CN104474268B - A kind of external-applied ointment and preparation method for the treatment of diabetic ulcer - Google Patents
A kind of external-applied ointment and preparation method for the treatment of diabetic ulcer Download PDFInfo
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- CN104474268B CN104474268B CN201410762118.8A CN201410762118A CN104474268B CN 104474268 B CN104474268 B CN 104474268B CN 201410762118 A CN201410762118 A CN 201410762118A CN 104474268 B CN104474268 B CN 104474268B
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- fructus
- radix
- ulcer
- rhizoma
- diabetic ulcer
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Abstract
A kind of external-applied ointment and preparation method for the treatment of diabetic ulcer, unguentum is made by weight: Fructus Mume 25g-35g by the composition of following crude drug, Concha Ostreae (calcined) 25g-35g, Flos Carthami 15g-25g, Radix Sophorae Flavescentis 15g-25g, Rhizoma Pinelliae 15g-25g, Fructus Kochiae 15g-25g, Cortex Dictamni 15g-25g, Radix Arnebiae (Radix Lithospermi) 25g-35g, catechu 20g-30g, Indigo Naturalis 5g-15g, Fructus Jujubae 15g-25g, Radix Codonopsis 10g-20g, Rhizoma Polygonati Odorati 10g-20g, Cortex Magnoliae Officinalis 10g-20g, Rhizoma Dioscoreae 25g-35g, Margarita powder 15g-25g, Herba Erigerontis 10g-20g, Folium Clerodendri Trichotomi 25g-35g, Pericarpium Granati 25g-35g, Folium Artemisiae Argyi 10g-20g, Fructus Gleditsia 10g-20g, Poria 10g-20g, Fructus Momordicae 10g-20g, Spica Prunellae 15g-25g, Soviet Union art 15g-25g, Radix Astragali 30g-50g, Cera Flava 60-150g, vitamin C? 100-200mg, Anisodamine 20-40mg.Chinese medicine preparation prescription compatibility science of the present invention, determined curative effect, safety is high, quality controllable; Crude drug consumption is low, greatly saves production cost, for suitability for industrialized production and the universal of consumer groups provide possibility.Ointment effectively can treat diabetic ulcer, and untoward reaction is few.
Description
Technical field
The present invention relates to a kind of Chinese medicine preparation for the treatment of diabetic ulcer and preparation method thereof, particularly relate to a kind of external-applied ointment for the treatment of diabetic ulcer and preparation method thereof.
Background technology
Ulcer is one of commonly encountered diseases of this area, often runs into the treatment of ulcer as clinicist.The definition of ulcer seems self-evident, but the difference of a lot of people to wound surface (wound) and ulcer (ulcer-) is not fully aware of.It is generally acknowledged that " deeply reach corium or subcutaneous tissue defect is called ulcer, wherein circle hole shape is called abscess at the suppurative ulcer of shape deeply, and the very dark little permeability ulcer in position is called fistula hole." ulcer is defined as and " leaves over the epidermis of cicatrix and the segmental defect of corium after healing by LeverShi." on the other hand, Anderson pathology are thought, and " near surface of tissue or organ is inflamed, and the inflammatory stimulus of strong row causes tissue necrosis, becomes ulcer after coming off." above visible dermis at tissue morphology, the segmental defect of epithelium and corium is called ulcer, not necessarily has inflammatory symptom as condition.On pathology, organ surface first has inflammation, forms ulcer after slough comes off.Namely in Dermatology, wound surface (wound) is divided into the category of ulcer, in pathology, then do not divided into the category of ulcer.
Skin ulcer is that skin injury involves corium or the more limitation defect that formed of deep tissues, leaves over cicatrix after healing.As for diabetic ulcer, the present inventor thinks that it is not the skin infection of above-mentioned meaning, wound surface ulcer or ulcer, it is that a kind of because suffering from diabetes, the special ulcer of ulcer sign occurs for the lower limb that cause and body surface organization, principal pathogenetic is at lower limb, having basic difference with the wound infections caused because of reasons such as wounds or morbidity, is the disease also not having ideal treatment medicine at present in the world.
Chinese patent ZL931002761 discloses a kind of pharmaceutical composition for the treatment of hot injury, this pharmaceutical composition is composed of the following components, according to pharmaceutical composition total weight, (A) Cera Flava of 3-5%, (B) extract of the Oleum sesami containing Radix Scutellariae, Rhizoma Coptidis, Cortex Phellodendri, Lumbricus and Pericarpium Papaveris of 85-97%, wherein Radix Scutellariae, Rhizoma Coptidis, Cortex Phellodendri, Lumbricus and Pericarpium Papaveris account for the 2-10% of Oleum sesami gross weight respectively according to its dry medicine weighing scale.
The pathogeny of diabetic ulcer is very complicated, clear understanding also ununified at present, sums up and gets up to comprise three interactional processes: vascular lesion, neuropathy and immune disorders.(1) vascular lesion: vascular lesion is divided into two large classes, a large class is the pathological changes of trunk inner membrance, a large class is microangiopathies, because vascular lesion causes lower limb and body surface soft tissue ischemia to cause ulcer.(2) neuropathy: neuropathy take part in the early stage pathogenesis of diabetic foot pathological changes is also the most important risk factor of diabetic foot ulcers.In the process, all function of nervous system all receive infringement, but normally long, the thinnest nerve fiber is first impaired, comprise the nervus motorius of domination muscle of foot.The forfeiture of lumbricales function causes foot deformity, under making metatarsophalangeal joints, toes back or toe point etc. site pressure or friction increase, easily there is ulcer.Vegetative nerve function is impaired causes artery and vein vascular short circuit also in the early stage appearance of neuropathy, and perfused tissue rate reduces.There is alopecia, sebaceous gland and sweat gland afunction, cause xerosis cutis, squama and easily chap.(3) immune disorders: in the generation that immune disorders infects at diabetics, role still exists dispute.Most researchers believes that glycemic control is dissatisfied makes patient be easy to infect.But the humoral immunization of diabetics is seemingly normal, and in circulation, immunoglobulin level is normal or higher, and bone-marrow-derived lymphocyte number is normal.In mouse model, do not find the defect that antibody response or complement combine.
The cardinal symptom of diabetic foot shows as diabetes patient because of the vascular lesion of lower limb, the factor such as neuropathy and infection and causes ulcer and the acromelic gangrene of the pain of lower limb, numbness, foot, and it shows as to be referred to as diabetic foot (being commonly called as rotten foot) clinically:
1. patient skin pruritus, dry and lossless, and acra is cool, edema or withered, and the dark and pigmented spots of skin color, fine hair on birds or animals hair comes off.
2. acra twinge, causalgia, numbness, insensitive or forfeiture, foot steps on cotton-wool sense.Duck walking is walked, intermittent claudication, rest pain.
3. acra malnutrition, amyotrophy Tension Difference, articular ligament easy damaged.
4. common head of metatarsal bone sink, and metatarsophalangeal joints is bent to form clawfoot, hammertoe. chicken feet toe, charcot's joint.Can pathologisch Bruch etc. be there is in bone destruction.
5. pulsation of foot dorsal artery weakens or disappears.Depth Reflection Insensitivity or disappearance.
6. acra chapped skin or vesicle, blood blister, erosion, ulcer, gangrene or downright bad.
Usually, diabetics can damage with various skin, and long-term metabolic is disorderly, and blood capillary and peripheral nerve generation pathological changes are the bases causing skin ulcer.Because long term vascular pathological changes make blood vessel especially lower limb vascular sclerosis, narrow, affect blood confession, cause skin-nourishing obstacle; Microangiopathies can make endoneurium blood for declining, and autonomic neuropathy increases the weight of, and neuropathy also can make cutaneous pain, pressure sensation threshold value rise, and plantar pressure bearing position changes; Therefore, infect in the majority with foot especially toe, in this case, as there is damage in patient skin, then repair ability is poor, easy secondary infection, ulcer, gangrene.Have obvious inducement during major part morbidity, common with wound, also easily there is fungal infection in the antibiotic diabetic foot of tinea pedis, tinea unguium and life-time service; Old-aged diabetic due to the course of disease long, movable few, peripheral circulation is poor, more easily there is skin ulcer, gerontal patient makes immunity of organisms decline because blood glucose raises, and the probability of ulcer postoperative infection is very high, and severe patient causes cellulitis, osteomyelitis and septicemia etc. that amputation rate is increased greatly.Usual diabetic skin ulcer should take Experience of Combined Treatment of Internal Medicine, comprises control blood glucose, infection, improves microcirculation and wound surface Local treatment.Such as: use cephalosporins, lincomycin, penicillin, clarithromycin, acyclovir, amoxillin and dicloxacillin sodium glue are assisted, Sulfamethoxazole Compound etc. carries out anti-infective therapy; External " Mupirocin Ointment " etc.But diabetic ulcer, once occur, is difficult to there are desirable effective ways of curing wound surface clinically, has the surgical method taking amputation time at present still.Extremely need a kind of method of non-operative treatment diabetic ulcer clinically, be also starved of new medical skill or medicine.
Therefore, the pharmaceutical composition of research treatment diabetic ulcer further is still needed, to obtain better therapeutic effect.
Summary of the invention
The object of this invention is to provide a kind of external-applied ointment and preparation method for the treatment of diabetic ulcer, the external-applied ointment of this treatment diabetic ulcer is safe, stable, effectively can treat diabetic ulcer, and untoward reaction is few.
The object of the invention is to be realized by following technical scheme:
Treat an external-applied ointment for diabetic ulcer, it is characterized in that, make unguentum by weight by the composition of following crude drug:
Fructus Mume 25g-35g, Concha Ostreae (calcined) 25g-35g, Flos Carthami 15g-25g, Radix Sophorae Flavescentis 15g-25g, Rhizoma Pinelliae 15g-25g, Fructus Kochiae 15g-25g, Cortex Dictamni 15g-25g, Radix Arnebiae (Radix Lithospermi) 25g-35g, catechu 20g-30g, Indigo Naturalis 5g-15g, Fructus Jujubae 15g-25g, Radix Codonopsis 10g-20g, Rhizoma Polygonati Odorati 10g-20g, Cortex Magnoliae Officinalis 10g-20g, Rhizoma Dioscoreae 25g-35g, Margarita powder 15g-25g, Herba Erigerontis 10g-20g, Folium Clerodendri Trichotomi 25g-35g, Pericarpium Granati 25g-35g, Folium Artemisiae Argyi 10g-20g, Fructus Gleditsia 10g-20g, Poria 10g-20g, Fructus Momordicae 10g-20g, Spica Prunellae 15g-25g, Soviet Union art 15g-25g, Radix Astragali 30g-50g, Cera Flava 60-150g, vitamin C 100-200mg, Anisodamine 20-40mg.
As described in a kind of external-applied ointment for the treatment of diabetic ulcer, it is characterized in that, the composition of crude drug is by weight:
Fructus Mume 25g, Concha Ostreae (calcined) 35g, Flos Carthami 15g, Radix Sophorae Flavescentis 25g, Rhizoma Pinelliae 15g, Fructus Kochiae 15g, Cortex Dictamni 25g, Radix Arnebiae (Radix Lithospermi) 25g, catechu 20g, Indigo Naturalis 15g, Fructus Jujubae 15g, Radix Codonopsis 20g, Rhizoma Polygonati Odorati 20g, Cortex Magnoliae Officinalis 10g, Rhizoma Dioscoreae 35g, Margarita powder 25g, Herba Erigerontis 20g, Folium Clerodendri Trichotomi 35g, Pericarpium Granati 25g, Folium Artemisiae Argyi 20g, Fructus Gleditsia 10g, Poria 20g, Fructus Momordicae 15g, Spica Prunellae 25g, Soviet Union art 18g, Radix Astragali 30g, Cera Flava 80g, vitamin C 120mg, Anisodamine 20mg.
As described in a kind of external-applied ointment for the treatment of diabetic ulcer, it is characterized in that, the composition of crude drug is by weight:
Fructus Mume 30g, Concha Ostreae (calcined) 30g, Flos Carthami 20g, Radix Sophorae Flavescentis 20g, Rhizoma Pinelliae 20g, Fructus Kochiae 20g, Cortex Dictamni 20g, Radix Arnebiae (Radix Lithospermi) 30g, 25 grams, catechu, Indigo Naturalis 10 grams, Fructus Jujubae 20g, Radix Codonopsis 15g, Rhizoma Polygonati Odorati 12g, Cortex Magnoliae Officinalis 15g, Rhizoma Dioscoreae 30g, Margarita powder 20g, Herba Erigerontis 15g, Folium Clerodendri Trichotomi 30g, Pericarpium Granati 30g, Folium Artemisiae Argyi 15g, Fructus Gleditsia 15g, Poria 15g, Fructus Momordicae 15g, Spica Prunellae 20g, Soviet Union art 20g, Radix Astragali 40g, 100 grams, Cera Flava, vitamin C 150mg, Anisodamine 20mg.
As described in a kind of preparation method for the treatment of the external-applied ointment of diabetic ulcer, it is characterized in that, comprise following steps:
(1) Fructus Mume, Concha Ostreae (calcined), Flos Carthami, Radix Sophorae Flavescentis, the Rhizoma Pinelliae, the Fructus Kochiae, Cortex Dictamni, Radix Arnebiae (Radix Lithospermi), catechu, Indigo Naturalis, Fructus Jujubae, Radix Codonopsis, Rhizoma Polygonati Odorati, Cortex Magnoliae Officinalis, Rhizoma Dioscoreae, Margarita powder, Herba Erigerontis, Folium Clerodendri Trichotomi, Pericarpium Granati, Folium Artemisiae Argyi, Fructus Gleditsia, Poria, Fructus Momordicae, Spica Prunellae, Su Shu, the Radix Astragali is taken, pulverize, sieve, be placed in water and soak 2-4 day;
(2) with very hot oven endure to boiling after change slow fire into, endure to decoction liquor volume be 150-350mL, cooling, removing medicinal residues;
(3) in decoction liquor, add Cera Flava, stir to paste, autoclaving, cooling;
(4) add the vitamin C be ground into powder and Anisodamine, stir, to obtain final product.
The external-applied ointment that the present invention treats diabetic ulcer has the following advantages:
1, Chinese medicine preparation prescription compatibility science of the present invention, determined curative effect, safety is high, quality controllable;
2, crude drug consumption of the present invention is low, greatly saves production cost, for suitability for industrialized production and the universal of consumer groups provide possibility;
3. ointment of the present invention effectively can treat diabetic ulcer, and untoward reaction is few.
Detailed description of the invention
A kind of external-applied ointment for the treatment of diabetic ulcer of the present invention, make unguentum by weight by the composition of following crude drug:
Fructus Mume 25g-35g, Concha Ostreae (calcined) 25g-35g, Flos Carthami 15g-25g, Radix Sophorae Flavescentis 15g-25g, Rhizoma Pinelliae 15g-25g, Fructus Kochiae 15g-25g, Cortex Dictamni 15g-25g, Radix Arnebiae (Radix Lithospermi) 25g-35g, catechu 20g-30g, Indigo Naturalis 5g-15g, Fructus Jujubae 15g-25g, Radix Codonopsis 10g-20g, Rhizoma Polygonati Odorati 10g-20g, Cortex Magnoliae Officinalis 10g-20g, Rhizoma Dioscoreae 25g-35g, Margarita powder 15g-25g, Herba Erigerontis 10g-20g, Folium Clerodendri Trichotomi 25g-35g, Pericarpium Granati 25g-35g, Folium Artemisiae Argyi 10g-20g, Fructus Gleditsia 10g-20g, Poria 10g-20g, Fructus Momordicae 10g-20g, Spica Prunellae 15g-25g, Soviet Union art 15g-25g, Radix Astragali 30g-50g, Cera Flava 60-150g, vitamin C 100-200mg, Anisodamine 20-40mg.
The present invention treats the preparation method of the external-applied ointment of diabetic ulcer, comprises the following step:
(1) Fructus Mume, Concha Ostreae (calcined), Flos Carthami, Radix Sophorae Flavescentis, the Rhizoma Pinelliae, the Fructus Kochiae, Cortex Dictamni, Radix Arnebiae (Radix Lithospermi), catechu, Indigo Naturalis, Fructus Jujubae, Radix Codonopsis, Rhizoma Polygonati Odorati, Cortex Magnoliae Officinalis, Rhizoma Dioscoreae, Margarita powder, Herba Erigerontis, Folium Clerodendri Trichotomi, Pericarpium Granati, Folium Artemisiae Argyi, Fructus Gleditsia, Poria, Fructus Momordicae, Spica Prunellae, Su Shu, the Radix Astragali is taken, pulverize, sieve, be placed in water and soak 2-4 day;
(2) with very hot oven endure to boiling after change slow fire into, endure to decoction liquor volume be 150-350mL, cooling, removing medicinal residues;
(3) in decoction liquor, add Cera Flava, stir to paste, autoclaving, cooling;
(4) add the vitamin C be ground into powder and Anisodamine, stir, to obtain final product.
Ointment can also be made by the conventional method of this area at above-mentioned crude drug.
The present invention treats in the crude drug of the external-applied ointment of diabetic ulcer:
Fructus Mume: sour in the mouth, property are puckery is flat.Return liver, spleen, lung, large intestine channel.Cure mainly astringing intestine to stop diarrhea, promote the production of body fluid.For chronic diarrhea; Dysentery; Have blood in stool; The function of hematuria.Malic acid in Fructus Mume directs into large intestine appropriate moisture, forms feces and excretes; Concha Ostreae (calcined): restrain astringent or styptic treatment for spontaneous sweating, relieving gastric hyperacidity to alleviate stomachache, tranquillization with heavy prescription, hard masses softening and resolving; Flos Carthami: have blood circulation promoting and blood stasis dispelling, wet dissipation goes the effect swollen; Radix Sophorae Flavescentis: cure mainly heat clearing and damp drying, diuresis.For hematodiarrhoea, have blood in stool; The Rhizoma Pinelliae: have drying dampness to eliminate phlegm, stopping nausea and vomiting by lowering the adverse flow of QI, raw with the furuncle and phyma effect that disappears; The Fructus Kochiae: have clearing away heat-damp and promoting diuresis, dispelling wind for relieving itching effect; Cortex Dictamni: have heat clearing and damp drying, the effect of removing toxic substances of dispeling the wind; Radix Arnebiae (Radix Lithospermi): energy removing heat from blood, invigorates blood circulation, heat clearing away, removing toxic substances.Control stranguria with turbid discharge, constipation with heat retention; Catechu: " detailed outline ": " control macule, pox poison, promoting blood circulation and cooling blood, sharp large intestine." " Jilin Chinese herbal medicine ": " treats constipation, hematuria "; Indigo Naturalis: have heat clearing away, promote the production of body fluid, reduce phlegm, stop blooding, sore, granulation promoting, the function such as analgesic therapy; Fructus Jujubae: sweet in the mouth is warm in nature, return taste warp, has the function of invigorating the spleen and replenishing QI, nourishing blood to tranquillize the mind, the mitigation property of medicine; Radix Codonopsis: property is put down, and sweet in the mouth, has effect of invigorating the spleen and replenishing QI, spleen invigorating lung benefiting, can also strengthen body immunity, improves the activity of superoxide dismutase, has the effect of Gastrointestinal motility adjustment, antiulcer, gastric acid secretion inhibiting, reduction pepsin activity.Modern study, Radix Codonopsis has enhancing immunity, blood vessel dilating, blood pressure lowering, improves microcirculation, strengthens the effects such as hemopoietic function; Rhizoma Polygonati Odorati: cure mainly yin nourishing, moisturizes, and relieving restlessness is quenched the thirst; Cortex Magnoliae Officinalis: acrid in the mouth, warm in nature, has effect of circulation of qi promoting removing dampness, warming middle-JIAO to relieve pain.There is stronger antibacterial action to staphylococcus, streptococcus, bloody dysentery bacillus, pasteurellosis bacillus, vibrio cholera, have therapeutical effect to the disease such as stagnation of QI due to dyspepsia, abdominal distention constipation; Rhizoma Dioscoreae: have nourishing strong, aid digestion, hold back sweating due to debility, effect of antidiarrheal, cure mainly insufficiency of the spleen diarrhoea, dyspeptic chronic enteritis; Margarita powder: have effects such as arresting convulsion, removing toxic substances and promoting granulation of calming the nerves, modern study also shows that Margarita powder is improving the effect all in body immunity, supplement calcium etc. with uniqueness; Herba Erigerontis: cold in nature, micro-hardship, Gan Wenxin, has effect of be slightly cold removing toxic substances, expelling wind and removing dampness, blood circulation promoting and blood stasis dispelling, dredge the meridian passage, anti-inflammatory analgetic.Expansible blood capillary improves vasospasm and microcirculation, and can suppress erythrocyte, platelet aggregation, fibrin degradation is former, effectively reduces blood viscosity, weakens blood coagulation simultaneously, dissolves microthrombus, has obvious anticoagulant; Folium Clerodendri Trichotomi: can expelling wind and removing dampness, suppressing the hyperactive liver blood pressure lowering, removing toxic substances parasite killing.Function cures mainly dysentery, skin sore; Pericarpium Granati: enter large intestine, lung, kidney channel.Cure mainly astringing intestine to stop diarrhea, hemostasis, anthelmintic.Control chronic diarrhea, chronic dysentery, have blood in stool, proctoptosis etc.; Folium Artemisiae Argyi: acrid in the mouth, hardship, warm in nature, slightly poisonous, there is warming the meridian for stopping bleeding, dispersing cold for relieving pain, effect of wet down parasite killing; Fructus Gleditsia: pungent, salty, temperature.Poison can whet the appetite in removing food stagnancy relieving dyspepsia, and containing guar gum; Fructus Gleditsia acupuncture (soap pin) includes flavonoid glycoside, phenols, aminoacid; Poria: sweet in the mouth, light, property are put down, and are used as medicine and have the function of promoting diuresis to eliminate damp pathogen, strengthening the spleen stomach function regulating, mind tranquilizing and the heart calming.Modern medicine study: Poria energy enhancing human body immunity function; Fructus Momordicae: sweet in the mouth is cool in nature, returns lung, large intestine channel, has nourishing the lung to arrest cough, effect of promoting the production of body fluid to quench thirst, has effect of loosening bowel to relieve constipation; Spica Prunellae: property is pungent, bitter, cold.Return liver, gallbladder meridian.Effect: clearing away heat-fire, improving eyesight, mass dissipating and swelling eliminating; Lignum Sappan: sweet in the mouth, salty, property is pungent cool.GUIXIN; Liver; Stomach; Spleen channel.Energy blood circulation promoting and blood stasis dispelling, subduing swelling and relieving pain; The Radix Astragali: have enhancing human body immunity function and antibacterial action more widely; Cera Flava: be four materials to cured glandular secretion below worker bee abdominal part.Its main component has: acids, free fatty, free alkyl alcohol and carbohydrate.In addition, carotenoid, vitamin A, aromatic substance etc. are also had.Astringent therapy, sore, granulation promoting, pain relieving.Outer for ulcer being unable to heal, ecthyma is rotten to the corn, wound, burn; Vitamin C: vitamin C is that antibody and collagen are formed, tissue repairing's (comprising some redox), the metabolism of phenylalanine, tyrosine, folic acid, the utilization of ferrum, carbohydrate, the synthesis of fat, protein, maintains immunologic function, hydroxylation and hydroxytryptamine, keep the complete of blood vessel; Anisodamine: the neural medicine of anticholinergic, has relaxing smooth muscle, remove vasospasm, improve microcirculatory effect, and have analgesic activity.
The morbidity of diabetic ulcer relates to the many factors such as lower limb vascular, nerve and infection, and diabetics often merges vascular lesion, especially acra microangiopathies, causes regional tissue perfusion deficiency, causes tissue ischemia downright bad; Blood glucose increases for a long time, organism metabolic disorder, makes nervous tissue's malnutrition, therefore occurs neuropathy; In addition the physical weakness of diabetics own, lower for the resistance, thus easily occurs infecting.Diabetic ulcer position bacteria cultivation results shows, I degree ulcer thing mostly is G+ coccus and infects, II degree, III degree ulcer mainly G-bacillus.So treatment main points: one is improve local blood circulation and nutrition, and two is infection.Through clinical verification, medicinal ointment therapy diabetic lower limb ulcer Be very effective of the present invention, mainly has following mechanism based on this medical instrument:
Anti-infection ability is strong.The Radix Astragali in ointment, Cortex Magnoliae Officinalis have stronger anti-infection ability, and can hinder bacterium, antibacterial, discharge of bacteria, promotion bacterial dissociation, destroy antibacterial conditions of existence, antibacterial is lost corrode living tissue ability and reduce toxicity.There are some researches prove, its infection principle may with following some be relevant: it can make wound surface keep physiological moist environment, thus maintains histiocytic normal life condition, adds the anti-infection ability of himself; The mobility of ointment is unfavorable for that antibacterial is lodged in the tissue, grows, breeds; Can bacterial dissociation be made, reduce toxicity and the agent of erosion of pathogenic bacterium.According to anti-infection ability this characteristic strong, the whole body can effective infection control with the use of sensitive antibiotic.
Diabetic lower limb ulcer gangrene person organism metabolic disorder, blood glucose raise, tissue repairing ability declines, therefore the very difficult healing of wound surface.Meanwhile, traumatic infection and slough also make body blood glucose raise further.Keeping on a diet, while oral antidiabetic drug, application insulin, application removes slough, to infection, the further rising stoping blood glucose.In crude drug of the present invention, the medicine such as Flos Carthami, Radix Codonopsis, Radix Arnebiae (Radix Lithospermi), Cera Flava, Anisodamine can improve local microcirculation, increases regional blood flow, creates the environment wound healing being conducive to tissue growth, collaborative and accumulative action can be played, promote the healing of ulcer gangrene.Research shows, the ability that external-applied ointment of the present invention can effectively stop wound surface moisture to evaporate close to normal skin, and can reduce while moisture evaporates as wound surface provides the moist environment of approximate physiological.
embodiment 1
Prescription: Fructus Mume 25g, Concha Ostreae (calcined) 35g, Flos Carthami 15g, Radix Sophorae Flavescentis 25g, Rhizoma Pinelliae 15g, Fructus Kochiae 15g, Cortex Dictamni 25g, Radix Arnebiae (Radix Lithospermi) 25g, catechu 20g, Indigo Naturalis 15g, Fructus Jujubae 15g, Radix Codonopsis 20g, Rhizoma Polygonati Odorati 20g, Cortex Magnoliae Officinalis 10g, Rhizoma Dioscoreae 35g, Margarita powder 25g, Herba Erigerontis 20g, Folium Clerodendri Trichotomi 35g, Pericarpium Granati 25g, Folium Artemisiae Argyi 20g, Fructus Gleditsia 10g, Poria 20g, Fructus Momordicae 15g, Spica Prunellae 25g, Soviet Union art 18g, Radix Astragali 30g, Cera Flava 80g, vitamin C 120mg, Anisodamine 20mg.
Preparation method:
take Fructus Mume, Concha Ostreae (calcined), Flos Carthami, Radix Sophorae Flavescentis, the Rhizoma Pinelliae, the Fructus Kochiae, Cortex Dictamni, Radix Arnebiae (Radix Lithospermi), catechu, Indigo Naturalis, Fructus Jujubae, Radix Codonopsis, Rhizoma Polygonati Odorati, Cortex Magnoliae Officinalis, Rhizoma Dioscoreae, Margarita powder, Herba Erigerontis, Folium Clerodendri Trichotomi, Pericarpium Granati, Folium Artemisiae Argyi, Fructus Gleditsia, Poria, Fructus Momordicae, Spica Prunellae, Su Shu, the Radix Astragali, pulverize, sieve, be placed in water and soak 2;
endure with very hot oven and change slow fire into boiling, enduring to decoction liquor volume is 150mL, and cooling, removes medicinal residues;
in decoction liquor, add Cera Flava, stir, to paste, autoclaving, cooling;
add the vitamin C and Anisodamine that are ground into powder, stir, to obtain final product.
embodiment 2
Prescription: Fructus Mume 30g, Concha Ostreae (calcined) 30g, Flos Carthami 20g, Radix Sophorae Flavescentis 20g, Rhizoma Pinelliae 20g, Fructus Kochiae 20g, Cortex Dictamni 20g, Radix Arnebiae (Radix Lithospermi) 30g, 25 grams, catechu, Indigo Naturalis 10 grams, Fructus Jujubae 20g, Radix Codonopsis 15g, Rhizoma Polygonati Odorati 12g, Cortex Magnoliae Officinalis 15g, Rhizoma Dioscoreae 30g, Margarita powder 20g, Herba Erigerontis 15g, Folium Clerodendri Trichotomi 30g, Pericarpium Granati 30g, Folium Artemisiae Argyi 15g, Fructus Gleditsia 15g, Poria 15g, Fructus Momordicae 15g, Spica Prunellae 20g, Soviet Union art 20g, Radix Astragali 40g, 100 grams, Cera Flava, vitamin C 150mg, Anisodamine 30mg.
Preparation method:
take Fructus Mume, Concha Ostreae (calcined), Flos Carthami, Radix Sophorae Flavescentis, the Rhizoma Pinelliae, the Fructus Kochiae, Cortex Dictamni, Radix Arnebiae (Radix Lithospermi), catechu, Indigo Naturalis, Fructus Jujubae, Radix Codonopsis, Rhizoma Polygonati Odorati, Cortex Magnoliae Officinalis, Rhizoma Dioscoreae, Margarita powder, Herba Erigerontis, Folium Clerodendri Trichotomi, Pericarpium Granati, Folium Artemisiae Argyi, Fructus Gleditsia, Poria, Fructus Momordicae, Spica Prunellae, Su Shu, the Radix Astragali, pulverize, sieve, be placed in water and soak 3;
endure with very hot oven and change slow fire into boiling, enduring to decoction liquor volume is 200mL, and cooling, removes medicinal residues;
in decoction liquor, add Cera Flava, stir, to paste, autoclaving, cooling;
add the vitamin C and Anisodamine that are ground into powder, stir, to obtain final product.
test example
(1) subjects:
In May ,-2014 in June, 2010, my institute admit to hospital altogether diabetic lower limb ulcer patient totally 128 example, wherein male 93 example, women 35 example; 49 years old-82 years old age, 57.2 years old mean age; Diabetic duration 3 months-18 years, average course of disease 7.4 years; The diabetic lower limb ulcer course of disease 26 days-2.8 years, average course of disease 6.7 months.Merge paralysed patient 23 example, the physical data such as medical history are in table 1.
Every diabetes index situation of table 1 subjects
Ulcer calibration: according to the diagnostic criteria of Armstrong diabetic ulcer, ulcer is divided into 3 degree.I degree: ulcer is only limitted to skin layer; II degree: ulcer, through skin, gos deep into Musclar layer; III degree: ulcer involves bone and joint.This group patient is after Cure the Primary Disease, use sensitive antibiotic, traditional debridement and local dressing change, and nothing is clearly better.
All patients has 263 place's ulcer, and area reckling about 1.0 cm x 1.5 centimetres, area the maximum is about 9.0 cm x 11.0 centimetres.Wherein, ulcer spot and proportion are in table 2.
The diabetic ulcer situation of table 2 subjects
Carry out antibacterial culturing to wherein 98 routine ulcer surfaces, result is 76 positive examples, isolates 79 strain antibacterials, cultivates bacterial strain in table 3.
Table 3 subjects ulcer surface antibacterial culturing situation
| Bacterial strain | Staphylococcus aureus | Bacillus pyocyaneus | Deformity bacillus variabilis | Hemolytic streptococcus | Mixed infection |
| Number of cases | 42 | 19 | 11 | 8 | 23 |
| Proportion | 53.16% | 24.05% | 13.92% | 10.12% | 29.11% |
(2) Therapeutic Method:
Be that patient thoroughly cleans ulcer surface and surrounding skin with povidone iodine liquid, remove degeneration necrosis tissue, incrustation and secretions, then wound surface is rinsed with 0.9% sodium chloride solution, again with sterile gauze wipe dry after smear ointment prepared by the embodiment of the present invention 1, to expose depending on employings different from position of wound surface size, partly exposure or occlusive dressing.Change dressings every day 1 time ~ 2 times, when changing dressings, remove liquefaction and necrosis tissue and foreign material at every turn.
(3) observation index
Wound Contraction rate [long (mm) * wound surface of=wound surface wide (mm)/former length (mm) * former wide (mm)] * 100%, wound healing time (d), wound primary colours pool, wound exudate or secretions, allergy and untoward reaction.
With reference to relative national standards design:
-recovery from illness: wound surface heals completely, wound surface epithelization, and Wound Contraction rate is 100%;
-effective: wound surface reduces 75%-100%, Wound Contraction rate 75%-100%;
-effectively: wound surface reduces 50%-75%, Wound Contraction rate 50%-75%;
-minor effect: wound surface reduces 25%-50%, Wound Contraction rate 25%-50%;
-invalid: wound surface reduces less than 25%, Wound Contraction rate >25%.
Ulcer surface sepage is assessed:
-seldom to measure: ulcer surface is moistening, but cannot measure sepage amount, or does not have sepage;
-a small amount of: ulcer surface sepage is few, adhesional wetting dressing less than 25%;
-middle amount: transudate adhesional wetting dressing 25%-75%;
-a large amount of: transudate adhesional wetting dressing 75%-100%.
Observe six weeks, record weekly once.
(4) result of the test:
By observing the indexs such as Wound Contraction rate, wound primary colours pool, wound exudate or secretions, allergy and untoward reaction, concrete result of the test is in Table 4-6.
The shrinkage factor change weekly of table 4 subjects wound surface
| After medication | Number of cases | Invalid (example, rate) | Minor effect (example, rate) | Effectively (example, rate) | Effective (example, rate) | Recovery from illness (example, rate) |
| 1 week | 128 | 32（25.00%） | 40（31.25%） | 26（20.31%） | 22（17.18%） | 8（6.26%） |
| 2 weeks | 128 | 23（17.96%） | 27（21.09%） | 30（23.43%） | 33（25.78%） | 15 (11.74%) |
| 3 weeks | 128 | 22（17.18%） | 15 (11.74%) | 29 (22.65%) | 26 (20.31%) | 36（28.20%) |
| 4 weeks | 128 | 17 (13.28%) | 13（10.15%） | 20（15.62%） | 26（20.31%） | 52（40.67%） |
| 5 weeks | 128 | 13（10.15%） | 14（10.93%） | 19（14.84%） | 21（16.40%） | 61（47.68%） |
| 6 weeks | 128 | 13（10.15%） | 11（8.59%） | 13（10.15%） | 15 (11.74%) | 76（59.37%） |
Table 5 subjects wound surface color base changes weekly
| After medication | Number of cases | Pale asphyxia (example, rate) | Kermesinus (example, rate) | Pale red (example, rate) | Ruddy (example, rate) | Epithelization (example, rate) |
| 1 week | 128 | 41（32.03%） | 26（20.31%） | 27（21.09%） | 26（20.31%） | 8（6.26%） |
| 2 weeks | 128 | 26（20.31%） | 27（21.09%） | 30（23.43%） | 30（23.43%） | 15 (11.74%) |
| 3 weeks | 128 | 22（17.18%） | 21 (16.40) | 24 (18.75%) | 25 (19.53%) | 36（28.14%) |
| 4 weeks | 128 | 18 (14.06%) | 12（9.37%） | 21（16.40%） | 25（19.53%） | 52（40.64%） |
| 5 weeks | 128 | 15（11.74%） | 10（7.81%） | 14（10.93%） | 28（21.87%） | 61（47.68%） |
| 6 weeks | 128 | 13（10.15%） | 9 （7.03%） | 11（8.59%） | 19 (14.84%) | 76（59.37%） |
Table 6 subjects wound exudate changes weekly
| After medication | Number of cases | In a large number (example, rate) | Middle amount (example, rate) | On a small quantity (example, rate) | Little amount (example, rate) | Without sepage (example, rate) |
| 1 week | 128 | 28（21.87%） | 35（27.34%） | 32（25.00%） | 25（19.53%） | 8（6.26%） |
| 2 weeks | 128 | 20（15.62%） | 24（18.75%） | 31（24.21%） | 38（29.68%） | 15 (11.74%) |
| 3 weeks | 128 | 19（14.84%） | 22 (17.18%) | 28 (21.87%) | 23 (17.96%) | 36（28.15%) |
| 4 weeks | 128 | 17 (13.28%) | 12（9.37%） | 21（16.40%） | 26（20.31%） | 52（40.64%） |
| 5 weeks | 128 | 14（10.93%） | 13（10.15%） | 19（14.84%） | 21（16.40%） | 61（47.68%） |
| 6 weeks | 128 | 13（10.15%） | 12（9.37%） | 12（9.37%） | 15 (11.74%) | 76（59.37%） |
Result of the test shows, wound surface I phase healing 103 example, cure rate is 83.59%, the shortest 14 days of its course for the treatment of, the longest 42 days.Wherein, after having 12 examples to change dressings through 14 days-21 days, wound surface without slough and secretions, granulation comparatively fresh (accounting for); 8 examples are because of tendon and exposed bone area larger row transfer of skin flap wound repairing (accounting for 9.37%); The 5 customary toes that cut perform the operation (accounting for 8.6%).128 routine patients are all without the anaphylaxis such as red swelling of the skin, pruritus.Above-mentioned test data shows, ointment of the present invention effectively can treat diabetic ulcer, and untoward reaction is few.
Claims (2)
1. treat an external-applied ointment for diabetic ulcer, it is characterized in that, make unguentum by weight by the composition of following crude drug:
Fructus Mume 25g, Concha Ostreae (calcined) 35g, Flos Carthami 15g, Radix Sophorae Flavescentis 25g, Rhizoma Pinelliae 15g, Fructus Kochiae 15g, Cortex Dictamni 25g, Radix Arnebiae (Radix Lithospermi) 25g, catechu 20g, Indigo Naturalis 15g, Fructus Jujubae 15g, Radix Codonopsis 20g, Rhizoma Polygonati Odorati 20g, Cortex Magnoliae Officinalis 10g, Rhizoma Dioscoreae 35g, Margarita powder 25g, Herba Erigerontis 20g, Folium Clerodendri Trichotomi 35g, Pericarpium Granati 25g, Folium Artemisiae Argyi 20g, Fructus Gleditsia 10g, Poria 20g, Fructus Momordicae 15g, Spica Prunellae 25g, Lignum Sappan 18g, Radix Astragali 30g, Cera Flava 80g, vitamin C 120mg, Anisodamine 20mg.
2. a kind of preparation method for the treatment of the external-applied ointment of diabetic ulcer as claimed in claim 1, is characterized in that, comprise following steps:
(1) Fructus Mume, Concha Ostreae (calcined), Flos Carthami, Radix Sophorae Flavescentis, the Rhizoma Pinelliae, the Fructus Kochiae, Cortex Dictamni, Radix Arnebiae (Radix Lithospermi), catechu, Indigo Naturalis, Fructus Jujubae, Radix Codonopsis, Rhizoma Polygonati Odorati, Cortex Magnoliae Officinalis, Rhizoma Dioscoreae, Margarita powder, Herba Erigerontis, Folium Clerodendri Trichotomi, Pericarpium Granati, Folium Artemisiae Argyi, Fructus Gleditsia, Poria, Fructus Momordicae, Spica Prunellae, Lignum Sappan, the Radix Astragali is taken, pulverize, sieve, be placed in water and soak 2-4 day;
(2) with very hot oven endure to boiling after change slow fire into, endure to decoction liquor volume be 150-350mL, cooling, removing medicinal residues;
(3) in decoction liquor, add Cera Flava, stir to paste, autoclaving, cooling;
(4) add the vitamin C be ground into powder and Anisodamine, stir, to obtain final product.
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| 袁琳等.胰岛素联合用药治疗糖尿病足的研究进展.《护理研究》.2008,(第14期), * |
| 马静.中医药治疗糖尿病足临床研究近况.《河北中医》.2011,(第06期), * |
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