CN117462644A - 一种治疗慢性萎缩性胃炎的中药组合物及其应用 - Google Patents
一种治疗慢性萎缩性胃炎的中药组合物及其应用 Download PDFInfo
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Abstract
本发明公开了一种治疗慢性萎缩性胃炎的中药组合物及其应用，由如下重量份数的原料制成：党参8‑15份，白术8‑15份，茯苓8‑15份，三棱8‑12份，五指毛桃25‑35份，半枝莲10‑20份，山药25‑35份，石斛8‑15份，法半夏6‑10份，柴胡8‑15份，郁金8‑15分，甘草4‑10份。本发明的中药组合物对慢性萎缩性胃炎具有确切的治疗作用，为治疗慢性萎缩性胃炎提供了新的药物选择。本发明的中药组合物为纯中药方剂，临床疗效好，毒副作用小，适用于临床推广应用。
Description
技术领域
本发明涉及中药技术领域，具体涉及一种治疗慢性萎缩性胃炎的中药组合物及其应用。
背景技术
慢性萎缩性胃炎是临床上最常见的慢性消化***疾病之一，被普遍认为是胃癌的癌前病变状态。慢性萎缩性胃炎的临床症状胃腹痛、食欲不振、体重减轻等，病理特征为胃黏膜的慢性炎症与胃腺部的细胞减少或丢失，常伴有肠化生，最终将导致胃癌的发生。逆转癌前病变，改善慢性萎缩性胃炎状态应成为避免胃癌发生的重要手段。慢性萎缩性胃炎的发病机制目前尚不清楚，但普遍认为是物理化学因素、幽门螺杆菌感染等因素对胃黏膜的反复损伤所致。
目前，西医对慢性萎缩性胃炎尚无特效疗法，治疗以根除幽门螺杆菌、保护胃黏膜、促进胃动力(如多潘立酮)、补充黏膜营养(如维酶素)等，疗效差，复发率高，难治愈。因此，亟需开发一种新的治疗慢性萎缩性胃炎的中药组合物。中医药在治疗胃肠道疾病方面有着悠久的历史和独特的优势。
发明内容
鉴于此，本发明的目的在于提供一种治疗慢性萎缩性胃炎的中药组合物，该中药组合物对慢性萎缩性胃炎具有良好的治疗作用。
本发明目的通过如下技术方案实现：
一种治疗慢性萎缩性胃炎的中药组合物，由如下重量份数的原料制成：
党参8-15份，白术8-15份，茯苓8-15份，三棱8-12份，五指毛桃25-35份，半枝莲10-20份，山药25-35份，石斛8-15份，法半夏6-10份，柴胡8-15份，郁金8-15份，甘草4-10份。
作为进一步优选的方案，所述的治疗慢性萎缩性胃炎的中药组合物，由如下重量份数的原料制成：
党参10份，白术10份，茯苓10份，三棱10份，五指毛桃30份，半枝莲15份，山药30份，石斛10份，法半夏9份，柴胡10份，郁金10份，甘草6份。
本发明的中药组合物来自于临床经验方，党参、白术、茯苓为君，此三药味甘，均入脾经，属补气药，配合使用，主要功效为益气健脾，温而不燥，补而不峻，徐徐图之，符合脾胃喜甘、用药轻缓特点。脾喜燥恶湿，脾虚易生湿，白术、茯苓在健补脾气之外，尚能燥湿利水，更适宜脾虚常兼湿邪患者。慢性胃炎见纳差，乏力，饥不欲食等脾虚不运、胃气阴虚症状，治疗应健脾益气，但不宜峻补，重在平补中气。五指毛桃、山药、三棱、郁金为臣，五指毛桃又名南芪，属于岭南道地药材，补气中兼有利湿之效，辅助君药补而不滞；山药补脾、生津，辅助君药补气，兼顾慢性萎缩性胃炎中久病伤阴、胃阴不足者；慢性萎缩性胃炎病程较长，病久成瘀，常见舌暗，胃脘刺痛，痛处固定，三棱、郁金既活血止痛，郁金行气解郁，兼顾调节久病患者情志。半枝莲、石斛、法半夏、柴胡为佐。半枝莲辛、苦，寒，功效为清热解毒，活血化瘀，消肿止痛，为本方反佐药，使本方温补而不温燥，在补益药中略加攻散之力，祛邪而不伤正，借解毒、消肿之力尚能驱邪，适用于慢性胃炎伴有黏膜萎缩、肠化、异型增生者，石斛味甘、归胃经，力在滋阴益胃，辅助山药滋养胃津，脾虚运化失职，食物之精微积滞，形成痰湿中阻，以法半夏、柴胡行气、化滞、燥湿。柴胡入肝经，为行气疏肝良药，佐全方补中有行，助郁金调节情志。甘草归补气和中，调和诸药，为使药。全方以益气健脾，活血散瘀为法，兼顾理气、散结、养阴之法，适用于慢性萎缩性胃炎中脾虚血瘀证患者，对慢性萎缩性胃炎具有确切的疗效。
本发明还提供了上述的治疗慢性萎缩性胃炎的中药组合物的制备方法，包括如下步骤：
将各原料加6-10倍量水煎煮2次，每次1-2h，合并提取液，浓缩，过滤，即得。
本发明还提供了上述的中药组合物在制备治疗慢性萎缩性胃炎的药物中的应用。
作为进一步优选的方案，所述慢性萎缩性胃炎为脾虚血瘀型慢性萎缩性胃炎。
作为进一步优选的方案，所述慢性萎缩性胃炎为慢性萎缩性胃炎伴有黏膜萎缩、肠化、异型增生。
作为进一步优选的方案，所述药物包含有效含量的中药组合物和药学上可接受的载体。本发明所述药物可经本领域常规方法制备成适宜的剂型。优选地，所述药物的剂型为合剂、片剂、胶囊剂、丸剂、粉剂或颗粒剂。
本发明与现有技术相比，具有如下优异效果：
本发明通过采用MNNG法建立大鼠慢性萎缩性胃炎模型，结果显示，本发明的中药组合物能明显改善MNNG诱导的慢性萎缩性胃炎大鼠的胃部损伤，改善大鼠体重下降、胃萎缩程度以及胃组织形态。且可显著降低PG II的水平，增加PG I和GAS，降低炎症因子IL6的含量，说明其可显著改善慢性萎缩性胃炎大鼠的胃部激素、炎症因子水平。以上结果表明，本发明的中药组合物对慢性萎缩性胃炎具有确切的治疗作用，为治疗慢性萎缩性胃炎提供了新的药物选择。
本发明治疗慢性萎缩性胃炎的中药组合物为纯中药方剂，临床疗效好，毒副作用小，适用于临床推广应用。
附图说明
图1为参术养胃方对慢性萎缩性胃炎大鼠体重的影响；
图2为参术养胃方对慢性萎缩性胃炎大鼠胃脏器指数的影响；
图3为各组大鼠胃外观图；
图4为参术养胃方对慢性萎缩性胃炎大鼠血清生化指标的影响；
图5为参术养胃方对慢性萎缩性胃炎大鼠血清炎症因子指标的影响。
其中Ctrl：空白组；Model：模型组；Vitacoenzyme：维酶素组；SZYW-L：参术养胃方低剂量组；SZYW-M：参术养胃方高剂量组。
具体实施方式
下面通过具体实施方式来进一步说明本发明，以下实施例为本发明具体的实施方式，但本发明的实施方式并不受下述实施例的限制。
实施例1：
一种治疗慢性萎缩性胃炎的中药组合物，由如下重量份数的原料制成：
党参10份，白术10份，茯苓10份，三棱10份，五指毛桃30份，半枝莲15份，山药30份，石斛10份，法半夏9份，柴胡10份，郁金10份，甘草6份。
其制备方法为：将各原料加8倍量水煎煮1.5h，收集提取液，药渣加入6倍体积的水并煮沸1小时，合并提取液，60℃下浓缩，过滤，即得。
实施例2：
一种治疗慢性萎缩性胃炎的中药组合物，由如下重量份数的原料制成：
党参12份，白术12份，茯苓12份，三棱8份，五指毛桃25份，半枝莲10份，山药35份，石斛8份，法半夏6份，柴胡8份，郁金15份，甘草4份。
其制备方法同实施例1。
实施例3：
一种治疗慢性萎缩性胃炎的中药组合物，由如下重量份数的原料制成：
党参15份，白术15份，茯苓15份，三棱12份，五指毛桃35份，半枝莲20份，山药25份，石斛12份，法半夏10份，柴胡15份，郁金8份，甘草5份。
其制备方法同实施例1。
试验例1：治疗慢性萎缩性胃炎药效学研究
1.实验材料
1.1药物
参术养胃方：(党参10g，白术10g，茯苓10g，三棱10g，五指毛桃30g，半枝莲15g，山药30g，石斛10g，法半夏9g，柴胡10g，郁金10g，甘草6g)购自广东省东莞市南京同仁堂药房。维酶素(CAS：83-88-5，Lot#：C14376028)购自上海麦克林生化科技有限公司。
制备方法：将生药加8倍的水煎煮1.5h，收集提取液，药渣加入6倍体积的水并煮沸1小时，合并提取液，60℃下浓缩，过滤，即制得浓缩液。
1.2试剂
MNNG(CAS：70-25-7，Lot#：C15811079)购自上海麦克林生化科技有限公司。
1.3动物
SD大鼠(购自辽宁长生生物技术股份有限公司)雄性，体重150-170g。大鼠笼养于广东医科大学实验动物中心(东莞校区)，室温24-25℃，湿度70-75％，12小时光照/黑暗，自由饮食。
2.实验方法
在用标准饮食和水进行适应性喂养(24-25℃，湿度70-75％，12小时光照/黑暗)7天后，将大鼠随机分为2组，包括空白组和模型组。空白组自由饮水，模型组连续口服200μg/ml MNNG溶液配合饥饱失常(禁食一天，给食一天)8周。8周结束后将模型组大鼠随机分为4组，即模型组、阳性药维酶素组(0.6g/kg)、参术养胃方低剂量组(7.191g/kg)、参术养胃方高剂量组(14.39g/kg)。参术养胃方低剂量组和高剂量组每日灌胃相应剂量药物1ml/100g，模型组和阳性药组分别给予当量的生理盐水和维酶素，持续给药4周。给药期结束，动物经麻醉后腹主动脉取血，处死，取大鼠胃脏。计算脏器指数：脏器指数＝脏器质量/大鼠体重。
取血后3000rpm离心10min，收集上层血清分装保存于-80℃。按照ELISA试剂盒说明检测血清中PG I、PG II、GAS、IL6等含量。
使用Graphpad Prism7.0统计分析软件对结果进行分析。各组数据表示，样本间比较采用ANOVA单因素方差分析。
3.结果与讨论
3.1参术养胃方对慢性萎缩性胃炎大鼠体重的影响
如表1和图1所示，12周造模给药期结束之后，模型组体重增长速度相较空白组更慢，第12周模型组与空白组体重比较具有显著性差异(P<0.001)，参术养胃方低剂量组和高剂量组可使慢性萎缩性胃炎大鼠体重增加(P＜0.01)。
表1.参术养胃方对慢性萎缩性胃炎大鼠体重的影响(n＝8)
注：#p＜0.05，##p＜0.01，###p＜0.001vs空白对照组，差异有统计学意义。*p＜0.05，**p＜0.01，***p＜0.001vs模型组，差异有统计学意义。
3.2参术养胃方对慢性萎缩性胃炎大鼠胃脏器指数的影响
如表2和图2所示，模型组大鼠胃脏器指数相比空白组明显增加(P<0.001)，而参术养胃方低剂量组和高剂量组均可显著降低慢性萎缩性胃炎大鼠的胃脏器指数(P<0.01)，缓解胃萎缩程度。
表2.参术养胃方对慢性萎缩性胃炎大鼠胃脏器指数的影响(n＝8)
注：#p＜0.05，##p＜0.01，###p＜0.001vs空白对照组，差异有统计学意义。*p＜0.05，**p＜0.01，***p＜0.001vs模型组，差异有统计学意义。
3.3参术养胃方对慢性萎缩性胃炎大鼠胃外观的影响
如图3所示，空白组大鼠胃黏膜颜色呈深红色，胃褶皱较深，黏膜层丰富；模型组大鼠胃组织颜色较空白组浅，胃褶皱较浅且较少。参术养胃方低剂量组和高剂量组大鼠的胃组织相比模型组颜色偏深，胃褶皱较多。
3.4参术养胃方对慢性萎缩性胃炎大鼠血清生化指标的影响
如表3和图4所示，模型组PG I和GAS含量相比空白组降低，PG II含量上升(P<0.01)。参术养胃方低剂量组和高剂量可有效增加PG I和GAS含量(P<0.001)，降低PG II含量(P<0.01)。
表3.参术养胃方对慢性萎缩性胃炎大鼠血清生化指标的影响(n＝6)
注：#p＜0.05，##p＜0.01，###p＜0.001vs空白对照组，差异有统计学意义。*p＜0.05，**p＜0.01，***p＜0.001vs模型组，差异有统计学意义。
如表4和图5所示，模型组IL-6含量相比空白组增加，参术养胃方低剂量组和高剂量组可显著降低IL-6水平，降低慢性萎缩性大鼠炎症水平。
表4.参术养胃方对慢性萎缩性胃炎大鼠血清炎症因子水平的影响(n＝6)
注：#p＜0.05，##p＜0.01，###p＜0.001vs空白对照组，差异有统计学意义。*p＜0.05，**p＜0.01，***p＜0.001vs模型组，差异有统计学意义。
4.结论
本发明的中药组合物(参术养胃方)能有效改善慢性萎缩性胃炎大鼠的体重减轻以及胃萎缩程度，改善萎缩性胃炎大鼠的胃褶皱减少，并增加慢性萎缩性胃炎大鼠的PG I和GAS含量，降低PG II含量和IL-6水平，说明其可改善慢性萎缩性胃炎大鼠的胃部激素水平和炎症水平。综上，参术养胃方可有效逆转MNNG诱导的慢性萎缩性胃炎。
临床病例：
(1)庄女士，40岁，2022年10月21日初诊，患者受反复腹胀困扰，2022年6月进行胃镜检查，提示慢性萎缩性胃炎，中医诊断胃痞，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗1年后，于2023年10月12日复查胃镜：慢性非萎缩性胃炎伴糜烂，病理诊断：(胃窦)轻度慢性非萎缩性胃炎伴灶区糜烂。随访2月，目前患者已停药2月，未见症状复发。
(2)魏先生，47岁，2021年6月18日初诊。因反复腹部隐痛就诊，2020年11月胃镜：慢性浅表性胃炎伴糜烂，病理提示肠化(+)。中医诊断胃脘痛，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗5月后，于2021年11月19日复查胃镜：糜烂性胃炎伴轻度肠化，病理:黏膜慢性胃炎，肠化(+)。继续采用本专利中的中药组合物，煎药服用，每日1剂，治疗11月后，于2022年10月28日复查胃镜：糜烂性胃炎。随访1年，无腹部不适。
(3)易先生，50岁，2022年5月20日初诊。患者诉上腹胀20年，2022年8月20日胃镜显示：慢性萎缩性胃炎C1伴糜烂，肠镜：结直肠多发息肉，中医诊断胃痞，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗9月，2023年5月31日复查胃镜：糜烂性胃炎，病理未见黏膜萎缩改变。目前症状已明显缓解。
(4)谭女士，54岁，2022年8月26日初诊，因上腹胀痛近3年，既往有慢性萎缩性胃炎伴肠化病史，中医诊断胃脘痛，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗8月，2023年4月18日复查胃镜：慢性非萎缩性胃炎。随访半年，无见症状复发。
(5)覃女士，41岁，2021年7月16日初诊，因胃脘隐痛就诊，2021年7月16日查胃镜：糜烂性胃炎伴肠化及不典型性改变，病理结果提示胃窦黏膜慢性炎伴糜烂、肠化及不典型性改变。中医诊断胃脘痛，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗1年，2022年7月1日复查胃镜：慢性非萎缩性胃炎。随访1年，未见复发。
(6)林女士，60岁，2022年6月23日初诊，因胃胀就诊，2021年7月30日我院胃镜：慢性胃炎伴重度肠化生，2022年3月28日我院胃镜：慢性萎缩性胃炎C1伴糜烂、肠化。病理结果：胃窦慢性萎缩性胃炎，伴糜烂、肠化(++)。中医诊断胃痞，脾虚血瘀证，采用本专利中的中药组合物，煎药服用，每日1剂，治疗8月，2023年4月7日复查胃镜：慢性萎缩性胃炎，病理提示轻度慢性萎缩性胃炎板肠上皮化生。目前症状已明显缓解。
Claims (8)
1.一种治疗慢性萎缩性胃炎的中药组合物，其特征在于，由如下重量份数的原料制成：
党参8-15份，白术8-15份，茯苓8-15份，三棱8-12份，五指毛桃25-35份，半枝莲10-20份，山药25-35份，石斛8-15份，法半夏6-10份，柴胡8-15份，郁金8-15份，甘草4-10份。
2.根据权利要求1所述的治疗慢性萎缩性胃炎的中药组合物，其特征在于，由如下重量份数的原料制成：
党参10份，白术10份，茯苓10份，三棱10份，五指毛桃30份，半枝莲15份，山药30份，石斛10份，法半夏9份，柴胡10份，郁金10份，甘草6份。
3.权利要求1或2所述的治疗慢性萎缩性胃炎的中药组合物的制备方法，其特征在于，包括如下步骤：
将各原料加6-10倍量水煎煮2次，每次1-2h，合并提取液，浓缩，过滤，即得。
4.权利要求1或2所述的中药组合物在制备治疗慢性萎缩性胃炎的药物中的应用。
5.根据权利要求4所述的应用，其特征在于，所述慢性萎缩性胃炎为脾虚血瘀型慢性萎缩性胃炎。
6.根据权利要求4所述的应用，其特征在于，所述慢性萎缩性胃炎为慢性萎缩性胃炎伴有黏膜萎缩、肠化、异型增生。
7.根据权利要求4所述的应用，其特征在于，所述药物包含有效含量的中药组合物和药学上可接受的载体。
8.根据权利要求7所述的应用，其特征在于，所述药物的剂型为合剂、片剂、胶囊剂、丸剂、粉剂或颗粒剂。
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