A method for the treatment of caseous pneumonia

 

The method relates to medicine, namely to Phthisiology, and can be used for the treatment of caseous pneumonia. On the background of anti-TB chemotherapy in a daily dosage: isoniazid 5 mg per 1 kg of body weight (mg/kg) of the patient, rifampicin 10 mg/kg, pyrazinamide 25 mg/kg and steptomycin 15 mg/kg, administered ausib 1 tablespoon 3 times a day 30 minutes before meals and its volatile fraction 2 tbsp. before lunch, pre-dissolved in 50 ml of water. This invention enhances the efficiency of the treatment of patients with caseous pneumonia by removing the severity of the intoxication symptoms, normalization of blood system, reduce adverse reactions to antituberculosis chemotherapy using the drug of plant origin ausib and its volatile fraction. 6 table.

The invention relates to the field of clinical medicine - Phthisiology and can be used in the treatment of patients with caseous pneumonia to reduce the severity of the intoxication syndrome, normalization of blood system, withdrawal side effects from anti-TB therapy.

There is a method of treatment of caseous pneumonia, where the reception during the day about the ti acetylation of isoniazid (slow and fast acetylator) [5].

There is a method of treatment of caseous pneumonia with anti-TB chemotherapy (prototype) with the purpose of daily isoniazid at a daily dosage of 5 mg per 1 kg of body weight (mg/kg) of the patient, rifampicin 10 mg/kg, pyrazinamide 25 mg/kg and streptomycin 15 mg/kg in combination with the traditional detoxification therapy: intravenous infusion gemodeza, reopoligliukina or saline solution daily or every other day for the first 2-3 weeks of starting treatment [4].

However, long-term, complex, consisting of 4-5 TB drugs, chemotherapy of tuberculosis of the lungs, leads to the accumulation of the products of metabolism of these drugs, which causes side effects, reduced detoxification capacity of the liver, enhancing existing endotoxicosis.

The problem solved by this invention is to increase the efficiency of treatment of patients with caseous pneumonia by removing the severity of the symptom of intoxication, normalization of blood system, reduce adverse reactions to antituberculosis chemotherapy using the drug of plant origin ausib and its volatile fraction.

The task of dostigaet is rapie: isoniazid at a daily dosage of 5 mg per 1 kg of body weight (mg/kg) of the patient, rifampicin 10 mg/kg, pyrazinamide 25 mg/kg and streptomycin 15 mg/kg while taking Abitibi 1 tablespoon 3 times a day 30 minutes before meals and its volatile fraction 2 tbsp. before lunch, pre-dissolve it in 50 ml of water.

Volatile fraction is a component selected from abiriba (extract of Siberian fir needles). Belongs to a class of bioflavonoids, factor inhibit the growth and development of organisms which is at least 100 times [1, 2].

In the analyzed scientific medical and patent literature not found in the use of abiriba in patients with caseous pneumonia. From literature data it is known the use of Abitibi for the treatment of patients with infiltrative tuberculosis of the lungs, however, the utilization factor Abitibi for caseous pneumonia is not obvious, because these two diseases are different in the pathogenesis [6] . Caseous pneumonia - independent form of the disease, reflected in the clinical classification of tuberculosis of the respiratory organs with initially diagnosed extensive caseous-destructive lesions of the lung tissue, which are usually irreversible and extremely difficult to treat. The clinical picture is manifested sudden stripperish blood revealed high neutrophilic leukocytosis, significant accelerated erythrocyte sedimentation rate (40-60 mm/h) and expressed lymphopenia, which is an essential characteristic caseous pneumonia and occurs in 100% of cases [3].

Data essential features is not explicitly follow to a person skilled in the art. This method is passed clinical trials in Regional clinical TB hospital. Thus, this solution meets the criteria of the invention of "novelty", "inventive step" and "capable of industrial application".

The method is as follows: a patient with caseous pneumonia prescribed daily anti-TB chemotherapy with isoniazid at a daily dosage of 5 mg per 1 kg of body weight (mg/kg) of the patient, rifampicin 10 mg/kg, pyrazinamide 25 mg/kg, streptomycin 15 mg/kg and inside ausib 1 tablespoon 3 times daily before meals and volatile fraction Abitibi 2 tbsp. before lunch, previously dissolved in 50 ml of water.

Clinical example: patient M, 43, was admitted to the medical Department of the regional tuberculosis hospital by ambulance care in serious condition with complaints of fever up to 39oWith during the day, coughing, sputum Muco-purulent character to 200,0 for su, eroticheskie pain in the right hypochondrium. From the anamnesis it was found that acutely ill, but periodic fever up to subfebrile figures were present in the last 3 weeks. Previously tuberculosis was not sick, but in the household had contact with patients with tuberculosis. Not working, idle, Smoking, abusing alcohol related diseases has not. During examination: the patient's condition is severe, the skin with an earthy shade, with insufficiently developed subcutaneous fat cover. Is basically in bed because of the severity of the condition, BP 80/50 mm RT.art., Heart rate 100/min, NPV 28 min, dyspnea at rest. When the percussion in the right lung shortening lung sound auscultation on the background of bronchial breathing right scapular region mass rales of different calibers, to the left in the lower sections of the diffuse dry. Muffled heart sounds, tachycardia. The liver stands out from the edge of a costal arch on 5 see Postsmost stop on both sides. When x-ray examination of the lungs was found in the upper lobe of the right lung broad inhomogeneous high intensity dimming with focal shadows in the lower sections of the right and left lung. Microscopic examination of sputum for Miko is l, stab neutrophils - 16%, segmented neutrophils - 58%, lymphocytes - 12%, monocytes - 14%, ESR - 64 mm/h LII - 2,85 srvc. unit , LI - 0.16 srvc.ed. The microscopy of bone marrow: undifferentiated blasts - 0.3, myeloblast - 0,7, immature neutrophils - 6,8, Mature neutrophils - 19,6, eosinophils - 1,2, lymphocytes - 4,5, monocytes - 4,91, plasma cells - 1,6, erythroid cells 4,18. On the basis of clinical and radiological methods of examination was diagnosed with right upper lobe caseous pneumonia in the phase of decay and contamination VK (+).

Assigned to anti-TB chemotherapy in a daily dosage: isoniazid 0.3 V/V, rifampicin 0,6 per os, pyrazinamide 1,5 inside, streptomycin 1.0 V/m, ausib inside of 1 tablespoon 3 times a day 30 minutes before meals and its volatile fraction 2 tbsp. before lunch, pre-dissolve it in 50 ml of water. The treatment was carried out for 2 months. As a result of therapy positive clinical dynamics of the disease as the temperature is reduced to subfebrile and normal numbers, improved appetite, weakness decreased, the patient has expanded its motor mode - I started to go, decreased shortness of breath. BP - 90/60 mm RT.art, heart rate 80 / min, NPV - 19 minutes Significantly decreased cough, TB therapy is not revealed.

Clinical material from which were made the appropriate conclusions, was comprised of 40 patients with caseous pneumonia. A male dominated (80%) aged from 27 to 56 years. 20 patients of the main group (1-I) along with the standard anti-TB therapy (isoniazid 0.3 V/V, rifampicin 0,6 per os, pyrazinamide 1,5 inside, streptomycin 1.0 V/m) was used ausib within 2 months, 1 tsp. for 30 min before meals and volatile fraction Abitibi 2 tbsp. before lunch, pre-dissolved in 50 ml of water, and 20 patients in the control group (2-I), which with anti-TB therapy (isoniazid 0.3 V/V, rifampicin is 0.6 per os, pyrazinamide 1,5 inside, streptomycin 1.0 V/m) was applied traditional detoxification therapy (prototype): intravenous infusion gemodeza, reopoligliukina or saline solution daily or every other day for the first 2-3 weeks of starting treatment.

The analysis included data from clinical manifestations of the disease, the objective status of the patient, as well as laboratory studies bone marrow and peripheral blood.

Microscopic examination of smears of bone marrow was performed on a binocular microscope (NIKON, Japan) using immersion volume is s (myelogram). Just counted 400-500 myelokaryocytes in 2-4 smears of bone marrow. Indicators myelogram expressed in percent.

The determination of the number of erythrocytes, haemoglobin concentration, content of reticulocytes, the color indicator, the total number of leukocytes and their individual morphological forms, the number of platelets, the value of the erythrocyte sedimentation rate was investigated by standard methods [3]. Lymphocytic index (LI) peripheral blood was determined by the relative number of lymphocytes to the relative content of neutrophils. Leukocyte index of intoxication (LII) (indirect test of endotoxemia) considered by the formulawhere mm is metamyelocyte; mon - stab neutrophils; SN - segmented neutrophils; PC - plasma cells; e - eosinophils, b - basophils; l, lymphocytes; m - monocytes.

Digital material results of the study were subjected to statistical analysis on a Pentium - II with the help of the software package for statistical analysis "Excel 2000". In each group of patients defined averages, mean errors, as well as criteria of difference (the reliability of the difference between the mean values for the criterion t) data values in different groups of patients (see table. 1-6).

Upon receipt alsogo syndrome, manifested by increased body temperature up to 38oWith 27 patients (65%) patients, and 39oWith in 6 (30%) and 40oWith 2 (10%) patients, which was accompanied by chills, weakness until adynamia. The appearance of the patients was characterized by pale skin with a bright blush on the cheeks (35%), sometimes even with an earthy shade (60%). All patients were observed excessive sweating, especially at night. 40 (100%) of patients reported severe cough with sputum more than 100 ml per day, some (2 people) even mixed with blood, in 9 (45%) people were reported pain in the chest on the affected side and shortness of breath at the slightest exertion (100%). The weight loss up to cachexia II-III degree was observed in 28 patients (70%). Objective examination light bright auscultatory picture in the lungs accompanied by occasional wheezing (100%) against the hard (50%) and bronchial breathing (65%). Almost all patients with caseous pneumonia occurred tachycardia of 120 beats per minute. Maximum AD when the intake was on average 103,02.8 mm RT. senior (individual fluctuations 70-130 mm RT. Art.). Other features of objective research almost every second were recorded ovalicin. On x-ray images of the lungs is a vast, homogeneous lesion of lung tissue destruction was present in 21 (52.5 per cent) patients and 2-sided lungs with a strong cheesy component in 19 (47.5%) patients.

Conducted Hematology research has established that caseous pneumonia is accompanied by pronounced changes in blood system, which was in the inhibition of lymphoid and granulocyte activation, and macrophage plasmocytoma sprouts blood (table.2-5). It is expressed primarily in the reduction in the number of lymphoid cells in the bone marrow in both groups of observations to 4.800,59% 4,240,46% at 12,710,60% in healthy people and increased macrophage and plasma cells respectively to 4.710,46%, 5,120,30% (2,080,12% from healthy donors) and 1.570,18%, 2,020,24% (1,200,22% in healthy people). The data of our study indicate, first of all, the significant impact of the common acute destructive specific infection Eritrean. So, the pain the blood corresponded to the concentration of hemoglobin 114,00of 3.45 g/l and 97,153,99 g/l, the number of erythrocytes - 3,240,10 T/l, and is 3.080,11 M/l, color index - 1,050,02, 0,940.03 and content of reticulocyteswhen 153,500,83 g/l, 4,790,04 T/l 0,850.01 andaccordingly, in healthy individuals (p<0,05). Changes in the bone marrow mirror display and on the periphery: the relative content of lymphocytes before treatment corresponded 19,900.20% 24,612,47% (39,700.20% of healthy people), and the absolute content of monocytes almost two times higher than the normal values (0,860.17 G/l 0,700,1417 l 0,390.07 G/l in healthy people). Any incoming ingredients white blood itself does not always accurately reflect the degree of tuberculous inflammation and endotoxemia. More guidance about the nature of the disease, in our opinion, give leukocyte index of intoxication (LII) and limtan indicators allows us to conclude, what value LEAH reflects the severity of intoxication syndrome in patients with common specific destruction in the lungs. So, before beginning the treatment of patients with caseous pneumonia LEAH statistically significantly (p<0,05) exceeded normal values: 38,18% (2,200.20 services. units ) in patients of the 1st group observations, 2nd - by 36.44% (2,140.27 srvc.ed.). Very convincing information characterizing the state of cellular reactivity to established infection, gives us lymphocytic index (LI). According to our research, prior to initiating specific therapy was reported to decrease IF 81% of the total population of the surveyed patients (respectively 0,130,03 services. units and 0.120,04 srvc.ed. when 0,740,04 srvc.ed. in healthy donors; p<0,05).oSince it was noted in 8 (40%) in the first group and in 10 (50%) in the second, i.e. the number temperaturewhich patients had not responded to treatment ausib and its volatile fraction remained almost unchanged. Increased sweating continued to admit all patients who did not use ausib and its volatile fraction, whereas in the group of patients with the use of Abitibi and its volatile fraction she disappeared in 12 people. Dyspnea was present in half of the patients of the 1st group and in 65% in the 2nd. In patients receiving anti-TB drugs using Abitibi and its volatile fraction has changed the nature and duration of cough, and almost not stated cough painful and paroxysmal, and the 4 people he disappeared, as evidenced by the auscultatory picture in the lungs (PL.1). On the basis of subjective and objective manifestations of the disease after 2 months of treatment the General condition of the patients of the first group was considered as satisfactory in 50% and 25% in the second group of observations. While adverse reactions when taking Abitibi and its volatile fraction was not found.

The results of the study showed a significant (p<0.05) improvement in peripheral blood in the main gruppering lymphocytes increased almost twice (in absolute and relative values). The favorable trend of increasing immunity can also be seen in the bone marrow. Patients of the main group observations registered a significant increase of lymphoid cells to 6.830,78% compared to patients who did not receive ausib and its volatile fraction (4,390,56%). Also in the main study group was significantly decreased ESR to 45,08to 2.29 mm/H. Dynamics of red blood in the main group has improved mainly by increasing the level of hemoglobin to 130,304,74 g/l and the number of reticulocytes toand the increase in the number of erythroid cells to 5,620,41% in the bone marrow. On the background of the application of Abitibi and its volatile fraction was observed a decrease in the level of LEAH to 1,690.30 services.ed. when 2,740.36 services.ed. in the control group and increased WHETHER to 0.240,07 srvc.ed. when stable in the control group (0,100.02 srvc.ed).

Thus, as shown by the results of clinical research, ausib in combination with its volatile fraction region is elemech results namely reducing the severity of the intoxication syndrome, normalization of blood counts, reducing side effects of anti-TB drugs. Using the proposed method of treatment in clinical practice will allow to increase the efficiency of treatment of patients with the most adverse prognostic forms of pulmonary tuberculosis. When applying Abitibi and its volatile fraction in patients with caseous pneumonia reduces the severity of intoxication and bronchitics syndromes, hematologic indices is increasing relative and absolute content of lymphocytes in the peripheral blood and the level of lymphoid cells in the bone marrow, reduced the absolute content of band neutrophils in the peripheral blood, increases the level of hemoglobin in the red blood cells and increases the number of erythroid elements in the bone marrow, decreased erythrocyte sedimentation rate, which is favorable objective evidence of the disease on the background of TB treatment together with abiriba and its volatile fraction. This is achieved by the fact that herbal medicine has certain advantages over the use of hard and fast synthetic drugs. Produced in art more are included in the biochemical processes in the human body, chemical alien synthetic drugs. With abiriba and its volatile fraction in the human body are biogenic amines, amino acids, vitamins, minerals, strengthens the body's resistance to adverse effects of etiologic factors and increase protective forces.

Literature 1. Abicab - the source of health. The preparations of fir: indications and methods of application. Tomsk, 2001, 14 S.

2. Kotecha N. I., Lukianenko P. I., Strelis A. K. Extract of Siberian fir ausib and its application in medicine. Tomsk, 1997, S. 136-140.

3. Menshikov centuries Laboratory methods in the clinic. - M.: Medicine. - 1987. - 350 S.

4. Mishin, C. Y., Erokhin Centuries, Chukanov, C. I., Naumov, C. N., Grigoriev, Y. G., Vasiliev, I. A. Caseous pneumonia: diagnosis, clinic and treatment. Methodological manual for doctors. Moscow, 2000, 47 S.

5. Sokolov, B. New technologies chemotherapy of tuberculosis infection. Manual for doctors. Moscow, 2000, 19 S.

6. Stralis A. K., Kotecha N. I., Gubina C. A., Andreev, I., the Use of Abitibi for pathogenetic treatment of patients with infiltrative tuberculosis of the lungs. Patent 2050855 from 4.02.1992.

Claims

The method of treatment cheesy mo the si body (mg/kg) of the patient, rifampicin 10 mg/kg, pyrazinamide 25 mg/kg and steptomycin 15 mg/kg, characterized in that at the same time appoint ausib 1 tablespoon 3 times a day 30 minutes before meals and its volatile fraction 2 tbsp. before lunch, pre-dissolved in 50 ml of water.

 

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