A method of treating the recurrence of gastroduodenal ulcers by transendoscopic use of lysozyme with molecular iodine

 

(57) Abstract:

The invention relates to medicine, namely to a gastroenterologist, and can be used for the treatment of recurrence of gastroduodenal ulcers by transendoscopic use of lysozyme with molecular iodine. Conduct targeted treatment of the ulcer and periultseroznoy zone 5 ml of an aqueous solution of lysozyme concentration of 5 mg/ml After three minutes exposure defect irrigated with 6 ml of Lugol solution. The procedure is repeated after 3-5 days to complete cicatrization of the ulcer. The way you can affect the microorganisms of the gastric mucosa. This increases the effectiveness of the treatment.

The invention relates to medicine, namely to a gastroenterologist, to transendoscopic methods of local treatment in complex therapy of ulcerative lesions of the upper parts of the gastrointestinal tract.

Currently in gastroenterology at transendoscopic pharmacological treatment of gastroduodenal ulcers (WHERE) apply the ways in which drugs are used to enhance tissue regeneration (1) providing an anti-inflammatory effect (3) forming a protective film on the surface of ulcers (5) that blocks the nerve endings or N. the treatment of ulcers can be attributed to the underestimation of the need for rehabilitation ulcerative crater and periultseroznoy zone from microorganisms and their metabolic products. Antibacterial drugs used in combination with transendoscopic treatments, WHERE, have only antimicrobial action, without solving the problems of adsorption, immobilization and deadening steps for living and dead microbial cells from the surface of somatic cells, inducing and supporting the inflammatory and immunological processes in tissues.

The prototype of the claimed method is a method for local application of lysozyme in the treatment of duodenal ulcer. The method is to chip ulcers lysozyme (100-150 mg) and repair drug (daily by or Actovegin) at a dose of 4-5 ml at different points, and then irrigation with 5 ml of sea-buckthorn oil. The point of injection in the edges of the ulcer with repeated procedures have changed. The procedure was carried out through the day, the course of treatment consisted of 3-5 treatments. Using this method were treated 12 patients with peptic ulcer of the duodenum, the treatment time which was 6-10 days (4).

The disadvantages of the prototype include the technical difficulty of the procedure, multiple additional trauma CO periultseroznoy zone. In addition, when the prototype of the method of application of lysozyme is not used in antimicrobial potential is July ulcers. Prototype technology tested in the treatment of patients with peptic ulcer disease only of the duodenum, but not in the stomach.

The authors propose the following method of local treatment of relapse of WHERE. When transendoscopic detection, WHERE using a Teflon catheter is aiming processing defect WITH and periultseroznoy zone 5 ml of an aqueous solution of lysozyme concentration of 5 mg/ml After three minutes of exposure to the treated area is applied with 6 ml of Lugol solution, which leads to the immediate formation of solid complexes of lysozyme with molecular iodine Lugol solution, immobilisers and sorbing microbial body. Re transendoscopic processing was performed 3-5 days to complete cicatrization of the ulcer. Along with local treatment, patients received medications depending on etiopathogenetic features, WHERE. We examined 100 patients. The composition of the microflora in the biopsies of the mucosa was studied quantitatively and qualitatively by determining the morphological, tinctorial, cultural, biochemical properties and method of micrometrology. Lysozyme activity was determined using standard methods in a) the concentration of lysozyme in saliva and HYP is of 19.2 µg/ml and of 1.52 µg/mg, respectively. It is established that when the WHERE in the mucosa periultseroznoy zone amid falling lysozyme activity constantly identified various associations of bacteria consisting of lactobacilli, fungi of the genus Candida, Helicobacter, staphylococci, streptococci, enterobacteria and other microorganisms that have expressed biological activity. Transendoscopic irrigation ulcers above the proposed method provided as microbicides and sorption, immovable and deadline activity against all microorganisms isolated from biopsies FROM HYP. The content of microorganisms in periultseroznoy area decreased with an average of 100 times. In the treatment of patients WHERE there was a positive dynamics of activity of lysozyme in saliva, and WITH HYP. Possible scarring ulcers compared with the control group decreased from 19 to 11 days (p < 0.05). The proposed method transendoscopic use of lysozyme with molecular iodine in the treatment of WHERE technically simple, cost-effective, efficient, practically has no contraindications and no complications.

The invention is illustrated by the following laboratory and clinical data:

EXAMPLE 1. Patient B., age is a period of two months. At endoscopy on the back of the duodenum revealed ulcer size 0,8h0,h,5 cm with fibrin in the bottom and overhanging edges. The activity of lysozyme in saliva - 4 µg/ml, biopsy samples WITH 0.25 microgram/mg Total microbial number of biopsies WITH before treatment by the proposed method - 3,h5CFU/g After the treatment by the proposed method is total bacterial count biopsies CO - 2,8x103CFU/g, the activity of lysozyme in saliva - 16 µg/ml, biopsy samples WITH 0.5 μg/mg for the Treatment of ulcers of the proposed method was carried out as an outpatient every 3 days. Scarring with the formation of pink scar achieved on day 12 of treatment.

EXAMPLE 2. Patient S., aged 55 HP (history N 6513) entered the medical Department with severe pain and dyspeptic syndrome, first identified ulcer in the body of the stomach with a diameter of 1.7 to see Treated in therapeutic patient receiving eradication antihelicobacter therapy, antisecretory and reparative preparations for 23 days without effect. It was decided to apply the proposed method. The activity of lysozyme in saliva - 4 µg/ml, biopsy FROM - 0.2 ág/mg of Total microbial number of biopsies WITH before treatment by the proposed method - 1,6X106CFU/g After the treatment by the proposed method is total bacterial number is a multiple of transendoscopic treatment achieved cicatrization of the ulcer.

List of abbreviations

GDZ - gastroduodenal area,

The WHERE - gastroduodenal ulcer,

Duodenum - duodenal gut,

CFU - colony forming unit,

CO - mucous membrane

References

1. Buyanov C. M., Mach Century H., Perminova, I. Therapeutic endoscopic gastroduodenal ulcers. - Stavropol, 1986, - 96 S.

2. Gavrilova O. A. Factors local protection of the oral cavity and the condition of periodontal tissues in preschool children and children with congenital cleft lip and palate: Diss. Kida. the honey. Sciences. - Tver, 1997, - 177 C.

3. Krichmar I. M. possibilities of endoscopic treatment of gastroduodenal ulcers in surgical practice // journal of surgery. Grekov. -1991. - T. 146, N 5/6. - S. 103-104.

4. Patent of the Russian Federation 2082413, publ. 27.06.1997.

5. Strelnikov B. E., Red A. M. Treatment of acute and long-term healing of gastroduodenal ulcers glue "gastrozol" outpatient // Clinical medicine. - 1983.- So 61, N 10. - S. 27-30.

6. Tolmach D. C., Chubenko S. C. Therapeutic endoscopy diseases of the digestive system // Medical business. - 1990. - N 11. - S. 84-86.

7. Fazylov A. C., S. Iskhakov I. Endoscopic therapy for peptic ulcer disease dvenadtsatyi="ptx2">

A method of treating the recurrence of gastroduodenal ulcers by local transendoscopic use of lysozyme, characterized in that conduct targeted treatment of the ulcer and Proletarskoy zone 5 ml of an aqueous solution of lysozyme concentration of 5 mg/ml with subsequent irrigation after three minutes exposure 6 ml of Lugol solution, the procedure is repeated after 3-5 days to complete cicatrization of ulcers.

 

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