技术领域technical field
本发明涉及中药领域，具体涉及一种用于治疗肺炎的中药组合物及其制备方法。The invention relates to the field of traditional Chinese medicines, in particular to a traditional Chinese medicine composition for treating pneumonia and a preparation method thereof.
背景技术Background technique
新型冠状病毒肺炎(简称：新冠肺炎)是由感染2019新型冠状病毒(2019-nCoV)而引起的一种急性传染病。本病发病迅速，传播速度快，人群普遍易感，已成为严重威胁公共安全健康的严峻问题之一。该新型冠状病毒感染的肺炎的临床表现以发热、乏力、干咳为主，少数患者可伴有纳差、腹泻、腹痛，极少数患者有恶寒、一身酸楚疼痛、鼻塞、流涕等，并具有极强的传染性，可通过呼吸道飞沫传播等多种途径传播，甚至可以接触传播，应属于中国医学“疫毒”范畴。本病属于感受湿毒为主要性质的疫疠邪气，可称之为“湿毒疫”。由口鼻而入，郁于上焦膜原，继而淫肺入营，逆传心包或横逆肝肾，但病变始终以上焦和肺为中心。病情潜伏期相对较长，可达1-14天，也是由于湿毒的湿性黏滞、留恋不解的特点。湿邪侵及人体，留滞于脏腑经络，最易阻遏气机，使气机升降失常，湿性重浊，常可见咳嗽、乏力、四肢酸懒等症状。湿邪中阻,清气不升、浊阴不降，故腹泻或纳差。Novel coronavirus pneumonia (abbreviation: new coronary pneumonia) is an acute infectious disease caused by infection with the 2019 novel coronavirus (2019-nCoV). The disease has a rapid onset, a rapid spread, and the population is generally susceptible. It has become one of the serious problems that seriously threaten public safety and health. The clinical manifestations of pneumonia caused by the novel coronavirus are mainly fever, fatigue, and dry cough. A small number of patients may be accompanied by anorexia, diarrhea, and abdominal pain. It is extremely contagious and can be transmitted through respiratory droplets and other means, and can even be transmitted by contact. It should belong to the category of "epidemic virus" in Chinese medicine. This disease belongs to the pathogenic qi of epidemic disease with the feeling of damp poison as the main nature, which can be called "damp poison epidemic". Entering from the mouth and nose, stagnant in the upper energizer membrane, and then intoxicating the lung into the camp, reversing the pericardium or traversing the liver and kidney, but the lesions are always centered on the upper energizer and the lung. The incubation period of the disease is relatively long, up to 1-14 days. Damp pathogens invade the human body and stay in the viscera and meridians, which are the easiest to block the qi movement, causing the qi movement to rise and fall abnormally. The dampness is blocked, the clear qi does not rise, and the turbid yin does not descend, so diarrhea or anorexia.
由于新冠肺炎的临床症状与其它肺炎相比具有一些新的不同特征，因此开发适用于新冠肺炎的药物迫在眉睫。Since the clinical symptoms of new coronary pneumonia have some new and different characteristics compared with other pneumonias, it is urgent to develop drugs suitable for new coronary pneumonia.
我们前期研究结果发现，此次新冠肺炎初期多以湿毒郁肺为主，治拟清肺化湿为宜，主要是通过宣开肺气而达化湿透热之目的。肺气气化功能恢复，湿邪则得以祛除，热无所依附亦随之而去。同时，在诊治过程中我们发现此病肺胃同病，需肺胃同治，故自拟中药配方治之，有明显的治疗效果。The results of our previous research found that in the early stage of the new coronary pneumonia, dampness and poison stagnation in the lungs are the main factors, and it is appropriate to treat and clear the lungs and remove dampness. The qi transformation function of the lung is restored, the dampness pathogens can be eliminated, and the heat will go away without any attachment. At the same time, in the process of diagnosis and treatment, we found that the lung and stomach are the same disease, and it is necessary to treat the lung and stomach together.
发明内容SUMMARY OF THE INVENTION
本发明的目的在于，提供一种用于治疗肺炎的中药组合物及其制备方法，特别是用于治疗2019-nCoV病毒引起的新型冠状病毒肺炎。The purpose of the present invention is to provide a traditional Chinese medicine composition for treating pneumonia and a preparation method thereof, especially for treating novel coronavirus pneumonia caused by 2019-nCoV virus.
本发明为实现上述目的所采用的技术方案如下：The technical scheme that the present invention adopts for realizing the above-mentioned purpose is as follows:
一种中药组合物，由以下质量份组分组成：炙麻黄6-10份、杏仁5-10份、石膏15-60份、甘草6-10份、僵蚕5-10份、熟大黄9-15份、蝉蜕3-6份、鱼腥草15-25份、金银花6-15份、陈皮3-10份。A traditional Chinese medicine composition is composed of the following components in parts by mass: 6-10 parts of ephedra, 5-10 parts of almonds, 15-60 parts of gypsum, 6-10 parts of licorice, 5-10 parts of silkworm, and 9-10 parts of cooked rhubarb. 15 parts, cicada slough 3-6 parts, Houttuynia cordata 15-25 parts, honeysuckle 6-15 parts, tangerine peel 3-10 parts.
所述中药组合物的配方是在抗击新冠肺炎过程中总结获得的，是基于古方麻杏石甘汤和升降散为基础方加减的新配方。The formula of the traditional Chinese medicine composition is obtained by summarizing the process of fighting against new coronary pneumonia, and is a new formula based on the addition and subtraction of ancient prescriptions Maxing Shigan Decoction and Shengsheng Powder.
“麻杏石甘汤”是《伤寒论》中专为清肺热而设定的经典方剂，君药麻黄入肺经，具有强大的辛散作用，驱散肺中邪热，又可平喘；因性大温，所以要配伍石膏，石膏也入肺经，乃辛寒之品，能清热散热，同时石膏的寒凉又可以抑制麻黄的温燥之性；杏仁配合麻黄可宣肺平喘，甘草调和诸药，共奏辛凉宣泄、清肺平喘之功。"Maxing Shigan Decoction" is a classic prescription specially designed for clearing heat in the lungs in Treatise on Febrile Diseases. The monarch medicine Mahuang enters the lung meridian and has a strong pungent and dispersing effect, dispelling evil heat in the lungs and relieving asthma; Due to its high temperature, gypsum should be combined with gypsum, which also enters the lung meridian. It is a pungent and cold product, which can clear heat and dissipate heat. At the same time, the coldness of gypsum can inhibit the warm and dry nature of ephedra. Licorice harmonizes various medicines, and plays the role of pungent and cool catharsis, clearing the lungs and relieving asthma.
“升降散”见于《伤暑全书》和《伤寒温疫条辨》，全方由僵蚕、蝉蜕、姜黄、大黄四味药组成，僵蚕为君，蝉蜕为臣，姜黄为佐，大黄为使，僵蚕和蝉蜕共升阳中之清阳，姜黄、大黄同降阴中之浊阴，一升一降，上焦肺气得宣、中焦胃气得降，使体内气机得畅，而邪去正安。本发明的配方中姜黄虑其味苦而去之，改生大黄为熟大黄，即可保留通降之意，且增加了活血凉血之功。国医大师李士懋认为升降散不仅是温病之总方，更是治郁热之总方，对于新冠肺炎的临床治疗期热毒闭肺型早期患者中常见发热、黄痰、气促、喘憋等，急需清畅闭肺之郁热，予升降散使郁热得解，三焦气机得畅。"Shangxiasan" can be found in "Shangshu Quanshu" and "Typhoid fever and epidemic identification". The whole formula is composed of four herbs: silkworm, cicada, turmeric, and rhubarb. So, the silkworm and the cicada slough together raise the clear yang in the yang, turmeric and rhubarb together reduce the turbid yin in the yin, one rise and the other fall, the upper energizer lung qi can be diffused, and the middle jiao stomach qi can be lowered, so that the qi in the body is smooth. , and evil goes to righteousness. In the formula of the present invention, turmeric is removed in consideration of its bitter taste, and the transformation of rhubarb into cooked rhubarb can retain the meaning of clearing and descending, and increase the effect of promoting blood circulation and cooling blood. Li Shimao, a master of traditional Chinese medicine, believes that Shengjingsan is not only the general prescription for febrile diseases, but also the general prescription for treating stagnation and heat. Fever, yellow phlegm, shortness of breath, wheezing, etc. are common in patients with early stage heat-toxin closed lung type during the clinical treatment of new coronary pneumonia. It is urgently needed to clear and smooth the stagnant heat in the lungs, so that the stagnant heat can be relieved and the triple burner qi flow is smooth.
本发明配方中炙麻黄为君药，取其能宣肺平喘而泄邪热，有“火郁发之”之义。但其性温，故配伍辛甘大寒之石膏为臣药，使宣肺而不助热，清肺而不留邪，宣肺平喘而不助热，同时配合蝉蜕、僵蚕疏风泄热、利咽开音，升阳益胃，共奏臣药之功效。杏仁味苦降肺气，金银花、鱼腥草清热排脓解毒，陈皮理气健脾护胃，合用为佐药，助君药臣药清肺泄热平喘。熟大黄泄热毒、行淤血，清降浊阴，甘草既能益气和中，补益脾气，又与石膏合而生津止渴，所以两者是佐使药。综观诸药，肺胃同治，升清降浊，气血并调，共奏清肺泄热、凉血解毒之功。In the formula of the present invention, ephedra is the monarch medicine, which can disperse the lungs and relieve asthma and expel pathogenic heat, and has the meaning of "fire and stagnation". However, it is warm in nature, so it is used in combination with the gypsum of Xingan and Dahan as a ministerial medicine, so that it can disperse the lung without helping heat, clearing the lung without leaving pathogens, dispersing the lung and relieving asthma without helping heat, and at the same time with the sloughing of cicadas and silkworms to disperse wind and relieve heat , Liyan to open the sound, Yang Yang Yiwei, a total of the efficacy of Chen's medicine. Almonds taste bitter and reduce lung qi, honeysuckle and houttuynia cordata clear heat, expel pus and detoxify, and tangerine peel regulates qi, invigorates spleen and protects stomach. They are used together as adjuvant drugs to help the monarch and minister medicine clear the lung and relieve heat and relieve asthma. Cooked rhubarb relieves heat and toxin, clears blood, clears turbid yin, and licorice can not only invigorate qi and neutralize, but also nourish spleen, and combine with gypsum to produce body fluid and quench thirst, so the two are adjuvant medicines. Looking at all the medicines, the lungs and stomach are treated with the same treatment, the promotion of clearing and the reduction of turbidity, the coordination of qi and blood, and the functions of clearing the lungs and expelling heat, cooling blood and detoxification.
作为优选实施例，所述配方中的炙麻黄采用蜜炙麻黄，杏仁采用燀苦杏仁，僵蚕采用蜜麸炒僵蚕。As a preferred embodiment, the roasted ephedra in the formula adopts honey roasted ephedra, the almond adopts the bitter almond, and the stiff silkworm adopts honey bran to fry the stiff silkworm.
作为优选实施例，所述中药组合物还包括药学上可接受的辅料，所述辅料优选为糊精。As a preferred embodiment, the traditional Chinese medicine composition further includes a pharmaceutically acceptable adjuvant, and the adjuvant is preferably dextrin.
作为优选实施例，所述中药组合物由以下质量份组分组成：炙麻黄9份、杏仁9份、石膏30份、甘草6份、僵蚕9份、熟大黄9份、蝉蜕6份、鱼腥草15份、金银花9份、陈皮6份。As a preferred embodiment, the traditional Chinese medicine composition is composed of the following components in parts by mass: 9 parts of ephedra, 9 parts of almonds, 30 parts of gypsum, 6 parts of licorice, 9 parts of silkworm, 9 parts of cooked rhubarb, 6 parts of cicada slough, fish 15 parts of Xingcao, 9 parts of honeysuckle, 6 parts of dried tangerine peel.
优选地，所述中药组合物每一剂的药量为：炙麻黄9g、杏仁9g、石膏30g、甘草6g、僵蚕9g、熟大黄9g、蝉蜕6g、鱼腥草15g、金银花9g、陈皮6g。这里每一剂的药量是指每一天服用的药量，包括早晚各一次，剂型包括汤剂或颗粒剂。Preferably, the dosage of each dose of the traditional Chinese medicine composition is: ephedra 9g, almond 9g, gypsum 30g, licorice 6g, silkworm 9g, cooked rhubarb 9g, cicada slough 6g, houttuynia cordata 15g, honeysuckle 9g, tangerine peel 6g . The amount of each dose here refers to the amount of the drug to be taken every day, including one in the morning and one in the evening, and the dosage form includes decoction or granule.
优选地，所述中药组合物的剂型为散剂、膏剂、丸剂、片剂、汤剂或胶囊制剂。Preferably, the dosage form of the traditional Chinese medicine composition is powder, ointment, pill, tablet, decoction or capsule preparation.
进一步优选地，所述中药组合物的剂型为颗粒散剂。Further preferably, the dosage form of the traditional Chinese medicine composition is granule powder.
本发明还提供所述颗粒散剂型中药组合物的制备方法，所述方法包括如下步骤：The present invention also provides a preparation method of the granule powder type traditional Chinese medicine composition, the method comprises the following steps:
(1)将各组分按照配比加入水中煎煮两次或以上，煎煮液过滤后合并；(1) each component is added in water to decoct twice or more according to the proportion, and the decoction liquid is filtered and merged;
(2)将合并后的滤液浓缩至相对密度为1.14-1.15(60-80℃)的清膏；(2) Concentrating the combined filtrate to a clear paste with a relative density of 1.14-1.15 (60-80° C.);
(3)糊精用纯水稀释后过滤，然后与清膏混合均匀，喷雾干燥制得干膏粉，所述清膏与糊精的质量比为12-320：1；(3) dextrin is diluted with pure water and filtered, then mixed with clear paste, spray-dried to obtain dry paste powder, and the mass ratio of said clear paste to dextrin is 12-320:1;
(4)将干膏粉进行制粒、包装，制得所述中药组合物的颗粒散剂。(4) granulating and packaging the dry paste powder to obtain the granule powder of the Chinese medicine composition.
本发明还提供了所述的中药组合物在治疗肺炎中的应用。The present invention also provides the application of the traditional Chinese medicine composition in the treatment of pneumonia.
优选地，所述肺炎是新型冠状病毒2019-nCoV引起的新型冠状病毒肺炎。Preferably, the pneumonia is novel coronavirus pneumonia caused by novel coronavirus 2019-nCoV.
与现有技术相比，本发明的有益效果如下：Compared with the prior art, the beneficial effects of the present invention are as follows:
(1)发明人在对新冠肺炎的诊治过程中发现此病肺胃同病，需肺胃同治。因此将“麻杏石甘汤”和“升降散”两方结合，再加鱼腥草、金银花清肺解毒、陈皮调和脾胃。与目前常用的中成药相比，本发明的中药配方更贴切疾病的病因病机，肺胃同治，升清降浊，气血并调，共奏清肺泄热、凉血解毒之功。(1) During the diagnosis and treatment of new coronary pneumonia, the inventor found that the disease is the same as the lung and stomach, and it is necessary to treat the lung and stomach together. Therefore, "Maxing Shigan Decoction" and "Lisheng San" are combined, and Houttuynia cordata, honeysuckle clearing the lungs and detoxifying, and dried tangerine peel to reconcile the spleen and stomach. Compared with the traditional Chinese patent medicines commonly used at present, the traditional Chinese medicine formula of the present invention is more suitable for the etiology and pathogenesis of diseases, the lung and stomach are treated together, the qi and blood are adjusted together, and the functions of clearing the lungs and expelling heat, cooling blood and detoxification are achieved.
(2)本发明的中药组合物在临床应用中，用药安全且具有较好的疗效。以汤剂用于部分新冠肺炎疑似患者的治疗，显示出良好的退热、止咳作用；其中的几例新冠肺炎确诊病例均已康复出院。(2) In clinical application, the traditional Chinese medicine composition of the present invention is safe and has good curative effect. The decoction was used for the treatment of some suspected patients with new coronary pneumonia, showing good antipyretic and cough-relieving effects; several of the confirmed cases of new coronary pneumonia have recovered and been discharged.
具体实施方式Detailed ways
以下通过具体实施例来说明本发明的技术方案。本发明中所用的原料和试剂均市售可得。The technical solutions of the present invention are described below through specific embodiments. The raw materials and reagents used in the present invention are all commercially available.
实施例1Example 1
中药组合物的组分组成(质量份)为：炙麻黄9份、杏仁9份、石膏30份、甘草6份、僵蚕9份、熟大黄9份、蝉蜕6份、鱼腥草15份、金银花9份、陈皮6份。The component composition (mass parts) of the traditional Chinese medicine composition is: 9 parts of fried ephedra, 9 parts of almonds, 30 parts of gypsum, 6 parts of licorice, 9 parts of silkworm, 9 parts of cooked rhubarb, 6 parts of cicada slough, 15 parts of Houttuynia cordata, 9 parts of honeysuckle and 6 parts of dried tangerine peel.
该中药组合物的颗粒散剂制备方法如下：The preparation method of the granule powder of the traditional Chinese medicine composition is as follows:
取石膏1500g加水先煎1小时，再投入其余药味蜜炙麻黄450g、蜜麸炒僵蚕450g、蝉蜕300g、燀苦杏仁450g、鱼腥草750g、金银花450g、陈皮300g、熟大黄450g、甘草300g，加入6倍量的水，煎煮1小时左右。煎煮液取出后，再加入5倍量的水进行第二次煎煮。煎煮液合并后过滤，浓缩至相对密度为1.14-1.15(60-80℃)的清膏。称取糊精适量，糊精用纯水稀释后过100目筛，然后与浓缩的清膏混合均匀，喷雾干燥制得干膏粉，干膏粉进行制粒、包装，获得颗粒产品，命名为麻杏清肺颗粒。Take 1500g of gypsum and add water to fry for 1 hour, then add the rest of the medicinal-flavored honey-baked ephedra 450g, honey bran fried silkworm 450g, cicada slough 300g, 450g bitter almond, 750g Houttuynia cordata, 450g honeysuckle, 300g dried tangerine peel, 450g cooked rhubarb, and 300g licorice , add 6 times the amount of water and cook for about 1 hour. After the decoction liquid is taken out, add 5 times the amount of water for the second decoction. The decoction liquid is combined, filtered, and concentrated to a clear paste with a relative density of 1.14-1.15 (60-80°C). Weigh an appropriate amount of dextrin, dilute it with pure water and pass it through a 100-mesh sieve, then mix it with the concentrated clear paste, spray dry to obtain dry paste powder, and the dry paste powder is granulated and packaged to obtain a granular product, named as Maxing Qingfei Granules.
制备的麻杏清肺颗粒产品的限度要求：(1)应具盐酸麻黄碱对照品的特征斑点；(2)应具金银花对照品的特征斑点；(3)应具橙皮苷对照品的特征斑点。The limit requirements for the prepared Maxing Qingfei Granules products: (1) should have the characteristic spots of the ephedrine hydrochloride reference substance; (2) should have the characteristic spots of the honeysuckle reference substance; (3) should have the characteristics of the hesperidin reference substance spot.
工艺验证：Process Validation:
1、蜜炙麻黄取本品适量，研细，取1g，加浓氨试液数滴，再加三氯甲烷10ml，加热回流1小时，滤过，滤液蒸干，残渣加甲醇2ml充分振摇，滤过，取滤液作为供试品溶液。另取盐酸麻黄碱对照品，加甲醇制成每1ml含1mg的溶液，作为对照品溶液。照薄层色谱法(通则0502)试验，吸取上述两种溶液各5μl，分别点于同一硅胶G薄层板上，以三氯甲烷-甲醇-浓氨试液(20：5：0.5)为展开剂，展开，取出，晾干，喷以茚三酮试液，在105℃加热至斑点显色清晰。供试品色谱中，在与对照品色谱相应的位置上，显相同的红色斑点。1. Take an appropriate amount of this product, grind it finely, take 1g, add a few drops of concentrated ammonia test solution, add 10ml of chloroform, heat under reflux for 1 hour, filter, evaporate the filtrate to dryness, add 2ml of methanol to the residue and shake well , filtered, and the filtrate was taken as the test solution. Take another ephedrine hydrochloride reference substance, add methanol to make a solution containing 1mg per 1ml, as the reference substance solution. According to the thin-layer chromatography (general rule 0502) test, draw 5 μl of each of the above two solutions, point them on the same silica gel G thin-layer plate, and use chloroform-methanol-concentrated ammonia test solution (20:5:0.5) as the development agent, unfolded, taken out, air-dried, sprayed with ninhydrin test solution, heated at 105°C until the spot color became clear. In the chromatogram of the test substance, the same red spots were displayed on the corresponding position of the chromatogram of the reference substance.
2、金银花取本品适量，研细，取0.2g，加甲醇5ml，放置12小时，滤过，取滤液作为供试品溶液。另取绿原酸对照品，加甲醇制成每1ml含1mg的溶液，作为对照品溶液。照薄层色谱法(通则0502)试验，吸取供试品溶液10～20μl、对照品溶液10μl，分别点于同一硅胶H薄层板上，以乙酸丁酯-甲酸-水(7：2.5：2.5)的上层溶液为展开剂，展开，取出，晾干，置紫外光灯(365nm)下检视。供试品色谱中，在与对照品色谱相应的位置上，显相同颜色的荧光斑点。2. Take an appropriate amount of this product from honeysuckle, grind it finely, take 0.2 g, add 5 ml of methanol, leave it for 12 hours, filter it, and take the filtrate as the test solution. Take another chlorogenic acid reference substance, add methanol to make a solution containing 1mg per 1ml, as the reference substance solution. According to the thin-layer chromatography (general rule 0502) test, draw 10-20 μl of the test solution and 10 μl of the reference solution, respectively, point them on the same silica gel H thin-layer plate, and use butyl acetate-formic acid-water (7:2.5:2.5 ) of the upper layer solution is the developing agent, which is developed, taken out, air-dried, and inspected under an ultraviolet lamp (365 nm). In the chromatogram of the test substance, there are fluorescent spots of the same color at the corresponding position of the chromatogram of the reference substance.
3、陈皮取本品适量，研细，取0.3g，加甲醇10ml，加热回流20分钟，滤过，取滤液5ml，浓缩至1ml，作为供试品溶液。另取橙皮苷对照品，加甲醇制成饱和溶液，作为对照品溶液。照薄层色谱法(通则0502)试验，吸取上述两种溶液各2μl，分别点于同一用0.5％氢氧化钠溶液制备的硅胶G薄层板上，以乙酸乙酯-甲醇-水(100：17：13)为展开剂，展至约3cm，取出，晾干，再以甲苯-乙酸乙酯-甲酸-水(20：10：1：1)的上层溶液为展开剂，展至约8cm，取出，晾干，喷以三氯化铝试液，置紫外光灯(365nm)下检视。供试品色谱中，在与对照品色谱相应的位置上，显相同颜色的荧光斑点。3. Take an appropriate amount of this product from dried tangerine peel, grind it finely, take 0.3g, add 10ml of methanol, heat under reflux for 20 minutes, filter, take 5ml of the filtrate, concentrate to 1ml, and use it as the test solution. Another reference substance of hesperidin was taken, and methanol was added to make a saturated solution, which was used as the reference substance solution. According to the thin-layer chromatography (general rule 0502) test, draw 2 μl of each of the above two solutions, and place them on the same silica gel G thin-layer plate prepared with 0.5% sodium hydroxide solution, respectively, with ethyl acetate-methanol-water (100: 17:13) is a developing agent, spread to about 3cm, take it out, air dry, and then use the upper layer solution of toluene-ethyl acetate-formic acid-water (20:10:1:1) as a developing agent, spread to about 8cm, Take it out, dry it, spray it with aluminum trichloride test solution, and inspect it under a UV lamp (365 nm). In the chromatogram of the test substance, there are fluorescent spots of the same color at the corresponding position of the chromatogram of the reference substance.
实施例2Example 2
中药组合物的汤剂制备Preparation of decoction of traditional Chinese medicine composition
每一剂的药量为：炙麻黄9g、杏仁9g、石膏30g、甘草6g、僵蚕9g、熟大黄9g、蝉蜕6g、鱼腥草15g、金银花9g、陈皮6g。这里每一剂的药量是指所述配比的中药组合物煎煮为汤剂后作为每一天服用的药量，包括早晚各一次。The dosage of each dose is: ephedra 9g, almond 9g, gypsum 30g, licorice 6g, silkworm 9g, cooked rhubarb 9g, cicada slough 6g, houttuynia cordata 15g, honeysuckle 9g, tangerine peel 6g. The dose of each dose here refers to the dose of the traditional Chinese medicine composition that is decoctioned into a decoction as a daily dose, including once in the morning and once in the evening.
具体制备过程为：将调配完成的中药组合物(炙麻黄9g、杏仁9g、石膏30g、甘草6g、僵蚕9g、熟大黄9g、蝉蜕6g、鱼腥草15g、金银花9g、陈皮6g)放入容器中浸泡，根据药的体积确定加水量，待药物吸足水后，再加水至高出液面2cm左右，浸泡30分钟以上，确保煎煮前药已浸透。煎药温度设定为105℃-120℃(压力<0.1Mpa)，煎煮一小时左右；煎煮两次，合并煎煮液，分装为两包，作为一天的服用药量。制备的汤剂命名为麻杏清肺汤。The specific preparation process is as follows: put the prepared Chinese medicinal composition (Sunbae Mahuang 9g, almond 9g, gypsum 30g, licorice 6g, silkworm 9g, cooked rhubarb 9g, cicada slough 6g, Houttuynia cordata 15g, honeysuckle 9g, tangerine peel 6g) into Soak in the container, and determine the amount of water to be added according to the volume of the medicine. After the medicine has absorbed enough water, add water to a height of about 2cm above the liquid surface, and soak for more than 30 minutes to ensure that the medicine has been soaked before decocting. The temperature of the decoction is set at 105°C-120°C (pressure < 0.1Mpa), and it is decocted for about an hour; decoct twice, combine the decoction liquid, and divide it into two packs as the dosage for one day. The prepared decoction is named Maxing Qingfei Decoction.
实施例3Example 3
将实施例2中制备的麻杏清肺汤用于治疗新冠肺炎的疑似患者，具体结果如下：The Maxing Qingfei Decoction prepared in Example 2 is used to treat the suspected patient of new coronary pneumonia, and the specific results are as follows:
1、病例基础情况1. Case basis
2020.1.15-2020.2.19龙华医院发热门诊新冠肺炎疑似患者15例，其中确诊新冠肺炎患者3例。病例基础信息参见表1。From 2020.1.15 to 2020.2.19, there were 15 suspected patients with new coronary pneumonia in the fever clinic of Longhua Hospital, including 3 confirmed patients with new coronary pneumonia. See Table 1 for basic case information.
表1Table 1
2、确诊病例情况2. Confirmed cases
2.1临床症状2.1 Clinical symptoms
3例确诊病例本院诊治过程中，有3例发热，其中1例最高体温39摄氏度，伴咳嗽，干咳为主，均无胸闷、无腹泻。During the diagnosis and treatment of the 3 confirmed cases in our hospital, there were 3 cases of fever, of which 1 case had a maximum body temperature of 39 degrees Celsius, with cough, mainly dry cough, and no chest tightness or diarrhea.
2.2治疗用药2.2 Therapeutic drugs
中医药干预治疗：发热门诊协定方(麻杏清肺汤)，中药房代煎，200ml/次，2次/天；痰热清注射液20ml/天，治疗2天。Intervention and treatment of traditional Chinese medicine: Fever clinic prescription (Maxing Qingfei Decoction), decoction in traditional Chinese pharmacy, 200ml/time, 2 times/day; Tanreqing injection 20ml/day, treatment for 2 days.
西药干预治疗：维生素C注射液2.0-5.0g/天，治疗2天。Western medicine intervention treatment: vitamin C injection 2.0-5.0g/day for 2 days.
2.3电话随访2.3 Telephone follow-up
3例患者确诊后按流程转入上海市公共卫生临床中心继续治疗，均为普通型，未转至重型。2020.2.5转入的患者于2020.2.20出院回家，2020.2.1转入的患者于2020.2.22出院回家，2020.2.12转入的患者治疗顺利，已无发热，肺部病变恢复中。After the 3 cases were diagnosed, they were transferred to the Shanghai Public Health Clinical Center for further treatment according to the procedure. The patients transferred on 2020.2.5 were discharged home on 2020.2.20, the patients transferred on 2020.2.1 were discharged home on 2020.2.22, and the patients transferred on 2020.2.12 were treated smoothly, with no fever, and their lung lesions were recovering.
3、疑似病例情况3. Suspected cases
12例疑似患者中发热10例，咳嗽11例，咳痰9例。诊断为肺炎9例，急性上呼吸道感染2例，慢阻肺1例。Among the 12 suspected patients, 10 had fever, 11 had cough, and 9 had sputum. Nine cases were diagnosed as pneumonia, 2 cases of acute upper respiratory tract infection, and 1 case of chronic obstructive pulmonary disease.
疑似患者住院期间均口服发热门诊协定方(麻杏清肺汤)，中药房代煎，200ml/次，2次/天，服药至出院。During the hospitalization period, all the suspected patients were given oral fever clinic prescription (Maxing Qingfei Decoction), decocted in Chinese pharmacy, 200ml/time, 2 times/day, until discharge.
10例发热患者体温恢复正常时间为2.4天。目前9例已出院，3例继续治疗中。The body temperature of 10 patients with fever returned to normal in 2.4 days. At present, 9 cases have been discharged, and 3 cases are still under treatment.
4、安全性评价4. Safety evaluation
12例疑似患者中，有2例为急性上呼吸道感染因病情恢复较快，拒绝复查血常规后出院。10例患者治疗后复查，白细胞轻度降低，仍在正常范围内；红细胞和血小板计数无明显变化。治疗前有1例患者轻度腹泻，治疗后腹泻无明显加重，治疗前后的血常规信息见表2。Among the 12 suspected patients, 2 patients with acute upper respiratory tract infection were discharged from the hospital after refusing to review blood routine due to their rapid recovery. After treatment, 10 patients were reexamined, and the white blood cells were slightly decreased, which was still within the normal range; the red blood cell and platelet counts did not change significantly. Before treatment, 1 patient had mild diarrhea, and the diarrhea did not worsen significantly after treatment. The blood routine information before and after treatment is shown in Table 2.
表2Table 2
5、小结5. Summary
从前期病例资料结果分析，发热门诊协定方(麻杏清肺汤)具有较好改善发热作用，并可促进咳嗽、咳痰症状好转。早期给予麻杏清肺汤有助于防治新冠肺炎病情进展，同时对肺炎和急性上呼吸道感染治疗有益。From the analysis of the previous case data, the fever clinic prescription (Maxing Qingfei Decoction) has a good effect on improving fever, and can promote the improvement of cough and expectoration symptoms. Early administration of Maxing Qingfei Decoction can help prevent and treat the progression of new coronary pneumonia, and is also beneficial for the treatment of pneumonia and acute upper respiratory tract infection.
本发明中药组合物中各组分的配比，可根据患者体质以及发热咳嗽等症状轻重的不同进行相应调整。依据药典记载和临床经验，本发明各组分的质量配比可在如下范围内变化：炙麻黄6-10份、杏仁5-10份、石膏15-60份、甘草6-10份、僵蚕5-10份、熟大黄9-15份、蝉蜕3-6份、鱼腥草15-25份、金银花6-15份、陈皮3-10份。The proportion of each component in the traditional Chinese medicine composition of the present invention can be adjusted correspondingly according to the patient's constitution and the severity of symptoms such as fever and cough. According to pharmacopoeia records and clinical experience, the mass ratio of each component of the present invention can be changed within the following range: 6-10 parts of ephedra, 5-10 parts of almonds, 15-60 parts of gypsum, 6-10 parts of licorice, silkworm 5-10 parts, cooked rhubarb 9-15 parts, cicada slough 3-6 parts, Houttuynia cordata 15-25 parts, honeysuckle 6-15 parts, tangerine peel 3-10 parts.
上述仅为本发明的部分优选实施例，本发明并不仅限于实施例的内容。对于本领域中的技术人员来说，在本发明技术方案的构思范围内可以有各种变化和更改，所作的任何变化和更改，均在本发明保护范围之内。The above are only some preferred embodiments of the present invention, and the present invention is not limited to the contents of the embodiments. For those skilled in the art, various changes and modifications can be made within the scope of the technical solution of the present invention, and any changes and modifications made are within the protection scope of the present invention.
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