阅读说明：本技术 治疗慢性筋伤的外用中药复方制剂 (External traditional Chinese medicine compound preparation for treating chronic tendon injury ) 是由 刘琼 张星五 于 2021-08-27 设计创作，主要内容包括：治疗慢性筋伤的外用中药复方制剂,涉及一种中药外用膏剂,尤其是一种用于治疗慢性筋伤的外用中药复方制剂的组成及临床应用。治疗慢性筋伤的外用中药复方制剂,由土茯苓、羌活、白芷、川芎、当归、鸡血藤、桑枝、姜黄、威灵仙、秦艽、乳香、丹参、川楝子、苏木、花椒、红花、透骨草、冰片制备成膏剂。本发明的膏剂配合推拿手法治疗筋伤,疗效明显,安全程度高,在临床上具有应用价值。(An externally applied traditional Chinese medicine compound preparation for treating chronic muscle and tendon injury relates to an externally applied traditional Chinese medicine ointment, in particular to a composition and clinical application of an externally applied traditional Chinese medicine compound preparation for treating chronic muscle and tendon injury. A topical Chinese medicinal compound preparation for treating chronic tendon injury is prepared from rhizoma Smilacis Glabrae, Notopterygii rhizoma, radix Angelicae Dahuricae, rhizoma Ligustici Chuanxiong, radix Angelicae sinensis, caulis Spatholobi, ramulus Mori, Curcuma rhizome, radix Clematidis, radix Gentianae Marcrophyllae, Olibanum, Saviae Miltiorrhizae radix, fructus Toosendan, lignum sappan, fructus Zanthoxyli, Carthami flos, herba Speranskiae Tuberculatae, and Borneolum Syntheticum by making into unguent. The ointment disclosed by the invention is matched with a massage manipulation to treat tendon injury, is obvious in curative effect and high in safety degree, and has an application value in clinic.)

1. The externally applied traditional Chinese medicine compound preparation for treating chronic muscle injuries is characterized in that the externally applied traditional Chinese medicine compound preparation is prepared into ointment by the following medicines according to the parts by weight;

5-50 parts of glabrous greenbrier rhizome, 5-50 parts of incised notopterygium rhizome, 5-50 parts of dahurian angelica root, 5-50 parts of szechuan lovage rhizome, 5-50 parts of Chinese angelica, 5-50 parts of suberect spatholobus stem, 5-50 parts of mulberry twig, 10-100 parts of turmeric, 10-100 parts of clematis root, 5-50 parts of large-leaved gentian, 5-50 parts of frankincense, 10-100 parts of salvia miltiorrhiza, 5-50 parts of szechwan chinaberry fruit, 5-50 parts of sappan wood, 5-50 parts of pepper, 5-50 parts of safflower, 10-100 parts of garden balsam stem and 1-20 parts of borneol.

Technical Field

The invention relates to a traditional Chinese medicine external paste, in particular to a composition and clinical application of an external traditional Chinese medicine compound preparation for treating chronic muscle and tendon injury.

Background

In the theory of traditional Chinese medicine, the narrow tendon and finger constitutes one of the five bodies of the human body; tendon in the broad sense refers to soft tissue such as skin, subcutaneous tissue, muscle, tendon sheath, ligament, fascia, joint capsule, synovial capsule, intervertebral disc, peripheral nerve, and blood vessel. Therefore, the tendon injury in the present invention is equivalent to the soft tissue injury in modern medicine, and includes nerve and blood vessel injuries.

Tendon injuries are classified according to the time of injury, and they can be classified into acute tendon injury and chronic tendon injury. Acute muscle injuries are injuries caused by sudden violence, generally referring to fresh injuries not more than 2 weeks after injury. The acute muscle injury is characterized by generally obvious history of trauma, local pain, swelling or ecchymosis, dysfunction and other symptoms. Chronic muscle injuries can be classified into primary muscle injuries and secondary muscle injuries. Primary tendon injury refers to chronic cumulative injury of some tendon of the body caused by small external force for a long time, which is better at multiple joints and load bearing parts. Secondary muscle injury refers to chronic soft tissue injury caused by improper or delayed treatment of acute muscle injury.

The understanding of the etiology of tendon injury, TCM has many discussions, such as "slamming", "lifting and exerting force", "five internal organs hurting", "damp feeling in the earth" and "feeling damaging the skin, muscle and tendons". It is mainly divided into two categories, internal and external, the external being invaded by external violence, chronic strain and six exogenous pathogenic factors; the internal factors are closely related to age, constitution, local anatomy and occupational worker species.

The main clinical manifestations of muscle and tendon injury are pain, swelling, and dysfunction. The complications mainly include: chronic swelling, muscular atrophy, osteoporosis, nerve entrapment syndrome, joint stiffness, ligament relaxation, ossification of joints, ligaments and muscles, free bodies of joints, traumatic arthritis and arthralgia syndrome. The complications which are common in later period of tendon injury can occur independently, but more complications are caused, and the rehabilitation and the quality of life of a patient in the future are seriously influenced. With the shift in modern work and lifestyle, there is a trend toward a marked increase and younger patients of this type.

For the diseases, oral nonsteroidal anti-inflammatory analgesic drugs or methods of closing pain spots and the like are mostly adopted for treating muscle injuries in western medicine, and the short-term analgesic effect is clear, but the long-term treatment effect is not ideal and the recurrence rate is high.

Disclosure of Invention

The invention aims to provide a traditional Chinese medicine preparation for external treatment of muscle and tendon injuries, which achieves the aim of clinical treatment by promoting blood circulation to remove blood stasis, expelling wind and removing cold, relaxing muscles and tendons and dredging collaterals.

The externally applied traditional Chinese medicine compound preparation for treating chronic muscle injuries is characterized in that the externally applied traditional Chinese medicine compound preparation is prepared into ointment by the following medicines according to the parts by weight;

5-50 parts of glabrous greenbrier rhizome, 5-50 parts of incised notopterygium rhizome, 5-50 parts of dahurian angelica root, 5-50 parts of szechuan lovage rhizome, 5-50 parts of Chinese angelica, 5-50 parts of suberect spatholobus stem, 5-50 parts of mulberry twig, 10-100 parts of turmeric, 10-100 parts of clematis root, 5-50 parts of large-leaved gentian, 5-50 parts of frankincense, 10-100 parts of salvia miltiorrhiza, 5-50 parts of szechwan chinaberry fruit, 5-50 parts of sappan wood, 5-50 parts of pepper, 5-50 parts of safflower, 10-100 parts of garden balsam stem and 1-20 parts of borneol.

The preparation method of the ointment comprises the steps of heating and melting the vaseline till the vaseline is boiled, adding the above medicines, frying, and cooling to form the ointment.

For external application, a proper amount of the Chinese medicinal composition is used as a massage medium.

The formula of the invention takes the salvia miltiorrhiza, the angelica and the frankincense as monarch drugs, and has the effects of promoting blood circulation to remove blood stasis, and relieving swelling and pain;

clematis root, gentiana macrophylla, glabrous greenbrier rhizome and garden balsam stem are used as a first group of ministerial drugs for dispelling wind and removing dampness, and dredging collaterals and relieving pain;

the notopterygium root and the angelica dahurica are used as a second group of ministerial drugs for dispelling wind and cold, and dredging collaterals and relieving pain;

rhizoma Ligustici Chuanxiong, caulis Spatholobi, Carthami flos, lignum sappan, Curcuma rhizome, and ramulus Mori can promote blood circulation and dredge channels;

the szechwan chinaberry fruit is used as an adjuvant drug for promoting the circulation of qi and relieving pain, and the pricklyash peel is used for dispelling cold and relieving pain to strengthen the effect of relieving pain of the recipe;

borneol is used as a guiding drug to relieve pain.

The prescription has the functions of removing blood stasis, expelling wind, dispelling cold, removing dampness and easing joint movement. Specifically, after the tendons of each part of the limb are injured, the blood vessels of the injured part are broken to cause stasis, or the blood vessels of the injured part are injected into joints of four limbs or left in muscle and skin striae of tendons and collaterals, so that swelling and pain are caused, and therefore, the medicine for promoting blood circulation to remove blood stasis, relieving swelling and pain is used for helping qi and blood circulation, regulating qi movement, smoothing tendons and collaterals, eliminating vasospasm, promoting blood circulation and accelerating the absorption of blood stasis, so that the purposes of regulating qi circulation to promote blood circulation, regulating qi movement, smoothing meridians, eliminating vasospasm, promoting blood circulation, accelerating the absorption of blood stasis are achieved, and the purposes of regulating qi circulation to promote blood circulation, relieving swelling and removing blood circulation and regulating blood circulation are achieved. After injury, no matter what kind of tendon is injured, the soft tissues such as local tendon, ligament, joint capsule and the like can be adhered due to the organization of bleeding and hematoma, so the medicine for dispelling wind and removing dampness, dispelling cold and easing joint movement can dredge qi and blood, strip and release adhered soft tissues, eliminate tendon sheath stenosis and relax joint movement.

The traditional Chinese medicine considers that the pain caused by the obstruction is not painful when the qi-blood-body fluid is obstructed, and the pain can be caused when the qi-blood-body fluid is obstructed. The six pathogenic factors have pain related to wind, cold and dampness. Cold stagnation, which causes pain due to obstruction, is the characteristic of pathogenic cold that causes the coagulation and blockage of qi, blood and body fluids of the body. When cold invades the body, it tends to block qi movement, congeal cold and blood stasis, block qi and blood and cause pain. Pain is the main characteristic of pathogenic cold, and is characterized by cold pain and severe pain which become warm and then decrease. Pathogenic wind has the characteristics of wandering disease and no fixed position. Pathogenic dampness is characterized by severe or persistent infection. An important material basis for pain is blood stasis. The obstruction of the circulation of qi and blood due to the accumulation of blood stasis can cause the obstruction of qi and blood in a certain part of the body, which can lead to pain, and has the characteristics of stabbing pain, immobility and tenderness. It indicates that various injuries can cause local swelling and pain, joint movement difficulty and limb dysfunction due to pathogenic wind-cold-dampness attacking the body and causing meridian obstruction, qi movement disorder and blood stasis obstruction.

The human body is a whole composed of viscera, meridians, skin and flesh, qi, blood and body fluids, which are physiologically coordinated and pathologically affected, so the superficial injuries of tendons and tendons are only the injuries of the skin and flesh, fascia and other soft tissues, but the occurrence and development of the injuries are closely related to the viscera, meridians, qi, blood, tendons and bones. Damage to the fascia of skin and flesh can cause dysfunction of viscera, meridians, qi and blood, tendons and bones, resulting in a series of symptoms. As described in "Zheng Jiang class Yao": "impairment of limbs to the outside will impair qi and blood in the interior, cause incoherence of nutrient and defense and disharmony of viscera". A local and global interaction mechanism is proposed. Therefore, the pathogenesis of tendon injury needs to consider both the pathological mechanism of local injury and its influence on the surrounding and the whole body, and also the influence of internal factors of the human body on local tissues.

The ointment of the invention is smeared on local skin, and the massage and muscle and tendon regulating technique is applied, thus being used as a medium for massage and having the function of lubrication; and the effects of promoting blood circulation, relieving pain, dispelling pathogenic wind, dispelling cold, removing dampness and dredging collaterals can be achieved by medicine penetration and manipulation of massage and tendon management, the treatment course can be shortened, and the pain of patients can be relieved. The traditional Chinese medicine method for treating the tendon injury has the advantages of safety, exact curative effect, economy and reliable long-term curative effect.

81 patients with confirmed diagnosis of chronic soft tissue injury in month 6 and 12 in 2020 were selected, the youngest age was 20 years, the youngest age was 69 years, 22 men and 59 women. The diagnosis is carried out according to the clinical guideline of chronic soft tissue injury in the clinical research guideline of new Chinese medicine issued by the Ministry of health of the people's republic of China in 2002. The paste of the invention is used for massage treatment, and the blood-activating pain-relieving paste is used as a medium, once every other day and 30 minutes each time. The curative effect is observed after 5 times of treatment. The treatment results are listed in table 1.

TABLE 1 [ examples (%) ]

Group of	Number of examples	Clinical cure	Show effect	Is effective	Invalidation	Total effective rate
							Treatment group	81	8	50	19	4	95%

The data in table 1 above were obtained as quantitative scores of symptoms and signs before and after observation treatment. The scoring standard is formulated according to the standard of diagnosis and treatment effect of Chinese medicine symptoms and the guiding principle of clinical research of new Chinese medicines, and comprises 3 parts:

(1) swelling: 0 point, no swelling; 1 point, minor edema of the local skin; 2 points, the local skin is red and swollen, and the swelling is obvious; for 3 minutes, the affected part had swelling, red skin and higher skin temperature.

(2) Degree of activity limitation: 0 min, no limitation; 1 minute, pain appeared during activity, and the disease was still tolerable; 2 minutes, the pain is serious during the activity, the patient is slightly accompanied with the discomfort of walking, sitting and lying, but the daily life is not influenced; 3 minutes, the pain is severe during the activity, which is difficult to endure, and the normal life is affected by the discomfort of walking, sitting and lying.

(3) Pain at the affected part: 0 point, no pain; 1, mild pain, tolerance; 2 points, moderate pain, tolerance, but slightly affect normal life; in 3 points, the pain is aggravated and cannot be tolerated, which greatly affects the normal living.

The integral reduction rate was calculated, integral reduction rate = (pre-treatment integral-post-treatment integral)/pre-treatment integral × 100%.

Then, the therapeutic effect is judged according to the integral reduction rate

The clinical cure is as follows: swelling, restricted activity, pain relief, integral reduction = 100%;

the effect is shown: swelling, limited activity and pain relief, and the integral reduction rate is more than or equal to 66 percent;

the method has the following advantages: swelling, limited activity and pain relief, and the integral reduction rate is more than or equal to 33 percent; but is less than 66 percent

And (4) invalidation: swelling, limited mobility, no improvement in joint pain, and an integral reduction of < 33%.

As can be seen from the above table 1, the ointment of the present invention has obvious curative effect on tendon injury by matching with massage manipulation, high safety degree and clinical application value.

Detailed Description

Example 1: patient Wangzhi, woman, 20 years old; first diagnosis is given in 2020, 7 months and 1 day; chief complaints about neck and shoulder pain for 1 month;

the current medical history: the patient is frequently on the table in about 1 month, and has the symptoms of neck and shoulder pain, difficult upper limb movement, no hand numbness and local stiffness. Poor sleep, easy accommodation and easy adjustment. The tongue is pale red and the coating is white; a wiry pulse;

and (3) diagnosis: tendon injury (neck-shoulder syndrome);

dialectical analysis: syndrome of qi stagnation and blood stasis;

treatment: local massage is performed and a proper amount of the ointment of the invention is taken as a medium, 30 minutes each time and once every other day. 5 times of treatment and observation of curative effect;

after 10 days, the symptoms disappeared without discomfort. Advising normal-time proper neck and shoulder function exercise; preventing long-time work at desk.

The ointment is prepared by frying 15g of glabrous greenbrier rhizome, 10g of incised notopterygium rhizome, 10g of dahurian angelica root, 9g of Szechuan lovage rhizome, 15g of Chinese angelica, 15g of suberect spatholobus stem, 10g of mulberry twig, 15g of turmeric, 15g of clematis root, 12g of large-leaved gentian, 10g of frankincense, 15g of red-rooted salvia root, 10g of szechwan chinaberry fruit, 10g of sappan wood, 6g of Chinese prickly ash, 10g of safflower, 15g of garden balsam stem and 3g of borneol in 2000 g of molten vaseline and cooling.

Example 2: the patient is Lijiang, male, 45 years old, and has a first diagnosis of 2020, 8 and 5 days;

the main complaints are: left ankle pain for more than 1 month;

the current medical history: the left ankle joint is sprained before 1 month when the patient carelessly falls down during exercise. Local red swelling and pain, and symptom is relieved after the movement limitation is treated. The existing part is slightly swollen, not red, bluish purple, arthralgia and incapable of bearing weight;

a pale and bluish tongue with white coating and a dry and astringent pulse. Year 2020, month 7, day 5, check X: the left ankle joint is not fractured;

and (3) diagnosis: muscle injuries (left ankle sprain);

dialectical analysis: syndrome of qi stagnation and blood stasis;

treatment: local tuina is performed with a proper amount of blood-activating pain-relieving ointment as the medium, once every other day for 30 minutes each time. 5 times of treatment and observation of curative effect;

after 10 days, the part is not swollen, the skin color returns to normal, the pain is slight, and the device can move freely.

The ointment is prepared by frying 15g of glabrous greenbrier rhizome, 10g of incised notopterygium rhizome, 10g of dahurian angelica root, 9g of Szechuan lovage rhizome, 15g of Chinese angelica, 15g of suberect spatholobus stem, 10g of mulberry twig, 15g of turmeric, 12g of clematis root, 12g of large-leaved gentian, 10g of frankincense, 15g of danshen root, 10g of szechwan Chinaberry fruit, 10g of sappan wood, 6g of Chinese prickly ash, 10g of safflower, 15g of garden balsam stem and 3g of borneol in 2000 g of molten vaseline and cooling.

Example 3: senior, female, 65 years old, first diagnosis 2020, 10 months and 15 days;

the main complaints are: the lumbago attacks repeatedly for more than 10 years and aggravates for a week;

the current medical history: the lumbar pain appears as stabbing pain when the waist is accidentally strained 10 years ago, and the pain is relieved after treatment and often occurs later due to fatigue and weather change. The lumbago is aggravated by cold, the activity is not good, the tongue is fat, the texture is dark, the fur is white and greasy, and the pulse is wiry and slow due to the change of weather before one week;

and (3) diagnosis: muscle injuries (old lumbar sprain);

dialectical analysis: syndrome of cold-dampness obstructing collaterals;

treatment: local tuina is performed with a proper amount of blood-activating pain-relieving ointment as the medium, once every other day for 30 minutes each time. 5 times of treatment and observation of curative effect;

after 10 days, the lumbago is relieved and the patient can move freely.

The ointment is prepared by frying 15g of glabrous greenbrier rhizome, 15g of incised notopterygium rhizome, 15g of dahurian angelica root, 10g of Szechuan lovage rhizome, 18g of Chinese angelica, 15g of suberect spatholobus stem, 10g of mulberry twig, 15g of turmeric, 15g of clematis root, 12g of large-leaved gentian, 10g of frankincense, 15g of red-rooted salvia root, 10g of szechwan chinaberry fruit, 10g of sappan wood, 6g of Chinese prickly ash, 10g of safflower, 20g of garden balsam stem and 3g of borneol in 2000 g of molten vaseline and cooling.