CN116850261B - 一种疏郁止咳方剂及其制备方法 - Google Patents

一种疏郁止咳方剂及其制备方法 Download PDF

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CN116850261B
CN116850261B CN202310951687.6A CN202310951687A CN116850261B CN 116850261 B CN116850261 B CN 116850261B CN 202310951687 A CN202310951687 A CN 202310951687A CN 116850261 B CN116850261 B CN 116850261B
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洪敏俐
黄小华
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Zhangzhou Traditional Chinese Medicine Hospital Of Fujian Province
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Abstract

本发明公开了一种一种疏郁止咳方剂及其制备方法。所述疏郁止咳方剂,包括以下重量份的组分:柴胡10‑15g、法半夏10g、太子参10g、黄芩10g、生姜10‑15 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。本发明提供的疏郁止咳方剂主治邪郁少阳,痰湿阻肺证引起的咳嗽,具有疏利少阳、燥湿化痰、利咽止咳的功效,该方治疗慢性咳嗽,可以通过降低咳嗽高敏性,减轻临床症状,以达到治疗作用。

Description

一种疏郁止咳方剂及其制备方法
技术领域
本发明属于中医制药技术领域,具体涉及一种疏郁止咳方剂及其制备方法。
背景技术
近年来,由于工业化及城市化的不断进展,大气污染等环境问题逐渐突出,加上生活节奏加快,生活压力增加,慢性咳嗽的发病率也呈逐年上升趋势。美国一项研究表明,约40%人口会出现慢性咳嗽。国内相关研究也表明在所有呼吸科就诊患者中,约10%~30%的患者以长期咳嗽为主诉就诊。慢性咳嗽严重影响患者的工作和生活,甚至会引起一些并发症,造成患者许多不必要的经济损失和心理负担。目前对慢性咳嗽的治疗,西医以针对病因治疗为主,针对不同病因已形成诊疗规范,然而我们在临床中仍可见部分患者经过规范检查和治疗后咳嗽症状仍不能改善,治疗效果欠佳,或停药后症状易反复或不良反应大于治疗效果等等问题。而中医论治咳嗽,辨证论治,灵活多变,疗效确凿,尤其对于西医治疗效果差的慢性咳嗽,更能凸显优势,因此充分发挥中医优势以提高临床疗效具有重要意义。
慢性咳嗽发病机制仍不明确,目前越来越多的研究表明,咳嗽高敏感性是其重要的病理生理机制,各种内外因导致的气道神经源性炎症是其发病的重要机制,由P物质(substance P, SP)、神经肽(neurokininA, NKA)、神经肽B(neurokininB, NKB)、降钙素基因相关肽(calcitonin gene-related peptide, CGRP)等神经肽引起的神经源性炎症在慢性咳嗽发病中起重要作用。近年来有研究显示中医药治疗慢性咳嗽的作用机制主要集中在抑制气道炎症,降低咳嗽敏感性。
发明内容
本发明的目的在于提供一种疏郁止咳方剂及其制备方法,从治疗前后患者临床症状、咳嗽敏感性变化等临床指标以评价其临床疗效,进一步研究疏郁止咳方对慢性咳嗽的作用机制,为临床应用提供科学依据。
为实现上述目的,本发明采用如下技术方案:
一种疏郁止咳方剂,包括以下重量份的组分:
柴胡10-15g、法半夏10g、太子参10g、黄芩10g、生姜10-15 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。
所述疏郁止咳方剂的制备方法如下:
1)按原料比例称取各药材,将药材浸泡于500~530mL水中,浸泡时间30~35min;
2)将浸泡后的药材进行一次煎煮,过滤,收集一级滤液和药渣;
一次煎煮过程将药材加热至沸腾,保持微沸直至一级滤液体积为200~210mL;
3)往药渣中加入400~430mL水进行二次煎煮,收集二级滤液;
二次煎煮过程将药渣加热至沸腾,保持微沸直至二级滤液体积为180~190mL;
4)合并一级滤液、二级滤液,得到疏郁止咳方药液,分2次服用。
本发明提供的疏郁止咳方剂主治:邪郁少阳,痰湿阻肺证引起的咳嗽。具有以下功效:疏利少阳,燥湿化痰,利咽止咳。
疏郁止咳方剂适用于以下临床病症:咳嗽、咽痒欲咳、遇风加重,痰白或淡黄,清嗓子或咽喉堵塞感,恶风怕冷、流清涕或鼻后滴流,口干口苦,胸闷脘痞,纳食欠佳,大便偏干或大便溏薄,舌质淡红或红、苔白滑或白腻或白中带黄、脉弦或弦细或滑。
本发明提供的疏郁止咳方剂中,柴胡辛散苦泄,疏散少阳郁滞,黄芩苦寒清泄少阳邪热,二者合用,外透内泄,疏解少阳之邪,共为君;半夏辛温燥湿化痰,降逆止呕,厚朴苦辛温,燥湿消痰,行气开郁,下气除满,半夏与厚朴合用,一化痰结,一行气滞,共为臣;生姜辛散,温中降逆,散寒化饮,苏叶辛温解表散寒,和胃止呕,桔梗辛散苦泄,宣利肺气;茯苓健脾利湿,太子参,生姜、大枣,炙甘草健脾和中;更加蝉蜕祛风解痉利咽,牛蒡子利咽化痰。太子参、生姜、灸甘草、大枣、茯苓、紫苏叶、桔梗、牛蒡子、蝉蜕共为佐使。柴胡、黄芩、厚朴苦降,生姜、半夏、苏叶、桔梗辛开散邪,复有参枣草甘温调补脾胃,诸药合用,清解少阳郁热,下气除满,健脾和中,调达上下,宣通内外,共奏疏利少阳,燥湿化痰,利咽止咳之功。
本发明提供的疏郁止咳方治疗慢性咳嗽,可以通过降低咳嗽高敏性,减轻临床症状,以达到治疗作用。
实施方式
一种疏郁止咳方剂,包括以下重量份的组分:
柴胡10-15g、法半夏10g、太子参10g、黄芩10g、生姜10-15 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。
所述疏郁止咳方剂的制备方法如下:
1)按原料比例称取各药材,将药材浸泡于500~530mL水中,浸泡时间30~35min;
2)将浸泡后的药材进行一次煎煮,过滤,收集一级滤液和药渣;
一次煎煮过程将药材加热至沸腾,保持微沸直至一级滤液体积为200~210mL;
3)往药渣中加入400~430mL水进行二次煎煮,收集二级滤液;
二次煎煮过程将药渣加热至沸腾,保持微沸直至二级滤液体积为180~190mL;
4)合并一级滤液、二级滤液,得到疏郁止咳方药液,分2次服用。
实施例1
一种疏郁止咳方剂,包括以下组分:柴胡10g、法半夏10g、太子参10g、黄芩10g、生姜10 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。
所述疏郁止咳方剂的制备方法如下:
1)将上述药材浸泡于500mL水中,浸泡时间30min;
2)将浸泡后的药材加热至沸腾,保持微沸,然后过滤,收集一级滤液(200mL)和药渣;
3)往药渣中加入400mL水,加热至沸腾,保持微沸,然后过滤收集二级滤液(180mL);
4)合并一级滤液、二级滤液,得到疏郁止咳药液,分2次服用。
使用实施例1的疏郁止咳药液治疗的典型病例如下:
案例1
患者:蓝某,女,32岁,教师。
2020.04.22初诊:反复咳嗽2月余。缘于患者2月余前始出现咳嗽咳痰,夜间咳甚,遇冷风及刺激性气味时咳嗽加剧,说话时咽痒欲咳,痰量少色白,易咳出,伴咽干咽痒,咽部堵塞感,呼吸不畅感,打喷嚏,曾就诊于漳州当地县医院,查胸片未见明显异常,口服药物(具体不详)后症状未明显改善。辰下:咳嗽,夜间尤甚,痰少色白,咽干咽痒,口干口苦,纳少,寐佳,二便尚调,舌淡红尖有点刺,苔薄白,脉弦细。辅助检查:肺功能:通气功能正常,小气道障碍,支气管激发试验阳性。FeNO:56ppb。皮肤点刺试验:粉尘螨、屋尘螨、蟑螂(+++),蟹肉(++)。西医诊断:咳嗽变异性哮喘,中医诊断:久咳,证属邪郁少阳,痰湿阻肺,治以疏郁止咳方疏利少阳,燥湿化痰,利咽止咳。
处方如下:
柴胡10g 黄芩10g 半夏10g 太子参10g
厚朴10g 茯苓15g 紫苏叶6g 蝉蜕6g
桔梗10g 大枣10g 炙甘草5g 生姜10g 牛蒡子10g
×5剂,水煎服,日1剂,上药味以水500ml先浸泡半小时,煎取200ml,药渣以水400ml,煎取180ml。两次药液混合分2次服。
2020.04.29二诊:患者咳嗽、咽部堵塞感缓解,偶呼吸不畅,遇冷流清涕,无口干口苦,纳可,寐欠安,二便调,舌淡红,苔薄白。效不更方,续予疏郁止咳方加白术、薏苡仁健脾化湿,调理而愈。
实施例2
一种疏郁止咳方剂,包括以下组分:柴胡10g、法半夏10g、太子参10g、黄芩10g、生姜15 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。
所述疏郁止咳方剂的制备方法如下:
1)将上述药材浸泡于500mL水中,浸泡时间30min;
2)将浸泡后的药材加热至沸腾,保持微沸,然后过滤,收集一级滤液(200mL)和药渣;
3)往药渣中加入400mL水,加热至沸腾,保持微沸,然后过滤收集二级滤液(180mL);
4)合并一级滤液、二级滤液,得到疏郁止咳药液,分2次服用。
使用实施例2的疏郁止咳药液治疗的典型病例如下:
案例2
黄某某,男,49岁
2023.05.24一诊:新型冠状病毒感染后咽痒引咳5月余。患者5月余前不慎感染新冠病毒后遗留咽痒引咳,干咳为主,午后3-5点明显,咳时胸闷,无闻及刺激性气味加剧,多次就诊外院,口服中药(具体不详)后症稍减,但仍迁延,来诊我科。辰下:咽痒,干咳,午后3-5点明显,咳甚胸闷,夜间口苦,纳寐可,二便调。PE:舌偏红苔微黄中厚,脉弦,咽稍充血。辅助检查:肺功能正常,支气管激发试验(-),FeNO:12ppb,咳嗽敏感性试验:C5:125μmol/L。中医诊断:咳嗽,证属邪郁少阳、痰湿阻肺,治以疏郁止咳方疏利少阳,燥湿化痰,利咽止咳。
柴胡10g 黄芩10g 法半夏10g 太子参10g
大枣10g 茯苓15g 紫苏叶6g 厚朴10g
桔梗10g 牛蒡子10g 蝉蜕6g 生姜15g 灸甘草5g
日1剂,水煎服,×5剂。
上药味以水500ml先浸泡半小时,煎取200ml,药渣以水400ml,煎取180ml。两次药液混合分2次服。
2023.05.29二诊:上药后咳嗽减少,夜间干咳,口干,二便调。PE:舌淡红苔薄白,脉弦。守上方,柴胡15g。日1剂,水煎服,煎服法同前。×7剂
2023.06.05三诊:基本无咳嗽,无咳痰,无口干苦,纳寐可,二便调,舌淡红苔薄白脉弦。守疏郁止咳方治疗10天,诸症缓解。复查:咳嗽敏感性试验:C5:250μmol/L,咳嗽敏感性明显降低。
实施例3
一种疏郁止咳方剂,包括以下组分:柴胡10g、法半夏10g、太子参10g、黄芩10g、生姜10 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g。
所述疏郁止咳方剂的制备方法如下:
1)将上述药材浸泡于500mL水中,浸泡时间30min;
2)将浸泡后的药材加热至沸腾,保持微沸,然后过滤,收集一级滤液(200mL)和药渣;
3)往药渣中加入400mL水,加热至沸腾,保持微沸,然后过滤收集二级滤液(180mL);
4)合并一级滤液、二级滤液,得到疏郁止咳药液,分2次服用。
使用实施例3的疏郁止咳药液治疗的典型病例如下:
案例3
洪某,女,50岁。
2019.08.05初诊:反复咳嗽、咳痰9年余,加剧10天。缘于患者9年余前始出现咳嗽咳痰,清嗓样咳,咽痒即咳,闻及刺激性气味或饮水后即咳,进食寒凉食物即咳,痰量少,色白质稀,咳剧伴清涕,无胸闷气喘,无鼻后滴流,无反酸嗳气,就诊多处服用中药后稍缓解,但仍反复咳嗽。自觉近10天咳嗽咳痰加剧,痰白稀,咽部异物感,口干口苦,纳寐尚可,小便调,大便偏稀,一日一行,舌边尖红苔薄白微黄,脉弦细。查体:咽无充血。辅助检查:胸部CT示肺气肿改变;肺功能检查(2017.9.18)):正常通气功能,支气管激发试验阴性。西医诊断:慢性咳嗽查因;中医诊断:中医诊断:咳嗽,证属邪郁少阳、痰湿阻肺,治以疏郁止咳方疏利少阳,燥湿化痰,利咽止咳。
柴胡10g 黄芩10g 法半夏10g 太子参10g
大枣10g 茯苓15g 紫苏叶6g 厚朴10g
桔梗10g 牛蒡子10g 蝉蜕6g 生姜10g 灸甘草5g
日1剂,水煎服,×5剂。
上药味以水500ml先浸泡半小时,煎取200ml,药渣以水400ml,煎取180ml。两次药液混合分2次服。
2019.08.09二诊:服药后症状好转,咳嗽减轻,痰多白稠,咽痛,偶流清涕,无胸背痛,稍口苦,二便调,舌边尖红苔白厚稍黄。效不更方,续服7剂。
2019.08.23三诊:服药后明显改善,遇风偶有咳嗽,痰少,咽部异物感,稍口苦,二便调,舌淡红苔薄白,续予上方加白术调理而愈。

Claims (3)

1.一种疏郁止咳方剂,其特征在于,由以下重量份的组分组成:
柴胡10-15g、法半夏10g、太子参10g、黄芩10g、生姜10-15 g、灸甘草5g、大枣10g、厚朴10g、茯苓15g、紫苏叶6g、桔梗10g、牛蒡子10g、蝉蜕6g;
所述方剂的制备方法,包括以下步骤:
1)按原料比例称取各药材,将药材浸泡于500~530mL水中,浸泡时间30~35min;
2)将浸泡后的药材进行一次煎煮,过滤,收集一级滤液和药渣;
3)往药渣中加入400~430mL水进行二次煎煮,收集二级滤液;
4)合并一级滤液、二级滤液,得到疏郁止咳方药液,分2次服用。
2.根据权利要求1所述的疏郁止咳方剂,其特征在于,一次煎煮过程将药材加热至沸腾,保持微沸直至一级滤液体积为200~210mL。
3.根据权利要求1所述的疏郁止咳方剂,其特征在于,二次煎煮过程将药渣加热至沸腾,保持微沸直至二级滤液体积为180~190mL。
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