CN115487283A - 治疗心衰的中药制剂 - Google Patents
治疗心衰的中药制剂 Download PDFInfo
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- CN115487283A CN115487283A CN202211180008.1A CN202211180008A CN115487283A CN 115487283 A CN115487283 A CN 115487283A CN 202211180008 A CN202211180008 A CN 202211180008A CN 115487283 A CN115487283 A CN 115487283A
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Abstract
本发明公开了一种治疗心衰的中药制剂,属于中药技术领域。是由以下重量份的原料药制成的:茯苓25~35g,生白术25~35g,黑附片25~35g,干姜25~35g,泽泻25~35g,桂枝25~35g,制川乌25~35g,法半夏12~18g,葶苈子25~35g,人参15~25g,麻黄6~12g。本发明的治疗心衰的中药制剂,具有温阳益气,化瘀利水,平喘消肿的功效,可有效治疗心衰,治疗时口服,每日两次,同时可辅以西药治疗,如福辛普利、倍他乐克、螺内酯片、呋塞米片。治疗过程中结合患者病情的变化给予吸氧,同时针对病因治疗控制血压,监测尿量及血钾的变化,给予利尿剂及补钾治疗。
Description
技术领域
本发明涉及一种治疗心衰的中药制剂,属于中药技术领域。
背景技术
心力衰竭(heart failure)简称心衰,是指由于心脏的收缩功能和/或舒张功能发生障碍,不能将静脉回心血量充分排出心脏,导致静脉系统血液淤积,动脉系统血液灌注不足,从而引起心脏循环障碍症候群,此种障碍症候群集中表现为肺淤血、腔静脉淤血。心力衰竭并不是一个独立的疾病,而是心脏疾病发展的终末阶段。其中绝大多数的心力衰竭都是以左心衰竭开始的,即首先表现为肺循环淤血。根据心力衰竭发生的缓急,临床可分为急性心力衰竭和慢性心力衰竭。根据心力衰竭发生的部位可分为左心、右心和全心衰竭。还有收缩性或舒张性心力衰竭之分。
发明内容
针对上述现有技术,本发明提供了一种治疗心衰的中药制剂。
本发明是通过以下技术方案实现的:
一种治疗心衰的中药制剂,是由以下重量份的原料药制成的:茯苓25~35g,生白术25~35g,黑附片25~35g,干姜25~35g,泽泻25~35g,桂枝25~35g,制川乌25~35g,法半夏12~18g,葶苈子25~35g,人参15~25g,麻黄6~12g。
优选的,是由以下重量份的原料药制成的:茯苓30g,生白术30g,黑附片30g,干姜30g,泽泻30g,桂枝30g,制川乌30g,法半夏15g,葶苈子30g,人参20g,麻黄9g。
所述治疗心衰的中药制剂的剂型为汤剂,其制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌1~2小时(先煎以减少毒性,30~50g先煎1小时,超过50g先煎2小时;川乌在煎煮的过程中使乌头碱转化成乌头次碱,现代中药药理研究认为,乌头次碱的毒性是乌头碱毒性的五千分之一。煎煮期间不能加凉水,如果煎煮期间水少了,需要加水,要加滚烫的开水),然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得,分两次服用。
本发明的治疗心衰的中药制剂,治疗时,口服,每日两次,同时可辅以西药治疗,如福辛普利、倍他乐克、螺内酯片、呋塞米片。治疗过程中结合患者病情的变化给予吸氧,同时针对病因治疗控制血压,监测尿量及血钾的变化,给予利尿剂及补钾治疗。4周一个疗程。
本发明的治疗心衰的中药制剂,组方中,制川乌疏通经络,黑附片温补脾肾,提供能量;人参大补元气,生津养血,一则补充人体亏空之气血,二则大补元气助力川乌疏通经络。附子、川乌、人参三药同用,温肾升阳,益气补心,扶阳固本。葶苈子泻肺平喘,配干姜温肺化饮,麻黄提壶揭盖,宣肺平喘,通调水道。泽泻利水渗湿,与茯苓相配,利化水饮,使水饮从小便出;白术健脾燥湿,促进运化,桂枝温通三焦阳气,助阳气化,协渗利以布津行水,法半夏祛湿和胃,燥湿化痰。
本发明的治疗心衰的中药制剂,作用原理为:心衰病位在心,涉及肺、脾、肾等脏。心衰的根本病机为心气不足,心阳亏虚,心主血脉,肺主治节,共同协调气血运行。心虚推动无力,肺气治节失司,则血行瘀滞,水津外渗出;脾失健运,化生乏源,心气内虚,心体失养,痰饮内聚;肾气亏虚,不能上资于心,则心体失荣,君火失用,进一步加重“虚、瘀、水”的恶性演变,因此,心衰的病机可以用“虚”、“瘀”、“水”三者概括,心气心阳亏虚是病理基础,血瘀是中心病理环节,痰浊和水饮是主要病理产物。整个病情是随着心之阳气亏虚的程度而从代偿逐步进展到失代偿阶段,失代偿的标志往往是血瘀、水饮的进行性加重。针对其病机,以益气温阳、化瘀利水,平喘消肿为法的处方思路。
(1)黑顺片、川乌、人参:心力衰竭病位主要在心,诸病渐积则心用过度,久病不复则心体受损,心阳耗竭。心于人体犹如自然界之太阳,心肾阳虚则机体不得温煦,阴寒内盛,产生痰饮、瘀血等病理产物,积聚于脏腑经络。故在治疗重症心衰病人时,常川乌、附子同用。川乌之性走而不守,通行十二经和奇经八脉,斩关夺隘,内通脏腑筋骨髓海,上至头首,下至丹田,中至五脏六腑,外达皮腠四末,使经可通,寒可温,阳可扶,瘀可祛,痰可蠲。附子回阳救逆,借川乌之行得以上助心阳以通脉,中暖脾阳以健运,下补肾阳以复元。附子川乌同用,其温补元阳、疏通经络之力宏大,但心衰病人久病本就气血亏虚,因此借用人参大补元气,生津养血。一则补充人体亏空之气血,二则大补元气助力川乌疏通经络。附子、川乌、人参三药同用,温肾升阳,益气补心,扶阳固本。
(2)茯苓、泽泻、白术、桂枝、法半夏:心衰后期因心之阳气亏虚导致“先病血结而水随蓄”,出现阳虚水泛时可见浮肿、尿少。泽泻直达肾与膀胱,利水渗湿,茯苓配泽泻增强泽泻利水渗湿之力,利化水饮,使水饮从小便出。白术健脾燥湿,促进运化,与茯苓相配增强健脾祛湿之功,既可以助运化以杜绝痰饮生成之源,又除已聚之痰饮,疏津四布;更用桂枝温通三焦阳气,助阳气化,协渗利以布津行水。法半夏祛湿和胃,燥湿化痰。
(3)麻黄、葶苈子、干姜:心衰病人多有痰涎壅盛,喘咳痰多,胸胁胀满,不得平卧,而葶苈子归肺、膀胱经,苦泄辛散,功专泻肺之实而下气定喘,尤善泻肺中水饮,泻肺气之壅闭,而通调水道,行水消肿;干姜辛热,入肺经,善于温肺散寒化饮;麻黄主入肺与膀胱经,上宣肺气,通调水道,下输膀胱以下助利尿之力。
本发明的治疗心衰的中药制剂,具有温阳益气,化瘀利水,平喘消肿的功效,心衰患者出现心悸、水肿、胸闷、喘憋不得平卧、气短、乏力、畏寒肢冷、口唇发绀、痛,或胁下痞块坚硬,颈脉显露,舌淡胖有齿痕,或有瘀点、瘀斑、脉沉细等,辨证为阳虚水泛证的慢性心衰或心衰加重期的病人均可使用此中药制剂。本发明的治疗心衰的中药制剂,疗效显著,可有效治疗心衰。与补阳强心汤(由人参、黄芪、黄精、炮附子、干姜、茯苓、川芎、赤芍、桂枝、红花、泽泻、丹参、白术、黄连、猪苓组成)相比较,两者虽均有人参、干姜、炮附子、茯苓、桂枝、泽泻、白术,但补阳强心汤中的黄芪、黄精重在补,川芎、赤芍、红花、丹参、黄连重在活血。而扶阳强心汤(即本发明的中药制剂)用川乌以豁痰祛瘀通络,法半夏燥湿化痰,与白术、干姜相配健运中焦,葶苈子更是针对慢性心力衰竭患者喘憋不能平卧之症状,泻肺平喘,再与麻黄相配,开肺气,助运阳气流通。综上,补阳强心汤重在补益与活血,扶阳强心汤重在扶阳固本、豁痰祛瘀,泻肺平喘。故两者从中医的治法治则、方药配伍上有根本差别。
具体实施方式
下面结合实施例对本发明作进一步的说明。然而,本发明的范围并不限于下述实施例。本领域技术人员能够理解,在不背离本发明的精神和范围的前提下,可以对本发明进行各种变化和修饰。
实施例1制备治疗心衰的中药制剂
原料药组成:茯苓30g,生白术30g,黑附片30g,干姜30g,泽泻30g,桂枝30g,制川乌30g,法半夏15g,葶苈子30g,人参20g,麻黄9g。
制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌2小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
临床资料
1.病例资料
1.1病例来源:本课题观察的68例阳虚血瘀证慢性心力衰竭患者,均为2020年10月至2021年12月中国中医科学院广安门医院心血管病科住院部及门诊的患者。
1.2诊断标准
1.2.1西医诊断准
1.2.1.1西医诊断标准参照《中国心力衰竭诊断和治疗指南2018》诊断标准制定:
(1)根据患者病史:冠心病,高血压病,肥胖,使用利尿剂,端坐呼吸/夜间阵发性呼困难。
(2)结合患者体格检查:肺部啰音,双下肢水肿,心脏杂音,颈静脉充盈,心尖搏动侧移或弥散。
(3)相关辅助检查:心电图异常,胸片,NT-proBNP≥125ng/L,心脏结构和/或功能异常。综合以上3点因素及患者病情予以诊断。
1.2.1.2心功能NYHA分级法参照美国纽约心脏病协会(NYHA)心功能分级标准制定。
心功能Ⅰ级:活动不受限。日常体力活动不引起明显的气促、疲乏或心悸。
心功能Ⅱ级:活动轻度受限。休息时无症状,日常活动可引起明显的气促、疲乏或心悸。
心功能Ⅲ级:活动明显受限。轻于日常活动即引起显著的气促、疲乏或心悸。
心功能Ⅳ级:休息时也有症状,任何体力活动均会引起不适。
1.2.2中医诊断标准
1.2.2.1参照2014年《慢性心力衰竭中医诊疗专家共识》制定慢性心力衰竭阳虚血瘀兼痰饮证的诊断标准。
阳虚血瘀证:
主症:气短/喘息,乏力,心悸。
次症:怕冷和/(或)喜温;胃脘/腹/腰/肢体冷感;冷汗;面色/口唇紫暗;小便不利;面肢浮肿。
舌脉:舌质紫暗(或有瘀斑、瘀点或舌下脉络迂曲青紫)脉象:脉细、沉、迟无力。
以上具有2项主症,兼具2项或2项以上次症,结合舌象、脉象即可确定诊断。
兼证痰饮证:咳嗽/咯痰、胸满/腹胀、面浮/肢肿、小便不利。
舌脉:舌苔润滑,或腻,或有滑脉。
具有兼证1项,结合舌脉,即可诊断。
1.2.3纳入标准
(1)符合西医慢性心力衰竭诊断标准及中医阳虚血瘀证的辨证标准。
(2)以心功能分级Ⅱ-Ⅲ级(NYHA)的慢性心衰患者为药物长期观察的主要研究对象。
(3)患者年龄在45~75岁之间,性别不限。
(4)告知患者及家属本试验的研究目的,患者自愿纳入并遵从医嘱治疗。
1.2.4排除标准
(1)由于肾、肝等重要脏器功能衰竭导致心力衰竭者。
(2)妊娠或哺乳期妇女,过敏体质及对多种药物过敏者。
(3)有精神异常且不能配合治疗者。
(4)正在参与其他临床试验者。
(5)由于各种原因无法判定疗效或资料不全者。
(6)凡能增加死亡率的因素:如心源性休克、严重室性心律失常、完全性房室传导阻滞、梗阻型心肌病、严重瓣膜疾病、缩窄性心包炎,心包填塞,肺动脉栓塞,有明显感染及控制不佳的严重高血压患者等,均不宜选用。
1.2.5剔除与脱落及中止试验标准
(1)患者病情恶化,有可能发生危险事件者,出现严重合并疾病,经判断应停止试验。
(2)病程未结束而出现严重不良反应者。
(3)受试者不愿继续试验,主动要求终止试验者。
(4)受试者依从性差,未按医嘱治疗者。
2.研究方法
2.1治疗方法
(1)将60例符合标准的患者按照随机数字表法分为对照组和治疗组,每组30例,对照组给予西医基础治疗,治疗组在西医基础治疗上加服中药汤剂治疗,疗程4周。
(2)中药汤剂的组成为:茯苓30g,生白术30g,黑附片30g,干姜30g,泽泻30g,桂枝30g,制川乌30g,法半夏15g,葶苈子30g,人参20g,麻黄9g。上药由中国中医科学院广安门医院中药房统一抓取煎煮(按实施例1的方法),150ml/袋,2袋。用法:1袋/次,2次/日,餐后温服。治疗疗程为4周。
(3)西医基础治疗:福辛普利10mg,日1次口服,倍他乐克23.75mg,日1次口服,螺内酯片20~40mg,日1次口服,呋塞米片20~40mg,日1次口服。结合患者治疗过程中病情的变化给予吸氧,调整药物种类、剂量及给药方式,同时针对病因治疗控制血压,监测尿量及血钾的变化,给予利尿剂及补钾治疗。
(4)纳入试验患者均宜低盐低脂饮食,忌过饥过饱,限制液体摄入,调情志,避风寒,戒烟限酒,保持充足休息。
2.2观察指标
2.2.1人口资料
2.2.2安全性指标
(1)监测体温、呼吸、脉搏、血压、心率。
(2)血、尿、便常规,心肌酶、肝功能、肾功能、离子。
(3)密切观察治疗期间出现的不良反应并详细记载,判断病情。
2.2.3疗效性指标
(1)心功能分级(NYHA)。
(2)NT-proBNP。
(3)中医证候积分。
(4)心脏超声检查左室射血分数(LVEF)。
2.3疗效评定标准(参照《中药新药临床研究指导原则》制定)
2.3.1心功能改善情况按NYHA分级方法,疗效标准为:
显效:心衰基本控制或心功能提高2级或以上者。
有效:心功能提高1级,但不及2级者。
无效:心功能提高不足1级者。
恶化:心功能恶化1级或1级以上。
2.3.2 NT-proBNP疗效判定
观察两组治疗前后的NT-proBNP水平变化。
2.3.3中医证候疗效判定标准
显效:主次症基本或完全消失,治疗后证候积分为0或减少≥70%。
有效:治疗后证候积分减少≥30%。
无效:治疗后证候积分减少不足30%。
加重:治疗后积分超过治疗前积分。
2.3.4左室射血分数(LVEF)疗效判定
观察两组治疗前后的LVEF变化。
2.4统计学处理
采用SPSS25.0统计软件分析和处理数据,计量资料用均数±标准差表示,符合正态分布的资料进行t检验,非正态分布进行秩和检验;等级资料选用秩和检验,计数资料选用卡方检验。对研究结果进行分析,P<0.05表明具有统计学意义。
3.结果
3.1一般资料分析
试验最初入组病例68例,其中对照组34例,试验组34例,在试验过程中,对照组发现不符合纳入标准2例予以剔除,因为自行出院和中途退出脱落2例;治疗组因拒服中药和中途出院脱落2例,未按照规定疗程服药2例予以剔除,试验结束后符和研究标准的病例为60例。
3.1.1治疗组与对照组两组年龄、性别、病程、心功能等级之间的差异无统计学意义,认为两组具有可比性(具体见表1、表2)。
表1试验两组性别、年龄、病程分布情况
注:经过检验后*P>0.05,#P>0.05,△P>0.05。
表2心功能分级比较
注:经过卡方检验后*P>0.05。
3.2疗效分析
3.2.1中医证候总积分比较
由表3可知,两组治疗前对比P>0.05,差异无统计学意义,具有可比性。两组组内对比P<0.05,差异有统计学意义,两组治疗后积分均下降,但治疗组差值大于对照组P<0.05,治疗组效果优于对照组。
表3中医证候治疗前后总积分比较(均数±标准差)
注:经过检验后,与治疗组治疗前对比△P>0.05,与本组治疗前比较*P<0.05,与治疗组差值比较#P<0.05。
3.2.2中医证候疗效比较
由4可知,两组中医证候疗效对比,治疗组优于对照组(P<0.05),差异具有统计学意义。
表4中医证候疗效比较[N(%)]
注:运用秩和检验比较P<0.05。
3.2.3两组患者治疗后心功能分级(NYHA)疗效比较
由5可知,两组心功能证候疗效对比,治疗组优于对照组(P<0.05),差异具有统计学意义。
表5心功能疗效比较[N(%)]
注:运用秩和检验P<0.05。
3.2.4两组患者治疗前后NT-proBNP数值比较
由表6可知,两组治疗前NT-proBNP差异无统计学意义(P>0.05),具有可比性。治疗后两组NT-proBNP均下降,但治疗组下降幅度大于对照组,差异具有统计学意义(P<0.05)。
表6两组患者治疗后NT-proBNP水平比较(均数±标准差,pg/mL)
注:经过检验后,与治疗组治疗前对比△P>0.05,与本组治疗前比较*P<0.05,与治疗组差值比较#P<0.05。
3.2.5两组患者治疗前后LVEF(%)水平比较
由表7可知,两组治疗前的LVEF值差异无统计学意义(P>0.05)。具有可比性。两组组内治疗后与治疗前比较P<0.05,提示两组都可升高LVEF(%)值,但治疗组升高幅度大于对照组(P<0.05),其差异具有统计学意义,证明治疗组效果优于对照组。
表7两组患者治疗后LVEF(%)水平比较(均数±标准差)
注:经过检验后,与治疗组治疗前对比△P>0.05,与本组治疗前比较*P<0.05,与治疗组差值比较#P<0.05。
3.3安全性指标结果
本次完成临床观察的60例患者,均行体温、脉搏、呼吸、血压、心率常规检测,治疗前后均行血、尿、大便常规、肝功能、肾功能等安全性指标检查,两组患者治疗前后各项安全性指标未见明显变化,波动较平稳;观察过程中未出现明显不良反应,故可以判定本次观察所用的中药汤剂安全性较好。
4.讨论
扶阳强心汤方选:茯苓30g、生白术30g、黑附片30g、干姜30g、泽泻30g、桂枝30g、制川乌30g、法半夏15g、葶苈子30g、人参20g、麻黄9g。
心衰病位在心,涉及肺、脾、肾等脏。心衰的根本病机为心气不足,心阳亏虚,心主血脉,肺主治节,共同协调气血运行。心虚推动无力,肺气治节失司,则血行瘀滞,水津外渗出;脾失健运,化生乏源,心气内虚,心体失养,痰饮内聚;肾气亏虚,不能上资于心,则心体失荣,君火失用,进一步加重“虚、瘀、水”的恶性演变,因此,心衰的病机可以用“虚”、“瘀”、“水”三者概括,心气心阳亏虚是病理基础,血瘀是中心病理环节,痰浊和水饮是主要病理产物。整个病情是随着心之阳气亏虚的程度而从代偿逐步进展到失代偿阶段,失代偿的标志往往是血瘀、水饮的进行性加重。针对其病机,以益气温阳、化瘀利水,平喘消肿为法的处方思路。心力衰竭病位主要在心,诸病渐积则心用过度,久病不复则心体受损,心阳耗竭。心于人体犹如自然界之太阳,心肾阳虚则机体不得温煦,阴寒内盛,产生痰饮、瘀血等病理产物,积聚于脏腑经络。故在治疗重症心衰病人时,常川乌、附子同用。川乌之性走而不守,通行十二经和奇经八脉,斩关夺隘,内通脏腑筋骨髓海,上至头首,下至丹田,中至五脏六腑,外达皮腠四末,使经可通,寒可温,阳可扶,瘀可祛,痰可蠲。附子回阳救逆,借川乌之行得以上助心阳以通脉,中暖脾阳以健运,下补肾阳以复元。附子川乌同用,其温补元阳、疏通经络之力宏大,但心衰病人久病本就气血亏虚,因此借用人参大补元气,生津养血。一则补充人体亏空之气血,二则大补元气助力川乌疏通经络。附子、川乌、人参三药同用,温肾升阳,益气补心,扶阳固本。心衰后期因心之阳气亏虚导致“先病血结而水随蓄”,出现阳虚水泛时可见浮肿、尿少。泽泻直达肾与膀胱,利水渗湿,茯苓配泽泻增强泽泻利水渗湿之力,利化水饮,使水饮从小便出。白术健脾燥湿,促进运化,与茯苓相配增强健脾祛湿之功,既可以助运化以杜绝痰饮生成之源,又除已聚之痰饮,疏津四布;更用桂枝温通三焦阳气,助阳气化,协渗利以布津行水。法半夏祛湿和胃,燥湿化痰。心衰病人多有痰涎壅盛,喘咳痰多,胸胁胀满,不得平卧,而葶苈子归肺、膀胱经,苦泄辛散,功专泻肺之实而下气定喘,尤善泻肺中水饮,泻肺气之壅闭,而通调水道,行水消肿;干姜辛热,入肺经,善于温肺散寒化饮;麻黄主入肺与膀胱经,上宣肺气,通调水道,下输膀胱以下助利尿之力。
临床研究结果表明,采用扶阳强心汤治疗慢性心力衰竭有助于提高患者的综合疗效,有效改善心功能状况及中医证候、NTpro-BNP水平、左室射血分数LVEF值,治疗效果均优于西药对照组(P<0.05),具有统计学意义。通过对扶阳强心汤进行药物的临床效果优选,并对工艺、质量、稳定性等研究,研制成中药制剂,以中医扶阳学说为理论依据,采用口服的方法,使药物通过口服的途径而发挥治疗作用。
5.结论
本发明的扶阳强心汤临床在心功能状况及中医证候、NTpro-BNP水平、左室射血分数LVEF值的应用效果明显优于临床常用西药,安全性好,加之其简便易行、价廉药简,为其在临床推广提供保障。
实施例2制备治疗心衰的中药制剂
原料药组成:茯苓35g,生白术25g,黑附片35g,干姜25g,泽泻35g,桂枝25g,制川乌35g,法半夏12g,葶苈子35g,人参15g,麻黄12g。
制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌2小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
实施例3制备治疗心衰的中药制剂
原料药组成:茯苓25g,生白术35g,黑附片25g,干姜35g,泽泻25g,桂枝35g,制川乌25g,法半夏18g,葶苈子25g,人参25g,麻黄6g。
制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌1小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
实施例4制备治疗心衰的中药制剂
原料药组成:茯苓28g,生白术28g,黑附片32g,干姜32g,泽泻28g,桂枝28g,制川乌32g,法半夏16g,葶苈子28g,人参18g,麻黄10g。
制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌2小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
实施例5制备治疗心衰的32g,生白术32g,黑附片28g,干姜28g,泽泻32g,桂枝32g,制川乌28g,法半夏14g,葶苈子32g,人参18g,麻黄8g。
制备方法如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌2小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤,此为第一煎;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
给本领域技术人员提供上述实施例,以完全公开和描述如何实施和使用所主张的实施方案,而不是用于限制本文公开的范围。对于本领域技术人员而言显而易见的修饰将在所附权利要求的范围内。
Claims (4)
1.治疗心衰的中药制剂,其特征在于,是由以下重量份的原料药制成的:茯苓25~35g,生白术25~35g,黑附片25~35g,干姜25~35g,泽泻25~35g,桂枝25~35g,制川乌25~35g,法半夏12~18g,葶苈子25~35g,人参15~25g,麻黄6~12g。
2.根据权利要求1所述的治疗心衰的中药制剂,其特征在于,是由以下重量份的原料药制成的:茯苓30g,生白术30g,黑附片30g,干姜30g,泽泻30g,桂枝30g,制川乌30g,法半夏15g,葶苈子30g,人参20g,麻黄9g。
3.权利要求1或2所述的治疗心衰的中药制剂,其特征在于:所述治疗心衰的中药制剂的剂型为汤剂。
4.权利要求1~3中任一项所述的治疗心衰的中药制剂的制备方法,其特征在于,步骤如下:
(1)黑附片、制川乌单独加水浸泡30分钟,备用;茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参混合,加水浸泡30分钟,备用;麻黄,备用;
(2)先煎煮黑附片和制川乌1~2小时,然后加入茯苓、生白术、干姜、泽泻、桂枝、法半夏、葶苈子和人参,再煎煮40分钟,倒出药汤;药渣加水,放入麻黄,再煎40分钟,倒出药汤;将两煎药汤混合在一起,即得。
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Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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WO2022021639A1 (zh) * | 2020-07-29 | 2022-02-03 | 汕头市中医医院 | 一种健脾通阳中药组合物及其应用 |
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Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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WO2022021639A1 (zh) * | 2020-07-29 | 2022-02-03 | 汕头市中医医院 | 一种健脾通阳中药组合物及其应用 |
Non-Patent Citations (2)
Title |
---|
叶建芳,张晓红,张赪辉: "苓桂术甘汤加减治疗慢性心力衰竭60例", 陕西中医, no. 07, pages 613 - 614 * |
陈浩琛等: "扶阳法治疗心力衰竭重症1例", 《中西医结合心脑血管病杂志》, vol. 20, no. 7, pages 1339 - 1342 * |
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