Summary of the invention
The inventor is through discovering, the kidney invigorating treatment osteoporosis curative effect is unsatisfactory separately.The old people is asthenia of renal qi not only, and the function of each internal organs all has and go down, and particularly digestive and absorptive functions weakens." the kidney being the origin of congenital constitution, the spleen being the foundation of acquired constitution ", the vital essence of kidney depends on supplementing nutrition of essence of water and grain, depends on the fortuneization of spleen.It also is futile mending and not absorbing.The inventor adopts the Therapeutic Principle of kidney and spleen invigorating based on this theory, and the result has obtained significant effect.
Therefore purpose of the present invention provides a kind of medicine of effective treatment osteoporosis.
Kidney-tonifying and bone-strengthening mixture of the present invention comprises following raw material: Fructus Psoraleae 6-35, and Rhizoma Drynariae 6-35, Herba Epimedii 6-35, Radix Rehmanniae Preparata 8-40, Fructus Schisandrae Chinensis 5-25, Radix Astragali 6-35, Radix Codonopsis 6-35, Cortex Moutan 5-25 and Radix Glycyrrhizae 0-12, all by weight.
The preferred weight proportioning of medicine of the present invention is: Fructus Psoraleae 10-30, Rhizoma Drynariae 10-24, Herba Epimedii 10-24, Radix Rehmanniae Preparata 10-30, Fructus Schisandrae Chinensis 8-16, Radix Astragali 10-24, Radix Codonopsis 10-24, Cortex Moutan 8-16 and Radix Glycyrrhizae 5-10.
The best proportioning of medicine of the present invention is: Fructus Psoraleae 16, Rhizoma Drynariae 16, Herba Epimedii 16, Radix Rehmanniae Preparata 20, Fructus Schisandrae Chinensis 12, the Radix Astragali 16, Radix Codonopsis 16, Cortex Moutan 12 and Radix Glycyrrhizae 6.
The side forms with pure Chinese herbal medicine of number flavor such as Fructus Psoraleae, Rhizoma Drynariae, Radix Rehmanniae Preparata, Radix Codonopsis, the Fructus Psoraleae kidney invigorating and YANG supporting, and the Radix Codonopsis invigorating the spleen and benefiting QI is monarch drug altogether; The power of Rhizoma Drynariae, the auxiliary Fructus Psoraleae kidney-replenishing of Herba Epimedii, the Radix Astragali helps the Radix Codonopsis spleen invigorating, is ministerial drug; Nourishing YIN for benefiting the kidney such as Radix Rehmanniae Preparata, the Cortex Moutan cooling blood and removing stasis is adjuvant drug; The Radix Glycyrrhizae coordinating the actions of various ingredients in a prescription is messenger drug in the side, full side's invigorating the kidney and strengthening the bones, and invigorating the spleen and benefiting QI, blood circulation promoting and blood stasis dispelling, spleen invigorating in the negative and positive of giving young employees remedial-courses in general knowledge and vocational skills kidney must be filled the congenital foundation, and the foundation of acquired constitution gets reality.
Can be used for osteoporosis finding soreness of the waist and knees, arthralgia, odontoseisis, inappetence, shortness of breath and fatigue, limbs asthenia.
A kind of method of preparation medicine of the present invention is: decoct with water secondary, and each about 1 hour, collecting decoction, filter, it is 1.25-1.30 (50 ℃) that filtrate decompression is concentrated into relative density, adds the ethanol (75-90% for example of triplication, especially about 80%), stir evenly, left standstill about 72 hours, get supernatant, reclaim ethanol, add water and suitably dilute to there not being the alcohol flavor, stir evenly, packing, sterilization, promptly.
Also can according to a conventional method prescription of the present invention be made clinical common formulations, pill for example, powder, capsule, concentrated pill, liquid preparation etc.
Be noted that medicine of the present invention can also contain other optional member, carrier for example, as excipient, diluent etc.; Can also make the Chinese medicine and western medicine compound preparation with the osteoporotic Western medicine of treatment.These change all in protection scope of the present invention.
Embodiment
Below in conjunction with embodiment the present invention is described, but these embodiment only are used for illustrative purposes, the invention is not restricted to these embodiment.
Embodiment 1
Get Fructus Psoraleae 16g, Rhizoma Drynariae 16g, Herba Epimedii 16g, Radix Rehmanniae Preparata 20g, Fructus Schisandrae Chinensis 12g, Radix Astragali 16g, Radix Codonopsis 16g, Cortex Moutan 12g, with Radix Glycyrrhizae 6g, decoct with water secondary, each 1 hour, collecting decoction, filter, it is 1.25-1.30 (50 ℃) that filtrate decompression is concentrated into relative density, adds 80% ethanol of triplication, stirs evenly, left standstill 72 hours, and got supernatant, reclaim ethanol, add water and adjust total amount to 100ml to there not being the alcohol flavor, stir evenly, packing, sterilization, promptly.
Embodiment 2
Get Fructus Psoraleae 30g, Rhizoma Drynariae 20g, Herba Epimedii 20g, Radix Rehmanniae Preparata 20g, Fructus Schisandrae Chinensis 16g, Radix Astragali 16g, Radix Codonopsis 16g, Cortex Moutan 12g, with Radix Glycyrrhizae 6g, decoct with water secondary, each 1 hour, collecting decoction, filter, it is 1.25-1.30 (50 ℃) that filtrate decompression is concentrated into relative density, adds 80% ethanol of triplication, stirs evenly, left standstill 72 hours, and got supernatant, reclaim ethanol, add water and adjust total amount to 120ml to there not being the alcohol flavor, stir evenly, packing, sterilization, promptly.
One, pharmacodynamics test
From in June, 1999 to the calendar year 2001 December, (96 examples are organized in treatment to have observed 160 examples in outpatient service, matched group 32 examples, blank group 32 examples), according to the balanced random packet table of layer and section, with 3: 1 ratios patient is divided into treatment group and matched group, the blank group reduces for diagnosing osteoporosis or bone amount, but does not take the medicine person (visiting the patient of check) of any treatment osteoporosis in half a year.With observing table record patient's clinical symptoms and laboratory examination result.Take medicine and do comprehensive review after half a year.The treatment by Chinese herbs group gives kidney-tonifying and bone-strengthening mixture of the present invention.The Chinese medicine matched group gives SHENGU JIAONANG.Observation bone density, clinical symptoms, Bone Gla protein (BGP), urine pyridol (PYD), estradiol (E2), testosterone (T), blood urea nitrogen (BUN), transaminase (GPT), calcium (Ca), phosphorus (P), alkali phosphatase (AKP) and hematuria routine.
The result: treatment group treatment back bone density has on average improved 4.06%, and bone density has on average improved 1.1% after the treatment of control group, blank group bone density decreased average 5.47%.The treatment group obviously is better than matched group and blank group.Treatment group Bone Gla protein significantly increases, and the urine pyridol significantly descends, and illustrates that this Chinese medicine has the effect that promotes bone formation and suppress bone resorption.There are no significant changes for E2, T before and after the treatment, and the mechanism of action that this medicine protect against osteoporosis is described not trafficability characteristic functions of hormones is realized.Produce effects 72 examples in 96 examples are organized in treatment, account for 75%, total effective rate 89.6%; In matched group 32 examples, produce effects 13 examples account for 40.6%, total effective rate 62.5%.The comprehensive therapeutic effect of treatment group obviously is better than matched group.The acute toxicity animal experiment shows that the kidney-tonifying and bone-strengthening mixture toxic and side effects is little, is safe and reliable.
1, clinical data
1.1 diagnostic criteria
According to osteoporosis committee of Chinese Gerontological Society, " diagnostic criteria of Chinese's primary osteoporosis " of diagnosing osteoporosis standard subject group in January, 1999 formulation, bone density value is compared (BMD%) with other peak density of the local same sex, and is normal substantially: reduce 1-12%; The bone amount reduces: reduce 13-24%; Osteoporosis: reduce 〉=25%.
1.2 case is selected
Include standard in: select the postmenopausal women and male more than 70 years old, meet the patient that osteoporosis and bone amount reduce.
Exclusion standard: except hepatic and renal function grievous injury person; The person's (comprising diabetes, chronic rheumatic, rheumatoid arthritis, constitutional myeloma, malignant metastatic tumor of bone etc.) that suffers from the incretion metabolism disease; Take heparin, corticosteroid, estrogen, calcitonin etc. in 3 months and influenced bone metabolism medicine person.
Age distribution: clinical observation 160 examples, male's 8 examples wherein, women's 152 examples, age 45-79 year, average 62.6 years old.Auspiciously see Table 1.
Table 1, age distribution and the comparison of state of an illness situation (X ± S)
Group | The example number | Age distribution (year) | State of an illness situation (example) |
On average | Maximum | Minimum | Osteoporosis | The bone amount reduces |
The treatment group | 96 (men 6) | 62.7±6.88 | ?79 | ?45 | ?85 | ?11 |
Matched group | 32 (men 1) | 62.75±7.04 | ?74 | ?49 | ?26 | ?6 |
Blank group | 32 (men 1) | 62.4±7.13 | ?79 | ?49 | ?25 | ?7 |
2, Therapeutic Method
2.1 medication
According to layer and section random packet table, divide three layers with age, sex, state of an illness weight, with 4 examples is that one section ratio with 3: 1 is divided into treatment group and matched group with patient, the blank group reduces for being diagnosed as osteoporosis or bone amount, but does not obey the medicine person (visiting the patient of check) of any treatment osteoporosis in half a year.With seeing look-up table patient's clinical symptoms and laboratory examination result.Do comprehensive review after taking half a year.The treatment by Chinese herbs group gives medicine of the present invention, and each 25ml, 3 months one courses of treatment, serve on 2 courses of treatment at day 2 times.The Chinese medicine matched group gives SHENGU JIAONANG (Beijing Tianjiu Pharmaceutical Co., Ltd.'s production), lot number: the accurate word (1997) of medicine is defended No. 039005 in the capital.Main component: Concha Ostreae etc., each 2, every day 3 times, take medicine half a year.
2.2 observation index:
Bone density (BMD) is measured.Use the DEXA dual intensity X line bone density meter of U.S. Lunar company, be responsible for measuring the proximal femur bone density, the same position of treatment fore-and-aft survey by the special messenger.
Clinical symptoms.Dialectical and the disease standard of traditional Chinese medical science osteoporosis: the disease diagnostic criteria of suffering from a deficiency of the kidney insufficiency of the spleen in the rheumatism involving the bone of " disease of tcm diagnosis criterion of therapeutical effect " that the national traditional chinese medical science administration of reference formulates and the Diagnostics of Chinese Medicine.
Cardinal symptom: lumbago and backache, osteodynia.
Minor symptom: aversion to cold and cold limbs, soreness of the waist and knees, indigestion and loss of appetite, abdominal distention, big dry stool or half congealed rushing down, frequent micturition, frequent urination at night, light red tongue or light red tongue are white, a little less than the deep-thready pulse.
2.3 laboratory examination
The bone formation index: Bone Gla protein (BGP) is measured with the RIA method.Medicine box is provided by Chinese Academy of Sciences Institute for Atomic Research.
The osteoclasia index: urine pyridol (PYD) is measured with the ELISA method.Adopt the medicine box of U.S. LEPRA company.
Gonadal hormone index: estradiol (E2), testosterone (T)
Differential Diagnosis and safety indexes: blood urea nitrogen (BUN), transaminase (GPT), calcium (Ca), phosphorus (P), alkali phosphatase (AKP), hematuria routine.
Statistical method: use SPSS 10.0 statistical softwares, measurement data adopts the t check, and ranked data adopt Ridit to analyze.
3, result
3.1 curative effect determinate standard (comprehensive therapeutic effect): produce effects: the more preceding raising of bone density value, and clinical cardinal symptom takes a turn for the better.Effectively: the more preceding nothing of bone density value increases, but biochemical indicator (BGP/PYD) improvement, and clinical cardinal symptom takes a turn for the better.Invalid: bone density value continue to descend, and biochemical indicator do not have improvement, and clinical symptoms does not have improvement.
The primary symptom standards of grading: no lumbago and backache is 0 minute; Slightly: pain is lighter, occur once in a while, and be 1 minute; Moderate: the time heavy when light, outbreak repeatedly, but do not influence life and work is 2 minutes; Severe: pain is heavier, and lasting pain has influenced orthobiosis, work, is 3 minutes.Before and after the treatment relatively: reduced by 2 fens or reduced to 0 and be divided into produce effects, reduce by 1 and be divided into effectively, it is invalid that reduction by 0 is divided into.
3.2 therapeutic outcome
BMD, AKP, BGP, PYD measurement result before and after the treatment
The result shows that treatment group treatment back bone density has on average improved 4.06%, has significant differences.Bone Gla protein significantly increases, and the urine pyridol significantly descends; Bone density has on average improved 1.1% after the treatment of control group, and Bone Gla protein does not have remarkable increase, and the urine pyridol has remarkable decline; Blank group bone density decreased average 5.47%.(seeing Table 2)
BMD measurement result comparison before and after three groups of treatments of table 2 (X ± S)
Group | The example number | BMD (%) before the treatment | Treatment back BMD (%) | Treatment back BMD rate of change (%) |
The treatment group | 96 | ?62.42±11.32 | ?66.48±11.54 | +4.06±5.31
***ΔΔ |
Matched group | 32 | ?62.81±11.83 | ?63.91±12.13 | ?1.09±5.86
*** |
Blank group | 32 | ?65.22±11.82 | ?59.75±11.66 | -5.47±4.13 |
Treatment group, matched group respectively and carry out t check between the blank group,
* *P<0.001
Treatment group and matched group carry out t check, Δ Δ p<0.01
BGP, PYD measurement result (X ± S) relatively before and after the treatment of two groups in table 3
Group | The example number | BGP(ng/ml) | ?PYD |
The treatment group | 70 | Treat preceding 7.42 ± 5.94 | ?39.27±24.15 |
| | Treatment back 10.94 ± 6.36
*** | ?30.38±13.52
** |
Matched group | 22 | Treat preceding 4.37 ± 3.97 | ?40.30±17.79 |
| | Treatment back 7.005.19
* | ?31.0711.54
* |
Carry out paired t-test before and after the treatment,
*P<0.05,
*P<0.01,
* *P<0.001
The observation of hormonal readiness before and after the treatment
Table 4 estrogen level is observed table
| The example number | Estradiol (E
2)
| Testosterone (T) |
The treatment group | 40 | Treat preceding 33.71 ± 45.01 | Treat preceding 92.12 ± 73.72 |
| | Treatment back 27.10 ± 16.68 | Treatment back 114.62 ± 99.93 |
Matched group | 11 | Treat preceding 40.45 ± 31.86 | Treat preceding 122.03 ± 88.29 |
| | Treatment back 32.54 ± 18.13 | Treatment back 123.98 ± 67.21 |
Carry out paired t-test, difference that there are no significant before and after treatment group, the treatment of control group.
Clinical primary symptom lumbar and back pain is improved situation (seeing Table 5)
The clinical primary symptom lumbago and backache of table 5 improves information slip
| Total routine number | Produce effects | Effectively | Invalid | Total effective rate % |
The example number | ?% | The example number | ?% | The example number | ?% |
The treatment group | 96 | ?52 | ?54.17 | ?43 | ?44.79 | ?1 | ?1.04 | ?99 |
Matched group | 32 | ?5 | ?15.63 | ?20 | ?62.50 | ?7 | ?21.88 | ?78.1 |
Carry out Ridit between two groups and analyze, utmost point significant difference is arranged, P<0.01
Treatment group cardinal symptom total effective rate is 99%, and obvious effective rate is 54.17%, and matched group cardinal symptom total effective rate is 78.1%, obvious effective rate is 15.63%, analyze through Ritid between two groups, total effective rate and obvious effective rate all have significant differences, and the treatment group obviously is better than matched group.
Comprehensive therapeutic effect
Produce effects 72 examples in 96 examples are organized in treatment, account for 75%, total effective rate 89.6%; In matched group 32 examples, produce effects 13 examples account for 40.6%, total effective rate 62.5%.
The analysis of table 6 comprehensive therapeutic effect
Group | Total routine number | Produce effects | Effectively | Invalid | Total effective rate % |
The example number | % | The example number | % | The example number | % |
The treatment group | 96 | ?72 | ?75.0 | ?14 | ?14.6 | ?10 | ?10.4 | ?89.6 |
Matched group | 32 | ?13 | ?40.6 | ?7 | ?21.9 | ?12 | ?37.5 | ?62.5 |
Carry out Ridit between two groups and analyze, utmost point significant difference is arranged, P<0.01 illustrates that the comprehensive therapeutic effect of treatment group obviously is better than matched group.
The adverse effect observed result
Treatment is had a blood test before and after organizing 96 routine patient treatments, is urinated, just abnormal change does not all appear in routine, transaminase, blood urea nitrogen, and gastrointestinal reaction does not appear in the treatment group, has 5 examples slightly discomfort of stomach to occur in matched group 32 examples, but not drug withdrawal spontaneous remission.
Result of the test shows that after the patient obeyed kidney-tonifying and bone-strengthening mixture, BGP significantly raise, and PYD decline P<0.01 illustrates that this Chinese medicine has the effect that promotes bone formation and suppress bone resorption.There are no significant changes for E2, T before and after the treatment, and the mechanism of action that this medicine protect against osteoporosis is described not trafficability characteristic functions of hormones realizes that its mechanism of action awaits further research.
In sum, kidney-tonifying and bone-strengthening mixture can improve bone density and improve clinical primary symptom, promotes bone formation, suppresses bone resorption, is a kind of medicine of evident in efficacy, safe and reliable control primary osteoporosis, has good DEVELOPMENT PROSPECT.
Two, acute toxicity animal experiment
1, the mensuration of mice oral administration maximum tolerated dose
Test objective
Measure the maximum tolerated dose and the minimum lethal dose of a gastric infusion of mice.
Be subjected to the reagent thing
Kidney-tonifying and bone-strengthening mixture (concentrating) is that pitchy is thick, and every gram cream contains crude drug amount 4.2g.Preserved at 4 ℃ of lower seals by the reagent thing, take by weighing ointment before the test, in beaker, add distilled water gradually and stir, make and to be equivalent to crude drug cream amount 4.2g/ml by the maximum suspendible concentration 1.0g/ml of No. 16 filling stomach syringe needles.
Animal
Three grades of Kunming mouses, totally 80, male and female half and half, body weight 19-21g, is provided the animal quality quality certification number by 20 every group by Nat'l Pharmaceutical ﹠ Biological Products Control Institute's Experimental Animal Center: No. the 079th, capital moving pipe matter word (1994).Mice is laboratory animal room's breeding observing 1 day, and choosing is healthy, body weight is consistent is used for test.10 mices of every cage.20-22 ℃ of laboratory animal temperature, relative humidity 53%.
Test method
Mice is by sex, body weight random packet.High dose group is irritated stomach with the only maximum administration volume of mice body weight 20g/ 0.8ml, divides into 3 dosage groups with 1: 0.85 dose apart from ratio, is administered once in one day.The mice fasting is 12 hours before the administration, observes 7 days reaction and the death condition of record animal after the administration continuously.
The result
The mice activity reduces after the administration, and is prostrate motionless, breathe deeply slowly, and lassitude, insensitive to stimulations such as light, sound, relaxed minimizings such as feed consumption, amount of drinking water by hair.Animal dead occurred later at 3 hours, peaked in 24 hours, stopped death in 48 hours later on.Dissect dead mice, each internal organs is not seen other toxic reaction.See table for details.
Table 7
Dosage g/kg | Log10 dose X | Number of animals n | Death toll n | Mortality rate % |
?47.1 | ?1.673 | ?20 | ?7 | ?35 |
?40.0 | ?1.602 | ?20 | ?2 | ?10 |
?34.0 | ?1.531 | ?20 | ?0 | ?0 |
?28.9 | ?1.461 | ?20 | ?0 | ?0 |
The dead mouse reason may to suppress the central nervous system relevant with medicine, cause lassitude, movable reduce, breathe dark slow.Clinical consumption is 2 times/day, and 50ml (being equivalent to crude drug amount 57g) is grown up and presses the calculating of 60kg body weight altogether, and actual absorption total amount is 0.95g/kg.Therefore gastric infusion 40g/kg of mice (crude drug amount 168g/kg) is equivalent to 177 times of clinical people's consumption.
Conclusion
Gastric infusion of Kunming mouse, its maximum tolerated dose is 34g/kg, is equivalent to 150 times of clinical people's consumption; Minimum lethal dose is 40g/kg, is equivalent to 177 times of clinical people's consumption.
2, mouse subcutaneous injection administration LD
50Mensuration
Test objective
Measure the toxic reaction and the median lethal dose(LD 50) of a subcutaneous injection administration of mice.
Be subjected to the reagent thing
Kidney-tonifying and bone-strengthening mixture (concentrating) is that pitchy is thick, and every gram cream contains crude drug amount 4.2g.Preserved at 4 ℃ of lower seals by the reagent thing, take by weighing ointment before the test, in beaker, add distilled water gradually and stir, make and to pass through No. 7 injection needle suspendible concentration 0.8g/ml, be equivalent to crude drug cream amount 3.36g/ml.
Animal
Three grades of Kunming mouses, totally 50, male and female half and half, body weight 19-21g, is provided the animal quality quality certification number by 10 every group by Nat'l Pharmaceutical ﹠ Biological Products Control Institute's Experimental Animal Center: No. the 079th, capital moving pipe matter word (1994).Mice is laboratory animal room's breeding observing 1 day, and choosing is healthy, body weight is consistent is used for test.10 mices of every cage.20-22 ℃ of laboratory animal temperature, relative humidity 53%.
Test method
The dosage scope is selected in trial test, sets 5 dosage groups with 1: 0.85 dose down apart from ratio.Formal test is by sex, body weight random packet.1 the subcutaneous injection 0.5ml in mice 20g body weight back.Mice non-fasting before the administration was observed 7 days after the administration continuously, reaction and the death condition of record animal.
The result
Mice lassitude, activity reduce after the administration, and be prostrate motionless, breathe deeply slowly, and lassitude, insensitive to stimulations such as light, sound, stand up reflection and fade away, chaeta is lax, minimizings such as diet, amount of drinking water.No sialorrhea and shedding tears.Animal dead occurred later at 2 hours, stopped death in 24 hours later on.Dissect dead mice, more pitchy medicinal liquid infiltration is arranged in soft tissue except that injection site is subcutaneous, all the other each internal organs no abnormality seens.Not dead mice administration after 7 days body weight increase to some extent, back part of animal injection pin hole has the hard scar of grain of rice size black, other toxic reaction is not seen in epidermis depilation on every side.See table for details.
Table 8
Dosage g/kg | Log10 dose X | Number of animals n | Death toll n | Mortality rate % |
?20.0 | ?1.301 | ?10 | ?10 | ?100 |
?17.0 | ?1.230 | ?10 | ?8 | ?80 |
?14.5 | ?1.161 | ?10 | ?4 | ?40 |
?12.3 | ?1.090 | ?10 | ?1 | ?10 |
?10.4 | ?1.017 | ?10 | ?0 | ?0 |
The dead mouse reason may to suppress the central nervous system relevant with medicine, cause lassitude, movable reduce, breathe dark slow, insensitive etc. to weak stimulation.
Conclusion
A subcutaneous injection administration of Kunming mouse, its LD
50And credible 14.93 (13.82-16.14) g/Kg that is limited to, be equivalent to crude drug amount 62.7 (58.0-67.8) g/Kg.
Three, preparation quality standard and stability test
Fructus Psoraleae is the monarch drug in the medicine of the present invention, has effect of warming kidney and strengthening yang, and psoralen and isopsoralen are the effective ingredient of Fructus Psoraleae, and content is higher, determine with psoralen and isopsoralen to be index, measure their content in preparation, control the quality of product with this.This test adopts high performance liquid chromatography to carry out.Measure through three batches of preparations, psoralen and isopsoralen content are basic identical, and total amount is not less than 0.13mg/ml.And raw material Fructus Psoraleae content measured, total amount is not less than 0.08%.The examination of clinical research medication preliminarily stabilised, with three batches of gentle putting three months of Drug Manufacturing Room, it is little, basicly stable to measure in three batches of preparations psoralen and isopsoralen changes of contents.
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