A kind of medicament for the treatment of gynaecopathia
Technical field: the present invention relates to a kind of medicament for the treatment of gynaecopathia, the medicament of the treatment gynaecopathia that particularly a kind of Main Ingredients and Appearance is a gossypol acetate.
Background technology:: gossypol from the seventies China this project as the case study of men's birth control medicine, by a large amount of research and experiment, gossypol is on probation first clinical from February, 1972 in Jiangsu, from then on acquisition has begun the clinical cooperative work of nationwide gossypol to the remarkable result of man's antifertility.Examination clothes 8806 examples gather by data altogether, and preparation gossypol antifertility effect is very remarkable, 5208 examples of wherein taking gossypol acetate, and effective percentage reaches 98.62%.But treat the gynopathic production that yet there are no with gossypol acetate, gynaecopathia is seriously perplexing numerous women, especially dysfunctional uterine hemorrhage, hysteromyoma, menorrhagia, endometriosis etc., according to domestic and international report, though treat these sick medicaments continuous listing is arranged, the gynaecopathia cure rate still has certain limit, some eutherapeutic medicament, the cost height, side effect is big, and the patient burden is heavy.
Summary of the invention: the purpose of this invention is to provide a kind of medicament for the treatment of gynaecopathia, its therapeutic effect is good, and side effect is little, production technology advanced person, and cost is low.
Technical scheme of the present invention: a kind of medicament for the treatment of gynaecopathia is provided, it is characterized in that: it mainly comprises gossypol acetate (C
32H
34O
10) and adjuvant; Gossypol acetate 3%-80% wherein.
Described adjuvant is starch and dextrin.
The medicament of described treatment gynaecopathia is: gossypol acetate 3%-5%; Potassium chloride 56%-64%; Vitamin B1 2%-3%; Vitamin B6 2%-3%; Starch 12%-15%; Dextrin 10%-18%.
The medicament of described treatment gynaecopathia is: gossypol acetate 5~20%; The Radix Astragali 15~50%; Radix Codonopsis 5~20%; Herba Leonuri 15~50%; Radix Angelicae Sinensis 5~20%; Herba Ecliptae 5~20%; Concha Ostreae 10~40%; Radix Curcumae 5~20%.
Described gossypol acetate (the C that mainly comprises
32H
34O
10) medicament, can be used for treating menorrhagia and hysteromyoma.
Described gossypol acetate (the C that mainly comprises
32H
34O
10) medicament, can be used for treating women's dysfunctional uterine hemorrhage.
Described gossypol acetate (the C that mainly comprises
32H
34O
10) medicament, can be used for treating cyclomastopathy.
Described gossypol acetate (the C that mainly comprises
32H
34O
10) medicament, can be used for the treatment and endometriosis.
The medicament production method of described treatment gynaecopathia is: the method with acetone hot reflux-acetic acid recrystallization extracts the gossypol acetate in the Semen Gossypii earlier, add adjuvant method routinely after the medicament mixed with gossypol acetate and other composition and make tablet or soft capsule, also can make drop pill or injection.
The method of described acetone hot reflux-acetic acid recrystallization is after Semen Gossypii is pulverized, put heat in the multi-function extractor 35 ℃-50 ℃ reflux, extract, 3-4 hour, extracting solution adds the cold crystallize of putting of glacial acetic acid, re-refine gossypol acetate.
Characteristics of the present invention: the medicament of this treatment gynaecopathia, mainly containing effective constituent is gossypol acetate, add adjuvant with purified gossypol acetate and make a kind of compound preparation of gynaecopathia for the treatment of for oral, its pharmacological action is: gossypol acetate can reduce endometrial cell slurry estradiol receptor quantity, reduces the estrogen organ to reactions female, progestogen; Also can act on ovary, ovarian hormone is descended, weaken negative feedback, strengthen pituitary function; Also suppress endometrial growth and prostaglandin thereof and generate, the cotton ketone of its metabolite can suppress the growth of body hormone.So can cause dysfunctional uterine hemorrhage patient atrophy of endometrium, inner membrance degeneration and short time amenorrhea.Gossypol acetate is a kind of complex salt of gossypol and acetic acid, and it has more safety, reliable, steady quality, gossypol acetate and potassium chloride; Vitamin B1, vitamin B6 mix preparation help to alleviate the side effect of gossypol and improve its stability, and the Radix Astragali, Radix Codonopsis, Herba Leonuri, Radix Angelicae Sinensis, Herba Ecliptae, Concha Ostreae, Radix Curcumae mix preparation are to treatment gynaecopathia better effects if.It not only is adapted to male contraception, also is highly suitable for women's dysfunctional uterine hemorrhage, hysteromyoma, cyclomastopathy, menorrhagia and endometriosis.Its gossypol acetate composition is produced by the hot pressing acetone after improving-acetic acid crystallization process, and is easy and simple to handle, utilization rate is high, cost is low, quality is good.
Gossypol is used as the interior disposable injection of rat uterine cavity with in the process of the test that reaches the antiearly pregnancy purpose, the Ultrastructural variation of endometrium and main organs.Test shows that rat endometrium epithelial cell, glandular cell, decidual cell all have damage in various degree.But gossypol is to the basic nonhazardous effect of rat internal organs cell, and the Change of Ultrastructure that causes of rat endometrium damaged cell, and majority is reversible, can progressively repair.The disposable in utero administration of evidence gossypol is a kind of more safe and effective antiearly pregnancy method, and function synthetic to ovary and the secretion progesterone does not have influence substantially.
Toxicological experiment: ameba Salmonella standard testing strain A98,100,1535,1537,1538, inductive rats'liver S9 activation system is not a mutagens.Take standard dose gossypol 30-48 month, nucleolar organizing region's number or acrocentric distributed did not have obviously influence.The not induced chromosome distortion of gossypol clinical dosage concentration.13 routine male take the gossypol 2 years of contraception dosage, compare with 12 example contrasts, and periphery lymphocyte micronucleus (MN) has rising slightly, but statistics is not remarkable.30 routine women take gossypol treatment in 6 months endometriosis, compare before and after taking medicine or with matched group, and their lymphocyte sister chromatids (SCE) is no significant difference all.Present evidence strong tendency is to finish its effect by the mechanism of a non-genotoxic in gossypol.
All more than 100ummol, promptly the high concentration gossypol interacts by enzyme relevant with the cell growth or functional protein and makes apoptosis deadly the gossypol concentration of inducing apoptosis of germ cells, the report of gossypol mutagenized cell neoplasm.At present do not find that as yet sexual cell has special apoptosis step, illustrate that sexual cell and somatic cell share same apoptosis mechanism.Imitate the rat test of human dosage form, the metabolism of discovery gossypol is to the normal diet group and lack all avirulence biochemical actions of protein energy group rat, and meaningfully gossypol and metabolite thereof have participated in reducing the metabolism of body inner cholesterol.Along with gossypol dosage increases and prolongs medicine time continuously, the hypokalemia time of origin shifts to an earlier date, and sickness rate also increases, and reduces the gossypol composition with potassium chloride, vitamin B1, vitamin B6 confection, can avoid hypokalemia and hypokalemia to take place.
Adopting gossypol-PVP effervescent tablet test, is that 25 times of amounts of human are included the rabbit intravaginal in dosage, and the result does not see that rabbit presents general toxic reaction.
The observed side reaction of relevant gossypol treatment gynaecopathia:
The medical college second Affiliated Hospital department of obstetrics and gynecology in Wuhan are used gossypol acetate and are treated 106 examples, patient's every day oral gossypol acetate 20mg, 1 month is 1 course of treatment, according to circumstances takes continuously 1-5 month, gossypol 0.54-2.7g is taken in accumulation.106 routine blood, routine urinalysis are all no abnormal.Person's 35 examples (33%) fully do not have no side effect.1 routine functional check ALT raises, and takes a turn for the better behind short term therapy.Serious side reaction appears in 5 examples (4.7%), and based on gastrointestinal symptom and weak, wherein 3 routine blood potassium are near lower bound, and it is not low that other 2 examples are burnt the obvious person's blood of hotness potassium.Once amenorrhea person's 62 examples, half drug withdrawal 3-6 month warp again naturally, multiple is patient more than 40 years old through the time above 6 months person overwhelming majority.Side reaction is many to be occurred 2-3 the course of treatment.
The specific embodiment
Extracting method:
Get Semen Gossypii and be pressed into dregs of rice pie, put in the multi-function extractor, in this multi-function extractor condensing unit is arranged, it can carry out the acetone hot reflux, and can extract volatile component.Doubly measure the aqueous acetone solution soak at room temperature 1 hour of 75-78% with volume 1-2, the 40 ℃ of reflux, extract, of heating again 3 hours are emitted acetone extract, the glacial acetic acid that adds 1/3 volume, mix the back and put 8 hours, separate out orange-yellow gossypol acetate, the crystallization of leaching crude product in the subzero essence.Discard residual solution behind the mother solution reclaim under reduced pressure acetone.Secondary is got in the aqueous acetone solution lixiviate of Semen Gossypii core slag reusable 75-80% emit acetone soln in above-mentioned production process after, and secondary raffinate is done following jar of extraction and applied mechanically, and useless cottonseed meal is by vapor recovery acetone; The acetone reusable that extracts, Semen Gossypii core slag are got oil and are made fertilizer.
Transform refining:
(1) gets the gossypol acetate crude product, with saturated, the filtration of an amount of dissolving of analytical pure acetone, under constantly stirring, add glacial acetic acid (analytical pure) and add in filtrate that solution is complete to become little turbid, place room temperature and change refrigerator 2 hours after 2 hours over to, with buchner funnel decompression leaching crystallization, with 30 ℃ of-60 ℃ of washings of a small amount of petroleum ether boiling range, promptly get more purified gossypol acetate.
(2) the above-mentioned gossypol acetate ether dissolution that does not contain peroxide that makes, filter, low temperature is below 55 ℃ or reduce pressure, concentrate the recovery ether, to original volume 2/3rds, the cooling back adds glacial acetic acid (analytical pure) and becomes little turbid to solution is complete under stirring condition, room temperature was placed 2 hours, relay refrigerator after 2 hours, with the buchner funnel leaching of reducing pressure, with 30 ℃ of-60 ℃ of washings of a small amount of petroleum ether boiling range, put the lucifuge place after doing, put into 40 ℃ of vacuum drying oven low temperature again, promptly got pure gossypol acetate in 4-8 hour in the vacuum under pressure drying of 0.05Mpa.
Getting medicament mixed after gossypol acetate that acetone-acid system makes and other composition are pulverized at last and add that supplementary product starch method routinely is synthetic makes tablet or injection, also can be soft capsule or drop pill.
The prescription of specific embodiment is as follows:
Embodiment 1: get gossypol acetate 100g, potassium chloride 2000g, 80g vitamin B1,80g vitamin B6, starch 500g, dextrin 300g and make 10000 as stated above altogether, cure mainly: dysfunctional uterine hemorrhage, hysteromyoma, menorrhagia, endometriosis.
The tablet of Application Example 1 treatment anovulatory dysfunctional uterine hemorrhage 32 examples, hysteromyoma bimonthly menses are through too much 57 examples, endometriosis 17 examples, and it counts 106 examples.Therapeutic scheme is 2 in an oral above-mentioned tablet, every day 2 times, once a day, according to circumstances successive administration 1-5 month, the result treated anovulatory dysfunctional uterine hemorrhage effective percentage 92.98%, treatment endometriosis effective percentage 100%, before 5 examples are used this medicines treatment in the endometriosis test group, once adopted pseudo pregnancy therapy treatment 2-4 month invalid, and 1 routine hypertension, 2 routine abnormal liver function (ALT rising), 2 examples are used testosterone propionate and are caused virilism.This illustrates that to a certain extent this medicine treatment endometriosis is better than pseudo pregnancy therapy.In 106 examples about 1/3rd patients to take medicine 1 month be onset, about 1/2nd patients onset in 2 months of taking medicine, only small number of patients need be taken medicine 4 months continuously.
Embodiment 2: get gossypol acetate 15%, the Radix Astragali 20%, Radix Codonopsis 5%, Herba Leonuri 20%, Radix Angelicae Sinensis 10%, Herba Ecliptae 6%, Concha Ostreae 14%, Radix Curcumae 10% by weight, make 10000 altogether.Cure mainly: dysfunctional uterine hemorrhage, uterus tumor, cyclomastopathy, menorrhagia, endometriosis.
Tablet treatment anovulatory dysfunctional uterine hemorrhage 36 examples of Application Example 2, hysteromyoma 6 examples, endometriosis 5 examples amount to 47 examples.Therapeutic scheme is oral tablets every day (20mg) a slice; Subtract 20mg after 60 days weekly until maintenance dose 2 times weekly, each 20mg; Kept 2-5 month.The result treats anovulatory dysfunctional uterine hemorrhage effective percentage 81.18%, treatment hysteromyoma effective percentage 83.3%, treatment endometriosis effective percentage 100%, to take medicine 1 month be onset to 17 examples in 47 examples, the onset in 2 months of taking medicine of 14 examples, the 10 examples onset in 3 months of taking medicine, only 2 examples need be taken medicine 4 months continuously.
The tablet treatment hysteromyoma bimonthly menses of Application Example 2 is through too much waiting gynaecopathia patient 53 examples, and oral tablets 1 time every day (20mg) changes maintenance dose 2 times weekly after 60 days, occur changing 1-2 time weekly after the amenorrhea, each 20mg; Kept altogether 6 months, total effective rate 84.9% as a result, and treatment hysteromyoma bimonthly menses is through too much effective percentage 84.4%.
Embodiment 3 makes 10000 tablets by weight synthesizing with gossypol acetate 76% supplementary product starch 24% method routinely.
Use gossypol treatment menorrhagia 148 examples, hysteromyoma 88 examples, endometriosis and gland flesh disease 26 examples amount to 262 examples, and therapeutic scheme is an oral gossypol acetate 1 time every day (20mg), changes maintenance dose after 60 days 2 times weekly, each 20mg, drug withdrawal after 3 months.Total effective rate 84.7% as a result, the treatment patients with uterine myoma, reduce in respect of efficient 93.2% by menstrual blood volume, dwindle in respect of efficient 36.4% by hysteromyoma, treatment endometriosis and gland flesh disease, take a turn for the better in respect of efficient 88.5% by dysmenorrhea, press rumpbone ligament tuberosity and touch a tender spot improvement in respect of efficient 84.6%.Treatment endometriosis and gland flesh disease are the shortest the course of treatment, and pain can alleviate in one month.Use gossypol treatment patients with uterine myoma 39 examples, total effective rate 87.18% is better than matched group.The control group medroxyprogestetone acetate treatment hysteromyoma 14 examples, total effective rate 50%
Treatment gynaecopathia patient 47 examples, patient's every day oral gossypol acetate 20mg, up to maintenance dose 2 times weekly, 20mg kept 2-5 month weekly.Slight dizziness, stomach poor appetite, nauseating, edema, weak appear in the initial partly patient that takes medicine, but the tolerance of patient's multipotency can disappear behind short-term regulation or the symptomatic treatment.Because of the conventional kalium replenishment 1g of test group, (3 times on the 1st), serious hypokalemia phenomenon appears in the end.Extremity were seriously unable after 1 example was taken medicine 3 months, changed maintenance dose into and continued kalium replenishment, transference cure.The maintenance dose of indivedual case histories changes into 1 time weekly, 20mg, and extend to 10-12 month total course of treatment, severe reaction do not occur.
In sum, gossypol treatment anovulatory dysfunctional uterine hemorrhage, hysteromyoma bimonthly menses are through too much and endometriosis, and fast, the short treating period of super effect all has superiority than operative treatment, androgen and pseudo pregnancy therapy.With " every days 20 gossypol dosage, 1 month be 1 course of treatment, auxiliary simultaneously kalium replenishment and polydipsia are eaten rich potassium; Carried out the treatment of second course of treatment in case of necessity at interval in 1 month again " be gynaecopathias such as therapeutic regimen, treatment endometriosis, be safe, relevant side effect is to alleviate or to cooperate the medicine of other composition avoidable.