Method for treating chronic diffuse hepatic diseases due to applying the course of intravenous injections of sodium hypochlorite solutions

FIELD: medicine, hepatology.

SUBSTANCE: the present innovation deals with treating hepatitis and hepatic cirrhosis of different etiology. For this purpose, in case of viral hepatitis B and C at the stage of active viral replication one should inject sodium hypochlorite solution into central vein at concentration of 300-600 mg/l at the rate of 60 drops/min, per about 200-400 ml every other day, about 5-7 procedures/course; in case of viral hepatitis B and C beyond the stage of active viral replication one should inject sodium hypochlorite solution into peripheral vein at concentration of 300 mg/l at the rate of 30 drops/min per about 200-400 ml every other day, about 5-7 procedures/course; in case of hepatitis of non-viral etiology one should inject sodium hypochlorite solution into peripheral vein at concentration of about 200-300 mg/l at the rate of 30 drops/min, per about 200-400 ml daily, about 3-5 procedures/course; in case of hepatic cirrhosis it is necessary to inject sodium hypochlorite solution into peripheral vein at concentration of about 100-200 mg/l at the rate of 40 drops/min, per about 200-400 ml every other day, about 3-5 procedures/course. The innovation suggested provides increased efficiency of detoxication and anti-viral impact due to differentiated matching both the dosages and modes of preparation injection at different forms of hepatic lesions.

EFFECT: higher efficiency of therapy.

2 ex, 1 tbl

 

The technical field:

The invention relates to medicine, section of Hepatology.

Level of the technique:

Currently worldwide, according to who, there has been a steady increase in the number of patients with chronic diffuse liver disease (HTTP) is a large group of diseases including chronic hepatitis and liver cirrhosis of different etiology. In total, 15 to 30% of humanity is suffering from these diseases and in need of medical care [1]. A protracted course of viral and toxic liver lesions with a high level of chronic, long-term disability of patients at high risk for liver failure syndromes cytolysis, cholestasis, hepatic encephalopathy and the possibility of death put HTTP in a number of socially significant diseases[2; 3; 4].

Treatment of chronic viral hepatitis at the present stage, the following groups of drugs: recombinant interferons, nucleoside analogues, inducers of interferon, immunomodulators [5]. They prevent the replication cycle of the virus, neutralize free virus and stimulate suppressed immune system. To ensure HDSP non-viral etiology (toxic hepatitis, alcoholic liver disease, primary biliary cirrhosis and other) used group of medications that improve the metabolism of heparin is acetow (essential phospholipids, hepatoprotectors) in combination with detoxification therapy and vitamin therapy [6; 7]. All links of the pathogenetic chain HTTP for the best results from the treatment it is advisable to act simultaneously.

However, none of the tools of traditional therapy does not have a simultaneous impact on all levels of the pathogenic chain HTTP, so the standard treatment regimen uses several drugs in combination. Dissatisfaction with the results of the application of traditional therapy HDSP, as well as the often high cost of treatment give a special relevance to the problem of finding new ways of treatment of this category of patients.

There is a method of treatment HDSP in the development of hepatic coma by the method of complex medical treatment with plasmapheresis (EN 2146948 C1, 27.03.2000. EN 2142814 C1, 20.12.1999. Naaber, Sarcastic. Clinical and biochemical evaluation of the effectiveness of plasmapheresis in the treatment of severe forms of hepatitis. Clinical medicine. 1991. 7. P.75-77). The main disadvantage of this method is that you must use continuous plasmapheresis with the replacement of a large (3-5 liters) volume of circulating plasma mainly donor plasma, and one procedure requires a considerable amount of time is about 24 hours. This significantly limits its use of the implement, and also increases the risk of immunological conflict.

There is a method of treatment of toxic hepatitis a combination of plasmapheresis with the introduction of a 5% glucose solution, reopoligliukina, a 0.06% solution of sodium hypochlorite and incubation of erythrocyte mass dalargin (EN 2180598 C1. Ammaarah. Method for the treatment of toxic hepatitis in patients with chronic addiction. Patent of the Russian Federation, IPC 7 A 61 M 1/38, 1/36). The main disadvantages of this method is that you need to use several drugs for infusion preparation for plasmapheresis, the patient is also necessary replacement therapy odnogroupna plasma, albumin, glucoseamine, water-salt solutions and dextrans. Necessary equipment to perform plasmapheresis. You need to remember about the financial cost to the patient this course of treatment.

Closest to the claimed technical solution is a method of treatment of chronic generalized viral infection complex/with the introduction of sodium hypochlorite in combination with exposure to dry radon (EN 2089194 C1, 1995. Eccenter. A method for the treatment of chronic generalized viral infection. RF patent №2044544. CL. A 61 K 31/435). The disadvantages of this method is that you must use two drugs: sodium hypochlorite together with radon, to conduct the ne procedure must be from 5 to 8 hours, the treatment course is long and an average of 4 months.

We propose a new method of treatment HDSP using monotherapy rate intravenous infusion of electrochemical sodium hypochlorite, which, as vysheperichislennye analogs refers to the efferent methods of treatment [8]. This method expands the Arsenal of drugs for the treatment of chronic diffuse liver diseases, provides significant beneficial effects in patients HDSP, reduces side effects, shorten duration of treatment, cost-effective. All this gives reason to consider the sodium hypochlorite as an effective method of therapy HTTP.

Disclosure of the invention:

The idea electrochemical oxidation was proposed S.J. Yao, S.K. Wolfson (1975). Humopehy, Ahiataku and Grazino in the research Institute of physical-chemical medicine, Ministry of health created an electrochemical model of microsomal detoxification functions of the liver by the cytochrome P-450 (1983). Since 1993 intravenous method indirect electrochemical detoxification of blood (NAND blood) has been applied in clinical practice [9; 10].

In vivo in humans sodium hypochlorite NaClO-is produced by macrophages during phagocytosis. Its action is due to the negative potential of the molecules. As a donor of active oxygen and a powerful oxidising agent is, the sodium hypochlorite in the body in the presence of oxidizing substances gradually splits into active atomic oxygen (O-) and sodium chloride (NaCl) or sodium ion (Na+) and hypochlorite anion (ClO-). Negatively charged ions react with a huge number of substrates in biological fluids, cell membranes and within them. As a result of oxidation or chlorination of these substrates and appears polyprolene action of sodium hypochlorite on the organs and systems of the body.

For the production of sodium hypochlorite medical regional center for scientific and technical research (REGNAMES, Moscow) was developed and introduced into medical practice apparatus electrochemical detoxification of the body - EDO-4 (Registration certificate of Ministry of health of the Russian Federation No. 92/135-180). Electrochemical sodium hypochlorite is produced by electrolysis of 0.89% saline solution in accordance with the passport application apparatus EDO-4 [11].

Implementing its action in the form of drug - solutions of various concentrations of sodium hypochlorite may be injected intravenously (Resolution farmkomiteta the USSR Ministry of health No. 418 from 13.04.91; Registration certificate of Ministry of health and the MP of the Russian Federation No. 95/178/10, composition VFS 42-2454-95). As the composition of simple and relatives for this reason, intra - and extracellular electrolyte, hypochlorite NAT the Oia does not require strict dosage.

Sodium hypochlorite, which is very important, has a simultaneous effect on the basic parts of the pathogenetic chain development HDSP, as he held a wide range of aseptic (in particular antiviral), detoxification and antioxidant effects.

The reproduction of the virus is reduced due to the dual effects of sodium hypochlorite: free viral shell (regulation of transport of potassium ions due to lipid peroxidation and disturbance of lipid-protein interactions) [12], and linked - by blocking receptors of lymphocytes ("hypochlorite protection").

The detoxification effect of sodium hypochlorite is due to the fact that he is a strong oxidant and at the same time, an unstable connection. Formed from sodium hypochlorite atomic oxygen and hypochlorite anion produce additional oxidation oxidized degradation products and metabolism and provide modeling detoxifying functions of the liver by indirect electrochemical oxidation of toxic agents, allowing you to bypass the effect of protein protection" of toxic metabolites. Even a single intravenous infusion of sodium hypochlorite is accompanied by a decrease in the level of medium-sized molecules, products of lipid peroxidation (LPO), bilirubin, blood urea, speed reduction is sedania erythrocytes (erythrocyte sedimentation rate) [10; 13; 14].

Having pronounced oxidative properties, sodium hypochlorite, however, does not inhibit the antioxidant activity. Moreover, in patients with baseline low level of antioxidant enzymes (AOD) observed a significant increase. Thus is realized the antioxidant effect of sodium hypochlorite. The use of intravenous infusion of sodium hypochlorite in patients with endogenous intoxication increases the protective functions of the organism, as the enzymes AOD effectively resists the damaging effects of free radicals on the main products of metabolism [14].

The concentration of the electrochemical sodium hypochlorite may be different. The most secure and recommended for intravenous injection by Farmkomiteta are concentrations up to 0.06% (600 mg/l). The introduction of sodium hypochlorite solution at a concentration of up to 0.06% carried out through a catheter in a Central vein with a speed of 20 to 40 drops per minute, at a concentration of 0.03% in peripheral vein about 30 to 40 drops per minute [8].

The volume of injected solution of sodium hypochlorite during the day is determined depending on the diagnosis and degree of activity of the pathological process of the patient HDSP, osmotic status of blood plasma. Thus follow the daily requirement of the body is in sodium, chlorine and water, creating the best possible electrolyte stream.

In the instructions to the apparatus electrochemical detoxification of the body (EDO-4), the main technical data and characteristics are tested concentration of the hypochlorite solution is obtained at a temperature of +20°With (from 190 to 1330 mg/l), all of which are valid. Source (uterine) solution to prepare solutions of sodium hypochlorite used for intravenous injection, is a solution with a concentration of sodium hypochlorite 600 mg/l At a dilution of its isotonic (0,89%) saline solution it is possible to obtain sodium hypochlorite solution for intravenous any concentration below 600 mg/l [11]. Thus, the concentration and volume of injected sodium hypochlorite may be selected by the physician individually for each patient depending on the above parameters.

The invention is:

The invention consists in that for the first time for the treatment of chronic diffuse liver diseases (hepatitis and liver cirrhosis of different etiology) as monotherapy was applied electrochemical sodium hypochlorite course of intravenous drip infusion in solutions of different concentrations. Identified complex normalizing effect of sodium hypochlorite on the main C is Enya pathogenetic chain HTTP. Depending on the diagnosis and degree of activity of the pathological process have been developed various schemes of treatment, significantly positive clinical and biochemical dynamics in patients HDSP.

The essential features of the invention

Essential features of the invention are the following:

1. For the first time for the treatment of chronic diffuse liver diseases (hepatitis and liver cirrhosis of different etiology) as monotherapy was applied electrochemical sodium hypochlorite course of intravenous drip infusion in solutions of different concentrations.

2. Identified simultaneous complex normalizing effect of sodium hypochlorite on the basic parts of the pathogenetic chain origin and development of HTTP when administered intravenously - antiviral (virusstatus and possible viruses), detoxification and antioxidant effects. These effects were confirmed by laboratory and clinical results in the treatment of 107 patients HTTP:

a) antiviral effect of sodium hypochlorite by its concomitant impact on the viral membrane and the blockade of receptors of lymphocytes - "hypochlorite protection. Thus the sodium hypochlorite prevents the replication cycle of hepatitis viruses and has virusstatus effect. Perhaps he is able to neutralize the free hepatitis, the closer the concentration of sodium hypochlorite solution to the upper threshold of the safe concentration of 0.06% (600 mg/l), the more evident it virucidal effect;

b) detoxification effect of sodium hypochlorite is carried out by modeling the detoxifying function of the liver by indirect electrochemical oxidation of toxic agents, allowing you to bypass the effect of protein protection" of toxic metabolites and is accompanied by a decrease in the level of LPO products, liver-specific enzymes, bilirubin, blood urea and ESR;

C) antioxidant effect of sodium hypochlorite is realized due to the fact that he is not stupid, but on the contrary, significantly increases the level of enzymes AOD, especially when their initial low values that emphasizes the physiology of the treatment. This effect is directly linked to the reduction of toxic free radicals on the main products of metabolism due to the detoxifying properties of sodium hypochlorite.

3. Depending on the diagnosis and degree of activity of the pathological process HDSP were developed by different regimens of patients:

a) in viral hepatitis b and C in the stage of active viral replication was used scheme is the introduction of sodium hypochlorite into the Central vein at a concentration of 300-600 mg/l at 60 drops per mine is, 200 or 400 ml a day, the total number of procedures 5-7;

b) in viral hepatitis b and C beyond the stage of active viral replication sodium hypochlorite was introduced into a large peripheral vein at a concentration of 300 mg/l at 30 drops per minute, 200-400 ml a day, the total number of procedures 5-7;

C) hepatitis non-viral etiology (autoimmune hepatitis, chronic hepatitis and others) sodium hypochlorite was injected into a peripheral vein at a concentration of 200-300 mg/l at 30 drops per minute, 200-400 ml daily, the total number of procedures 3-5;

g) with cirrhosis of the liver sodium hypochlorite was injected into a peripheral vein at a concentration of 100-200 mg/l at 40 drops per minute, 200-400 ml a day, the total number of procedures from 3 to 5.

These schemes provide a significant positive clinical and biochemical dynamics, no side effects, and reduction of terms of treatment of patients HDSP.

The technical result

The technical result of the proposed method of treatment is expanding Arsenal of drugs for the treatment of chronic diffuse liver diseases, and at the same time, improving the efficiency of treatment of patients HDSP with a significant reduction of side effects, its efficiency and the reduction of treatment time. The duration of treatment ranged from 3 to 13 days. the donkey treatment level FLOOR liver-specific enzymes, bilirubin, blood urea and ESR were significantly decreased, and the activity of enzymes AOD increased. It is important to note that a significant portion of HBV DNA and HCV RNA positive patients with chronic viral hepatitis b and C after a course of monotherapy with sodium hypochlorite HBV DNA and HCV RNA in serum by the method of PCR was not determined, most patients with chronic viral hepatitis b and C, a decrease in the titers of antibodies to HBV and HCV. Patients reported a decrease in severity and severity of pain in the right hypochondrium, termination skin itching, normalization of sleep and appetite. These results, according to the dynamic observation, was significantly preserved in patients 3, 6, and 12 months after treatment.

The novelty of the method:

For the first time for the treatment of chronic diffuse liver diseases (hepatitis and liver cirrhosis of different etiology) applied electrochemical sodium hypochlorite. Depending on the diagnosis and degree of activity of the diseases belonging to the group HDSP developed different regimens of these patients. In the long-term dynamic monitoring regular monitoring of clinical and laboratory data was proven the effectiveness of the treatment with sodium hypochlorite in all groups of patients HDSP. This method provides reliable against the virus (virusstatus and possible antiviral) activity against viruses of hepatitis b and C, removing the hepatitis virus from the blood of patients and reducing viral load liver, provides reliable detoxification action of reducing elevated levels of toxic products in the blood plasma and reducing the severity of syndromes of cytolysis and cholestasis, exerts a significant antioxidant effect, increasing the level of enzymes AOD. All this contributes to the improvement of the functional state of the liver. These positive effects are preserved in patients within 3, 6 and 12 months after treatment. A method of treating patients HTTP sodium hypochlorite technically simple, cost-effective and accessible in practical medicine.

The implementation of the invention:

All therapeutic and diagnostic work was carried out on the basis of the medical departments of the Volgograd Regional clinical hospital №1 (VOCB No. 1).

Drug sodium hypochlorite in the form of solutions of different concentrations we received from isotonic 0,89% solution of sodium chloride by electrolysis apparatus EDO-4 according to the passport of the device [11]. Before intravenous infusion was performed for selective control of solution concentration in harvested party titration method. Vials with sodium hypochlorite solution marked with date of manufacture and the concentration of the solution. The apparatus EDO-4 allows to obtain sterile solutions of g is of pajarita sodium concentration ranges from 190 mg/l to 1330 mg/l depending on the specific mode of electrolysis. If necessary, a solution of sodium hypochlorite at concentrations different from that obtained by the given modes of electrolysis produced dilution of sodium hypochlorite solution of a fixed concentration of isotonic 0,89% solution of sodium chloride. To extend the shelf life of solutions of sodium hypochlorite to 35 days, they kept in the refrigerator at a temperature of +3°C-+5°C, preventing freezing of the solution. The sodium hypochlorite solution was administered to patients in the Central (subclavian) vein and large peripheral vein on the General rules of conduct intravenous infusion.

The treatment of 107 patients HDSP, including 14 patients with chronic viral hepatitis b, 23 with chronic viral hepatitis C, 31 - hepatitis non-viral etiology, and 39 with liver cirrhosis. Before the course and after the treatment was carried out clinical examination and extensive laboratory research.

Methods study patients HTTP:

Standard:

- The General analysis of blood coagulation time, blood sugar, total protein with protein fractions of blood, coagulation tests, and urinalysis.

Standard liver function tests:

- Total bilirubin, thymol test, blood urea, transaminases: alanine aminotransferase (ALT), aspartate aminotransferase (AST).

Liver-specific methods:

- Lipid peroxidation: malonic dialdehyde (MDA), diene conjugates (DC).

The antioxidant enzymes: catalase (Cat), superoxide dismutase (SOD), glutathione peroxidase (GP).

- Organ-specific enzymes: L-serendipitous, L-trainingsgerate, N-acetyl-β-D-glucosaminidase (NAG), serum urokinase (SU), serum histidase (SG).

When treating patients with viral hepatitis b and C in the stage of active viral replication (as a positive PCR data, high titer anti-HBcor IG M and anti-HCV IG M, and high total titer of antibodies to HBV and HCV) were used scheme is the introduction of sodium hypochlorite at a concentration of 300-600 mg/l at 60 drops per minute into the Central vein, 200-400 ml a day, the total number of procedures 5-7. When treating patients with viral hepatitis b and C beyond the stage of active replication of the virus (anti-HBcor IG M and anti-HCV IG M in low titre or not detected, the total titer of antibodies to HBV and HCV low) were used scheme is the introduction of sodium hypochlorite at a concentration of 300 mg/l at 30 drops per minute in a large peripheral vein, 200-400 ml a day, the total number of procedures 5-7. In the treatment of hepatitis non-viral etiology (autoimmune hepatitis, chronic hepatitis and others) were used scheme is the introduction of sodium hypochlorite at a concentration of 200-300 mg/l with speed is 30 drops per minute into a peripheral vein, in 200-400 ml daily, the total number of procedures 3-5. Liver cirrhosis purpose of therapy with sodium hypochlorite depended on the pattern of complications: extent of varicose veins of the esophagus, the severity of ascites and edema syndrome of portal hypertension. When treating this group HTTP sodium hypochlorite was injected at a concentration of 100-200 mg/l for 200-400 ml at 40 drops per minute into a peripheral vein. Procedures were performed every other day. The total number of procedures 3-5. These schemes provide a significant positive clinical and biochemical dynamics and the absence of side effects in patients HDSP.

It is important to note that the three HBV DNA positive patients with chronic viral hepatitis b and eleven HCV RNA positive patients with chronic viral hepatitis C after a course of monotherapy with sodium hypochlorite HBV DNA and HCV RNA in serum by the method of PCR ceased to be, and all studies were conducted in the same laboratory of the Center of state sanitary and epidemiological supervision of the Volgograd region (laboratory of especially dangerous infections DIC ROSS RU 0001. 510266). Most patients with chronic viral hepatitis b and C, a decrease in the titers of antibodies to HBV and HCV.

After a course of monotherapy with sodium hypochlorite in all groups HDSP level FLOOR, liver-specific enzymes, bilirubin, blood urea, and the MA was significantly decreased, and the activity of enzymes AOD was significantly increased. Patients reported improvement in overall health, reduce the seriousness and severity of pain in the right hypochondrium, termination skin itching, normalization of sleep and appetite, increase efficiency.

Dynamics laboratory data of all patients before and after treatment with sodium hypochlorite reflected in the table.

Dynamics of laboratory parameters of patients HDSP, treated with sodium hypochlorite (NaClO-)

8,79±2,4
IndexBefore treatment (average)After treatment (average)The dynamics of the indicator %
Indicators GENDER:
Malonic dialdehyde (MDA) (µmol/l)16,65±1,111,13±0,66-33,1%*
Diene conjugates (DC) (ed)1,36±0,061,12±0,05- 17, 3C%*
Indicators AOD:
Catalase (Cat) (µmol/ml/min)18,63±0,519,8±0,5+6,23%*
Superoxide dismutase (SOD) ($/ml)1,93±0,122,24±0,1+16,0*
The glutathione peroxidase (GP) (µmol/ml/min)1,54±0,221,63±0,16+5,79%*
Indicators of liver-specific enzymes:
L-Serendipitous (SDG) (µmol/l.h)81,11±4,672,49±2,9-10,63%*
L-Trainingsgerate (STR) (µmol/l.h)82,28±4,573,21±3,1-11,0%*
Serum urokinase (SU) (u)1,1±0,30,47±0,1-57,4%*
Serum histidase (SG) (u)0,86±0,180,26±0,06-69,3%*
Ceruloplasmin (CPL) (mg/ %)48,6±1,536,9±2,3-20,2%*
N-acetyl-β-D-glucosaminidase (NAG) (nmol/ml/min)13,93±0,711.87 per±0,6-14,82%*
Alanine aminotransferase (ALT) (IU/l)0,6±0,10,42±0,1-29,4%*
Aspartate aminotransferase (AST) (IU/l)0,27±0,030,19±0,04-29,0%
The total bilirubin (µmol/l)37,93±7,918,83±2,5-50,4%*
Thymol turbidity test (ed)4,87±0,8-44,6%*
Blood urea (mmol/l)12,4±0,85,9±0,3-52,42%*
*p<0,05

In the long-term dynamic monitoring with monitoring of clinical and laboratory data of treated patients positive dynamics have significantly persisted after 3 and 6 months, and in some patients, and 12 months after the treatment.

Driven clinical observation 1:

Patient S., 51 years old, was admitted to the hospital with complaints of intermittent pain in the right hypochondrium and pressing nature, decreased performance, poor appetite and sleep. no history of the disease 23611/834. Diagnosis at admission: "Chronic viral hepatitis C with the syndrome of cytolysis and cholestasis, acute stage"confirmed PCR data. No specific antiviral treatment the patient had not previously held. A course of monotherapy with sodium hypochlorite from 7 procedures at a concentration of 300 mg/l intravenous drip into the cubital vein in 400 ml a day. After treatment, there was complete normalization of GENDER indicators, liver-specific enzymes and standard liver samples, a significant increase in the enzymes AOD. The patient Ave is gracilis pain in the right hypochondrium, appetite, improved sleep, increased efficiency. Conducted after treatment, the tests for the presence of hepatitis C virus by PCR method showed that HCV RNA is not detected. With repeated testing, 3, 6, and 12 months after treatment, the positive dynamics of all laboratory data was preserved. HCV RNA again not detected.

Driven clinical observation 2:

Patient T., aged 65, was admitted to the hospital with complaints of constant heaviness and dull pain in the right hypochondrium, yellowing of skin and sclera, severe itching, swelling of the lower extremities. no history of the disease 24011/932. Diagnosis at admission: "Biliary cirrhosis, active phase. The syndrome of portal hypertension. A course of monotherapy with sodium hypochlorite of 5 treatments at a concentration of 200 mg/l intravenous drip into the cubital vein in 200 ml a day. After a course of monotherapy with sodium hypochlorite level FLOOR decreased MDA - 14,82 to 10.25 mmol/l, DK from 1.35 to 1.1 units of enzyme Activity AOD increased level of Cat was increased from 18.8 to 18,82 µmol/ml/min, SOD - from 1.4 to 1.75 cu/ml, SE - from 1.0 to 1.6 µmol/ml/min Activity SU decreased from 0.02 to 0 u, SG - 0.02 to 0 units, CPL - 49,2 to 36.0 mg%, NAG - 19,67 to 14.98 nmol/ml/min, L-serendipidity from 96 to 60 µmol/l.h, L-trainingsgerate from 102 to 64 µmol/l.h, ALT - from 0.56 to 0.4 IU/l, AST from 0.38 to 0.26 IU/l, the level b is larobina - from 37.8 to 12.0 mmol/l, thymol samples from 7.0 to 2.5 units, blood urea - from 14.2 to 5.1 mmol/l, erythrocyte sedimentation rate, up to 13 mm/HR, after - 6 mm/h. After treatment was observed cessation of pain in the right hypochondrium, the normalization of the color of skin and eyes, itching disappeared, improved sleep and appetite.

Sources of information

1. Fbeing: Clinic and therapy of damage to the membranes of the liver. Rhore-Poulenc Rorer. Köln. 1999.

2. Plagiaries, Epekeina. Intrahepatic cholestasis liver disease: from diagnosis to treatment. The attending physician. 1999. 6. P.55-59.

3. Aselinos, Lyulchenko, Temzelides. Liver drug addicts. Therapeutic archive. 1999. 9. P.39-44.

4. Wed. Pharmacotherapy of chronic diffuse liver diseases. New drugs and news pharmacotherapy. 2000. 6. P.3-16.

5. DoD, V. Skvortsov, Sassquatch, Reglazing. To the question about modern tactics of treatment of viral hepatitis. The attending physician. 2002. 11. P.44-50.

6. Sedepadova. Liver disease. M: Medicine. 1998.

7. Theologia. Drug hepatitis. Therapeutic archive. 1999. 12. P.46-49.

8. Humopehy and other Methodological manual for doctors: the Preparation and conduct of efferent methods of treatment. Efferent therapy. 1996. Vol.2. 4. C.2-32.

9. Nmediate. Combined extracorporeal detoxification in the complex treatment of peritonitis. Abstract. Diss. on saisc. UCST, M. 1993.

10. VCG stisev, Nmediate. Pathogenetic rationale and basic principles of a comprehensive detoxification therapy of purulent peritonitis. Herald of the Russian Academy of medical Sciences. 1994. 8. P.29-33.

11. Apparatus electrochemical detoxification of the body EDO-4. Passport BKGY. 3029. 000. 00 PS. 1995.

12. E.A. Petrosyan. Pathogenetic principles and rationale of treatment of purulent surgical infection by indirect electrochemical oxidation. Abstract. Diss. on saisc. wcstcrn L. 1991.

13. Auatralian, Accede, Antitruste, Anapolon, Lowgrow. The influence of sodium hypochlorite on the system of lipid peroxidation in the treatment of experimental biliary peritonitis. Efferent therapy. 2000. V.6. 3. Pp.62-67.

14. Allpurinol, Vghemusrahvuste, Mddemo, Youreview, Gay, Ehigiator. Endogenous intoxication and its treatment using sodium hypochlorite at neuroregeneration patients. Anesthesiology and resuscitation. 1997. 3. Pp.62-65.

A method of treating hepatitis or cirrhosis of the liver by intravenous drip infusion of sodium hypochlorite solution, characterized in that in viral hepatitis b and C in the stage of active viral replication, the sodium hypochlorite solution is injected into a Central vein at a concentration of 300-600 mg/l at 60 drops per minute, 200-400 ml a day, 5-7 treatments per course, with viral hepatitis b and C beyond the stage of active replicas the virus and the sodium hypochlorite solution is injected into a peripheral vein at a concentration of 300 mg/l at 30 drops per minute, in 200-400 ml a day, 5-7 treatments per course, non-viral hepatitis etiology of the sodium hypochlorite solution is injected into a peripheral vein at a concentration of 200-300 mg/l at 30 drops per minute, 200-400 ml daily, 3-5 procedures for the course; liver cirrhosis solution of sodium hypochlorite is injected into a peripheral vein at a concentration of 100-200 mg/l at 40 drops per minute, 200-400 ml a day, 3-5 procedures for the course.



 

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2 cl, 1 tbl, 1 ex

FIELD: organic chemistry, medicine, pharmacy.

SUBSTANCE: invention relates to derivative of triazaspiro[5.5]undecane of the formula (I): wherein R1 means compound of the formula (1): or (2): wherein G represents a bond, (C1-C4)-alkylene, (C2-C4)-alkenylene or -CO-; ring A represents: (1) C5-10-membered mono- or bicarbocyclic ring or (2) 5-10-membered mono- or bicyclic heterocycle comprising 1-2 nitrogen atoms and/or 1-2 oxygen atoms; substitute R6 means the following values: (1) (C1-C4)-alkyl, (2) halogen atom, (3) nitrile group, (4) trifluoromethyl group and others; R2 represents: (1) (C1-C4)-alkyl, (2) (C2-C4)alkynyl or (3) (C1-C4)-alkyl substituted with a substitute represented in claim 1 of the invention claim; each R3 and R4 represents independently: (1) hydrogen atom, (2) (C1-C4)-alkyl or (3) (C1-C4)-alkyl substituted with 1-2 substituted taken among: (a) Cyc 2 and (b) hydroxy-group (wherein Cyc 2 represents (1) C5-6-membered monocarbocyclic ring or (2) 5-6-membered monocyclic heterocycle comprising 1-2 nitrogen atoms and/or one oxygen atom), or R3 and R4 form in common group of the formula: wherein R26 represents (C1-C4)-alkyl or Cyc 2; R5 represents hydrogen atom or (C1-C4)-alkyl, its quaternary ammonium salt, its N-oxide or its nontoxic salt. Also, invention relates to pharmaceutical composition inhibiting HIV, regulator of chemokine/chemokine receptor and agent used in treatment and prophylaxis of some diseases, such as inflammatory diseases, asthma, atopic dermatitis, nettle rash, allergic diseases, nephritis, hepatitis, arthritis and other diseases that comprise as an active component above described compound of the formula (I) or its quaternary ammonium salt, its N-oxide or its nontoxic salt. Also, invention relates to (3R)-1-butyl-2,5-dioxo-3-((1R)-1-hydroxy-1-cyclohexylmethyl)-9-(4-(4-carboxyphenyloxy)phenylmethyl)-1,4,9-triazaspiro[5.5]undecane or its pharmaceutically acceptable salt and pharmaceutical composition based on thereof, and to (3R)-1-butyl-2,5-dioxo-3-((1R)-1-hydroxy-1-cyclohexylmethyl)-9-(4-(4-carboxyphenyloxy)phenylmethyl)-1,4,9-triazaspiro[5.5]undecane hydrochloride and pharmaceutical composition based on thereof.

EFFECT: valuable medicinal properties of derivative and composition.

16 cl, 32 ex

FIELD: medicine.

SUBSTANCE: the present innovation deals with the ways of extracorporal detoxication and treatment of hepatic failure. The method should be implemented due to introducing albumin-containing solution through a catheter into abdominal cavity at concentration of 30-40 g/l as dialyzing liquid for 2-4 h. This solution should be purified through "Artificial kidney" apparatus, coal sorbent and anion-exchange resin. Perfusion rate of albumin-containing solution in the course of its purification corresponds to 20-30 ml/min. Detoxication cycle with the help of albumin followed by its deligandization should be repeated many times. The innovation provides optimal mode of perfusion and, thus, high rate of toxins elimination through patient's peritoneum and excludes the necessity in applying anticoagulants and expensive "MARS" system.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine.

SUBSTANCE: one should perform the following stages: a) removal of contaminants out of plant; b) plant's reducing; c) treatment of reduced plant with laser radiation; d) suspending the mixture obtained at stage c) in water; e) maceration of suspension obtained at stage d) and f) separation of liquid developed. Composition should be obtained due to this technique. It should be applied at treating hepatitis C as an aqueous extract. It should be applied as aqueous extract as immunostimulant. Pharmaceutical preparation includes aqueous extract as an active constituent.

EFFECT: increased biological activity of the product.

43 cl, 16 ex, 1 tbl

FIELD: medicine, infectology.

SUBSTANCE: one should introduce rhoncoleukin in standard dosages and standard mode in combination with corbiculin for internal intake per 2 g once daily after meals, being pre-dissolved in 50 ml water, at 8-wk-long course. The present innovation enables to decrease the size of liver, favors regression of disease clinical manifestations in shorter period of time and normalization of detoxicational, protein-synthetic, pigment functions of liver and prolonged remission of the disease mentioned due to corbiculin and rhoncoleukin synergism.

EFFECT: higher efficiency of therapy.

3 dwg, 2 ex, 3 tbl

FIELD: organic chemistry, medicine, pharmacy.

SUBSTANCE: invention relates to new derivatives of triazaspiro[5,5]undecane of the formula (I):

wherein values of radicals R1-R5 are given in the invention claim, ort o their quaternary ammonium salts, N-oxides or nontoxic salts. Proposed compounds possess inhibitory and regulating activity with respect to chemokine/chemokine receptors and can be useful in prophylaxis and treatment of different inflammatory diseases, such as asthma, atopic dermatitis, nettle rash, allergic diseases, nephritis, hepatitis, arthritis or proliferative arthritis and other similar diseases. Also, invention relates to pharmaceutical compositions based on compounds of the formula (I).

EFFECT: improved control method, valuable medicinal properties of compounds.

9 cl, 5 sch, 36 tbl, 70 ex

FIELD: medicine.

SUBSTANCE: method involves giving 3 ozonized physiologic saline procedures 5-6 days before operation. Single ozone dose is equal to 42.8 mcg.

EFFECT: reduced risk of erosive ulceration injuries.

FIELD: veterinary science.

SUBSTANCE: calves are intaken with milk with preliminary addition of the following components, g/l: sodium hydrocarbonate, 5-10; serum albumin, 50-60; sodium acetate, 20-50, and sodium chloride 8-9 for 6-8 days. Method is effective in prophylaxis and treatment of newborn calves in acute and toxic forms of dyspepsia.

EFFECT: improved method for treatment and prophylaxis.

FIELD: medicine, surgery.

SUBSTANCE: after sanitation one should once inject intravenously 0.04%-sodium hypochlorite solution at 10 ml/kg body weight and then - repeatedly in about 10-12 h at the same dosage; then in about 10-12 h twice and in 36 h it is necessary to perform intravenous laser blood irradiation with a He-Ne laser at the dosage of 2 mW at exposure of 5 min. The innovation enables to normalize the quantity of erythrocytes, thrombocytes and leukocytes, provides complete restoration of phagocytic and digestive capacity of neutrophilic granulocytes that, in its turn, enables to interrupt syndrome of endogenic intoxication in earlier terms.

EFFECT: higher efficiency of therapy.

1 cl, 2 ex

FIELD: experimental medicine.

SUBSTANCE: in rabbits one should induce hepatic ischemia due to occlusion of hepato-duodenal ligament for 30 min. Moreover, reamberin should be introduced at the dosage of 35 ml/kg during the whole period of occlusion, and at the dosage of 5 ml/kg for 10 min after removing the above-mentioned occlusion. The method provides preventing the death of experimental animals in case of ischemic exposure being harmful for this type of animals.

EFFECT: higher efficiency of protection.

2 tbl

FIELD: medicine, obstetrics, gynecology.

SUBSTANCE: uterine cavity should be drained in the course of operation, moreover, irrigator's distal end should be withdrawn through operation wound at anterior abdominal wall, and 2 h after the end of operation uterine cavity should be washed through irrigator with 400 ml of cooled 0.06%-sodium hypochlorite solution at perfusion rate being 200 ml/h, 6 times every 12 h up to 3-4 d; after each perfusion one should introduce 1 g kanamycin directly into uterine cavity, moreover, in case of availability of bacterioid and/or anaerobic flora in uterine cavity according to the results obtained due to pre-operational antibioticogram one should add 100 ml 3%-hydrogen peroxide solution into perfusion solution. The present innovation enables to efficiently sanitize uterine cavity due to intrauterine injection of antibiotics by taking into account antibioticogram performed at all stages of operative treatment.

EFFECT: higher efficiency of prophylaxis.

1 cl, 2 ex

FIELD: medicine, pediatrics, hematology.

SUBSTANCE: the present innovation could be applied in treating surgical and oncological diseases in children during treating and preventing anemia of different etiology. One should introduce ceruloplasmin at daily single dosage ranged 50-200 mg depending upon child's age against 100-200 ml 0.9%-sodiumchloride solution intravenously by drops at the rate of 40-50 drops/min. Moreover, for preventing and/or treating posthemorrhagic anemia in case of surgical operations one should introduce ceruloplasmin during 2 d before surgical operation, intraoperationally, and for 2-10 d after operation. For preventing and/or treating anemia in case of purulent-septic diseases ceruloplasmin should be introduced during chemotherapeutic days during the whole period of the course conducted, for preventing and treating radiation anemia at the background of radiation therapy ceruloplasmin should be injected once weekly during the whole period of radiotherapy course, for preventing and treating toxic and radiation anemia at the background of chemoradiation therapy ceruloplasmin should be introduced once weekly on the day of chemotherapy during the whole course of chemoradiation treatment. The innovation enables to avoid inflows of erythrocytic mass and donor's blood along with shortened number of procedures on introduction of ceruloplasmin and 4-times decrease in the risk for the development of severe anemia in children due to matching peculiar mode for ceruloplasmin introduction.

EFFECT: higher efficiency of therapy and prophylaxis.

4 cl, 5 ex

FIELD: medicine.

SUBSTANCE: method involves introducing 0.06% sodium hypochlorite solution from intravaginally arranged cathode during 10-15 min every session in 5-7 days long course.

EFFECT: reduced risk of abdominal pregnancy relapses; retained reproductive function.

1 tbl

FIELD: gynecology.

SUBSTANCE: method is accomplished in the following order. First, daily sanations of vagina with 0.06% sodium hypochlorite solution are fulfilled for 10 min, total number of procedures being 5. If clinical-laboratory symptoms of inflammation disappear, eubiotics are then introduced intravaginally. In case of persistence of clinical-laboratory symptoms of inflammation, dosage forms with antimicrobial agents are introduced intravaginally or introduction of the latter is combined with oral administration of antibacterial preparations followed by intravaginal introduction of eubiotics.

EFFECT: accelerated immunocorrection leading to reduced treatment course to combined effect of sodium hypochlorite, antibiotics, and eubiotics.

4 ex

FIELD: medicine, infectology.

SUBSTANCE: in acute period of bacterial dysentery one should perorally introduce azitromycin once daily at the dosage of 5 mg/kg for 5 d at simultaneous introduction of 1.5%-rheamberin solution by drops at its daily dosage being 10 ml/kg, course of 1.5-2 d. The present innovation enables to overcome antibioticoresistance of dysenteric microbes at the background of keeping and restoring intestinal microflora.

EFFECT: higher efficiency of therapy.

2 ex, 2 tbl

FIELD: medicine, surgery, urology.

SUBSTANCE: method involves administration of hypochlorite sodium in the concentration 0.004% that is combined with its intra-bladder administration in the concentration 0.06% in pre-operative and post-operative periods. Invention promotes to complete sanitation of urinary ways for the shortest time after surgery of transurethral resection of prostate. Invention can be used in prophylaxis of suppurative-inflammatory complications in patients with benign prostate hyperplasia in post-operative period.

EFFECT: improved method for prophylaxis.

2 ex

FIELD: medicine, obstetrics, gynecology.

SUBSTANCE: rehabilitation should be carried out in the third trimester of pregnancy based upon dispensary situated in ecologically safe region, as an enterosorbent one should apply "Carbopect" preparation per 0.5-0.6 g once daily for 3 wk; as an iodine preparation it is necessary to prescribe "Potassium iodide" 200 mcg once daily till the end of pregnancy period and during the whole period of lactation; as adaptogens one should additionally prescribe "Revit" per 2 lozenges thrice daily for 2 wk; vitamin-containing tea; one should, also, apply aerotherapy named "mountain air" per 15-40 min, 15 procedures, totally. The present innovation enables to improve anthropometric parameters in neonatals, decrease the percentage of complications in babies in early neonatal period, among them those that require antibioticotherapy.

EFFECT: higher efficiency of rehabilitation.

2 ex

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