CN117180361B - Traditional Chinese medicine for treating spleen deficiency and qi stagnation combined with damp-heat type ulcerative colitis - Google Patents

Abstract

The invention relates to a traditional Chinese medicine for treating spleen deficiency and qi stagnation and damp-heat type ulcerative colitis, which can effectively solve the medication problem of spleen deficiency and qi stagnation and damp-heat type ulcerative colitis, and the technical scheme is that the traditional Chinese medicine is prepared from the following raw materials in parts by weight: 10-15g of costustoot, 10-15g of wrinkled gianthyssop herb, 15-20g of nutgrass galingale rhizome, 15-30g of honey-fried astragalus root, 10-15g of kudzuvine root, 12-15g of baical skullcap root, 6-10g of golden thread, 20-30g of purslane, 5-10g of sinkiang arnebia root, 5-10g of heartleaf houttuynia herb and 3-5g of liquorice, the preparation method is simple, the cost is low, the administration is easy, the effect is good, and the medicine is innovation in treating ulcerative colitis due to spleen deficiency and qi stagnation and damp-heat by ascending and descending the spleen and stomach are orderly caused by the effect of dredging and regulating the viscera qi.

Description

Traditional Chinese medicine for treating spleen deficiency, qi stagnation and damp-heat type ulcerative colitis

1. Technical Field

The invention relates to the field of medicine, in particular to a traditional Chinese medicine for treating spleen deficiency, qi stagnation and damp-heat type ulcerative colitis.

2. Background Technology

Chronic nonspecific ulcerative colitis (UC) is a digestive tract disease with diarrhea, bloody stools, abdominal pain, tenesmus, etc. as the main symptoms, and chronic inflammation and ulcer formation of the colon as the pathological characteristics. The disease has a high incidence rate in developed areas of Europe and the United States, about 18 per 100,000. In recent years, due to the continuous improvement of living standards, changes in dietary structure and living habits, and the improvement of examination technology, the incidence rate has also shown an upward trend year by year. Because the disease is difficult to cure, it is often prone to recurrence, and it has a certain relationship with the incidence of colon cancer, it is listed as one of the modern intractable diseases by the World Health Organization.

According to the "Consensus on the Diagnosis and Treatment of Inflammatory Bowel Disease (2018·Beijing)", UC is divided into primary and chronic relapsing types, and the chronic relapsing type is more common clinically. The characteristics of the disease are "repeated relapses and temporary recovery", long course of disease, repeated attacks, and remission periods of varying lengths. Most patients will enter the chronic relapsing UC stage as the disease progresses. "Suwen·Zangqi Fa Shi Lun" says: "For spleen disease, ... deficiency will cause abdominal distension, intestinal rumbling, diarrhea, and indigestion." "Jingyue Quanshu" also says: "The root of diarrhea is all due to the spleen and stomach." Spleen and stomach weakness, dampness, and qi stagnation are of great significance in the onset of UC. The disease process of chronic relapsing UC is a process of fighting between evil and righteousness. During the attack period, the spleen and stomach are often damaged by improper diet, external evil, emotional stimulation, etc., resulting in spleen dysfunction, endogenous phlegm and dampness, accumulation of dampness and heat, stagnation of qi and blood, and damage to the intestines, causing UC relapses. Repeated attacks of UC can aggravate spleen deficiency, so spleen deficiency is the root of UC and runs through the disease. Deficiency will inevitably lead to stagnation, and qi deficiency is unable to push, resulting in qi stagnation. "Medical Truth" says: "The power of ascending and descending lies in the middle qi. When the middle qi is strong, the spleen rises and the stomach descends, and the zang-fu organs rotate. When the middle qi is weak, the spleen is depressed and the stomach is reversed." UC recurs repeatedly, damaging the spleen and stomach, causing middle qi deficiency, qi stagnation, abnormal ascending and descending, obstruction of the movement of body fluids, and accumulation of dampness. In addition to affecting the qi of the middle jiao, weak spleen and stomach also affect the qi of the intestines and viscera. The small intestine separates the clear and turbid, and the large intestine transmits the dregs. Both are smooth when they descend, and both rely on the descending of stomach qi. Spleen deficiency causes qi stagnation in the middle jiao, and stomach qi does not descend. Qi deficiency is unable to push, resulting in abnormal intestinal and visceral transmission and transformation, and visceral qi is blocked. Its transmission and excretion of dregs are reduced, resulting in symptoms such as abdominal distension and incomplete defecation. The intestines are tortuous and the transmission is not in good working order. Damp-heat turbidity and toxins are easily retained during this period, which damages the intestines over time. The spleen is responsible for transportation and transformation. When the spleen is deficient and fails to transport and transform, phlegm and dampness are generated internally and move downward to the intestines. The stagnation of phlegm and dampness over time turns into heat. Damp-heat is generated internally, and blood is rotten and the flesh is rotten. Therefore, symptoms such as mucus, pus and blood in the stool and abdominal pain are seen. Clinically, chronic relapsing UC is based on spleen deficiency, combined with the pathogenesis of qi stagnation and dampness and heat. The active period is dominated by pathogenic factors. The spleen is responsible for transportation and transformation of water and dampness. The weaker the spleen, the more severe the qi stagnation. Dampness accumulates day by day, causing the dampness to become heavier. The heavy and sticky nature of dampness is easy to block the qi mechanism, further aggravating the stagnation of qi mechanism. Dampness is easy to be combined with other pathogens and cause disease. Dampness is blocked for a long time, and it turns into heat. Heat is stagnant and dampness steams, which stays in the large intestine. Qi stagnation, dampness and heat are combined, and it is difficult to distinguish them, making this disease lingering and difficult to cure quickly. Therefore, it is imperative to develop new drugs for the treatment of ulcerative colitis.

III. Summary of the invention

In view of the above situation, in order to solve the defects of the prior art, the purpose of the present invention is to provide a traditional Chinese medicine for treating ulcerative colitis, which can effectively solve the medication problem of ulcerative colitis of spleen deficiency, qi stagnation and damp-heat type.

The technical solution of the present invention is that the traditional Chinese medicine is prepared from the following raw materials by weight: 10-15g of costusroot, 10-15g of patchouli, 15-20g of cyperus, 15-30g of roasted astragalus, 10-15g of kudzu root, 12-15g of scutellaria, 6-10g of coptis root, 20-30g of purslane, 5-10g of lithospermum, 5-10g of houttuynia, and 3-5g of liquorice, wherein the above raw materials are mixed in Together, add 400-600ml of water, soak for 15-25 minutes at 18-25℃, then boil over high heat, then turn to low heat, boil for 20-30min, filter, and obtain the filtrate for later use; add 300-400ml of water to the residue, boil over high heat, then turn to low heat, boil for 10-15min, filter, discard the residue, and obtain the filtrate, combine the two filtrates, and concentrate to 1/2~1/3 of the amount of water added twice.

The invention has abundant raw materials, simple preparation method, low cost, easy to take, good effect, and is used for both dredging and tonifying in treatment, with dredging as the main method. Dredging means unblocking, which implies the meaning of "dredging for the general purpose". UC is a disease with internal damp-heat in the intestines and viscera, qi stagnation and blood stasis and other pathological disorders. Combined with the physiological characteristics of "the six viscera are used for dredging and descending for compliance", the method of "dredging for the general purpose" is adopted in treatment, and products with the functions of dredging qi, clearing away heat and removing dampness are used. When the evil is removed, the body is at peace, the spleen and stomach rise and fall in order, and the visceral qi is regulated. It is an innovation in the medicine for treating spleen deficiency, qi stagnation and damp-heat type ulcerative colitis.

4. Specific implementation methods

The specific implementation modes of the present invention are further described in detail below in conjunction with the embodiments.

Example 1

When the present invention is implemented, it can be prepared from the following raw materials by weight: 10g of costusroot, 10g of patchouli, 15g of cyperus, 15g of roasted astragalus, 10g of kudzu root, 12g of scutellaria, 6g of coptis, 20g of purslane, 5g of lithospermum, 5g of houttuynia, and 3g of liquorice, wherein the raw materials are mixed together, 400ml of water is added, and the mixture is soaked at 18°C for 15 minutes, then boiled over high heat, then turned to low heat, decocted for 20 minutes, filtered, and a filtrate is obtained for standby use; 300ml of water is added to the filter residue, boiled over high heat, then turned to low heat, decocted for 10 minutes, filtered, the filter residue is discarded, a filtrate is obtained, the two filtrates are combined, and concentrated to 1/2 of the amount of water added twice, thereby obtaining the product.

Example 2

When the present invention is implemented, it can also be prepared from the following raw materials by weight: 12g of costusroot, 12g of patchouli, 17g of cyperus, 22g of roasted astragalus, 12g of kudzu root, 13g of scutellaria, 8g of coptis, 25g of purslane, 7g of lithospermum, 7g of houttuynia, and 4g of liquorice, wherein the raw materials are mixed together, 500ml of water is added, and the mixture is soaked at 21°C for 20 minutes, then boiled over high heat, then turned to low heat, decocted for 25 minutes, filtered, and a filtrate is obtained for standby use; 350ml of water is added to the filter residue, boiled over high heat, then turned to low heat, decocted for 12 minutes, filtered, the filter residue is discarded, a filtrate is obtained, the two filtrates are combined, and concentrated to 1/3 of the amount of water added twice.

Example 3

When the present invention is implemented, it can also be prepared from the following raw materials by weight: 15g of costus root, 15g of patchouli, 20g of cyperus, 30g of roasted astragalus, 15g of kudzu root, 15g of scutellaria, 10g of coptis root, 30g of purslane, 10g of lithospermum, 10g of houttuynia, and 5g of liquorice, wherein the raw materials are mixed together, added with 600ml of water, soaked at 25°C for 25 minutes, then boiled over high heat, then turned to low heat, decocted for 30min, filtered, and filtrate was obtained for standby use; 400ml of water was added to the filter residue, boiled over high heat, then turned to low heat, decocted for 10-15min, filtered, the filter residue was discarded, a filtrate was obtained, the two filtrates were combined, and concentrated to 1/3 of the amount of water added twice.

The effective combination of the above drugs of the present invention supports each other and is scientifically prepared. It has the functions of regulating qi and strengthening the spleen, clearing away heat and removing dampness. The costus root in the prescription harmonizes various qi, and its fragrance can also wake up the spleen, promote the smooth flow of qi, and help the spleen function; Cyperus rotundus has the effect of regulating qi, relieving depression and relieving pain, "with costus root, stagnation and harmonizing the middle", Cyperus rotundus and costus root, one relieves gastrointestinal qi stagnation, and the other relieves liver and stomach qi stagnation, and the two are used together to regulate the qi of the three burners; Patchouli regulates qi and harmonizes the middle, wakes up the spleen and helps function, and aromaticizes dampness and turbidity, and can remove phlegm and dampness in the middle burner. The three are monarch drugs, and are used together to dredge the spleen, gastrointestinal viscera qi, wake up the spleen and help function, and Pueraria root, Scutellaria baicalensis, and Coptis chinensis are commonly used drugs for treating damp-heat syndrome UC, and their functions are clearing heat and removing dampness, stopping diarrhea and dysentery, and they are used together as ministers. Astragalus has the function of replenishing qi, and roasting it can strengthen the function of replenishing the middle qi. Roasting Astragalus can replenish the spleen qi in the middle jiao to consolidate the foundation. When the spleen and stomach are healthy, the qi can flow smoothly and dampness cannot be generated. In addition, Astragalus has the function of astringing sores and promoting tissue regeneration, which helps to promote the healing of intestinal ulcers. Purslane, Houttuynia cordata, and Lithospermum officinale can help clear heat and cool blood, and can be used as adjuvants to remove dampness, heat, turbidity and toxins. Licorice is used to harmonize the various medicines, and it has the function of strengthening the spleen and replenishing qi. The whole prescription is used for both unblocking and replenishing, with unblocking as the main method. Unblocking means unblocking the spleen, stomach, intestines and qi, and removing dampness and heat; replenishing means replenishing the spleen to protect the acquired foundation, and experiments have achieved very good beneficial technical effects. The relevant experimental data are as follows:

1 Case source

This study selected 62 patients with chronic relapsing active mild to moderate (spleen deficiency, qi stagnation and damp-heat type) UC who visited the inpatient department of the Department of Gastroenterology of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2021 to December 2022 as the research subjects.

2 Diagnostic criteria

2.1 Western medicine diagnostic criteria refer to the "Consensus on the diagnosis and treatment of ulcerative colitis with integrated Chinese and Western medicine (2017)"

1) Clinical manifestations: ① During the active phase of the disease, symptoms include abdominal pain, diarrhea, bloody and mucus-purulent stools, and tenesmus. The symptoms often recur, and the course of the disease is usually longer than 4-6 weeks. ② When the disease is severe or acute, it may be accompanied by systemic symptoms of varying degrees. ③ Extraintestinal manifestations often occur in the skin, joints, eyes, and other parts of the body.

2) Colonoscopy: ① Intestinal mucosal damage is mostly continuous and backwash, developing retrogradely toward the proximal end; the lesions originate from the rectum; ② Endoscopic examination shows varying degrees of mucosal damage, manifested as erythema, congestion, edema, erosion, spontaneous bleeding or contact bleeding; the mucosal vascular texture is blurred or even disappears; the mucosal surface is rough and granular; ③ The colonic pouches may become shallower, blunt or disappear, and pseudopolyps may form.

3) Mucosal histological examination: The main pathological manifestations in the active stage are: ① There are a large number of acute and chronic inflammatory cell infiltrations in the lamina propria, and there are crypt inflammation and crypt abscesses; ② The crypt structure is changed, with irregular shape and size, disordered arrangement, and a decrease in goblet cells; ③ Erosion, shallow ulcer formation and granulation tissue can be seen on the mucosal surface.

The diagnosis of the disease requires that the above three diagnostic criteria are met at the same time and other types of intestinal diseases are excluded.

2.2 TCM diagnostic criteria

With reference to the "Consensus on the Diagnosis and Treatment of Ulcerative Colitis with Integrated Traditional Chinese and Western Medicine (2017)" and "Guidelines for Clinical Research of New Chinese Medicines (Trial)", the following was formulated in combination with clinical practice:

Spleen deficiency, qi stagnation and damp-heat syndrome:

Main symptoms: ① diarrhea; ② bloody stool with mucus and pus; ③ abdominal distension; ④ abdominal pain; ⑤ tenesmus

Secondary symptoms: ① poor appetite; ② fatigue; ③ intestinal rumbling and flatulence; ④ uncomfortable bowel movements; ⑤ burning sensation in the anus. Tongue and pulse: pale red or red tongue, thick white or thick yellow tongue coating, thin or slippery stringy pulse.

Determination of syndrome type: diagnosis can be made by presenting 3 main symptoms plus 3 secondary symptoms, referring to the tongue and pulse.

3 Inclusion criteria

1) Meet the Western medical diagnostic criteria for chronic relapsing active mild to moderate UC (modified Mayo score 3-10 points);

2) TCM diagnosis of spleen deficiency, qi stagnation and dampness-heat type;

3) Age: 18 ≤ ≤ 70 years old, regardless of gender;

4) The patient has good compliance, is willing to accept telephone and outpatient follow-up, voluntarily participates in this study, and signs the "Informed Consent Form".

4 Exclusion criteria

1) Patients with a clear diagnosis of infectious colitis, ischemic enteritis, Crohn's disease, radiation enteritis or other intestinal diseases;

2) Patients with severe complications such as local stenosis, intestinal obstruction, toxic megacolon, massive bleeding, intestinal perforation, and (rectal) colon cancer;

3) Pregnant and lactating women, and patients who have plans to have children in the near future;

4) Use of other western medicines such as immunosuppressants that may affect the efficacy observation;

5) Those with serious heart, liver, lung, brain, kidney, and blood system diseases, such as tumors, acute cerebral hemorrhage, acute and chronic heart failure, etc.;

6) Those who are allergic to the drugs used in this experiment;

7) Participating in other research projects at the same time;

8) Those who suffer from severe mental or intellectual disabilities and are unable to cooperate.

If any of the above items are met, it will be excluded.

5. Elimination criteria

1) Those with poor compliance, who do not take medication as prescribed after inclusion, and whose efficacy cannot be determined;

2) Those whose treatment plan is changed due to changes in their condition;

3) Use other drugs that have a significant impact on the experiment;

4) Allergic reaction occurs.

6 Shedding Standard

1) Those who voluntarily withdraw from treatment due to personal reasons;

2) Patients whose medical records are incomplete and statistical analysis cannot be completed.

If any of the above situations occur, please record the cause and time of shedding in detail.

7 Research Groups

A total of 62 patients with chronic relapsing active mild-to-moderate UC (spleen deficiency, qi stagnation and damp-heat type) who visited the Department of Gastroenterology of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2021 to December 2022 were selected as the research subjects. The patients were numbered from 1 to 62 according to the order of visit, and random numbers were generated using SPSS27.0. The patients were divided into the treatment group and the control group according to the random grouping principle, with 31 cases in each group.

8. Medication

Control group: mesalazine enteric-coated tablets (250 mg × 24 tablets, national medicine standard number H19980148, Kuihua Pharmaceutical Group Jiamusi Luling Pharmaceutical Co., Ltd.), 4 g/d, taken orally in divided doses before meals and bedtime, 1 g/time.

Treatment group: Mesalazine enteric-coated tablets (specific usage is the same as the control group) combined with Chinese medicine Example 1 of the present invention, once in the morning and once in the evening, each time 200-300 ml.

One course of treatment for both the control group and the treatment group was 7 days, and the efficacy was statistically analyzed after 4 courses of treatment.

9. Efficacy evaluation criteria

The scoring method in the "Study on the Application of Integral Method in the Diagnosis and Grading of Chronic Ulcerative Colitis and Evaluation of Efficacy" (see Table 1) was used, and the efficacy was evaluated by the following formula:

Efficacy judgment value = pre-treatment score - post-treatment score / pre-treatment score × 100%

The efficacy standards are as follows: markedly effective: judgment value > 2/3, effective: 1/3 < judgment value < 2/3, ineffective: judgment value < 1/3.

Table 1 Scoring criteria

10 Clinical efficacy evaluation

According to statistics, there were 2 ineffective cases, 11 effective cases, 16 markedly effective cases, 2 clinically cured cases in the treatment group, and the total effective rate was 93.5%. There were 7 ineffective cases, 17 effective cases, 7 markedly effective cases, 0 clinically cured cases in the control group, and the total effective rate was 77.4%. This group of data was ordered rank data, and the Mann-Whitney U test was used. After testing, ^▲ P<0.05, the difference between the two groups was statistically significant, and the therapeutic effect of the treatment group was better than that of the control group.

Clinical efficacy evaluation [n(%)]

While conducting the experiment on the above-mentioned Example 1, the same experiment was also conducted on other examples, and the same or similar results were obtained, which will not be listed here one by one. In addition, no adverse reactions were found in the experiments, indicating that the medication is safe and the efficacy is stable and reliable.

in conclusion

As can be seen from the above, the present invention has abundant raw materials, simple preparation method, easy to take, low cost, good effect, components support each other, has the effects of regulating qi and strengthening spleen, clearing away heat and removing dampness, and the whole prescription is used for both dredging and replenishing, with dredging as the main method, dredging is to dredge the spleen, stomach, intestines and viscera qi mechanism, and remove damp-heat evil; replenishing is to replenish the spleen to protect the acquired foundation. Not only is the efficacy stable, but also the long-term efficacy is good, it is not easy to recur, and it is easily accepted by patients, and is effectively used to treat spleen deficiency, qi stagnation and damp-heat type ulcerative colitis. The three-fragrant decoction of the present invention, which is simple, convenient, cheap and effective, not only conforms to the pathogenesis of ulcerative colitis, but also conforms to the theory of both dredging and replenishing in traditional Chinese medicine, and is an innovation in the treatment of ulcerative colitis medicine, with huge economic and social benefits.

Claims (4)

1. A Chinese medicine for treating ulcerative colitis of spleen deficiency, qi stagnation and damp-heat type, characterized in that the Chinese medicine is made of the following raw materials by weight: 10-15g of costusroot, 10-15g of patchouli, 15-20g of cyperus, 15-30g of roasted astragalus, 10-15g of kudzu root, 12-15g of scutellaria, 6-10g of coptis root, 20-30g of purslane, 5-10g of lithospermum, 5-10g of houttuynia, 3-5g of liquorice, wherein The above raw materials are mixed together, 400-600 ml of water is added, and the mixture is soaked at 18-25°C for 15-25 minutes, then boiled over high heat, then simmered over low heat, decocted for 20-30 minutes, filtered, and the filtrate is set aside; 300-400 ml of water is added to the residue, boiled over high heat, then simmered over low heat, decocted for 10-15 minutes, filtered, the residue is discarded, the filtrate is obtained, the two filtrates are combined, and concentrated to 1/2 to 1/3 of the amount of water added twice. 2. The Chinese medicine for treating ulcerative colitis of spleen deficiency, qi stagnation and damp-heat type according to claim 1, characterized in that it is made from the following raw materials by weight: 10g of costusroot, 10g of patchouli, 15g of cyperus, 15g of roasted astragalus, 10g of kudzu root, 12g of scutellaria, 6g of coptis, 20g of purslane, 5g of lithospermum, 5g of houttuynia, and 3g of liquorice, wherein the above raw materials are mixed together, added with 400ml of water, soaked at 18°C for 15 minutes, then boiled over high heat, then turned to low heat, decocted for 20min, filtered, and a filtrate is obtained for standby use; 300ml of water is added to the filter residue, after boiling over high heat, turned to low heat, decocted for 10min, filtered, the filter residue is discarded, a filtrate is obtained, the two filtrates are combined, and concentrated to 1/2 of the amount of water added twice. 3. The Chinese medicine for treating ulcerative colitis of spleen deficiency, qi stagnation and damp-heat type according to claim 1, characterized in that it is made from the following raw materials by weight: 12g of costusroot, 12g of patchouli, 17g of cyperus, 22g of roasted astragalus, 12g of kudzu root, 13g of scutellaria, 8g of coptis, 25g of purslane, 7g of lithospermum, 7g of houttuynia, and 4g of liquorice, wherein the above raw materials are mixed together, 500ml of water is added, and soaked at 21°C for 20 minutes, then boiled over high heat, then turned to low heat, decocted for 25min, filtered, and a filtrate is obtained for standby use; 350ml of water is added to the filter residue, after boiling over high heat, turned to low heat, decocted for 12min, filtered, the filter residue is discarded, a filtrate is obtained, the two filtrates are combined, and concentrated to 1/3 of the amount of water added twice. 4. The Chinese medicine for treating ulcerative colitis of spleen deficiency, qi stagnation and damp-heat type according to claim 1, characterized in that it is made from the following raw materials by weight: 15g of costusroot, 15g of patchouli, 20g of cyperus, 30g of roasted astragalus, 15g of kudzu root, 15g of scutellaria, 10g of coptis root, 30g of purslane, 10g of lithospermum, 10g of houttuynia cordata, and 5g of liquorice, wherein the above raw materials are mixed together, 600ml of water is added, and soaked at 25°C for 25 minutes, then boiled over high heat, then turned to low heat, decocted for 30min, filtered, and a filtrate is obtained for standby use; 400ml of water is added to the filter residue, after boiling over high heat, turned to low heat, decocted for 10-15min, filtered, the filter residue is discarded, a filtrate is obtained, the two filtrates are combined, and concentrated to 1/3 of the amount of water added twice.