CN103623376A - 一种治疗三叉神经痛的药物及其制备方法 - Google Patents
一种治疗三叉神经痛的药物及其制备方法 Download PDFInfo
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Abstract
本发明公开了一种治疗三叉神经痛的药物及其制备方法,它主要是由蔓荆子、龙胆、生地黄、菊花、白芍、桑叶、川芎、生石膏等药物按一定重量配比制备而成,本发明药物具有宁心安神,活血通络,祛风解痉的功能,用于治疗三叉神经痛疗程短,见效快,治愈后不复发。
Description
技术领域
本发明涉及一种治疗三叉神经痛的药物及其制备方法,属中药领域。
技术背景
三叉神经痛是最常见的脑神经疾病之一,以一侧面部三叉神经分布区内反复发作的阵发性剧烈痛为主要表现。三叉神经痛多发生于中老年人,右侧多于左侧。该病的特点是:在头面部三叉神经分布区域内,发病骤发,骤停、闪电样、刀割样、烧灼样、顽固性、难以忍受的剧烈性疼痛。说话、洗脸、刷牙或微风拂面,甚至走路时都会导致阵发性时的剧烈疼痛。疼痛历时数秒或数分钟,疼痛呈周期性发作,发作间歇期同正常人一样。目前,西药治疗三叉神经痛效果不佳,且长期服用西药有较多副作用,因此,人们对有效治疗三叉神经痛的中药存在很大的需求。
发明内容
本发明人依据中医理论的研究及临床反复的试验和验证,终于找到了有效治疗三叉神经痛的药物,从而完成了本发明。
本发明的目的就是提供一种能够有效治疗三叉神经痛的组合药物。
本发明的另一个目的就是提供了该组合药物的制备方法。
本发明药物是选择蔓荆子、龙胆、生地黄、菊花、白芍、桑叶、川芎、生石膏、栀子、黄芩、黄连、牡丹皮、防风、柴胡、胆星、半夏、茯苓、枳壳、红花、僵蚕、蚯蚓、生姜、桃仁、甘草、白芷、赤芍、荆芥、升麻、全蝎、白附子、薄荷、羌活、细辛药物进行组合的,将这些药物组合使得各药物功效产生协同作用,从而能够快速有效治疗三叉神经痛的复发。其中选用蔓荆子是因为其性味苦辛,凉,入肝、胃,膀胱经,有疏散风热,清利头目的功能,治风热感冒,正、偏头痛,齿痛,目睛内痛。选用龙胆是因为其性味苦,寒,入肝、胆经,有泻肝实火,除下焦湿热的功能,治肝经热盛,惊癎狂躁,乙型脑炎,头痛,目赤,咽痛,黄疸,热痢,痈肿疮疡,阴囊肿痛,阴部湿痒。选用生地黄是因为其性味甘,寒,归心、肝、肾经,有清热凉血,养阴,生津的功能,治热病烦渴,阴虚内热,骨蒸劳热,内热消渴,吐血,衄血,发斑发疹。选用菊花是因为其性味甘苦,凉,入肺,肝经,有疏风,消热,明目,解毒的功能,治头痛,眩晕,目赤,心胸烦热,疔疮,肿毒。选用白芍是因为其性味苦酸,凉,入肝、脾经,有养血柔肝,缓中止痛,敛阴收汗的功能,治胸腹胁肋疼痛,泻痢腹痛,自汗盗汗,阴虚发热,月经不调,崩漏,带下。选用桑叶是因为其性味苦甘,寒,入肺、肝经,有祛风清热,凉血明目的功能,治风湿发热,头痛,目赤,口渴,肺热咳嗽,风痹,瘾疹,下肢象皮肿。选用川芎是因为其性味辛,温,入肝、胆经,有行气开郁,祛风燥湿,活血止痛的功能,治风冷头痛旋晕,胁痛腹疼,寒痹筋挛,经闭,难产,产后瘀阻块痛,痈疽疮疡。选用石膏是因为其性味辛甘,寒,入肺、胃经,生用有解肌清热,除烦止渴的功能,治热病壮热不退,心烦神昏,谵语发狂,口渴咽干,肺热喘急,中暑自汗,胃火头痛、牙痛,热毒壅盛,发斑发疹,口舌生疮,煅敷生肌敛疮,外治痈疽疮疡,溃不收回,汤火烫伤。选用栀子是因为其性味苦,寒,入心、肝、肺、胃经,有清热,泻火,凉血的功能,治热病虚烦不眠,黄疸,淋病,消渴,目赤,咽痛,吐血,衄血,血痢,尿血,热毒疮疡,扭伤肿痛。选用黄芩是因为其性味苦寒,入心肺、胆、大肠经,有泻实火,除湿热,止血安胎的功能,治壮热烦渴,肺热咳嗽。选用黄连是因为其性味苦,寒,入心、肝、胃、大肠经,有泻火,燥湿,解毒,杀虫的功能,治时行热毒、伤寒,热盛心烦,痞满呕逆,菌痢,热泻腹痛,肺结核,吐、衄、下血,消渴,疳积,蛔虫病,百日咳,咽喉肿痛,火眼,口疮,痈疽疮毒,湿疹,汤火烫伤。选用牡丹皮是因为其性味辛苦,凉,入心、肝、肾经,有清热,凉血,和血,消瘀的功能,治热入血分,发斑,惊癎,吐、衄、便血,骨蒸劳热,经闭,癥瘕,痈疡,扑损。选用防风是因为其性味辛甘,温,入膀胱、肺、脾经,有发表,祛风,胜湿,止痛的功能,治外感风寒,头痛,目眩,项强,风寒湿痹,骨节酸痛,四肢挛急,破伤风。选用柴胡是因为其性味苦,凉,入肝、胆经,有和解表里,疏肝,升阳的功能,治寒热往来,胸满胁痛,口苦耳聋,头痛目眩,疟疾,下利脱肛,月经不调,子宫下垂。选用胆星是因为其性味苦,性凉,入心、肝、肺三经,有清火化痰,镇惊定癎,痰火喘嗽,头风眩晕。选用半夏是因为其性味辛,温,有毒,入脾、胃经,有燥湿化痰,降逆止呕,消痞散结的功能,治湿痰冷饮,呕吐,反胃,咳喘痰多,胸膈胀满,痰厥头痛,头晕不眠,外消痈肿。选用茯苓是因为其性味甘淡,平,入心、脾、肺经,有渗湿利水,益脾和胃,宁心安神的功能,治小便不利水肿胀痛,痰饮咳逆,呕哕,泄泻,遗精,淋浊,惊悸,健忘。选用枳壳是因为其性味苦辛,凉,入肺、脾、大肠经,有破气,行痰,消积的功能,治胸膈痰滞,胸痞,胁胀,食积,噫气,呕逆,下痢后重,脱肛,子宫脱垂。选用红花是因为其性味辛,温,入心、肝经,有活血通经,去瘀止痛的功能,治经闭,癥瘕,难产,死胎,产后恶露不行,瘀血作痛,痈肿,跌扑损伤。选用僵蚕是因为其性味辛、咸,平,归肝,肺经。祛风解痉,化痰散结。用于中风口眼歪斜,惊痫抽搐,头赐,喉痹,瘰疠结核,风疹丹毒。选用蚯蚓是因为其性味咸,寒,入肝、脾、肺经,有清热,平肝,止喘,通络的功能,治高热狂躁,惊风抽搐,风热头痛,目赤,中风半身不遂,喘息,喉痹,关节疼痛,齿衄,小便不通,瘰疬,痄腮,疮疡。选用生姜是因为其性味辛,温,入肺、胃、脾经,有发表,散寒,止呕,开痰的功能,治感冒风寒,呕吐,痰饮,喘咳,胀满,泄泻,解半夏、天南星及鱼蟹、鸟兽肉毒。选用桃仁是因为其性味苦甘,平,入心、肝、大肠经,有破血行瘀,润燥滑经的功能,治经闭,癥瘕,热病蓄血,血痹,疟疾,跌打损伤,瘀血肿痛,血燥便秘。选用甘草是因为其性味甘,平,入脾、胃、肺经,有和中缓急,润肺,解毒,调和诸药的功能;炙用,治脾胃食少,腹痛便溏,劳倦发热,肺痿咳嗽,心悸,惊癎;生用,治咽喉肿痛,消化性溃疡,痈疸疮疡,解药毒及食物中毒。选用白芷是因为其性味辛,温,入肺、脾、胃经,有祛风,燥湿,消肿,止痛的功能,治头痛,眉棱骨痛,齿痛,鼻渊,寒湿腹痛,肠风痔漏,赤白带下,痈疽疮疡,皮肤燥痒,疥癣。选用赤芍是因为其性味苦,微寒,归肝经,有清热凉血,散瘀止痛的功能,治温毒发狂,吐血衄血,目赤肿痛,肝郁胁痛,经闭痛经,癎瘕腹痛,跌扑损伤,痈肿疮疡。选用荆芥是因为其性味辛,温,入肺、肝经,有发表,祛风,理血的功能,炒炭止血,治感冒发热,头痛,咽喉肿痛,中风口噤,吐血,衄血,便血,崩漏,产后血晕,痈肿,疮疥,瘰疬。选用升麻是因为其性味甘辛微苦,凉,入肺、脾、胃经,有升阳,发表,透疹,解毒的功能,治时气疫劳,头痛寒热,喉痛,口疮疤,斑疹不透,中气下陷,久泻久痢,脱肛,妇女崩带,子宫下坠,痈肿疮毒。选用全蝎是因为其性味咸辛,平,有毒,入足厥阴经,有祛风,止痉,通络,解毒的功能,治惊风抽搐,癫癎,中风、半身不遂、口眼喎斜,偏头痛,风湿痹痛,破伤风,淋巴结结核,风疹疮肿。选用白附子是因为其性味辛,温,归胃、肝经,有祛风痰,镇痉的功能,治中风、口眼歪斜,面神经麻痹,偏头痛,破伤风,淋巴结结核,痈肿。选用薄荷是因为其性味辛,凉,入肺、肝经,有疏风,散热,辟秽,解毒的功能,治外感风热,头痛,目赤,咽喉肿痛,食滞气胀,口疮,牙痛,疮疥,瘾疹。选用羌活是因为其性味辛苦,温,入膀胱、肾经,有散表寒,祛风湿,利关节的功能,治感冒风寒,头痛无汗,风寒湿痹,项强筋急,骨节酸疼,风水浮肿,痈疽疮毒。选用细辛是因为其性味辛,温,入肺、肾经,有祛风,散寒,行水,开窃的功能,治风冷头痛,鼻渊,止痛,痰饮咳逆,风湿痹痛。
本发明药物组分的用量也是发明人经过大量摸索总结得出的,各组分的用量在下述重量范围内都具有较好疗效
蔓荆子 10-20克 龙 胆 10-20克 生地黄 10-20克
菊 花 10-20克 白 芍 10-20克 桑 叶 10-20克
川 芎 10-20克 生石膏 25-35克 栀 子 5-15克
黄 芩 5-15克 黄 连 5-15克 牡丹皮 5-15克
防 风 5-15克 柴 胡 5-15克 胆 星 5-15克
半 夏 5-15克 茯 苓 5-15克 枳 壳 5-15克
红 花 3-9克 僵 蚕 3-9克 蚯 蚓 3-9克
生 姜 3-9克 桃 仁 3-9克 甘 草 3-9克
白 芷 3-9克 赤 芍 3-9克 荆 芥 3-9克
升 麻 3-9克 全 蝎 3-9克 白附子 3-9克
薄 荷 3-9克 羌 活 8-15克 细 辛 8-15克。
优选用量为
蔓荆子 15克 龙 胆 15克 生地黄 15克
菊 花 15克 白 芍 15克 桑 叶 15克
川 芎 15克 生石膏 30克 栀 子 10克
黄 芩 10克 黄 连 10克 牡丹皮 10克
防 风 10克 柴 胡 10克 胆 星 10克
半 夏 10克 茯 苓 10克 枳 壳 10克
红 花 8克 僵 蚕 8克 蚯 蚓 8克
生 姜 8克 桃 仁 8克 甘 草 8克
白 芷 8克 赤 芍 8克 荆 芥 8克
升 麻 8克 全 蝎 8克 白附子 8克
薄 荷 8克 羌 活 10克 细 辛 10克。
本发明药物的制备方法如下
一、备料
1、蔓荆子:筛净灰屑,除去残存萼片,置锅内用武火炒至焦黄色,略喷清水,放凉;
2、龙胆:拣去杂质,除去残茎,洗净,润透后切段,晒干;
3、生地黄:取原药材,除去杂质,洗净,稍润,切厚片,干燥,筛去碎屑;
4、菊花:拣净叶梗、花柄及泥屑杂质;
5、白芍:拣去杂质,分开大小个,用水浸泡至八成透,捞出,晒晾,润至内外湿度均匀,切片,干燥;
6、桑叶:拣去杂质,搓碎,簸去梗,筛去泥屑;
7、川芎:拣去杂质,分开大、小个,用水浸泡,晒晾,闷润后切片,干燥;
8、生石膏:去净杂石,洗净泥土,打碎成小块;
9、栀子:筛去灰屑,拣去杂质,碾碎过筛或剪去两端;
10、黄芩:拣去杂质,除去残茎,用凉水浸润或置开水中稍浸捞出,切片,晒干;
11、黄连:拣去杂质,洗净泥砂,润透,切片,阴干;
12、牡丹皮:拣去杂质,洗净,润透,切片,晾干;
13、防风:除去残茎,用水浸泡,捞出,润透切片,晒干;
14、柴胡:拣去杂质,除去残茎,洗净泥沙,捞出,润透后及时切片,随即晒干;
15、胆星:取原药材,拣去杂质;
16、半夏:拣去杂质,筛去灰屑;
17、茯苓:用水浸泡,洗净捞出,闷透后,切片,晒干;
18、枳壳:除去瓤、核,冼净,稍浸,捞出,润软,切片,晾干;
19、红花:拣净杂质,除去茎叶、蒂头,晒干;
20、僵蚕:取原药材,除去残丝,杂质;
21、蚯蚓:拣去杂质,用水漂净,及时捞出,晒干,切段;
22、生姜:拣去杂质,洗净泥土,用时切片;
23、桃仁:除去硬壳杂质,置沸水锅中煮至外皮微皱,捞出,浸入凉水中,搓去种皮,晒干,簸净;
24、甘草:拣去杂质,洗净,用水浸泡至八成透时,捞出,润透切片,晒干;
25、白芷:拣净杂质,用水洗净,浸泡,捞出润透,略晒至外皮无滑腻感时,再闷润后,切片干燥;
26、赤芍:取原药材,除去杂质,大小分档,洗净,润透,切薄片,干燥,筛去碎屑;
27、荆芥:拣净杂质,用水略泡,捞出切段,晒干;
28、升麻:拣去杂质,略泡洗净,捞出,润透,切片,晒干;
29、全蝎:清水漂去盐质,晒干,或微火焙用;
30、白附子:取原药材,除去杂质,洗净,干燥;
31、薄荷:拣净杂质,除去残根,先将叶抖下另放,然后将茎喷洒清水,润透后切段,晒干,再与叶和匀;
32、羌活:拣去杂质,洗净,润透,切片,晾干;
33、细辛:除净杂质,用水喷润,及时切段,晒干。
二、制备
1、将所述重量的蔓荆子、龙胆、生地黄、菊花、白芍、桑叶、川芎、生石膏、栀子、黄芩、黄连、牡丹皮、防风、柴胡、胆星、半夏、茯苓、枳壳、红花、僵蚕、蚯蚓、生姜、桃仁、甘草、白芷、赤芍、荆芥、升麻、全蝎、白附子、薄荷、羌活、细辛药物加水煎煮两次,第一次加水8倍量,浸泡150分钟后,武火煎煮沸腾10分钟,再用文火煎煮30分钟,过滤得第一次煎煮液,将第一次煎煮液倒入容器内。
2、将过滤的药渣加水6倍量,先用武火煮沸,再用文火煎煮30分钟,过滤得第二次煎煮液。
3、合并两次煎煮液,混合搅拌均匀,再用文火煎煮10分钟即得,将药液分成3剂。
本发明药物具有宁心安神,活血通络,祛风解痉的功能,用于治疗三叉神经痛,疗程短、见效快、治愈后不复发、无毒副作用。
具体实施方式
以下通过试验例来进一步阐述本发明所述药物的有益效果,这些试验例包括本发明药物的动物毒性试验报告和临床疗效观察资料。
[试验例1]本发明药物的动物毒性试验报告
取家兔30只,雌雄兼用,体重2.0-2.5kg,分两组,每组15只,其中一组为超剂量试验组,另一组为正常量试验组。超常量组为20ml/kg,正常量为10ml/kg,给药方式为灌胃法给药,每天两次,连服7天,每天观察给药反应,结果表明二组家兔活动、饮食正常,药物无不良毒副作用。
[试验例2]本发明药物治疗三叉神经痛的临床观察资料
1、一般资料
收治门诊患者共215例。
2、诊断标准
疼痛部位:右侧多于左侧,疼痛由面部、口腔或下颌的某一点开始扩散到三叉神经某一支或多支,以第二支、第三支发病最为常见,第一支者少见。其疼痛范围绝对不超越面部中线,亦不超过三叉神经分布区域。偶尔有双侧三叉神经痛者,占3%;
疼痛性质:如倒割、针刺、撕裂、烧灼或电击样剧烈难忍的疼痛,甚至痛不欲生;
疼痛的规律:三叉神经痛的发作常无预兆,而疼痛发作一般有规律。每次疼痛发作时间由仅持续数秒到1~2分钟骤然停止。初期起病时发作次数较少,间歇期亦长,数分钟、数小时不等,随病情发展,发作逐渐频繁,间歇期逐渐缩短,疼痛亦逐渐加重而剧烈。夜晚疼痛发作减少。间歇期无任何不适;5、诱发因素:说话、吃饭、洗脸、剃须、刷牙以及风吹等均可诱发疼痛发作,以致病人精神萎靡不振,行动谨小慎微,甚至不敢洗脸、刷牙、进食,说话也小心,惟恐引起发作;
表情和颜面部变化:发作时常突然停止说话、进食等活动,疼痛侧面部可呈现痉挛,即“痛性痉挛”,皱眉咬牙、张口掩目,或用手掌用力揉搓颜面以致局部皮肤粗糙、增厚、眉毛脱落、结膜充血、流泪及流涎。表情呈精神紧张、焦虑状态;
神经系统检查:无异常体征,少数有面部感觉减退。此类病人应进一步询问病史,尤其询问既往是否有高血压病史,进行全面的神经系统检查,必要时包括腰穿、颅底和内听道摄片、颅脑CT、MRI等检查,以助与继发性三叉神经痛鉴别。
3、治疗方法
选用上述药剂,给患者服用,每次服用1剂,每天早、中、晚各服1次,7天为一个疗程,连续服用4个疗程。
4、疗效评定标准
显效:症状消失,体质恢复正常,观察半年无复发者;
好转:症状明显好转,体质逐步恢复;
无效:达不到好转标准者。
5、治疗结果(见下表)
在上述的治疗中,用本发明药物治疗三叉神经痛患者215例,结果显效206例,显效率为95.81%,好转6例,好转率为2.79%,无效3例,总有效率为98.6%。
Claims (3)
1.一种治疗三叉神经痛的药物,其特征在于:它是由下列重量范围内的原料药制成:
蔓荆子 10-20克 龙 胆 10-20克 生地黄 10-20克
菊 花 10-20克 白 芍 10-20克 桑 叶 10-20克
川 芎 10-20克 生石膏 25-35克 栀 子 5-15克
黄 芩 5-15克 黄 连 5-15克 牡丹皮 5-15克
防 风 5-15克 柴 胡 5-15克 胆 星 5-15克
半 夏 5-15克 茯 苓 5-15克 枳 壳 5-15克
红 花 3-9克 僵 蚕 3-9克 蚯 蚓 3-9克
生 姜 3-9克 桃 仁 3-9克 甘 草 3-9克
白 芷 3-9克 赤 芍 3-9克 荆 芥 3-9克
升 麻 3-9克 全 蝎 3-9克 白附子 3-9克
薄 荷 3-9克 羌 活 8-15克 细 辛 8-15克。
2.根据权利要求1所述的药物,其中各原料药的用量为:
蔓荆子 15克 龙 胆 15克 生地黄 15克
菊 花 15克 白 芍 15克 桑 叶 15克
川 芎 15克 生石膏 30克 栀 子 10克
黄 芩 10克 黄 连 10克 牡丹皮 10克
防 风 10克 柴 胡 10克 胆 星 10克
半 夏 10克 茯 苓 10克 枳 壳 10克
红 花 8克 僵 蚕 8克 蚯 蚓 8克
生 姜 8克 桃 仁 8克 甘 草 8克
白 芷 8克 赤 芍 8克 荆 芥 8克
升 麻 8克 全 蝎 8克 白附子 8克
薄 荷 8克 羌 活 10克 细 辛 10克。
3.根据权利要求1或2所述药物的制备方法,其特征在于:它包括下列步骤:
(一)备料
(1)蔓荆子:筛净灰屑,除去残存萼片,置锅内用武火炒至焦黄色,略喷清水,放凉;
(2)龙胆:拣去杂质,除去残茎,洗净,润透后切段,晒干;
(3)生地黄:取原药材,除去杂质,洗净,稍润,切厚片,干燥,筛去碎屑;
(4)菊花:拣净叶梗、花柄及泥屑杂质;
(5)白芍:拣去杂质,分开大小个,用水浸泡至八成透,捞出,晒晾,润至内外湿度均匀,切片,干燥;
(6)桑叶:拣去杂质,搓碎,簸去梗,筛去泥屑;
(7)川芎:拣去杂质,分开大、小个,用水浸泡,晒晾,闷润后切片,干燥;
(8)生石膏:去净杂石,洗净泥土,打碎成小块;
(9)栀子:筛去灰屑,拣去杂质,碾碎过筛或剪去两端;
(10)黄芩:拣去杂质,除去残茎,用凉水浸润或置开水中稍浸捞出,切片,晒干;
(11)黄连:拣去杂质,洗净泥砂,润透,切片,阴干;
(12)牡丹皮:拣去杂质,洗净,润透,切片,晾干;
(13)防风:除去残茎,用水浸泡,捞出,润透切片,晒干;
(14)柴胡:拣去杂质,除去残茎,洗净泥沙,捞出,润透后及时切片,随即晒干;
(15)胆星:取原药材,拣去杂质;
(16)半夏:拣去杂质,筛去灰屑;
(17)茯苓:用水浸泡,洗净捞出,闷透后,切片,晒干;
(18)枳壳:除去瓤、核,冼净,稍浸,捞出,润软,切片,晾干;
(19)红花:拣净杂质,除去茎叶、蒂头,晒干;
(20)僵蚕:取原药材,除去残丝,杂质;
(21)蚯蚓:拣去杂质,用水漂净,及时捞出,晒干,切段;
(22)生姜:拣去杂质,洗净泥土,用时切片;
(23)桃仁:除去硬壳杂质,置沸水锅中煮至外皮微皱,捞出,浸入凉水中,搓去种皮,晒干,簸净;
(24)甘草:拣去杂质,洗净,用水浸泡至八成透时,捞出,润透切片,晒干;
(25)白芷:拣净杂质,用水洗净,浸泡,捞出润透,略晒至外皮无滑腻感时,再闷润后,切片干燥;
(26)赤芍:取原药材,除去杂质,大小分档,洗净,润透,切薄片,干燥,筛去碎屑;
(27)荆芥:拣净杂质,用水略泡,捞出切段,晒干;
(28)升麻:拣去杂质,略泡洗净,捞出,润透,切片,晒干;
(29)全蝎:清水漂去盐质,晒干,或微火焙用;
(30)白附子:取原药材,除去杂质,洗净,干燥;
(31)薄荷:拣净杂质,除去残根,先将叶抖下另放,然后将茎喷洒清水,润透后切段,晒干,再与叶和匀;
(32)羌活:拣去杂质,洗净,润透,切片,晾干;
(33)细辛:除净杂质,用水喷润,及时切段,晒干;
(二)制备
(1)将所述重量的蔓荆子、龙胆、生地黄、菊花、白芍、桑叶、川芎、生石膏、栀子、黄芩、黄连、牡丹皮、防风、柴胡、胆星、半夏、茯苓、枳壳、红花、僵蚕、蚯蚓、生姜、桃仁、甘草、白芷、赤芍、荆芥、升麻、全蝎、白附子、薄荷、羌活、细辛药物加水煎煮二次,第一次加水8倍量,浸泡150分钟后,武火煎煮沸腾10分钟,再用文火煎煮30分钟,过滤得第一次煎煮液,将第一次煎煮液倒入容器内;
(2)将过滤的药渣加水6倍量,先用武火煮沸,再用文火煎煮30分钟,过滤得第二次煎煮液;
(3)合并两次煎煮液,混合搅拌均匀,再用文火煎煮10分钟即得。
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