Method for treating acute viral hepatitis

FIELD: medicine, hepatology.

SUBSTANCE: at entering a hospital, one should detect patient's percentage content of lymphocytes in blood, and at its value being under 18% it is necessary to inject myelopid, every other day, 5 injections/course. Then comes conventional therapy of the above-mentioned disease. The innovation provides earlier prescription of immunocorrecting preparation as myelopid at acute period of the disease in question due to simple, objective criterion of individual necessity for myelopid prescription.

EFFECT: higher efficiency of therapy.

1 cl, 3 ex

 

The invention relates to medicine, namely to infectious diseases, Hepatology and immunology.

Hepatitis a is one of the most massive infections of the modern period. Since 2000, there has been another rise in the incidence of hepatitis a in the country as a whole, and for individual territories. Often, the disease takes a protracted course. In this regard, it is urgent to develop methods of treatment, which would reduce the treatment time and, thus, to reduce the economic losses related to disability huge number of people.

The closest to the technical nature of the claimed is a method of treatment of acute viral hepatitis (Miller GV, Stepchenko R.N., RF patent No. 2008007 C1 from 28.02.1994), where mielopid injected patients with viral hepatitis with acute and protracted recovery in the amount of 3 injections, if the exacerbation accompanied Alat-Terminalia minor gepatomegalia and minor objective violations. If the disease is in the acute or protracted convalescence is accompanied, in addition, jaundice, intoxication, excessive performance alkaline fosfatazy neutrophils and NBT-test, mielopid enter in the amount of 6 injections together with pathogenetic therapy, including anti-inflammatory agents, in particular as picillin or erythromycin, within 5-7 days in the usual doses for adults. Mielopid dissolved in physiological solution of sodium chloride (prototype)).

However, as bone marrow factor mammals, the drug with the introduction of excluding individual readings can cause decreased production of this factor's own bone marrow of the patient, i.e. complications. At least may develop a withdrawal syndrome manifested in increased sensitivity to the same diseases and conditions (General and local infectious complications after surgery, traumatic brain injuries, fractures, thermal and chemical burns; septic condition, sepsis, acute and chronic inflammatory processes of the respiratory tract, gastrointestinal tract, urogenital tract, acute leukemia, and effects of ionising radiation, chemotherapy and prevention of cancer in persons exposed to factors of radiation accidents), for the treatment which he intended.

Considering the fact that mielopid causes an increase in the level of b-lymphocytes to 4 times, this drug is recommended when a reduced level of b-lymphocytes. Note, however, that the determination of the level of b-lymphocytes, as well as tests used by authors known way, treb which are costly and time-consuming methods, which have low preparative performance, time-consuming, compliance with certain strictly defined conditions and high-quality laboratory equipment and materials.

The main disadvantage of this method is that mielopid is prescribed to the patients with acute and long lasting, that is late enough, for example, for a 100-day sickness (example 1), on day 41 of the disease (example 2).

In the claimed invention solved the problem of the cost of treatment for acute viral hepatitis, simplify testimony to the appointment, reducing painful sensations in the introduction.

The technical result is the development of efficiency in the treatment of acute viral hepatitis.

This technical result is achieved in that in the method of treatment of acute viral hepatitis, including the introduction of mielopid, characterized in that the admission to the clinic patients determine the percentage of lymphocytes in the blood and when it is less than 18% assign mielopid course of 5 injections a day. Mielopid in the amount of 3 mg dissolved in 3 ml of 0.25-0.5% solution of novocaine.

You know, leukopenia, lymphocytosis, slow-motion ESR-response characteristic of the normal (typical) immunological reactions in viral infectious diseases, such as acute is irony hepatitis b (Lobzin J.V., Zhdanov C.V., Volzhanin V.M., Gusev D.A. Viral hepatitis: clinical features, diagnosis, treatment. - St. Petersburg, FOLIO, 2003. - P.23)).

The level of lymphocytes in 18% and below the selected considering the fact that it is known that the minimum relative content of lymphocytes in healthy individuals can be 18%.

New, previously unknown features of the claimed method of treatment of acute viral hepatitis are:

1. using a simple objective test for the diagnosis of individual indications for prescription of mielopid;

2. developed and proposed a level percentage of lymphocytes, below which the diagnosed individual indication for the mielopid;

3. the purpose of mielopid in the acute period of the disease, immediately after admission of the patient to treatment;

4. use for dissolving mielopid 0.25-0.5% solution of novocaine to reduce pain with the drug.

The method is carried out in the following sequence. After admission of the patient to the hospital prescribed examinations, including complete blood count. When detecting in a patient with acute viral hepatitis percentage of lymphocytes less than 18% assign mielopid as a stimulant To the immune system, as it is known, that certain content In lymphocytes corresponds to a certain percentage of UB is Yan lymphocytes. In order to reduce pain medication in the amount of 3 mg dissolved in 3 ml of 0.25-05% solution of novocaine. After 5 injections of the drug, which is injected through the day, re-define indicators of clinical blood analysis, including lymphocytes. With the increasing content of lymphocytes consider the effect of treatment mielopid positive.

According to this method, treated 22 patients with acute viral hepatitis. It was found that the duration of hospitalization in patients mielopid under conditions similar to the rest of the treatment and identical indicators percentage of lymphocytes compared with the control group (25 patients with acute viral hepatitis who did not receive mielopid) was significantly lower (7.4±0.1 days).

Example 1. Patient Kuznetsov V.N., 24 years, history No. 2314, was admitted to the infectious diseases clinic with a diagnosis of acute viral hepatitis A. In the clinical analysis of blood was installed level percentage of lymphocytes in 15%. This was the indication for the purpose of mielopid. Conducted the treatment. After 10 days in the clinical analysis of blood, the percentage of lymphocytes was increased to 38%. Observed regression of clinical and biochemical manifestations of the disease. Further treatment was carried out in a traditional way.

Example 2. Patient Ivanov S.N., 32 years old, medical history, No. 215, entered in to iniko infectious diseases with the diagnosis of acute viral hepatitis A. In the clinical analysis of blood was installed level percentage of lymphocytes in 13%, that is, diagnosed with HIV In the system and assigned mielopid. Conducted the treatment. After 10 days in the clinical analysis of blood, the percentage of lymphocytes was increased to 39%. There was an improvement in clinical and biochemical manifestations of the disease. Further treatment was carried out in a traditional way. The transition to a protracted course was not observed.

Example 3. Patient Smirnov A.A., 25 years old, medical history, No. 342, was admitted to the infectious diseases clinic with a diagnosis of acute viral hepatitis C. In the clinical analysis of blood was installed level percentage of lymphocytes in 12%, that is, diagnosed with HIV In the system and assigned mielopid. Conducted the treatment. After 7 days in the clinical analysis of blood, the percentage of lymphocytes increased to 31%. Clinical improvement was seen after 3 days of starting treatment. The disease ended recovery at the optimum time.

This method is simple to perform, does not require expensive reagents and equipment, able to objectively prove the need as a remedy immunostimulant In-system mielopid when entering a patient with acute viral hepatitis in the hospital, that PR is a quality therapeutic effect, significantly reduces hospitalization in a hospital bed and, thus, provides a significant economic effect. This is a simple way to determine the indications for prescription of mielopid can increase the quality of treatment to avoid side effects and complications, as well as to monitor the effectiveness of actions mielopid in the treatment process during dynamic observation of patients.

1. Treatment of acute viral hepatitis, including the introduction of mielopid, characterized in that the admission to the clinic patients determine the percentage of lymphocytes in the blood, and when it is less than 18% assign mielopid course of 5 injections a day.

2. Treatment of acute viral hepatitis according to claim 1, characterized in that 3 mg of mielopid dissolved in 3 ml of 0.25-0.5%solution of novocaine.



 

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