Yin-nourishing dryness-moistening spray

Abstract

A preparation method of the spray comprises the following steps: taking 3g of agastache rugosus, 6g of platycodon grandiflorum, 5g of liquorice, 5g of folium eriobotryae, 9g of radices trichosanthis, 9g of asparagus cochinchinensis and 9g of pulp of smoked plum, adding each dose into 250ml of water, decocting, decocting into 150ml of precipitate mixture, filtering, and filling into a 15ml traditional Chinese medicine spray bottle. The yin-nourishing and dryness-moistening spray disclosed by the invention is fast in oral local administration absorption, high in bioavailability and convenient to use in a spraying manner, the first-pass effect of gastrointestinal tracts and livers is avoided, and the medicine utilization rate is improved; the traditional Chinese medicine composition can be used for relieving postoperative thirst and ozostomia symptoms of colorectal cancer patients, and the effect is better than that of conventional postoperative oral care; meanwhile, the nursing time can be shortened, the patient comfort is improved, the halitosis of the patient is improved, and the method is worthy of clinical reference and application.

Description

Technical Field

[0001] The invention relates to the field of medical technology, and in particular to a yin-nourishing and dryness-removing spray. Background Art

[0002] Colorectal cancer patients are very prone to thirst due to factors such as routine postoperative fasting, surgical methods, anesthetic drugs, and intraoperative endotracheal intubation, and the feeling of thirst is most intense within 6 hours. Relevant surveys have shown that the incidence of mild thirst in patients within 2 hours after surgery is 25%, and the incidence of moderate to severe thirst is 75%. A study analyzed the incidence and severity of thirst in 220 ICU patients who underwent endotracheal intubation after surgery. The results showed that the incidence of thirst was 80.9% and the incidence of severe thirst was 52.3%. It can be seen that thirst is one of the most intense symptoms felt by perioperative patients and the most common clinical symptom.

[0003] As a negative stressor of the body, thirst not only increases the patient's postoperative stress response, increases oxygen consumption and metabolic load after surgery, but also causes negative emotions such as helplessness and fear in patients. At the same time, persistent thirst can cause abnormal vital signs in patients, such as arrhythmia and increased blood pressure; and increase the incidence of accidental risks such as postoperative catheter detachment, wound bleeding, and falling out of bed.

[0004] However, traditional thirst care methods all have limitations to varying degrees. For example, a cotton swab dipped in water can only moisturize the lips, and the evaporation of moisture from the lips may even accelerate the drying of the lips; although oral care can achieve the purpose of cleaning the mouth, the effect time is limited and it is difficult to continuously relieve thirst symptoms.

[0005] Therefore, it is necessary to propose a yin nourishing and dryness moistening spray to solve the above problems. Summary of the invention

[0006] Aiming at the problem that colorectal cancer patients suffer from thirst and bad breath after surgery and that traditional thirst nursing methods are ineffective, the present invention provides a yin-nourishing and dryness-removing spray.

[0007] The raw materials of this yin-nourishing and dryness-removing spray include: Patchouli, Platycodon, Licorice, loquat leaves, Radix Trichosanthis, Asparagus cochinchinensis, and black plum pulp.

[0008] Furthermore, the raw materials of the Yin-nourishing and dryness-replenishing spray are calculated by weight and include: 3 parts of Patchouli, 6 parts of Platycodon, 5 parts of Licorice, 5 parts of Loquat Leaves, 9 parts of Radix Trichosanthis, 9 parts of Asparagus cochinchinensis, and 9 parts of Black Plum Meat.

[0009] In a preferred embodiment of the present invention, the preparation method of the nourishing yin and moistening spray is: take 3g of Patchouli, 6g of Platycodon, 5g of Licorice, 5g of Loquat Leaf, 9g of Radix Trichosanthis, 9g of Asparagus cochinchinensis, and 9g of Plum Meat for a total of 6 doses, each dose is put into 250 ml of water and boiled, and then boiled into 150 ml of precipitation mixture, filtered separately and put into 15 ml Chinese medicine spray bottle.

[0010] The implementation of the embodiments of the present invention has the following beneficial effects: the Yin-nourishing and moisturizing spray of the present invention is administered locally in the oral cavity in a spraying manner, has fast absorption, high bioavailability, is easy to use, avoids the first-pass effect of the gastrointestinal tract and liver, and improves the drug utilization rate; and can be used to relieve the thirst and bad breath symptoms of colorectal cancer patients after surgery, and the effect is better than conventional oral care after surgery; at the same time, it can shorten the nursing time, improve the patient's comfort, and improve the patient's bad breath, which is worthy of clinical reference and application. BRIEF DESCRIPTION OF THE DRAWINGS

[0011] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative work.

[0012] Figure 1 A scale to assess facial expressions based on the patient's oral sensations. DETAILED DESCRIPTION

[0013] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0014] The yin nourishing and moistening spray comprises: Patchouli, Platycodon grandiflorum, Licorice, loquat leaf, Radix Trichosanthis, Radix Asparagus, and Plum pulp. Specifically, the raw materials of the yin nourishing and moistening spray are calculated by weight: 3 parts of Patchouli, 6 parts of Platycodon grandiflorum, 5 parts of Licorice, 5 parts of loquat leaf, 9 parts of Radix Trichosanthis, 9 parts of Asparagus, and 9 parts of Plum pulp.

[0015] The preparation method of the Yin nourishing and dryness moistening spray is as follows:

[0016] Take 3g of Patchouli, 6g of Platycodon, 5g of Licorice, 5g of Loquat Leaf, 9g of Radix Trichosanthis, 9g of Asparagus cochinchinensis, and 9g of Plum Pulp for one dose, for a total of 6 doses. Put 250ml of water into each dose and boil it until 150ml of precipitated mixture is obtained. After filtering, put it into a 15ml Chinese medicine spray bottle.

[0017] Experimental research:

[0018] 1. Object selection:

[0019] A total of 90 patients who underwent colorectal cancer surgery at Chongqing Traditional Chinese Medicine Hospital from March 2023 to March 2024 were selected as the research subjects. Inclusion criteria: ① Patients with stage I to III colorectal tumors and surgical indications who were scheduled for elective tumor resection; ② Surgery under general anesthesia and endotracheal intubation; ③ Aged 18 to 80 years old; ④ Voluntary participation in the experiment; ⑤ Clear consciousness and able to communicate normally before surgery.

[0020] Exclusion criteria: ① Communication barriers prevent the patient from cooperating to complete the experiment; ② Patients with poor multi-organ function and unable to cooperate to complete the whole process; ③ Patients with severe cardiovascular diseases; ④ History of salivary gland dysfunction before surgery; ⑤ History of allergy to the drugs in the Yangyin Runzao spray; ⑥ Patients with oral and pharyngeal diseases, such as surgery, ulcers or inflammation.

[0021] The patients were divided into control group, nourishing yin and moistening dryness group, and nourishing yin and moistening dryness combined with acupoint massage group according to the random number table method, 30 cases in each group. There was no statistically significant difference in gender, age, operation time, fasting time, intraoperative blood loss, intraoperative urine volume, and intraoperative blood transfusion volume among the three groups (P>0.05), and they were not comparable.

[0022] 2. Methods:

[0023] 1. Intervention Plan

[0024] All patients in the three groups fasted for 12 hours before surgery and were prohibited from drinking water for 10 hours before surgery. The anesthesia method was intravenous inhalation combined general anesthesia, and the airway management plan was endotracheal intubation guided by a visual laryngoscope. The ventilation mode adopted a volume control mode, with a tidal volume of 8-10mL / kg, a ventilation frequency of 12-20 times / minute, and an expiratory CO2 partial pressure of 30-35mmHg (1mm Hg=0.133kPa).

[0025] Control group:

[0026] The patient takes a semi-recumbent position, with the head naturally tilted to one side and given routine oral care. Oral care is carried out in the order from proximal to contralateral and from lateral to medial. The teeth, gums, hard palate, and cheeks are brushed with an oral care bag. Negative pressure suction is used during the operation. After replacing the dental pad, the adhesive tape is fixed according to the original scale to avoid unplanned extubation during the operation. Oral care is carried out once every 6 hours. 0-6 hours after the extubation of the trachea, when the patient indicates thirst or dry mouth, the nursing staff or the patient's family members use a spoon dipped in water to smear the patient's lips. Observe the changes in the patient's vital signs after the intervention.

[0027] Yin nourishing and dryness moistening group:

[0028] On the basis of routine vital signs monitoring, add Yangyin Runzao spray. According to the formula of Yangyin Runzao, brew the oral spray. Instructions for use: squeeze the nozzle 3-4 times before operation to exhaust the air in the bottle. Within 6 hours after the endotracheal tube is removed, apply Yangyin Runzao oral spray to the patient twice an hour, with an interval of 30 minutes each time, for a total of 12 times. The spray action site selects the left and right parotid glands and sublingual glands. The spray volume is about 0.1ml per press, and the intervention volume is about 0.3ml. When using the spray, tilt the patient's head to one side to avoid reflex choking and aspiration. After spraying, the patient's mouth secretes saliva, and the patient swallows the liquid medicine to quench thirst. Each intervention process is controlled within 1 minute, and the patient's vital signs are observed after the intervention.

[0029] Yin nourishing and moistening spray combined with acupoint massage group:

[0030] On the basis of the intervention of the Yin-nourishing and moistening spray group, the common acupoints were selected according to the meridians according to the reference of Acupuncture and Moxibustion and the literature on the selection of acupoints for thirst, and the Shuiquan acupoint and Yuji acupoint of the patient were selected for massage. Method of pressing Shuiquan acupoint: The operator stands at the end of the bed, and when pressing the right foot, the left hand lifts the right ankle, and the 5 fingers of the right hand clamp the Shuiquan acupoint. The fingertips press the acupoints from light to heavy, and the pressing strength varies according to the patient's gender, age, and sensitivity, so that the patient feels local or lower limb soreness, numbness, slight pain, fever, etc. Each massage lasts about 5 minutes. Massage another acupoint in the same way. Observe the patient's condition at any time during the massage. Method of pressing Yuji acupoint: ① Press Yuji acupoint: Press the Yuji acupoints of both hands with your thumb or fingertips to produce slight pain and soreness for about 5 minutes. ② Press and rub the Yuji acupoint: After pressing the Yuji acupoint with the thumb and fingertips, massage it repeatedly in a clockwise and counterclockwise direction, preferably to produce local soreness and slight pain, for about 5 minutes. Massage another acupoint in the same way. Each intervention was controlled within 1 minute, and the patient's vital signs were observed after the intervention.

[0031] 2. Evaluation Indicators

[0032] Demographic data questionnaire: The research team designed the questionnaire after reviewing the data, including gender, age, hospitalization number, surgical method, fasting time, surgical time, intraoperative urine volume, intraoperative infusion volume, and intraoperative blood loss, which were recorded by reviewing the patient's medical records.

[0033] Numerical score sheet: Nurses used the NRS numerical score method to assess the patient's thirst level before and 6 hours after the intervention. This score is a simple, easy-to-understand, objective, practical and repeatable symptom evaluation method developed by the National Institutes of Health. Currently, this scale is commonly used to assess patients' subjective symptoms, such as pain, dyspnea and thirst. The scale assessment score represents the degree of thirst, with a total of 11 points from 0 to 10. Patients choose a number based on their thirst level, where 0 represents "no thirst", 1-3 represents mild thirst, 4-7 represents moderate thirst, and 8-10 represents severe thirst. Specific score data are collected by trained assessors through questions and displaying thirst score cards. Patients who can write normally tick the corresponding number with a pen, and patients who cannot hold a pen nod when the assessor points out the number corresponding to their thirst level.

[0034] Oral comfort score: Before and 6 hours after the intervention, the nurses evaluated the oral comfort based on whether the thirst sensation affected the sleep quality, physical activity, mood, etc. Comfortable: Feeling comfortable and refreshing, acceptable; relatively comfortable: No odor in the mouth, barely acceptable; Uncomfortable: Bitter mouth, bad breath, unacceptable. The scale uses a 0-10 point system for scoring, 10 points means very comfortable, 0 points means very uncomfortable, and the higher the score, the higher the oral comfort.

[0035] Moisture of oral mucosa of lips and tongue: Nurses used the oral mucosa moisture scale to evaluate the moisture of the patient's mucosa, gums, tongue, lips, and palate before and 6 hours after the intervention. The scale mainly evaluates the moisture of the patient's mucosa, gums, tongue, lips, and palate. A flashlight was used to illuminate the inside of the patient's mouth, and the score was graded according to the lip and tongue oral mucosa moisture scoring standard. 1 point means that both the lips and the mouth are moist; 2 points means dry lips and moist mouth; 3 points means dry lips and mouth; 4 points means peeling and cracking of the lips and dry and white mouth.

[0036] Bad breath scoring: Nurses scored the occurrence of bad breath before and 6 hours after the intervention. The evaluation criteria were the test values ​​of the breath tester: 1 for no bad breath, 2 for weak bad breath, 3 for obvious bad breath, 4 for strong bad breath, 5 for stronger bad breath, and 6 for very strong bad breath. The test values ​​of 1 and 2 were defined as comfortable oral cavity without odor, and test values ​​of 3 and above were considered to be the occurrence of bad breath.

[0037] Dry mouth score: Dry mouth score expression is a scale developed by KamashitaY to evaluate facial expressions based on the patient's oral sensation, see Figure 1 Before and 6 hours after the intervention, the patients pointed out the corresponding facial expressions according to their oral sensations to express their subjective feelings. 1 point means no dry mouth, 7 points means very dry mouth, and the higher the score, the more obvious the dry mouth of the patient.

[0038] 3. Statistical Analysis

[0039] SPSS26.0 was used to analyze the data. Count data were expressed as frequency and composition ratio; measurement data were expressed as mean ± standard deviation. Intra-group comparison: if the data conformed to normal distribution, paired sample t test was used; if it did not conform to normal distribution, non-parametric test was used. Inter-group comparison: count data were compared with chi-square test or Fisher's exact probability method; if the measurement data conformed to normal distribution, variance analysis was used; if it did not conform to normal distribution, non-parametric Kruskal-Wallish test was used. P < 0.05 was considered statistically significant.

[0040] 3. Results:

[0041] 1. General Information

[0042] A total of 90 patients who underwent colorectal cancer surgery in our hospital from March 2023 to March 2024 were selected and randomly divided into a Yin-nourishing and moistening spray group, a Yin-nourishing and moistening spray combined with acupoint massage group, and a blank control group, with 30 cases in each group. There was no statistically significant difference in gender, age, fasting time, operation time, intraoperative blood loss, intraoperative urine volume, and intraoperative infusion volume among the three groups (P>0.05). The specific results are shown in Table 1:

[0043] Table 1 Comparison of general data among the Chinese medicine spray group, the Chinese medicine spray combined with acupoint massage group and the blank control group

[0044]

[0045] 2. Intervention Results

[0046] Comparison of thirst levels among the three groups of patients before and after intervention is shown in Table 2:

[0047] Table 2 Comparison of thirst levels in the Chinese medicine spray group, Chinese medicine spray combined with acupoint massage group, and blank control group

[0048]

[0049] Comparison of oral comfort among the three groups of patients before and after intervention is shown in Table 3:

[0050] Table 3 Comparison of oral comfort in the Chinese medicine spray group, Chinese medicine spray combined with acupoint massage group and blank control group

[0051]

[0052] Comparison of the moisturizing degree of the lip and tongue mucosa of the three groups of patients before and after intervention is shown in Table 4:

[0053] Table 4 Comparison of the moisturizing degree of the lip and tongue mucosa in the Chinese medicine spray group, the Chinese medicine spray combined with acupoint massage group and the blank control group

[0054]

[0055] Comparison of dry mouth degree among the three groups of patients before and after intervention is shown in Table 5:

[0056] Table 5 Comparison of dry mouth degree among the Chinese medicine spray group, the Chinese medicine spray combined with acupoint massage group and the blank control group

[0057]

[0058] Comparison of halitosis degree among the three groups of patients before and after intervention is shown in Table 6:

[0059] Table 6 Comparison of halitosis in the Chinese medicine spray group, Chinese medicine spray combined with acupoint massage group and blank control group

[0060]

[0061] The results of the present invention showed that the thirst scores of the three groups of patients were high before the intervention, with the thirst scores of 5.40±1.49 in the nourishing yin and moistening dryness group, 5.06±1.04 in the nourishing yin and moistening dryness combined with acupoint massage group, and 5.13±1.43 in the control group, all of which were moderately thirsty; 65% of the patients had dry lips and mouth before the intervention, as shown in Table 2. For colorectal cancer patients, if the thirst symptoms are ignored and no intervention measures are taken, persistent thirst will distract their attention, induce negative emotions, and cause electrolyte imbalance. In more serious cases, it may even lead to postoperative delirium, delayed recovery, and increase later medical expenses.

[0062] There were significant differences in thirst scores, oral comfort scores, lip and tongue mucosal moisturizing scores, and dry mouth and halitosis scores before and after intervention in the Yangyin Runzao spray combined with acupoint massage group (P < 0.05). The Yangyin Runzao spray combined with acupoint massage group was more effective in relieving postoperative thirst in patients with colorectal cancer than the Yangyin Runzao group and the blank control group (P < 0.05). This study suggests that regular use of Yangyin Runzao spray after colorectal cancer surgery can effectively relieve thirst discomfort, promote oral health, and relieve postoperative thirst symptoms. In addition, Chinese medicine believes that thirst is generally caused by deficiency of body fluid or obstruction of body fluid distribution. Patients with colorectal cancer are forbidden to eat or drink during the perioperative period, which leads to the lack of body fluid biochemical source; traumatic bleeding during surgery leads to deficiency of qi, blood and body fluid, causing heart fire inflammation or excessive heat in the lungs and stomach, and damage to body fluid due to excessive heat; after surgery, the spleen and stomach qi are not smooth, the ascending and descending of qi are disordered, body fluid is stagnant in the middle burner, body fluid distribution is abnormal, body fluid is insufficient, and heat in the lungs and stomach is damaged, resulting in symptoms such as thirst, bitter taste in the mouth, and bad breath; Chinese medicine treatment focuses on nourishing yin and promoting body fluid, tonifying the middle and replenishing qi, neutralizing and replenishing qi, and regulating the gastrointestinal tract.

[0063] In the formula for nourishing yin and moistening dryness used in this study, black plum is warm in nature, sweet and sour in taste, rich in citric acid and malic acid, etc., which can produce fluid and quench thirst, eliminate yin and relieve restlessness; licorice is sweet in taste, can resolve phlegm, moisten the lungs, clear away heat and detoxify; loquat leaves can clear the lungs and stomach, descend qi and resolve phlegm, and treat restlessness, heat and thirst; Tiandong nourishes yin and clears heat, moistens the lungs and nourishes the kidneys; Radix Trichosanthis can clear heat and resolve fire, produce fluid and quench thirst; Platycodon can resolve phlegm, relieve sore throat and reduce swelling. The combination of multiple drugs has the effect of producing fluid and quenching thirst.

[0064] In addition, the water transfer of Shuiquan acupoint and the regulating qi and relieving throat of Yuji acupoint can greatly improve the symptoms of dry mouth and sore throat. At the same time, the saliva secretion of patients after surgery is reduced, and the spray has a large spraying range, which can quickly moisten the mouth. The sour taste of the black plum in the prescription can stimulate the secretion of salivary glands and increase saliva secretion; water in the mouth can only temporarily moisturize the mouth, and drinking water directly can easily cause patients to choke and aspirate, and coughing will pull the postoperative wound, affecting wound healing, so it is not suitable for clinical use.

[0065] According to traditional Chinese medicine, bad breath is mainly caused by heat accumulation in the internal organs. During the period of fasting and abstinence after general anesthesia, patients suffer from qi deficiency, loss of qi, blood and body fluids, poor internal qi circulation, dysfunction of internal organs, and fumigate the spleen and stomach. Excessive heat causes meat rot and foul air in the mouth. After general anesthesia for colorectal cancer patients, due to mechanical stimulation of endotracheal intubation, fasting and abstinence, the use of anesthetic sedatives and anticholinergic drugs, and the coma of patients during the perioperative period, the swallowing reflex is weakened and oral secretions are reduced, leading to a large number of bacteria in the oral cavity multiplying, forming colonies and dental plaque, and producing volatile sulfides such as indole, sulfhydryl and ammonia, which aggravate the breath. Patients often experience bad breath, sore throat, inflammation of the oral mucosa and even upper respiratory tract infection after surgery.

[0066] In the prescription for nourishing yin and moistening dryness, black plum is used heavily. Black plum has a sour taste and is mild. It can produce body fluid and quench thirst, moisten the lungs and astringe the intestines. Licorice has a mild and sweet nature. It can nourish the middle and replenish qi, nourish yin and produce body fluid. The combination of the two is a common prescription for the "acid and sweet Yin" method. At the same time, modern medical research shows that black plum is extremely rich in acidic substances such as citric acid and malic acid. Acidic and pungent substances can stimulate the salivary glands to secrete saliva. Saliva contains salivary amylase, lysozyme, immunoglobulins (IgA, IgG, IgM), blood type substances (A, B, H), free amino acids, etc., which have bactericidal and antibacterial effects and can prevent oral infections. This has been confirmed [8]. In addition, the main components of licorice, such as glycyrrhizic acid, glycyrrhizin, isoliquiritigenin and licorice chalcone, have multiple pharmacological activities, including anti-inflammatory, antibacterial, antioxidant, and immunomodulatory. They can play an anti-inflammatory role by inhibiting cyclooxygenase. This study showed that there was a statistically significant difference in the postoperative halitosis scores between the Yangyin Runzao spray group and the blank control group (P<0.05), indicating that the Yangyin Runzao spray can effectively improve postoperative halitosis in patients with colorectal cancer.

[0067] In summary, the present invention adopts a Yin nourishing and moistening spray for oral spray intervention, and selects the parotid gland and sublingual gland on the left and right sides of the oral mucosa as the spraying site. After the drug contacts the three salivary glands of the oral mucosa, it directly stimulates the salivary glands to secrete a large amount of saliva, thereby increasing the flow rate of saliva. This oral topical administration has fast absorption, high bioavailability, and is easy to use, avoiding the first-pass effect of the gastrointestinal tract and liver, and improving the utilization rate of the drug.

[0068] This Yin-nourishing and moistening spray combined with acupoint massage can better relieve the thirst and bad breath symptoms of colorectal cancer patients after surgery, and the effect is better than conventional oral care after surgery. At the same time, it can shorten the nursing time, improve the patient's comfort, and improve the patient's bad breath, which is worthy of clinical reference and application.

[0069] The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention. Any modifications, equivalent substitutions, improvements, etc. made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. A yin nourishing and dryness moistening spray, characterized in that: Its raw materials include: Patchouli, Platycodon, Licorice, Loquat Leaves, Radix Trichosanthis, Asparagus cochinchinensis, and Black Plum Meat.

2. The yin nourishing and dryness moistening spray according to claim 1, characterized in that: The raw materials of the yin nourishing and dryness moistening spray are calculated by weight and include: 3 parts of Patchouli, 6 parts of Platycodon, 5 parts of Licorice, 5 parts of Loquat Leaves, 9 parts of Radix Trichosanthis, 9 parts of Asparagus cochinchinensis, and 9 parts of Black Plum Meat.

3. The yin nourishing and dryness moistening spray according to claim 1, characterized in that: The preparation method of the yin nourishing and dryness moistening spray is: Take 3g of Patchouli, 6g of Platycodon, 5g of Licorice, 5g of Loquat Leaf, 9g of Radix Trichosanthis, 9g of Asparagus cochinchinensis, and 9g of Plum Pulse for one dose, for a total of 6 doses. Put 250ml of water into each dose and boil them into 150ml of precipitated mixture. After filtering, put them into a 15ml Chinese medicine spray bottle.

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