The method of therapy of bronchial asthma in children
(57) Abstract:The invention relates to medicine, in particular to Pediatrics (pediatric Allergology). The aim of the invention is the reduction of terms of treatment of bronchial asthma and prolongation of the remission period by assigning in complex therapy of domestic nucleoside - Riboxin. The proposed method of treatment is as follows. Children with bronchial asthma exacerbation in comprehensive basic therapy (Hypo-allergenic diet, Allergy-free environment2agonists, methylxanthines, Intal, tiled, membrane stabilizers, according to testimony - corticosteroids) is assigned Riboxin for 14 to 15 days. Children up to 3 years of 0.05 g per reception; from 3 to 7 years - 0.1 g; from 7 to 15 years - 0.2 g 3 times a day. The inclusion of Riboxin in the complex therapy of bronchial asthma in children can significantly improve the effectiveness of therapy, which is manifested in the reduction of attack period 3.5 times the elongation of remission 2.1 times, and reduction sensitization and the normalization of immunological parameters. In General, asthma in this group of children has become more smooth, long interictal periods and short acute illness the community respiration. Given the high clinical and immunological efficacy of Riboxin in bronchial asthma in children, the drug can be widely applied in the treatment of this pathology. The invention relates to medicine, in particular to Pediatrics (pediatric Allergology).The purpose of the invention is the shortening of the treatment of bronchial asthma and prolongation of the remission period by assigning in complex therapy of domestic nucleoside - Riboxin.The increase in severe forms of asthma in children, resistance to therapy requires the search for new effective methods of treatment. Pathogenetically justified in this pathology the purpose of medicines, correcting metabolic processes in the body. These drugs include purine nucleoside Riboxin, which is a natural metabolite. It stimulates the oxidation-reduction processes in the cell due to the activation of hydrolytic enzymes pentoses cycle, increases the energy formation in the tissues, reduces hypoxia cells , which is especially important in the context of respiratory failure. The use of Riboxin is all the more justified that children with this pathology occurs on uchitelnoj as contributing to the processes of hypersensitivity, allergic inflammation, lysis and catabolism antigen , which requires metabolic correction. It was established experimentally that the introduction of Riboxin also leads to a decrease of the strength of anaphylactic reactions in animals that received strong sensitization to allergens . In the literature there are only few reports about the use of this drug [4, 5].We first conducted research on the application of Riboxin in complex therapy of bronchial asthma in children in the period of exacerbation. Riboxin was prescribed course within 14-15 days for children under 3 years of 0.05 g per reception, from 3 to 7 years - 0.1 g, from 7 to 15 years - 0.2 g 3 times a day. Criteria of clinical effectiveness were serving terms of reducing the duration of the period of exacerbation and prolongation of remission, as well as indicators of hemogram and immunological indexes and functions of external respiration.The method is tested in the Allergy Department, 2nd pediatric clinical hospital, Kazan.Under supervision there were 145 children with asthma aged from 10 months to 15 years. Of them boys of 71.7%, girls - 28,3%. Was dominated by moderate and severe over - 69,3%, while light was noted in 20.7 percent. Polyvalent sensitization otmecheni by age, sex, clinical structure and course were not statistically significant, 1 group consisted of 107 children with bronchial asthma treated in the complex basis of drug therapy Riboxin. The control group consisted of 38 children with asthma who received only basic therapy. Basic therapy did not differ in both groups were prescribed depending on the condition of the patient and includes: hypoallergenic diet, Allergy-free environment2agonists, methylxanthines, anti-inflammatory drugs (Intal, tiled), membrane stabilizers (ketotifen, zaditen), in severe cases, according to testimony - corticosteroids.Clinical observation showed that combination therapy of bronchial asthma with the inclusion of Riboxin allows to achieve clinical efficacy in 74,7% of cases. This is reflected in the reduction in the duration of the period of exacerbation and prolongation of remission. Installed shortening attack period 3.5 times, the duration of which was on average 6.6 hours (before treatment - 23.4 hours). In the control group of children not receiving Riboxin, the duration of the attack period decreased by only 1.5 times and amounted to 18.0 hours (before treatment - 27,4 hour).In the group of children, pvil of 5.8 months (whereas before treatment - 2.7 months), p < 0,05. In the control group, the duration of remission increased only 1.3 times and amounted to 3.7 months (whereas before treatment is 2.8 months).Decrease exacerbations of asthma in children receiving in complex therapy of Riboxin, was accompanied by significant improvement of respiratory function. So, in this group noted the increase of PEF on 20 - 35%, while in the control group at 9-15%.Thus, the inclusion of Riboxin in the complex therapy of bronchial asthma in children can significantly improve the effectiveness of therapy, which is manifested in the reduction of attack period 3.5 times the elongation of remission 2.1 times. In General, asthma in this group of children has become more smooth with long interictal periods and short exacerbations of the disease. Ischemia acute illness results in a significant improvement of respiratory function.Analysis of hemogram showed that in the group of children receiving Riboxin, compared with the control group significant increase in the number of leukocytes and is to ensure 5,8109/l, while after treatment - 6,5109/l and in controlflow in the peripheral blood in all groups of patients - 4.3% before treatment was 7.9%, after treatment - 3.6%, while in the control group eosinophils are reduced only by 1.9%, respectively - of 6.3% and 4.4%.A study of the effect of Riboxin on the complex immunological parameters in children with bronchial asthma. Comparison of changes in immunological parameters in the period of exacerbation and remission in the group of children receiving Riboxin in adjuvant therapy and in the control group showed a significant (p < 0.001) change CD8+- T-lymphocytes, IRI, total lgE and HCT-test-driven. So, the average change in the target group CD8+- T-lymphocytes was evident in their increasing by 4.8%, whereas in the control - only 1.5%, IRI increased by 1.2 units in the target group and by 0.38 units in the control, the content of total lgE decreased by 259,4 KE and 180,0 KE, respectively, and the values of HCT-test stimulated increased by 15.8% and 3.4%, respectively.The data obtained show that Riboxin has immunocorrective action in bronchial asthma in children, which is manifested in the reduction of CD8+- T-lymphocytes and normalization of immunoregulatory index, as well as the inhibition of the production of common lgE. Kricheskii cell activity by increasing the reserve capacity of various systems of the body.The advantage and novelty of this method is that the purpose of shortening the treatment of acute exacerbations of asthma in children and prolong remission in comprehensive basic therapy included domestic nucleoside Riboxin.Example 1. Patient A., age 12. The history N 359. Hospitalized in the 1st division of the 2nd children's hospital 2/02-98 g with a diagnosis of Bronchial asthma. Atopic asthma. Exacerbation. Medium severity. Polyvalent Allergy. Reactive pancreatitis. Giardiasis intestinal.Complaints at admission for asthma, wheezing, coughing fits. Worsening at night, after exercise. The attacks are repeated 1 time in 10-14 days and last for about 3 hours, the duration of remission for 2 months. Ill just 6 years old.History of life - a child from the third pregnancy, III birth. Pregnancy proceeded with the toxicity of the first half, the threat of miscarriage. Birth weight 3300 g, born in asphyxia. On breastfed to 4 months, then artificial. The burdened heredity - the mother of atopic dermatitis. Living conditions are satisfactory.When applying the General state of moderate severity due to dejatelnosti forced - with the fixation of shoulder girdle. BH - 28 per minute. The skin is clean. Lymph nodes are not enlarged. Zev - hyperemia not. In the lungs breathing hard, in all lung fields listened dry whistling and mixed moist rales. Percutere above the light box the color of the sound. Heart sounds are clear, rhythmic. Ps - 94 strike in minutes , rhythmic. The abdomen is soft, painless. Liver at the edge of the costal arch. Chair decorated. Diuresis is not broken.The hemogram from 3.02.98 g: L - 4,3109/l, n - 1, C - 49, e - 7, m - 3, l 40%.The function of external respiration: PEF was $ 255 l/min (reduced by 69%).The immunological: CD3+- 60%, CD4+- 41%, CD8+- 15%, IRI - 2,7, CD19+- 25%, IgI - 2.1 g/l, AGg - 17.1 g/l, IgM - 1,9 g/l, CEC - 0,017 ed, CH50- 58%, HCTSP- 27%, HCTarticle- 30%, F. I.lat- 12%, £Hlat- 1,4, IgE - 560 KE.In the complex basic therapy (Hypo-allergenic diet, Allergy-free life, aminophylline, Intal) was included drug Riboxin 0.2 g 3 times daily for 14 days. The attack was stopped after 40 minutes On the background of treatment, the frequency of attacks decreased to 1 time per 3 months. On the 15-day treatment the leukocyte count increased to 5.3 109/l and eosinophils decreased to 2%. Figure PEF increased and UB>+- 12%, IgA - 2.3 g/l, IgG - 15.2 g/l, IgM - 2.0 g/l, CEC - 0,020 ed, CH50- 63%, HCTSP- 12%, HCTarticle- 45%, F. I.lat- 30%, F. Hlat- 1,2, IgE - 220 KE. Dynamic observation of patients showed that the duration of remission in the patient increased to 6 months.Example 2. Patient P., aged 6. The history N 3493. Hospitalized in the 1st division of the 2nd children's hospital 17/12-98 g with a diagnosis of Bronchial asthma. Atopic asthma. Exacerbation. Medium severity. Polyvalent Allergy.Complaints upon receipt by recurrent attacks of breathlessness, wheezing, coughing fits. Worsening at night, after contact with Pets. The attacks are repeated 2 times per month, the duration of the remission period - 2 months. Asthma attacks are marked with 3 and last approximately 2 hours.The history of life:child 1 pregnancy, 1 birth. Pregnancy proceeded with the toxicity of the 1st half. Weight at rojdenni 3500, breastfed up to 2 months, then artificial. Heredity is not burdened. Living conditions are satisfactory.When applying the General state of moderate severity due to respiratory failure. Shortness of breath expertrender shoulder girdle. BH 30 minutes the Skin is clean. Lymph nodes are not enlarged. Zev - hyperemia not. In the lungs breathing hard, in all lung fields listened dry whistling and moist rales. Percutere above the light box the color of the sound. Heart sounds are clear, rhythmic. Ps - 100 beats per min, rhythmic. The abdomen is soft, painless. Liver at the edge of the costal arch. Chair decorated. Diuresis is not broken.The hemogram from 18.12.98 g: L - 4,6109/l, n - 2, p 43, e - 5, m - 3, l - 47%.The function of external respiration: PEF was 48 l/min (reduced by 62%).The immunological: CD3+- 48%, CD4+- 49%, CD8+- 27%, IRI - 1,8, CD19+- 28%, IgA - 0.8 g/l, IgG with 15.4 g/l, IgM - 3.8 g/l, CEC - 0,041 ed, CH50- 48%, HCTSP- 17%, HCTarticle- 51%, F. I.lat- 50%, F. Hlat- 5, IgE - 350 KE.The patient received a comprehensive basic therapy (Hypo-allergenic diet, Allergy-free life, aminophylline, Intal). Riboxin in the combined therapy was not included. The attack was stopped after 2.5 hours. On the background of treatment, the frequency of attacks decreased only up to 1 times per month. On the 15-day treatment the leukocyte count increased to 5,0109/l and eosinophils decreased to 3%. Figure PEF has not increased and amounted 48-50 l/min In the immunological: CD3+50- 59%, HCTSP- 11%, HCTarticle- 60%, F. I.lat- 49%, F. Hlat- 5, IgE - 270 KE. Dynamic observation of patients showed that the duration of remission in the patient increased only up to 3 months.Thus, the above examples show the positive clinical effect of Riboxin in comprehensive basic therapy for bronchial asthma in children, which contributes to the reduction of exacerbation and prolongation of remission, reduction sensitization and the normalization of immunologicheskikh indicators.SOURCES OF INFORMATION
1. Bakanov W. I., Balabolkin I. I., Gordeev, F. and et al. Materials of all-Russian scientific-practical conference: "Allergic diseases in children", Moscow, 1996. - C. 10.2. Kukes C. T., Fedorova N. M. et al. - Owls. the honey. - 1983. - N 2. - S. 84-86.3. Levi E. C., Shchukin So I. In the book: Abstracts of the national scientific conference, L., 1980. - S. 40.4. Malanichev.G., A. Shamov,, Shamov B. A. - KAZ. the honey. journal, 1998, No. 5, S. 370-372.5. Yakovlev A. A., Conde L. A. journal of ophthalmology., The 1982 - N 5 104 C. The method of therapy of bronchial asthma in children, including complex drug therapy, characterized in that as Lech
SUBSTANCE: the present innovation deals with antiviral preparations that contain aliphatic alcohol C21-C28 in combination with either nucleoside or nucleotide analog or phosphoformic acid in pharmaceutically acceptable carrier. It is necessary to mention that n-docosanol is considered to be a preferable aliphatic alcohol. Concentration of aliphatic alcohol C21-C28 corresponds to 0.05% to 40% by weight. Concentration of either nucleoside or nucleotide analog or phosphoformic acid corresponds to 0.1% to 10% by weight. The innovation, also, deals with the ways to treat viral infections due to applying such compositions. Aliphatic alcohols C21-C28 synergistically intensify antiviral activity of nucleoside analogs directed against replication of several herpetic viruses and that of cow's pox.
EFFECT: higher efficiency of inhibition.
28 cl, 13 dwg, 21 ex, 6 tbl
FIELD: organic chemistry, chemical technology, medicine, pharmacy.
SUBSTANCE: invention describes derivatives of 8-phenyl-6,9-dihydro[1,2,4]-triazolo[3,4-I]purine-5-one of the general formula:
wherein R1 means hydrogen atom, group -CH2-R6 wherein R6 means phenyl; R2 means (C1-C5)-alkyl or group -(CH2)n-R6 wherein n= 1 or 2; R6 means (C1-C4)-alkoxy-group or pyridyl group; R3 means (C1-C6)-alkyl; R4 means hydrogen atom or (C1-C4)-alkyl; R5 means -(CH2)n-R7 wherein n = 0-4; R7 means 3-7-membered ring comprising 1-3 heteroatoms taken among nitrogen atom (N) and oxygen atom (O), (C3-C7)-cycloalkyl or phenyl wherein indicated groups can be substituted with different substitutes; or R4 and R5 mean independently hydrogen atom (H), (C2-C6)-alkynyl or (C1-C6)-alkyl that can be substituted possibly; or R4 and R5 in common with nitrogen atom (N) form 4-7-membered ring comprising 1-2 heteroatoms taken among N and O and substituted possibly. Also, invention relates to their pharmaceutically acceptable salts, methods for preparing these compounds, intermediate substances, pharmaceutical composition and a to a method for treatment of different diseases mediated by activity of phosphodiesterase-5 (PDE-5). Described compounds of the formula (I) are inhibitor of PDE-5.
EFFECT: improved preparing method and treatment, valuable properties of compounds.
20 cl, 5 tbl, 149 ex
FIELD: vitamins, chemical technology, food industry, pharmacy.
SUBSTANCE: invention relates to crystalline alkaline-earth salts of 5-methyl-(6R,S)-, -(6S)- and -(6R)-tetrahydrofolic acid with the content of at least one equivalent of crystallizing water per equivalent of 5-methyltetrahydrofolic acid, in particular, 5-methyl-(6R)-tetrahydrofolic acid crystalline calcium salt or to different types of 5-methyl(6S)-tetrahydrofolic acid crystalline calcium salts. These salts can be used in preparing medicinal agents or as a nutrition supplement for treatment or prophylaxis of folic acid-mediated diseases. Also, invention relates to a method for preparing crystalline salts of 5-methyl-(6R,S)-, -(6S)- and -(6R)-tetrahydrofolic acid by crystallization of the corresponding salt of 5-methyl-(6R,S)-, -(6S)- or -(6R)-tetrahydrofolic acid from a polar medium by using heat treatment at temperature above 60°C followed, if necessary, by drying the prepared product. Also, invention relates to a composition for pharmaceutical agents or nutrition supplements.
EFFECT: improved preparing method, valuable properties of salts and composition.
13 cl, 5 dwg, 4 tbl, 11 ex
FIELD: medicine, gerontology.
SUBSTANCE: the present innovation deals with rehabilitation therapy of cerebrovascular diseases. One should introduce microcirculators and nootropic preparations to conduct training neuropsychological procedures. Moreover, microcirculatory and nootropic preparations should be introduced as intravenous infusions for 10 d, ten during 1 mo it is necessary to introduce tableted forms of the same preparations at simultaneous neuropsychological training directed to improving household skills valuable for a patient that deal with memorizing different names, important dates, names of medicinal preparations and location of domestic articles. On achieving a success the tasks should be complicated. Training should last for 30 min carried out thrice weekly: therapy course includes 12 trainings. The innovation widens the number of preparations for treating elderly and senile patients at discirculatory encephalopathy stage III and coarse cognitive deficiency.
EFFECT: higher efficiency of therapy.
3 ex, 1 tbl
FIELD: medicine, oncology.
SUBSTANCE: one should carry out chemoradiation therapy at applying a cytostatic preparation followed by distance and intracavitary irradiation. Depending upon development of tumor lesion during the first 3 or 6 d it is necessary to conduct monochemotherapy only due to introducing proxiphen together with dimethyl sulfoxide at weight ratio of 4.5-5.0 : 0.5-1.5, correspondingly by applications in "Coletex" napkins. Moreover, a napkin should be pre-impregnated in 20%-dimethylsulfoxide solution and fixed with a tough vaginal tamponade by changing napkins every 24 h. Then since the 4th d or the 7th d simultaneously with application it is necessary to carry out contact irradiation and distance impact onto minor pelvis every 4-6 h at single focal dosage (SFD) being 2 Gy at 10 seances 5 times/weekly with high-activity sources of SFD 2 Gy. The innovation provides tumor regress under conditions of no therapeutic complications, thus, improving patients' quality of life.
EFFECT: higher therapy.
FIELD: medicine, infectious diseases, psychotherapy.
SUBSTANCE: method involves antiviral therapy, immune correction with thymus hormones and interferon inductors. Since the first day the relapse symptom method involves prescription of antiox+ (1 capsule per a day) and detox+ (1 capsule, 2 times per a day) for 30 days, profluzak (20 mg, 3 times per a day for 5 days) and then in the dose 20 mg, 1 time per a day for 20 days. Derinate is prescribed topically as installation into urethra in the dose 3-5 ml or with tampon into vagina and with simultaneous prescription of microenemas in the dose 10-40 ml for 10 days. Since 10-14 day in exacerbation period in the proliferative stage of an antiherpetic immune response derinate is prescribed by intramuscular injections in the dose 5 ml, 1 time in a day, 10 injections in total number. Then since 6-th day of exacerbation and intake of profluzak psychotherapy seances are carried out. The first seance of rational psychotherapy involves explanation to a patient in available form mechanism of the disease, the necessity of prolonged treatment and motivation for treatment is enhanced by suggestion. The second psychotherapy seance involves neurolinguistic programming wherein a patient colorful and detailed description of desirable function when he imagines achievement of the desire result, and positive emotional and vegetative symptoms are notes and the conditional-reflect association is formed by tactile contact. Under psychotherapist control a patient imagines "part of person" responsible for achievement of the desire result the patient attention is accented for the desire result and arisen physiological responses are fixed by using tactile contact. Also, new behavior methods are proposed to take for a patient that are directed for achievement of the desire result - avoiding sexual contacts during exacerbation of genital herpes in one of partner and during every month hormonal cycles, avoiding stress situations, and in case of each stress situation significant for patient profluzak has to be intake in a single dose 40 mg, using a condom in sexual contact in the exacerbation period. Patient analyzes the proposed new behavior methods that help avoiding relapses, provide good state of health, promotes to recovery process of genitals recovery and selects at least three the most rationally available for him behavior methods. In the case of the positive response that is controlled by physiological symptoms the result is fixed by tactile contact. The third seance involves the suggestive psychotherapy directed for fixing the attained result. The suggestive therapy seance is carried out once per a week for 6 months. Method provides declining the treatment time, to reduce relapse frequency of genital herpes and to recover the emotional state of patient.
EFFECT: improved treatment method.
2 cl, 3 tbl, 1 ex
SUBSTANCE: invention relates to a granulated pharmaceutical composition comprising granulated material and erythritol. Granulated material comprises a medicinal substance of unpleasant taste and wax. Also, invention relates to a pharmaceutical product for oral using that comprises the indicated granulated composition. The composition masks unpleasant taste of a medicinal agent and provides good feeling in oral using. The granulated composition can be swallowed easily by elderly humans, children and patients suffering with dysphagia. Except for, the product is useful for administration by using a tube.
EFFECT: improved and valuable properties of composition.
15 cl, 5 tbl, 6 ex
SUBSTANCE: method involves applying antiherpetic therapy using Phamcyclovir. Then, Trental is sequentially introduced during 5 days with 2-5 ml of cerebrolysin being concurrently intratissularly introduced behind mastoid process tip. Mexidol is administered for 10 days. The treatment is finished by introducing Polyoxydonium.
EFFECT: combined microcirculation improvement; high neurotrophic and antioxidant activity; secondary immune deficiency adjustment; eliminated labyrinth hydrops.
FIELD: organic chemistry, neurology, medicine.
SUBSTANCE: invention relates to a new medicinal agent used in treatment of feeble-mindedness comprising a derivative of 2-aryl-8-oxodihydropurine, namely, a derivative of 2-aryl-8-oxodihydropurine that comprises acetamide group at position 7 or 9 of purine ring. Invention proposes compounds of formulae (Ia) and (Ib) wherein radicals X1, Y1, R12, R13, R22, R23, R32, R42 and R43 have the corresponding values, or their pharmaceutically acceptable acid-additive salt. Also, invention proposes using compounds of the formulae (Ia) and (Ib) or their pharmaceutically acceptable acid-additive salt for preparing a medicinal agent used in treatment or prophylaxis of feeble-mindedness wherein feeble-mindedness represents deterioration of the teaching process, dysmnesia, dysmnesia-based disorientation, mental dysfunction, Alzheimer's disease, cerebrovascular feeble-mindedness and/or senile feeble-mindedness, and in treatment or prophylaxis of higher cerebral dysfunction. Invention provides the development of a medicinal preparation for prophylaxis or treatment of feeble-mindedness symptoms associated with diseases that can induce feeble-mindedness and higher cerebral dysfunction.
EFFECT: valuable medicinal properties of agents.
12 cl, 3 tbl, 5 ex
FIELD: medicine, cardiology.
SUBSTANCE: the present innovation deals with treating patients with ischemic cardiac disease at the background of type II diabetes. For this purpose, in case of stenocardia of functional class II and type II diabetes of average severity degree one should introduce enalapril at the dosage of 20 mg/d in combination with trental at the dosage of 400 mg/d, and at stenocardia of functional class III and type II diabetes of severe flow one should introduce enalapril at the dosage of 30 mg/d in combination with trental at the dosage of 400 mg/d. The innovation suggested normalizes monocytic-macrophageal link of immune system.
EFFECT: higher efficiency of correction.
2 ex, 4 tbl