The method of complex pathogenetic therapy of patients with opisthorchiasis


(57) Abstract:

The invention relates to medicine, in particular to a gastroenterologist, and can be used for the integrated treatment of opisthorchiasis. Previously conducted diagnostic sensing. During the first three days appoint drink electroactivated aqueous solution EVR-K. It is prepared by adding a small anodic capacity of the apparatus "Espero" 20 ml of 10% aqueous solution l2, 25 ml of a 5% solution of MgSO415 ml of 4% aqueous solution of KCl, and a large cathode capacity of 50 ml of 0.01% aqueous solution KMPO4. Do rectally microclysters with the use of heated neutral EVR solution (anolyte) with the addition in the anode zone 1/3 teaspoon of salt. Antihelminthic drugs prescribed 5 day standard scheme reduced by 1/3 and pay obscurati dose. The next day, spend duodenal lavage herbal solutions. table 1.

The invention relates to medicine, in particular to a gastroenterologist, and can be used for the integrated treatment of parasitic diseases, for example of opisthorchiasis in different clinical forms.

Currently, the successful solution of the system sabm therapies. The prevalence of helminthiasis large areas makes them study the actual problem. Clinic of opisthorchiasis is characterized by signs of organ damage of parasitism opistorhisov (liver, bile ducts, gall bladder, pancreas), as well as changes in gastro-intestinal tract. This explains the need to develop a comprehensive step by step-restorative treatment of patients with inclusion of remedial measures anti-inflammatory, stimulating, preparatory therapy with the aim of creating conditions for more effective treatment of disease using known chemical drugs, as well as potentiation of their actions and the subsequent correction of functional disorders of the digestive system, persisting after deworming.

As a rule, the treatment of parasitic diseases is carried out only if infected with opisthorchis persons of any violations on the part of the digestive system. So, in chronic opisthorchiasis in the pathological process is constantly involved the liver and the hepatic ducts, pancreas, duodenum, tonkinson to tens of thousands of mechanical damage areas of the mucosa of the biliary system. These changes result in dyskinetic disorders of the gallbladder and bile ducts, which in turn leads to the development of the inflammatory process. Differential diagnosis and subsequent treatment of various forms of cholecystitis, biliary dyskinesia, cholangitis is basically carried out according to the x-ray study, echolocation, duodenal intubation. Modern methods of treatment of parasitic diseases include first of all the drugs causal actions aimed at suppressing the invasion, the etching of parasites with the help of specific chemotherapeutic agents. It is known that deworming patients with chronic opisthorchiasis to help stop the progression of the process, in some cases, does not lead to full recovery.

For the treatment of chronic opisthorchiasis currently there are two major drug - biltricid and haxel and their analogues, including foreign ones. However, satisfactory tolerability sick of many of these drugs unavoidable adverse reactions: headache, increased stools, dizziness, dyspeptic symptoms, pain in the right hypochondrium, nausea, heartburn, itchy skin, hives. Moreover, many of these preparato is s (Fingers A. I. Clinic, diagnostics, treatment of lesions of the pancreato-duodenal area in opisthorchiasis. - Abstract. Kida. dessert. - 1983. - S. 147-153).

Most chemicals have many contraindications because of their side effects. Moreover, some authors have noted the lack of positive clinical dynamics after specific chemotherapy and the development of organ pathology after application of drugs such as, for example, floxil. To ensure the possibility of reducing the side effects of chemical drugs suggested holding pathogenetic preventive therapy with special emphasis on the relief of manifestations of the main pathogenic syndromes. But some funds preventive therapy does not solve the problem of reducing intoxicado action of chemical substances.

Known methods of treatment of parasitic diseases, including pathogenic preventive therapy using antibiotics, sedatives, anabolic steroids, prednisolone, vitamins. (A. I. Fingers. - Diseases of the digestive system chronic opisthorchiasis (clinic, diagnostics, treatment). - Novosibirsk. - 1996. - S. 145-146). The comprehensive pathogenic to premiumfineroast clinical, biochemical, immunological characteristics of different parts of digestive system, primarily the liver, and nausea signs of major pathogenic syndromes before (or after) the specific chemotherapy. However, the use as a preventative measure hormonal drugs, antibiotics also has a profound effect on patients whose digestive system is already burdened by intoxication, significant shifts of the immune system and so on, moreover, that the dosage of chemicals remain unchanged and do not tend to decrease.

Deworming-based combination chemotherapy that includes tyubazhi on Demyanova, colonic irrigation, the purpose of anti-inflammatory drugs, choleretic herbs. After completion of the course of deworming medication and physiotherapy stimulation functions of the biliary tract continues.

In recent years, there has been the development of methods of complex treatment of opisthorchiasis, including the use of a new physiotherapy products - diadinamophoresis of a 5% solution of dry brine as the stage of rehabilitation treatment after chemotherapy (E. I. Beloborodov et al. Chronic pistorio the x events with the aim of improving the functional state of the stomach, changes which inevitably remain after deworming. However, such rehabilitation activities are conducted only at the stage of recovery (sanatorium-resort treatment, and not preceded by chemotherapy.

For the prototype accepted method for the treatment of opisthorchiasis, including, along with chemotherapy, preventive pathogenetic therapy using tyubazhi with mineral water and colonic irrigation. (A. I. Fingers. Clinic, diagnostics, treatment of lesions of the pancreato-duodenal area of chronic opisthorchiasis. - Abstract. Kida. Diss. - 1983. - S. 14).

However tyubazhi are appointed, usually after several days of receiving chemotherapy, for example hloksila, moreover, the effectiveness of this procedure is low, and colonic irrigation, often with plant solutions is performed after chemotherapy.

The aim of the present invention is mild manifestations of the main pathogenic syndromes of opisthorchiasis by specific therapeutic lavage prior chemotherapy, and creating conditions for potentiation of drugs.

This goal is achieved by the fact that preventive pathogenetic tone of nutritional supplements "Narine-f" designate electroactivated aqueous solutions (EVR) per os in the form of rectal microenema within three days of hospital stay after diagnostic duodenal intubation and immediately prior to admission (the introduction) of chemotherapy and subsequent intestinal irrigation, and for drinking prepare a solution EVR (catholyte) with the addition of 1000 ml of distilled water and 20 ml of 10% aqueous solution of CaCl215 ml of 4% aqueous KCl solution, 25 ml of a 5% solution of MgSO4- in the anode zone, 50 ml of 0.01% aqueous solution of KMnO4- in the cathode area of the device "Espero"; for rectal washes use warmed neutral solution EVR (analyte) with the addition in the anode zone 1/3 teaspoon of table salt (NaCl). After chemotherapy prescribed treatment of duodenal lavage.

Solutions for drinking assign within 3 followed the first sensing days of hospital stay at a dosage of 100-200 ml 3 times a day for 20-40 minutes before eating; in the evening spend a cleansing enema with warm neutral EVR solution (anolyte), activate 12 min and use the solution of larger capacity. Enema with single-And anti-inflammatory, antiseptic, and in conjunction with the reception of per os single-To the effect of activation of eggs opistorhisov (Parasitology effect). Food supplements "Narine-f" broad-spectrum designate 1 day for the entire course of treatment at a dosage of 1 tablespoon 3 times daily before meals to reduce toxicity while receiving chemotherapy.

5 KSIL and analogues) according to the scheme in accordance with the instructions for use, but with reduced pay and obscurati dosage of chemotherapy drugs. The next day, spend duodenal lavage plant solutions (for example, chamomile).

Patients with massive invasion, concomitant diseases and especially burdened with allergic history, deworming is toxic and allergic reactions, appoint intraduodenal electrophoresis with electrolytic silver and delagil. (E. E. Bazhenov et al. Treatment of chronic opisthorchiasis intraduodenal electrophoresis electrolysis of silver and delagila. Topical issues of gastroenterology. - Sat. the scientific. Tr. - Tomsk. - 1994. - S. 14).

Analysis of various methods of treatment of common parasitic diseases, such as opisthorchiasis conducted by a number of researchers and practitioners, and confirms the need for adjuvant therapy, aimed at a more rapid identification and relief of the main clinical symptoms. Used to date physiotherapeutic methods of treatment, for example tyubazhi, do not allow to achieve the effect of activation (Wake) eggs opistorhisov that multiply in the intestine of the host in a huge kolichestvo nutrients, first of all fats and fat-soluble vitamins. Using of electroactivated aqueous saturated solutions of salts, trace elements, allows during the pre-treatment wash (preventive therapy) to create the possibility of activation of helminth eggs and partial loss of the bile ducts and gall bladder of their maximum accumulation and reproduction is already at the stage preceding chemotherapeutic treatment. Subsequent chemical exposure is more effective, because more parasites get into the zone of action of chemotherapeutic agents. Bacteriological examination of feces for opisthorchiasis reveals the presence of a dysbacteriosis of various degrees of severity of a great number of patients, which in turn leads to decreased immune system of the body.

therapeutic effect is enhanced by the inclusion in the stage of preventive therapy supplements "Narine-f"and implantation of intestinal omnilore high bacteriostatic activity and stimulating the growth of native microflora of man.

Proposed according to the invention the stage of preventive treatment allows you to enter drugs at subtherapeutic di microflora person has the effect of activation of parasites, their partial leaching, and enhancing the action of chemotherapeutic agents.

Thus, inclusion in treatment complex "Narine-f, implantation of intestinal omnilore and destination electroactivated aqueous solutions according to a certain scheme and in certain ratios of trace elements, allows to make a conclusion about conformity of the invention, the criterion of "substantial differences".

The method of complex pathogenetic therapy of patients with opisthorchiasis is as follows.

On the first day appointed medical intubation with herbal solutions, which is aimed at relieving inflammation of the bile ducts and active flow of bile, which allows access to the places where parasites. With 2 days during the entire course of treatment is prescribed receiving per os electroactivated aqueous solution (100 ml 3 times a day for 20-40 minutes before eating in small SIPS), prepared according to the following recipe: in a small and a large capacity apparatus "Espero" pour 1000 ml of warmed up to 30-40oC distilled water. In a small container (anode) add 20 ml of 10% aqueous solution of CaCl2, 25 ml of a 5% solution of MgSO4, 15 ml of 4% KCl; in the cathode zone, add 50 ml of 0.01% is the duty to regulate drinking until the day of his preparation, the next day the solution is prepared again.

In these early days (every other day) in the evening before bedtime patients designate a cleansing enema with Catolica (1-1 .5 l) of the following composition: in the anode area with distilled water, heated to 45-55oC, add 1/3 teaspoon of table salt (NaCl); solution activate 12 min and injected into the intestine in the form of heat (t = 38-40oC). For washing of the large capacity of the apparatus taken this amount of liquid, which causes the urge for defecation, but is retained in the rectum is not less than 20-40 minutes the Purpose of this manipulation is to achieve anti-inflammatory effect, to restore the integrity of the mucosa and to prepare the bowel for subsequent implantation of omnilore. "Narine-f" designate from 1 day to 1 tbsp 2-3 times a day for 30-40 minutes before meals for the entire course to achieve immunostimulating, bacteriostatic effect, improving the metabolic processes, and also to stimulate the growth of intestinal microflora. Diet - milk, bread, vegetables. 4-8 day - no-Spa on 2 tab. 3 times a day.

On the 9th day is a day treatment biltricid, but the daily dose is divided into three reception at night time: 22 hours, 2 and 6 hours. While the single dose reduced: instead ogushi (10) day appointed medical duodenal intubation with plant solutions for example chamomile, to relieve intoxication due to active erosion bodies of worms and residues of drugs.

On the 11th day in the evening held a cleansing enema with anolyte (1-1 .5 l), on the 15th day with Catolica order to obtain an antiseptic, bactericidal and bacteriostatic effect against living helminths and leaching them from the intestines. The next (12) day to improve your own immune system and create a physiological balance is rectal through the probe implantation of bacterial preparations (bacteriophage, bificol and others) by the method developed by us (U.S. Pat. RF N 2092167).

The proposed method of treatment with application of electroactivated aqueous solutions on the background of dietary supplements "Narine-f" broad-spectrum has obvious advantages over the known methods of treatment of parasitic diseases, including before the method adopted as a prototype. Our research has shown that the appointment of electroactivated aqueous solutions with a certain number and ratio of active elements in the first days of hospital stay not only contributes to the activation of the parasites, but has a prot is Biopreparat.

The effectiveness of the proposed method is studied on the example of two groups of patients. Patients of the first group (38 people) received antihelminthic treatment with praziquantel (biltricid), which was administered in a daily dose of 60 mg per kg of body weight (one-day course). Pathogenetic therapy consisted of conducting tyubazhi with mineral water (on Demyanova) after completion of chemotherapy. 18 (47,3%) patients experienced side effects of praziquantel in various manifestations - from headaches, fever to joint pain, ECG changes, and others; the frequency of their appearance has led to the need to abolish anthelmintic 4 (10,5%) patients, 5 (13,1%) patients was also performed symptomatic treatment. Sensing is carried out after treatment with praziquantel, has revealed the presence of parasites in 7 patients who were assigned to the re-rate after 6 months.

Patients of the second group (96 people) underwent combined pathogenetic treatment by the proposed method with the use of food supplements "Narine-f" for the entire course and electroactivated aqueous solutions prior to appointment of praziquantel.

Daily dose of praziquantel for the majority of patients (91 people) was 3 doses per day). 14 (14,5%) patients after chemotherapy showed adverse effects (6 - itching, hyperemia of face, 8 - dizziness, weakness). The remaining group of patients is 82 persons (85,4%) did not complain of anything during the entire treatment course. Duodenal intubation, done 6 months revealed no parasites in 96 (100%) of the patients.

Dynamic observation of patients in both groups in 3-6-12 months showed that most of the patients of the first group (29 persons of 76.3%) positive dynamics is not marked, 8 person (8,3%) showed a clinical improvement, 1 person on the re-examination was not. On the contrary, a greater number of patients of group 2 (85 people and 88.5%) showed clinical improvement (see table at the end of the description).

Example 1. Patient P., 36 years. Was admitted to the hospital, Interregional center of correction of microbiocenosis person (MCMC) with a diagnosis of opisthorchiasis, XP. parasitic cholecystitis. History - XP. gastro, XP. tonsillitis. Complaints of pain in the right hypochondrium, flatulence, bitter taste in the mouth.

During examination - abdomen normal configuration, painful in the projection of the gallbladder. The diagnosis of opisthorchiasis (identified for the first time), Chr. parasitic cholecystitis cf. Art. of gravity, dyskinesia GIT on the mixed type.

6 day - drug biltricid - day course in three steps (after 6 hours) and 15 mg per kg of body weight after eating. The next day, the second duodenal intubation - washing in Vitebsk, at the end of the wash - through the probe to enter the bacteriophage (10,0).

Already on day 5 of hospitalization pain in the right hypochondrium decreased. Left dyspeptic symptoms, anorexia, General weakness. The abdomen is soft, moderately painful during deep palpation. Chair 1 times a day, decorated.

On the 7th day (after receiving biltricid and duodenal lavage) parasites not detected, bitter taste in the mouth disappeared, feeling normal. Discharged with positive dynamics.

Recommended to continue taking choleretic herbs within 1 month, tyubazhi 1 time per week, "Narine-f" - within 1 month. When sounding at 6 months. parasites were not found.

Example 2. Patient Z., 41. Admitted to the hospital with a diagnosis of opisthorchiasis, aggravation. Makes complaints is. cholecystitis with acute exacerbations of 2-3 times per year. Probing results: in the portion "B" (60 ml) egg opistorhisov. Feces on the helminthes eggs opistorhisov. The examination of the tongue coated, the tension in the projection of the gallbladder. Abdomen palpation is painful. The diagnosis of opisthorchiasis in the acute stage, hyposmocoma dyskinesia GIT.

Purpose: within the first 3 days after sensing - drink warm solution EVR-100 ml 3 times a day for 40 minutes before meals, the product "Narine-f" 1 tbsp 3 times a day, suprastin - 1 tab. on the night.

On day 5 after cleansing enema - rectal lavage with warm water EVR-And with NaCl. On the 6th day appointed antiparasitic therapy - biltricid - not more than 45 mg per 1 kg of body weight three times in an hour after a meal. Herbal medicine - a decoction of oats - 50 ml 3 times a day before meals. Diet - table No. 5.

On day 6 - duodenal lavage in Vitebsk (with a solution of chamomile). At the end of the washing - introduction of bificol through the probe (40,0). The patient does not submit a plaintive nausea, pain in the right hypochondrium decreased. The headaches stopped after 5 day hospital stay.

The study of duodenal contents and microscopic analysis of parasi is lnoe. Nausea't bother, appetite, sleep calm. On palpation, the liver is not enlarged. Chair 1 time per day, is decorated.

Was discharged in good condition under the supervision of a specialist. Recommended: tyubazhi - 1 time in 10 days, within 10 days, to continue receiving choleretic herbs.

At the next sensing (6 months) parasites were not identified.

The method of complex pathogenetic therapy of patients with opisthorchiasis, including the appointment of anthelminthic drugs, characterized in that after the diagnostic sensing taking "Narine-f" during the first three days the patient drink electroactivated aqueous solution EVR-K, prepared by adding in a small anodic capacity of the apparatus "Espero" 20 ml of 10% aqueous solution of CaCl2, 25 ml of a 5% solution of MgSO415 ml of 4% aqueous KCl solution, and in most cathode capacity of 50 ml of 0.01% aqueous solution of KMnO4and rectal microclysters with the use of heated neutral EVR solution (anolyte) with the addition in the anode zone 1/3 teaspoon of table salt (NaCl), and antihelminthic drugs prescribed on day 5 on the standard scheme, but with reduced pay 1/3 and obscurati dose, the next


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