The method of treatment of chronic viral hepatitis

 

(57) Abstract:

The invention relates to medicine, Hepatology, to methods of treatment of chronic viral hepatitis. Enter the interferon inducer yodantipirin at a dose of 200 mg/day 4 times a week for 6 months, and throughout the course of treatment every two weeks supervise clinical syndromes, transaminase levels, and normalization of dose reduced to 100 mg/day 3-4 times a week. This method allows you to expand the Arsenal of tools for the treatment of this disease, can be treated with a drug without side effects, typical of the drugs interferon increases the effectiveness of treatment of viral hepatitis.

The invention relates to the field of medicine, Hepatology, particularly to a method of treatment of chronic viral hepatitis.

Closest to the present invention is a method of treatment of chronic viral hepatitis, which consists in assessing the stage of viral liver disease by conducting biochemical, serological, morphological tests and in determining the replicative phase of the virus interferon at a dose of 3 million ED times a week for 6 months. However, this method has h the virus, seroconversion HBe Ag, anti-HBe normalization of the levels of Alt and AST, is associated with numerous side effects: chills, fever up to 40oC and above, bone and joints, muscle pain, General weakness, headache, allergic skin reactions, hair loss, depression of bone marrow function, dysfunction of the thyroid gland, autoimmune processes [2].

A new technical result is a decrease in the number of complications - reaching application of the new method of treatment of chronic viral hepatitis, including the determination of the stage of viral liver disease by conducting biochemical, serological, morphological studies, and when determining the replicative phase of the development of virus-purpose antiviral drug, and as an antiviral drug prescribed interferon inducer yodantipirin at a dose of 200 mg/day 4 times a week, for 6 months, and throughout the course every two weeks of treatment to control clinical syndromes, transaminases, and when normalization of dose reduced to 100 mg/day 3-4 times a week.

The method is as follows. At admission the patient spend obeslim of biuret reaction, bilirubin method Indrasena-Grof, AST and Alt in Reitman Frankel, alkaline phosphatase method Bessey, Lowry, Thymol turbidity tests on Huergo and Poplar serological (definition of HBs Ag, HBeAg, HBcor At YgM, HCV At YgM) Virology (definition HBVOHK, HCVPHK by polymerase chain reaction), morphological (data percutaneous puncture, coresidence biopsy). Identify the replicative phase of the development of the virus, at which point the chronic viral lesions, increased transaminase not less than two times, the presence of serum HBeAg, HBeAb YgM, HCV Ab YgM, DHK HBV ^HCV RNA [3]. When determining the replicative phase of the development of the virus, the patient is assigned yodantipirin at a dose of 200 mg/day 4 times a week, for 6 months.

Yodantipirin (1-phenyl, 2-3-dimethyl, 4-iteration) is the official drug (instruction Pharm. Committee of the Ministry of Health and Medical industry of the Russian Federation) registration number 96/316/2-96/316/5 permitted for use as interferoninducible, neutralizing, membrane-stabilizing, anti-inflammatory, antiproliferative, immunocorrective tool, and recommended for the treatment of tick-borne encephalitis, influenza and other acute respiratory viral infections in adults. On the drug reduced to 100 mg/day 3-4 times a week.

In this way treated 20 patients, including viral hepatitis b in 12 patients, viral hepatitis C in 8 people, women and 6 men 14, the average age 351,5. The dose selected on the basis of observations for the given category of patients. A lower dose was not effective, a large dose could cause the opposite effect associated with inhibition of the induction of interferon and lead to undesirable consequences. A break in the appointment caused the pharmacological characteristics of the drug action in 24-48 hours. Monitor transaminases, conducted after 2 weeks associated with the need for careful evaluation of the action of the drug, the exact time of onset of clinical-biochemical sustained improvement. When normalizing transamin dose was reduced due to the need to reduce drug burden on the patient. The medication twice a day, morning and evening, selected for uniform inflow and distribution of medicines in the body of the patient.

Example 1. Patient T., 46 years old was admitted with a diagnosis of chronic viral hepatitis (b+C) moderate activity, St. the chronic phase of viral replication. Upon receipt of a complaint of heaviness in the epigastric region, the hen during the professional inspection accidentally revealed the increase of transaminases, bilirubin. Contact with patients with viral hepatitis denies. History for 5-6 months before the appearance of weakness, reduced efficiency, light pain in the right hypochondrium repeated dental procedures. The diagnosis of chronic viral hepatitis is confirmed in the Department of gastroenterology OKB. From the proposed treatment with IFN patient refused due to the high cost of medication and the inability of its acquisition. Indicators of transaminases before treatment Act Of 3.64 Alt 3,98 markers of viral hepatitis HBS ag+, Nveag+, Nsat YgM+, V YgM+, PCR:HBV DNA+, HCVPHK+, needle biopsy showed inflammatory infiltration of portal tracts 8 points, degeneration of hepatocytes 3 points, weak degree of fibrosis 1 point assigned yodantipirin 200 mg/day 4 times a week every two weeks of receiving the dynamics of transaminase, the next 2 weeks

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Dose yodanthipirina during the whole time of receiving 200 mg/day, dose adjustment was not carried out. For the entire period of observation, there were no complications of therapy, characteristic of the drug interferon, which is the main method of treatment of viral liver disease. The subject of the rd, and by the end of 2 months and relief of these symptoms, increase efficiency, significant reduction of weakness, fatigue. The improvement remained stable for the entire period of observation. The drug is well-tolerated, side effects are not identified.

Example 2. Patient A., 25 years old was admitted with a diagnosis of chronic viral hepatitis With mild stage of activity, stage 1 chronic phase of viral replication. Upon receipt complained of loss of appetite, nausea, General weakness, insomnia, heaviness pain in the right hypochondrium almost constant. Considers himself ill in 1992 after blood transfusion. After 3-4 months the following symptoms of a flu-like condition, then came jaundice, after examination, was diagnosed with chronic viral hepatitis. From the proposed treatment with IFN patient refused because of the side effects associated with the use of the latter and its high cost. Indicators of transaminases before treatment AST 1.9 Alt 1,8 Markers of viral hepatitis: HBS ag, HCV at YgM+, PCR: HCV RNA+, HBV DNA, needle biopsy showed inflammatory infiltration of portal tracts 4 points, degeneration of hepatocytes 2 points, weak degree of fibrosis 1 point. Assigned yodantipirin 200 mg/su per week

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For the entire period of observation, there were no complications of therapy, are typical for the use of the antiviral drug interferon - (reaferona), which is used as the main method of treatment of chronic viral hepatitis. By the end of the first month of treatment, the patient noted improvement in health as edema dyspepsia, asteno vegetative, pain syndromes, the improvement remained stable during the whole observation period. Tolerability assessed by the patient as a good, side effects are not identified. Held every two weeks in the control of clinical and biochemical parameters showed a strong tendency to normalization of transaminases and was used as a criterion for evaluation of treatment effectiveness, adequacy selected dose of medicinal product - yodanthipirina.

Thus, the proposed method for the treatment of chronic viral hepatitis allows you to expand the Arsenal of tools for the treatment of this disease, can be treated with the drug without the side effects typical of interferon products. Yodantipirin is a domestic, affordable, effective, non-toxic, well-tolerated by patients Preparata.

References

1. Podymova C. D. Russian Medical Journal, 1996, 2. "The problem of chronic viral hepatitis /diagnosis treatment/".

2. Mashkovsky M. D. Drugs, volume 2, S. 389. - M.: Medicine, 1993

3. Grigoriev, P. J. Manual of gastroenterology. - M.: Medicine, 1997, S. 216.

The method of treatment of chronic viral hepatitis, including the determination of the stage of viral liver disease by conducting biochemical, serological, morphological studies and the determination of replicates phase of development of virus-purpose antiviral drug, characterized in that as an antiviral drug prescribed interferon inducer yodantipirin, at a dose of 200 mg/day 4 times a week for 6 months, and throughout the course of treatment every two weeks supervise clinical syndromes, transaminase levels, and normalization of dose reduced to 100 mg/day 3-4 times a week.

 

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SUBSTANCE: the innovation suggested interrupts infectious-toxic shock, moreover, after that it is necessary to prescribe peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg. Then one should sample patient's blood to obtain leukocytes to be washed and diluted in 0.9%-NaCl solution, activated due to incubation with immunophan and intravenously injected for a patient. Then comes peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg once daily for 5 d. The innovation enables to decrease the number of complications and lethality due to decreasing immunodeficiency.

EFFECT: higher efficiency of therapy.

3 ex, 1 tbl

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