CN113713060B

CN113713060B - Blood stasis removing and turbidity lowering prescription for treating gout

Info

Publication number: CN113713060B
Application number: CN202111241025.7A
Authority: CN
Inventors: 肖洋; 柯婷; 杭程; 祁海燕; 王高雷; 王露露; 师韩菲; 董丹丹; 成路平; 刘厚利; 钟艺鸣; 吴宇祥; 高向宏
Original assignee: Shaanxi Traditional Chinese Medicine Hospital
Current assignee: Shaanxi Traditional Chinese Medicine Hospital
Priority date: 2021-10-25
Filing date: 2021-10-25
Publication date: 2022-07-05
Anticipated expiration: 2041-10-25
Also published as: CN113713060A

Abstract

The invention relates to the field of traditional Chinese medicine preparations, in particular to a blood stasis removing and turbidity lowering prescription for treating gout, which is prepared from the following raw materials: parched rhizoma Atractylodis, radix Cyathulae, cortex Phellodendri, parched Coicis semen, radix Angelicae sinensis, radix rehmanniae, rhizoma Ligustici Chuanxiong, parched Atractylodis rhizoma, Poria, semen plantaginis, radix Glycyrrhizae Preparata, Saviae Miltiorrhizae radix, and radix et rhizoma Rhei. The traditional Chinese medicine composition has the effects of tonifying spleen and middle energizer, removing blood stasis and promoting diuresis, can consolidate the constitution and remove blood stasis, can effectively relieve the symptoms of patients, can effectively reduce uric acid and blood fat, has few adverse reactions, is not easy to induce gout, and has satisfactory clinical effect.

Description

Blood stasis removing and turbidity lowering prescription for treating gout

Technical Field

The invention relates to the field of traditional Chinese medicine preparations, in particular to a blood stasis removing and turbidity lowering prescription for treating gout.

Background

Gout is a clinical syndrome that purine metabolism is abnormal in vivo and serum uric acid concentration is increased due to metabolic and genetic factors, monosodium urate crystals are deposited in tissues such as joint capsules, bursa, cartilage, bone and the like in a chronic mode to cause inflammatory reaction and disease damage, and the gout is directly related to hyperuricemia caused by reduction of uric acid excretion and (or) purine metabolic disorder and is the second major metabolic disease in China. With the improvement of social and economic levels and the living standard of people, the prevalence rate of gout rises year by year and the onset age tends to be younger. If the disease is treated improperly, the disease can cause complications such as uric acid nephropathy and uric acid urinary calculus, and serious patients can cause problems such as renal insufficiency and joint disability, thereby seriously affecting the life of people.

A prerequisite for gout attacks is hyperuricemia. Uric acid is the end product of purine breakdown, and hyperuricemia occurs when purine-containing food is ingested too much, synthesis is increased due to partial enzyme deficiency, or renal excretion is reduced. When uric acid levels are continuously high, blood uric acid in an over-saturated state can be crystallized and deposited in tissues, so that gout attacks are caused, and symptoms such as arthralgia, red swelling, skin temperature rise and the like are presented. At present, the western medicine has 3 main ways on the treatment of gout: a drug for inhibiting uric acid production: the generation of uric acid is inhibited by inhibiting xanthine oxidase, which represents the drugs allopurinol and febuxostat; (ii) drugs that promote uric acid excretion: the purpose of reducing uric acid is achieved by inhibiting reabsorption of renal tubules on uric acid, such as benzbromarone and probenecid. ③ anti-inflammatory agents: mainly comprises non-steroidal anti-inflammatory drugs, glucocorticoids, colchicine and the like. Although western medicine can achieve the purposes of effectively reducing uric acid level, controlling acute attack and relieving clinical symptoms in the aspect of treatment, some defects still exist: the opportunity and the target of reducing the uric acid and the possible adverse effect of reducing the uric acid still have great controversy at present; secondly, in clinical practice, acute recurrence of gout symptoms is easily caused at the early stage of application of the uric acid reducing drug, and the recurrence of gout cannot be effectively avoided by reducing uric acid, and research shows that: in the treatment of febuxostat and allopurinol for reducing uric acid for 1 year, 53 percent of patients have SUA controlled to be less than or equal to 6 mg-dL^-1But of goutThe recurrence rate still reaches 63 percent. And thirdly, the incidence of adverse reaction is high after long-term administration. Traditional Chinese medicine treatment has unique advantages in controlling disease development, reducing recurrence, reducing adverse reaction rate and the like, so that the application of traditional Chinese medicine to treat gout and hyperuricemia, preventing compound diseases and the like becomes a focus and hot point of research on the disease.

Disclosure of Invention

According to the pathogenesis of the gout, the gout disease is indicated to be improper diet, internal damage to spleen and stomach, spleen deficiency and excessive phlegm dampness, phlegm turbidity and dampness internal stagnated heat, flow into joint channels and collaterals and obstructed qi and blood circulation, and obstruction of qi and blood blockage.

In order to achieve the purpose, the invention adopts the technical scheme that: a blood stasis removing and turbidity lowering prescription for treating gout comprises the following raw materials: fried rhizoma atractylodis, medicinal cyathula root, golden cypress, fried semen coicis, angelica, radix rehmanniae recen, ligusticum wallichii, fried rhizoma atractylodis macrocephalae, poria cocos, plantain seed, honey-fried licorice root, salvia miltiorrhiza and raw rhubarb.

Further, the preparation method comprises the following steps: 15-20g of fried rhizoma atractylodis; 10-15g of medicinal cyathula root; 9-12g of phellodendron; 15-30g of fried coix seeds; 9-12g of angelica; 10-15g of radix rehmanniae; 10-12g of ligusticum wallichii; 15-30g of bighead atractylodes rhizome; 12-15g of poria cocos; 15-30g of plantain seeds; 6-9g of honey-fried licorice root; 12-15g of salvia miltiorrhiza; 3-6g of rhubarb.

The invention can effectively relieve the symptoms of patients, can effectively reduce uric acid and blood fat, has less adverse reaction, is not easy to induce gout, and has satisfactory clinical effect, and the prescription is as follows: the fried largehead atractylodes rhizome is used for eliminating dampness and promoting diuresis, and strengthening the spleen and replenishing qi; the fried coix seeds only enter yangming, clear heat and remove dampness to promote meridian and collateral; poria has the effects of eliminating dampness, promoting diuresis, invigorating spleen, regulating stomach function, calming heart, tranquilizing mind, invigorating spleen, and transporting lung to eliminate dampness; excessive water retention in the body, obstruction of the limbs and veins due to dampness, obstruction of obstruction, and the combination of plantain seed for inducing diuresis and excreting dampness to remove pathogens from the lower energizer, so that the body is healthy and safe when pathogens are removed; the medicines are combined to play the effects of invigorating spleen and tonifying middle-jiao, and removing blood stasis and promoting diuresis. The angelica, the radix rehmanniae and the rhizoma ligustici wallichii are used as ministerial drugs, wherein the angelica has the functions of enriching the blood and activating the blood; the rehmannia root has the effects of clearing heat and nourishing yin, and can prevent the medicines from being over-warmed and over-dried; chuan Xiong is a qi-flowing herb in blood and can promote blood circulation. For blood stasis due to chronic disease, Dan Shen is combined to enhance the blood-activating effect of the four-ingredient decoction (removing white peony root); for phlegm-turbid dampness pathogen stagnation leading to heat transformation, intestinal dysfunction and obstructed fu-organs qi, raw rhubarb is added to eliminate stagnation, clear damp-heat, purge fire and cool blood, remove stasis and remove toxicity. Cortex Phellodendri and rhizoma Atractylodis are adjuvant drugs, wherein cortex Phellodendri is bitter and cold in nature, and can clear heat and dry dampness. Huang Bai has descending and descending properties to clear damp-heat in the lower energizer and enter liver and kidney meridians. For example, in the pearl sac, cloud: "Huang Bai is used for six, purge bladder and dragon fire, one is also used; the feces and urine are convenient to take, and the stool and urine are convenient to take; the recipe also includes damp-swelling of lower energizer and so on. Rhizoma Atractylodis is bitter in taste and warm in nature, fragrant and dry dampness, its efficacy can directly reach spleen and middle energizer, and is good at drying dampness and invigorating spleen, for example, in Zhongyan cang shui phlegm and fluid retention in Ben Cao gang mu (compendium of materia Medica). The combination of phellodendron and rhizoma atractylodis can disperse the middle-lower phase, treat both symptoms and root causes, especially has the strong effect of eliminating dampness and clearing heat, and is a preferred prescription for treating symptoms such as arthralgia and myalgia, red swelling of feet and knees and the like caused by downward flow of damp-heat. Radix cyathulae and prepared licorice root are used as guiding drugs, radix cyathulae is neutral in nature, sweet in taste and bitter in flavor, enters liver and kidney meridians, can be used for treating traumatic injury, rheumatic arthralgia and other symptoms, and is easy to cause liver and kidney deficiency due to long-term illness, so radix cyathulae is added to tonify liver and kidney, strengthen tendons and bones, remove stasis and relieve pain, and is matched with prepared licorice root for harmonizing the drugs. The medicines are combined to play the effects of removing blood stasis, dredging collaterals, strengthening spleen and eliminating dampness and embody the thought of 'consolidating the foundation and removing blood stasis'.

Detailed Description

In order that the objects and advantages of the invention will be more clearly understood, the invention is further described in detail below with reference to examples. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.

Example 1

A blood stasis removing and turbidity lowering prescription for treating gout is prepared from the following components: 15g of fried rhizoma atractylodis; 10g of medicinal cyathula root; 9g of phellodendron amurense; 15g of fried coix seeds; 9g of Chinese angelica; dried rehmannia root 10 g; 10g of ligusticum wallichii; 15g of bighead atractylodes rhizome; 12g of poria cocos; 15g of plantain seeds; 6g of honey-fried licorice root; 12g of salvia miltiorrhiza; rhubarb, radix et rhizoma Rhei 3 g.

Example 2

A blood stasis removing and turbidity lowering prescription for treating gout is prepared from the following components: stir-frying 20g of rhizoma atractylodis; 15g of medicinal cyathula root; 12g of phellodendron amurense; 30g of fried coix seeds; 12g of Chinese angelica; 15g of dried rehmannia root; 12g of ligusticum wallichii; 30g of bighead atractylodes rhizome; 15g of poria cocos; 30g of plantain seeds; 9g of honey-fried licorice root; 15g of salvia miltiorrhiza; rhubarb, radix et rhizoma Rhei 6 g.

Example 3

A blood stasis removing and turbidity lowering prescription for treating gout is prepared from the following components: 17.5g of stir-fried rhizoma atractylodis; 12.5g of medicinal cyathula root; 10.5g of phellodendron; 22.5g of fried coix seeds; 10.5g of angelica; dried rehmannia root, radix rehmanniae 12.5 g; 11g of ligusticum wallichii; 22.5g of bighead atractylodes rhizome; 13.5g of tuckahoe; 22.5g of plantain seeds; 7.5g of honey-fried licorice root; 13.5g of salvia miltiorrhiza; rhubarb, radix et rhizoma Rhei 4.5 g.

Clinical data:

the method comprises the following steps: selecting patients meeting the diagnosis standard of the gouty arthritis in the remission stage, carrying out traditional Chinese medicine diagnosis and differentiation, wherein the types of the patients belong to spleen deficiency and dampness abundance and blood stasis and collateral obstruction type, dividing the patients into a treatment group (30 cases of stasis removing and turbidity reducing decoction treatment) and a control group (30 cases of benzbromarone treatment) randomly, and comparing the blood uric acid level, symptom syndrome integral, blood fat, blood rheological level, safety index, curative effect, adverse reaction and the like of the two groups of patients before and after treatment and intervention.

1. The blood uric acid levels and syndrome scores of two groups of patients before and after treatment are compared with the blood uric acid concentrations of the patients in the treatment group and the patients in the control group before treatment (P is more than 0.05), and the difference has no statistical significance. After treatment, the blood uric acid concentration of the two groups of patients is reduced to some extent compared with the blood uric acid level of the patients in the prior group, and the difference between the blood uric acid levels of the patients in the treated group and the blood uric acid level of the patients in the control group has no statistical significance (P is more than 0.05), which indicates that the blood uric acid levels of the treated group and the control group are equivalent. In the aspect of syndrome score, the symptom scores of the two groups of patients before treatment are compared (P is more than 0.05), and no statistical difference exists. The control group is higher than the treatment group after treatment, and the two groups have statistical difference (P is less than 0.05) compared, thereby proving that the treatment group is better than the control group in relieving the clinical symptoms of patients. See table 2.

TABLE 2 blood uric acid level, syndrome integral comparison (X + -s)

Note: compared with the treatment before the treatment,^* Pless than 0.05; compared with the control group, the compound of the formula,△P＜0.05。

2. the blood fat and blood flow change levels of the patients in the two groups before and after treatment are compared with the blood fat and blood flow change levels of the patients in the treatment group before treatment and the patients in the control group before treatment (P is more than 0.05), and the difference has no statistical significance. After treatment, TG, CHO, HDL-G and plasma viscosity of the treatment groups are all obviously different (P is less than 0.05); after the control group is treated, no statistical difference exists in TG, CHO, HDL-G and plasma viscosity (P is more than 0.05); the results show that the treatment groups are all more effective than the control group in reducing blood lipid (TG, CHO, HDL-G) and improving blood rheology (plasma viscosity). See table 3.

TABLE 3 comparison of blood lipid and blood rheology before and after treatment in two groups of patients: (

±s）

Note: compared with the treatment before the treatment,^* Pless than 0.05; compared with the control group, the compound of the formula,△P＜0.05

3. safety indexes before and after treatment, compared with the control group and the treatment group of patients before and after treatment, the safety indexes of the two groups of patients before and after treatment comprise liver function (ALT) and kidney function (BUN and Cr), the difference has no statistical significance (P is more than 0.05), and the treatment group of the medicines can be safely used, which is shown in table 4.

TABLE 4 comparison of safety indices of two groups of patients before and after treatment: (

±s）

The results confirmed that: the blood uric acid concentration of the patients in the treatment group and the patients in the control group before treatment is compared (P is more than 0.05), and the difference has no statistical significance. After treatment, the blood uric acid concentration of the two groups of patients is reduced to some extent compared with the former blood uric acid level, and the difference between the blood uric acid levels of the treated group of patients and the blood uric acid level of the control group of patients after treatment has no statistical significance (P is more than 0.05), which indicates that the uric acid reducing levels of the treated group and the control group are equivalent. In the aspect of syndrome score, the symptom scores of the two groups of patients before treatment are compared (P is more than 0.05), and no statistical difference exists. The control group is higher than the treatment group after treatment, and the two groups have statistical difference (P is less than 0.05) compared, thereby proving that the treatment group is better than the control group in relieving the clinical symptoms of patients. The blood fat and blood rheological levels of patients in the treatment group and patients in the control group are compared before treatment (P is more than 0.05), and the difference has no statistical significance. After treatment, the treatment groups have obvious differences in Triglyceride (TG), total Cholesterol (CHO), high density lipoprotein cholesterol (HDL-C) and plasma viscosity (P is less than 0.05); after the control group is treated, no statistical difference exists in Triglyceride (TG), total Cholesterol (CHO), high density lipoprotein cholesterol (HDL-C) and plasma viscosity (P is more than 0.05); the results show that the treatment groups are all more effective than the control group in reducing blood lipid (TG, CHO, HDL-C) and improving blood rheology (plasma viscosity). The safety indexes of the control group and the treatment group of patients before and after treatment comprise liver function (ALT) and kidney function (BUN and Cr), the difference has no statistical significance (P is more than 0.05), and the treatment group of patients can be safely used. In the control group, mild nausea appears in some cases, gouty arthritis appears in 4 cases, and pain is relieved after 1mg of colchicine is orally taken for 3 times/d, so that the observation period is completed smoothly. One of the treatment groups showed mild diarrhea (query related to unclean diet), with no other discomfort and no effect on the continued treatment.

As a result: after treatment, the blood uric acid concentration of two groups of patients is reduced to some extent compared with the prior art, and the curative effect is equivalent. The treatment groups are more effective than the control group in reducing blood fat (TG, CHO, HDL-C), improving blood rheology (blood plasma viscosity), syndrome score and inducing acute gout. ② the safety indexes of two groups of patients including liver function (ALT) and kidney function (BUN, Cr) and other indexes have no significant difference before and after treatment. And (4) conclusion: the decoction for removing blood stasis and descending the turbid for the patients with the gouty arthritis in the remission stage is given based on syndrome differentiation, so that the symptoms of the patients can be effectively relieved, uric acid and blood fat can be effectively reduced, the adverse reaction is less, gout is not easily induced, and the clinical effect is satisfactory.

The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and amendments can be made without departing from the principle of the present invention, and these modifications and amendments should also be considered as the protection scope of the present invention.

Claims

1. A traditional Chinese medicine composition for removing blood stasis and descending turbidity for treating gout is characterized in that: the preparation method comprises the following steps:

17.5g of fried rhizoma atractylodis; 14g of medicinal cyathula root; 10.5g of phellodendron; 28g of fried coix seeds; 10.5g of angelica; 14g of radix rehmanniae; 10.5g of ligusticum wallichii; 28g of largehead atractylodes rhizome; 14g of poria cocos; 28g of plantain seeds; 7g of honey-fried licorice root; 14g of salvia miltiorrhiza; rhubarb, radix et rhizoma Rhei 3.5 g.