Summary of the invention
Be the gastric abscess that the treatment qi depression to blood stasis causes, disease is seen stomachache, after the meal or increase the weight of when hungry, localized pain or do not have fixed place, its pain show as angor, twinge, paroxysmal pain, severe pain etc., dark tongue quality, yellow and thin fur or thin white, stringy and thready pulse is puckery; And chronic gastritis etc. is seen and the person that has the above-mentioned symptom be the invention provides a kind of compound Chinese medicinal preparation for the treatment of gastric abscess and preparation method thereof.
The present invention is a kind of compound Chinese medicinal preparation for the treatment of gastric abscess, and it mainly makes active component by the alcohol and water of following raw materials according or following raw materials according or the extract of water, and described raw material is formed:
Fructus Litseae 335~755g, Fructus Toosendan 335~755g, Rhizoma Corydalis (processed with vinegar) 201~453g, Radix et Rhizoma Rhei (processed with wine) 100~227g, Rhizoma Coptidis 100~227g, Fructus Evodiae 50~114g, Rhizoma Cyperi (processed with vinegar) 335~755g, Fructus Citri 335~755g, Fructus Citri Sarcodactylis 201~453g, Endoconcha Sepiae 335~755g, calcine Concha Arcae 335~755g.
Raw material weight proportioning preferable in above-mentioned Chinese medicine is:
Fructus Litseae 419~604g, Fructus Toosendan 419~604g, Rhizoma Corydalis (processed with vinegar) 251~362g, Radix et Rhizoma Rhei (processed with wine) 125~181g, Rhizoma Coptidis 125~181g, Fructus Evodiae 63~91g, Rhizoma Cyperi (processed with vinegar) 419~604g, Fructus Citri 419~604g, Fructus Citri Sarcodactylis 251~362g, Endoconcha Sepiae 419~604g, calcine Concha Arcae 419~604g.
Best proportioning of the present invention is: Fructus Litseae 503g, Fructus Toosendan 503g, Rhizoma Corydalis (processed with vinegar) 302g, Radix et Rhizoma Rhei (processed with wine) 151g, Rhizoma Coptidis 151g, Fructus Evodiae 76g, Rhizoma Cyperi (processed with vinegar) 503g, Fructus Citri 503g, Fructus Citri Sarcodactylis 302g, Endoconcha Sepiae 503g, calcine Concha Arcae 503g.
Above-mentioned Chinese medicine preparation, it can be the dosage form of recording in any pharmacopeia such as granule, capsule, tablet or pill, the preparation of Chinese medicine preparation also can be carried out with reference to the method for conventional Chinese medicine preparation, but in order to improve drug effect, make things convenient for administration, compound Chinese medicinal preparation of the present invention preferably adopts following preparation method.
The preparation technology who above-mentioned Chinese medicine is made Chinese traditional compound medicine of the present invention is:
(1) take by weighing following traditional Chinese medicines and make raw material:
Fructus Litseae 335~755g, Fructus Toosendan 335~755g, Rhizoma Corydalis (processed with vinegar) 201~453g, Radix et Rhizoma Rhei (processed with wine) 100~227g, Rhizoma Coptidis 100~227g, Fructus Evodiae 50~114g, Rhizoma Cyperi (processed with vinegar) 335~755g, Fructus Citri 335~755g, Fructus Citri Sarcodactylis 201~453g, Endoconcha Sepiae 335~755g, calcine Concha Arcae 335~755g.
(2) with above-mentioned medical material alcohol and/or water reflux, the extracting solution that obtains is as active component.
(3), make required dosage form with above-mentioned active component.
Stasis in the side in the Fructus Litseae circulation of qi promoting; The stagnation of QI in the Rhizoma Corydalis promoting the circulation of blood; Rhizoma Cyperi goes into liver, the resolving depression pain relieving of regulating the flow of vital energy; The master goes into edema caused by disorder of QI, and stasis in the circulation of qi promoting of holding concurrently among the circulation of qi promoting is blood medicine in the gas.Fructus Toosendan, Rhizoma Corydalis, Rhizoma Cyperi three cooperate, can promoting blood circulation and stopping pain, and again can regulating the flow of QI to ease the stomach; Rhizoma Coptidis relieves inflammation or internal heat, the Fructus Evodiae resolving depression therapeutic method to keep the adverse QI flowing downwards, and harmonizing the liver and stomach, the two share, and has the effect of liver clearing and depression relieving, antacid.The then clear stagnant heat of compatibility Endoconcha Sepiae, Concha Arcae, antacid stomach function regulating effect is stronger; The Radix et Rhizoma Rhei (stir-fried with wine) merit is apt to purging FU-organs; The special warming middle-JIAO of Fructus Litseae merit, promoting the circulation of QI to relieve pain; Fructus Citri, Fructus Citri Sarcodactylis relieving distension pain relieving, Radix Et Rhizoma Rhei, Rhizoma Coptidis are the product of bitter cold in addition, match with the product of Fructus Litseae, Fructus Evodiae temperature suffering, have temperature clear and execute again, dispersing the stagnated pathogen with pungent drugs and lowering the adverse QI with bitter drugs wonderful.All medicine phases 5, the energy promote qi circulation opening stagnates, promoting blood circulation and stopping pain, soothing liver-QI for relieving depression, stomach function regulating antacid.In step (2), preferred hot reflux number of times is a secondary, and hot reflux liquid is water, and the hot reflux time is 2 hours for the first time, 1 hour for the second time, help the extraction of active ingredient, and give full play to curative effect, and make things convenient for administration.
The specific embodiment
Below by embodiment, the present invention is further described:
Embodiment one is the preparation of Chinese medicine granules a of the present invention
(1) presses column weight amount proportioning and take by weighing each component: Fructus Litseae 503g, Fructus Toosendan 503g, Rhizoma Corydalis (processed with vinegar) 302g, Radix et Rhizoma Rhei (processed with wine) 151g, Rhizoma Coptidis 151g, Fructus Evodiae 76g, Rhizoma Cyperi (processed with vinegar) 503g, Fructus Citri 503g, Fructus Citri Sarcodactylis 302g, Endoconcha Sepiae 503g, calcine Concha Arcae 503g.
(2) take by weighing each component by above-mentioned weight proportion, decoct with water secondary, 2 hours for the first time, 1 hour for the second time, merge decoction liquor, filter, filtrate is concentrated into the clear paste that relative density is 1.10~1.15 (60~70 ℃ of surveys), and is standby.
(3) get above-mentioned clear paste, it is an amount of to add dextrin, steviosin, hyprolose, makes about 1000g granule, promptly obtains the made Chinese medicine granules a of the present invention.Per 1 gram granule is equivalent to about 4 grams of raw medicinal herbs.
Embodiment two is the preparation of Chinese medicine granules b of the present invention
(1) presses column weight amount proportioning and take by weighing each component: Fructus Litseae 755g, Fructus Toosendan 755g, Rhizoma Corydalis (processed with vinegar) 453g, Radix et Rhizoma Rhei (processed with wine) 227g, Rhizoma Coptidis 227g, Fructus Evodiae 114g, Rhizoma Cyperi (processed with vinegar) 755g, Fructus Citri 755g, Fructus Citri Sarcodactylis 453g, Endoconcha Sepiae 755g, calcine Concha Arcae 755g.
(2) take by weighing each component by above-mentioned weight proportion, add 50% alcohol reflux secondary, for the first time add 8 times of amounts, reflux, extract, 2 hours adds 6 times of amounts for the second time, reflux, extract, 1 hour, merge extractive liquid, filters decompression filtrate recycling ethanol, and be concentrated into the clear paste that relative density is 1.08~1.15 (60~70 ℃ of surveys), standby.
(3) get above-mentioned clear paste, it is an amount of to add dextrin, steviosin, hyprolose, makes about 1000g granule, promptly obtains the made Chinese medicine granules b of the present invention.Per 1 gram granule is equivalent to about 6 grams of raw medicinal herbs.
Embodiment three is the preparation of Chinese medicine granules c of the present invention
(1) presses column weight amount proportioning and take by weighing each component: Fructus Litseae 335g, Fructus Toosendan 335g, Rhizoma Corydalis (processed with vinegar) 201g, Radix et Rhizoma Rhei (processed with wine) 100g, Rhizoma Coptidis 100g, Fructus Evodiae 50g, Rhizoma Cyperi (processed with vinegar) 335g, Fructus Citri 335g, Fructus Citri Sarcodactylis 201g, Endoconcha Sepiae 335g, calcine Concha Arcae 335g.
(2) take by weighing each component by above-mentioned weight proportion, Fructus Litseae, Fructus Toosendan, Rhizoma Corydalis, Rhizoma Coptidis add 65% alcohol reflux secondary, add for the first time 10 times of amounts, reflux, extract, 2 hours adds 7 times of amounts, reflux, extract, 1.5 hours for the second time, merge extractive liquid,, filter, decompression filtrate recycling ethanol, and be concentrated into the clear paste that relative density is 1.06~1.15 (60~70 ℃ of surveys); Other gets Radix Et Rhizoma Rhei, Fructus Evodiae, Rhizoma Cyperi, Fructus Citri, Fructus Citri Sarcodactylis, Endoconcha Sepiae, Concha Arcae and decocts with water three times, add for the first time 10 times of amounts, decocted 2 hours, and added 8 times of amounts for the second time, decocted 1.5 hours, add 6 times of amounts for the third time, decocted 1 hour, and merged decoction liquor, filter, filtrate is concentrated into the clear paste that relative density is 1.12~1.18 (60~70 ℃ of surveys), and is standby.
(3) get above-mentioned clear paste, it is an amount of to add dextrin, protein sugar, starch, microcrystalline Cellulose, makes about 1000g granule, promptly obtains the made Chinese medicine granules C of the present invention.Per 1 gram granule is equivalent to about 2.67 grams of raw medicinal herbs.
Embodiment four is the preparation of Chinese medicine compound capsule of the present invention
Press embodiment one described method, but the preparation method of extract obtained Chinese medicinal capsule routinely agent is made the 1000g capsule, packing promptly obtains the made capsule of the present invention.Per 1 gram capsule is equivalent to about 4 grams of raw medicinal herbs.
Embodiment five is the preparation of Chinese medicine compound tablet of the present invention
Press embodiment one described method, but the preparation method of extract obtained Chinese medicinal tablet is routinely made the 1000g tablet, promptly obtain the made tablet of the present invention.Per 1 gram tablet is equivalent to about 4 grams of raw medicinal herbs.
Embodiment six is the preparation of Chinese medicine compound pill of the present invention
Press embodiment one described method, but the preparation method of extract obtained medicine pill is routinely made the 1000g pill, promptly obtain the made pill of the present invention.Per 1 gram pill is equivalent to about 4 grams of raw medicinal herbs.
The animal acute toxicity test of animal embodiment one granule a of the present invention
Select 20 mices for use, with the dosage 42.5g/kg of maximum volume under the Cmax (be equivalent to approximately human dosage 250 times) gastric infusion, observed seven days, do not see animal dead, tissue, the obvious pathological changes of internal organs are not seen in the surviving animals postmortem, and the mouse peritoneal drug administration by injection is calculated as by Bliss method program: LD
50=6.28g/kgB (slope)=3.72LD
10The confidence limit of=5.80g/kg 95%: 6.12-6.44g/kg.
The long term toxicity test of animal embodiment two granule a of the present invention
The Sprague-Dawley rat was measured continuous gastric infusions three months for 5,20,50 times with suitable human dosage, result of the test: each treated animal body weight obviously increases, the body weight gain curve is good, does not have significant difference (P>0.05) between each group, does not see in the experiment that animal dead and other are unusual; Each group all has minority animal urine conventional visible trace albumin, small quantities of leukocytes and indivedual erythrocyte.Liver function: each is organized part animal GPT and slightly raises, but does not relatively have significant difference with matched group, and every inspections such as all the other routine blood tests, renal function all in normal range, relatively do not have significant difference with matched group.
Naked eyes and histological examination, the main organs of all animals are not seen to be had because of drug-induced pathological change, the weight coefficient of each treated animal main organs, and all in normal range, not statistically significant.
The Pharmacodynamic test of active extract of animal embodiment three granule a of the present invention
The formative method of having adopted with three kinds of experimental peptic ulcers (stress ulcer, gastric mucosa injury ulcer and Shay ' s pyloric ligation ulcer) is observed the therapeutical effect of granule a of the present invention to gastric abscess, the result shows that granule a of the present invention is better than matched group (P<0.01) and ranitidine significantly to the area and the ulcer lesion degree grade of stress ulcer, in the irritability test, though ulcer level and ulcer area be all less than matched group, equal not statistically significants.In the glacial acetic acid moulding, damage has significant preventive and therapeutic effect to visible granule a of the present invention to mucosal pattern.Ulcer level is compared with matched group, its ulcer area and volume, and all there were significant differences, with the ranitidine no significant difference.In addition, two serious gastric perforation death of animal (not included in) are arranged in the matched group, in Shay ' the s rat test, granule a of the present invention compares with matched group with ranitidine, all can reduce gastric secretion, rising gastric acidity, has remarkable or highly significant difference, and granule a of the present invention can reduce gastric enzyme vigor (P<0.01) significantly and is better than ranitidine, to Shay ' s rat ulcer curative effect, granule a of the present invention and ranitidine and matched group relatively have highly significant and significant difference, and granule a of the present invention slightly is better than ranitidine.
Mice hot plate method and two kinds of analgesic model of acetic acid twisting method are still used in this experiment, observed the analgesic activity of the granule a of the present invention of variable concentrations, the result shows, granule a of the present invention has certain analgesic activity, analgesic activity promptly appears in oral administration 20min, between the valid density scope 20%-50%, and strengthen, and keep 1h with its analgesic activity of the increase of dosage.Promptly occur analgesic activity behind the lumbar injection 15min, 30min reaches optimum curative effect, and significant analgesic activity is all arranged behind codeine oral administration and the lumbar injection; In turning round the body experiment due to the acetic acid, the granule a of the present invention of oral 40% above concentration has significant analgesia role, and keeps 1h, and obvious analgesic activity appears in 30min behind the aspirin oral administration, and keeps more than the 2h.
This experiment also used and exsomatized, in body intestinal tube smooth muscle self-disciplining shrinkage test method, observe the influence of variable concentrations granule a of the present invention to intestinal tube, strict control experiment condition in the experiment, room temperature, is led to and is mixed oxygen before the Botting nutritional solution faces usefulness at 15 ± 2 ℃, reagent pH transfers to about 7.0, influenced by body nerve and respiratory movement etc. in the test of body intestinal tube, alleviate intestinal tube to stir as far as possible, avoid the mesentery damage.Experiment method after prerun is stable, once can show contraction to gastrointestinal smooth muscle due to ileum contraction inhibitory action and the acetylcholine with spasmolytic medicine atropine.The above results shows: granule a of the present invention does not have the obvious suppression effect to mice intestinal ahead running, its effect increases with dosage, but and the intestinal tube smooth muscle contraction due to the antagonism acetylcholine, point out granule a of the present invention that gastrointestinal convulsion is had certain spasmolysis.
To sum up, granule a of the present invention can suppress the gastric enzyme secretion and reduce gastric acidity, reduces the gastric enzyme vigor, gastric mucosa injury is had significant protective effect, and have the effect of pain relieving and spasmolytic, points out the clinical control that can be used for peptic gastric ulcer.
The clinical trial of application examples one granule a treatment gastric abscess of the present invention
One, the randomized control study method is adopted in this research, and total qualified study subject 540 examples are divided into granule a of the present invention treatment at random and organize 333 examples, qizhi weitong granules agent matched group 207 examples.Whole research process adopts single blind method that study subject is observed, and in a hospital, carry out the observation of 1 course of treatment in week and 8 courses of treatment in week, in the hope of gastroscope results change, the pathological change of the gastric abscess (duodenal ulcer, chronic superficial gastritis) of caused by energy stagnation and blood stasis being made comparatively objectively real evaluation.
Result of study shows that total effective rate is 94.6% after 1 week of treatment group treatment, and produce effects and clinic control rate are 77.5%, and matched group is respectively 74.9%, 38.6%.Total effective rate 100% after 8 weeks of treatment, produce effects and clinic control rate are 87.7%, and matched group is respectively 72.2%, 29.7%.Two groups relatively, and difference has highly significant meaning (P<0.001).Point out granule a treatment gastric abscess total effects of the present invention obviously to be better than the qizhi weitong granules agent.
Granule a of the present invention compares with matched group the curative effect of the gastric abscess of simple Qi-stagnation type or qi stagnation and blood stasis type, a course of treatment in week with eight all courses of treatment difference highly significant meaning (P<0.001) is all arranged.Point out the curative effect of the gastric abscess that granule a of the present invention causes the stagnation of QI or qi depression to blood stasis also to be better than matched group.
Curative compares the curative effect of Qi-stagnation type, two kinds of syndromes of qi stagnation and blood stasis type, learns by statistics and handles, and difference does not have significance meaning (P=0.8622), points out granule a of the present invention similar to the gastralgia curative effect of the stagnation of QI or caused by energy stagnation and blood stasis.
Two, from the clinical indication efficacy analysis, compare with matched group, as onset time after taking medicine, 1 all recurrence situations after 1 course of treatment in week, the treatment group all is better than matched group, learns by statistics and handles, and difference has highly significant meaning (P<0.001).
Gastralgia, gastral cavity portion tenderness, diet is depressed, and symptom curative effects such as belch are compared with matched group, and the curative effect of the course of treatment in treatment group 1 week, 8 courses of treatment in week all is better than matched group, learns by statistics and handles, and difference has highly significant meaning (P<0.001).Shorten stomachache time curative effect 1 course of treatment in week, compares with matched group, and the treatment group is better than matched group, learns by statistics and handle, and difference has highly significant meaning (P<0.01).Point out the main clinical indication curative effect of granule a treatment syndrome of stagnation of QI of the present invention, syndrome of qi stagnation and blood stasis gastric abscess to be better than control drug.
Two groups to the acid regurgitation curative effect relatively, and difference does not have significance meaning (P>0.05), points out granule a of the present invention similar to control drug to acid regurgitation improvement effect.
Three, 8 week gastroscopy course of treatment results show, compare with matched group, after the treatment of treatment group, duodenal ulcer white fur number obviously reduces, the hyperemia of chronic superficial gastritis, edema, cell infiltration, mucus are adhered to etc. all and are obviously improved, learn by statistics and handle, difference has significance meaning (P<0.05).Duodenal ulcer area, mucosa swelling, aspects such as the gastric mucosa color change of chronic superficial gastritis, two groups are relatively, learn by statistics and handle, and difference does not have significance meaning (P>0.05).
8 the course of treatment in week pathological examination results show, with matched group relatively, treatment group treatment metaduodenum ulcer pathological staging is by A
1, A
2Phase is changed S into
1, S
2Phase is totally 13 examples, and conversion ratio is 52.0% (13/25), apparently higher than matched group 4.4% (1/23).Learn by statistics and handle, difference has highly significant meaning (P<0.01).And two groups of treatment metaduodenum ulcer pathological stagings are by A
1, A
2Phase is converted into H
1, H
2The conversion ratio of phase is relatively learned by statistics and is handled, and difference does not have significance meaning (P>0.05).Two groups of chronic superficial gastritis pathological examination results relatively, remove treatment group treatment back state of an illness classification improvement rate (86.1%, 31/36) apparently higher than matched group (24.0%, 6/25) outer (P<0.01), two groups of treatment back intestinal epithelial metaplasia improvement rates, learn to handle difference there are no significant meaning (P>0.05) by statistics.
The above results prompting granule a of the present invention can obviously improve duodenal ulcer, the most gastroscopys of chronic superficial gastritis, pathologic finding index after treating for 8 weeks.
Four, from picture of the tongue, pulse condition efficacy analysis, unusual picture of the tongue (purplish tongue, ecchymosis, the petechia) disappearance rate of treatment 8 week back treatment group is 61.5% (8/13), compare with matched group 18.2% (2/118), learn by statistics and handle, difference has significance meaning (P<0.05).
Five, after 1 course of treatment in week, drug withdrawal 1 all gastric abscess recurrence situation comparative results show that treatment group relapse rate is 9.2% (23/229), and matched group then is 18.1% (19/105).Two groups relatively, and difference has significance meaning (P<0.05).Point out granule a treatment gastric abscess one all relapse rates of the present invention to be starkly lower than the contrast medicine.
Six, 1 course of treatment in week, 8 the course of treatment in week the result show that granule of the present invention produce effects 1 course of treatment in week and clinic control rate are 84.6% (55/65), total effective rate is 98.5% (64/65); And 8 the week course of treatment produce effects and the clinic control rate be 87.7% (57/65), total effective rate is 100.0% (65/65).Two kinds of different course of treatment group compare, and difference does not have significance meaning (P>0.05).Since 1 the course of treatment in week curative effect determinate standard only require to treat the back cardinal symptom and improve, and the curative effect determinate standard of 8 courses of treatment in week also must have objective indicators such as gastroscopy, pathologic finding except that treatment back cardinal symptom is improved.So the curative effect determinate standard of 8 courses of treatment in week is than the 1 week curative effect determinate standard strictness course of treatment.Thereby the invention described above granule a treatment gastric abscess curative effect 1 course of treatment in week with 8 the course of treatment in week therapeutic equivalence the result comparatively reflect practical situation, and 8 all courses of treatment curative effect more objective.
Seven, from analysis of adverse reactions, this research is to treating the part patient in 1 week and 8 weeks of treatment, physico-chemical examination result before and after treating relatively, comprise projects such as routine blood test, stool routine examination, routine urinalysis, BUN, GPT, serum HP antibody, electrocardiogram, the result shows have that ventricular premature contraction appears in 1 example, 1 routine routine blood test is unusual, 1 routine routine urinalysis is unusual after the granule a of the present invention treatment; And have 4 routine routine blood tests unusual after the treatment of control group.
More than studies show that: granule a of the present invention has the effect of vital energy regualting and blood circulation-promoting, soothing liver-QI and Weishang pain.Being used for the treatment of Chinese medical discrimination belongs to the gastric abscess that qi depression to blood stasis causes clinical efficacy is preferably arranged.Be applicable to that cards such as duodenal ulcer, chronic superficial gastritis belong to syndrome of stagnation of QI, syndrome of qi stagnation and blood stasis person, disease is seen the gastral cavilty distending pain, or attacks and scurry two sides of body, or the stomachache tenderness, pain in fixed position is as stinging as cutting, or stomachache meets angry and recurrence or increase the weight of, belch or vow that gas then relaxes, lack of appetite uncomfortable in chest, general acid regurgitation water, bitter taste, dizzy, food back or stomachache at nightfall, the white or purplish tongue of tongue fur, or ecchymosis (point) is arranged, stringy and thready pulse etc. all can be used.This research clinical research design is rigorous, reasonable, more objective, confirmed that truly granule a of the present invention is that the gastric abscess that causes of a treatment qi depression to blood stasis is effective, and the Chinese medicine preparation of safety.