A method for the treatment of nephropathy in children in the neonatal period

 

(57) Abstract:

The invention relates to medicine and can be used in the treatment of nephropathy in children in the neonatal period. The method includes a General background therapy, and, in addition, the patient once a day injected through application Tizol with heparin and TESOL with proserin. Applications execute on the skin of the lumbar region of the patient in the area of the projection of the kidneys and in the suprapubic area in the zone of projection of the bladder, respectively. This is followed by a second treatment in which the patient is administered once a day through application Tizol with aminophylline. Applications execute on the skin of the cervical and lumbar spine. Each procedure is carried out for 5-10 minutes, courses of treatment are 10-15 days. The method allows to stimulate the kidneys to restore the rheology and urodynamics while reducing the amount of typing in the body of the child pharmacological preparations.

The invention relates to medicine, namely to methods of treatment, including the introduction of drugs into the body by diffusion through the skin, and can be used in Nephrology for treatment of nephropathy in children in the neonatal period.

From what pyelonephritis, based on the antibiotic therapy, which includes the introduction of antibiotics and other pharmaceutical drugs, and the use of herbal medicine. This specific means of treatment depends on the clinical characteristics of the patient, nature of microbial flora, immunological parameters, patient age, comorbidities. In addition, in all cases used for the treatment of membrane stabilizers and antioxidants (Nephrology. / Guide. Ed. by I. E. Freeway, volume 1, M.: Medicine, 1995, S. 433).

Closest to the present invention is a method for the treatment of nephropathy in children in the neonatal period (the treatment of patients with infection of the urinary tract, including patients with pyelonephritis), in accordance with which the patient carry out a course of antibacterial therapy. While the patient is injected drugs, broad-spectrum, able to inhibit both gram-negative and gram-positive flora (A. C. Papayan, I. C. R stjazhkin is assured Neonatal Nephrology. / Management, St. Petersburg: Piter, 2002, S. 361).

The disadvantage of known methods is their one-sided focus of treatment: elimination of microbial inflammatory process in the kidneys and the urine is only a mild inflammatory process. However small the possibility of drug therapy because of the limitations in applying for a newborn in doses, and indications reduce the effectiveness of the known methods of treatment. In addition, it is known that each age period characteristic of a certain functional state of the kidneys. In the neonatal period, children are characterized by the presence of small immature kidneys, which in children, patients with nephropathy, in contrast to healthy children are not allow to satisfy the needs of the body, aimed at maintaining homeostasis. Antibiotic therapy entails the introduction into the organism of the child for more drugs, mitigating the negative effect on him antibiotics. Usually advanced for the prevention of dizbakterioz appoint Lactobacterin, bificol and their analogues. Extensive use of the vitamin. For the prevention of osteoporosis is prescribed a vitamin D simultaneously with calcium. One-sided orientation of the known methods of treatment of nephropathy (mild inflammatory process by eliminating the source of infection) not only provides an opportunity to strengthen kidney function, but because of the need in the treatment process introduction this reduces the effectiveness of the treatment.

Thus, identified as a result of a patent search the treatment of nephropathy in children in the neonatal period, the analogue and the prototype of the proposed method, when the implementation does not achieve the technical result consists in increasing the effectiveness of treatment due to the possibility of stimulating the growth of kidney recovery rheology and urodynamics and simultaneously reduce the amount of typing in the body of the child pharmacological preparations.

The present invention solves the task of creating a method for the treatment of nephropathy in children in the neonatal period, which ensures the achievement of the technical result consists in increasing the effectiveness of treatment due to the possibility of stimulating the growth of kidney recovery rheology and urodynamics and simultaneously reduce the amount of typing in the body of the child pharmacological preparations.

The invention consists in that in the method for the treatment of nephropathy in children in the neonatal period, including General background therapy, in addition, the patient once a day injected through application Tizol with heparin and TESOL with proserin, while applications execute on the skin of the lumbar is about, this is followed by a second treatment in which the patient is administered once a day through application Tizol with aminophylline, while applications execute on the skin of the cervical and lumbar spine, every procedure is carried out for 5-10 minutes, courses of treatment are 10-15 days.

The technical result is achieved in the following way. In the proposed method, the possibility of administering drugs by running applications on the skin of the patient is due to the fact that for the transport of drugs through the skin using Tizol. Tizol - Xiamen happy valley water Park of glitzerofosfata titanium. Has a high permeability through the skin, normalizes the amount of fluid in the tissues, strengthens their oxygenation, non-toxic, easily mixed with medicinal additives. Form title - gel white. Used topically (Farmacia No. 2, 1994, S. 9-10).

Form title - gel, as well as its ability to easily mixed with medicated additives that provide the ability to use title for the preparation of compounds for applications. The coating composition in the form of applications allows you to limit the scope of the impact of the composition used in the SP who want to make the treatment. The introduction of drugs into a patient through applications that are executed on the skin of the patient, provides a soft effect of an administered drug, because in this case they act on the body by reflex, by humoral and, in addition, have a local effect; provide a more gradual entering them in the body, more prolonged effect on the body due to the formation in the skin depot of injected drugs, painless administration of drugs, non-invasive, no deformation of tissues that occur at other ways of pharmacotherapy due to the introduction of solvent, increasing the volume of injected simultaneously drug in his appointment intramuscularly or subcutaneously. All this contributes to the most complete penetration through the skin of the components and enhances the biological activity of the input structures and the effectiveness of their therapeutic effects. Due to their nontoxicity of title eliminates the possibility of the occurrence of pathological changes of the skin that can occur with long-term use of artificial accelerators suction.

As mentioned above, each Wei characterized by the presence of small immature kidneys. As hypoplasia of the kidney is quite a rare condition, we mean the more common term “little Bud”, which nature is extremely diverse (Nephrology /Guide. Ed. by I. E. Freeway, volume 1, M.: Medicine, 1995, S. 409, 421 S.).

It is believed that reliable diagnosis-related nephropathy, can be put only after three months of life. To assess renal function in the newborn cannot use the standards relating to older children and adults. Therefore, the treatment in the neonatal period was to maintain life, the creation of conditions for nursing baby.

However, it is known that acute renal failure in children of early age in approximately 70% of cases occur in the first week of life. While approximately 80% of children the disease in the first month of life due to congenital structural anomaly of the kidneys and urinary tract, as well as hypoxia. Causes of acute renal failure can be including thrombosis renal vein thrombosis renal artery (Pediatrics. Translation from English under the editorship of Prof. I. M. Vorontsov, M.: Medicine, 1988, S. 412; 413 S., table 13-13). In addition, children with birth injuries of the Central nervous system have cogitations-traumatic brain damage, and georegistry bladder - damage of the cervical and lumbar spine (A. C. Papayan, I. C. R stjazhkin is assured. Neonatal Nephrology. / Management, St. Petersburg: Piter, 2002, S. 216). The presence of these factors was the basis for the holding in the neonatal period in addition to background targeted therapy aimed at treating nephropathy.

Heparin is the anticoagulant direct fast action, effective in vitro and in vivo. The latter allows to introduce its percutaneous, namely by applications using the conductive properties of title. Heparin is used to prevent blood clots, and in violation of the microcirculation. Heparin when injected into the body is concentrated in the liver and spleen. Reduces the viscosity of the blood, reduces vascular permeability. Is a biologically active substance of a regulatory nature. Provides direct stimulation of the autonomic (oxaloacetate plexus, fat cells) or spinal (skin end of the spinal nerves) peripheral reflex elements (Register of medicines of Russia 99, S. 565). As a result, the introduction of heparin prevents blood clots, normalizes crematorium function and growth of the kidneys, consequently, urodynamics.

In addition, since heparin is injected into the patient's body by running applications on the skin of the patient, the first effect of the medicinal product is perceived by receptors in the skin (such as Oliferenko. Hydrotherapy., M.: Medicine, 1986, S. 111). Skin receptors transform external effects in the nervous impulses that reach the Central nervous system and serves as a base for the formation of a complete reaction of the organism (B. C. ulasik. Essays General physiotherapy. Minsk: "Nauka i Tehnika", 1994, S. 81). Proceeding from this it follows that for maximum saturation of the medicinal product, administered through the skin, the skin receptors should not be perceived negatively interact with him, because otherwise, the signal generated by skin receptors in the Central nervous system, will result in response to the formation of protective and adaptive reactions of the skin: the spasm of blood vessels of the skin and a sharp decrease in permeability, and formation of a protective adaptive response associated with projected onto these areas organs. It is known that heparin is sour mucopolysaccharide produced in the human body basic leukocytes, most found in the liver is. the resulting heparin is an integral part of the product life of the organism, and therefore it is adequate to the body when ingested, is not vulnerable to the negative impact in General. Heparin has anti-allergic (proportionally) effect, which is important, because the body of a child, especially a newborn, is very sensitive to interference from outside. Thus, heparin is adequate to the human body and does not cause the formation of skin receptors negative adaptive reactions at its introduction through the skin, which contributes to more complete penetration to his sick body and increases the effectiveness of the treatment.

Of homeopathy is known that small doses effects on the body drugs are weak stimuli and signals caused them to freely pass into the nerve centers, not oppressing them and not suppressing protective forces of an organism, i.e., without causing negative adaptive reactions to the exposure (C. A. Linde Homeopathy in obstetrics and gynecology. S.-Petersburg: Publishing house "D and f", 1977, S. 28). High penetrating ability of title through the skin, the toxicity of title and adequacy of heparin to human body poses is how to facilitate the work of the kidneys and increases the effectiveness of the treatment. As a result, in small immature kidney increases blood circulation, increases oxygen saturation, which improves the working conditions of the kidneys and stimulates their growth, and consequently, increases the efficiency of the treatment.

Neostigmine increases the contractility of smooth muscle. Used in atony of the urinary bladder (Register of medicines of Russia 99, S. 851).

Due to the fact that as a carrier through the skin using Tizol high transcutaneous permeability, allows use of therapeutic drugs in small doses. The possibility of introducing a neostigmine methylsulfate in the child's body in small doses provides maximum exposure of the drug to bladder, as small doses of a drug affect organs and tissues, regulating cell function. (C. A. Linde Homeopathy in obstetrics and gynecology. S.-Petersburg: Publishing house "D and f", 1977, S. 28). It provides the most complete receipt neostigmine methylsulfate to a sick body, and hence, the maximum effect of a drug in the bladder and increase the effectiveness of treatment.

Due to the fact that the application of heparin and proserin perform on the STI), there is provided a direct influence of drugs through the skin on the patient body, which increases the effectiveness of the treatment.

The combined use of neostigmine methylsulfate with heparin increases the effectiveness of treatment as a improve kidney function stimulates at the same time improving the function of the bladder. The result is improved urodynamics. This allows to reduce the duration of antibiotic therapy, and therefore, reduce the amount of antibiotics and other pharmaceutical drugs, which also facilitates the work of the kidneys and contributes to further improvement of urodynamics. As a result of joint use of heparin and neostigmine methylsulfate can improve the effectiveness of the treatment while reducing the amount of typing pharmacological preparations.

Use in the claimed method of treatment of nephropathy in children in the neonatal period compositions containing Tizol, also provides increased effektivnosti treatment. This is because the proposed method for the treatment of nephropathy Tizol used not only as the basis of gel applications and transport of the active ingredient, but in addition, using himself as the urodynamics, which was not previously known.

Below are the results of the studies confirming the presence of title properties that contribute to the improvement of the kidneys, stimulating their growth and improvement of urodynamics, on the background of local therapy etizolam. Research conducted on a group of patients out of 18 people. Each patient had a common background therapy individually.

The results of the research. The terms of relief of dysuria (pastoznost, edema, oliguria) the fifth day - 7 people, by the tenth day 11 members; the preservation of bladder syndrome: normalized to the tenth day 18 persons; restoration of functional parameters of the samples: the sample of the first one is normalized to 10 days in 12 patients; improvement in instrumental examination: reducing the size of the pelvis in 12 patients, improvement parenchyma in 10 man.

Research shows that Tizol a positive effect on the clinical picture nephropathy, putting on the kidneys and bladder therapeutic effect, which consists in improving the functioning of the kidneys, stimulating their growth and improvement of urodynamics.

In addition, the inventors have proved that the proposed method tisol is not only an active conductor through ansport these drugs directly to the patient body. This is confirmed by spectral study of urine, which showed that after one day of treatment, the basal level of titanium was 0.01 µg/ml After the ten-day use of drugs with etizolam level titanium was increased to 0.24-0.31 µg/ml.

Aminophylline is used in chronic insufficiency of cerebral circulation, disorders of the renal arteries. One of the pharmacological action of aminophylline - diuretic (Register of medicines of Russia 99, S. 885). It is known that the functional state of the kidney in a child is under complex neurohumoral control. Thanks to the choice of treatment zones on the skin of the patient through the implementation of applications: on the skin of the cervical and lumbar spine, aminophylline affects kidney function through the Central nervous system, penetrating it through the bloodstream.

The reaction to the effect (in our case, the external factor) depends on its application. This is due to the specific organization of the nervous system, through which are as exposure and response to them. The execution of the applications of title with aminophylline at the same time on the skin of the cervical and lumbar spine has a drug vodei lumbar spine and spinal cord are the most common under birth injuries associated with the Central nervous system and causing hipreplacement bladder (A. C. Papayan, I. C. R stjazhkin is assured. Neonatal Nephrology / Guide. St. Petersburg: Piter, 2002, S. 216). The autonomic nervous system is determined by a regulating influence on the capillary network, lymphonodi etc., Aminophylline adjusts the tone of the autonomic nervous system, affecting the condition of blood vessels, improves renal blood flow (Register of medicines of Russia 99, S. 885). From homeopathy it is known that large doses of a drug affecting the Central nervous system and small - to organs and tissues, regulating cell functions (C. A. Linde. Homeopathy in obstetrics and gynecology. S.-Petersburg: Publishing house "D and f", 1977, S. 28). Used in the way aminophylline provides the impact on the Central nervous system. The result is improved blood and CSF circulations, the normalization of the activity of the autonomic nervous system, stimulation of metabolism in brain structures.

Using title for transport of aminophylline through the skin by non-toxic title does not cause negative adaptive reactions of the organism in contrast to conventional injection of aminophylline electrophoresis, which increases effective directly on the affected organs, and of course title with aminophylline fixes this medicinal effects through regulating effect on the Central nervous system of the whole organism as a whole.

The result in the claimed method of treatment of nephropathy in children neonatal period increase the effectiveness of treatment is provided by a synergistic effect produced by the ingredients of the compositions used in the method, when carrying out the first course of treatment, namely: title with heparin and title with proserin, and also due to the synergistic effect of the treatment, created the above-mentioned compositions and composition of title with aminophylline. The possibility of obtaining synergies from sharing title with heparin and title with proserin is ensured thanks to the introduction of the ingredients of each formulation through execution of applications on the skin of the patient, which allows you to enter two simultaneous drug treatment: TESOL with heparin and TESOL with proserin.

The number of applications a day: once a day for 5-10 minutes and the duration of treatment for 10-15 days determined by experiment and are optimal for obtaining sustainable effect from l the sustainability of the child, since the duration of the procedure determines the number of entered drug. The possibility of varying the length of time of the procedure and the duration of treatment allows to take into account the individual needs of the patient, which also increases the effectiveness of the treatment.

Execution General background therapy allows to take into account the individual characteristics of nephropathy in every sick child, which increases the effectiveness of treatment.

From the above it follows that at the first stage of treatment with the introduction into the organism of title with heparin and title with proserin through applications, and applications perform on the skin of the patient at the lumbar region in the area of the projection of the kidneys and in the area of the projection of the bladder (suprapubic area), thereby a direct impact on patient body, the proposed method for the treatment of nephropathy in children neonatal period provides an improvement of microcirculation and blood flow to the kidneys, stimulates the growth of kidney and stabilizes urodynamics. Data Doppler of the renal arteries resulting from research conducted on a group of patients out of 42 people showed recovery shelter at the same time on the skin of the cervical and lumbar spine reinforces the action of the first course of treatment, exerting a positive influence on function of kidneys and a bladder through a regulatory influence of the Central nervous system, improving hemolymphoreticular, normalizing the activity of the autonomic nervous system, stimulating the metabolism in brain structures that enhances the growth stimulation of the kidneys and stabilization of urodynamics. The result is higher increases the effectiveness of treatment. Due to the fact that the claimed method speeds up the process of normalization of renal function and urodynamics, reduces the treatment time and, consequently, reduces the number entered in the body of a newborn baby pharmacological drugs, including antibiotics.

In addition, the claimed method extends the capabilities of drug therapy in the treatment of nephropathy in newborn infants, expanding Arsenal of drugs.

Thus, the claimed method of treatment of nephropathy in children in the neonatal period when the implementation ensures the achievement of the technical result consists in increasing the effectiveness of treatment due to the possibility of stimulating the growth of kidney and simultaneous reduction of the number entered in the body of the child pharmacological preparations.

Contents background therapy was determined by the condition of the patient.

Therapeutic drugs taken in accordance with conventional therapies with regard to the age and weight of the child. To perform the method of preparing a mixture of ingredients: TESOL - heparin, Tizol - neostigmine, Tizol - aminophylline. A mixture prepared in advance by the pharmacist. In the example implementation of the method Tizol was mixed with 100 IU of heparin per kilogram of body weight, from 0.02% proserin, 2% aminophylline. The required number of title determined depending on the area of application. In the example title took a single application of 1.5, Ready the drug was applied, for example, the spar is N. 15 days Tizol - neostigmine 15 days, the duration of each procedure 7 minutes; Tizol - aminophylline 10 days, the duration of each procedure 10 minutes.

When running applications from title with heparin and title with proserin applications have respectively similar to the arrangement of the electrodes on the back of the patient when performing electrophoresis on the kidneys and the abdominal wall above the pubic articulation when performing electrophoresis on the area of the bladder (the Guide to physical therapy edited by Prof. Century, one. M.: Medicine, 1992, S. 47).

When running applications from title with aminophylline applications have the same arrangement of electrodes when performing electrophoresis when exposed to the collar region (Guide to physical therapy edited by Prof. Century, one, M.: Medicine, 1992, S. 37).

Example 1. Patient Vova E., neonatal care unit. Weight at birth 2900 g, length 50 cm Score Apgar 5/7 points. Condition at birth of moderate severity. At the age of three days with a diagnosis of chronic intrauterine hypoxia, stroke, aspiration syndrome, the child was transferred to the neonatal care unit.

The diagnosis of perinatal trauma Zeliony hydrocephalic syndrome.

In the clinic noted: pallor, dry skin, coarse lamellar desquamation, pastos century, acrocyanosis, unstable chair, decrease urination. Even royalty both kidneys. The urine analysis showed proteinuria (0,03-0,06%), hematuria (20-30 p/view), a large number of salts (urates, oxalates). In General, the analysis of blood anemia, neutrophilic shift to the left. In the biochemical analysis of blood revealed hypoproteinemia, increased urea (7.6 mmol/l); lactate dehydrogenase 1.6 times above the norm; 2- MG in serum corresponded to the norm;2- MG in urine - the upper limit of normal. According to the U.S.: the kidneys are usually the fuzzy contours, dimensions less than the age norm, phronima on both sides of 8 mm with a dense foci, the collective system has been expanded.

The child received background therapy, antibacterial, chimes, vitamins, enzymes, lasix, biologics. In addition, the child is treated in accordance with the claimed method. In addition to the General background therapy, the patient once a day alternately performed on the skin of the lumbar region in the area of the projection of the kidneys and in the area of the projection of the bladder, respectively appliques Tizol with heparin and TESOL with proserin. Then there was the second year the requirements were performed on the skin of the cervical and lumbar spine.

Indicator DPPA recovered on the seventh day. The bladder function was normal on the fifth day of treatment. Partial renal function normalized to the twelfth day. Disappeared manifestations of hypertensive hydrocephalic syndrome, showed normalization of CSF dynamics.

At the age of twenty-nine days the child was discharged home under the supervision of a nephrologist.

Thus, the claimed method speeds up the process of normalization of renal function and urodynamics, reduces treatment time and, consequently, reduces the number entered in the body of a newborn baby pharmacological drugs, including antibiotics.

A method for the treatment of nephropathy in children in the neonatal period, including General background therapy, wherein the patient once a day injected through application Tizol with heparin and TESOL with proserin, while applications execute on the skin of the lumbar region of the patient in the area of the projection of the kidneys and in the suprapubic area in the zone of projection of the bladder, respectively, followed by a second treatment in which the patient is administered once a day through application Tizol with aminophylline, while applications execute on the skin SEUT for 10-15 days.

 

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