僵硬，严重影响患者生活水平的问题。
为实现上述目的，本发明提供如下技术方案：一种治疗伤筋骨病的壮骨伸筋丸，由以下原料组成：当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋和甘草；
具体原料配比如下：
当归11～12％、赤芍5～6％、桃仁3～4％、红花3～4％、木香6～7％、地枫11～12％、香附6～7％、川断3～4％、丹参3～4％、血竭1～2％、肉桂2～3％、陈皮3～4％、地龙3～4％、土元3～4％、牛膝5～6％、制乳没各1～2％、水蛭3～4％、苧麻根炭3～4％、牛蹄筋11～12％、甘草3～4％。
作为本发明的一种优选技术方案，所述当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草均研磨为粉，同时在研磨过程中进行混合，之后炼蜜为丸，且每丸9克，日服3次，7日为一个疗程，共治疗2个疗程。
作为本发明的一种优选技术方案，所述制乳没各为1～2％为乳香和没药各1～2％，所述当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草均为优质中药材。
作为本发明的一种优选技术方案，所述当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草的一种原料配比为当归100g、赤芍50g、桃仁30g、红花30g、木香60g、地枫100g、香附60g、川断30g、丹参30g、血竭10g、肉桂20g、陈皮30g、地龙30g、土元30g、牛膝50g、制乳没各15g、水蛭30g、苧麻根炭30g、牛蹄筋100g以及甘草30g。
与现有技术相比，本发明的有益效果是：
本发明通过设置当归11～12％、赤芍5～6％、桃仁3～4％、红花3～4％、木香6～7％、地枫11～12％、香附6～7％、川断3～4％、丹参3～4％、血竭1～2％、肉桂2～3％、陈皮3～4％、地龙3～4％、土元3～4％、牛膝5～6％、制乳没各1～2％、水蛭3～4％、苧麻根炭3～4％、牛蹄筋11～12％以及甘草3～4％制成的药丸能够舒筋活血，通络止痛，祛瘀生新，骨正筋柔。用于骨折、脱臼整复后或伤筋、骨痹、腰痛症等筋骨断而未续、骨质疏松症、骨无菌性坏死，且对于脱臼复位后患者活动功能障碍的改善及疼痛情况，能起到较好的临床疗效，对复位的再次脱臼有很好的的改善作用，从而解决了现今脱臼治疗进行复位后固定期间极易导致肩、肘关节黏连、僵硬，严重影响患者生活水平的问题。
附图说明
图1为本发明的2组患者治疗前后肩关节活动度比较图表结构示意图；
图2为本发明的2组患者治疗前后肩关节功能评分比较图表结构示意图。
具体实施方式
下面将结合本发明实施例中的附图，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。基于本发明中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本发明保护的范围。
请参阅图1-2，本发明提供了一种治疗伤筋骨病的壮骨伸筋丸的技术方案：
由以下原料组成：当归具有补血和血，调经止痛，润燥滑肠、抗癌、抗老防老、免疫之功效；桃仁、红花、赤芍、丹参、苎麻根活血化瘀，使血归经，其中丹参、桃仁、苎麻根既可活血又可凉血；木香、香附、陈皮行气止痛，调中导滞，配伍活血药，气行则血行，推动气血运行；其中陈皮固化脾胃，调畅中焦；血竭、乳香、没药活血散瘀，消肿止痛；地枫、牛膝、川断补肝肾，强筋骨，祛风湿止痛；通则不痛，肿痛早消，通则瘀祛，祛瘀生新，故用地龙、水蛭、土元破血逐瘀消肿，配伍乳香、没药可治骨折疼痛；肉桂，坚骨节，通血脉，理疏不足，宣导百药，与当归相配伍，温通行瘀；牛蹄筋为血肉有形之品，配伍补血之药，精血相互滋生、相互转化，配伍活血化瘀之药瘀去新生；甘草调和诸药。各药配伍，活血化瘀，行气止痛，可收相得益彰之效。本方以上述药物炼蜜为丸，不但有利于人体所吸收，同时易于服用，耐于保存，且携带方便。
具体原料配比如下：
当归11～12％、赤芍5～6％、桃仁3～4％、红花3～4％、木香6～7％、地枫11～12％、香附6～7％、川断3～4％、丹参3～4％、血竭1～2％、肉桂2～3％、陈皮3～4％、地龙3～4％、土元3～4％、牛膝5～6％、制乳没各1～2％、水蛭3～4％、苧麻根炭3～4％、牛蹄筋11～12％、甘草3～4％。
当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草均研磨为粉，同时在研磨过程中进行混合，之后炼蜜为丸，且每丸9克，日服3次，7日为一个疗程，共治疗2个疗程。
制乳没各为1～2％为乳香和没药各1～2％，当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草均为优质中药材。
当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草的一种原料配比为当归100g、赤芍50g、桃仁30g、红花30g、木香60g、地枫100g、香附60g、川断30g、丹参30g、血竭10g、肉桂20g、陈皮30g、地龙30g、土元30g、牛膝50g、制乳没各15g、水蛭30g、苧麻根炭30g、牛蹄筋100g以及甘草30g。
本发明的具体操作方式：
首先随机选取肩关节前脱位患者14例，依随机数字表分为2组，每组7例。对照组男性3例、女性4例，且平均年龄(55.4±5.6)岁；观察组男性4例、女性3例，且平均年龄(54.6±5.7)岁；2组患者的一般资料差异无统计学意义(P>0.05)。
纳入的标准如下：经过患者症状体征及辅助检查，并参考《中医骨伤科学》诊断为肩关节前脱位；均有明显的外伤史；所有患者均行手法复位治疗并行外固定者；17岁≤年龄≤70岁；患者及家属对治疗方案知情同意。
排除标准如下：其他疾病导致的病理性脱位；伴有严重开放性损伤者；先天性习惯性脱位者或陈旧性脱位者；伴有神经、血管损伤者；手法复位困难或者伴有严重的肩关节周围骨折需要手术复位治疗者；哺乳期、妊娠期妇女；合并有严重的心血管、内分泌等系统疾病者。
治疗方法：收集所有患者诊治前均行X片、CT等相关检查明确损伤情况，以确定手法复位是否为其最适合的治疗手段，两组手法复位后，再次拍X片以确认复位成功，复位后用前臂吊带将患肢内收、内旋、屈肘90°悬吊于胸前。对照组采用常规的止痛药物进行治疗，观察组在其基础上加以壮骨伸筋丸治疗，具体药物为：当归100g、赤芍50g、桃仁30g、红花30g、木香60g、地枫100g、香附60g、川断30g、丹参30g、血竭10g、肉桂20g、陈皮30g、地龙30g、土元30g、牛膝50g、制乳没各15g、水蛭30g、苧麻根炭30g、牛蹄筋100g以及甘草30g；上述药物共研为细末，炼蜜为丸，每丸9g，日服3次，7日为一个疗程，共治疗2个疗程。
观察指标如下：肩关节活动度治疗前后测量并记录两组患者患侧肩关节前屈、外展、后伸活动度数；肩关节功能评分治疗前后采用肩关节功能评定量表评分评定患者肩关节功能，包括肩关节疼痛(0～30分)、肩关节活动范围(0～25分)、肌力(0～5分)、日常生活活动能力(0～35分)、局部形态(0～5分)，分数越高则表示肩关节功能越好；
结果计算：统计学分析运用SPSS25.0统计学软件分析数据，计量资料用(X±s)表示，采用t检验；计数资料采用X2检验。设置α＝0.05为统计学参照标准，计算结果如图1以及图2；
结论如下：两组患者治疗后的VAS评分和ODI指数均好于治疗前，存在显著差异(P＜0.01)；两组在治疗后进行同一组间比较，ODI指数和VAS量表分数均存在显著差异(P＜0.01)，由此可知观察组对于脱臼复位后患者活动功能障碍的改善及疼痛情况相对于对照组而言，能起到较好的临床疗效，对复位的再次脱臼有很好的的改善作用。
服用禁忌：伤肢严重肿胀，患处已出现血液循环障碍者禁用；严重的开放性骨折禁用伴随严重的心脑血管系统疾病禁用；孕妇及哺乳期妇女禁忌；有肝病史或肝功能指标严重异常者禁用。
图2评分标准为VAS评分标准，VAS评分标准即疼痛等级评分标准，是用视觉模拟的方法评判疼痛的严重程度，评分标准是使用尺子分为10等份，0是不疼，1-3是轻度疼痛，4-6是中度疼痛，7-10是重度疼痛，使用分为10等份的尺子，让病人用视觉模拟疼痛感受的评分标准说出自己处于的刻度,比如在3分刻度或者7分刻度，通过视觉模拟评估患者的疼痛程度，所以VAS评分标准在临床应用比较广泛，且能较好提示疼痛的严重程度和治疗前后疼痛缓解程度。
在本发明中，除非另有明确的规定和限定，例如，可以是固定连接，也可以是可拆卸连接，或成一体；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通或两个元件的相互作用关系，除非另有明确的限定，对于本领域的普通技术人员而言，可以根据具体情况理解上述术语在本发明中的具体含义。
尽管已经示出和描述了本发明的实施例，对于本领域的普通技术人员而言，可以理解在不脱离本发明的原理和精神的情况下可以对这些实施例进行多种变化、修改、替换和变型，本发明的范围由所附权利要求及其等同物限定。

Claims (3)

1.一种治疗伤筋骨病的壮骨伸筋丸，其特征在于：由以下原料组成：当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋和甘草；
具体原料配比如下：
当归11～12％、赤芍5～6％、桃仁3～4％、红花3～4％、木香6～7％、地枫11～12％、香附6～7％、川断3～4％、丹参3～4％、血竭1～2％、肉桂2～3％、陈皮3～4％、地龙3～4％、土元3～4％、牛膝5～6％、制乳没各1～2％、水蛭3～4％、苧麻根炭3～4％、牛蹄筋11～12％、甘草3～4％。
2.根据权利要求1所述的一种治疗伤筋骨病的壮骨伸筋丸，其特征在于：所述当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草的具体原料配置为当归100g、赤芍50g、桃仁30g、红花30g、木香60g、地枫100g、香附60g、川断30g、丹参30g、血竭10g、肉桂20g、陈皮30g、地龙30g、土元30g、牛膝50g、制乳没各15g、水蛭30g、苧麻根炭30g、牛蹄筋100g以及甘草30g。
3.根据权利要求1所述的一种治疗伤筋骨病的壮骨伸筋丸，其特征在于：所述制乳没各为1～2％为乳香和没药各1～2％，所述当归、赤芍、桃仁、红花、木香、地枫、香附、川断、丹参、血竭、肉桂、陈皮、地龙、土元、牛膝、制乳没、水蛭、苧麻根炭、牛蹄筋以及甘草均为优质中药材。
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