A method of treating hyperlipidemia


(57) Abstract:

The invention relates to medicine , in particular to the prevention and treatment of atherosclerosis. For the correction of hyperlipidemia offer every 4-7 days during the day to enter sequentially cholagogue in the maximum daily dose, then vaseline-pectin emulsion in a daily dose of 160 g of the following composition, %: pectin 6,5; vaseline oil 38,5; jelly from carrots 14,5; distilled water - the rest. After the emulsion is injected drugs that increase peristalsis. table 1.

The invention relates to medicine, namely to clinical methods for treating hyperlipidemia, which is the main cause progressive disease of the arteries of the extremities atherosclerosis of Genesis.

Hyperlipidemia (HLP) is detected in 0.2% of the world population. Typically, this disorder is associated with inheritance of mutant genes encoding the receptors of the low density lipoprotein (LDL), and therefore, the majority of patients with familial hypercholesterolemia.

The analysis of numerous literature data shows that the main complication GLP is the development of coronary atherosclerosis the last years, based on a large statistical material shows that the increase of cholesterol level by 10% increases the risk of myocardial infarction in 4 times.

Accurately shown on the example of the treatment of patients with ischemic heart disease patients, even unexpressed symptoms of angina, but with an increased risk of developing the disease due to elevated concentrations of cholesterol in the blood, need lifelong treatment, which in most cases is associated with the medication.

It is proved that the only way to prevent the progression of atherosclerotic lesions in the arteries is a long and steady decline in the concentration of cholesterol and atherogenic lipoproteins in plasma.

The analysis of long-term experience conservative treatment methods GLP shows that there are the following main criteria for the effectiveness of therapy: 1) the reliability of the method; 2) the duration of the effect of reducing the concentration of cholesterol in the blood plasma; 3) a sufficient degree of decrease in level of cholesterol (less than 20-25%); 4) no side effects.

It is known that dietary and pharmacological treatment, in the main, do not meet the above criteria. In addition to t surgical treatment GLP, which hitherto widely used all over the world.

Indications for surgery is a rapidly progressive atherosclerosis with high cholesterol and LDL. The essence of the operation is to turn off from the digestive processes of two meters of the distal ileum (partial ilocutionara). However, as shown by long experience of operation Buchwald within the Surgical Control of Hyperlipidemia, this method has some significant drawbacks.

The operation is performed on a healthy body and is essentially a serious interference in the metabolism of the liver. The operated patient is doomed to long-term, up to one year, and diarrhea, which in some cases requires the inclusion of a device is activated loops of intestine. The foregoing, including the development of adhesive intestinal obstruction, expressed in restrained attitude towards this operation. All these factors severely limit the application of the above method.

The most common way to treat GLP is currently pharmacologic therapy. From a wide array of drugs most effective in the treatment of GLP was achieved with the advent of new is n, mevakor and others). These drugs allow success to korrigirovat severe GLP. Treatment with drugs of this group (the study used mevacor) adopted for the prototype method.

However, as shown by data from the literature and the results of experience mevacor in clinical practice, there are numerous contraindications to its use. First, the treatment is effective only during long years of use, which precludes its use in patients younger in view of its toxicity (risk of development of cirrhosis, cataracts, progressive myopathy, impotence, and others). Secondly, the treatment is expensive, requires constant increasing doses of the drug. And thirdly, there are numerous contraindications to the use of drugs of this group.

The above circumstances limit the use of the prototype method in the treatment of hyperlipidemia and may not apply for a long-term decrease in levels of plasma lipids.

The aim of the invention is the elimination of side effects of drugs and complications associated with the treatment of hyperlipidemia.

This is achieved by the fact that the patient determine the level of cholesterol and is in the small intestine, and drugs that enhance intestinal peristalsis, every 4-7 days.

New in the invention is that the reduced concentration of cholesterol is blocking the enterohepatic circulation of bile acids with a joint appointment cholagogue preparations and paraffin oil, emulsified in pectin (blocking suction).

Vaseline-pectin emulsion (drug FIEND) is a product containing pectin, vaseline oil and jelly from carrots. In the preparation of this product's components are taken in the following ratio, pectin 6,5; vaseline oil 38,5; jelly from carrots 14,5; distilled water the rest.

The drug is prepared as follows. In the capacity serves pectin, pour distilled water, mix thoroughly, and this mass of strays with a mixer until a homogeneous mixture is obtained at a temperature of 55-65aboutC for 3-4 min; without interrupting the process of churning introduced gradually in small portions vaseline oil; the resulting mass is injected jelly from carrots and continue to beat for 2-3 minutes

Before you bring the characteristics of the drugs prescribed to achieve the desired goal, it is necessary Otaniemi proven in normal principal amount of cholesterol and bile acids are absorbed in the terminal ileum. Off from the digestion of two meters ileum leads to a significant increase in the excretion of bile acids and cholesterol and reduce their revenues through the system of the portal vein in the liver (blockade of the enterohepatic circulation of bile acids). This leads on the basis of feedback to compensatory increased gelegenes in the liver. To support spent the last reserves of the first cholesterol in the liver, then in the plasma and tissues. Thus, therapeutic effect of the proposed method is mediated by three mechanisms: block absorption of bile acids in the small intestine; the evacuation of bile acids from the intestine; increases the production of bile in the liver.

Defined in the invention pharmacological agents in the basis of their mechanism of actions are identical pathophysio - logical aspects of the implementation of the clinical effect of the method-analogue.

When developing the method defined parameters necessary for the successful implementation of the proposed method. The minimum time to control cholesterol and atherogenic lipoproteins are 7 days, posi following. 2-3 months after the treatment method proposed control examinations after 7 days the concentrations of cholesterol and atherogenic lipoproteins did not return to baseline indicators in 83% of patients, i.e., increased susceptibility of the organism to pharmacological ilocutionari due to the physiology of the method.

The invention explain the following examples.

P R I m e R 1. Sick So 54 years, history 25329, was admitted to the hospital with complaints of pain in both lower extremities, intermittent claudication after 50 meters.

An angiographic examination revealed multiple long occlusion of the aorta, both the iliac and femoral arteries on both sides.

Ultrasonography of the walls of the right and left femoral arteries revealed that the elasticity was 2.6 and of 14.28%, respectively (normal 22,400 + 1,063%).

For biochemical analysis of blood set: cholesterol 422 mg/DL; triglycerides 282 mg/DL; high-density lipoprotein 58 mg/DL; low-density lipoprotein 376 mg/DL; ratio of athero - hennoste 6,26

Due to severe allergic reaction to mevacor manifest in rashes, pain in the liver, dizziness, nausea therapy according to the following scheme.

To increase the synthesis of bile in the liver used allohol two tablets six times a day before meals. Decrease of absorption was facilitated by the reception vaseline-pectin emulsion on 40,0 four times a day 40 minutes after taking choleretic drugs. Vaseline oil is not absorbed in the intestine, mucous coats and has mild laxative properties. Pectin is used to create the emulsion, improving the ingestion, reducing the loss of paraffin oil in the mouth, esophagus and stomach. Jelly from carrots improves the taste of the drug. Enhance peristalsis was achieved by taking castor oil 30,0 ml three times a day. All drugs permitted to be used.

Controlling biochemical study after 6 months: cholesterol, 286 mg/DL; triglycerides 180 mg/DL; high-density lipoprotein 68 mg/DL; low-density lipoprotein 182 mg/DL; factor ATA - ravennati 3,2.

One year after treatment appointed way obtained the following results: cholesterol 248 mg/DL; triglycerides 178 mg/DL; high-density lipoprotein 72 mg/DL; low-density lipoprotein 140 mg/DL; haemoglobin rate of 2.4.

Control angiographies the NCI has improved significantly: the right to 12.2% left 18,1%

Pain in the limbs do not bother, it takes about one kilometer without stopping. Any complications in the treatment method proposed patient notes. Social adaptation to treatment were presented difficulties.

This example shows the high efficiency of the proposed method in the treatment of a patient with GLP complicated by progressive atherosclerosis.

P R I m m e R 2. Patient M 44 years old, medical history, 24379, was in the hospital about obliterating atherosclerosis, occlusion of both iliac arteries 27% hyperlipidemia 2A type.

Biochemical blood test: cholesterol 297 mg/DL; triglycerides 165 mg/DL; LDL-you - high density 69 mg/DL; low-density lipoprotein 195 mg/DL; factor ATA - ravennati 3,3.

A patient with an interval of five days were treated according to the scheme similar to that shown in example 1. 6 months after the start of treatment offered by way of the patient's condition improved significantly increased the number of painless steps from 450 m to 1.5 km

Biochemical blood test: cholesterol 237 mg/DL; triglycerides 160 mg/DL; high-density lipoprotein 89 mg/DL; LDL bottom - koi density of 116 mg/DL; factor s, i.e., the effective reaction of the patient to the proposed treatment method, GLP korrelirovana.

Control angiography showed that atherosclerotic disease of the iliac arteries is not progressing. Stenosis is 25-26% (as in Exodus), i.e., occurred in the stabilization of the atherosclerotic process in the face of adequate correction GLP. Any complaints the patient does not show.

This example shows that the proposed method of correction GLP allows to achieve stable and long-lasting correction of the lipid spectrum of blood plasma without the complications associated with medications. In addition, to achieve stabilization of the atherosclerotic process.

For verification of the correct choice of pharmacological preparations, we performed radionuclide study of the liver. The fact that radiopharmacological drug BUTYL-IDA (RN) stands out in the composition of bile and absorbed in the small intestine and its elimination from the body can be traced within 24 h, was used to estimate the enterohepatic circulation of bile acids. The study was conducted on gamma-camera Daina firm Picker (USA), through the accumulation of radiotracer in the liver (T Max. liver);

time plateau (T plateau);

the half-life of RN (T 1/2);

the time of detection of the radiopharmaceutical in the gallbladder (TJ.P.);

the time of maximum accumulation of radiotracer in the gallbladder (Tmax. HA)

evacuation function of the gallbladder (% reduction J. P.);

the time of appearance of the radiopharmaceutical in the gut (T colon).

Radiometry of the abdominal cavity after 1.5 h and 24 h from the beginning of the study defined the specific unit activity of radiotracer in the liver and intestine. Expected return of radiotracer in the liver by the formula:

UEA liver after 24 hours in Exodus To return= ______________________________________

UEA liver 24 hours after the FISH

Norm To return more than 1.0.

The coefficient of evacuation (evac.) RN from the intestine was determined as follows: UEA intestine through the day after the start of pharmacological reasontherefore was determined by the residual activity of the radiopharmaceutical. Reliable was considered To evacuate less than 50%

After 1 day after giving drugs were assessed quantitative indicators of UEA liver and intestines, reflecting the state of AGC LCD and evacuation function of the intestine. In addition, it was estimated indicators of cholesterol and lipoproteins and determined the magnitude in absolute terms. Treatment method farmacologiche the study. The results of radionuclide studies EGP LCD in the outcome and dynamics of some parameters after the FISH is presented in table. When analyzing the results of hepatobilliary found that all the parameters characterizing ulcerative the liver's ability, testify to strengthening of gelegenes, and it indicates achieving the desired choleretic effect.

Quantitative assessment of the return of radiotracer in the liver showed that after pharmacological reasontherefore (FISH) is the blockade of the enterohepatic circulation of bile acids (UEA in the liver in Exodus 5,20,77.E. when the FISH 3,880,32.E. P < 0,05). The recovery rate of radiotracer in the liver increased significantly compared with the control study. The number of RN in the intestine during the control study was on average 2.5% of the control. This clearly shows the significant increase in the rate of evacuation of the radiopharmaceutical from the intestine, and is achieved by blockade of the suction RN in the gut.

Thus, the obtained data indicate that the FISH spent within 24 h, a therapeutic effect, similar to the way Pro - totype. After 4-7 days after the onset FISH re-examines indicators of cholesterol and heterogeneities lesions of the arteries of the pelvis and lower extremities, the cause of which was marked hyperlipidemia. In 38 patients were able to achieve stable and long-term correction of hyperlipidemia, the results have been traced for 1.5 years. Of these three patients had previously taken a variety of drugs, after the proposed pharmacological effects need medication that lowers lipids, disappeared, the way was an alternative to drug treatment.

Analysis of the results of cholesterol reduction during the twelve-month monitoring of patients showed 28-30% reduction of its concentration in comparison with the original data (table). The drug mevakor efficiency is 30-35% decrease in the concentration of plasma cholesterol.

However, the proposed method can achieve long-term correction help without taking special lipidosterolic drugs with numerous side effects. The effectiveness of the proposed method is about 90% which is also not inferior to the most modern drugs that reduce cholesterol in the blood plasma.

These advantages of the proposed method make it possible to significantly improve the results of treatment GLP a factor in the development of atherosclerosis blood, proposed in the treatment method of pharmacological reasontherefore shown in the table.

A METHOD of TREATING HYPERLIPIDEMIA, comprising the introduction of tools that reduce the absorption of bile acids in the small intestine, characterized in that every 4 - 7 days per day administered sequentially choleretic drugs maximum daily dose, then vaseline-pectin emulsion in a daily dose of 160 g of the following composition,%:

Pectin is 6.5

Liquid paraffin is 38.5

Jelly with carrot - 14,5

Distilled water - Rest

and then a drug that enhances peristalsis.


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