Method of treating diabetic microangiopathy by mineral water "obukhovskaya"

FIELD: medicine.

SUBSTANCE: patients with diabetic microangiopathy are subjected to an examination which includes: general blood test, blood sugar, general urine analysis, ultrasonic examination of kidneys with the determination of indices of the kidney blood flow (Vmax, Vmin, S/D, PI, RI), basic ophthalmological parameters (vision acuity, examination of eye fundus vessels). Then, the intake of mildly-mineralised hydrocarbonate-chloride-sodium mineral water "Obyhovskaya" directly from the spring under sanatorium conditions is administered. Water is taken in heated to a temperature of 37°C in a dose of 3 ml per 1 kg of body weight 3 times per day 40 minutes before meal, the course constitutes 18 days.

EFFECT: application of the invention makes it possible to normalise the general blood test, blood sugar, general urine analysis, improve the condition of the visual analyser and indices of the kidney blood flow.

1 ex

 

The invention relates to medicine, namely to physiotherapy (balneology), ophthalmology, urology, and is intended for the treatment of diabetic microangiopathy.

A method of treating various diseases drinking mineral water in patients (Patent for invention of the Russian Federation No. 2076713) and can be used in the treatment of gastritis with low, high secretory function, chronic colitis, cholecystitis, diseases of the operated stomach, gastric ulcer and 12 duodenal ulcer, pancreatitis, chronic hepatitis, pyelonephritis, chronic adnexitis, prostatitis without exacerbation, as well as diseases of the Central nervous system (CNS), hypertension, coronary heart disease (CHD), pulmonary tuberculosis without exacerbation, metabolic disease (diabetes, oxaluria, obesity). Patients is a natural mineral bischofite, diluted in distilled water in various proportions(1:38 600; 1:38 - 58; 1:59 - 230; 1:231 - 460; 1:461 - 600). The disadvantage of this method is the need of laboratory manipulations with the applicable agent (cultures of bischofite in various concentrations), the presence of data on the effects of the proposed method of treatment (diuretic, choleretic and decontaminant) in the absence of information about the pathological effect on the underlying disease.

A method of preventing the progression of impaired glucose tolerance with mineral water Essentuki type (Patent for invention of the Russian Federation No. 2162697), which consists in the fact that the mineral water Essentuki # 4 take in a dose of 200 ml for 15-20 minutes before meals for 30 days. The method allows to normalize the glycemic curve, increase the early phase of insulin secretion, improve lipid metabolism. This increases the efficiency of prevention of the disease. Despite the effectiveness of the method is highly specialized preventive orientation and does not characterize the impact on vascular changes in patients with diabetes mellitus.

The known method of prevention and treatment of mineral water (Patent for invention of the Russian Federation No. 2235547), namely that as a treatment-drinking mineral water use of natural silt solution, isolated from freshwater treatment sapropel relating its characteristics to the hydrocarbonate sodium-magnesium-calcium low-mineralized water solutions. Solution obtained in the dehydration of therapeutic and enrichment of sapropel with humidity 97-93% to a moisture content of from 80 to 60% by way of gravitational hydraulic impact, with a salinity of natural silt solution is not less than 0.33 g/DM3. As the mineral and table water R�gas consumption dose recommended 100-200 ml 3-4 times a day when the course 21-28 days. As table water or mineral refreshing drink single dose recommended consumption up to 250 ml or 1.5 l up to 30 days. The disadvantage of this method is the complicated process of preparation of the dosage form, the lack of data on specific diseases and the lack of data on complex balneotherapy.

Closest to the claimed method is a method of correction of metabolic disorders in patients with diabetes mellitus (Patent for invention of the Russian Federation No. 2157692). A method for the treatment of metabolic disorders in patients with diabetes by Spa treatment, including the acceptance of ascorutin at a dose of 100 mg three times a day along with taking mineral water Essentuki # 4 of 200 ml for 20-30 minutes before meals on the background diet (table 9, 9a), glucose-lowering medications (insulin and/or sulfonylurea) according to the testimony, carbonate-mineral baths in a course of 10 treatments within 30 days. The method allows to improve carbohydrate, protein, water-salt metabolism, indicators of lipid peroxidation. Despite the good results of the known method of treatment of patients with diabetes mellitus in this method, there are no data on the dynamics of ophthalmic parameters, while the organ of vision is one of the most affected anatomical structures of the body the effects of metabolic disorders p�and diabetes. Not provided reliable data about the effect of the proposed treatment scheme, not common balneological complex of factors.

Relevant is the need to further improve methods of combined treatment of diabetic microangiopathy.

The technical result of the invention consists in the improvement of the excretory system and the organ of vision in patients suffering from microangiopathy in diabetes mellitus, contributing to the improvement of renal function and ocular parameters (visual acuity, visual field, state of the vessels of the retina).

Claimed method of correction of metabolic disorders in patients with diabetes mellitus by a combination of Spa treatments, including reception acidulous hydrocarbonate chloride-sodium mineral water, characterized in that patients with diabetic microangiopathy running tests: General blood test, blood sugar, urinalysis, conducting a study on the indicators of renal blood flow: Vmax, Vmin, S/D, PI, RI, major ophthalmic parameters: visual acuity, field of vision, the state of the vessels of the fundus, and assign ingestion of low-mineralized hydrocarbonate-chloride-sodium mineral water "Obukhov", water accept heated to a temperature of�s 37°C at the rate of 3 ml per 1 kg of body weight 3 times a day 40 minutes before meals, the course of 18 days, on the 8th and the 14th day of stay at the resort conduct control tests.

Significant differences of the claimed method are:

1) the Use of hydrocarbonate-chloride-sodium mineral water "Obukhovskaya" in the treatment of diabetic microangiopathy, providing the normalization of urinalysis tests and analyses on Nichiporenko, blood sugar.

2) Improvement of the visual analyzer: visual acuity, performance, improvement of visual fields in patients with diabetic angiopathy of the retina after treatment hydrocarbonate-chloride-sodium mineral water "Obukhovskaya" sanatorium "Obukhovskaya".

3) Improvement of renal hemodynamics: increased maximal systolic and diastolic blood flow velocity (Vmax, Vmin), and the decrease of the resistance index (RI) at the level of peripheral vessels.

The advantage of the inventive method lies in the use of mineral water "Obukhovskaya" with the following characteristics:

Organoleptic properties: odorless, without color. Transparent.

The basic chemical composition of mineral water "Obukhovskaya" describes the specified formula:

CI78 HCO321SO41

The org. to 0,010 M1,97(Na+K) more than 95 Ca 3 Mg 2

pH=7,69

Study of the quality and composition of mineral water "Obukhovskaya" for many�them produced in years, Yekaterinburg medical research center for prophylaxis and health protection of industrial workers".

Basically ionic composition of the water is dominated by bicarbonate and chloride ions and the cations of sodium, which is typical for water Obukhov field and allows us to classify this water as hydrocarbonate-chloride-sodium. The magnitude of salinity varies from to 1,96 1,92 g/DM3that allows to consider them as low-mineralized.

Along with the basic chemical composition of the medicinal properties of mineral water "Obukhovskaya" associated with present in biologically active compounds, mainly represented by organic substances. In addition, due to the dominance in the composition of organic substances: alcohol resins, humic substances, the content of which varies from 2 to 7 mg/DM3this type of water it is possible to attribute to the mineral water with high content of organic matter humus type.

In addition to humic substances, mineral water detected the presence of neutral bitumen (oil, neutral resins, petroleum hydrocarbons) in the amount of 1.6-3.5 mg/DM3and sour bitumen (naphthenic acids, light, medium and acidic resins, acidic bitumen) to 1.0-1.4 mg/DM3. The total content of organic substances in General varies from 10.0 to 20.0 mg/DM3. Thus the highest content of organic matter is observed � water wells 10-D (With org. from 5,19 to 11,74 mg/DM3operated and used in the health-drinking purposes sanatorium "Obukhovskaya".

In terms of content of organic matter - "the org.", regulated by GOST 13273-88 "mineral drinking Water treatment and medical-table" (org. up to 10 mg/DM3).

In addition to organic substances, medicinal properties "Obukhovskaya" cause water present in relatively small concentrations, the following therapeutically active components:

- metasilicic acid - 40,9-43,2 mg/DM3;

- orthoboric acid of 26.3-26.6 mg/DM3;

- bromo - 3,94-to 4.26 mg/DM3;

- iron - 0.1 mg/DM3;

- hydrogen sulphide to 5.0 mg/DM3;

- iodine - 0,68-0,85 mg/DM3.

The study of basic physiological groups of bacteria in "Obukhovskaya" the water showed that it is dominated by nitrification, denitrifiers and butyric acid bacteria, in a somewhat smaller number are ammonifiers bacteria.

Long-term monitoring of the content in "Obukhovskaya" mineral water trace elements with concentrations in some toxic effects (cobalt, vanadium, barium, zinc, copper, arsenic, chromium, etc.) or have an adverse effect on organoleptic properties, show that their content in water wells 10-D is valid for a mine�social drinking medicinal-table water concentrations.

It follows from the above that mineral water "Obukhovskaya" from the well 10-D is used for internal admission to the sanatorium, and has favorable chemical, Toxicological, microbiological and organoleptic characteristics, but also has a pleasant taste.

Clinical example

As an example of treatment of diabetic microangiopathy driven scheme outpatient treatment of patient L., born in 1957, admitted to the sanatorium "Obukhovskaya" with complaints of weakness, fatigue, decreased performance, headache, dry mouth, thirst, polydipsia. With 30.01.2014 on 03.03.2014 were observed in the endocrinology center Ekaterinburg-based MAU "GKB №40" with a diagnosis of Pancreatogenic diabetes mellitus, first diagnosed. Ketoacidosis at admission. Diabetic microangiopathy: initial cataract, microangiopathy of the retina of both eyes. Diabetic nephropathy stage of microalbuminuria. CKD 1".

In September 2013, Moved the necrotizing pancreatitis on the background of alcohol abuse, underwent conservative treatment in the hospital. 30.01.2014 enters a state of ketoacidosis in urban endocrinology centre, the examination revealed diabetes. Underwent conservative treatment: Robinson WITH 28 UNITS+16 UNITS, Robinson P (Panfil) 12+12+12 ED.

The results of the survey to the treatment�: 4.03.2014 G. Blood sugar: 8:00-9:00 - 8.1 mmol/l, 11:00 - 10.8 mmol/l urinalysis: Specific gravity 1007, protein - 0.4 g/l, glucose 0.5 g/l, PL epithelium - 6-8 in p/Zr, leukocytes in 5-10 p/Zr.

Indicators of renal blood flow:

Vmax - 23,8 cm/h

Vmin - 6,91 cm/h

S/D - 3,44

PI - 1,22

RI - 0,71

Further examination by ophthalmologist:

Refractometry OD s is 0.25. Cyl - 0,25, ax 88

OS s is 0.5. Cyl - 0,5, ax 88

TVHD OD=19, TGD OD=21

VOD=0.9 n/a, VOS=0.85 n/a

04.03.2014 When taken to Sanatorium "Obukhovskaya" complaints of weakness, fatigue, decreased performance, headache, dry mouth, a veil before the eyes.

Objective data: the condition is satisfactory. Consciousness is clear. Skin normal physiological staining. There is no swelling. Tongue moist, coated with white bloom. The abdomen was soft, clubbritney in the epigastric region. The kidneys are not palpable, the low positive symptom Pasternatskogo right, to the left negative. There is a weakening of the pulsation of the arteries of the lower extremities. Height - 178 cm, weight - 69 kg, the body temperature is 36.5 ° C, BP is 135/85 mm Hg.PT.

In the sanatorium the patient L had an appointment inside of low-mineralized mineral water with high content of organic matter: hydrocarbonate-chloride-sodium mineral water "Obukhovskaya". The water took preheated to a temperature of 37°C from RAS�ETA 3 ml per 1 kg of body weight 3 times a day 40 minutes before meals, the course of 18 days. In addition, receive a diet food table # 9 + additional meals, physical therapy, massage on the collar area No. 10 in a day, vikhreva bath on the upper and lower extremities No. 10 in a day, magnetic therapy to the lower extremities No. 10 in a day.

Control examination was conducted on 8th and 14th day of stay at the resort.

8 days of treatment. The indicators of the General analysis of urine and analysis by Nichiporenko within normal limits. Blood sugar: 8:00-9:00 - 7,4 mmol/l, 11:00 - 9,2 mmol/L.

Ophthalmologist consultation: Refractometry OD s is 0.25. Cyl - 0,25, ax 88

OS s is 0.5. Cyl - 0,5, ax 88

TVHD OD=18, TGD OD=20

VOD=0.9 n/a, VOS=0.85 n/a

14-e the day of treatment. The indicators of the General analysis of urine and analysis by Nichiporenko within normal limits. Blood sugar: 8:00-9:00 and 5.86 mmol/l, 11:00 - 8,28 mg/L. ophthalmologist Consultation: Refractometry OD s is 0.25. Cyl - 0,25, ax 88

OS s is 0.5. Cyl - 0,5, ax 88

TVHD OD=18, TGD OD=20

VOD=1.0, VOS=0.95

Indicators of renal blood flow:

Vmax - 26.7 cm/h

Vmin - 8.1 cm/sec

S/D - 3,29

PI - 1,21

RI - 0.69

Method of correction of metabolic disorders in patients with diabetes mellitus by a combination of Spa treatments, including reception acidulous hydrocarbonate chloride-sodium mineral water, characterized in that patients with diabetic microangiopathy running tests: General blood test, blood sugar, urinalysis, conducting� study indicators of renal blood flow: a Vmax, Vmin, S/D, PI, RI, major ophthalmic parameters: visual acuity, field of vision, the state of the vessels of the fundus, and assign ingestion of low-mineralized hydrocarbonate-chloride-sodium mineral water "Obukhov", take water heated to a temperature of 37°C at the rate of 3 ml per 1 kg of body weight 3 times a day 40 minutes before meals, course 18 days, on the 8th and the 14th day of stay at the resort conduct control tests.



 

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9 cl, 13 dwg, 13 tbl, 1 ex

FIELD: medicinal microbiology, medicine, pharmacy.

SUBSTANCE: invention relates to agents used for enhancing sensitivity of microorganisms to antibacterial preparations. Invention involves applying hydrocarbonate chloride-sodium drinking mineral water "Obukhovskaya" with the total mineralization 1.8-2.2 g/l as an agent for enhancing sensitivity of microorganisms to antibacterial preparations that is used early for treatment of atopic dermatitis and as an agent for treatment of iodine-deficient states. It has been found by method using disks that mineral water "Obukhovskaya" provides enhancing sensitivity of microorganisms to such antibacterial preparations as antibiotics and specific preparations against yeast-like fungi.

EFFECT: improved and valuable agent.

6 tbl, 6 ex

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