The method of treatment of chronic viral hepatitis
(57) Abstract:The invention relates to medicine, therapy, can be used for the treatment of chronic viral hepatitis. In the replicative phase of the virus is injected drug exogenous interferon-alpha - Roferon in the dose of 1.5 ME intramuscularly 3 times a week with an interval of 48 h in combination with taking yodanthipirina in the days of injections of interferon 100 mg/day for 6 months. This invention will reduce the number of complications. table 2. 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, by carrying out biochemical, serological, morphological tests, and when determining the replicative phase of the virus interferon at a dose of 3 ME intramuscularly 3 times a week for 6 months.However, this method has low efficiency due to the significant number of complications, namely 30-40% of patients give a complete response to therapy, as manifested in the disappearance of DNA, RNA virus, normalize level, and, myalgia, weakness, headache, allergic skin reactions, hair loss, impaired thyroid function, autoimmune processes) .A new technical result is a decrease in the number of complications achieve application of a new method of treatment of chronic viral hepatitis, including the appointment in the replicative phase of the virus to antiviral drugs, and prescribe medication exogenous interferon-alpha (e.g., IFN) in the dose of 1.5 ME intramuscularly 3 times a week (with a break in 48 hours) in combination with taking yodanthipirina in the days of injections of interferon 100 mg/day for 6 months.The method is as follows. At admission the patient to conduct clinical research (collection of complaints, anamnesis, objective examination, biochemical (determination of protein by the unified method of biuret reaction, bilirubin method Indrasena-Grof, ACT and ALT on Reitman, Frankel, alkaline phosphatase method Bessey, Lowry, thymol test on Huergo and Popper), serology (detection of HBsAg, HBeAg, HBcorAb IgM, HCVAb IgM), virological (determination of HBV DNA, HCV RNA by polymerase chain reaction), morphological (data puncture percutaneous crespe the m virus lesions, increased transaminase levels not less than twice, the presence of serum HBeAg, HbeAb IgM, HBV DNA, HCV RNA . When determining the replicative phase of the development of the virus is assigned to exogenous alpha-interferon (IFN (Russia), or alpha-Feron (Italy) or Roferon (Austria) or wellferon (England) at the dose of 1.5 ME intramuscularly 3 times a week, in combination with taking yodanthipirina at a dose of 100 mg/day, 3 times a week for 6 months.Yodantipirin (1 phenyl, 2-3 dimethyl, 4 iteration) is officinal drug (instruction of the pharmacological Committee of the Ministry of health of the Russian Federation), registration number 96/316/2-96/316/5 permitted for use as interferoninducible, virusneutralizing, protivovospalitel-tion, antiproliferative, immunocorrective tool, and recommended for the treatment of tick-borne encephalitis, influenza and other acute respiratory viral infections in adults.Exogenous alpha-interferon, such as IFN (Russia) - recombinant alpha 2 interferon produced by a bacterial strain found in the genetic apparatus, which is integrated gene human leukocyte alpha-2-interferon. IFN - porous white powder, soluble in water. Has protivovirusnoj, 4]. Can be used and others that are available in each case, the preparations of exogenous alpha-interferon in the same dose.In this way treated 20 patients, including viral hepatitis In 10 people, viral hepatitis C in 10 people, women and 8 men -12, the average age 36,02. The dose selected on the basis of observations for the given category of patients. The minimum dose was ineffective. A large dose could increase the number of side effects of interferon. The medication 3 times a week caused the pharmacological characteristics of drugs within 48 hours. Application yodanthipirina in combination with alpha interferon (e.g., IFN) reduces side effects of exogenous interfrontal.Example 1. Patient E., 34 years old was admitted with a diagnosis of chronic viral hepatitis b, moderate activity, stage I chronic phase of viral replication. Upon receipt of a complaint of weakness, joint pain, constant heaviness in the right hypochondrium, reduced efficiency. Considers himself ill since January 1998, when the first noted appearance of isterichnost sclera and skin, therefore was treated in therapeutic Department of MSU 2, where for the first time the detection is item there is a history. Drug abuse within 3 years. Treatment with the antiviral drugs were not received. The diagnosis of chronic viral hepatitis b is confirmed in the Department of gastroenterology OKB. Indicators of transaminases before treatment ALT 2,9; ACT of 2.7 Ámol/CL, markers of viral hepatitis: HBsAg+, HBcorAb IgM+, PCR HBV DNA+. Needle biopsy showed inflammatory infiltration of portal tracts 8 points, degeneration of hepatocytes 2 points, weak degree of fibrosis 1 point. Assigned IFN 1,5 ME 3 times a week in combination with yodantipirin in the days of injections reaferona 100 mg/day. Combination therapy was conducted during 6 months. On the background of treatment dynamics transaminases are given in table.1.For the entire period of observation there was a good tolerability of referencefree, no side effects and complications. By the end of the first month of treatment, the patient noted a decrease in fatigue, heaviness in the right hypochondrium, steady improvement to 3 months of treatment continued all the time of observation. Conducted PCR revealed after 6 months from start of treatment, the absence of HBV DNA. The patient was well tolerated combination therapy.Example 2. Patient D., 30 years old was admitted with a diagnosis of chronic viral hepatitis C, a weak degree is insomnia, loss of appetite, constant nagging pain in the right hypochondrium. Considers himself to be patient since 1997, when 4 months after gynecological surgery noted the appearance of jaundice, after examination confirmed the diagnosis of chronic viral hepatitis C. In 1998 for 2 months were treated with IFN, independently stopped taking reaferona due to severe symptoms of side effects of the latter (namely, high fever, muscle aches, joint pain, increased fatigue, and the emergence of depressive syndrome). In the gastroenterology Department of the city hospital 3 confirmed the diagnosis of viral hepatitis C. Indicators of transaminases before treatment ACT of 1.8, ALT of 1.9. Markers of viral hepatitis: HBsAg, HCVAb IgM+, HCV PCR+, HBV DNA. Needle biopsy showed inflammatory infiltration of portal tracts 4 points, degeneration of hepatocytes 2 points, weak degree of fibrosis 1 point. Assigned IFN 1.5 to ME 3 times in a week, in combination with yodantipirin at a dose of 100 mg 3 times a week for 6 months. On combination therapy dynamics transaminases are given in table.2.After the course of applying the combination reaferona and yodanthipirina the patient had noted the disappearance of HCV RNA from serum (PCR). For the whole period of observations about the treatment of viral hepatitis. By the end of the first month of treatment, the patient noted improvement in health as edema asthenic manifestations, pain syndromes. Tolerability of combination therapy assessed by the patient as good, no adverse events were noted. Conducted each month control 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 optimal doses reaferona and yodanthipirina.Thus, the proposed method for the treatment of chronic viral hepatitis allows you to expand the Arsenal of treatment of this pathology and the treatment is devoid of side effects caused by exogenous interferencia. Combined therapy with half-dose alpha-interferon (IFN) and yodanthipirina is affordable, effective, non-toxic, well tolerated by the patients.Sources of information
1. Podymova C. D. the Problem of chronic viral hepatitis /diagnosis and treatment/ // Russ. the honey. Journe. - 1996. - 2.2. Mashkovsky M. D. Medicines. M.: Medicine, 1993, volume 2, S. 389-392.3. Grigoriev, P. J. Guide Gus is overusing actions. Materia Medica, 1996, 2 (10), S. 15-29. The method of treatment of chronic viral hepatitis, including the appointment in the replicative phase of the development of the virus to antiviral drugs, characterized in that the prescribed drug exogenous interferon-alpha - reaferona in the dose of 1.5 ME intramuscularly 3 times a week with an interval of 48 h in combination with taking yodanthipirina in the days of injections of interferon 100 mg/day, for 6 months.
FIELD: medicine, anesthesiology-resuscitation, infectology, detoxication.
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.
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