CN112220860A - Traditional Chinese medicine protective plaster for internal arteriovenous fistula of uremia patient - Google Patents

Abstract

The invention relates to the field of traditional Chinese medicines, in particular to a traditional Chinese medicine protective plaster for internal arteriovenous fistula of uremia patients, which comprises a plaster carrier and a medicinal composition coated on the plaster carrier, wherein the medicinal composition consists of a traditional Chinese medicine composition and a blending agent which are blended together according to a certain proportion. The traditional Chinese medicine composition is composed of the following raw material medicines in parts by weight: 3-6 parts of ligusticum wallichii, 2-6 parts of safflower, 3-5 parts of peach kernel, 3-6 parts of angelica sinensis, 8-12 parts of frankincense, 8-12 parts of myrrh, 2-6 parts of cassia twig, 3-6 parts of corydalis tuber, 3-6 parts of red peony root, 3-6 parts of honeysuckle flower and 6-12 parts of radix scrophulariae. The traditional Chinese medicine protective plaster for the internal arteriovenous fistula of the uremia patient is externally applied, is used for daily blood vessel passage blood circulation promotion, blood stasis removal, detoxification, maintenance and prevention and treatment of local angiosclerosis of the internal arteriovenous fistula of a hemodialysis patient, prolongs the service time of the internal arteriovenous fistula to a certain extent, has a certain effect on the aspect of improving the blood flow of hemodialysis, and provides an effective treatment measure for prevention and treatment of related complications such as stenosis occlusion, thrombosis, subcutaneous hematoma and the like of the internal arteriovenous fistula.

Description

Traditional Chinese medicine protective plaster for internal arteriovenous fistula of uremia patient

Technical Field

The invention relates to the field of traditional Chinese medicine compositions, in particular to a traditional Chinese medicine protective plaster for protecting and improving arteriovenous internal fistula of a uremia patient.

Background

The maintenance hemodialysis is an effective treatment method for keeping the body health of a uremia patient, and continuous puncture dialysis is carried out on arteriovenous internal fistula blood vessels of the patient during hemodialysis, so that the protection of arteriovenous internal fistula is very important for the hemodialysis patient. The arteriovenous internal fistula is called as internal fistula for short, and is a life line of a hemodialysis patient, while the maintenance hemodialysis is a replacement therapy for maintaining the life of a chronic renal failure uremia patient, and whether the internal fistula is unobstructed is the basic guarantee for prolonging the life of the patient and improving the life quality. Repeated puncture or improper nursing not only increase the misery for patient, still can lead to internal fistula to block up, influence patient's quality of life, from this, it is very important to the hemodialysis patient to protect internal fistula extension its life.

At present, more methods for treating and maintaining arteriovenous internal fistula complications are available at home and abroad. In the aspect of external application, Xiliaotai is mainly used for external application clinically, and magnesium sulfate is used for wet compress. The Xiliaotao is a polysaccharide sulfonate, which has an impedance effect on thrombus formation mainly by means of a fibrinolysis system and a blood coagulation function, and the Xiliaotao drug has strong permeability, can play a role in resisting inflammation and sterilization, has an obvious resistance effect on phlebitis, can inhibit lymph exudation and promotes wound healing; secondly, the Xiliaotu can inhibit various catabolic enzymes and can affect a complement system and prostaglandin, thereby achieving an anti-inflammatory effect; in addition, Xiliaotu can also utilize the promotion effect of synthesis of mesenchymal cells to comprehensively restore intercellular substances, so that the Xiliaotu can have the capacity of keeping water and further regenerate connective tissue blood. Therefore, the Xishituo can avoid the formation of superficial thrombus, promote absorption, avoid the malignant development of local inflammation and accelerate the absorption swelling condition of the patient.

The oral drug intervention is mainly based on the interaction among the mechanisms, indications and drugs of the anticoagulant and thrombolytic drugs of clopidogrel and indobufen tablets. Although the drugs only can do work on the internal circulation, in order to ensure the smoothness of the vascular access, reduce the failure rate of arteriovenous internal fistula and simultaneously reduce the risk of systemic embolism caused by the falling of local thrombus particles, the oral administration of the anticoagulant thrombolytic drugs is necessary.

The active protein extracted from fresh urine of healthy people with urokinase system can activate plasminogen in microthrombus to be converted into fibrinolytic enzyme, which can dissolve surface and inside of thrombus, when acute vascular access (autoarteriovenous internal fistula) embolism occurs to a patient who establishes autoarteriovenous internal fistula to be dialyzed, urokinase local infusion thrombolysis is adopted in conservative therapy, and the service life of the internal fistula can be prolonged by infusing urokinase thrombolysis into a lumen every two to three weeks for a patient in a high-coagulation state.

The method has a certain curative effect on protecting and improving the internal arteriovenous fistula, but no particularly effective method is available for better and prolonging the service time of the internal arteriovenous fistula.

The complication of the arteriovenous internal fistula is known from the perspective of traditional Chinese medicine, the disease name of the complication of the arteriovenous internal fistula does not exist in the classic traditional Chinese medicine, and the complication of the arteriovenous internal fistula is equivalent to the categories of 'vessel impediment', 'blood impediment' and the like in the traditional Chinese medicine according to symptom signs of disappearance of blood flow noise, unsmooth blood flow and the like of the internal fistula. The Huangdi's classic has the name of "maibi" and the suzhou-bi-syndrome has the following symptoms: "Bi-syndrome is caused by blood coagulation and not flow in the vessels". The medical books of jin Kui Yao L ü e are recorded with blood arthralgia, and in Shui Qi Bian it is written that "blood is unfavorable and water is produced". In the book of Beiji Qianjin prescriptions by Sun Simiao in Tang Dynasty, it is mentioned that "Qi and blood stagnation causes pain and obstruction of the vessels causes swelling" consistent with the syndrome of internal arteriovenous fistula. Song dynasty, King's conception of "Taiping Shenghui Fang" calls that "yin pathogen enters blood channel to cause arthralgia, so it is called arthralgia due to blood, also called arthralgia due to wind-blood. The Qing Dynasty leaf Tianshi believes that the arthralgia syndrome, … …, is caused by qi and blood deficiency, striae and striae, wind, cold and dampness attacking the exterior with deficiency and retention in the interior to cause damp phlegm and turbid blood flow and congealing. The theory of pulse bi-syndrome is that the blood vessels do not flow and the color changes are mentioned in Yi Bian Bi of He Meng Yao. In the Qing Dynasty Tang Zong Hai, the "blood stasis and swelling" are mentioned in the "blood syndrome and swelling" in Tang Zong Hai, so it is seen that blood stasis caused by vessel obstruction and blood circulation disorder is a thrombus if it is retained in the blood vessel, and subcutaneous hematoma and limb swelling if it is not. The book Yi Zong jin Jian mentions that the arthralgia-syndrome is caused by deficiency of qi and blood; those with excessive arthralgia are also called qi-blood excess syndromes. The traditional Chinese medicine analyzes that the body of the uremic patient is complicated with deficiency, phlegm-dampness and blood stasis, and the Ling Shu & Jing Mai mentions that the pulse channel is used for dredging and the blood and qi are flowing, so the treatment principle of activating blood and dissolving stasis, treating from stasis and treating from dredging is adopted.

Therefore, the traditional Chinese medicine is mainly used for preventing internal fistula in protection, but the research on the aspect is less at present.

Disclosure of Invention

The invention aims to solve the problems and provides a traditional Chinese medicine protective plaster for arteriovenous internal fistula of uremia patients aiming at the characteristics of arteriovenous fistula.

The invention provides a traditional Chinese medicine protective plaster for internal arteriovenous fistula of a uremia patient, which comprises a plaster carrier and a medicine composition coated on the plaster carrier, wherein the medicine composition consists of a traditional Chinese medicine composition and a blending agent which are blended together according to a certain proportion.

The traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 3-6 parts of ligusticum wallichii, 2-6 parts of safflower, 3-5 parts of peach kernel, 3-6 parts of angelica sinensis, 8-12 parts of frankincense, 8-12 parts of myrrh, 2-6 parts of cassia twig, 3-6 parts of corydalis tuber, 3-6 parts of red peony root, 3-6 parts of honeysuckle flower and 6-12 parts of radix scrophulariae.

Preferably, the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 5 parts of ligusticum wallichii, 3 parts of safflower, 4 parts of peach kernel, 5 parts of angelica, 10 parts of frankincense, 10 parts of myrrh, 3 parts of cassia twig, 5 parts of corydalis tuber, 5 parts of red paeony root, 4 parts of honeysuckle flower and 10 parts of figwort root.

The hemodialysis patients have more pathogenesis and have body deficiency, blood stasis, toxin and the like. If the patient has internal fistula dysfunction, induration, pain, red swelling, swelling and the like mainly occur, the main pathogenesis of the patient lies in heat toxicity, blood stasis and the like, and therefore, detoxification, blood stasis removal and deficiency reinforcement are needed during the treatment period.

The traditional Chinese medicine formula in the fistula-protecting patch mainly plays a role in dredging collaterals, removing blood stasis and detoxifying, and various medicinal components in the traditional Chinese medicine composition formula have the following key points: the safflower, the peach kernel and the angelica have the functions of removing blood stasis, promoting blood circulation and nourishing blood; the corydalis tuber mainly has the functions of promoting blood circulation and relieving pain; cassia twig, ramulus Cinnamomi, radix Paeoniae Rubra, flos Lonicerae and radix scrophulariae are used together to clear away heat and toxic materials.

Further, in the traditional Chinese medicine protective plaster for internal arteriovenous fistula of patients with uremia, the blending agent is vaseline; the Chinese medicinal composition is in the form of granule, and is concocted with warm water before use; when in blending, the traditional Chinese medicine granular composition and vaseline are blended according to the weight ratio of 1: 1.

According to the traditional Chinese medicine composition, the traditional Chinese medicine composition is prepared from traditional Chinese medicine formula particles, the medicine directly acts on an affected part in an external application mode, the defect that the traditional Chinese medicine is taken orally to increase the water content in the body of a patient can be effectively prevented, the weight of the patient is increased, the blood flow volume can be effectively improved, blood vessels can be softened, the arteriovenous internal fistula function of the hemodialysis patient can be comprehensively protected, and the symptoms of phlebitis, internal fistula stenosis and the like of the patient can be obviously prevented.

In addition, the external traditional Chinese medicine preparation has the advantages of promoting blood circulation, removing blood stasis, detoxifying and maintaining the vascular access (autologous arteriovenous internal fistula) with the least toxic and side effects on human bodies, promoting exudate absorption when being externally applied to the damaged veins, having the functions of diminishing inflammation, reducing swelling, removing blood stasis, relieving pain, softening blood vessels, accelerating blood circulation and promoting repair of damaged tissue cells, effectively preventing complications of the vascular access such as swelling, hardening, stenosis, pain and the like, and achieving the effects of protecting the arteriovenous internal fistula and prolonging the service life of the arteriovenous internal fistula.

Furthermore, in the traditional Chinese medicine protective plaster for the internal arteriovenous fistula of the uremia patient, the plaster carrier is a non-woven fabric containing cotton paper, the plaster area is 15 multiplied by 10cm, and the coating thickness of the medicine is 5-6 mm.

After the traditional Chinese medicine composition and the vaseline are mixed, the prepared medicine is uniformly coated on a non-woven fabric containing cotton paper, and is properly and fixedly pasted at the local part of the internal arteriovenous fistula, and is fixed by an adhesive tape, the application is carried out on a non-dialysis day, and one treatment course is 15 times every time.

Action and Effect of the invention

The traditional Chinese medicine protective plaster for the internal arteriovenous fistula of the uremia patient is externally applied, is used for daily blood circulation promotion, blood stasis removal, detoxification and maintenance of vascular pathways and prevention and treatment of local angiosclerosis of the internal arteriovenous fistula of a hemodialysis patient, has certain effects on improving the function of the internal arteriovenous fistula, prolonging the service time of the internal arteriovenous fistula to a certain extent and improving the blood flow of hemodialysis, and provides an effective treatment measure for prevention and treatment of related complications such as stenosis occlusion, thrombosis, subcutaneous hematoma and the like of the internal arteriovenous fistula. Compared with the existing externally-applied medicine, the medicine can effectively improve the vascular condition of a patient, promotes the maturation of arteriovenous internal fistula, and has important clinical value in the research of preventing and treating arteriovenous internal fistula complications of hemodialysis patients.

Detailed Description

The present invention will now be described in detail with reference to examples, but the practice of the present invention is not limited thereto.

The experimental procedures, in which specific conditions are not noted in the following examples, are generally carried out under conventional conditions or conditions recommended by the manufacturers. The medicinal materials used in the embodiments of the present invention can be obtained from Chinese medicinal material selling companies unless otherwise noted. The obtained medicinal materials are Chinese medicinal decoction pieces unless otherwise noted. The decoction pieces can be obtained from a selling company or can be obtained and processed.

Example 1: preparation of traditional Chinese medicine protecting plaster for internal arteriovenous fistula of uremia patient

A traditional Chinese medicine protection plaster for internal arteriovenous fistula of a uremia patient comprises a plaster carrier and a medicine composition coated on the plaster carrier, wherein the medicine composition consists of a traditional Chinese medicine composition and a blending agent which are blended together according to a certain proportion.

The traditional Chinese medicine composition with the effect is granules, and the preparation method comprises the following steps:

weighing the following raw medicinal materials in parts by weight: 5 parts of ligusticum wallichii, 3 parts of safflower, 4 parts of peach kernel, 5 parts of angelica, 10 parts of frankincense, 10 parts of myrrh, 3 parts of cassia twig, 5 parts of corydalis tuber, 5 parts of red paeony root, 4 parts of honeysuckle flower and 10 parts of figwort root. Soaking in water for more than half an hour, boiling with strong fire, decocting with slow fire for 30 min, and shortening the second decocting time; the traditional Chinese medicine decocting machine is at 115 ℃ and 0.7kg.cm^-2The pressure is proper, the total solid content is high, and the absorption A value is large. Filtering to obtain extract of the Chinese medicinal composition, concentrating, adding dextrin and sugar powder, mixing, sieving, granulating, drying at 50 deg.C for 2 hr, and packaging.

Each packaging part of granules comprises 15g of ligusticum wallichii, 9g of safflower, 12g of peach kernel, 15g of angelica, 30g of frankincense, 30g of myrrh, 9g of cassia twig, 15g of corydalis tuber, 15g of red paeony root, 12g of honeysuckle flower and 30g of figwort root, and is used as a dosage for one-time nursing.

Before use, the granules are mixed with warm water and vaseline is mixed according to the ratio of 1:1 to prepare the pharmaceutical composition. The prepared medicine is uniformly coated on non-woven fabric containing cotton paper, the thickness is about 5mm, the application area is 15cm multiplied by 10cm, the medicine is properly and fixedly applied to the local part of arteriovenous internal fistula, the medicine is fixed by adhesive tapes, and the medicine is applied on a non-dialysis day, and one treatment course is 15 times every time.

Example 2: clinical observation of the effects

1. Clinical data

The source of the cases is: all cases in this study were derived from uremic pruritic patients who underwent prolonged maintenance hemodialysis in hemodialysis center (n ═ 60 cases) and were followed for a long period of time.

Inclusion criteria were:

performing autologous arteriovenous internal fistula formation for more than 6 weeks; age 30-80 years; uremic patients who meet the U.S. K/DOQI diagnostic criteria. According to the internal fistula maturation condition of (K/DOQI) under the 'renal disease prognosis quality initiative' of the national kidney Foundation (NFK), a person with poor internal fistula maturation is determined by the blood flow volume of less than 600mL/min, the diameter of less than 0.6cm and the subcutaneous depth of more than 0.6 cm; severe diseases such as lack of severe center of gravity, liver and lung, or combined pregnancy of women and other severe chronic diseases; signing an informed consent; the cognitive ability was normal.

Exclusion criteria:

organ dysfunction such as severe liver and lung is complicated; treating local skin ulceration of lateral limbs; pregnant or lactating women; those with malignant tumor; the treatment is interrupted due to heart failure, severe infection, acute cerebrovascular disease and other reasons; patients who need to use internal fistula in advance due to the vascular access problem during the treatment period; failure to coordinate treatment or investigators for advanced age, psychiatric disorders, expression disorders, or other reasons; the medication contraindications are combined; patients who had participated in other clinical trials within 3 months or are currently participating in other drug clinical trials.

The treatment method comprises the following steps:

the clinical curative effect of the traditional Chinese medicine protective plaster for treating uremia pruritus patients with arteriovenous internal fistula is scientifically evaluated by adopting random and contrast clinical experimental design, researching hemodialysis uremia pruritus patients and adopting the mode of contrast of experimental groups and parallel contrast of contrast groups.

The control group is applied with basic treatment (trade name: Xiliaotu mucopolysaccharide sulfate cream; manufacturing enterprise: Mobilt products GmbH; specification: 40 g/count; national standard: H20150010), the skin of the puncture part of the patient is smeared, and the finger abdomen is used to follow the trend of arteriovenous internal fistula of the patient; the treatment group is applied with the fistula protecting traditional Chinese medicine external application therapy in the embodiment 1, the medicine is externally applied to the arteriovenous internal fistula, the main treatment position of the arteriovenous internal fistula with the puncture point of about 10cm is selected as the main treatment position, the feeling of the patient is mainly considered, and the optimal treatment scheme is comfortable and tolerant; both groups were administered on non-dialysis days, once daily, and both groups were treated continuously for 3 months; medical staff who is in the background of professional knowledge is responsible for collecting subjective data information related to the treatment of the patient before and after treatment.

Observation indexes are as follows: the treatment collects the general clinical data of patients, analyzes the occurrence condition of complications of the arteriovenous fistula before and after treatment, and analyzes the traditional Chinese medicine symptom integral, psychological state score and other conditions.

The statistical method comprises the following steps: all data were analyzed using GraphPad Prism 5.0 software, the metrology data were expressed as mean ± standard deviation (± S), data comparisons before and after treatment were performed using paired t-tests, the count data were tested using X2, P <0.05 was a significant difference and was statistically significant.

2. Analysis of results

2.1 general clinical data Condition comparison

TABLE 1 comparison of the clinical general data characteristics of the control and treated patients

As can be seen from Table 1, the difference between the age, dialysis time, dialysis abundance and dialysis duration of the patients in the control group and the patients in the treatment group, and the syndrome type, mental state score and related clinical data of the traditional Chinese medicine are not statistically significant (P is more than 0.05), and are comparable.

2.2 comparative analysis of Pump-controlled blood flow in two groups of hemodialysis

During hemodialysis, the pump-controlled blood flow was recorded for 30 patients in each group, and the average was calculated as shown in table 2:

TABLE 2 Pump-controlled blood flow in hemodialysis

The difference in the comparison of pump-controlled blood flow in hemodialysis of the control group and the treated group was statistically significant (P-0.0136 < 0.05).

2.3 comparative analysis of Chinese medicine syndrome integrals and clinical psychological state scores

According to the traditional Chinese medicine symptom score scale and the psychological state score scale, 30 patients in each group are scored and counted, and the comparison result is shown in table 3:

TABLE 3 comparison of Chinese medicine syndrome integrals and clinical psychological State scores

The difference in the comparison of Chinese medicine symptom integrals and clinical psychological state scores in the control group and the treatment group has significant statistical significance (P < 0.0001).

2.4 comparative analysis of incidence of two groups of related complications

TABLE 4 comparison of incidence of two groups of related complications

As can be seen from the above, the comparative analysis of the incidence of related complications between the control group and the treatment group has significant statistical significance (P ═ 0.0249<0.0001), and the treatment group can significantly reduce the incidence of complications.

In conclusion, compared with the existing externally-applied medicine, the medicine can effectively improve the vascular condition of a patient, promotes the maturation of arteriovenous internal fistula, and has important clinical value in the research of preventing and treating arteriovenous internal fistula complications of hemodialysis patients. The traditional Chinese medicine protective plaster for the internal arteriovenous fistula of the uremia patient is externally applied, is used for daily blood circulation promotion, blood stasis removal, detoxification and maintenance of vascular pathways and prevention and treatment of local angiosclerosis of the internal arteriovenous fistula of a hemodialysis patient, has certain effects on improving the function of the internal arteriovenous fistula, prolonging the service time of the internal arteriovenous fistula to a certain extent and improving the blood flow of hemodialysis, and provides an effective treatment measure for prevention and treatment of related complications such as stenosis occlusion, thrombosis, subcutaneous hematoma and the like of the internal arteriovenous fistula.

The foregoing shows and describes the general principles, essential features, and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, which are given by way of illustration of the principles of the present invention, and that various changes and modifications may be made without departing from the spirit and scope of the invention as defined by the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.

Claims (7)

1. A Chinese medicine protective plaster for arteriovenous internal fistula of uremia patients is characterized by comprising a plaster carrier and a medicine composition coated on the plaster carrier, wherein the medicine composition consists of a Chinese medicine composition and a blending agent which are blended together according to a certain proportion,

the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 3-6 parts of ligusticum wallichii, 2-6 parts of safflower, 3-5 parts of peach kernel, 3-6 parts of angelica sinensis, 8-12 parts of frankincense, 8-12 parts of myrrh, 2-6 parts of cassia twig, 3-6 parts of corydalis tuber, 3-6 parts of red peony root, 3-6 parts of honeysuckle flower and 6-12 parts of radix scrophulariae.

2. The traditional Chinese medicine protective plaster for the arteriovenous internal fistula of the uremia patient according to claim 1, which is characterized in that the traditional Chinese medicine composition is prepared from the following raw material medicines in parts by weight: 5 parts of ligusticum wallichii, 3 parts of safflower, 4 parts of peach kernel, 5 parts of angelica, 10 parts of frankincense, 10 parts of myrrh, 3 parts of cassia twig, 5 parts of corydalis tuber, 5 parts of red paeony root, 4 parts of honeysuckle flower and 10 parts of figwort root.

3. The traditional Chinese medicine protective plaster for arteriovenous internal fistula of a uremic patient according to claim 1, wherein the blending agent is vaseline.

4. The uremia patient arteriovenous internal fistula traditional Chinese medicine protective plaster according to claim 3, wherein the traditional Chinese medicine composition and vaseline are blended according to a weight ratio of 1: 1.

5. The traditional Chinese medicine protective plaster for arteriovenous internal fistula of a uremic patient according to claim 1, wherein the traditional Chinese medicine composition is granules which are adjusted with warm water before use.

6. The traditional Chinese medicine protective plaster for arteriovenous internal fistula of a uremic patient according to claim 1, wherein the plaster carrier is a non-woven fabric containing cotton paper and has an area of 15 x 10 cm.

7. The traditional Chinese medicine protective plaster for the internal arteriovenous fistula of the uremic patient according to claim 1, wherein the coating thickness of the pharmaceutical composition on the plaster carrier is 5-6 mm.