CN103263641B - 一种护理预防子宫内膜异位症术后复发的药物组合物 - Google Patents
一种护理预防子宫内膜异位症术后复发的药物组合物 Download PDFInfo
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Abstract
本发明公开了一种护理预防子宫内膜异位症术后复发的药物组合物，涉及中药技术领域。其由如下重量份的中药材制备而成：丹参15-25份，牛蒡子15-25份，桑叶15-25份，当归12-20份，红花12-20份，血竭12-20份，莪术12-20份，益母草12-20份。采用本发明的中药组合物灌肠治疗后，患者的疼痛消失率较高，无副作用发生，几乎无复发，取得了显著的治疗效果。
Description
技术领域
本发明属于中医药技术领域，具体涉及一种预防子宫内膜异位症术后复发的药物组合物。
背景技术
子宫内膜异位症现已成为妇科常见病，目前治疗的最佳手段是根治性手术，术后复发率低，但手术切除了子宫，故不适合未生育或年轻的患者。保守或半保守手术可保留卵巢功能和生育功能，但术后易复发。孕三烯酮是睾酮类衍生物，是目前临床上常来治疗子宫内膜异位症的西药之一，疗效确切。然而，预防子宫内膜异位症复发的西药普遍存在价格昂贵、不良反应多、停药后复发率高，受孕率低等问题。在内分泌及免疫调节方面，中药相比西药具有显著的优势，避免了术后使用西药而影响最佳受孕时间，具有较好的应用前景。因此，开发一种成本低、副作用小、预防子宫内膜异位症术后复发的中药显得很有必要。
发明内容
本发明根据传统中医理论，经过对药物组分的大量筛选、重组、尝试、又通过大量实验研究作出的。因此，本发明的目的在于通过对传统药物药理进行研究后重新组方，提供一种疗效好、见效快、花费少的预防子宫内膜异位症术后复发的药物组合物。
本发明的目的是这样实现的：
本发明一种护理预防子宫内膜异位症术后复发的药物组合物，由如下重量份的中药材原料制备而成：丹参15-25份，牛蒡子15-25份，桑叶15-25份，当归12-20份，红花12-20份，血竭12-20份，莪术12-20份，益母草12-20份。
上述的护理预防子宫内膜异位症术后复发的药物组合物，由如下重量份的中药材原料制备而成：丹参20份，牛蒡子20份，桑叶20份，当归16份，红花16份，血竭16份，莪术16份，益母草16份。
优选地，上述的护理预防子宫内膜异位症术后复发的药物组合物，它为外用制剂。
进一步优选地，上述护理的预防子宫内膜异位症术后复发的药物组合物，它为中药灌肠液。
根据中医药史料记载，上述药物材的药理活性如下：
丹参：具有活血调经，祛瘀止痛，凉血消痈，清心除烦，养血安神的功效。主治月经不调，经闭痛经， 症瘕积聚，胸腹刺痛，热痹疼痛，疮疡肿痛，心烦不眠；肝脾肿大，心绞痛。选用双子叶植物唇形科 Labiatae鼠尾草属植物丹参 Salvia miltiorrhiza Bge. 的干燥根。
牛蒡子：具有疏散风热、宣肺透疹、利咽散结、解毒消肿的功效，主治风热咳嗽、咽喉肿痛、斑疹不透、风疹瘙痒、疮疡肿毒。选自菊科植物牛蒡Arctium lappa L.的干燥成熟果实。
桑叶：具有疏散风热，清肺润燥，平抑肝阳，清肝明目，凉血止血的功效。选用桑科 Moraceae 植物桑 Morus alba L. 的干燥叶。
当归：补血活血，调经止痛，润肠通便。用于血虚萎黄、眩晕心悸、月经不调、经闭痛经、虚寒腹痛、肠燥便秘、风湿痹痛、跌扑损伤、痈疽疮疡。选用伞形科植物当归Angelica sinensis (Oliv.) Diels 的干燥根。
红花：具有活血通径、散瘀止痛的功效。用于经闭、痛经、恶露不行、症瘕痞块、跌打损伤。选用菊科植物红花Carthamus tinctorius L.的筒状花冠。
血竭：内服活血散瘀，定痛，外用止血生肌，敛疮。主治：①淤血经闭、痛经，产后瘀阻。②症瘕痞块，胸腹刺痛。③跌打损伤，淤血肿痛。④外伤出血，溃疡不敛。选自百合科剑叶龙血树或柬埔寨龙血树树脂。
莪术：行气破血，消积止痛。用于燀瘕痞块，瘀血经闭，食积胀痛；早期宫颈癌。选用姜科植物桂莪术Curcuam kwangsiensis S.G.Leset C.F.Liang的根茎。
益母草：活血调经，用于血滞经闭、痛经、经行不畅，产后恶露不尽、瘀滞腹痛。唇形科植物益母草Leonurus japonicus Houtt. 的新鲜或干燥地上部分。
本发明的药物组合物用于患者的预防或治疗子宫内膜异位症术后复发时，采用的是灌肠护理疗法，治疗期间需注意如下事项：（1）灌肠前应耐心向病人讲解灌肠目的，了解病人思想，多方给予安慰，解除顾虑，紧张的心里。并注意病室环境的安静、清洁、舒适、使病人身心愉快。（2）取100mL灌肠液，患者取右侧卧位,用16号尿管1根插入肛门5-6厘米，接上吊瓶缓慢让药涂灌注在直肠内，右侧卧位20分钟后再平卧20分钟，避免药液进入乙状结肠。灌注时间：月经来潮前2天开始，直到月经干净天停药，隔日1剂，5个月经周期为一个疗程，休息1个月再开始第2个疗程。（3）灌肠液温度要适宜，切勿过热过凉，一般以38～40℃为宜。（4）拔出肛管后，手持软纸轻轻按柔肛门处，并嘱患者平卧休息，以利药物充分吸收。（5）排气后用温开水清洁臀部及肛门，保持床单、衣裤清洁，干燥。
将上述各中药材制备成中药灌肠液的制备方法为：
（1）取处方量的丹参15-25份，牛蒡子15-25份，桑叶15-25份，当归12-20份，红花12-20份，血竭12-20份，莪术12-20份，益母草12-20份，洗净去杂，晾干，粉碎成颗粒；（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1-1.2h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材8-12倍量的水，煎煮2h，取煎液，滤过，第二次加总药材6-10倍量的水，煎煮2h，取两次煎液合并，滤过，浓缩至90℃时相对密度（相比水）为1.10-1.15的浓缩液；（3）将浓缩液置0-5℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含0.5g生药量，得灌肠液。
采用本发明的中药组合物灌肠治疗后，患者的疼痛消失率较高，无副作用发生，几乎无复发，取得了显著的治疗效果。
具体实施方式
以下是本发明的具体实施例，对本发明的技术方案做进一步作描述，但是本发明的保护范围并不限于这些实施例。凡是不背离本发明构思的改变或等同替代均包括在本发明的保护范围之内。
实施例1
生药处方：丹参200克，牛蒡子200克，桑叶200克，当归160克，红花160克，血竭160克，莪术160克，益母草160克。
制备工艺：
（1）称取处方量的上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材10倍量的水，煎煮2h，取煎液，滤过，第二次加总药材8倍量的水，煎煮2h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置4℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含0.5g生药量，得灌肠液。
实施例2
生药处方：丹参150克，牛蒡子250克，桑叶200克，当归200克，红花120克，血竭200克，莪术160克，益母草200克。
制备工艺：
（1）称取处方量的上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材12倍量的水，煎煮2h，取煎液，滤过，第二次加总药材10倍量的水，煎煮2h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.10的浓缩液；
（3）将浓缩液置2℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含0.5g生药量，得灌肠液。
实施例3
生药处方：丹参250克，牛蒡子200克，桑叶180克，当归120克，红花160克，血竭120克，莪术200克，益母草120克。
制备工艺：
（1）称取处方量的上述中药材，洗净去杂，晾干，粉碎成颗粒；
（2）再将上述颗粒状药材加水漫过药面2cm，浸泡1h，捞出药材置多功能提取灌中加水煎煮二次，第一次加总药材10倍量的水，煎煮2h，取煎液，滤过，第二次加总药材10倍量的水，煎煮2h，取两次煎液合并，滤过，浓缩至90℃时相对密度为1.15的浓缩液；
（3）将浓缩液置5℃低温冷藏24h，将冷藏液加0.3%的助滤剂硅藻土，滤过，滤液再浓缩至每毫升含0.5g生药量，得灌肠液。
实施例4
59例行保守或半保守手术、并经病理检查证实为子宫内膜异位症的患者，年龄24～41岁，平均年龄(34.6±3.9)岁，平均病程(3.3±1.8)年。术后，按就诊顺序将59例患者随机分为两组，一组为西药组（29例），一组为中药组（30例），两组在性别、平均年龄和平均病程上差别不大，不具有统计学意义。
西药组：术后第7d开始口服孕三烯酮，每次2.5mg，每周2次，疗程为6周。
中药组：术后取按本发明实施例1制备的灌肠液约100mL，患者取右侧卧位,用16号尿管1根插入肛门5-6厘米，接上吊瓶缓慢让药涂灌注在直肠内，右侧卧位20分钟后再平卧20分钟，避免药液进入乙状结肠。灌注时间：月经来潮前2天开始，直到月经干净天停药，隔日1剂，5个月经周期为一个疗程，休息1个月再开始第2个疗程。
治疗后三个月复查如下项目：(1)观察记录患者自述疼痛症状，如痛经、性交痛等；(2)B超及妇科其他检查，观察患者体征缓解情况；(3)观察药物是否有不良反应；(4)有无复发。复查结果见表1。
表1 两组疗效情况比较
根据治疗后的复查结果可以看出，经本发明的中药灌肠液治疗后，患者的疼痛情况消失率较高，无副作用发生，几乎无复发，优于西药孕三烯酮的治疗结果。
Claims (1)
1.一种护理预防子宫内膜异位症术后复发的药物组合物，其特征在于由如下重量份的中药材原料制备而成：丹参20份，牛蒡子20份，桑叶20份，当归16份，红花16份，血竭16份，莪术16份，益母草16份；所述的药物组合物为中药灌肠液。
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| CN102671108A (zh) * | 2011-03-07 | 2012-09-19 | 中国中医科学院广安门医院 | 一种中药药物组合物的用途 |
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