CN118217337A - Traditional Chinese medicine for treating constipation and preparation method and application thereof - Google Patents
Traditional Chinese medicine for treating constipation and preparation method and application thereof Download PDFInfo
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- CN118217337A CN118217337A CN202410314531.1A CN202410314531A CN118217337A CN 118217337 A CN118217337 A CN 118217337A CN 202410314531 A CN202410314531 A CN 202410314531A CN 118217337 A CN118217337 A CN 118217337A
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- constipation
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- Medicines Containing Plant Substances (AREA)
Abstract
The invention relates to the technical field of traditional Chinese medicines, in particular to a traditional Chinese medicine for treating constipation and a preparation method and application thereof. Fructus cannabis and radish seeds are used as monarch drugs, so that the bowel relaxing, digestion promoting, distention removing, and phlegm qi reducing effects are realized; stir-baked semen Cassiae is added into liver, kidney and large intestine to moisten intestine and relieve constipation, and it is combined with stir-baked Lai Fu Zi to enhance intestinal peristalsis; ginseng is used for reinforcing primordial qi, tonifying spleen, benefiting lung, nourishing blood, promoting the production of body fluid, and the human participation semen cassiae is taken as ministerial drug; with the assistance of almond, peach kernel and dried orange peel, the functions of relaxing bowel, removing blood stasis, relieving pain, regulating qi and strengthening spleen; so that the honey is used for strengthening the middle warmer and moistening dryness and lubricating intestines. The medicines are used together to moisten intestines, relieve constipation, tonify qi, invigorate spleen and slow down, and are particularly suitable for constipation due to qi deficiency caused by opioid medicines.
Description
Technical Field
The invention belongs to the field of traditional Chinese medicines, in particular relates to a traditional Chinese medicine for treating constipation and a preparation method and application thereof, and especially relates to a traditional Chinese medicine with a treatment effect on constipation caused by opioid medicines and a preparation method and application thereof.
Background
Constipation is complicated, and the main symptoms are reduced stool frequency, dry stool, difficult defecation or weakness of defecation, and various general discomfort symptoms such as bitter taste in mouth, abdominal distention, distending pain in hypochondrium, belch, inappetence, dizziness and debilitation, listlessness, headache, insomnia and the like, and long-term constipation can also cause intestinal obstruction, cause anorectal diseases and even cause colorectal cancer.
Opioid analgesics are commonly used as agents for controlling pain in patients with advanced tumors, and are often accompanied by various adverse reaction symptoms while relieving pain, constipation being the most frequent side effect. For patients with late tumor stage, opioid-induced constipation is one of the common types of constipation. For long-term treatment with opioids, prophylactic cathartic should be used simultaneously unless diarrhea is present.
The existing laxative drugs which are used together with the traditional laxative drugs comprise (1) stimulating laxatives, such as senna leaves, polyphenol compounds bisacodyl, and the like; (2) osmotic cathartics such as magnesium sulfate, lactulose, etc.; (3) Volume type laxatives such as stool softener, liquid paraffin and the like. However, the use of the above-mentioned drugs, while greatly helping to relieve constipation symptoms in patients, has various drawbacks. For example, the stimulatory cathartic produces active molecules by glycosidase hydrolysis of colonic bacteria, affecting movement and secretion of colon, and has greatly different clinical effectiveness, and the drug itself has great stimulatory effect, and weak patients need to use with cautions; the osmotic cathartic magnesium sulfate is used for treating hypermagnesemia caused by excessive administration, and is required to be vigilant of kidney function damage, lactulose is not absorbed by small intestine, drug effect can be delayed for 2-3 days, and partial people can produce nausea, abdominal distention and other uncomfortable symptoms for the taste of lactulose; volume cathartic is useful for patients who cannot ingest enough dietary fiber, but over time, requires large amounts of body fluids and has reduced effect, and is therefore not recommended for relief of opioid-induced constipation.
The traditional Chinese medicine has unique advantages for treating constipation caused by opioid medicines. Constipation caused by opium is mostly based on deficiency and excess, and the treatment needs to be aimed at the cause of disease, and the principle of excess diarrhea and deficiency tonifying is followed, and the preparation method of traditional Chinese medicine combining tonifying, moistening and dredging is adopted, so that the constipation is not really finished by purely using purgative drugs according to the differentiation of symptoms and signs and the differences of causes, pathogenesis and symptoms. The existing medicine for treating constipation caused by opioid medicines does not divide constipation into different types, and the traditional Chinese medicine is taught to treat constipation according to syndrome differentiation, and the constipation is divided into a plurality of syndrome types according to different actual conditions of patients, so that the constipation of all types can be solved by not the same prescription.
The invention aims to overcome various defects of the existing stimulative cathartic, osmotic cathartic or volumetric cathartic for treating constipation caused by opioid, and aims to overcome the defects of the general medicine administration in the prior art by differentiating the constipation, and provide a traditional Chinese medicine composition which can enhance intestinal motility and treat qi deficiency type constipation caused by opioid, and a preparation method and application thereof.
Disclosure of Invention
In order to overcome the defects in the prior art, the invention provides a traditional Chinese medicine composition which can enhance intestinal motility and treat qi deficiency type constipation caused by opioid medicines, and a preparation method and application thereof.
The traditional medicine considers that the basic pathogenesis of constipation of cancer patients is that long-term disease consumes qi to hurt yin, yin deficiency and internal heat, burns body fluid, and the body fluid is insufficient, and the intestine is not moistened, so that constipation is easy to cause. Chemotherapy drugs aggravate the spleen and stomach function, abnormal spleen and stomach movement and transformation, and body fluids can not moisten large intestine, and constipation is aggravated. As an opioid analgesic for controlling pain in patients with advanced tumors, constipation is a common side effect associated with the use thereof. Constipation caused by opioids itself has the pathogenetic properties of advanced tumors. Therefore, in the treatment of constipation caused by opioid, attention must be paid to the use of qi-tonifying, spleen-strengthening and dryness-moistening drugs in addition to general bowel relaxing.
The invention is especially suitable for patients with constipation caused by opioid and with syndrome differentiation of qi deficiency, and the symptoms are as follows: although the stool is intentional, the stool is weak, the stool is difficult to discharge, the sweat is short, the pale complexion, the lassitude, the pale and fat tongue, the margin or the tooth trace, the thin and white coating and the weak pulse are caused. For invigorating qi and spleen, and loosening bowel to relieve constipation.
The invention provides a traditional Chinese medicine composition for treating constipation, which comprises the following components: fructus Cannabis 5-15g, parched Raphani semen 5-15g, parched semen Cassiae 3-9g, ginseng radix 3-9g, semen Armeniacae amarum 3-9g (peeled and parched), semen Persicae 3-9g (peeled and parched), pericarpium Citri Tangerinae 1-3g, and Mel 3-9g.
The efficacy of each drug is as follows:
Fructus cannabis: relaxing bowel. Can be used for treating constipation due to blood deficiency and fluid deficiency, and intestinal dryness.
Parching Raphani semen: promote digestion and remove distention, reduce qi and resolve phlegm. Is used for treating food stagnation, abdominal distention and pain, constipation, diarrhea due to accumulation of food stagnation, phlegm accumulation, asthma and cough.
Parching semen Cassiae: clear heat and improve eyesight, moisten intestines and relieve constipation. Can be used for treating conjunctival congestion, pain, photophobia, lacrimation, headache, dizziness, dim eyesight, constipation.
Ginseng: the medicine has the functions of invigorating primordial qi, restoring pulse, strengthening spleen, benefiting lung, promoting fluid production, nourishing blood, tranquilizing mind and improving intelligence. Can be used for treating asthenia, listlessness, cold limbs, weak pulse, spleen deficiency, anorexia, lung deficiency, asthma and cough, body fluid consumption, thirst, internal heat, thirst, deficiency of qi and blood, deficiency of both long-term illness, palpitation, insomnia, sexual impotence, and cold womb.
Parching semen Armeniacae amarum: descending qi, relieving cough and asthma, and relaxing bowel. Can be used for treating cough, asthma, chest fullness, excessive phlegm, constipation due to intestinal dryness.
Parching semen Persicae: promoting blood circulation, removing blood stasis, loosening bowel to relieve constipation, and relieving cough and asthma. Can be used for treating amenorrhea dysmenorrhea, abdominal mass, pulmonary abscess, acute appendicitis, traumatic injury, constipation due to intestinal dryness, cough and asthma.
Dried orange peel: regulate qi, invigorate spleen, dry dampness and resolve phlegm. Can be used for treating abdominal distention, anorexia, vomiting and diarrhea, cough with excessive phlegm.
Honey: tonify middle energizer, moisten dryness, relieve pain, detoxify; the external application is used for promoting tissue regeneration and healing sore. Can be used for treating pain due to stomach and abdomen deficiency, dry cough due to lung dryness, constipation due to intestinal dryness, and aconite toxin relieving; it is indicated for external heat and water scald due to unhealed sores and ulcers.
Fructus Cannabis and Raphani semen are used as the main materials, and fructus Cannabis has sweet taste, mild nature, moistening and fat-increasing properties, and has effect in loosening bowel to relieve constipation; the stir-fried radish seed is pungent, sweet, flat, and has the effects of promoting digestion, removing distention, reducing qi and phlegm, resisting bacteria, enhancing intestinal motility, and the like, and can be used for constipation, abdominal distention, intestinal obstruction, and the like. The stir-fried semen cassiae in the prescription can be added into liver, kidney and large intestine to moisten intestines and relieve constipation, contains anthraquinone such as emodin, chrysophanol, cassia element, rhein and other purgative components, and can moisten intestines and relieve constipation, and the stir-fried semen cassiae are used in the prescription, so that intestinal peristalsis can be obviously enhanced; the ginseng is used for reinforcing primordial qi, tonifying spleen, benefiting lung, nourishing blood, promoting the production of body fluid, soothing nerves and improving intelligence, and is used as ministerial drug together with semen cassiae; the almond has the effects of reducing qi and moistening intestines, the peach kernel strengthens the effects of fructus cannabis and the almond has the effects of moistening intestines and relaxing bowels, and the effects of removing blood stasis and relieving pain are enhanced; dried orange peel can regulate qi and invigorate spleen, and promote gastrointestinal qi stagnation; so that the honey is used for strengthening the middle warmer and moistening dryness and lubricating intestines. The medicines are combined together to have the functions of moistening intestines, relaxing bowels, tonifying qi, strengthening spleen and relieving constipation.
The invention also provides a preparation method of the traditional Chinese medicine composition for treating constipation, which comprises the following steps:
1. Weighing fructus Cannabis, parched Raphani semen, parched semen Cassiae, semen Armeniacae amarum and semen Persicae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting, extracting at 40-50deg.C for 60min, and extracting at 80-95deg.C for 30min.
2. Weighing Ginseng radix and pericarpium Citri Tangerinae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting at 70-80deg.C for 60min, and extracting at 95-100deg.C for 30min.
3. Mixing the two extractive solutions, filtering, centrifuging at high speed on line, removing impurities, and adding Mel.
In addition, the invention also provides application of the traditional Chinese medicine composition for treating constipation in preparing food, health care products or medicines for treating constipation, wherein the constipation is qi deficiency type constipation, and the traditional Chinese medicine composition is particularly suitable for qi deficiency type constipation caused by opioid medicines.
The invention also provides application of the traditional Chinese medicine composition for treating constipation in preparation of food, health care products or medicines for enhancing intestinal motility.
Detailed Description
Various exemplary embodiments of the invention will now be described in detail, which should not be considered as limiting the invention, but rather as more detailed descriptions of certain aspects, features and embodiments of the invention.
Example 1 prescription: fructus Cannabis 5g, semen Raphani 5g, semen Cassiae 3g, ginseng radix 3g, semen Armeniacae amarum 3g (peeled and parched), semen Persicae 3g (peeled and parched), pericarpium Citri Tangerinae 1g, and Mel 3g.
The preparation method comprises the following steps:
1. Weighing fructus Cannabis, parched Raphani semen, parched semen Cassiae, semen Armeniacae amarum and semen Persicae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting, extracting at 40-50deg.C for 60min, and extracting at 80-95deg.C for 30min.
2. Weighing Ginseng radix and pericarpium Citri Tangerinae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting at 70-80deg.C for 60min, and extracting at 95-100deg.C for 30min.
3. Mixing the two extractive solutions, filtering, centrifuging at high speed on line, removing impurities, and adding Mel.
Fructus Cannabis 5-15g, parched Raphani semen 5-15g, parched semen Cassiae 3-9g, ginseng radix 3-9g, semen Armeniacae amarum 3-9g (peeled and parched), semen Persicae 3-9g (peeled and parched), pericarpium Citri Tangerinae 1-3g, and Mel 3-9g.
Example 2 prescription: fructus Cannabis 5g, semen Raphani Preparata 5g, semen Cassiae Preparata 3g, ginseng radix 3g, semen Armeniacae amarum 3g (peeled and parched), semen Persicae 3g (peeled and parched), pericarpium Citri Tangerinae 1.5g, and Mel 3g.
The preparation was the same as in example 1.
Example 3 prescription: 10g of fructus cannabis, 10g of fried radish seeds, 6g of fried semen cassiae, 6g of ginseng, 5g of almond (peeled and fried), 5g of peach kernel (peeled and fried), 2g of dried orange peel and 9g of honey.
The preparation was the same as in example 1.
Example 4 prescription: 15g of fructus cannabis, 15g of fried radish seeds, 9g of fried semen cassiae, 9g of ginseng, 9g of almond (peeled and fried), 9g of peach kernel (peeled and fried), 3g of dried orange peel and 9g of honey.
The preparation was the same as in example 1.
Examples of drug effects:
1. Experiment: effect experiment of enhancing intestinal motility
1. Preparation of medicine
Taking the traditional Chinese medicine composition described in the embodiment 2 as the composition, concentrating to 1.0g crude drug solution in 1mL according to the step-by-step water decoction method of the invention to obtain the water decoction of the composition, and taking the water decoction as the composition group of the invention.
The traditional Chinese medicine formula is compared with the formula: fructus Cannabis 5g, parched Raphani semen 8g, semen Armeniacae amarum 3g (peeled and parched), ginseng radix 3g, semen Persicae 3g (peeled and parched), pericarpium Citri Tangerinae 1.5g, and Mel 3g. Compared with the composition group, the semen cassiae is replaced by the same amount of radish seeds, and the preparation method is the same as that of the composition group.
Positive control drug: the preparation method comprises decocting radix et rhizoma Rhei in water for 30min with 10 times of water for 2 times, mixing the water decoctions, concentrating to 1.0g crude drug solution per 1mL, and storing.
Normal control group: physiological saline.
2. Experimental animal
Kunming mice, weighing 20-22 g, male and female halves, SPF grade.
3. Experimental method
Mice fasted for one day are divided into 15 mice of the composition group, the traditional Chinese medicine formula comparison group, the rheum officinale decoction group and the normal control group (normal saline) respectively, and are administrated by 15mL/kg stomach infusion. Then, the three groups of animals are respectively irrigated with 0.1mL/10g of ink, the animals are killed by a cervical dislocation method after 30min of administration, immediately dissected, all intestinal tracts from pylorus to tail end are taken out, the intestinal tracts are laid on filter paper, the distance from the front edge of the ink to the pylorus and the total length of the small intestine are measured under the tension-free state, and finally the small intestine propulsion rate is calculated.
Small intestine thrust/% = distance of ink front to pylorus/total small intestine length x 100%
TABLE 1 Effect of drugs on mouse intestinal motility
Note that: p <0.05, P <0.01 compared to normal control;
The results show that: the composition can obviously improve the ink propulsion rate, enhance the intestinal peristalsis and promote the small intestine movement, and the traditional Chinese medicine formula comparison group has obviously weaker effect on promoting the intestinal peristalsis than the composition, so that the compatibility of cassia seeds in the formula can obviously enhance the intestinal peristalsis. The effect of the drug on the small intestine movement of mice is shown in table 1.
2. Clinical effects of constipation treatment
1. Patient inclusion criteria were: 1) Patients with cancer pain who need to take opioid for pain relief in oncology department; 2) Patients who had no symptoms of constipation before opioid use, and had constipation due to opioid use; 3) Patients who did not use other medications that could cause constipation. 50 patients meeting the above inclusion criteria and differentiating qi deficiency type constipation are classified into a composition group, a traditional Chinese medicine formula comparison group, a rheum officinale tablet group, a liquid paraffin group and a lactulose group according to a random number table method, and each group comprises 10 patients. The general data of gender, age, pathological type and the like of the 5 groups of patients are compared, and the differences have no statistical significance (P is more than 0.05) and are comparable. The treatment period was 2 weeks.
2. The Chinese medicinal composition in the embodiment 2 is the composition, and the composition is concentrated to 1.0g crude drug solution per 1mL according to the step-by-step water decoction method to obtain the water decoction of the composition, which is taken as the composition group. The traditional Chinese medicine formula is compared with the formula: fructus cannabis 5g, fried radish seed 8g, almond 3g (peeled and fried), ginseng 3g, peach seed 3g (peeled and fried), dried orange peel 1.5g and honey 3 g. The composition and the traditional Chinese medicine formula comparison group are taken twice in the morning and evening; the rhubarb slice group is prepared twice a day, three slices each time; the liquid paraffin group is 15mL once a day; the lactulose group was 10mL each time three times daily.
3. Constipation symptom scoring criteria:
statistics were performed based on table 2:
TABLE 2 score criteria for constipation symptoms
4. Treatment effect judgment of constipation:
Cure, symptom elimination, the final score is reduced to 0 score, and the normal can be maintained within 2 weeks;
the symptoms are obviously reduced, the final score is reduced to 1 score, and the normal score can be maintained within 2 weeks;
the symptoms are relieved, and the final score is reduced to 2 points;
less symptomatic relief, and a final score drop to 3 points.
And (3) calculating the effect significance rate: significant effect rate = (cure+onset)/n×100%
5. The treatment effect is as follows:
table 3 comparison of therapeutic effects of each group of drugs
Table 4 comparison of the performance of each group of drugs after administration
6. The results illustrate:
The experiments show that the traditional Chinese medicine composition can achieve the treatment effect equivalent to or even better than the current common medicine for treating constipation caused by opioid medicines in terms of cure rate and remarkable effect rate.
On the basis, the medicine has excellent improvement on aspects of promoting intestinal peristalsis, defecation form, emptying, comfort, gastrointestinal discomfort reaction and the like after being used compared with other groups. The results are shown in Table 4: the composition is superior to a traditional Chinese medicine formula comparison group, a liquid paraffin group and a lactulose group in promoting intestinal peristalsis, is superior to a rheum officinale tablet group, a liquid paraffin group and a lactulose group in terms of stool shape and formability, is superior to a traditional Chinese medicine formula comparison group, a rheum officinale tablet group, a liquid paraffin group and a lactulose group in terms of emptying and comfort, and is superior to a rheum officinale tablet group, a liquid paraffin group and a lactulose group in terms of gastrointestinal tract discomfort reaction.
3. Typical cases:
The patients, male, 55 years old, have definite lung cancer diagnosis, take opioid analgesic drugs to relieve cancer pain and constipation, and the patients have no constipation symptoms before using opioid drugs, and do not use other drugs which can cause constipation.
According to the patient's own instructions, the symptoms of abdominal distension, abdominal pain and nausea are sometimes intentional, but the symptoms are not easy to discharge, after the enema is used, the sheep manure is firstly discharged in an egg shape, dried and hard feces, then the watery feces appear, and the enema is still often intentional after the defecation assistance, and the emptying sense is poor. The symptoms of the constipation are marked by the symptoms of appearance, lassitude, pale complexion, pale and fat tongue, thin and white coating, weak pulse and deficiency of qi. The composition of the embodiment 2 is prepared according to the preparation method of the invention, and is taken twice a day in the morning and at night for two weeks without suspending the original analgesic during the taking period. After taking for 3 days, the defecation starts to be gradual and regular, the defecation is soft, the symptoms of abdominal distension, abdominal pain and nausea disappear, the mental state is good, and all test indexes are normal.
Therefore, the composition can effectively treat qi deficiency constipation and accompanying symptoms caused by opioid, relieve the associated accompanying symptoms such as abdominal pain, abdominal distension, anorexia, nausea and the like caused by opioid preparations, and improve the life quality of patients with advanced tumor pain.
Claims (7)
1. A Chinese medicinal composition for treating constipation comprises the following raw materials in part by weight: 5-15g of fructus cannabis, 5-15g of fried radish seeds, 3-9g of fried semen cassiae, 3-9g of ginseng, 3-9g of almond, 3-9g of peach kernels, 1-3g of dried orange peel and 3-9g of honey.
2. A traditional Chinese medicine composition for treating constipation according to claim 1, wherein the raw materials and the dosage are as follows: fructus Cannabis 5g, parched Raphani semen 5g, parched semen Cassiae 3g, ginseng radix 3g, semen Armeniacae amarum 3g, semen Persicae 3g, pericarpium Citri Tangerinae 1.5g, and Mel 3g.
3. The method for preparing a traditional Chinese medicine composition for treating constipation according to any one of claims 1-2, comprising the following steps: weighing fructus Cannabis, parched Raphani semen, parched semen Cassiae, semen Armeniacae amarum and semen Persicae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting, extracting at 40-50deg.C for 60min, and extracting at 80-95deg.C for 30min; weighing Ginseng radix and pericarpium Citri Tangerinae according to the formula, mixing, adding 10 times of water, soaking at 25deg.C for 60min, gradient extracting at 70-80deg.C for 60min, and extracting at 95-100deg.C for 30min; mixing the two extractive solutions, filtering, centrifuging at high speed on line, removing impurities, and adding Mel.
4. Use of a traditional Chinese medicine composition according to claim 1 or 2 for preparing a medicament for treating constipation.
5. The use of the Chinese medicinal composition according to claim 4 for preparing a medicament for treating constipation, wherein the constipation is constipation due to qi deficiency.
6. The use of the Chinese medicinal composition according to claim 5 in the preparation of a medicament for treating constipation, wherein the constipation due to qi deficiency is constipation due to opioid.
7. Use of a traditional Chinese medicine composition according to claim 1 or 2 for the preparation of a medicament for enhancing intestinal motility.
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