A method for the treatment of chronic diffuse liver diseases

 

(57) Abstract:

The invention relates to medicine, namely to Hepatology. Allocate groups depending on the severity of the process and conduct subsequent intravenous laser irradiation of blood continuous emission wavelength of 0.63 Ám. When moderate activity process and satisfactory condition of the patient peripheral blood of the patient is subjected to laser irradiation for five consecutive days for 30 min with a total dose of 9 j. When expressed activity of the pathological process and the patient's condition moderate daily for seven days for 30 min with a total dose of 12.6 j. With significantly pronounced activity of the process and the severe condition of the patient daily for 10 days in a row for 40 min total dose of 24 joules. A second course of intravenous laser irradiation of blood spend in 3 months. The method is characterized by the absence of adverse reactions, use in patients with different severity of the process, to achieve defined laboratory and clinical effect, persisting for a long time.

The invention relates to medicine, in particular to Hepatology and for the treatment of chronic diffuse sableman the W treatment of chronic diffuse liver diseases (HZP) is associated with aggressive spread of hepatitis and cirrhosis of the liver. According to statistics, the annual incidence has increased by one third each year from hepatitis dies about two billion people on Earth. Despite the achievements of modern therapy HDSP, treatment is often ineffective or prevent the onset of long-term remission.

Existing methods of treatment of chronic hepatitis and cirrhosis of the liver can be divided into pharmacological and non-pharmacological. The first group includes a number of powerful antiviral drugs (Apollonia, Amiksin) and analogues or inducers of interferon (Roferon, alpha-interferon, cycloferon) in viral liver disease, prescription of hormones (prednisolone) in autoimmune hepatitis and cirrhosis. The second group is the use of in vitro methods. As an example, plasmapheresis, which is aimed at elimination of the patient's blood antibodies, autoantibodies, circulating immune complexes. In clinical practice also applies ultraviolet blood irradiation, the main effects of which are bactericidal and General-stimulating.

Listed drug treatment methods are quite effective which you will cause a number of side effects significantly impair the patient's quality of life. The appointment of a less powerful drug administration (hepatoprotectors - Kars, Essentiale, hepabene) leads only to a temporary improvement of the patient.

The closest analogue of the proposed method is the treatment of chronic diffuse liver disease with non-invasive irradiation of blood pulsed laser radiation wavelength of 0.83-0.95 microns. The main disadvantage of this method is the necessity of using complex multifunctional device containing a laser light source, control unit and pump oscillator, etc. in Addition, these differences in application of the above method with different degrees of severity of the pathological process, there are no data about the persistence of a positive effect.

The aim of the present invention is to develop the most effective controlled non-pharmacological treatment of chronic diffuse liver diseases through effects on peripheral blood of the patient.

This goal is achieved by the fact that initially assess the severity of the patient and degree of activity of the pathological process pechenochnozhelchegonnyi enzymes (urokinase, histidase, fructose-1-hospitalilty, serendipitously, trainingsgerate), assessment of the intensity of lipid peroxidation (LPO) levels in the blood of peroxide oxidation (diene conjugates, malonic dialdehyde), a detailed study of nonspecific immunity to 16 parameters (CD3, CD4, CD8, CD16, CD19, CD22, CD4/CD8, HLA in CD3, IgG, IgM, IgE, IgA, HCT, CIC, C1-C5), state regional blood flow using rogatory, system disturbances using co biomicroscopy, agregators, then depending on the obtained results highlight the group of patients for which, depending on the severity of diffuse liver will select the appropriate way of treatment and the dose of laser radiation. The blood of the patient is subjected to laser irradiation with a wavelength of 0.63 Ám using disposable optical fibers with moderate activity process and relatively satisfactory condition of the patient daily for five consecutive days for 30 min in a continuous mode radiation (total dose of 9 j), when expressed activity of the pathological process and the condition of the patient closer to moderate daily for seven consecutive days for 30 min in continuous mode the CSOs daily for ten consecutive days for 40 min in a continuous mode (total dose 24 j), then monitor the patient's condition on all of the above parameters, a second course of intravenous laser irradiation of blood for fastening effect spend in 3 months.

This method of treatment of chronic diffuse liver disease underwent 187 patients.

The most conspicuous are the following examples.

1. Patient K., aged 47, case history No. 13014, was treated at GEA OKB, Volgograd with 03.08.1999, 21.08.1999, with a diagnosis of chronic viral hepatitis b exacerbation.

Along with the conventional laboratory and instrumental methods of research were conducted in-depth examination, it was revealed increased levels of urokinase, histidase to 0.5%, fructose-1-hospitalilty, serendipitously, trainingsgerate, LPO products and circulating immune complexes (CIC) up to 1.5 times the index increase of CD4/CD8 and intravascular conjuctival index to 2, a slight improvement in regional blood flow. Based on the results of the examination of the patient K. was diagnosed with a mild degree of pathologic process. The patient was conducted five sessions of intravenous laser therapy has long been improved, normalized level of liver-specific enzymes and other investigated parameters.

2. Patient N., 53 years history No. 12035, was hospitalized in GEA OKB, Volgograd with 06.04.2000, 24.04.2000, with a diagnosis of chronic viral hepatitis C, acute stage, chronic gastritis, chronic cholecystitis. In the process of conducting in-depth clinical and immunological studies revealed increased levels of urokinase, histidase to 0.75%, fructose-1-hospitalilty, serendipitously, trainingsgerate, LPO products and circulating immune complexes in 2 times, index increase of CD4/CD8 to 2.5, conjuctival index to 4, found moderate improvement in regional blood flow. On the basis of the survey is diagnosed, the average severity of the pathological process. The patient was seven sessions of intravenous laser irradiation of blood with a duration of 30 min each, the total radiation dose was 12.6 j. Under the influence of intravenous laser therapy has become less pronounced astheno-vegetative syndrome, normal laboratory values. To consolidate the effect of 3 months was conducted poteryannom treatment GEA OKB, Volgograd, 24.08.2000 on 18.09.2000 was diagnosed with cirrhosis of the liver as the outcome of viral hepatitis C, acute stage; the syndrome of portal hypertension, varicose veins of the esophagus II-III degree; chronic gastritis, chronic colitis, intestinal dysbacteriosis.

In-depth examination revealed increased levels of urokinase, histidase higher than 0.75%, fructose-1-hospitalilty, serendipitously, trainingsgerate, products, FLOOR, circulating immune complexes more than 2 times, the increase of the index CD4/CD8 higher than 2.5, conjuctival index to 5, found significant improvement in regional blood flow. The application of all the above additional laboratory and instrumental methods made it possible to diagnose severe pathological process with a poor prognosis. However, the patient's state was allowed to spend ten sessions of intravenous laser irradiation of blood with a duration of 40 min each, the total radiation dose was 24 j. During intravenous therapy was marked improvement of health, reduction of expression of cytolytic syndrome (confirmed by reduced levels of serum liver enzymes), lazarat is Zernovo irradiation of blood. In the interval between courses and after repeated sessions health and the patient's condition remained satisfactory.

We offer a controlled method of treatment HTTP characterized by the absence of adverse reactions, use in patients with different severity of the process, to achieve defined positive laboratory and clinical effect, persisting for a long time.

Compared with the prototype of this method does not require the use of complex equipment, observe the principle of individualization of treatment and can be applied depending on the severity of the disease.

A method for the treatment of chronic diffuse liver diseases, including the selection of groups depending on the severity of the process and subsequent intravenous laser irradiation of blood continuous emission wavelength of 0.63 Ám, characterized in that during moderate activity process and satisfactory condition of the patient peripheral blood of the patient is subjected to laser irradiation for five consecutive days for 30 min with a total dose of 9 j, as expressed by the activity of the pathological process and the patient's condition moderate iedom the patient daily for 10 days in a row for 40 min total dose of 24 j, then a second course of intravenous laser irradiation of blood in 3 months.



 

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FIELD: medicine.

SUBSTANCE: method involves introducing 0.1-0.3 ml of photosensitizing gel preliminarily activated with laser radiation, after having removed neovascular membrane. The photosensitizing gel is based on a viscoelastic of hyaluronic acid containing khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-2% by mass. The photosensitizing gel is in vitro activated with laser radiation having wavelength of 661-666 nm during 3-10 min with total radiation dose being equal to 100-600 J/cm2. The gel is introduced immediately after being activated. To compress the retina, vitreous cavity is filled with perfluororganic compound or air to be further substituted with silicon oil. The operation is ended with placing sutures on sclerotomy and conjunctiva areas. Compounds like chealon, viscoate or hyatulon are used as viscoelastic based on hyaluronic acid. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity.

EFFECT: excluded recurrences of surgically removed neovascular membrane and development of proliferative retinopathy and retina detachment; retained vision function.

3 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, the flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vascular cutaneous neoplasms, such as nevus flammeus and gemangiomas. Light-thermal impact at energy ranged 39-47 J/sq. cm should be performed in two stages, and between them, 2-3 wk after the onset of vascular resistance at the first stage one should perform beta-therapy daily for 2-3 d at single dosage being 20 g. Then, 3 wk later it is necessary to conduct the second stage of light-thermal impact by starting at energy value being 42 J/sq. cm, not less. The method enables to shorten therapy terms due to applying combined method to affect vascular cutaneous neoplasms.

EFFECT: higher therapeutic and cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine, applicable for stopping of pains of various nature.

SUBSTANCE: the device has a quantum-mechanical oscillator located in a casing, magnet, vessel for medicinal agent and a hollow cylinder. The magnet is installed between the oscillator and the vessel. Positioned in the vessel is a hollow cylinder having through holes on its surface.

EFFECT: quick and absolute anestesia.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves administering laser radiation therapy once a day using low intensity pulsating radiation of wavelength equal to 890nmand power density of 0.03 mW/cm2. Injured organ projection to frontal abdominal wall is exposed to radiation at the first laser therapy stage in two fields acting upon each field for 2 min with radiation pulse succession frequency equal to 80 Hz in applying stable contact-type method. Total treatment dose on two fields is equal to 0.008 J/cm2. The second laser therapy stage begins immediately after having finished the first one in applying radiation along the large intestine path using labile contact-type method in a way that radiation pulse succession frequency equal to 80 Hz is applied first during 1 min and then frequencies of 600, 150 and 300 Hz are applied also during 1 min, respectively. Total treatment dose is equal to 0.032 J/cm2 at the second stage. Total treatment dose is equal to 0.04 J/cm2 at both stages.

EFFECT: enhanced effectiveness in inhibiting dysbacteriosis; reduced frequency of postoperative complications.

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