CN116211982B - Compound preparation for treating middle-low-risk pulmonary nodules, preparation method and application - Google Patents

Compound preparation for treating middle-low-risk pulmonary nodules, preparation method and application Download PDF

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CN116211982B
CN116211982B CN202310055780.9A CN202310055780A CN116211982B CN 116211982 B CN116211982 B CN 116211982B CN 202310055780 A CN202310055780 A CN 202310055780A CN 116211982 B CN116211982 B CN 116211982B
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pulmonary nodules
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沈红权
刘鑫晔
鲁曦
张志丹
庞谊
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SHANGHAI PUTUO DISTRICT CENTRAL HOSPITAL
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Abstract

The invention discloses a compound preparation for treating middle-low risk pulmonary nodules, a preparation method and application thereof, wherein the compound preparation comprises the following components in parts by weight: 12-18 parts of dandelion, 27-30 parts of radix cynanchi wilfordii, 9-12 parts of fritillaria thunbergii, 27-30 parts of raw corrugated, 9-12 parts of prepared pinellia ternate, 9-30 parts of selfheal, 9-12 parts of curcuma zedoary, 9-12 parts of semen brassicae, 12-30 parts of radix scrophulariae and 6-9 parts of fructus aurantii. The traditional Chinese medicine compound preparation takes a lung clearing and detoxifying method as a treatment principle, and has obvious curative effect on patients with low-risk pulmonary nodules.

Description

Compound preparation for treating middle-low-risk pulmonary nodules, preparation method and application
Technical Field
The invention relates to a traditional Chinese medicine compound preparation, in particular to a compound preparation for treating middle-low risk pulmonary nodules, a preparation method and application thereof.
Background
Pulmonary Nodules (PN) refer to round-like or irregular lesions with a diameter of less than or equal to 30mm in the lung, and are represented by shadows with increased density in imaging, which may be single or multiple lesions with clear or unclear boundaries. The detection rate of lung nodules in chest CT examination of healthy people can reach 35.5%.
Pulmonary nodules are classified as solid pulmonary nodules, ground glass density nodules, and multiple pulmonary nodules. Surgical treatment options are most preferred for high-risk pulmonary solid nodules, pulmonary branch solid nodules, and multiple pulmonary nodules. For low-risk lung nodules, including solid lung nodules with the diameter less than or equal to 8mm, solid lung nodules and ground glass density nodules with the diameter less than 5mm, if no surgical indication exists, a follow-up mode is mostly adopted clinically, the control is not needed, and the surgical treatment is first selected when the growth is found.
However, over time, a significant portion of benign knots at low risk may turn malignant, life threatening, and existing treatment regimens fail to improve the patient's clinical symptoms, lacking effective intervention.
Disclosure of Invention
The invention aims to provide a traditional Chinese medicine compound preparation for treating middle-low risk pulmonary nodules by taking a lung clearing and detoxifying method and a phlegm resolving and mass resolving method as treatment principles.
In order to achieve the aim, the invention provides a compound preparation for treating middle-low risk pulmonary nodules, which comprises the following components in parts by weight: 12-18 parts of dandelion, 27-30 parts of radix cynanchi wilfordii, 9-12 parts of fritillaria thunbergii, 27-30 parts of raw corrugated, 9-12 parts of prepared pinellia ternate, 9-30 parts of selfheal, 9-12 parts of curcuma zedoary, 9-12 parts of semen brassicae, 12-30 parts of radix scrophulariae and 6-9 parts of fructus aurantii.
Optionally, the compound preparation comprises the following components in parts by weight: 14-16 parts of dandelion, 28-30 parts of radix cynanchi wilfordii, 10-11 parts of fritillaria thunbergii, 28-30 parts of raw corrugated, 10-11 parts of prepared pinellia ternate, 20-30 parts of selfheal, 10-11 parts of curcuma zedoary, 10-11 parts of semen brassicae, 14-20 parts of radix scrophulariae and 6-8 parts of fructus aurantii.
Optionally, the compound preparation comprises the following components in parts by weight: 15 parts of dandelion, 30 parts of radix cynanchi, 10 parts of fritillaria thunbergii, 30 parts of raw corrugated, 10 parts of prepared pinellia tuber, 30 parts of selfheal, 10 parts of rhizoma curcumae, 10 parts of white mustard seed, 15 parts of radix scrophulariae and 6 parts of fructus aurantii.
The invention also provides a preparation method of the compound preparation for treating the middle-low risk pulmonary nodules, which comprises the following steps:
step 1, soaking the components for 0.5 to 1 hour;
step 2, adding water until the weight of the water is 2 times of the sum of the weight of the components, decocting for 15-20 minutes, and pouring out to obtain a first liquid medicine;
step 3, adding water again until the weight of the water is 2 times of the sum of the weight of the components, decocting for 30-40 minutes, and pouring out to obtain a second liquid medicine;
and step 4, combining the first liquid medicine and the second liquid medicine to obtain the compound preparation for treating the middle-low risk pulmonary nodules.
Optionally, the method comprises:
step 1, soaking each component for 1 hour;
step 2, adding water until the weight of the water is 2 times of the sum of the weight of the components, decocting for 15 minutes, and pouring out the water to serve as a first liquid medicine;
step 3, adding water again until the weight of the water is 2 times of the sum of the weight of the components, decocting for 30 minutes, and pouring out to obtain a second liquid medicine;
and step 4, combining the first liquid medicine and the second liquid medicine to obtain the compound preparation for treating the middle-low risk pulmonary nodules.
The invention also provides application of the compound preparation for treating the middle-low risk pulmonary nodules in preparing medicines for treating the middle-low risk pulmonary nodules.
The invention has the beneficial effects that:
jin Suowei is bitter and cool, and selfheal is bitter and cold in nature, clear away lung-heat and detoxify, and has the efficacy of dissipating middle-low risk pulmonary nodules; dandelion has sweet taste, clears heat and eliminates stagnation, zhejiang fritillary has bitter taste and cold property, eliminates phlegm and eliminates stagnation, pinellia has pungent taste and can promote qi circulation and eliminate phlegm, and the three medicines together play the roles of eliminating phlegm and eliminating stagnation; the four medicines are combined to soften hardness and remove mass; fructus Aurantii regulates qi and moves stagnancy, guides the medicines.
Detailed Description
The main traditional Chinese medicine treatment methods for treating lung nodules at present comprise the methods of promoting qi circulation and blood circulation, clearing heat and detoxicating, soothing liver and regulating qi, promoting blood circulation and removing blood stasis, promoting qi circulation and soothing liver, and eliminating mass and resolving hard mass. The invention claims to prepare the medicine for treating the middle-low risk pulmonary nodule by taking a lung clearing and detoxifying method and a phlegm resolving and masses resolving method as a principle.
The invention takes the radix cynanchi wilfordii and the selfheal as the monarch drugs, clears away the lung-heat and detoxifies, leaves Jin Suowei bitter and cool, has bitter and cold property of the selfheal, has the efficacy of dissipating middle-low risk pulmonary nodules, contains ferulic acid, and has the anti-tumor effect in modern pharmacology; dandelion, fritillaria thunbergii and pinellia ternate are taken as ministerial drugs, dandelion is sweet and neutral in taste, clear heat and dissipate nodulation, fritillaria thunbergii is bitter and cold in property and is capable of resolving phlegm and resolving nodulation, pinellia ternate is pungent and parallel in taste and qi-moving and resolving phlegm, and the three drugs have the effects of resolving phlegm and resolving nodulation together; the preparation is prepared from raw corrugated, rhizoma curcumae, semen brassicae and radix scrophulariae serving as adjuvant drugs, wherein the raw corrugated is used for softening and resolving hard mass, the rhizoma curcumae is used for promoting qi circulation and removing food retention, the semen brassicae is used for eliminating phlegm and promoting qi circulation, the radix scrophulariae is used for nourishing yin and removing toxicity, and the radix scrophulariae is used for softening and resolving hard mass; fructus Aurantii is used as a guiding drug, and the fructus Aurantii regulates qi and moves stagnancy to guide the drugs.
Example 1
A compound formulation for treating low-risk pulmonary nodules comprising: 12g of dandelion, 27g of radix cynanchi, 9g of fritillaria thunbergii, 27g of raw corrugated, 9g of prepared pinellia tuber, 9g of selfheal, 9g of rhizoma curcumae, 9g of white mustard seed, 12g of radix scrophulariae and 6g of fructus aurantii.
Example 2
A compound formulation for treating low-risk pulmonary nodules comprising: 18g of dandelion, 30g of radix cynanchi, 12g of fritillaria thunbergii, 30g of raw corrugated, 12g of prepared pinellia tuber, 30g of selfheal, 12g of rhizoma curcumae, 12g of white mustard seed, 30g of radix scrophulariae and 9g of fructus aurantii.
Example 3
A compound formulation for treating low-risk pulmonary nodules comprising: 15g of dandelion, 30g of radix cynanchi, 10g of fritillaria thunbergii, 30g of raw corrugated, 10g of prepared pinellia tuber, 30g of selfheal, 10g of rhizoma curcumae, 10g of white mustard seed, 15g of radix scrophulariae and 6g of fructus aurantii.
Example 4
A preparation method of a compound preparation for treating middle-low risk pulmonary nodules comprises the following steps:
step 1, soaking each component in examples 1-3 with water for 1 hour;
step 2, adding water until the weight of the water is 2 times of the sum of the weight of the components, decocting for 15 minutes, and pouring out the water to serve as a first liquid medicine;
step 3, adding water again until the weight of the water is 2 times of the sum of the weight of the components, decocting for 30 minutes, and pouring out to obtain a second liquid medicine;
and step 4, combining the first liquid medicine and the second liquid medicine to obtain the compound preparation for treating the middle-low risk pulmonary nodules.
In the clinical treatment, the effect of the compound preparation for treating the middle-low-risk pulmonary nodules is verified.
1. Case selection and grouping
(1) Case selection: reference is made to the guidelines for classification, diagnosis and treatment of pulmonary nodules in China (2016 edition) formulated by the expert group for early diagnosis and treatment of Chinese lung cancer in 2016.
(1) No obvious signs of malignancy CT; (2) pulmonary solid nodules with the diameter less than or equal to 8mm and pulmonary partial solid nodules with the diameter less than or equal to 8mm; (3) lung-ground glass density nodules.
(2) Case grouping: the treatment groups and the control groups were randomized according to a random table.
(1) Treatment group (administration of the formulation of the invention + follow-up): 29 cases
(2) Control group (follow-up only): 28 cases
The two groups of patients were comparable with no significant differences in age, sex, course of disease and severity of disease (P > 0.05).
2. Method of observation and treatment
(1) The observation method comprises the following steps: the morphology of lung CT lung nodules was observed before and after treatment of group 2.
(2) The treatment method comprises the following steps: the treatment group uses the formula of clearing lung and resolving masses: according to the processing specification of Shanghai city decoction pieces, the medicinal materials of 1995 edition are dandelion, pinellia tuber, figwort root, selfheal and the like. The amounts of the components of example 3 were prepared as provided in example 4. After the first liquid medicine and the second liquid medicine are mixed, the first liquid medicine and the second liquid medicine are separated into bags for encapsulation, and each bag is about 160 ml. 160ml of the medicine is taken twice a day, each time in the morning and evening, and 3 months is a treatment course.
3. Standard of efficacy: reference is made to the guidelines of clinical research on new Chinese medicine.
(1) Clinical recovery: the lung nodules disappeared;
(2) The effect is shown: lung nodules were reduced by more than 60%;
(3) The method is effective: the lung nodule is reduced by 30 to 59 percent;
(4) Invalidation: pulmonary nodules do not change or turn into high risk nodules;
the total effective rate is the sum of healing, obvious effect and effective rate.
4. Therapeutic results and analysis
(1) Treatment group 29: 2 cases of clinical recovery, 10 cases of obvious effects, 11 cases of effective cases and 6 cases of ineffective cases, and the total effective rate is 79.31%;
(2) control 28 cases: 0 cases of clinical recovery, 2 cases of obvious effects, 11 cases of effective cases, 15 cases of ineffective cases, and the total effective rate is 46.42%;
compared with the control group, the total effective rate of the patients in the treatment group is obviously higher than that of the patients in the control group, the difference is obvious, and the statistical significance is achieved (P < 0.05).
Typical cases:
case 1
Zhang, woman, age 46, han nationality. 2020-07 in external chest CT: the left subpulmonary She Weixiao nodule (left subpulmonary lobe with a solid nodule lamina 198 with a major diameter of about 4.8mm; right subpulmonary lobe with a solid nodule lamina 180 with a major diameter of about 4.1mm. Bilateral pleural cavity has no apparent effusion). The doctor can make a doctor before 8 months in 2020, and chest distress and urgent need not be caused during the doctor's doctor, and cough and expectoration are avoided, and other discomforts are avoided. The medicines are decocted for 1 dose in 1 day, and the medicine is orally taken in the morning and evening. 2020-11 chest CT in my hospital: no obvious abnormalities were seen. Chest distress and short breath during the re-diagnosis are not caused, and other discomforts are avoided.
Case 2
Some in summer, men, 65 years old, han nationality. 2021-03 in external chest CT: two lung air bags and lung bulla; the lower right lung is She Xiongmo with tiny ground glass nodules; lower right lung She Weixiao nodule; lower right lung She Gaihua kitchen; the middle lobe and the chordae of the right lung (the texture of the two lungs is deepened, the two lungs see lung air bags and lung large bubbles, the IM25 under the right lung She Xiongmo is a 3mm undersize micro ground glass nodule, the boundary is undersize, the lower right lung lobes IM43 and 48-49 are 4mm uniform micro nodules, the boundary is clearer, the lower right lung lobes see calcification foci, the middle right lung lobes see chordae shadows, the cavities of the bronchi are smooth, the phylum and the mediastinum do not see enlarged lymph nodes, the bilateral pleura does not see obvious thickening, and the bilateral pleural cavity does not see obvious effusion). The diagnosis is carried out 10 months in 2022, and the following steps are: the occasional cough is accompanied by a small amount of white sticky phlegm, has no chest distress and no other discomfort. The medicines are decocted for 1 dose in 1 day, and the medicine is orally taken in the morning and evening. 2021-01 external hospital review chest CT: both lungs are scattered in chronic inflammation and are locally old; two lung powder are scattered in the vesicular emphysema with large lung bleb (two lung powder are scattered in the maize shadow, the chordae shadow and the calcification foci), two lung powder are scattered in the vesicular emphysema with large lung bleb, the visible trachea and bronchus cavity are smooth, the two lung gates and the mediastinum are not obvious enlarged lymph nodes, and no hydrops exists in the chest of the two sides.
Case 3
Wu is a certain, female, 37 years old, han nationality. 2020-12 chest CT: upper right lung She Weixiao nodule (upper right lung leaf IM24 seen with a ground glass micro nodule, long diameter about 3mm. No apparent effusion was seen in bilateral chest). The doctor can make a diagnosis in the 12 months of 2020, and feel occasional force during the diagnosis, and has no chest distress, urgent need, cough and expectoration and other discomfort. The medicines are decocted for 1 dose in 1 day, and the medicine is orally taken in the morning and evening. 2021-03 breast CT: no obvious abnormalities were seen.
Case 4
Mulberry is somewhere, male, 63 years old, han nationality. 2020-10 chest CT: the upper right and lower two-lung lobular nodes (about 4-6mm. Bilateral hilar structure is clear, the morphology, size and location are all obvious abnormalities. No abnormal enlargement of lymph nodes in each group in mediastinum). The doctor can make a diagnosis 11 months before 2020, and cough is obvious at night, cough is white and sticky with phlegm, chest distress is felt, and other discomfort is avoided. The medicines are decocted for 1 dose in 1 day, and the medicine is orally taken in the morning and evening. 2021-03 breast CT: multiple focal small emphysema on upper lobe of two lungs, and pleural promyelocytic range on lower lobe of left lung. The cough and expectoration and chest distress symptoms of the re-diagnosis are not caused, and other discomforts are avoided.
In conclusion, the invention provides a compound preparation for treating middle-low risk pulmonary nodules, which takes radix cynanchi wilfordii and selfheal as monarch drugs to clear away lung heat and detoxify; dandelion, fritillary bulb and pinellia tuber are taken as ministerial drugs for resolving phlegm and resolving masses; takes raw corrugated, rhizoma zedoariae, white mustard seed and radix scrophulariae as adjuvant drugs to soften hardness and eliminate mass; fructus Aurantii is used as guiding drug to guide the drugs. The compound preparation has obvious curative effect on middle-low risk pulmonary nodules.
While the present invention has been described in detail through the foregoing description of the preferred embodiment, it should be understood that the foregoing description is not to be considered as limiting the invention. Many modifications and substitutions of the present invention will become apparent to those of ordinary skill in the art upon reading the foregoing. Accordingly, the scope of the invention should be limited only by the attached claims.

Claims (6)

1. The compound preparation for treating the middle-low risk pulmonary nodules is characterized by comprising the following components in parts by weight: 12-18 parts of dandelion, 27-30 parts of radix cynanchi wilfordii, 9-12 parts of fritillaria thunbergii, 27-30 parts of raw corrugated, 9-12 parts of prepared pinellia ternate, 9-30 parts of selfheal, 9-12 parts of curcuma zedoary, 9-12 parts of semen brassicae, 12-30 parts of radix scrophulariae and 6-9 parts of fructus aurantii.
2. The compound preparation for treating middle-low risk pulmonary nodules of claim 1, which consists of the following components in parts by weight: 14-16 parts of dandelion, 28-30 parts of radix cynanchi wilfordii, 10-11 parts of fritillaria thunbergii, 28-30 parts of raw corrugated, 10-11 parts of prepared pinellia ternate, 20-30 parts of selfheal, 10-11 parts of curcuma zedoary, 10-11 parts of semen brassicae, 14-20 parts of radix scrophulariae and 6-8 parts of fructus aurantii.
3. The compound preparation for treating middle-low risk pulmonary nodules of claim 2, which consists of the following components in parts by weight: 15 parts of dandelion, 30 parts of radix cynanchi, 10 parts of fritillaria thunbergii, 30 parts of raw corrugated, 10 parts of prepared pinellia tuber, 30 parts of selfheal, 10 parts of rhizoma curcumae, 10 parts of white mustard seed, 15 parts of radix scrophulariae and 6 parts of fructus aurantii.
4. A method for preparing a compound preparation for treating low-risk pulmonary nodules according to any one of claims 1 to 3, comprising:
step 1, soaking the components for 0.5 to 1 hour;
step 2, adding water until the weight of the water is 2 times of the sum of the weight of the components, decocting for 15-20 minutes, and pouring out to obtain a first liquid medicine;
step 3, adding water again until the weight of the water is 2 times of the sum of the weight of the components, decocting for 30-40 minutes, and pouring out to obtain a second liquid medicine;
and step 4, combining the first liquid medicine and the second liquid medicine to obtain the compound preparation for treating the middle-low risk pulmonary nodules.
5. The method for preparing the compound preparation for treating the middle-low risk pulmonary nodules according to claim 4, comprising the steps of:
step 1, soaking each component for 1 hour;
step 2, adding water until the weight of the water is 2 times of the sum of the weight of the components, decocting for 15 minutes, and pouring out the water to serve as a first liquid medicine;
step 3, adding water again until the weight of the water is 2 times of the sum of the weight of the components, decocting for 30 minutes, and pouring out to obtain a second liquid medicine;
and step 4, combining the first liquid medicine and the second liquid medicine to obtain the compound preparation for treating the middle-low risk pulmonary nodules.
6. Use of a compound formulation according to any one of claims 1-3 for the treatment of medium-low risk pulmonary nodules in the manufacture of a medicament for the treatment of medium-low risk pulmonary nodules.
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