CN106913711A - 治疗膝骨关节炎的药物组合物及其制备方法 - Google Patents
治疗膝骨关节炎的药物组合物及其制备方法 Download PDFInfo
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- CN106913711A CN106913711A CN201710292890.1A CN201710292890A CN106913711A CN 106913711 A CN106913711 A CN 106913711A CN 201710292890 A CN201710292890 A CN 201710292890A CN 106913711 A CN106913711 A CN 106913711A
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Abstract
本申请公开了一种治疗膝骨关节炎的药物组合物及其制备方法,所述药物组合物包含下述植物原料的提取物作为活性成分:生黄芪20重量份‑30重量份、茯苓9重量份‑12重量份、炒白术6重量份‑9重量份、炙甘草3重量份‑6重量份、川芎6重量份‑10重量份、当归6重量份‑9重量份、炒白芍10重量份‑20重量份、山萸肉10重量份‑12重量份(或牛膝9重量份‑15重量份)、可选的桑寄生9重量份‑12重量份、杜仲10重量份‑15重量份、枸杞子10重量份‑15重量份和独活6重量份‑9重量份。经临床使用,本发明治疗膝骨关节炎证属脾肾两虚有良好疗效。
Description
技术领域
本申请涉及中药领域,特别涉及一种治疗膝骨关节炎的中药药物。
背景技术
膝骨关节炎(Knee Osteoarthritis,KOA)为关节软骨退变和磨损,以及骨赘形成,症状表现为膝关节疼痛、僵直、畸形和功能障碍,症状呈慢性、进行性加重。又称为膝关节增生性关节炎、老年性关节炎、退行性关节炎等。流行病学调查资料显示该病在我国中老年人中的发病率在60%以上,严重影响着中老年人群的生活质量,已成为严重的社会和经济问题。本病治疗目的在于缓解疼痛、阻止和延缓疾病的进展,保护关节功能、改善生活质量,治疗上西医治疗包括非药物治疗健康教育、运动及生活指导、各种物理治疗,药物有控制病情药物、骨关节炎慢作用药及软骨保护剂,病变严重及关节功能严重障碍的患者多采用关节镜手术、人工关节置换术等外科治疗。其中非手术疗法以症状治疗为主,包括抗炎止痛药和非类固醇类抗炎药(NSAIDs)的应用。而中医治疗KOA方法多样,疗效确切,不良反应少,在临床中得到广泛应用。
膝骨关节炎是骨关节科多发病、常见病,患者主要为中老年人,《骨关节炎诊断及治疗指南(2010)》指出,骨关节炎60岁以上的人群中患病率可达50%,75岁的人群则达80%,并有一定的致残率,是严重影响老年人生活质量的一大因素。据相关资料统计,本病随年龄增长,发病趋势呈逐渐上升趋势。另据学者对老年膝骨关节炎患者生活质量影响因素进行分析得出后发现,对于老年KOA患者,除KOA疾病本身疼痛、病程、步行能力之外,内科慢性病数目亦是影响其生活质量的主要因素,其中膝关节疼痛是重要影响因素。据笔者临床中观察发现,重度KOA患者中,老年人为绝大部分,其中同时患有高血压、冠心病、糖尿病、慢性肾功能不全等其他***慢性疾病的患者不在少数,这种情况不仅影响患者生活质量,同时增加了药物及各种疗法选择的难度。
在我国,由于对KOA缺乏相应的健康宣教,就诊时大多患者病变已发展到中期甚至晚期,慢性进行性的关节肿痛、畸形和活动受限表现突出。对于重度KOA,西医治疗中往往需要人工膝关节置换手术才能取得满意的疗效;但其中一部分患者或因身体状况、或因经济原因、或不愿接受人工膝关节置换而病情持续不能缓解,因此采取保守疗法,希望病情也能得到一定程度的改善,而保守疗法的主要选择就是中医疗法。
膝骨关节炎为西医诊断,目前中医诊断多称为膝痹病或膝骨痹。膝骨关节炎虽属痹病范畴,在风寒湿痹之外,现代医家对其病机认识多有不同,概而言之为虚、瘀、邪三者,临床治疗及研究中或择其一二以立法组方遣药,或兼而治之,或辨证论治,不一而同;用方上或沿承古方,或谨循中医辨证自行组方,利用中医单方治疗膝骨关节炎,取得了良好疗效,同时极少发生不良反应。
本中药内服治疗膝骨关节炎可疗效可靠,毒副作用相对较小、相对于中医针灸、推拿、中药外洗、中药离子导入等疗法,方便快捷,有其独特优势。单独使用或配合中西医其他方法对骨关节炎患者病情,有不同程度的改善作用。
发明内容
本发明目的在于改善膝骨关节炎的病情,作为膝骨关节炎保守治疗方法的一种,单独或辅助治疗膝骨关节炎,减轻膝骨关节炎症状、提高疗效。
本申请提供了一种治疗膝骨关节炎的药物组合物,包含下述植物原料的提取物作为活性成分:
生黄芪20重量份-30重量份、茯苓9重量份-12重量份、炒白术6重量份-9重量份、炙甘草3重量份-6重量份、川芎6重量份-10重量份、当归6重量份-9重量份、炒白芍10重量份-20重量份、山萸肉10重量份-12重量份(或牛膝9重量份-15重量份)、桑寄生9重量份-12重量份、杜仲10重量份-15重量份、枸杞子10重量份-15重量份和独活6重量份-9重量份。对于中医诊断为膝痹病或膝骨痹的患者,或者西医诊断为膝骨关节炎的患者,可以采用该药物组合物治疗,能够减轻膝骨关节炎的症状,改善患者的生活水平。
对于主诉有腰膝酸软、下肢畏寒严重的患者,所述植物原料可进一步包括益智仁10重量份-15重量份或菟丝子10重量份-15重量份或续断10重量份-15重量份。也就是说,对于进一步有腰膝酸软、下肢畏寒症状的患者,在上述基本药物的基础上,可以加上10重量份-15重量份益智仁或者10重量份-15重量份菟丝子或者10重量份-15重量份的续断。益智仁温脾暖肾、固精缩尿,治疗脾寒肾虚诸症,菟丝子补肝肾、益精髓,续断补肝肾、强筋骨,治疗肝肾不足之腰膝酸痛,三药均性温,有助阳之功,与山萸肉、杜仲、桑寄生、枸杞子诸药相伍,增强补肝肾、壮腰膝之功,从而缓解膝痹症诸症。
对于舌苔白腻的患者,所述植物原料可进一步包括生薏苡仁10重量份-20重量份或砂仁6重量份。舌苔白腻为湿邪粘滞之象,生薏苡仁健脾、补肺、清热、利湿,能治湿痹之筋脉拘挛,屈伸不利,砂仁温脾化湿,可治脾胃虚寒、湿邪中阻之证,二药择其一,与上述主药中茯苓、白术配合,共奏健脾祛湿之功。
对于苔黄腻的患者,所述植物原料可进一步包括黄连3重量份或竹茹6重量份或生薏苡仁10-30重量份。黄腻苔主湿热内蕴,而黄连专攻清热燥湿,善清中焦湿热,竹茹性微寒,有清热化痰除烦之功。
对于神疲乏力及舌胖有齿痕的患者,所述植物原料进一步包括山药或党参或太子参,优选含量为山药9重量份-12重量份或党参9重量份-12重量份或太子参6-12重量份。患者脾肾气虚,见神疲乏力、舌胖有齿痕诸症,选择益气之品,或山药或党参或太子参,配合主药中黄芪、白术等药,补中益气,助脾运化,充养肌肉筋骨。
对于咽干、口干、手足心热的患者,所述植物原料进一步包括北沙参和麦冬或石斛或生地或玄参,优选包括北沙参10重量份-15重量份和麦冬10重量份-20重量份,或者石斛10重量份-20重量份,或生地10重量份-15重量份,或玄参10重量份-15重量份,北沙参、麦冬有生津润燥之功,生地、玄参养阴之外更兼清热之功,用为佐药,治疗口干、咽干、手足心热之症。
对于关节肿痛严重者,所述植物原料进一步包括黄柏和苍术或萆薢或泽泻或泽兰,优选包括黄柏6重量份-9重量份和苍术6重量份-15重量份,或萆薢10重量份-15重量份,或泽泻10重量份-12重量份或泽兰10重量份-12重量份。湿热之邪流注膝关节,发为肿胀,而致膝关节局部皮温升高,疼痛尤著,黄柏、苍术二药伍用,清热燥湿健脾之功效更著,且功专于下,用于治疗湿热下注引起的筋骨疼痛,萆薢利湿去浊,祛风通痹。利湿去浊,祛风除痹,可治风湿痹痛,关节不利,腰膝疼痛,泽泻利水渗湿,泽兰行水消肿,选择一二应用以清热利湿消肿,肿胀消,疼痛渐除。
对于下肢沉重、拘挛严重的患者,所述植物原料进一步包括威灵仙或木瓜或伸筋草或路路通,优选包括威灵仙10重量份-15重量份、木瓜9重量份-12重量份、伸筋草9重量份-15重量份、路路通9重量份-12重量份。威灵仙能够祛风湿、通络止痛、消骨鲠,木瓜舒筋活络,伸筋草祛风散寒、除湿消肿、舒筋活血,路路通祛风通络,利水除湿,对于下肢沉重、拘挛严重的患者,需要多种具有祛风活络功能的药物共同作用,以便更快地解除患者的痛苦。
对于疼痛明显、舌暗有瘀的患者,所述植物原料进一步包括丹参或鸡血藤或三七,优选包括丹参15重量份-20重量份、鸡血藤15重量份-20重量份,或三七3重量份-6重量份、元胡10重量份、香附6重量份-9重量份。瘀血阻滞于膝,而见疼痛明显、舌暗诸症,选用鸡血藤、丹参、三七、元胡、香附之类活血化瘀行气止痛之品以更好解除瘀痹带来的疼痛,与主药中川芎的配合,更是协同增加了药物的效果。
对于心烦、健忘、失眠的患者,所述植物原料进一步包括首乌藤或炒枣仁或远志,优选包括首乌藤10重量份-15重量份或炒枣仁10-15重量份、远志10-15重量份。首乌藤养心安神,祛风通络,酸枣仁养肝宁心安神,远志宁心安神,选用以改善患者情绪、睡眠情况,更有利于膝关节病情恢复。
另外,上述植物原料中还可以加入陈皮,陈皮理气健脾,调中燥湿,可以防止主辅药过于滋补碍胃。
本发明还提供了制备上述药物组合物的方法,优选所述重量份为克,将所述植物原料按上述重量份混合后,按照每付药300-500ml,优选400ml药液量+20%损耗水量计算加水量,使用煎药机制备药液;或者取所述植物原料的免煎颗粒剂,根据患者的具体需要按照上述的重量份配比混合,所述重量份为克,用温度在92至100摄氏度的水溶解所得混合物。
具体实施方式
发明人结合多年膝骨关节炎临床治疗经验,认为除其他先天、外伤等因素外,长期劳损是膝骨关节炎发病的重要因素,《黄帝内经·素问·宣明五气篇》中有“久坐伤肉,久立伤骨,久行伤筋”之论,人体肢体关节的运动,肌肉的舒缩功能为其一,另外筋在肌肉、骨节之间起协同作用,故言“宗筋主束骨而利机关也”,肌肉、筋、骨共同维持关节的正常功能,现代生活长期不当的坐位及过量或不当的行走、站立累积劳损引起关节部位的疼痛,进而出现功能障碍、畸形。脾主肌肉四肢,肝主筋,肾主骨。脾胃为水谷之海,气血生化之源,脾胃健旺,化源充足,气血充盈,则肝有所滋,肌肉、筋、骨有所濡养。现代生活饮食结构的改变,多肥甘厚腻,脾极易为湿所困,或素体脾胃虚弱,则气血生化乏源,化源不足,肌肉、筋、骨失其所养,而致肢体关节软弱无力,甚至废用。气血生化不足,运行无力,瘀血阻滞局部,而致关节疼痛。中老年患者随着年龄增长,伴随着肝肾亏虚。发明人总结出脾肾两虚为膝骨关节炎的基本病机,主要特点为本虚标实、虚实夹杂,本虚为核心,夹以血瘀、水湿等之实,其发病过程与脾、肝、肾三脏密切相关,治则以补肾健脾,益气活血为主,药方采用本发明的药物组合物,即补肾健脾活血方随症加减。
具体而言,本发明的补肾健脾活血方如下:
经国家中医药管理局中国中医药信息检索中心文献查新检索,未查到采用与本发明药物组方相同的中药复方治疗膝骨关节炎/膝骨痹的研究报道。
和其他治疗骨关节炎的中药相比,本发明的药物组合物(也称补肾健脾方)的独特之处表现在从骨关节炎的发病根源入手,在脾肾两虚为膝骨关节炎的基本病机基础上,加上益气、通络及活血药物。方中生黄芪,白术,茯苓,炙甘草为主药补气健脾,生黄芪,温微甘,重用以补气,上达下通,益气固表,防邪入侵,通利营卫,并能消肿,治气虚血滞不行之痹痛。白术苦温,健脾燥湿,益气助运;茯苓甘淡,健脾渗湿;苓术合用,健脾祛湿更效。炙甘草益气和中,调和诸药,与黄芪、白术、茯苓合用彰益气健脾之功。
山萸肉,杜仲,桑寄生,牛膝,枸杞,补肾壮腰膝为方中辅药,桑寄生味苦甘,性平,补肝肾、强筋骨、祛风湿。杜仲味甘微辛,性温,是治肝肾亏虚,久痹腰膝酸痛、乏力之要药。山萸肉味酸苦而涩,性微温,补益肝肾,敛汗益阴;枸杞子味甘性平,补肝肾兼益肾中之阳。牛膝味苦酸性平,能补肝肾,强筋骨,散瘀血,走下焦入肝肾,可引血下行除痹。诸药合用补肾兼以除痹。
川芎,当归,白芍为方中佐药养血活血、益气健脾,当归味辛甘微苦,性温,补血活血,散寒,消肿止痛,主治屈伸不利,风寒痹阻之疼痛证;炒白芍味甘酸苦,性微寒,养血荣筋,缓急止痛;川芎味辛性温,为血中之气药活血行气。独活味辛性温,祛风胜湿,引药使其下行;元胡活血、行气、止痛,配合独活、桑寄生以通痹止痛。全方补肝肾、强筋骨、益气健脾、活血止痛,补而不滞,滋而不腻。经临床使用,本方治疗膝骨关节炎证属脾肾两虚有良好疗效。
另外,对于一些有其他症状的患者,可以加上其他中药来调和整个药物组合物的效用,进行辨证加减以达到最优的治疗效果:腰膝酸软、下肢畏寒甚者另加益智仁、菟丝子或续断等,舌苔白腻者选用生薏苡仁或砂仁等,苔黄腻者加黄连、竹茹或生薏苡仁等,神疲乏力及舌胖有齿痕者加用山药、党参或太子参等,咽干、口干、手足心热等酌加北沙参、麦冬或石斛等,关节肿痛者选用黄柏、苍术或萆薢等,下肢沉重、拘挛甚者选用威灵仙、木瓜、伸筋草或路路通等、疼痛明显、舌暗有瘀者加用丹参、鸡血藤或三七等。对于心烦、健忘、失眠的患者,所述植物原料进一步包括首乌藤或炒枣仁或远志。这些药物与上述主药互相配合,能够进一步更加有效地对症施治,缓解患者的病痛。
另据研究,补肾健脾方中药味山萸肉中有效成分山茱萸总甙具有免疫调节及抗炎作用,白芍提取物对大鼠蛋清性急性炎症有显著抑制作用,具有明显的抗炎及免疫调节作用,二者配伍作用协同,可以增强其免疫调节及抗炎作用;另白芍甘草伍用,名曰芍药甘草汤,现代研究证实,芍药甘草汤有明显的抗炎作用,补肾健脾活血方中黄芪枸杞子具有一定的抗疲劳作用。枸杞子能增强机体体力、迅速消除运动后的疲劳。方中杜仲、牛膝、山萸肉、枸杞子等药有补肝肾、强筋骨、壮腰膝之功用。
本发明的补肾健脾活血方单独使用或配合中西医其他治疗方法,可以对膝骨关节炎患者病情(包括症状及体征)有一定程度的治疗效果。为了说明本发明的效果,附病例如下:
病例1:患者某,女,62岁,2014年3月4日首诊。双膝疼痛伴腰痛10年余,加重2个月,行走不足1km即出现膝痛,坐下休息疼痛加剧,下蹲受限,自觉腰膝酸软,怕冷,口干,不易出汗,晨起痰多,二便调,饮食可,眠差梦多,舌质暗红。查体:双膝关节轻度肿胀,局部皮温不高,双膝内侧间隙压痛(+),膝关节活动受限,被动活动无明受限,主动活动左侧屈伸140°,右侧150°。舌苔根部白腻,前部苔少,脉沉细。行骨密度检查T值为-2.7。先后予本发明的补肾健脾活血方加味28付服用,1个半月后回访,膝关节已无明显不适,基本生活自如。具体处方如下:
水煎服,每日1剂,分2次温服。
该药剂在上述药物的基础上增加了养血安神、驱风通络的首乌藤,进一步优化了治疗效果。
病例2:某女,63岁,2014年2月11日首诊。右膝关节疼痛10年余,此次加重1个月,伴有明显肿胀及活动受限,自觉下肢沉重,步履艰难。眠差便干,口干不欲饮。X线片:右膝关节退变,关节间隙变窄,关节囊肿胀。舌脉:舌质淡,根部苔白腻,脉滑数。先后予本发明的补肾健脾活血方加味免煎颗粒剂21付服用,右膝肿胀疼痛均明显缓解,活动后右膝稍有无力感。具体处方如下(免煎颗粒剂):
水冲服,日一剂,每日2次温服。
在本发明上述药物组合物之外,进一步加上了泽泻和炒枣仁,利用泽泻的利水消肿、渗湿泄热的功效和炒枣仁养肝宁心,安神敛汗的功效。
病例3:某女,51岁,2015年2月14日初诊。右膝关节疼痛,拘挛不利,跛行步态,口干、口渴。查:关节无明显肿胀,膝内侧及后侧均有压痛,被动活动尚可。X线:右膝退变,关节囊轻度肿胀。首诊予补肾健脾活血方加味免煎颗粒剂7付服用,具体处方如下(免煎颗粒剂):
水冲服,日一剂,每日2次温服。
二诊疼痛拘挛均有所改善,前方去泽兰、玄参,加生薏苡仁15g,7付继服。三诊膝关节已无明显疼痛,轻微拘挛不适。
此病例中,先用泽兰活血行水,玄参滋阴,降火,除烦,解毒的功效配合其余主药,缓解疼痛拘挛。再去泽兰、玄参后换用生薏苡仁增加除湿功效,最终治疗该患者的膝骨关节炎。
病例4.患者聂某某,女,68岁,2013年9月03日初诊。主诉膝关节疼痛、腰痛3年余,近半年来症状加重,膝关节屈伸不利,行走困难。患者平素畏寒,汗出,目干涩,眠差,纳食尚可,二便调,舌淡稍胖,有裂纹,苔薄黄腻,舌底脉络瘀曲,脉弦数,右尺脉沉弱。查体:膝关节活动度减小,局部无压痛。X线示:双膝骨关节退行性改变,腰椎骨质增生,部分椎间隙变窄。
处方:生黄芪20g 茯苓10g 炒白术9g 甘草6g
黄连3g 麦冬10g 桑寄生10g 杜仲12g
牛膝10g 川芎10g 丹参15g 枸杞子15g
白芍20g 山药10g 香附6g 元胡10g
生薏苡仁15g 当归6g 续断12g 北沙参10g 7剂,水煎服,日一剂分2次温服
先后服21剂随诊,患者关节疼痛症状改善明显,畏寒、目干症状好转,睡眠情况较前有所改善。
病例5.杨某某,女,52岁,2013年10月15日初诊。主诉双膝关节疼痛2周。刻下症见:双膝疼痛,屈伸不利,畏寒,耳鸣,平素嗜食荤腥,食量时多时少,眠可,二便调,舌淡胖,苔白腻,脉弦滑。X线片示:双膝骨关节炎。
用方:陈皮9g 茯苓10g 甘草6g 竹茹10g
丹参15g 香附6g 元胡10g 麦冬10g
炒白术9g 白芍20g 黄芪30g 独活6g
牛膝10g 川芎10g 威灵仙10g 生薏苡仁20g
苍术6g 枸杞子15g 杜仲10g 桑寄生10g
黄柏6g 3剂,水煎服,日一剂分2次温服
先后服17剂随诊,双膝疼痛屈伸不利症状明显缓解。
病例6、某患者主诉膝关节疼痛,首诊给予本发明药物组合物,其中植物原料含有以下药物:
生黄芪20g、茯苓9g、炒白术6g、炙甘草3g、川芎6g、当归6g、炒白芍10g、山萸肉10g、桑寄生9g、杜仲10g、枸杞子10g和独活6g,每种药物取免煎颗粒剂,按照上述重量混合,嘱用92摄氏度至100摄氏度的水溶解混合的药物后口服。
每日一剂,连服七日后复诊,症状已有大大减轻。
病例7、
某患者,主诉膝关节疼痛,并且伴有腰膝酸软,下肢畏寒严重,取具有下述组成和含量的药物组合物,使用煎药机按照说明书煎药:
生黄芪20g、茯苓9g、炒白术6g、炙甘草3g、川芎6g、当归6g、炒白芍10g、牛膝9g、桑寄生9g、杜仲10g、枸杞子10g、独活6g和益智仁10g。
每日一剂,连服七日后复诊,症状已有大大减轻。
病例8、
某患者,主诉膝关节疼痛,并且伴有神疲乏力,舌诊发现舌胖有齿痕,取具有下述组成和含量的药物组合物,使用煎药机按照说明书煎药:
生黄芪30g、茯苓12g、炒白术9g、炙甘草6g、川芎10g、当归9g、炒白芍20g、牛膝15g、桑寄生12g、杜仲15g、枸杞子15g、独活9g和山药12g。
每日一剂,连服七日后复诊,症状已有大大减轻。综合上述病例可见,在本发明基础方的基础上,根据具体症状加减相应的药物,可以获得治疗的最佳效果。
另发明人进行60例临床病例观察,共选取符合中华医学会风湿病学分会2010年膝OA分类标准临床标准,且年龄≥46岁,≤80岁,Kellgren-Lawrence放射诊断学分级为III级及IV级,膝骨关节炎严重性指数(ISOA)评分≥8分的重度KOA患者,女性51例,男性9例,共60例患者。治疗组32例,对照组28例进行疗效观察。
对比例
上述对照组采用健康教育及心理疏导,洛索洛芬钠片(商品名:乐松,第一三共制药(上海)有限公司生产,国药准字H20030769,规格:60mg×20片。口服,每日3次,一次1片,于饭后服),盐酸氨基葡萄糖胶囊(商品名:葡立,山西中远威药业有限公司,国药准字H20020306,规格0.24g×42粒,口服,每次2粒,一日3次)。
实施例
上述治疗组在对照组基础上联合补肾健脾活血方内服(由颗粒剂药房配置,每日一剂,分早晚2次温服),其基础方为生黄芪20g,茯苓10g,炒白术9g,炙甘草6g,川芎10g,当归9g,炒白芍20g,山萸肉10g,牛膝10g,桑寄生10g,杜仲10g,枸杞子15g,元胡10g,陈皮9g,独活9g,临床随症加减。每7天为一个疗程,连续治疗2个疗程,共计2周,根据尼莫地平法进行疗效统计。
结果比较
依据WOMAC量表,治疗2周后治疗组无效7例(21.875%),有效25例(78.125%),显效、痊愈均为0例;对照组无效13例(46.43%),有效15例(53.57%),显效、痊愈均为0例。两组总有效率分别为78.13%、53.57%。经卡方检验,有统计学意义(χ2=0.01<0.05),说明治疗组疗效优于对照组。治疗组对患者的夜间疼痛、站立及行走时疼痛症状,坐位起立、最大步行距离/上下楼梯、下蹲等生活能力均有一定改善。
综上所述,本发明的药物组合物对于膝骨关节炎具有良好的治疗效果,改善了患者的生活体验。
以上所述仅为本发明的较佳实施例而已,并不用以限制本发明,凡在本发明的精神和原则之内,所做的任何修改、等同替换、改进等,均应包含在本发明保护的范围之内。
Claims (11)
1.一种药物组合物,包含下述植物原料的提取物作为活性成分:
生黄芪20重量份-30重量份、茯苓9重量份-12重量份、炒白术6重量份-9重量份、炙甘草3重量份-6重量份、川芎6重量份-10重量份、当归6重量份-9重量份、炒白芍10重量份-20重量份、山萸肉10重量份-12重量份(和/或牛膝9重量份-15重量份)、可选的桑寄生9重量份-12重量份、杜仲10重量份-15重量份、枸杞子10重量份-15重量份和独活6重量份-9重量份。
2.如权利要求1所述的药物组合物,所述植物原料进一步包括益智仁10重量份-15重量份或菟丝子10重量份-15重量份或续断10重量份-15重量份。
3.如权利要求1所述的药物组合物,所述植物原料进一步包括生薏苡仁10重量份-20重量份或砂仁6重量份。
4.如权利要求1所述的药物组合物,所述植物原料进一步包括黄连3重量份或竹茹6重量份或生薏苡仁10重量份-30重量份。
5.如权利要求1所述的药物组合物,所述植物原料进一步包括山药9重量份-12重量份或党参9重量份-12重量份或太子参6重量份-12重量份。
6.如权利要求1所述的药物组合物,所述植物原料进一步包括北沙参10重量份-15重量份和麦冬10重量份-20重量份,或石斛10重量份-20重量份,和/或生地10-15g和/或玄参10-15g。
7.如权利要求1所述的药物组合物,所述植物原料进一步包括黄柏6重量份-9重量份和苍术6重量份-15重量份,或萆薢10重量份-15重量份,和/或泽泻10-12g和/或泽兰10-12g。
8.如权利要求1所述的药物组合物,所述植物原料进一步包括威灵仙10重量份-15重量份或木瓜9重量份-12重量份或伸筋草9重量份-15重量份或路路通9重量份-12重量份。
9.如权利要求1所述的药物组合物,所述植物原料进一步包括丹参15重量份-20重量份或鸡血藤15重量份-20重量份或三七3重量份-6重量份、元胡10重量份、香附6重量份-9重量份。
10.如权利要求1所述的药物组合物,所述植物原料进一步包括首乌藤10-15g或炒枣仁10-15g或远志10-15g。
11.制备如权利要求1至10中任一项权利要求所述的药物组合物的方法,所述重量份为克,将所述植物原料按上述重量份混合后,按照每付药300ml至500ml药液量+药液量的20%作为损耗水量计算加水量,使用煎药机制备药液;或者
取所述植物原料的免煎颗粒剂,按照权利要求1至10中任一项所述的重量份配比混合,所述重量份为克,用温度在92摄氏度至100摄氏度的水溶解所得混合物。
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CN111093398A (zh) * | 2017-09-14 | 2020-05-01 | 韩国韩医学研究院 | 含有益智提取物作为有效成分的用于预防、改善或治疗骨关节炎的组合物 |
CN110755563A (zh) * | 2019-11-15 | 2020-02-07 | 汕头市中医医院 | 一种改善膝关节功能的中药组合物及其应用 |
CN110755563B (zh) * | 2019-11-15 | 2021-11-23 | 汕头市中医医院 | 一种改善膝关节功能的中药组合物及其应用 |
CN112755137A (zh) * | 2021-03-18 | 2021-05-07 | 复旦大学附属金山医院(上海市金山区核化伤害应急救治中心、上海市金山区眼病防治所) | 一种治疗轻中度膝骨关节炎的中药组合物及其应用 |
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