A kind of pharmaceutical composition that prevents to anaesthetize rear shiver with cold
Technical field
The present invention relates to the field of Chinese medicines, be specifically related to a kind of pharmaceutical composition that prevents to anaesthetize rear shiver with cold.
Background technology
Anesthesia is the mark of modern medical service progress, various anesthesias no doubt make sufferer carry out surgical operation under calm, painless comfort conditions, but anaesthetic is except impact consciousness, change Pain Cognition degree, also can disturb the normal physiological function of sufferer, such as heart beating, blood pressure, breathing etc.
Shiver with cold after anesthesia, first shows as peripheral blood vessel contraction and central body temperature and declines, i.e. so-called " shivering with cold after idiopathic general anesthesia ", " penthiobarbital sample is tetanic ", and its incidence rate is conventionally 5%~65%.The hazardness of shiver with cold: 1. organism metabolism rate significantly raises, body oxygen consumption increases, and oxygen consumption is for common 2~5 times, carbon dioxide and lactic acid generate and increase simultaneously, body is breathed by reinforcement and cardiac work is obtained compensatoryly, and therefore cardiopulmonary loads increases, and can cause cardiorespiratory failure to critical patient.2. ambulatory electrocardiogram confirms, body temperature is lower than the patient of 35 DEG C, and the ratio of myocardial ischemia is apparently higher than the normal patient of body temperature.3. under low temperature, shiver with cold, platelet function can be damaged, and coagulation cascade reaction suppresses, and blood loss significantly increases, and transfusion volume increases.
After anesthesia, the mechanism of shiver with cold is not yet completely clear.Sessler research is thought: under narcotism, due to sympathetic nerve function retardance, peripheral blood vessel weakens the contractile response of cold stimulation.Like this, body heat is by central compartment fast to peripheral compartment conduction (heat distributes again), and central temperature declines rapidly, thereby stimulates organism temperature sensor and cause chill reaction.And Rosenberg etc. think, after anesthesia, shiver with cold is to recover the speed of awakening with the rear nerve centres at different levels of anesthesia, and sequencing difference is relevant, and spinal cord RC is more Zao than the awakening of brain response maincenter, thereby causing spontaneous muscle to tremble, is the result of autonomic reflex not.Separately someone thinks, shiver with cold is because of in patient's anesthesia recovery process, brain thermotaxic centre dysfunction and occurring.
Summary of the invention
Technical assignment of the present invention is for above the deficiencies in the prior art, provides a kind of curative effect certainly and the pharmaceutical composition of the rear shiver with cold of prevention anesthesia that side effect is little.
The technical scheme that the present invention solves its technical problem is: a kind of pharmaceutical composition that prevents to anaesthetize rear shiver with cold, is characterized in that being prepared from by the crude drug of following weight proportion: 10 ~ 30 parts of Radix Satyrii nepalensiss, 6 ~ 12 parts of Herba Changnieniae amoenaes, 3 ~ 10 parts of Spina Gleditsiaes, 6 ~ 12 parts of Rhizoma Cimicifugaes, 3 ~ 10 parts of Squama Maniss, 6 ~ 12 parts of Radix Puerariaes, 6 ~ 12 parts of Herba Sarcandraes, 6 ~ 12 parts of Cortex Ponciri trifoliatae, 6 ~ 12 parts of Rhizoma Anemones Altaicaes, 1 ~ 5 part of Asarum forbesii Maxim, 3 ~ 10 parts of Fructus Chaenomeliss, 10 ~ 25 parts of Retinervus Luffae Fructuss.
Chinese medicine of the present invention is to be prepared from by the raw material of following optimum weight part proportioning: 20 parts of Radix Satyrii nepalensiss, 10 parts of Herba Changnieniae amoenaes, 6 parts of Spina Gleditsiaes, 10 parts of Rhizoma Cimicifugaes, 6 parts of Squama Maniss, 10 parts of Radix Puerariaes, 10 parts of Herba Sarcandraes, 10 parts of Cortex Ponciri trifoliatae, 10 parts of Rhizoma Anemones Altaicaes, 2 parts of Asarum forbesii Maxims, 6 parts of Fructus Chaenomeliss, 20 parts of Retinervus Luffae Fructuss.
Wherein said: Radix Satyrii nepalensis is the long tuber apart from the blue Satyrium nepalense D. Don of bird foot of orchid.Nature and flavor are flat; Sweet.Return kidney; Heart channel.Merit can strengthening waist and nourishing kidney.
Herba Changnieniae amoenae, for the orchid family Herba Changnieniae amoenae Changuienia amoena Chien, is used as medicine with herb, root.Merit can heat clearing away, removing heat from blood, removing toxic substances.
Spina Gleditsiae is the dry Spina jujubae of leguminous plant Fructus Gleditsia Gleditsia sinensis Lam..Nature and flavor are pungent, temperature.Return liver, stomach warp.The merit poison holding of can subsiding a swelling, evacuation of pus, parasite killing.
Rhizoma Cimicifugae is ranunculaceae plant C.heracleifolia Cimicifuga heracleifolia Kom., Cimicifuga Dahurica Cimicifuga dahurica (Turcz.) Maxim. or the dry rhizome of Rhizoma Cimicifugae Cimicifuga foetida L..Nature and flavor are pungent, micro-sweet, are slightly cold.Return lung, spleen, stomach, large intestine channel.Merit can be delivered rash, heat-clearing and toxic substances removing, elevate a turnable ladder yang-energy.
Squama Manis is the scute of Manidae animal Squama Manis Manis pentadactyla Linnaeus.Nature and flavor are salty, are slightly cold.Return liver, stomach warp.The merit stimulating milk secretion of can stimulating the menstrual flow, detumescence and apocenosis, expel wind to dredge collateral.
Radix Puerariae is the root of leguminous plant Pachyrhizua angulatus.Sweet, pungent, flat.Enter spleen, stomach warp.Merit can be induced sweat, rash, and relaxing muscles and tendons, promotes the production of body fluid, antidiarrheal.
Herba Sarcandrae is the dry Herb of Chloranthaceae plant plait Corallium Japonicum Kishinouye Sarcandra glabra (Thunb.) Nakai.Bitter, pungent, flat.GUIXIN, Liver Channel.Merit can clearing away heat and cooling blood, the speckle removing of invigorating blood circulation, dispelling wind and removing obstruction in the collateral.
Cortex Ponciri trifoliatae is bark bits or the peel bits of rutaceae Fructus Ponciri Trifoliatae (Fructus Ponciri Trifoliatae Immaturus) Poncirus tuifoliata (L.) Raf..Nature and flavor are pungent; Temperature.Return liver; Kidney channel.Merit can endogenous wind stopping relieving convulsion; Eleminating phlegm and freeing channels.
Rhizoma Anemones Altaicae, for Ranunculaceae thimbleweed anemone altaica Anemone altaica Mey., is used as medicine with root stock.Nature and flavor are pungent, temperature.Merit can causing resuscitation with aromatic drugs, reduces phlegm, and calms the nerves.
Asarum forbesii Maxim is rhizome and root or the herb of aristolochiaceae plant Herba Asari Forbesii Asarum forbesii Maxim..Nature and flavor are pungent; Temperature.Return lung; Liver; Kidney; Urinary bladder channel.Merit can expelling wind and cold; Expectorant diuretic; Promoting blood circulation and stopping pain.
Fructus Chaenomelis is the dry almost ripe fruit of rosaceous plant chaenomeles lagenaria Chaenomeles speciosa.Nature and flavor acid, temperature.Return liver, spleen channel.Merit can suppressing the hyperactive liver relaxing muscles and tendons, stomach function regulating removing dampness.
Retinervus Luffae Fructus is the vascular bundle of the dry mature fruit of cucurbitaceous plant Fructus Luffae Luffa cylindrica (L.) Roem..Sweet, flat.Return lung, stomach, Liver Channel.Merit can dredging collateral, invigorates blood circulation, and dispels the wind.
Composition principle: shiver with cold after anesthesia different from exterior syndrome due to wind-cold shiver with cold, not only, without the high heat of secondary, also show as central body temperature simultaneously and decline.In exterior syndrome due to wind-cold, to be cold-evil visitor defend point in flesh table the reason of shiver with cold heating, and shiver with cold after anesthesia as anaesthetic, cause inside and outside the negative and positive of physiological status can not traffic, be embodied in Yuanyang and lie prostrate in Shao Yin, yang-energy is hindered, defend gas not with flourish phase-splitting and, the gas defended of battalion can not reach due to flesh table thoroughly.Exterior syndrome due to wind-cold is with the cold expelling medicine divergence cold-evil of inducing sweat with except shiver with cold, but if shiver with cold is used relieving the exterior syndrome with drugs of pungent in flavor and warm in nature medicine after anesthesia, lunar first YANG deficiency, when hiding counter letting out, or becomes raw his disease.Therefore its prevention, should with inside and outside traffic, resolving mass and removing the obstruction of the collateral, consolidate heat clearing away and go forward side by side.
Compared with prior art, the present invention has following characteristics.
1, prescription uniqueness: get Radix Satyrii nepalensis, Spina Gleditsiae in side for monarch, described Radix Satyrii nepalensis, Spina Gleditsiae coordinate, for shiver with cold after anesthesia, the few cloudy Yuanyang of the Radix Satyrii nepalensis temperature dim glow of the setting sun, Spina Gleditsiae follows Liver Channel Xin Wentuo and falls apart; Radix Satyrii nepalensis is different from other training tonic thing, and its negative and positive are gentle, and nature and flavor are flat sweet, and without the anxiety of derivative endogenous fire, but the feature of Radix Satyrii nepalensis is to keep and do not walk, the clinical strengthening waist and nourishing kidney that is used for, but coordinate Spina Gleditsiae to lift yang-energy, the gas of Yuanyang can walk in shaoyin channel network.Experimental results show that: Radix Satyrii nepalensis, Spina Gleditsiae 1:3 ratio decocting liquid gavage, can improve rat plasma prostaglandin E l level, and the amount of being-effect linear relationship trend, and single Radix Satyrii nepalensis and single Spina Gleditsiae decocting liquid are for impact and the relatively not statistically significant of blank group of blood prostaglandin E l level.
2, in side, getting Herba Changnieniae amoenae, Rhizoma Cimicifugae, Squama Manis, Radix Puerariae, Herba Sarcandrae is minister: Herba Changnieniae amoenae, Herba Sarcandrae have the merit of removing summer-heat, can effectively prevent that yang-energy from too laxing brought intenseness of heat, Rhizoma Cimicifugae, Radix Puerariae elevate a turnable ladder yang-energy, and auxiliary Spina Gleditsiae is lifted yang-energy; Squama Manis expel wind to dredge collateral, increases walking effect.
3, supplementary drug thing is fewer but better, Cortex Ponciri trifoliatae endogenous wind stopping dredging collateral; Rhizoma Anemones Altaicae is had one's ideas straightened out and calms the nerves; The pungent temperature of Asarum forbesii Maxim is wandered away, and has effect of promoting blood circulation and stopping pain, is suitable for Postoperative relief pain; Fructus Chaenomelis relaxing muscles and tendons.Retinervus Luffae Fructus dredging collateral is invigorated blood circulation.
4, medicine material consumption of the present invention is groped in a large number to sum up through inventor and is drawn, each raw material consumption is for all to have good curative effect in following weight parts scope.
Detailed description of the invention
Below in conjunction with practical situation, the specific embodiment of the present invention is elaborated.
Embodiment 1, crude drug weight proportion: 20 parts of Radix Satyrii nepalensiss, 10 parts of Herba Changnieniae amoenaes, 6 parts of Spina Gleditsiaes, 10 parts of Rhizoma Cimicifugaes, 6 parts of Squama Maniss, 10 parts of Radix Puerariaes, 10 parts of Herba Sarcandraes, 10 parts of Cortex Ponciri trifoliatae, 10 parts of Rhizoma Anemones Altaicaes, 2 parts of Asarum forbesii Maxims, 6 parts of Fructus Chaenomeliss, 20 parts of Retinervus Luffae Fructuss.
The preparation method of embodiment 1 is: Radix Satyrii nepalensis, Herba Changnieniae amoenae, Spina Gleditsiae, Rhizoma Cimicifugae, Squama Manis, Radix Puerariae, Herba Sarcandrae, Cortex Ponciri trifoliatae, Rhizoma Anemones Altaicae, Asarum forbesii Maxim, Fructus Chaenomelis, Retinervus Luffae Fructus mixing and water adding are decocted, after 30 minutes, get filtrate, medicinal residues add water to continue to decoct after 20 minutes and get filtrate, twice filtrate merges, and is divided into two parts of morning and evenings to take.
Embodiment 2, crude drug weight proportion: 10 parts of Radix Satyrii nepalensiss, 6 parts of Herba Changnieniae amoenaes, 3 parts of Spina Gleditsiaes, 6 parts of Rhizoma Cimicifugaes, 3 parts of Squama Maniss, 6 parts of Radix Puerariaes, 6 parts of Herba Sarcandraes, 6 parts of Cortex Ponciri trifoliatae, 6 parts of Rhizoma Anemones Altaicaes, 1 part of Asarum forbesii Maxim, 3 parts of Fructus Chaenomeliss, 10 parts of Retinervus Luffae Fructuss.
Embodiment 3, crude drug weight proportion: 20 parts of Radix Satyrii nepalensiss, 10 parts of Herba Changnieniae amoenaes, 6 parts of Spina Gleditsiaes, 10 parts of Rhizoma Cimicifugaes, 6 parts of Squama Maniss, 10 parts of Radix Puerariaes, 10 parts of Herba Sarcandraes, 10 parts of Cortex Ponciri trifoliatae, 10 parts of Rhizoma Anemones Altaicaes, 2 parts of Asarum forbesii Maxims, 6 parts of Fructus Chaenomeliss, 20 parts of Retinervus Luffae Fructuss.
Embodiment 4, crude drug weight proportion: 30 parts of Radix Satyrii nepalensiss, 12 parts of Herba Changnieniae amoenaes, 10 parts of Spina Gleditsiaes, 12 parts of Rhizoma Cimicifugaes, 10 parts of Squama Maniss, 12 parts of Radix Puerariaes, 12 parts of Herba Sarcandraes, 12 parts of Cortex Ponciri trifoliatae, 12 parts of Rhizoma Anemones Altaicaes, 5 parts of Asarum forbesii Maxims, 10 parts of Fructus Chaenomeliss, 25 parts of Retinervus Luffae Fructuss.
The Chinese medicine of embodiment 2 ~ 4 can be prepared from by following method:
(1) Herba Sarcandrae, Herba Changnieniae amoenae, Rhizoma Anemones Altaicae, Cortex Ponciri trifoliatae, Asarum forbesii Maxim coarse powder are extracted to volatile oil with vapor distillation respectively, and collect mixing for standby use after volatile oil, medicinal residues are for subsequent use;
(2) in Radix Satyrii nepalensis, Spina Gleditsiae, Rhizoma Cimicifugae, Radix Puerariae, Fructus Chaenomelis, Squama Manis, Retinervus Luffae Fructus and step 1, gained medicinal residues mix and add 4 times of water yields, decoct with water 2 times, and each 1 hour, collecting decoction, left standstill; Then toward 95% the ethanol that adds 3 ~ 4 times of medicinal liquids in decocting liquid, leave standstill 15 minutes, then with 3000rpm/min centrifugal 20 minutes, extracting centrifugal liquid, concentrated, spraying is dry, draws just material;
(3) gained volatile oil in step 1 is sprayed into step 2 gained and just in material, mix, pulverize, cross 60 mesh sieves, encapsulated forming.
Can set every capsules is 0.5g.
Effective combination of said medicine, coordinates mutually, and traffic is inside and outside, resolving mass and removing the obstruction of the collateral, consolidate heat clearing away, effectively reach the object of shiver with cold after prevention anesthesia, and side effect is less.The above results is that clinical data fully proves, interrelated data is as follows.
1 object and method.
1.1 object.
1.1.1 case selection: the 182 routine patient with operation that accept for medical treatment year February in February, 2013~2014, and in preoperative 3 days, do not use the medicine of the treatment shiver with colds such as ondansetron, tramadol, clonidine.Wherein patients with general anesthesia 85 examples, local anaesthesia patient's 97 examples.Be specially: prostatic hyperplasia or patients with ureteral calculi 41 examples, bone injury patient 41 examples, Appendicitis Patients 37 examples, tumor resection patient 35 examples, other patient with operation 28 examples; Age between 7~66 years old, 42.1 ± 6.3 years old mean age, wherein: 16 years old 27 example of age <, 60 years old 33 example of age >; Male patient's 97 examples, female patient 85 examples.
1.1.2 grouping: patient is divided into matched group 60 examples, decoction group 61 examples and Capsules group 61 examples at random.Before three groups of patient treatments, on sex, age, the state of an illness, anesthesia method, compare, difference not statistically significant (P>0.05), has comparability.
1.2 method.
1.2.1 interference method: the conventional preoperative and postoperative administration of matched group, is incubated by skin.Decoction group and Capsules group, on the basis of matched group, from preoperative three days, respectively with gained decoction in the embodiment of the present invention 1, with gained capsule oral in the embodiment of the present invention 3,2 times/d, add up to three days.
1.2.2 statistical analysis: SPSS 13.0 carries out statistical analysis.Enumeration data χ
2inspection.
2 results.
After 2.1 3 groups of anesthesia, shiver with cold incidence rate is respectively: matched group 22.45%(11/60), decoction group 6.56%(4/61), Capsules group 4.92%(3/61).Decoction group and Capsules group shiver with cold incidence rate are starkly lower than matched group (χ
2=3.86, P<0.05; χ
2=5.32, P<0.05).
The comparison of 2.2 3 groups of other recovery rooms of patient (PACU) complication: see the following form,
? |
Number of cases |
Cardiovascular related complication |
Digestive complication |
Spirit complication |
Respiratory complication |
The delay of reviving |
Matched group |
60 |
17 |
6 |
5 |
1 |
1 |
Decoction group |
61 |
18 |
5 |
2 |
1 |
1 |
Capsules group |
61 |
16 |
7 |
6 |
2 |
1 |
Matched group, decoction group, Capsules group difference not statistically significant aspect cardiovascular related complication, Digestive complication, spirit complication, respiratory complication, the delay of reviving.
2.3 adverse reaction rate comparisons: obvious medicine related reactions does not appear in decoction group, Capsules group.
3. conclusion.
This result of study shows, after taking decoction group of the present invention and Capsules group anesthesia, shiver with cold incidence rate is starkly lower than matched group, and can not cause other PACU complication, illustrate that pharmaceutical composition prepared by the inventive method has aspect shiver with cold after prevention anesthesia that untoward reaction is light, the higher advantage of safety.