The method of treatment of infectious diseases associated with the syndrome of angina


(57) Abstract:

The invention relates to medicine and for the treatment of infectious diseases associated with the syndrome of angina, particularly in children, and can be used in outpatient clinical practice. To do this, in the acute phase of disease in patients with localized form of diphtheria, bacterial tonsillitis, infectious mononucleosis has been the treatment of tonsils enzyme preparation 0,15 - 0,25% solution bioantioxidant properties of the complex, including superoxide dismutase, catalase, peroxidase. The method provides a good therapeutic effect, which is manifested in reduced local inflammatory manifestations in the oropharynx, in the absence of complications, reduced length of stay of patients in permanent establishment and normalization pathobiochemistry of blood. table 2.

The invention relates to medicine and for the treatment of infectious diseases associated with the syndrome of angina, particularly in children, and can be used in clinical and outpatient practice.

Under the infections that occur with the syndrome of angina, understand those diseases in which there is preferential orientada bacterial sore throats, a localized form of diphtheria throat and infectious mononucleosis.

As a rule, therapy data of infectious disease includes antibiotics, most of the antibiotics penicillin, symptomatic treatment, and such diseases as diphtheria is specific serum therapy.

Closest to the claimed method of treatment of infectious diseases associated with the syndrome of angina, is a combination antibacterial therapy or intramuscularly, or through the mouth, depending on the severity of the patient's state, and local therapy in the form of gargle with antibacterial solutions, such as Iodinol, 5% solution of ascorbic acid and antibiotics

The shortcomings of local therapy is that in the process of rinsing a remedy practically settles on the surface of the tonsils, which could explain the insignificant effect, and the children rinse acceptable only from a certain age when a child can perform this procedure. In addition, local application of antibiotics causes suppression of pathogenic organisms of the normal flora of the pharynx and oral cavity, which entails us and other fungal infections of the mucous membranes of the oropharynx.

The objective of the invention to develop an effective method for the treatment of infectious diseases associated with the syndrome of angina.

Since opening in 1969, the researchers ' attention was attracted by superoxide dismutase (SOD) is a key antioxidant enzymes. In animal experiments it was found that SOD has a pronounced anti-inflammatory and antihypoxic effect.

Currently SOD due to their substrate specificity against superoxide radical is recognized as the most powerful natural antioxidant). However, drugs SOD obtained from the blood of humans and animals (orgotein, Proxim, Germany), are not widely applied in the clinic due to labor-intensive production technology and the need for expensive tests for the AIDS virus, hepatitis, tuberculosis mycobacteria.

Known enzyme complex isolated from the biomass of cultured plant cells collection kalievyh, in particular, ginseng and policies that contains SOD, catalase and peroxidase: the specific activity of SOD - 20.1 + 1.8 UE D/mg protein, specific activity of catalase - 0.14+0.02 mm H2O2/min/mg protein, specific activity perox is biostructure cells from toxic oxygen radicals and hydrogen peroxide.

Enzymatic antioxidant complex (LHC) has been successfully used in the treatment of early stages of inflammatory diseases and hypoxic conditions of the periodontium.

The task of the invention is realized by the proposed method, which provides, along with antibacterial therapy to conduct local treatment in the treatment of tonsils solution enzymatic antioxidant complex (LHC), including SOD, catalase and peroxidase.

The TANK was used in the form of a solution in aqueous glycerol concentration of 0.15 to 0.25% (wt.) by lubricating the tonsils 2-5 times a day to get the effect, characterized by the disappearance of agricultural communities on tonsils, were tested solutions with a concentration of 0.15 - 0.20 to 0.25, which gave similar clinical effect. In the examples used 0,20% solution for statistical validity.

Example 1. Sergey A. 8 years old (case history N 4145), came on the 2nd day of the disease with suspected diphtheria throat. Ill sharply with the rise of temperature to febrile digits, was worried about a severe sore throat, weakness, lethargy. When inspecting a state of moderate severity, expressed the specific symptoms of intoxication. In the shed was noted stagnant har the EPA - dense, shiny, greyish-white, not removable raids. Submandibular lymph nodes were enlarged to 2 see Edema of the subcutaneous tissue of the neck was not. Has been clinically diagnosed with diphtheria of the fauces, the localized form, which is then confirmed by seeding toxigenic strains of Corynebacterium diphtheria of the pharynx. The child was assigned to antibiotic therapy, without the introduction of APDS. From the first day in the hospital has been the treatment of the tonsils solution TANK. By the end of the first day by local treatment, the child ceased to bother sore throat, on the 2nd day in a child's appetite. Raids disappeared after 6-fold processing tonsils drug after 2 days of a hospital stay. Accordingly stoped the specific symptoms of intoxication, temperature was normalized. On the background of complex therapy the child was not the development of specific complications of diphtheria in the form of cardiomyopathy and polyneuropathy. The child was discharged on the 15th day from the onset of the disease with recovery after a negative smear from a throat and nose on toxigenic Corynebacterium diphtheria.

Example 2. Alexander P. (history N 1468) was received on the 3rd day of the disease the show doctor emergency suspected diphtheria and child hospitalized in the clinic of the research Institute of children's infections, Saint-Petersburg. The state of admission was regarded as moderate, the child continued high fever. In the shed was loose ostrovche white-yellow blend, bright diffuse hyperemia, a modest increase in the submandibular lymph nodes. Clinically and after bacteriological examination, she was diagnosed with acute lacunar tonsillitis caused by S. aureus, moderate to severe form. In the hospital from the first day of admission were conducted antibacterial therapy and the treatment of the tonsils solution TANK. On the background of therapy raids disappeared by the 3rd day of hospital stay. It should be noted that on the second day of inpatient treatment, the patient returned to normal temperature, improved health, ceased to bother sore throat, appetite. When instrumental methods of examination of the cardiovascular system, control tests of blood, urine data for the complicated course of the disease have been identified. The child was discharged on the 10th day from the onset of the disease with recovery.

Example 3. Timothy C. 14 years old (case history N 688).The child was admitted to the Institute of children's infections, St. Petersburg on the 4th day of the disease with suspected diphtheria of the fauces. Ill selectie front - and zadnesheynyh groups of lymph nodes, the difficulty of nasal breathing. On the third day of illness, a doctor discovered raids in the shed and the boy was hospitalized. When entering the state was regarded as srednetjazheloe, fauces marked spilled bright redness, tonsils ostrovche white friable deposits, increase pain and Penne and zadnesheynyh lymph nodes, difficulty in nasal breathing, enlarged liver and spleen. Clinically, serologically, bacteriologically, according to blood tests and immunological indexes was diagnosed with infectious mononucleosis, medium-heavy flow. From the first day of a hospital stay in the complex therapy of diseases included local treatment of tonsils preparation TANK, which contributed to the disappearance of raids within 2 days. Simultaneously with the disappearance of raids has improved the General condition of the child, were stopped intoxication symptoms, hepatosplenomegaly was observed before the 5th day of illness. The child was discharged with recovery with normalization of blood on the 12th day of illness under outpatient supervision.

Proposed by applicants method is associated with the following moments: one of the main clinical signs of diphtheria, a bacterial sore throat and infectious machine disease. Long-lasting, widespread raids create favorable conditions for the activity of the pathogen, production of bacterial toxins and their absorption in the interstitial space of the tonsils and lymphatic system of the neck. Reducing time spent raids on the tonsils and duration of local inflammation in the oropharynx leads to a decrease intoxication syndrome, and also reduces the total dose that absorb toxins, particularly diphtheria toxin, and therefore, reduces the likelihood of developing severe complications and improves the prognosis of the disease.

When comparing the clinical course of diphtheria of the fauces in 17 children who were treated tonsil optional solution TANK and the control group (16 people) it should be noted that on average, children were hospitalized on the 3rd day of the disease in moderate condition with moderate symptoms of intoxication. From the moment of receipt in the tonsils of patients was noted fibrinous overlay on the tonsils. Character, consistency, localization raids patients analyzed two groups were very similar. When the same source antibacterially therapy in patients of the 1st group the duration of those is ratev of 2.5+0.7 days, respectively. On the background of advanced therapy in patients faster stoped local pathological changes in the shed: the duration of the raids from the onset, averaged patients of the first group of 4.1+0.6 days 7.8+0.9 days in the control group. Drew attention to the fact that the duration of the raids in the shed in patients who Palatine tonsil was treated with a solution TANK, the hospital did not exceed 2 days, while patients of the control group raids continued up to 5 days of inpatient treatment. A more rapid disappearance of raids correlated with the improvement of the General condition of patients. It should be noted that after the first processing of the tonsils solution TANK patients almost disappeared sore throat. A clear positive trend with an additional application of the solution TANK in treatment contributed to the reduction of the period of stay of patients on inpatient treatment: duration of bed-days in the 1st group of patients was 14.6+1.7 days compared to 18.5+2.3 days in the control group.

Children who have had bacterial sore throat, there were on average 2-3 days from the onset of the disease in the state of moderate severity. It is established that the clinical course of angina in 22 patients to the Comparison group on the severity of the disease, age and baseline therapy were representative. The receiving TANK, the duration of the temperature reaction and intoxication syndrome was significantly lower than in the control group (1.5 to+0.4 and 0.8+0.2 days versus 2.8+0.3 days, respectively). The duration of the overlays on the tonsils in the processing TANK does not exceed 2 days of inpatient treatment, while in the comparison group raids continued until 4-5 days. Duration pronounced hyperemia in the shed in children who underwent local treatment of tonsils TANK was 2 times lower compared to patients who received standard therapy (3,6+0.4 days versus 6.9+0.3 days). The purpose of the solution TANK topically in treatment contributed to the reduction in bed-days, which amounted to 7.2+0,3 vs. 9.4+0.5 in the control group.

Comparative characteristics of groups of children, patients with infectious mononucleosis have shown the feasibility of using the TANK in the complex therapy of this disease, age, severity and clinical sign of disease. It was found that in patients with infectious mononucleosis receiving TANK (21 children), duration local inflammatory manifestations in the oropharynx was significantly less than the control group (17 people who. When the source is the same basic therapy the duration of the intoxication syndrome in patients of the 1st group was significantly less than was 1.6+0.2 days compared to 3.2+0,4 days of the control group. The increase in peripheral lymph nodes in children who were handling tonsils TANK, reflected in the shortening of hospital stay (8,5+1.0 days 11.6+0.7 days in the control group).

One of the significant indicators of the immune system in infectious diseases is the index of regulation, which is characterized by the ratio of fractions of T-lymphocytes (T-helper cells to T-suppressor). The predominance of T-helper cells is indicative of the severity of the infectious process. The turning point to recovery is to increase the number of T-suppressors, indicating a full immune response of the organism to the introduction of the pathogen and the change of the acute phase of the disease at the stage of convalescence. It was established that in patients with bacterial sore throat, and infectious mononucleosis, which received the TANK, after treatment for 7-10 days of illness index regulation was significantly decreased, reaching values of healthy children, indicating that activation of proliferative activity immunos is the suppressor was increased compared with the first survey, therefore, patients continued the acute phase of infection (table 1).

Unlike other infectious lesions of the oropharynx diphtheria infection characterized by severe toxemia, which plays a key role in the pathogenesis of the disease. Diphtheria toxin apparently exerts immunosuppressive effects on immunocompetent cells, as evidenced revealed significantly low index of regulation in the acute period of the disease. After the proposed method of treatment marked activation of the functional state of the immune system in contrast to the control group, where the index of regulation of HSL throughout the disease remained reduced. The data obtained indicate immunomodulating action of the TANK.

The functional state of immune cells largely depends on the structure and composition of the lipids of cellular membranes, an important factor in maintaining and updating which is the intensity of free radical processes. We found a pronounced antioxidant effect of the drug TANK, as evidenced by normalization of the indicator of lipid peroxidation concentration of diene conjugates in lymphocytes and activebook compared with the control group patients (table 2).

Thus, the proposed method for the treatment of infectious diseases associated with the syndrome of angina, consisting in the local processing of the tonsils preparation TANK, increases therapeutic effect, reduces the duration of local inflammatory manifestations in the oropharynx, on average, 2-3 days, reduces the length of stay of patients in hospital and normalizes the free-radical processes in the body and, in particular, in immunocompetent cells and exert immunomodulatory effects.

A method for the treatment of children with infectious diseases that occur with the syndrome of angina, consisting of antibacterial and local therapy, characterized in that the local treatment treatment of the tonsils 0,15-0,25% solution of enzyme antioxidant complex, including superoxide dismutase, catalase and peroxidase, 2-5 times a day until the disappearance of raids on tonsils.


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