The method of treatment of rheumatoid arthritis

 

(57) Abstract:

The invention relates to medicine, namely to rheumatology, and is intended for the treatment of rheumatoid arthritis. The method includes the introduction of non-steroidal anti-inflammatory drugs and ceruloplasmin, which is injected intravenously 10 times a day. 100 mg of ceruloplasmin before the introduction dissolved in 200 ml of 5% glucose or saline solution. The method allows correcting serum enzyme level of the antioxidant system and reduce endogenous intoxication in this disease. 1 C.p. f-crystals.

The invention relates to medicine, namely to rheumatology, and is intended for the treatment of rheumatoid arthritis.

Known methods of treatment of rheumatoid arthritis, in which the complex traditional treatments include pharmacological tools antioxidant, such as vitamin E and vitamin A, C, P, K and with non-steroidal anti-inflammatory drugs /1/, tocopherol at high doses (500-600 mg/day) and Essentiale-Forte oral or intravenous /2/. These methods are based on correction of the deficiency nonenzymatic element of the antioxidant system, inhibition of peroxidation OK is Musasa in patients with rheumatoid arthritis insufficiency element of the antioxidant enzymatic system, because of antioxidant enzymes in this way are not used.

Closest to the claimed is a method of treatment of rheumatoid arthritis, including the introduction of enzymatic antioxidant orgotein on the background of oral administration of non-steroidal anti-inflammatory drugs /3/. Orgotein injected intra-articular dose of 8 mg on an injection once a week). The course of treatment 4-6 injections.

The disadvantage of this method of treatment is the fact that corrects only the cellular element of the antioxidant enzymatic system of the body, because orgotein have superoxide dismutase activity, which is the main cellular antioxidant enzyme carrying out its protective action is intracellular. Serum accumulate highly aggressive superoxide radicals and toxic products of lipid peroxidation, which requires correction of serum enzyme level of the antioxidant system.

The objective of the invention is the correction of serum enzyme level of the antioxidant system. This task is solved in that in the method of treatment of rheumatoid arthritis, including the introduction of enzymatic antivimentin antioxidant use of serum ceruloplasmin, which is injected intravenously 10 times a day, to which 100 mg of ceruloplasmin ex temporae dissolved in 200 ml of 5% glucose or saline solution.

Drug "ceruloplasmin" - "Ceruloplasminum humanum placentaris" produced from waste products of the blood products. It stimulates hematopoiesis (red blade of blood), reduces toxicity and immunosuppression, binding of superoxide radicals and providing membranostabiliziruyuschee action.

Ceruloplasmin is a copper-containing enzyme alpha-globulin fraction, is the main antioxidant serum. In the serum of a healthy person contains 303 + 124 mg/l ceruloplasmin, which is the "interceptor" oxygen free radicals circulating in the blood. It protects lepidosperma patterns from the action of superoxide radicals, prevents the free lipid oxidation.

In patients with rheumatoid arthritis the content of ceruloplasmin in the serum may be normal or elevated, but even increasing the concentration of ceruloplasmin in the blood does not compensate the existing intensification of the processes of lipid peroxidation.

The introduction of full donor ceruloplasmin in patients with rheumatoid arthritis. Ten intravenous infusion of ceruloplasmin allow to improve the clinical condition of the patient, leading to a pronounced detoxifying, antioxidant and anti-anemic effect. Introduction ceruloplasmin through the day due to the fact that the effect of the introduction of the drug is not more than 48 hours.

The method is as follows. The contents of one vial of ceruloplasmin (100 mg) immediately before introduction dissolved in 200 ml of 5% glucose solution or isotonic sodium chloride solution and injected intravenously at a rate of 30 drops in one minute. The introduction of the drug carry a day in patients receiving nonsteroidal anti-inflammatory drugs (indomethacin, diclofenac, ortofen and others), the course of treatment 10 intravenous infusion.

Example 1. Patient E., 50 years of age, was treated in the Republican artrologicheskoy the centre of Sarnico with a diagnosis of rheumatoid arthritis, arthritis, HIV infection, stage 3 total activity 2, functional failure of joints 1.

At admission the patient was weakness, lethargy, stiffness in the morning for 6 hours, severe pains in the interphalangeal and metacarpophalangeal joint of the GDS for the first time, without apparent reason, pains and swelling in the wrist joints, in the small joints of the right wrist, and then in the ankle, metatarsophalangeal joints of both feet. Repeatedly was in outpatient and inpatient treatment for rheumatoid arthritis were treated: non-steroidal anti-inflammatory drugs (ortofen in table 1. 2 times a day), intra-articular injection of hormones (kenalog).

On examination: the patient is lethargic, marked pallor of the skin. Visually there is swelling, defigure left and right wrist joints, the second metacarpal-phalangeal joint of right wrist, II and IV interphalangeal joints of the left hand. Palpation tenderness in the area of the above joints. Movement in the joints is limited because of pain.

Laboratory data: complete blood count: erythrocytes 3,410", hemoglobin 91 g/l, colour index of 0.8, leukocytes 5,510', ESR 32 mm per hour, total protein, 76 g/l, SRV 2 mm, seromucoid 0,59.E., malonic dialdehyde 2.5 Ámol/l ceruloplasmin 333 mg/l, the average molecule weight 0,284.E.

The patient completed the treatment by the proposed method, including the introduction of ceruloplasmin in the background of continued therapy with nonsteroidal anti-inflammatory drugs in the same dosage as before therapy ceruloplasmin was dissolved in 200 ml of 5% glucose solution and injected intravenously at a rate of 30 drops per minute. Treatment consisted of 10 investments held through the day.

After treatment showed improvement in overall health and the clinical picture consisted in reducing lethargy, weakness, stiffness in the morning is actually absent, improved sleep and appetite, decreased the severity of joint pain (before treatment 5 points, after treatment 2 points), decreased swelling of the wrist joints. There was a positive dynamics laboratory indicators: increased number of erythrocytes to 3,910", the level of hemoglobin 114 g/l, colour index of 0.9. 2 times decreased erythrocyte sedimentation rate (16 mm per hour), Vietnam fell to 1.5 mm, seromucoid to 0.39.e, the level of malondialdehyde up to 2 Ámol/l, the level of molecules of average weight dropped to 0,268.E., the content of ceruloplasmin was equal to 335 mg/l

Thus, the patient with advanced and reasonable activity of the rheumatoid process introduction ceruloplasmin improved health, clinical status and laboratory values.

Some patients already after 2-3 injections showed a significant decrease in erythrocyte sedimentation rate, a reduction in the number of cells, a positive shift in terms of the blood formula, the increase is when he first showed swelling, pain in the small joints of both feet, then there was swelling of the left knee and small joints of both hands. Repeatedly was in hospital, where she was held the traditional course of conservative treatment, including non-steroidal anti-inflammatory drugs, intra-articular injection of hormones. At admission the patient experience pain in the right elbow, wrist, small joints of the hands, knee, ankle, small joints of both feet, as well as weakness, lethargy, stiffness in the morning till five o'clock. Objectively there is swelling, contracture of the wrist joint, right elbow, metacarpophalangeal joints of both hands, the smoothness of the contours of defigure right knee joint. Palpation is determined by tenderness along the line of the joint space, the signs of resultnode internal and external lateral ligaments, the symptom front of a drawer. In General, the analysis of blood upon receipt of erythrocytes 3,310", hemoglobin 95 g/l, colour index of 0.8, leukocytes 3,810', lymphocytes 26, ESR 65 mm/hour. In the biochemical analysis of blood flow C reactive protein 2,5; sialic acid 310; seromucoid 0,46, ceruloplasmin 310 mg/l Rheumatoid factor is adiya's, stage II, functional failure II. The patient started treatment with ceruloplasmin in the form of a course of intravenous fluids conducted through the day on the back of continued therapy with indomethacin (1 tab. 3 times a day). The contents of the vial of ceruloplasmin (100 mg) was dissolved immediately before introduction into 200 ml of saline and injected intravenously at a rate of 30 drops per minute. After three injections, the patient noted improvement in General condition, decreased intoxication symptoms: weakness, lethargy; stiffness in the morning decreased from 5 to 3 hours, the patient clearly notes the feeling of lightness in the joints after the introduction of ceruloplasmin, which was maintained for about 48 hours after the injection. After 10 injections, the patient has no symptoms of intoxication (weakness, lethargy, stiffness in the morning, decreased by approximately 60%, significantly reduced pain in joints, synovitis of the right knee joint was practically stopped. There has been a dramatic positive dynamics of indicators of the "red" blood and a positive trend in the decrease of the activity of the inflammatory process in the joints according to the General analysis of blood and reactive was more pronounced in two weeks after the start of treatment.

Thus, in addition to the antioxidant, the product has detoxifying and haemostimulating action, increasing the efficiency of treatment of rheumatoid inflammation.

The proposed method in the Republican artrologicheskoy center at Sarnico treated 45 patients reliable rheumatoid arthritis.

The proposed method of treatment has a positive effect on patients peroxidation-antioxidant imbalance and has a pronounced anti-anemic effect. The positive moment of introduction of ceruloplasmin is a significant detoxifying effect, which is manifested in the reduction of weakness, sweating, time, morning stiffness, improve sleep and appetite, normalization of body temperature. It was noted positive dynamics of the concentration of molecules of average weight - integrated biochemical test, reflecting the level of endogenous intoxication.

An additional positive aspect of the proposed method is intravenous, but not intra-articular, as in the prototype, the introduction of the drug. The latter avoids the difficulties and disadvantages inherent in intra-articular introduction, namely: does not require special training of the physician and sterile relavely method allows to achieve a pronounced therapeutic effect much faster (15-20 days), what is known (30-45 days).

In the proposed method uses the drug, derived from retroplatsentarno human blood, rather than a preparation from animal tissues.

Sources of information

1. Lobaria L. S. Denisov, L. N., Yakushev, E. O. "Antioxidant vitamins in the treatment of rheumatic diseases". The wedge. rheumatol., 1994, No. 3. C. 7-8.

2. Noskov, S. M. "Pathogenetic therapy of RA in the aspect of free-radical and lipid mechanisms of inflammation". - Abstract., Diss. Dr. med. Sciences. - Yaroslavl, 1993. - S. 50.

3. Kerimov, H. A. O., "Experimental and clinical evaluation of the effectiveness of orgotein in rheumatoid arthritis and deforming arthrosis". - Diss. Kida. the honey.Sciences., M., 1988. - N-100 /prototype/.

1. The method of treatment of rheumatoid arthritis, including the introduction of the enzymatic antioxidant drugs on the background of oral administration of non-steroidal anti-inflammatory drugs, characterized in that the enzymatic antioxidant use of serum ceruloplasmin, which is injected intravenously 10 times through the day.

2. A method of treating rheumatoid arthritis under item 1, characterized in that the intravenous injection of 100 mg Torulopsis the

 

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