A method of treating metabolic syndrome

 

The invention relates to medicine and relates to the treatment of the metabolic syndrome. To do this, enter captopril 12.5 mg daily. The introduction of captopril combined with mineral water "Jamajka 1-T" in a daily dose of 1.5-2.0 ml per 100 g body weight. The method provides an effect on the pathogenesis of the disease, including increasing the sensitivity of tissues to insulin, antiatherogenic lipoproteins, if possible, reduce the daily dose of captopril in 2-3 times. 1 C.p. f-crystals, 4 PL.

The invention relates to medicine and the use of mineral waters in combination with angiotensin-converting enzyme inhibitor captopril for the treatment of metabolic syndrome, including insulinrezistentnost, increase blood levels of low density lipoprotein and glucose, impaired carbohydrate tolerance, decreased levels of high density lipoprotein and increased blood pressure. According to leading researchers in the world, it is the metabolic syndrome is the basis for the development of atherosclerosis, ischemic and hypertensive heart disease, diabetes and obesity. For this reason, search tools, which are able to influence the main pathogenetic links of the correction of the links of the metabolic syndrome may enable prevention of these devastating diseases of modern man, which is the main cause of his premature death.

In traditional cardiology accepted division of atherosclerosis in two phases. The first phase - atherogenic, when there is a growth of atheromatous plaques (approximately 40 years). In this phase, the disease usually runs asymptomatic, but sometimes manifesting signs of ulterior myocardial ischemia. The second phase - thrombogenic with the presence of Mature plaques, including esters of cholesterol, while it may have two ways of its development - or to grow slowly and gradually close the lumen of the vessel, or (at separation) to cause acute thrombosis and subsequent myocardial infarction or stroke (R. S. Karpov, V. A. Dudko, Atherosclerosis. Pathogenesis, clinic, diagnostics, treatment. STT: Tomsk, 1998).

And in fact, in another case, the treatment requires a long time to adjustments in diet, physical activity, use of pharmacological drugs, and occasionally surgical interventions, however, as underlined by the academician Y. M. Lopukhin (science, creativity and health. Knowledge: M, 1991), with little hope of a great future.

Currently, drugs remain the primary method of treatment of metabolic si is Amity effect is observed only if they are continuous. This situation requires the development of new therapeutic programs for the treatment of metabolic syndrome with combined use of medication and non-medication means. This is because at the present time it has become clear - reduction reaction of activated simultaneously with the beginning of the action of pathogenic factors, and physical factors (e.g., drinking water can significantly promote these reactions recovery (N. D. Polushina, C. K. Frolov, L. A. Botvinov. Preventive balneology. Pyatigorsk, 1997).

The recognition that there are preclinical stage of atherosclerosis, can give the opportunity to "push" the development of this pathology at a later date. In the monograph by E. I. Sokolova "diabetes and atherosclerosis" (M., Nauka, 1996) sets out the views of researchers about what in the pathogenesis of atherosclerosis primary hormonal disorders and changes in metabolism.

Therefore, there is every reason to recommendation of the use of various preventive measures on these preclinical stages. This conclusion could only be declarative in nature, but in us there are reasons, which were obtained by analysis of the results of drinking mineral is topril. Gen-captopril - competitive inhibitor of angiotensin-convertible enzyme, which converts angiotensin 1 in antiotensin-2. Exerts a braking action on the renin-angiotensin-aldosterone system, resulting in reduced blood angiotensin and aldosterone. Manufacturer - Genpharm TNC. Toronto, Canada (Reference Vidal. Drugs in Russia. Sixth edition, Attraversare. 2000, C. B-217). In addition, captopril identified the ability to increase the sensitivity of peripheral tissues to insulin and reduce the activity of lipid peroxidation (I.e. Gminski, M. Stosic. Antiatherosclerotic effect of hypotensive drugs. //News pharmacy and medicine. Polfa. 5-6.1997. - S. 66-77).

However, treatment with this method of therapy is not devoid of disadvantages, of which the main is the fact that after administration of captopril already on 9-11 days of treatment in the blood begins to increase the level of specific antibodies to it. When this falls in 28-30 days (O. C. Ilyukhin, M. B. Statsenko, A. I. Yakovlev, Y. M. Lopatin. The level of specific antibodies to captopril and therapeutic activity of the drug in the treatment of patients with arterial hypertension //Cardiology 2001. - 9. - C. 60-61). and, therefore, increasing the cost of treatment, on the one hand, and the possibility of allergization of an organism.

We have shown that alternatively can be combined administration of captopril and drinking mineral water (MB) Mineralovodsky source Gamehike 1-T, at which therapeutic effect is observed even at the lowest dose of pharmaceuticals. This is due to the fact that MB have a similar mechanism of action - reduce the level of aldosterone in the blood and increase tissue sensitivity to insulin (N.D. Polushina, C. K. Frolov, L. A. Botvinov. Preventive balneology. Pyatigorsk, 1997).

The essence of the invention lies in the fact that drinking mineral water is prescribed as a means of enhancing therapeutic effect of captopril in the metabolic syndrome. The proposed method is as follows. Course drinking is 12-14 days. Animals receive mineral water at a dose of 1.5-2 ml per 100 g body weight.

Mineral water in combination with captopril appointed after simulation of experimental atherosclerosis (purpose 140-150 mg mercazole 1 animal for 2 weeks on the background enriched with fats and carbohydrates diet), resulting in what have come to attend on the basis of the research results.

It is noted that in animals who received a course of combined intake of mineral water and captopril, there were more significant reduction in the level of aldosterone (2.2 times) and triiodothyronine (57.2%), a statistically significant increase in the content of ACTH and cortisol. It is noteworthy that only in the case of combined admission MB and captopril decreased in 2 times the atherogenic index. Elevated levels of blood glucose also decreased notably (though not reached the original values).

Similar to this was and dynamics of enzymes Alt and AST. After almost two-fold increase in the content of their blood in models of atherosclerosis combined admission MB with captopril in different dosages resulted in normalization of indicators (table.1 and 2).

Fundamentally important is the fact that the nature and extent of favorable changes in the mix of the use of MB and captopril in different doses (12.5 and 25 mg) was almost the same. So, it was the same as the increase in blood levels of insulin, cortisol, ACTH and thyroxine, and decrease in the content of aldosterone, cholesterol, atherogenic index, glucose, Alt, AST, CPK.

Moreover, when a lower dose of the drug could even talk about some of its advantage. More znacie was higher by 19.3%, and atherogenic index (at a lower dose reduction was 21.5%) and high blood cholesterol (20%).

Thus, not only is there no need to use a double dosage of captopril, but it is even undesirable.

There is no doubt that the observed synergism in action MB Jamajka 1-T" and captopril allows, firstly, reduce the dose and, consequently, reduce the cost of treatment of patients, but also, secondly, the ability to reduce the side effects of medication therapy.

Clinical testing method combined admission MB and captopril was conducted on 16 patients - men aged 45 to 60 years old, suffering from coronary heart disease (CHD) for 2 to 15 years. Patients were divided into 2 groups (8 each), identical in age, duration of illness and functional class of angina.

Patients of the 1st (main) group in addition to the complex pharmaceuticals (captopril at a dose of 75 mg per day, kardiket 20-40 mg per day Preductal - 1 table. 3 times a day and aspirin 25 mg at night) received the acceptance MB Jamajka 1-T" in a dose of 3 ml per 1 kg of body weight of the patient 3 times a day for 30-45 minutes before meals. The treatment course was 21-22 days. Patients 2 (control) group MB not procalim MB all patients tolerated well. In the first 2-3 days they observed increased output up to 2-3 liters per day, then he was restored to its original value. No other changes being observed.

All 8 patients of the main group were studied the effects of a single dose of MB on the ECG, blood pressure (BP) and heart rate before and after treatment in the hospital.

Analysis of the material showed that before treatment a single dose of MB Jamajka 1-T" influenced some ECG parameters (table. 3). We failed to note any significant changes in systolic and diastolic blood pressure, heart rate. The main changes were related to the magnitude of the T wave of the electrocardiogram.

In most cases it was possible to note an increase in the size of the T wave and reducing the severity of the depression of the ST segment, and it was observed, as a rule, to the 30th minute. Thus, the magnitude of the T wave was significantly increased already to 5 minutes (2-3 times), but because of the magnitude of the error average of this rise was not statistically significant. At the 30th minute, the difference was statistically significant, but the error was still high, indicating a large deviation pokazatel is lnyh was observed duratest steps - on 5-th and 15-th minute of the reception MB contributed to the increase in ST-segment depression and negative prong So On the 30th minute it was changed opposite effects became less pronounced ST segment depression, there has been an increase in the size of the tooth So

Example 1 as an example, here is the data of the patient A. S. Belianska - 45 years, admitted in the cardiology Department of the Central hospital 5 of the Ministry of Railways (e.g. mineral water) on 5 June 2001 with a diagnosis of acute lower transmural myocardial infarction. The study of the dynamics of the ECG in patients on background of forsterei showed that the 5-th minute after administration of 250 ml MB the II-m standard lead ST segment depression was 5 mm, prong T - 10 mm, However, at 15 and 30 minutes was observed the increase of the ST segment and the T wave (respectively 15-20 and 25-27 mm).

After treatment with concomitant intake of pharmaceuticals and MB single dose of mineral water did not lead to such changes of the ECG before treatment (table. 4). Was less pronounced dynamics of the ST segment and the T wave, which can be explained by the phenomenon of desentization - a reduction in the sensitivity to habitual irritation. This phenomenon has been described in studies of the Gulf Mearnog (Hormonal mechanisms of primary prevention of gastroduodenal ulcers under the action of mineral waters: author.....Diss. Prof. the honey. Sciences, Pyatigorsk, 1993). At the same time after treatment clearly increased the basal level of the T wave, although in this case the average error is still large.

After treatment in hospital were positive dynamics data of blood pressure, the T wave of the ECG, as well as some hormonal and immune parameters in patients of the main group (admission MB) and control groups (table. 4). Thus, the level of systolic blood pressure in patients with concomitant intake of MB and pharmaceuticals declined statistically significantly, whereas patients from the control group (without admission MB) the reduction of blood pressure was not significant.

It was also noted that the additional use of MB has a dampening effect on secretion of interleukin-6 (more than 3 times). It is known that interleukin synthesized by T - and b-cells of the immune system, as well as macrophages, has the ability to stimulate the formation of immunoglobulins of different classes and acute phase proteins. Twice declined and the level of interleukin-8 with its proinflammatory effects (D. K. Novikov, V. I. Novikov. 1996. "Evaluation of immune status. Moscow-Vitebsk; 1996. G. Lawlor, T. Fischer, D. Adelman. "Clinical immunology and alergologichna activity of the process is reduced and the output of this interleukin, the most pronounced exactly in patients receiving a course of mineral water "Jamajka 1-T".

Received another very remarkable fact. Found that patients with coronary heart disease is much higher (almost 2 times) in the blood is reduced basal levels of the hormone serotonin -1,80,032 against 5-6 ng/ml standards. In our research in 5 healthy volunteers his blood was 3.90.15 ng/ml, which is twice more than in patients. In the light of literature data, serotonin plays a very important role in STRESSOMETER system, limiting the severity of pathological stress reactions (M, pshennikov, 1987. The role of opioid peptides in the body's response to stress //Pathologist. physiology and experimental. therapy. - 1987. - vol. 3. - S. 85-89). In addition, according to C. A. Pereverzev, A. I., Cybarco, A. And Balaklavskogo, N. And. Gubkina (the Role of serotonin and histamine in increasing the body's resistance to some of the extreme effects. Fiziol. Journe. - 1992. Volume 78, 6. - S. 48-52), this hormone is directly related to organ and organism resistance.

For this reason, the reduction of serotonin levels in the blood of patients with ischemic heart disease may play a pathogenetic role. This view is further supported by the fact that improvements in the condition of the patients, reducing their blood pressure, positive dynamics of ECG data.

From the data table. 4 can be defined and the overall effectiveness of treatment. Of the 8 patients with CHD additional admission MB with a rating of "improvement" issued 6 people, whereas in the control group of 4 persons. It is obvious that the small number of observations, as in our studies, it is not authentically meaningful conclusions. However, you should also pay attention to the fact that among patients without admission MB, 2 people were discharged from hospital with the conclusion of a slight improvement, and 1 with a grade of "no change."

Thus, the obtained experimental and clinical data provide a basis to conclude that the advantage of the combined use MB "Jamajka 1-T" and captopril for regenerative therapy of the metabolic syndrome.

Claims

1. A method of treating metabolic syndrome, including the introduction of captopril, characterized in that the introduction is combined with mineral water "Jamajka 1-T".

2. The method according to p. 1, characterized in that captopril is administered at a reduced daily dose.

 

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