Method for treating gastric and duodenal ulcerous disease

FIELD: medicine, gastroenterology.

SUBSTANCE: it is necessary to apply omeprasol 20 mg twice daily, furasolidone at 100 mg thrice daily and hydrogen sulfide solution at concentration of 10 mg/l per 150 ml thrice daily. Therapeutic course corresponds to 10 d. Due to additional anti-Helicobacter impact of hydrogen sulfide solution at hydrogen sulfide concentration being 10 mg/l the present innovation provides efficient eradication of Helicobacter pylori without using antibiotics.

EFFECT: higher efficiency of therapy.

3 ex

 

The invention relates to medicine, namely to internal medicine.

Peptic ulcer and duodenal ulcer is the most common disease of the internal organs, which, according to world statistics, distributed in approximately 10% of the adult population.

In Russia, about 1.5-5% of the adult population suffer from peptic ulcer disease in the countries of Western Europe duodenal ulcer annually at 0.1-0.3% of persons older than 15 years. In the U.S., 10% of adults were able to obtain historical data about previous gastric ulcer or duodenal ulcer. From an economic point of view, the problem is very serious - the annual cost of maintenance therapy N2-blockers, particularly in France, is 700 million US dollars. At the same time, compared with supportive therapy with antisecretory drugs eradication of Helicobacter pylori (H.pylori) requires additional costly drugs that change the very course of peptic ulcer. After successful eradication of relapses describe only 5% of patients.

The aim of the method of treatment of gastroduodenal ulcer is healing, prevention of recurrence and complications. Currently, the main condition of anti-relapse treatment of peptic ulcer disease is recognized as holding eradication of H. pylori therapy.

Currently BP is me for eradication therapy using three - or four-part (quadrature) scheme, meets the following requirements: 1) the destruction of H. pylori is not less than 80% of cases; 2) the occurrence of side effects is less than 5% of cases; the duration of treatment no more than 7-14 days.

The well-known scheme with the use of proton pump blocker in combination with clarithromycin (500 mg twice daily) and amoxicillin (1000 mg twice a day) for at least 7 days (Ivashkin V.T., 1995).

The well-known scheme using colloidal bismuth subcitrate - 240 mg two times a day together with clarithromycin 250 mg twice a day and furazolidone 100 mg twice a day for 7 days (Isakov V.A., Shcherbakov P.L., 2002).

The well-known scheme: a proton pump blocker at standard dose twice a day + bismuth subsalicylate/subcitrate 120 mg four times daily + metronidazole 250 mg four times daily + tetracycline 500 mg four times per day (Ilchenko A.I., 2002).

The disadvantages of the known schemes of eradication therapy are:

- used bulky multipillar scheme, including three or four of the medicinal product, two of which are strong antibiotics, which have side effects on the intestinal flora;

- prolonged use of antibiotics results in resistance and the emergence of new, more resistant strains of H. pylori;

- used drugs are expensive because they will not all to the category of patients can afford these schemes, that is often the cause of failure of medical treatment and the occurrence of complications such as scar deformity, bleeding and perforations.

The above-mentioned disadvantages of the methods of treatment determine the need for further search and implementation of new products, aimed at improving treatment outcomes of patients with peptic ulcer of stomach and duodenum.

The aim of the invention is the identification of specific H. pylori action of sulphurous water at certain concentrations.

As the study material as well as biopsies of the gastric mucosa taken at fibrogastroduodenoscopy in patients with peptic ulcer of stomach and duodenum (4 biopsies from each patient: 2 biopsies from antrum, 2 biopsies from the gastric body). The biopsies were transported to the laboratory of Department of Microbiology, Kazan state medical Academy in the transport thioglycolic environment for 4-6 hours.

Bacteriological diagnosis helikobakterioza conducted a comprehensive method that includes microscopy of biopsy specimens, defining them in urease activity (Clo-test) and the culture method, developed at the Department of Microbiology, Kazan state medical Academy.

From the first biopsy was preparing mA is OK were stained with Gram and microscopically, determined the mobility of the method of phase-contrast, microscopy. Tribal affiliation of Helicobacter was determined by the morphology of bacteria: gram-negative curved or twisted wand, a typical mobility: rapid translational and spiral movement crushed in a drop.

This sampling was subjected to biochemical research, which is based on the ability of H. pylori to produce urease in conditions of weak acid environment of the stomach. Allocation of ammonia in the decomposition of urea by urease bacteria there is a change in pH of the medium and thus changing the color of the indicator (widespread in the world Clo-test).

From the second biopsy was preparing a suspension, rubbing it in a sterile porcelain mortar in the presence of 2 ml of physiological solution to a homogeneous state, followed by 0.5 ml of suspension was made in a test tube with 1 ml of sulphurous water at concentrations of 25 mg/l 10 mg/l and 2.5 mg/l, and in a test tube with 1 ml of saline as a control. After 20 and 50 minutes spent crops by making a loop of 0.004 ml emulsion per Cup with blood agar.

Seeded Cup with blood agar incubated in a desiccator in microaerophilic conditions at a temperature of 37°C and 80% humidity for 5 days.

In the control cups with blood agar obtained the stable growth characteristic of H. pylori small (about 1 mm) transparent shiny colonies. Pilot cups when breeding hydrogen sulfide water 2.5 mg/l inhibition of growth of colonies of Helicobacter not mentioned, and at a concentration of 10 mg/l and 25 mg/l at all the cups of growth of colonies of H. pylori were absent, which indicates the presence of antimicrobial effect of hydrogen sulfide water against H. pylori.

Security reception sulphurous water at doses of 25 mg/l and 10 mg/l 450 ml / day proven by the research that we conducted on the patients. Defined some parameters biochemical syndromes caused the functional state of the liver, in particular indicators of cytolysis syndrome - alanine and aspartic aminotransferase, bilirubin. The study was performed in the laboratory of the Republican medical center health Ministry of the Chuvash Republic on automatic biochemical analyzer "Dimension" DUPONT (USA) using reagents from the same company.

Biochemical parameters studied in these patients, taking mineral water. Before you start taking the studied blood parameters did not differ from the norm. After drinking of course sulphurous waters of the sanatorium "Chuvashia" there was a trend to lower levels of bilirubin and aminotransferases in serum, indicating the absence of the hepatotoxic action and the adequacy of our methods of dosing. At the same time these patients underwent control the performance communications endoscopy of the stomach and duodenum with morphological examination of biopsies of the mucosa - pathological changes as a result of consuming hydrogen sulfide water at these concentrations was not found.

The proof of security for patients this dosage and positive results of antimicrobial activity in vitro was the basis for the study of hydrogen sulfide water in vivo.

The studied group of patients with peptic ulcer of stomach and duodenal ulcers associated with Helicobacter pylori.

All patients received a ten-day courses of anti-ulcer therapy using drugs (omeprazole 20 mg 2 times a day, furazolidone 100 mg 3 times a day and sulphurous water at a concentration of 10 mg/l 150 ml 3 times a day). The biopsies of all patients were examined for the detection of H. pylori (method - see above) before and after the course of treatment. After treatment the patients had a complete absence of H. pylori in the gastric mucosa and positive clinical effect with the healing of ulcers.

Examples:

Patient No. 1,

DS: peptic Ulcer.

Received treatment: omeprazole 20 mg 2 times a day, furazolidone 100 mg 3 times a day, sulphurous water at a concentration of 10 mg/l 150 ml 3 times a day for 10 days.

The results of bacteriological studies:

1. Before treatment: Antral Department - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 8.8×10 3kolonialismus units (CFU) per 1 sampling.

The body of the stomach - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 5.4×103SOME 1 sampling.

2. After treatment: Antral Department - dense nutrient media H.pylori is not selected.

The body of the stomach - dense nutrient media H.pylori is not selected.

Patient No. 2

DS: peptic Ulcer of the duodenum.

Received treatment: omeprazole 20 mg 2 times a day, furazolidone 100 mg 3 times a day, sulphurous water at a concentration of 10 mg/l 150 ml 3 times a day for 10 days.

The results of bacteriological studies:

1. Before treatment: Antral Department - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 6.8×103SOME 1 sampling.

The body of the stomach - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 3.6×103SOME 1 sampling.

2. After treatment: Antral Department - dense nutrient media H.pylori is not selected.

The body of the stomach - dense nutrient media H.pylori is not selected.

Patient No. 3

DS: Multiple gastroduodenal ulcers.

Received treatment: omeprazole 20 mg 2 times a day, furazolidone 100 mg 3 times a day, sulphurous water at a concentration of 10 mg/l 150 ml 3 times a day for 10 days.

Results bacteriological what their research:

1. Before treatment: Antral Department - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 5.5×104SOME 1 sampling.

The body of the stomach - dense nutrient medium is observed characterized by the growth of colonies of H. pylori in the amount of 2.7×104SOME 1 sampling.

2. After treatment: Antral Department - dense nutrient media H.pylori is not selected.

The body of the stomach - dense nutrient media H.pylori is not selected.

Sources of information

1. Ivashkin V.T. // ROS. the honey. Journe. - 1995. - Vol. 1, No. 2. - P.18-19.

2. Isakov V.A., Shcherbakov P.L. proposals for the use of the recommendations from the second of the Maastricht agreement for the eradication of Helicobacter pylori. // J. "prospects of Clinical gastroenterology, Hepatology". - M, 2002. No. 4. - P.31-34.

3. Ilchenko A.I. peptic Ulcer disease and Helicobacter pylori. Problems of diagnosis and treatment (review). // "Central research Institute of gastroenterology - M., 2002. - C.2.

The method of treatment of peptic ulcer of stomach and duodenum, including eradication of H. pylori therapy, characterized in that the quality of medicines prescribed omeprazole 20 mg 2 times a day, furazolidone 100 mg 3 times a day and sulphurous water at a concentration of 10 mg/l 150 ml 3 times a day, a course of 10 days.



 

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