CN113633748B - 治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 - Google Patents
治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 Download PDFInfo
- Publication number
- CN113633748B CN113633748B CN202110840468.1A CN202110840468A CN113633748B CN 113633748 B CN113633748 B CN 113633748B CN 202110840468 A CN202110840468 A CN 202110840468A CN 113633748 B CN113633748 B CN 113633748B
- Authority
- CN
- China
- Prior art keywords
- parts
- medicine
- damp
- heat
- liver
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
- 239000003814 drug Substances 0.000 title claims abstract description 83
- 208000019425 cirrhosis of liver Diseases 0.000 title claims abstract description 47
- 206010062070 Peritonitis bacterial Diseases 0.000 title claims abstract description 36
- 238000002360 preparation method Methods 0.000 title claims abstract description 15
- 229940079593 drug Drugs 0.000 title claims description 12
- 206010041956 Stasis syndrome Diseases 0.000 title claims description 7
- 208000005634 blind loop syndrome Diseases 0.000 title claims description 7
- 210000004369 blood Anatomy 0.000 claims abstract description 27
- 239000008280 blood Substances 0.000 claims abstract description 27
- 239000002994 raw material Substances 0.000 claims abstract description 18
- 241001598107 Imperata Species 0.000 claims abstract description 14
- 244000025254 Cannabis sativa Species 0.000 claims abstract description 10
- 241000007126 Codonopsis pilosula Species 0.000 claims description 14
- 241000037740 Coptis chinensis Species 0.000 claims description 14
- 244000303040 Glycyrrhiza glabra Species 0.000 claims description 14
- 235000006200 Glycyrrhiza glabra Nutrition 0.000 claims description 14
- 241001522129 Pinellia Species 0.000 claims description 14
- 240000004534 Scutellaria baicalensis Species 0.000 claims description 14
- 235000017089 Scutellaria baicalensis Nutrition 0.000 claims description 14
- 240000001519 Verbena officinalis Species 0.000 claims description 14
- LPLVUJXQOOQHMX-QWBHMCJMSA-N glycyrrhizinic acid Chemical compound O([C@@H]1[C@@H](O)[C@H](O)[C@H](O[C@@H]1O[C@@H]1C([C@H]2[C@]([C@@H]3[C@@]([C@@]4(CC[C@@]5(C)CC[C@@](C)(C[C@H]5C4=CC3=O)C(O)=O)C)(C)CC2)(C)CC1)(C)C)C(O)=O)[C@@H]1O[C@H](C(O)=O)[C@@H](O)[C@H](O)[C@H]1O LPLVUJXQOOQHMX-QWBHMCJMSA-N 0.000 claims description 14
- 235000011477 liquorice Nutrition 0.000 claims description 13
- 208000011580 syndromic disease Diseases 0.000 claims description 13
- 240000004980 Rheum officinale Species 0.000 claims description 12
- 235000008081 Rheum officinale Nutrition 0.000 claims description 12
- 235000007212 Verbena X moechina Moldenke Nutrition 0.000 claims description 12
- 235000001594 Verbena polystachya Kunth Nutrition 0.000 claims description 12
- 235000007200 Verbena x perriana Moldenke Nutrition 0.000 claims description 12
- 235000002270 Verbena x stuprosa Moldenke Nutrition 0.000 claims description 12
- 239000003651 drinking water Substances 0.000 claims description 8
- 235000020188 drinking water Nutrition 0.000 claims description 8
- 239000000706 filtrate Substances 0.000 claims description 6
- 238000001914 filtration Methods 0.000 claims description 6
- 238000010438 heat treatment Methods 0.000 claims description 5
- 239000000843 powder Substances 0.000 claims description 5
- 239000002775 capsule Substances 0.000 claims description 4
- 239000006187 pill Substances 0.000 claims description 4
- 238000002156 mixing Methods 0.000 claims description 3
- 238000002791 soaking Methods 0.000 claims description 3
- 238000005303 weighing Methods 0.000 claims description 3
- 238000009835 boiling Methods 0.000 claims description 2
- 238000011282 treatment Methods 0.000 abstract description 58
- 208000024891 symptom Diseases 0.000 abstract description 40
- 230000000694 effects Effects 0.000 abstract description 33
- 210000004185 liver Anatomy 0.000 abstract description 32
- 206010016654 Fibrosis Diseases 0.000 abstract description 25
- 230000007882 cirrhosis Effects 0.000 abstract description 25
- 230000003908 liver function Effects 0.000 abstract description 19
- 208000004880 Polyuria Diseases 0.000 abstract description 11
- 230000035619 diuresis Effects 0.000 abstract description 11
- 230000001737 promoting effect Effects 0.000 abstract description 9
- 230000003907 kidney function Effects 0.000 abstract description 7
- 230000002924 anti-infective effect Effects 0.000 abstract description 6
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 abstract description 6
- 230000006378 damage Effects 0.000 abstract description 5
- 230000002829 reductive effect Effects 0.000 abstract description 5
- 239000003053 toxin Substances 0.000 abstract description 5
- 231100000765 toxin Toxicity 0.000 abstract description 5
- 238000010926 purge Methods 0.000 abstract description 4
- 206010059866 Drug resistance Diseases 0.000 abstract description 3
- 230000006870 function Effects 0.000 abstract description 3
- 230000003014 reinforcing effect Effects 0.000 abstract description 3
- 231100000331 toxic Toxicity 0.000 abstract description 3
- 230000002588 toxic effect Effects 0.000 abstract description 3
- 241000756943 Codonopsis Species 0.000 abstract 1
- 230000008030 elimination Effects 0.000 abstract 1
- 238000003379 elimination reaction Methods 0.000 abstract 1
- 244000052769 pathogen Species 0.000 abstract 1
- 230000002787 reinforcement Effects 0.000 abstract 1
- 206010003445 Ascites Diseases 0.000 description 50
- 238000012360 testing method Methods 0.000 description 24
- 208000004998 Abdominal Pain Diseases 0.000 description 21
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 21
- 210000000265 leukocyte Anatomy 0.000 description 21
- 238000003745 diagnosis Methods 0.000 description 20
- 206010000060 Abdominal distension Diseases 0.000 description 19
- 102000009027 Albumins Human genes 0.000 description 19
- 108010088751 Albumins Proteins 0.000 description 19
- 210000003622 mature neutrocyte Anatomy 0.000 description 19
- 108010074051 C-Reactive Protein Proteins 0.000 description 15
- 102100032752 C-reactive protein Human genes 0.000 description 15
- 108010048233 Procalcitonin Proteins 0.000 description 15
- 238000008050 Total Bilirubin Reagent Methods 0.000 description 15
- 210000001015 abdomen Anatomy 0.000 description 15
- CWCXERYKLSEGEZ-KDKHKZEGSA-N procalcitonin Chemical compound C([C@@H](C(=O)N1CCC[C@H]1C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@H](C(=O)N[C@@H](C)C(=O)N[C@@H]([C@@H](C)CC)C(=O)NCC(=O)N[C@@H](C(C)C)C(=O)NCC(=O)N[C@@H](C)C(=O)N1[C@@H](CCC1)C(=O)NCC(O)=O)[C@@H](C)O)NC(=O)[C@@H](NC(=O)[C@H](CC=1NC=NC=1)NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@H](CCCCN)NC(=O)[C@H](CC(N)=O)NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@@H](NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCSC)NC(=O)[C@H]1NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CO)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC(N)=O)NC(=O)CNC(=O)[C@@H](N)CSSC1)[C@@H](C)O)[C@@H](C)O)[C@@H](C)O)C1=CC=CC=C1 CWCXERYKLSEGEZ-KDKHKZEGSA-N 0.000 description 15
- 208000002193 Pain Diseases 0.000 description 14
- 108010003415 Aspartate Aminotransferases Proteins 0.000 description 13
- 102000004625 Aspartate Aminotransferases Human genes 0.000 description 13
- 210000002966 serum Anatomy 0.000 description 13
- 210000000952 spleen Anatomy 0.000 description 13
- 206010037660 Pyrexia Diseases 0.000 description 12
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 11
- 208000006454 hepatitis Diseases 0.000 description 11
- 239000003826 tablet Substances 0.000 description 11
- 238000002604 ultrasonography Methods 0.000 description 11
- 210000000683 abdominal cavity Anatomy 0.000 description 10
- 201000010099 disease Diseases 0.000 description 10
- 231100000283 hepatitis Toxicity 0.000 description 10
- 238000002347 injection Methods 0.000 description 10
- 239000007924 injection Substances 0.000 description 10
- 210000001616 monocyte Anatomy 0.000 description 10
- 230000003187 abdominal effect Effects 0.000 description 9
- 208000006083 Hypokinesia Diseases 0.000 description 8
- 206010030113 Oedema Diseases 0.000 description 8
- 206010041660 Splenomegaly Diseases 0.000 description 8
- 210000003141 lower extremity Anatomy 0.000 description 8
- 210000002700 urine Anatomy 0.000 description 8
- 102000008100 Human Serum Albumin Human genes 0.000 description 7
- 108091006905 Human Serum Albumin Proteins 0.000 description 7
- 235000019658 bitter taste Nutrition 0.000 description 7
- 230000002440 hepatic effect Effects 0.000 description 7
- 238000002636 symptomatic treatment Methods 0.000 description 7
- 210000003815 abdominal wall Anatomy 0.000 description 6
- 239000011248 coating agent Substances 0.000 description 6
- 238000000576 coating method Methods 0.000 description 6
- 230000013872 defecation Effects 0.000 description 6
- 206010013781 dry mouth Diseases 0.000 description 6
- 230000006872 improvement Effects 0.000 description 6
- 238000012552 review Methods 0.000 description 6
- 206010023126 Jaundice Diseases 0.000 description 5
- 235000019789 appetite Nutrition 0.000 description 5
- 230000036528 appetite Effects 0.000 description 5
- 229960000980 entecavir Drugs 0.000 description 5
- YXPVEXCTPGULBZ-WQYNNSOESA-N entecavir hydrate Chemical compound O.C1=NC=2C(=O)NC(N)=NC=2N1[C@H]1C[C@H](O)[C@@H](CO)C1=C YXPVEXCTPGULBZ-WQYNNSOESA-N 0.000 description 5
- 206010016766 flatulence Diseases 0.000 description 5
- 229960003883 furosemide Drugs 0.000 description 5
- ZZUFCTLCJUWOSV-UHFFFAOYSA-N furosemide Chemical compound C1=C(Cl)C(S(=O)(=O)N)=CC(C(O)=O)=C1NCC1=CC=CO1 ZZUFCTLCJUWOSV-UHFFFAOYSA-N 0.000 description 5
- 208000019423 liver disease Diseases 0.000 description 5
- 238000000034 method Methods 0.000 description 5
- 230000001717 pathogenic effect Effects 0.000 description 5
- 238000011160 research Methods 0.000 description 5
- LXMSZDCAJNLERA-ZHYRCANASA-N spironolactone Chemical compound C([C@@H]1[C@]2(C)CC[C@@H]3[C@@]4(C)CCC(=O)C=C4C[C@H]([C@@H]13)SC(=O)C)C[C@@]21CCC(=O)O1 LXMSZDCAJNLERA-ZHYRCANASA-N 0.000 description 5
- 229960002256 spironolactone Drugs 0.000 description 5
- 241000894006 Bacteria Species 0.000 description 4
- 206010012735 Diarrhoea Diseases 0.000 description 4
- 206010061218 Inflammation Diseases 0.000 description 4
- 241000700605 Viruses Species 0.000 description 4
- 238000009825 accumulation Methods 0.000 description 4
- 208000022531 anorexia Diseases 0.000 description 4
- 230000036760 body temperature Effects 0.000 description 4
- DDRJAANPRJIHGJ-UHFFFAOYSA-N creatinine Chemical compound CN1CC(=O)NC1=N DDRJAANPRJIHGJ-UHFFFAOYSA-N 0.000 description 4
- 206010061428 decreased appetite Diseases 0.000 description 4
- 206010016256 fatigue Diseases 0.000 description 4
- 210000000232 gallbladder Anatomy 0.000 description 4
- 208000002672 hepatitis B Diseases 0.000 description 4
- 208000015181 infectious disease Diseases 0.000 description 4
- 239000007788 liquid Substances 0.000 description 4
- 230000027939 micturition Effects 0.000 description 4
- 239000000203 mixture Substances 0.000 description 4
- 210000003786 sclera Anatomy 0.000 description 4
- 238000010186 staining Methods 0.000 description 4
- 206010000097 Abdominal tenderness Diseases 0.000 description 3
- 206010030302 Oliguria Diseases 0.000 description 3
- 208000019229 Spleen disease Diseases 0.000 description 3
- 208000019790 abdominal distention Diseases 0.000 description 3
- 238000004458 analytical method Methods 0.000 description 3
- 239000003242 anti bacterial agent Substances 0.000 description 3
- 230000002155 anti-virotic effect Effects 0.000 description 3
- MRMBZHPJVKCOMA-YJFSRANCSA-N biapenem Chemical compound C1N2C=NC=[N+]2CC1SC([C@@H]1C)=C(C([O-])=O)N2[C@H]1[C@@H]([C@H](O)C)C2=O MRMBZHPJVKCOMA-YJFSRANCSA-N 0.000 description 3
- 229960003169 biapenem Drugs 0.000 description 3
- 238000002192 cholecystectomy Methods 0.000 description 3
- 201000001352 cholecystitis Diseases 0.000 description 3
- 230000004069 differentiation Effects 0.000 description 3
- 239000012530 fluid Substances 0.000 description 3
- 210000001035 gastrointestinal tract Anatomy 0.000 description 3
- 230000004054 inflammatory process Effects 0.000 description 3
- 238000001802 infusion Methods 0.000 description 3
- 230000000968 intestinal effect Effects 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 230000008506 pathogenesis Effects 0.000 description 3
- 208000007232 portal hypertension Diseases 0.000 description 3
- 230000001105 regulatory effect Effects 0.000 description 3
- 208000027140 splenic disease Diseases 0.000 description 3
- 238000005728 strengthening Methods 0.000 description 3
- 239000013589 supplement Substances 0.000 description 3
- 206010052489 Abdominal rebound tenderness Diseases 0.000 description 2
- 206010067484 Adverse reaction Diseases 0.000 description 2
- 229930186147 Cephalosporin Natural products 0.000 description 2
- 206010013954 Dysphoria Diseases 0.000 description 2
- 206010015137 Eructation Diseases 0.000 description 2
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 description 2
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 2
- ZLMJMSJWJFRBEC-UHFFFAOYSA-N Potassium Chemical compound [K] ZLMJMSJWJFRBEC-UHFFFAOYSA-N 0.000 description 2
- 241000219061 Rheum Species 0.000 description 2
- 235000009411 Rheum rhabarbarum Nutrition 0.000 description 2
- 235000018718 Verbena officinalis Nutrition 0.000 description 2
- 244000273928 Zingiber officinale Species 0.000 description 2
- 235000006886 Zingiber officinale Nutrition 0.000 description 2
- PNNCWTXUWKENPE-UHFFFAOYSA-N [N].NC(N)=O Chemical compound [N].NC(N)=O PNNCWTXUWKENPE-UHFFFAOYSA-N 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 230000006838 adverse reaction Effects 0.000 description 2
- 230000000844 anti-bacterial effect Effects 0.000 description 2
- 229940088710 antibiotic agent Drugs 0.000 description 2
- 244000052616 bacterial pathogen Species 0.000 description 2
- 230000004888 barrier function Effects 0.000 description 2
- 210000001124 body fluid Anatomy 0.000 description 2
- 239000010839 body fluid Substances 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- 229940124587 cephalosporin Drugs 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 2
- 239000000084 colloidal system Substances 0.000 description 2
- 229940109239 creatinine Drugs 0.000 description 2
- 230000008034 disappearance Effects 0.000 description 2
- 239000007919 dispersible tablet Substances 0.000 description 2
- 239000003792 electrolyte Substances 0.000 description 2
- 238000011156 evaluation Methods 0.000 description 2
- 235000008397 ginger Nutrition 0.000 description 2
- 208000007386 hepatic encephalopathy Diseases 0.000 description 2
- 235000008216 herbs Nutrition 0.000 description 2
- 230000028709 inflammatory response Effects 0.000 description 2
- 210000004347 intestinal mucosa Anatomy 0.000 description 2
- 210000000936 intestine Anatomy 0.000 description 2
- 238000001990 intravenous administration Methods 0.000 description 2
- 230000009545 invasion Effects 0.000 description 2
- 230000005976 liver dysfunction Effects 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 210000000496 pancreas Anatomy 0.000 description 2
- 239000011591 potassium Substances 0.000 description 2
- 229910052700 potassium Inorganic materials 0.000 description 2
- 230000035935 pregnancy Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 239000011734 sodium Substances 0.000 description 2
- 229910052708 sodium Inorganic materials 0.000 description 2
- 230000003393 splenic effect Effects 0.000 description 2
- 208000018556 stomach disease Diseases 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 229940126680 traditional chinese medicines Drugs 0.000 description 2
- 210000003462 vein Anatomy 0.000 description 2
- 210000001835 viscera Anatomy 0.000 description 2
- LITBAYYWXZOHAW-XDZRHBBOSA-N (2s,5r,6r)-6-[[(2r)-2-[(4-ethyl-2,3-dioxopiperazine-1-carbonyl)amino]-2-phenylacetyl]amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid;(2s,3s,5r)-3-methyl-4,4,7-trioxo-3-(triazol-1-ylmethyl)-4$l^{6}-thia-1-azabicyclo[3.2.0]hept Chemical compound C([C@]1(C)S([C@H]2N(C(C2)=O)[C@H]1C(O)=O)(=O)=O)N1C=CN=N1.O=C1C(=O)N(CC)CCN1C(=O)N[C@H](C=1C=CC=CC=1)C(=O)N[C@@H]1C(=O)N2[C@@H](C(O)=O)C(C)(C)S[C@@H]21 LITBAYYWXZOHAW-XDZRHBBOSA-N 0.000 description 1
- 208000007788 Acute Liver Failure Diseases 0.000 description 1
- 206010000804 Acute hepatic failure Diseases 0.000 description 1
- 206010061623 Adverse drug reaction Diseases 0.000 description 1
- 102100036475 Alanine aminotransferase 1 Human genes 0.000 description 1
- 108010082126 Alanine transaminase Proteins 0.000 description 1
- 208000035143 Bacterial infection Diseases 0.000 description 1
- 206010004542 Bezoar Diseases 0.000 description 1
- VEXZGXHMUGYJMC-UHFFFAOYSA-M Chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 description 1
- ZAMOUSCENKQFHK-UHFFFAOYSA-N Chlorine atom Chemical compound [Cl] ZAMOUSCENKQFHK-UHFFFAOYSA-N 0.000 description 1
- 208000004845 Cholecystolithiasis Diseases 0.000 description 1
- 208000017667 Chronic Disease Diseases 0.000 description 1
- 208000000668 Chronic Pancreatitis Diseases 0.000 description 1
- 206010069729 Collateral circulation Diseases 0.000 description 1
- 206010010774 Constipation Diseases 0.000 description 1
- 206010061818 Disease progression Diseases 0.000 description 1
- 208000030453 Drug-Related Side Effects and Adverse reaction Diseases 0.000 description 1
- 206010014080 Ecchymosis Diseases 0.000 description 1
- 102000004190 Enzymes Human genes 0.000 description 1
- 108090000790 Enzymes Proteins 0.000 description 1
- 241000588724 Escherichia coli Species 0.000 description 1
- 208000012671 Gastrointestinal haemorrhages Diseases 0.000 description 1
- 239000004378 Glycyrrhizin Substances 0.000 description 1
- 235000017443 Hedysarum boreale Nutrition 0.000 description 1
- 235000007858 Hedysarum occidentale Nutrition 0.000 description 1
- 208000034767 Hypoproteinaemia Diseases 0.000 description 1
- 208000022559 Inflammatory bowel disease Diseases 0.000 description 1
- 102000004889 Interleukin-6 Human genes 0.000 description 1
- 108090001005 Interleukin-6 Proteins 0.000 description 1
- WQZGKKKJIJFFOK-VSOAQEOCSA-N L-altropyranose Chemical compound OC[C@@H]1OC(O)[C@H](O)[C@@H](O)[C@H]1O WQZGKKKJIJFFOK-VSOAQEOCSA-N 0.000 description 1
- 241000827125 Lupinus flavoculatus Species 0.000 description 1
- 208000008771 Lymphadenopathy Diseases 0.000 description 1
- IPWKIXLWTCNBKN-UHFFFAOYSA-N Madelen Chemical compound CC1=NC=C([N+]([O-])=O)N1CC(O)CCl IPWKIXLWTCNBKN-UHFFFAOYSA-N 0.000 description 1
- 208000036626 Mental retardation Diseases 0.000 description 1
- 208000012902 Nervous system disease Diseases 0.000 description 1
- 206010067482 No adverse event Diseases 0.000 description 1
- 206010053159 Organ failure Diseases 0.000 description 1
- 206010033645 Pancreatitis Diseases 0.000 description 1
- 206010033647 Pancreatitis acute Diseases 0.000 description 1
- 206010033649 Pancreatitis chronic Diseases 0.000 description 1
- 208000008469 Peptic Ulcer Diseases 0.000 description 1
- 206010062237 Renal impairment Diseases 0.000 description 1
- 208000013738 Sleep Initiation and Maintenance disease Diseases 0.000 description 1
- 206010041519 Spider naevus Diseases 0.000 description 1
- 206010068677 Splenic embolism Diseases 0.000 description 1
- NGBFQHCMQULJNZ-UHFFFAOYSA-N Torsemide Chemical compound CC(C)NC(=O)NS(=O)(=O)C1=CN=CC=C1NC1=CC=CC(C)=C1 NGBFQHCMQULJNZ-UHFFFAOYSA-N 0.000 description 1
- 108060008682 Tumor Necrosis Factor Proteins 0.000 description 1
- 102000000852 Tumor Necrosis Factor-alpha Human genes 0.000 description 1
- 208000003443 Unconsciousness Diseases 0.000 description 1
- 206010046996 Varicose vein Diseases 0.000 description 1
- IXUZXIMQZIMPSQ-ZBRNBAAYSA-N [(4s)-4-amino-4-carboxybutyl]azanium;(2s)-2-amino-4-hydroxy-4-oxobutanoate Chemical compound OC(=O)[C@@H](N)CCC[NH3+].[O-]C(=O)[C@@H](N)CC(O)=O IXUZXIMQZIMPSQ-ZBRNBAAYSA-N 0.000 description 1
- 210000003489 abdominal muscle Anatomy 0.000 description 1
- 208000020560 abdominal swelling Diseases 0.000 description 1
- 231100000836 acute liver failure Toxicity 0.000 description 1
- 201000003229 acute pancreatitis Diseases 0.000 description 1
- 230000000172 allergic effect Effects 0.000 description 1
- 229940024606 amino acid Drugs 0.000 description 1
- 230000001754 anti-pyretic effect Effects 0.000 description 1
- 230000000840 anti-viral effect Effects 0.000 description 1
- 239000002221 antipyretic Substances 0.000 description 1
- 239000003443 antiviral agent Substances 0.000 description 1
- 206010003549 asthenia Diseases 0.000 description 1
- 208000010668 atopic eczema Diseases 0.000 description 1
- 230000001363 autoimmune Effects 0.000 description 1
- 230000001580 bacterial effect Effects 0.000 description 1
- 208000022362 bacterial infectious disease Diseases 0.000 description 1
- 208000027687 belching Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 210000000941 bile Anatomy 0.000 description 1
- 238000009640 blood culture Methods 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- FUDAIDRKVVTJFF-UHFFFAOYSA-N butane-1,1-disulfonic acid Chemical compound CCCC(S(O)(=O)=O)S(O)(=O)=O FUDAIDRKVVTJFF-UHFFFAOYSA-N 0.000 description 1
- 230000002308 calcification Effects 0.000 description 1
- 239000003054 catalyst Substances 0.000 description 1
- 230000005779 cell damage Effects 0.000 description 1
- 208000037887 cell injury Diseases 0.000 description 1
- 150000001780 cephalosporins Chemical class 0.000 description 1
- 239000000460 chlorine Substances 0.000 description 1
- 229910052801 chlorine Inorganic materials 0.000 description 1
- 201000001883 cholelithiasis Diseases 0.000 description 1
- 230000001684 chronic effect Effects 0.000 description 1
- 230000007012 clinical effect Effects 0.000 description 1
- 230000019771 cognition Effects 0.000 description 1
- 230000002016 colloidosmotic effect Effects 0.000 description 1
- -1 compound amino acid Chemical class 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000003111 delayed effect Effects 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- GUJOJGAPFQRJSV-UHFFFAOYSA-N dialuminum;dioxosilane;oxygen(2-);hydrate Chemical compound O.[O-2].[O-2].[O-2].[Al+3].[Al+3].O=[Si]=O.O=[Si]=O.O=[Si]=O.O=[Si]=O GUJOJGAPFQRJSV-UHFFFAOYSA-N 0.000 description 1
- 230000005750 disease progression Effects 0.000 description 1
- 239000002552 dosage form Substances 0.000 description 1
- 230000035622 drinking Effects 0.000 description 1
- 238000001035 drying Methods 0.000 description 1
- 230000010102 embolization Effects 0.000 description 1
- 239000002158 endotoxin Substances 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 230000007717 exclusion Effects 0.000 description 1
- 230000001815 facial effect Effects 0.000 description 1
- 238000005562 fading Methods 0.000 description 1
- 239000000796 flavoring agent Substances 0.000 description 1
- 235000019634 flavors Nutrition 0.000 description 1
- 235000013305 food Nutrition 0.000 description 1
- 235000011389 fruit/vegetable juice Nutrition 0.000 description 1
- 208000020694 gallbladder disease Diseases 0.000 description 1
- 208000001130 gallstones Diseases 0.000 description 1
- LPLVUJXQOOQHMX-UHFFFAOYSA-N glycyrrhetinic acid glycoside Natural products C1CC(C2C(C3(CCC4(C)CCC(C)(CC4C3=CC2=O)C(O)=O)C)(C)CC2)(C)C2C(C)(C)C1OC1OC(C(O)=O)C(O)C(O)C1OC1OC(C(O)=O)C(O)C(O)C1O LPLVUJXQOOQHMX-UHFFFAOYSA-N 0.000 description 1
- 239000001947 glycyrrhiza glabra rhizome/root Substances 0.000 description 1
- 229960004949 glycyrrhizic acid Drugs 0.000 description 1
- UYRUBYNTXSDKQT-UHFFFAOYSA-N glycyrrhizic acid Natural products CC1(C)C(CCC2(C)C1CCC3(C)C2C(=O)C=C4C5CC(C)(CCC5(C)CCC34C)C(=O)O)OC6OC(C(O)C(O)C6OC7OC(O)C(O)C(O)C7C(=O)O)C(=O)O UYRUBYNTXSDKQT-UHFFFAOYSA-N 0.000 description 1
- 235000019410 glycyrrhizin Nutrition 0.000 description 1
- 208000019622 heart disease Diseases 0.000 description 1
- 208000021760 high fever Diseases 0.000 description 1
- 230000036737 immune function Effects 0.000 description 1
- 239000002955 immunomodulating agent Substances 0.000 description 1
- 229940121354 immunomodulator Drugs 0.000 description 1
- 230000002401 inhibitory effect Effects 0.000 description 1
- 206010022437 insomnia Diseases 0.000 description 1
- 230000010354 integration Effects 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 229940100601 interleukin-6 Drugs 0.000 description 1
- 238000010253 intravenous injection Methods 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 230000005977 kidney dysfunction Effects 0.000 description 1
- 230000006651 lactation Effects 0.000 description 1
- 201000007270 liver cancer Diseases 0.000 description 1
- 210000005229 liver cell Anatomy 0.000 description 1
- 208000018191 liver inflammation Diseases 0.000 description 1
- 208000014018 liver neoplasm Diseases 0.000 description 1
- 230000014759 maintenance of location Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000003340 mental effect Effects 0.000 description 1
- 244000000010 microbial pathogen Species 0.000 description 1
- 229910052901 montmorillonite Inorganic materials 0.000 description 1
- 210000004877 mucosa Anatomy 0.000 description 1
- 210000004400 mucous membrane Anatomy 0.000 description 1
- 210000000440 neutrophil Anatomy 0.000 description 1
- 239000002547 new drug Substances 0.000 description 1
- 235000016709 nutrition Nutrition 0.000 description 1
- 230000035764 nutrition Effects 0.000 description 1
- 229960002313 ornidazole Drugs 0.000 description 1
- 108010049063 ornithylaspartate Proteins 0.000 description 1
- 230000003204 osmotic effect Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 210000003200 peritoneal cavity Anatomy 0.000 description 1
- 210000004303 peritoneum Anatomy 0.000 description 1
- 229940126532 prescription medicine Drugs 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
- 238000003672 processing method Methods 0.000 description 1
- 238000010791 quenching Methods 0.000 description 1
- 230000000171 quenching effect Effects 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 230000028327 secretion Effects 0.000 description 1
- 230000035939 shock Effects 0.000 description 1
- 230000005982 spleen dysfunction Effects 0.000 description 1
- 210000002563 splenic artery Anatomy 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 229960000614 sulbactam sodium Drugs 0.000 description 1
- 230000001502 supplementing effect Effects 0.000 description 1
- 239000000829 suppository Substances 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 210000002435 tendon Anatomy 0.000 description 1
- 229940126585 therapeutic drug Drugs 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000035922 thirst Effects 0.000 description 1
- 229960005461 torasemide Drugs 0.000 description 1
- 230000001131 transforming effect Effects 0.000 description 1
- 238000011269 treatment regimen Methods 0.000 description 1
- 206010045458 umbilical hernia Diseases 0.000 description 1
- 210000003606 umbilical vein Anatomy 0.000 description 1
- RUDATBOHQWOJDD-UZVSRGJWSA-N ursodeoxycholic acid Chemical compound C([C@H]1C[C@@H]2O)[C@H](O)CC[C@]1(C)[C@@H]1[C@@H]2[C@@H]2CC[C@H]([C@@H](CCC(O)=O)C)[C@@]2(C)CC1 RUDATBOHQWOJDD-UZVSRGJWSA-N 0.000 description 1
- 229960001661 ursodiol Drugs 0.000 description 1
- 239000011782 vitamin Substances 0.000 description 1
- 229940088594 vitamin Drugs 0.000 description 1
- 229930003231 vitamin Natural products 0.000 description 1
- 235000013343 vitamin Nutrition 0.000 description 1
- 230000004584 weight gain Effects 0.000 description 1
- 235000019786 weight gain Nutrition 0.000 description 1
- 239000013585 weight reducing agent Substances 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/70—Polygonaceae (Buckwheat family), e.g. spineflower or dock
- A61K36/704—Polygonum, e.g. knotweed
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/34—Campanulaceae (Bellflower family)
- A61K36/344—Codonopsis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
- A61K36/484—Glycyrrhiza (licorice)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/53—Lamiaceae or Labiatae (Mint family), e.g. thyme, rosemary or lavender
- A61K36/539—Scutellaria (skullcap)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/70—Polygonaceae (Buckwheat family), e.g. spineflower or dock
- A61K36/708—Rheum (rhubarb)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/71—Ranunculaceae (Buttercup family), e.g. larkspur, hepatica, hydrastis, columbine or goldenseal
- A61K36/718—Coptis (goldthread)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/185—Magnoliopsida (dicotyledons)
- A61K36/85—Verbenaceae (Verbena family)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/88—Liliopsida (monocotyledons)
- A61K36/888—Araceae (Arum family), e.g. caladium, calla lily or skunk cabbage
- A61K36/8888—Pinellia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/88—Liliopsida (monocotyledons)
- A61K36/899—Poaceae or Gramineae (Grass family), e.g. bamboo, corn or sugar cane
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
- A61K36/18—Magnoliophyta (angiosperms)
- A61K36/88—Liliopsida (monocotyledons)
- A61K36/906—Zingiberaceae (Ginger family)
- A61K36/9068—Zingiber, e.g. garden ginger
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/04—Antibacterial agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K2236/00—Isolation or extraction methods of medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicine
- A61K2236/30—Extraction of the material
- A61K2236/33—Extraction of the material involving extraction with hydrophilic solvents, e.g. lower alcohols, esters or ketones
- A61K2236/331—Extraction of the material involving extraction with hydrophilic solvents, e.g. lower alcohols, esters or ketones using water, e.g. cold water, infusion, tea, steam distillation or decoction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K2236/00—Isolation or extraction methods of medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicine
- A61K2236/30—Extraction of the material
- A61K2236/39—Complex extraction schemes, e.g. fractionation or repeated extraction steps
Landscapes
- Health & Medical Sciences (AREA)
- Natural Medicines & Medicinal Plants (AREA)
- Life Sciences & Earth Sciences (AREA)
- Pharmacology & Pharmacy (AREA)
- Chemical & Material Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Medicinal Chemistry (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Botany (AREA)
- Mycology (AREA)
- Epidemiology (AREA)
- Microbiology (AREA)
- Medical Informatics (AREA)
- Biotechnology (AREA)
- Alternative & Traditional Medicine (AREA)
- Chemical Kinetics & Catalysis (AREA)
- General Chemical & Material Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Organic Chemistry (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Gastroenterology & Hepatology (AREA)
- Neurosurgery (AREA)
- Communicable Diseases (AREA)
- Oncology (AREA)
- Medicines Containing Plant Substances (AREA)
Abstract
本发明公开了一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法,旨在以解决西医抗感染治疗存在肝肾功能损害、耐药率逐渐增高的技术问题。该药物主要由水红花子、马鞭草、大黄、白茅根、半夏、黄连、黄芩、党参、干姜、甘草等制成。本发明组方药物配伍科学合理,具有良好的清热利湿、消癥散结、解毒通腑之功效,其重在祛除湿热瘀毒实邪,兼以培补正气,攻补兼施,令气血水调和,诸症得减;能够有效治疗湿热瘀结型自发性细菌性腹膜炎,其原料来源丰富,服用方便,成本较低,且安全无毒副作用。
Description
技术领域
本发明涉及中药技术领域,具体涉及一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法。
背景技术
自发性细菌性腹膜炎(SBP)是肝硬化失代偿期常见的并发症之一,是指在腹腔内或邻近组织没有感染灶的情况下,病原微生物侵入腹腔诱发的腹水细菌性感染。据统计,在肝硬化腹水住院患者中SBP发病率高达30%,1年后病死率约为63%;其病死率高的原因考虑与SBP发生后启动以肿瘤坏死因子-α和白介素-6为主的瀑布式炎症反应,加重肝肾功能损害,加快肝硬化病情进展有关。
当前,本病发病机制尚未阐明,而相关的病原学研究则显示SBP患者腹水病原菌以革兰阴性菌居多,且以大肠埃希菌最为多见。因此,认为导致肝硬化患者发生SBP的致病菌主要来自肠道,细菌异位是关键病理环节,即肝硬化时多种因素相互作用导致肠粘膜屏障功能受损,肠腔内细菌通过破损的肠粘膜屏障异位进入腹膜、腹水等肠外组织器官,机体免疫功能低下无力清除细菌,最终细菌定植于腹水或腹腔而致病。
目前,对于该病症的西医治疗,主要是以抗炎、补充白蛋白、利尿、保肝降酶、退黄及其它对症治疗为主;尽早、有效的抗感染治疗是阻止病情进展、降低病死率的关键。西医抗感染治疗在取得较好疗效的同时,仍存在肝肾功能损害、耐药率逐渐增高等问题,影响SBP治疗的有效率。
基于此,研究开发出能够提高临床治疗有效率、减轻肝肾功能损害的治疗药物势在必行。
发明内容
本发明的目的在于提供一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,以解决西医抗感染治疗过程中存在肝肾功能损害、耐药率逐渐增高的技术问题。本发明之另一目的是提供了该药物的工艺流程简单、成本低的制备方法。
本发明所述病症治法之研究理应从自发性细菌性腹膜炎的基本病机入手,基于该病证是在肝硬化的基础上进一步发展而来,肠道中大量存在细菌内毒素是病情进展的催化剂的初步认知;发明人进一步结合长期的临床实践研究认为:在肝硬化病情进展过程中,肝失疏泄影响机体肠腑的泌别清浊和传化糟粕,导致肠道瘀毒内结,腑气不通,湿、热、瘀、毒诸邪内侵脏腑,“肝脾肾失调,湿热水瘀互结”是其基本病机。
基于此,发明人认为该病症之治疗,应从整体观念出发,因肝硬化者久病消耗,正气不足,治法应以祛邪为主兼顾扶正,健运中土,以达祛邪不伤正之目的。组方首当清热利湿、消癥通腑,使湿、热、毒、瘀等病邪有出路,邪去则气机调畅、血脉通利、水道通利、津液得布,辅以健脾益气,攻补兼施,以有效地加快缓解患者临床症状及体征,提高临床治疗有效率,减轻炎症反应,加快肝功能修复,延缓病情进展。据此遣方如下:
治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,以重量份计,由以下原料药制成:
水红花子15~35份、马鞭草15~35份、大黄5~15份、白茅根15~35份、半夏5~12份、黄连3~10份、黄芩4~10份、党参9~20份、干姜1~6份、甘草4~10份。
优选的,由以下原料药制成:
水红花子20~35份、马鞭草20~35份、大黄6~15份、白茅根20~35份、半夏6~12份、黄连3~9份、黄芩4~9份、党参9~18份、干姜2~6份、甘草6~10份。
进一步优选的,由以下原料药制成:
水红花子30份、马鞭草30份、大黄10份、白茅根30份、半夏9份、黄连6份、黄芩6份、党参15份、干姜3份、甘草6份。
以上治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物可制成药剂学上的任何一种剂型,如汤剂、丸剂、散剂、胶囊剂等,以下以汤剂为例,说明其制备方法,包括如下步骤:
(1)按所述原料药配比称取各原料药备用;
(2)先将水红花子、马鞭草、白茅根、半夏、黄连、黄芩、党参、干姜、甘草加入饮用水(加水量以浸没过药面2~5cm为准),,浸泡30~40min,然后加热煮沸后继续煎煮30~35min,纳入大黄继续煎煮5~10min,过滤得滤液和药渣;
(3)将上步所得药渣加入饮用水,水量浸没过药面2~5cm,加热煮沸后继续煎煮25~30min,过滤得滤液;
(4)合并各次煎煮药剂,得煎煮汤剂,或进一步制成丸剂、散剂或胶囊剂。与现有技术相比,本发明的主要有益技术效果在于:
1. 本发明组方药物配伍科学合理,具有良好的清热利湿、消癥散结、解毒通腑之功效,其重在祛除湿热瘀毒实邪,兼以培补正气,攻补兼施,令气血水调和,诸症得减。方中,水红花子、马鞭草:清热消癥,散瘀利水、退黄;大黄:清热解毒,泻下通腑;白茅根:清热利尿,育阴生津;半夏、黄连、黄芩:辛开苦降,清热燥湿,消痞散结;党参:补脾益气,健运中土;干姜:制约诸药寒凉之性;甘草:补益中气,调和诸药。
2. 临床应用研究表明,本发明药物能够有效治疗湿热瘀结型自发性细菌性腹膜炎,尤其对于早中期自发性细菌性腹膜炎患者有很好地治疗作用。
3. 本发明原料来源丰富,制备成本较低,成剂后服用方便,且安全无毒副作用,具有良好地应用前景。
具体实施方式
下面结合实施例来说明本发明的具体实施方式,但以下实施例只是用来详细说明本发明,并不以任何方式限制本发明的范围。
在以下实施例中所涉及的中药原料如无特别说明,均为市售常规原料;所涉及的加工制备方法,如无特别说明,均为常规方法。
实施例1: 一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其原料配方如下:
水红花子30份、马鞭草30份、大黄10份、白茅根30份、半夏9份、黄连6份、黄芩6份、党参15份、干姜3份、甘草6份。
上述药物的制备方法,包括如下步骤:
(1)按所述原料药配比称取各原料药备用;
(2)先将水红花子、马鞭草、白茅根、半夏、黄连、黄芩、党参、干姜、甘草加入饮用水,水量浸没过药面2~5cm,浸泡30~40min后进行煎煮,温度达到100℃后煎煮30~35min,纳入大黄继续煎煮5~10min,过滤得滤液和药渣;
(3)将上步所得药渣加入饮用水,水量浸没过药面2~5cm,加热,温度达到100℃后煎煮25~30min,过滤得滤液;
(4)合并各次煎煮药剂,得煎煮汤剂,或进一步制成丸剂、散剂或胶囊剂。
实施例2: 一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其原料配方如下:
水红花子20份、马鞭草20份、大黄6份、白茅根20份、半夏6份、黄连3份、黄芩4份、党参9份、干姜2份、甘草6份。
其制备方法同实施例1。
实施例3: 一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其原料配方如下:
水红花子35份、马鞭草35份、大黄15份、白茅根35份、半夏12份、黄连9份、黄芩9份、党参18份、干姜6份、甘草10份。
其制备方法同实施例1。
临床试验例:
1.病例选择
来自河南中医药大学第一附属医院脾胃肝胆病科住院患者,共61例,随机分为对照组31例,试验组30例。两组患者的性别、年龄、腹水病程、SBP病史、合并肝癌、饮酒史、Child-Pugh分级等方面均无明显差异,见表1。
表1 两组病例一般资料比较
病例纳入标准:①年龄18-75岁;②符合肝硬化自发性细菌性腹膜炎西医诊断标准和湿热瘀结证中医辨证标准;③患者知情同意。
肝硬化自发性细菌性腹膜炎西医诊断标准:
参照中华医学会肝病学分会2017年发布的《肝硬化腹水及相关并发症的诊疗指南》中自发性细菌性腹膜炎的诊断标准。
中医辨证分型标准:参照《肝硬化腹水中医诊疗专家共识意见(2017)》,根据湿热水停证和血瘀水停证,拟定SBP湿热瘀结证辨证标准。
主症:①腹大坚满如鼓,脘腹撑急;②腹痛拒按,按之痛甚;③腹壁青筋暴露;④身目发黄;⑤胁肋刺痛。
次症:①口干;②口苦;③面颈部胸臂有赤丝血缕;④肌肤甲错;⑤面色晦暗或黧黑;⑥小便短黄;⑦大便秘结或溏垢。
舌脉:①舌质红或暗红或有瘀斑,舌下脉络迂曲,舌苔黄腻;②脉弦滑或涩。具备主症、舌脉和任意2项次症即可诊断。
病例排除标准:
①治疗前1月内使用过微生态制剂、抗生素、免疫调节剂;②合并急性消化道大出血、休克、慢加急性肝功能衰竭、其它脏器功能衰竭及其他危重并发症;③合并急慢性胰腺炎、消化道溃疡或穿孔、炎症性肠病等影响肠道功能的疾病;④对头孢类抗菌素过敏者;⑤有严重心脏、神经***疾病者;⑥孕期、哺乳期或计划妊娠者。
2.治疗方案
对照组:采用西医基础治疗。
试验组:采用西医基础治疗+本发明组方药物煎煮汤剂口服。
西医基础治疗方案:
参考2017年中华医学会肝病学分会制定的《肝硬化腹水及相关并发症的诊疗指南》:
①抗菌药物:根据指南推荐首先选用三代类头孢抗菌药物,同时做腹水培养和(或)血培养,依据药敏结果调整抗菌药物;②人血白蛋白:ALB<30g/L者输注人血白蛋白(华兰生物工程股份有限公司,规格:10g(20% 50ml),批准文号:S10950009)10g,qd,ivgtt;③抑制肝脏炎症反应药:复方甘草酸苷注射液(Minophagen Pharmaceutical CompanyLimited,批准文号:H20080264)80mg,qd,ivgtt;④其它内科综合支持治疗:包括病因治疗(抗病毒、戒酒等)、利尿(螺内酯、呋塞米剂量比100mg:40mg,以体重下降0.5-1 kg/d为宜,并根据患者腹水消退情况及时调整剂量和频次)、补充各种维生素等。
中药口服治疗方案:
在对照组西医基础治疗上给予本发明组方药物煎煮汤剂口服。
来源与制备:由河南中医药大学第一附属医院中药煎药房煎制而成,每天1剂,早晚两次分服,每次200ml。药物组成有水红花子30g、马鞭草30g、大黄10g、白茅根30g、半夏9g、黄连6g、黄芩6g、党参15g、干姜3g、甘草6g。
3.观察指标
主要疗效指标:发热、腹痛缓解时间;腹水PMN计数;中医症状积分。腹水PMN计数首次为入组前诊断性腹腔穿刺所得,治疗72小时后行第二次腹腔穿刺,随后根据病情需要进行检测。
次要疗效指标:血清中性粒细胞百分比(%NEUT)、C-反应蛋白(CRP)、降钙素原(PCT)、谷丙转氨酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、白蛋白(ALB),分别在0天、7天、14天进行检测。
安全性指标:尿常规、大便常规、肾功能(尿素氮、肌酐)、电解质(血清钾、钠、氯)、心电图。
4.疗效评价标准
西医临床疗效评价标准:
参考《肝硬化腹水及相关并发症的诊疗指南》和《证候类中药新药临床研究技术指导原则》制定标准如下:
①腹水PMN计数<0.25×109/L或腹水消失;②发热消失;③腹痛消失;三个条件均满足者为临床治愈。
中医症状疗效评价标准:参考《脾胃病症状量化标准共识意见》和《证候类中药新药临床研究技术指导原则》。
显效:症状和体征明显改善,即症状疗效分级指数≥70%;有效:症状和体征好转,即症状疗效分级指数30%≤疗效指数<70%;无效:症状和体征无减轻或有加重倾向者,即症状疗效分级指数疗效指数<30%。
7.结果
(1)主要疗效指标分析:
两组治疗后发热、腹痛消失时间比较:61名受试者中共有35例有发热(对照组17例,试验组18例),共有47例有腹痛(对照组25例,试验组22例)。试验组发热、腹痛消失时间少于对照组,差异有统计学意义(P<0.05),见表2。
表2 两组治疗后发热、腹痛消失时间比较(x±s)
注:采用独立样本t检验。
两组腹水PMN计数比较:治疗前两组腹水PMN计数比较,差异无统计学意义(P>0.05)。治疗72h后两组腹水PMN计数均较治疗前降低(P<0.01)。组间比较,试验组腹水PMN计数下降更明显(P<0.05),见表3。
表3 两组腹水PMN计数比较[M(Q25,Q75)]
注:组间比较,采用两独立样本秩和检验,▲ P>0.05,# P<0.05;组内比较,采用两相关秩和检验,○ P<0.01。
两组临床疗效比较:对照组临床治愈26例,未治愈5例,临床治愈率为83.97%;试验组临床治愈28例,未治愈2例,临床治愈率为93.33%;治疗14天后试验组临床疗效优于对照组(P<0.05)。
两组中医症状总积分比较:两组治疗前比较差异无统计学意义(P>0.05),治疗14天后两组中医症状总结分均较治疗前下降(P<0.01),试验组下降更为明显(P<0.01),见表4。
表4 两组病例中医症状总积分比较(x±s)
注:组间比较,采用独立样本t检验,▲ P>0.05,△ P<0.01;组内比较,采用配对样本t检验,○ P<0.01。
两组中医症状疗效比较:治疗前后各单项症状比较,对照组口干、口苦、纳差无改善(P>0.05),发热、腹痛、腹胀、胁痛、身目黄染、乏力、小便短黄有改善(P<0.05),试验组对各项症状均有改善(P<0.05);组间比较,试验组发热、腹痛改善与对照组相当(P>0.05),其余各项症状的改善优于对照组(P<0.05)。治疗后试验组症状总积分的改善优于对照组(P<0.01)。中医症状疗效比较,对照组总有效率为80.65%,试验组总有效率为93.37%优于对照组(P<0.05)。
(2)次要疗效指标分析:
治疗前两组炎症指标(%NEUT、CRP、PCT)、肝功能(ALT、AST、ALB、TBIL)差异无统计学意义(P>0.05)。治疗7天后试验组%NEUT、CRP、PCT、AST的下降较对照组明显(P<0.05),ALT、ALB、TBIL的改善与对照组相当(P>0.05);治疗14天后试验组%NEUT、PCT、ALT、AST、TBIL的下降较对照组明显(P<0.05),CRP、ALB的改善与对照组相当(P>0.05),见表5、表6。
表5 两组病例治疗前后炎症指标比较[M(Q25,Q75)]
注:组间比较,采用两独立样本秩和检验,▲ P>0.05,# P<0.05,△ P<0.01;组内比较,采用两相关样本秩和检验,* P<0.05,○ P<0.01。
表6 两组治疗前后肝功能比较[M(Q25,Q75)]
注:组间比较,采用两独立样本秩和检验,▲ P>0.05,# P<0.05;组内比较,采用两相关样本秩和检验,· P>0.05,* P<0.05,○ P<0.01。
(3)安全性指标分析:
本方案实行期间,未发现明显药物不良反应。两组患者治疗前后尿常规、大便常规、肾功能(尿素氮、肌酐)、电解质(血清钾、钠、氯)、心电图未见明显变化。
上述结果表明,在西医治疗的基础上加用本发明所示中药组方治疗肝硬化自发性细菌性腹膜炎患者,能够缩短发热和腹痛缓解时间,快速降低腹水PMN计数水平,提高临床有效率,更显著地改善患者临床症状,同时抑制炎症反应,减轻肝细胞损伤的作用优于单纯西医基础治疗。在本试验中未发现有不良反应,表明本发明用药安全,疗效稳定可靠。
典型病例
病例一:
患者黄某某,男性,39岁,主因“间断右胁不适6月余,加重伴意识不清1天”于2020年07月15日就诊。
六月前患者无明显诱因出现右胁不适,伴重度腹胀,无身目黄染,无腹痛腹泻,就诊于当地医院住院诊断为“乙肝肝硬化失代偿期”,给予恩替卡韦片抗病毒、护肝、利尿、放腹水及对症治疗,症状好转后出院。此后间断发作,对症治疗后可好转。
一天前患者饮食不洁后出现烦躁,右胁隐痛,腹胀,腹痛,尿少,就诊于我院,门诊以“肝炎肝硬化 乙型 失代偿期”为诊断收治。入院症见:烦躁,记忆力下降,右胁隐痛,口干苦,脘腹撑急,腹痛,周身乏力,纳食欲差,尿少,大便2-3天1次。舌质暗红,苔黄厚腻,脉弦数。入院时查体:T 36.4℃ P 108次/分 R 23次/分 BP 150/105mmHg Ht 172cm Wt 55kg。体格检查:反应迟钝,定向力下降,皮肤及巩膜轻度黄染,肝掌阳性,腹部膨隆,腹部压痛及反跳痛阳性,肝肋下未触及,脾肋下5cm可触及,质韧无触痛,移动性浊音阳性,双下肢轻度水肿。2020年07月15日查血常规:WBC 7.2×109/L,%NEUT 84.1%,CRP 7.0ng/L。肝功:TBIL76.1μmol/L,DBIL 25.9μmol/L,ALB 37.7g/L,ALT 56.2U/L。血清PCT 2.03ng/ml。腹水常规:淡黄,微浑,白细胞1000×106/L,单核细胞比率68%,多核细胞比率32%,PMN计数0.32×109/L。腹部彩超示:1.肝硬化并结节;2.肝源性胆囊炎;3.脾大 4腹水(患者平卧位,肝前水深约39mm,脾窝深约34mm,左髂窝深约50mm,右髂窝深约60mm,下腹部范围约130×117mm)。
中医诊断:1.鼓胀 湿热瘀结证;2.肝积。
西医诊断:1.肝炎肝硬化 乙型 失代偿期 活动性(脾大,腹水);2.肝性脑病Ⅱ期;3.自发性细菌性腹膜炎。
入院后给予恩替卡韦分散片抗病毒;门冬氨酸鸟氨酸注射液纠正肝性脑病;头孢哌酮舒巴坦钠联合左奥硝唑抗感染;予呋塞米片、螺内酯片利尿消胀,及护肝、对症支持治疗;同时采用本发明所示中药口服(每日早晚各1次,每次200ml)。治疗14天后,患者腹痛、腹胀消失,尿量恢复正常,口苦消失,右胁隐痛、纳差、乏力明显好转。期间未见明显不适及其它不良反应。复查血常规:WBC 5.1×109/L,%NEUT 67.8%,CRP 4.4ng/L。肝功:TBIL 49.0μmol/L,DBIL 17.3μmol/L,ALB 45.7g/L,ALT 23.1U/L。血清PCT 0.03ng/ml。腹水常规:淡黄,清,白细胞220×106/L,单核细胞比率75%,多核细胞比率25%,PMN计数0.21×109/L。腹水彩超:患者平卧位,肝前深约14mm,脾窝深约10mm,左髂窝深约18mm,下腹部范围约54×36mm。
病例二:
患者孙某某,男性,42岁,主因“间断腹胀伴身目黄染1年,加重伴发热5天”于2020年10月27日就诊。
一年前患者无明显诱因出现腹部胀满、身目黄染,在某三甲医院诊断为“乙肝肝硬化失代偿期”,给予保肝、利尿、补充白蛋白及对症治疗,症状好转后出院。此后反复发作,于当地医院住院治疗。
五天前患者无明显诱因出现寒战、高热,体温最高39.3℃,在当地诊所输液后症状未见好转,腹部胀满、身目黄染、乏力,为求进一步中西医***诊疗,来我院求治。入院症见:精神差,腹部胀满,腹痛,身目黄染,乏力,口干,纳差,大便难下,小便量少色黄,入睡困难。舌质暗红,舌苔黄腻稍厚,脉弦。入院时查体:T 36.1℃ P 112次/分 R 23次/分 BP 108/66mmHg Ht 165cm Wt 70kg。体格检查:周身皮肤黏膜、巩膜黄染,腹部膨隆,腹壁静脉显露,腹肌紧张,腹部压痛及反跳痛阳性,肋下4cm可触及脾脏,移动性浊音阳性,双下肢中度指凹性水肿。2020年10月27日查血常规:WBC 22.5×109/L,%NEUT 87.1%,%NEUT 19.55×109/L,CRP 121.3ng/L。肝功:TBIL 91.3μmol/L,DBIL 34.4μmol/L,ALB 24.6g/L,ALT 21.5U/L,AST 24.9U/L。血清PCT 1.44ng/ml,腹水常规:黄色,浑浊,白细胞11000×106/L,单核细胞比率8%,多核细胞比率92%,PMN计数10.12×109/L。全腹部CT平扫:1.肝硬化,脾大,侧枝循环形成;2.腹腔内少许肿大***,腹盆腔大量积液;3.胆囊颈部多发小结石;4.副脾。
中医诊断:1.鼓胀 湿热瘀结证; 2.肝积。
西医诊断:1.肝炎肝硬化 乙型 失代偿期 活动性(脾大 腹水);2.自发性细菌性腹膜炎;3.胆囊结石。
入院后给予哌拉西林他唑巴坦针联合奥硝唑针抗感染,人血白蛋白针纠正低蛋白血症,呋塞米片、螺内酯片利尿,恩替卡韦分散片抗病毒,及护肝、对症治疗;采用本发明所示中药口服(每日早晚各1次,每次200ml)。治疗14天后,患者腹痛、口干消失,身目黄染、腹胀、双下肢水肿明显减轻,纳差、乏力好转,大便日2次,小便正常。期间未见明显不适及其它不良反应。复查血常规:WBC 6.4×109/L,%NEUT 65.6%,%NEUT 4.81×109/L,CRP 2.75ng/L。肝功:TBIL 38.8μmol/L,DBIL 9.7μmol/L,ALB 31.3g/L,ALT 6.2U/L,AST 15.6U/L。血清PCT<0.05ng/ml,腹水常规:深黄色,微浑,白细胞450×106/L,单核细胞比率82%,多核细胞比率18%,PMN计数0.08×109/L。腹水彩超:患者卧位,肝前深约27mm,肝肾隐窝处深约23mm,脾周深约10mm,左下腹肠间隙深约14mm,右侧腹深约31mm,下腹深约49mm。
病例三:
患者韩某,女性,57岁,主因“间断右胁胀痛4年余,加重伴发热1天”于2020年08月03日就诊。
四年前患者因右胁不适就诊于某三级甲等医院,诊断为“自身免疫性肝硬化失代偿期”,给予护肝等对症治疗症状缓解。此后间断发作,反复住院治疗。
一天前患者无明显诱因出现右胁胀痛加重,伴发热、腹泻,体温最高37.8℃,自服蒙脱石散及肛塞退热栓,腹泻减轻,体温未恢复正常,就诊于我院,门诊以“肝硬化失代偿期”为诊断收入院;入院症见:神志清,精神差,右胁及腹部胀痛,发热,乏力,嗳气,口干苦,小便色黄量少,大便日1次,近1周体重增加4Kg。舌质红,苔黄稍厚腻,脉弦。入院时查体:T37.8℃ P 97次/分 R 23次/分 BP 115/64mmHg Ht 160cm Wt 69kg。体格检查:巩膜重度黄染,肝掌及蜘蛛痣阳性,腹部膨隆,腹壁静脉曲张,腹壁紧张度增加,腹部压痛、反跳痛阳性,肝肋下未触及,脾脏肋下4cm可触及,移动性浊音阳性,双下肢轻度水肿。2020年08月03日查血常规:WBC 6.2×109/L,%NEUT 75.7%,%NEUT 4.69×109/L,CRP 16.5ng/L。肝功:TBIL164.1μmol/L,DBIL 109.0μmol/L,ALB 27.6g/L,ALT 36.6U/L,AST 50.5U/L。血清PCT3.1ng/ml。肝胆脾胰彩超:1.肝硬化;2.脾大;3.胆囊切除术后。腹水彩超:腹腔可探及液性暗区,肝前深约14mm,肝肾隐窝深约30mm,右侧髂窝深约41mm,下腹深约48mm。腹水常规:淡黄,浑浊,白细胞3000×106/L,单核细胞比率20%,多核细胞比率80%,腹水PMN计数2.4×109/L。既往史:7年前因胆囊结石行胆囊切除术。
中医诊断:1.鼓胀 湿热瘀结证;2.肝积。
西医诊断:1.肝硬化 失代偿期 活动性(脾大 腹水);2.自发性细菌性腹膜炎;3.胆囊切除术后状态。
入院后给予静脉输注比阿培南注射液抗感染、人血白蛋白提高血浆胶体渗透压,口服呋塞米片、螺内酯片利尿,并予以护肝、退黄等治疗;同时采用本发明所示中药口服(每日早晚各1次,每次200ml)。治疗7天后复查腹水常规:淡黄,清亮,白细胞120×106/L,单核细胞比率68%,多核细胞比率32%,PMN计数0.04×109/L。治疗14天后,患者体温恢复正常,右胁部胀痛、乏力明显好转,腹胀腹痛基本消失,双下肢水肿、嗳气、口干苦消失,二便调,纳食欲正常,眠可。复查血常规:WBC 4.4×109/L,%NEUT 69.3%,%NEUT 3.06×109/L,CRP 5.2ng/L。肝功:TBIL 130.4μmol/L,DBIL 60.2μmol/L,ALB 37.9g/L,ALT 19.5U/L,AST 38.5U/L。血清PCT 0.07ng/ml。腹水彩超:患者卧位,腹腔未探及液性暗区。
病例四:
患者杨某某,女性,42岁,主因“间断右胁不适伴腹胀5月余,再发10天”于2020年11月05日就诊。
五月前患者因劳累出现有些不适伴腹胀,于当地医院诊断为乙肝肝硬化失代偿期,予抗病毒、护肝、输注人血白蛋白等治疗,症状好转后出院。5月间腹胀反复加重,间断于当地医院住院治疗,病情相对稳定。
十天前患者无明显诱因右胁不适、腹胀再发加重,于当地住院治疗,效不明显,遂来我院求治。入院症见:右胁胀痛,脘腹撑急,腹痛,周身乏力,纳食欲减退,口干,饮不解渴,眠可,小便色黄量少,大便质可,日2~3次,双下肢重度指凹性水肿。舌红,苔中根部黄厚腻,脉弦稍滑。入院时查体:T 37.7℃ P 96次/分 R 23次/分 BP 93/55mmHg Ht 170cm Wt87kg。体格检查:肝病面容,皮肤粘膜及巩膜轻度黄染,腹部膨隆,腹壁静脉显露,脐疝大约3×3cm,腹壁紧张度增加,腹部压痛、反跳痛阳性,肝肋下未触及,脾脏肋下2cm可触及,移动性浊音阳性,双下肢重度指凹性水肿。2020年11月05日查血常规:WBC 5.7×109/L,NEUT83.6%,%NEUT 4.79×109/L,CRP 133.9ng/L。肝功:TBIL 60.1μmol/L,DBIL 44.0μmol/L,ALB 21.6g/L,ALT 32.5U/L,AST 44.2U/L。血清PCT 37.92ng/ml。腹水常规:淡黄,微浑,白细胞1856×106/L,单核细胞比率15%,多核细胞比率85%,PMN计数1.58×109/L。腹水彩超:患者平卧位,腹腔可探及液性暗区,肝前深约33mm,髂窝深约32mm,左侧腹深约106mm,右侧腹深约102mm,下腹深约122mm。上腹部16排CT平扫:1.肝硬化、脾大、门脉高压、大量腹水;2.肝源性胆囊炎。
中医诊断:1.鼓胀 湿热瘀结证;2.肝积;3.黄疸。
西医诊断:1.肝炎肝硬化 乙型 失代偿期 活动性(脾大 腹水);2.自发性细菌性腹膜炎。
入院后给予静脉滴注比阿培南注射液抗感染治疗,人血白蛋白注射液以补充胶体、提高血浆胶体渗透压;口服呋塞米片、螺内酯片利尿,恩替卡韦片抗病毒;及对症支持治疗。采用本发明所示中药口服(每日早晚各1次,每次200ml)。治疗14天后,患者腹痛消失,腹胀、乏力、双下肢水肿明显减轻,纳食欲改善,口干消失,二便正常。复查血常规:WBC 1.9×109/L,%NEUT 58.5%,CRP 33.7ng/L。肝功:TBIL 44.2.1μmol/L,DBIL 17.8μmol/L,ALB35.5g/L,ALT 13.7U/L,AST 28.9U/L。血清PCT 0.15ng/ml。腹水常规:黄色,清,白细胞180×106/L,单核细胞比率80%,多核细胞比率20%,PMN计数0.04×109/L。腹水彩超:患者平卧位,腹腔可探及液性暗区,肝前深约17mm,髂窝深约12mm,左侧腹深约20mm,右侧腹深约22mm,下腹深约43mm。
病例五:
患者曹某某,男性,57岁,主因“间断右胁部不适9年余,加重伴腹胀、乏力半月”于2020年11月23日就诊。
九年前患者因右胁不适至某三甲中医院就诊,检查诊断为乙肝肝硬化,给予抗病毒、保肝及对症治疗,症状好转出院。此后长期服用抗病毒药物,间断复查,肝功能相对稳定。1月前因血WBC、PLT低,在当地某三级医院行脾动脉栓塞术。
半月前患者右胁不适加重,腹部胀大如鼓,身目黄染,乏力,就诊于我院,门诊以“肝炎肝硬化 乙型 失代偿期”为诊断收住院。入院症见:右胁不适,脘腹撑急,腹痛,身目黄染,口干口苦,周身乏力,纳差,眠可,小便色黄量少,大便日1次。舌质暗红,苔黄厚腻,脉弦数。2020年11月27日查血常规:WBC 15.5×109/L,%NEUT 91.9%,%NEUT 14.24×109/L,CRP41.5ng/L。肝功:TBIL 104.4μmol/L,DBIL 57.2μmol/L,ALB 34.4g/L,ALT 12.0U/L,AST29.9U/L。血清PCT 17.29ng/ml。腹水常规:棕色,微浑,白细胞2900×106/L,单核细胞比率80%,多核细胞比率20%,PMN计数0.58×109/L。肝胆脾胰彩超:1.肝硬化并结节;2.肝内钙化灶;3.门静脉高压;4.肝源性胆囊炎;5.脾大。腹水彩超:患者卧位,腹腔可探及不规则液性暗区,肝右前深约16mm,脾下极深约27mm,下腹部深约61mm。
中医诊断:鼓胀 湿热瘀结证。
西医诊断:1.肝炎肝硬化 乙型 失代偿期 活动性(门脉高压 腹水);2.自发性细菌性腹膜炎;3.脾栓塞术后。
入院后给予恩替卡韦片抗病毒;比阿培南注射液抗感染治疗;人血白蛋白注射液以补充白蛋白;托拉塞米静脉注射利尿;并予以丁二磺酸腺苷蛋氨酸改善胆汁淤积、口服牛黄熊去氧胆酸利胆退黄,复方氨基酸注射液营养支持等;采用本发明所示中药口服(每日早晚各1次,每次200ml)。治疗7天后复查腹水常规:淡黄色,微浑,白细胞464×106/L,单核细胞比率72%,多核细胞比率28%,腹水PMN计数0.13×109/L。治疗14天后,患者右胁不适、乏力明显减轻,腹胀、腹痛、口干苦基本消失,身目黄染减轻,二便正常。复查血常规:WBC 5.1×109/L,%NEUT 72.1%,%NEUT 3.67×109/L,CRP 10.9ng/L。肝功:TBIL 82.5μmol/L,DBIL54.2μmol/L,ALB 42.3g/L,ALT 14.2U/L,AST 23.4U/L。血清PCT 2.67ng/ml。腹水彩超:患者卧位,腹腔扫查,内未见游离液性暗区。
上面结合实施例对本发明作了详细的说明,但是,所属技术领域的技术人员能够理解,在不脱离本发明构思的前提下,还可以对上述实施例中的各个具体参数进行变更,或者是对相关方法、步骤及原料进行等同替代,从而形成多个具体的实施例,均为本发明的常见变化范围,在此不再一一详述。
Claims (4)
1.一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其特征在于,以重量份计,由以下原料药制成:
水红花子15~35份、马鞭草15~35份、大黄5~15份、白茅根15~35份、半夏5~12份、黄连3~10份、黄芩4~10份、党参9~20份、干姜1~6份、甘草4~10份。
2.根据权利要求1所述的治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其特征在于,由以下原料药制成:
水红花子20~35份、马鞭草20~35份、大黄6~15份、白茅根20~35份、半夏6~12份、黄连3~9份、黄芩4~9份、党参9~18份、干姜2~6份、甘草6~10份。
3.根据权利要求1所述的治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物,其特征在于,由以下原料药制成:
水红花子30份、马鞭草30份、大黄10份、白茅根30份、半夏9份、黄连6份、黄芩6份、党参15份、干姜3份、甘草6份。
4.一种治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物的制备方法,包括如下步骤:
(1)按权利要求1所述配比称取各原料药备用;
(2)先将水红花子、马鞭草、白茅根、半夏、黄连、黄芩、党参、干姜、甘草加入饮用水,水量浸没过药面2~5cm,浸泡30~40min,加热煮沸后继续煎煮30~35min,然后纳入大黄继续煎煮5~10min,过滤得滤液和药渣;
(3)将上步所得药渣加饮用水,水量浸没过药面2~5cm,加热煮沸后继续煎煮25~30min,过滤得滤液;
(4)合并各次煎煮药剂,得煎煮汤剂,或进一步制成丸剂、散剂或胶囊剂。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202110840468.1A CN113633748B (zh) | 2021-07-24 | 2021-07-24 | 治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202110840468.1A CN113633748B (zh) | 2021-07-24 | 2021-07-24 | 治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 |
Publications (2)
Publication Number | Publication Date |
---|---|
CN113633748A CN113633748A (zh) | 2021-11-12 |
CN113633748B true CN113633748B (zh) | 2022-09-30 |
Family
ID=78418402
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN202110840468.1A Active CN113633748B (zh) | 2021-07-24 | 2021-07-24 | 治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 |
Country Status (1)
Country | Link |
---|---|
CN (1) | CN113633748B (zh) |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN105311265A (zh) * | 2015-11-19 | 2016-02-10 | 黄富根 | 一种用于治疗肝硬化腹水的中药及制备方法 |
CN106511940A (zh) * | 2016-12-08 | 2017-03-22 | 刘春兰 | 一种治疗重症肝病的药物 |
CN111760006A (zh) * | 2020-08-13 | 2020-10-13 | 河北省中医院 | 一种治疗肝硬化的药物配方 |
Family Cites Families (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN102698114B (zh) * | 2012-06-28 | 2013-12-04 | 陈慧婷 | 治疗鼓胀的黄芩中药制剂及制备方法 |
-
2021
- 2021-07-24 CN CN202110840468.1A patent/CN113633748B/zh active Active
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN105311265A (zh) * | 2015-11-19 | 2016-02-10 | 黄富根 | 一种用于治疗肝硬化腹水的中药及制备方法 |
CN106511940A (zh) * | 2016-12-08 | 2017-03-22 | 刘春兰 | 一种治疗重症肝病的药物 |
CN111760006A (zh) * | 2020-08-13 | 2020-10-13 | 河北省中医院 | 一种治疗肝硬化的药物配方 |
Also Published As
Publication number | Publication date |
---|---|
CN113633748A (zh) | 2021-11-12 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN111671880B (zh) | 用于治疗冠状病毒肺炎发热的中药制剂 | |
CN102772781B (zh) | 一种治疗慢性结肠炎的中药制剂及其制备方法 | |
CN106729212B (zh) | 治疗痛风急性期的复方中药组合物及其应用 | |
CN102847021B (zh) | 一种治疗溃疡性结肠炎的灌肠剂及其制备方法 | |
CN107913370A (zh) | 一种中西医结合治疗酒精性肝病的药物及制备方法 | |
CN111991535B (zh) | 一种具有治疗幽门螺杆菌相关性胃炎功能的中药提取物及其制备方法和应用 | |
CN113633748B (zh) | 治疗肝硬化自发性细菌性腹膜炎湿热瘀结证的药物及其制备方法 | |
CN115501169A (zh) | 一种治疗克罗恩病腹胀的中药灌肠剂 | |
CN104324350A (zh) | 一种用于慢性结肠炎的中药组合物及其制备方法 | |
CN111228367B (zh) | 一种治疗小儿过敏性紫癜的中药外用洗剂及其制备方法 | |
CN104998158A (zh) | 一种治疗肝硬化的药物组合物及其应用 | |
CN110478416A (zh) | 治疗风湿性类风湿性关节炎的组合物及其制备方法和应用 | |
CN112972559B (zh) | 用于治疗骨和软组织化脓性炎症的中药组合物和中药合剂 | |
CN102764325B (zh) | 祛湿除痛中药组合物 | |
CN107126527A (zh) | 一种治疗肝癌的中药组合物及其制剂 | |
CN102552798B (zh) | 一种治疗胆石症的药物组合 | |
CN106581468A (zh) | 一种能够治疗胃溃疡的中药制备方法 | |
CN105079487A (zh) | 一种治疗热淋的中药组合物 | |
CN105213975A (zh) | 一种治疗肝硬化的药物组合物及其应用 | |
CN103432409B (zh) | 一种治疗嗜食烤肉型腋下急性化脓性***炎的中药 | |
CN116983365A (zh) | 一种治疗气阴两虚证慢性萎缩性胃炎的中药组合物、制剂和应用 | |
CN116549520A (zh) | 一种气血双补、清肺止咳的中药组方、中药液和药物制剂 | |
CN104116991A (zh) | 一种治疗放射病的中药制剂及制备方法 | |
CN111166850A (zh) | 一种治疗萎缩性胃炎的药物及其制备方法 | |
CN118320028A (zh) | 中药组合物、制备方法及应用 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
GR01 | Patent grant | ||
GR01 | Patent grant |