Method for treatment of children with diseases of upper digestive tract segment associated with helicobacter pylori

FIELD: medicine, gastroenterology, pediatrics.

SUBSTANCE: method involves using drugs directed on eradication of microorganism Helicobacter pylori that comprises the preparation "Vetoron" additionally. The preparation "Vetoron" is prescribed in the dose 6-8 drops to children of age 7-12 years and in the dose 8-10 drops to children of age 13-17 years for 7-10 days. Invention provides decreasing the mutagenic effect in carrying out the anti-helicobacter therapy in children. Invention can be used in treatment of children suffering from diseases of upper regions of digestive tract associated with infection with Helicobacter pylori.

EFFECT: improved method of treatment.

3 tbl, 2 ex

 

The invention relates to medicine, in particular to pediatric gastroenterologists, namely the treatment of diseases of the upper gastrointestinal tract, associated with Helicobacter pylori (HP.)

The interest in the problem of diseases of the upper digestive tract, associated with Helicobacter pylori, is not reduced. Currently some concern is the environmental pollution of different mutagenic factors physical, chemical and biological nature, which are able to affect the genetic apparatus. To assess mutagenesis decided to use the frequency of spontaneous mutagenesis. It is likely that different medicinal substances can cause the same mutation, and one medicinal substance different mutations. A large number of new mutagens put forward the issue of the protection of genotypes of living beings from the destructive action of mutagens.

In the literature there are no data on the effect of the schemes of eradication therapy on the karyotype of children with Helicobacter lesions of the digestive system. In this respect, the main objective of the study was to investigate the effect of infection .pylori, scheme of eradication therapy (quadrature) karyotype children, and when detecting mutagenic effect of possible ways of treatment.

The well-known scheme with the use of proton pump blocker in combination with clarithromycin the Ohm (500 mg twice daily) and amoxicillin (1000 mg twice a day) for at least 7 days (Vasiliev J.V. Peptic ulcer disease: pathogenesis, modern strategy of diagnosis and treatment. // J. "Practical medicine". - Kazan, 2003. No. 4. - P.56-60).

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., 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. - Pp.31-34).

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 (Abdulkhakov R.A. Modern principles of treatment of peptic ulcer. // "KAZ. Made" - 2002. - T, 3 no. - S-236).

Known treatment regimens varied and based on the empirical approach to the development of optimal treatment regimens for diseases. So described using quadrakey: amoxicillin - colloidal bismuth subcitrate - metronidazolebuy (Materialisations "Diagnosis and treatment of diseases associated with Helicobacter pylori" Opportunities antihelicobacter therapy in the treatment of inflammatory and erosive-ulcerative diseases gastroduodenal the Noi area, and prevention of neoplastic changes in the stomach. (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. - Pp.31-34). In this scheme, taken as a prototype, used a combination of 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. Despite the efficient eradication, this regimen has some shortcomings: causes side effects, such as violations of the microflora of the intestine, allergic reactions, violations of the autonomic nervous system (headache, dizziness, sweating).

The prototype of the invention has the following essential characteristics: children with diseases of the digestive tract, associated with Helicobacter pylori, are prescribed medicines (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) with the aim of eradication of Helicobacter pylori.

The disadvantage of the prototype is that the treatment of children with diseases of the upper gastrointestinal tract, associated with Helicobater pylori, described in the prototype, does not ensure the elimination of the mutagenic effect of drugs included in the eradication therapy of diseases of the upper gastrointestinal tract, associated with Helicobacter pylori.

The claimed invention is directed to the solution of this problem involves the development of a treatment Helicobacter infection in children with additional use of the drug VETORON.

The solution to this problem provides the elimination of the mutagenic effect of drugs included in the eradication therapy of diseases of the upper gastrointestinal tract, associated with Helicobacter pylori.

To achieve this, the technical result of the claimed invention, a method of treatment of diseases of the upper gastrointestinal tract, associated with Helicobacter pylori, a treatment medicines with additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days.

In relation to the prototype of the claimed invention has the following distinctive features: a treatment with the additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days.

Between the features and there following the causal connection: drugs, used for eradication of Helicobacter pylori, have a pronounced mutagenic effect, the level of chromosomal aberrations is after therapy 5,2± and 2.4%-5,6±2,8% (0-3%). The additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days resulted in decrease in the level of chromosomal aberrations in 3 times (range of chromosomal aberrations was from 0 to 3% at 100% of the children, i.e. within the normal range.

VETORON aqueous solution of beta-carotene, consisting of beta-carotene (provitamin a - interacts with peroxyl radicals, trap O2) and vitamin E (translates O2HE and lipid radicals in an inactive form, terminates lipid peroxidation (LPO), which is the main negative effects of "oxidative stress". The latter is expressed in the sustainable imbalance of Pro - and antioxidant processes in the predominance of the first and causes a variety of cytotoxic damage). VETORON normalizes lipid metabolism, has a radioprotective and antioxidant, immunostimulant, anti-inflammatory, adaptogenic effect. The act reduces the content of free radicals, protects cellular structures from damage, inhibits lipid peroxidation, reduces cholesterol in the blood, normalizes zootoxin the e lipids high and low density. Activates cellular immunity, Ig G antibody production, phagocytosis. Increases the adaptive capacity and resilience to stress with intense physical exertion and exposure to noise, vibration and other environmental factors.

According to the authors the information set of essential features that characterize the essence of the claimed invention, is not known, which allows to make a conclusion about conformity of the invention, the criterion of "novelty".

According to the authors, the essence of the claimed invention to a person skilled should not be explicitly known level of medicine, since it is not detected above method of treatment of children with inflammatory diseases of the upper gastrointestinal tract, associated with Helicobacter pylori, with the additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days, as antimutagen, which allows to conclude that the criterion of "inventive step".

The set of features that characterize the invention, in principle, can be used repeatedly in medicine with the technical result consists in the treatment of children with inflammatory diseases of the upper gastrointestinal tract, associated with Helicobacter pylori, additionally the m drug use VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days, as antimutagen, VETORON normalizes lipid metabolism, has a radioprotective and antioxidant, immunostimulant, anti-inflammatory, adaptogenic effect. The act reduces the content of free radicals, protects cellular structures from damage, inhibits lipid peroxidation, reduces cholesterol in the blood, normalizes lipid ratio of high and low density. Activates cellular immunity, Ig G antibody production, phagocytosis. Increases the adaptive capacity and resilience to stress with intense physical exertion and exposure to noise, vibration and other environmental factors that can make a conclusion according to the invention, the criterion of "industrial applicability".

This method is as follows.

The analyzed group of patients with gastroduodenal pathology associated with Helicobacter pylori (H.p.), - 60 children divided into 3 groups:

The first group consisted of 16 children (21.3%), which was appointed quadrature (omez, de - Nol, amoxicillin, metronidazole),

II group consisted of 14 children (18.6 per cent), took quadrature and VETORON,

III - the control group consisted of 30 healthy children.

Cytogenetic studies of peripheral blood lymphocytes is rowdily twice: at admission and after treatment. In children with diseases of the gastroduodenal region associated with HP, the level of chromosomal aberrations averaged a 3.0±0.2%, which is 1.3 times higher than the control (2,43±2,25%), but is within the upper limit of normal, which probably indicates infectious mutagenesis.

Table 1

The frequency of HA in the control group and the main group
The control groupThe main groupStdP
Chromosomal aberrations2,43±2,25%3,0±0,2%0.250

When studying the impact of quadrature in the second group (N=16) on the karyotype of children with Helicobacter lesions of the digestive system associated H.p., the level of HA averaged 5,2± and 2.4% (p<0,001). After applying quadrature the percentage of children with normal levels of chromosomal aberrations is missing. This fact demonstrates the phenomenon of comutagenic when using quadrature.

In the group of patients who quadrature (N=30), the spectrum of HA before the treatment: at 53.3% ranged from 0 to 3%, at 53.3% from 3 to 5% and 6.6% from 5%-7% HA. After quadrature the level of HA in 50% of children presents from 3-5%, 37.5% had 5-7% HA, 6.3% of children (HA exceeded 7-9% and 6,3% exceeded 9%.

So what Braz, we studied drugs included in eradication therapy (quadrature) have a pronounced mutagenic effect.

Table 2

Changes in the level of chromosomal aberrations after quadrature
Before the treatmentAfter the treatmentStdP
Control2,43%±2,25
Group I (21,3%)3,0%±0,25,2%±0,434.64<0.001

To reduce the mutagenic effect on the karyotype of children was conducted following modification of eradication therapy: advanced medicines if quadrature used and VETORON.

Children who quadrature with Metronom (N=14), the level of chromosomal aberrations averaged 1±0,9% (p<0,001). When studying the structure of HA in children who quadrature with Metronom, the spectrum of chromosomal aberrations was 0-3% 100% children, i.e. within the normal range, there is a decrease in the level of chromosomal aberrations in the 3 times table. No. 3).

Table 3

Comparative analysis of chromosomal aberrations in children I, II, III GRU is p before and after the treatment
Before the treatmentAfter the treatment
control2,43±2,25%
Group I (21,3%)3,0% ± 0,25,2%±0,43
Group II (18,6%)3,0% ± 0,21,2%±0,2

Thus, our studies allow us to recommend the additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days with drugs used for the treatment of children with inflammatory diseases of the upper gastrointestinal tract, associated with Helicobacter pylori.

Example 1

David B., age 7, 01.08.1996 year of birth, was admitted to the RCCH may 27, 2004 with a diagnosis of Chronic gastroduodenitis? Complaints received at a pain in epigastrium, 15 minutes after eating, cramping. Bothered by nausea, belching air. Disease duration up to 1 month. The primary hospitalization. Heredity burdened by his father's side (my grandfather suffers from peptic ulcer of the duodenum). Child medium level of physical development. The white furred tongue, breath putrid. Palpation of the abdomen is determined by the tenderness in the epigastrium. The liver is increased by 0.5 the M.

Data paraclinical methods: in total blood and urine abnormality is not detected. At endoscopy from 14.05.2004, No. 255(SBA) is defined erosive gastritis antrum of the stomach, associated with Helicobacter pylori, duodenoplasty. Breath test - 7 mm (positive), urease test - 3 mm (positive). Using karyotyping to ensure a defined level of chromosomal aberrations - 4±1.25 percent.

Diagnosed with Erosive gastritis associated with Helicobacter populating pylori. Duodenoplasty.

Conducted eradication therapy (omez 20 mg 1 time per day, de-Nol 240 mg 2 times a day, amoxicillin 1000 2 times a day metronidazole 500 2 times a day) and Vetoron 7 drops 1 time per day for 7-10 days. On repeat EGD - the mucosa of the stomach with mild inflammatory changes. Urease and breath tests are negative. The level of chromosomal aberrations after treatment amounted to 1.6±1,6%.

Example 2

Inal D., age 13, born in 1991, he entered 01.04.2004 year in the children's Republican clinical hospital with a diagnosis of Chronic gastroduodenitis? Complaints at admission: pain in the epigastrium, in piloroduodenalnoy area, within 1 hour after a meal, cramping, bothered by nausea, heartburn, belching air, disease duration more than one year. The re-hospitalization. Heredity is not burdened.

Objective: the Boy in the average level physical the ski development. Skin pale pink color. Tongue coated white bloom. Breath putrid, sour belching. Palpation of the abdomen painful, is defined in the epigastrium, in piloroduodenalnoy area, in the right hypochondrium. The liver is not enlarged, cystic symptoms positive.

Data paraclinical methods: In total blood and urine abnormality is not detected. On EGD is determined erosive gastropathy. Urease and breath tests positive. Ultrasound of internal organs is determined by the deformation of the gallbladder with a bend in the body.

Diagnosed with Erosive gastritis associated with Helicobacter pylori. GIT

The level of chromosomal aberrations before treatment was 4±2,8%.

After quadrature (denol 240 mg 2 times a day amoxicillin 500 mg 2 times a day metronidazole 500 mg 2 times a day, omez 20 mg 1 time per day) for 7 days plus Vetoron 10 drops 1 time per day for 7-10 days. On repeat EGD mucosa without inflammatory changes. Urease test is negative, the breath test is 3 mm, the level of chromosomal aberrations after treatment was - 2±1,9.

Thus, the additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days, as antimutagen, provides elimination mutagenic effect the KTA medicines, included in the eradication therapy of diseases of the upper gastrointestinal tract, associated with Helicobacter pylori. VETORON normalizes lipid metabolism, has a radioprotective and antioxidant, immunostimulant, anti-inflammatory, adaptogenic effect, reduces the content of free radicals, protects cellular structures from damage, inhibits lipid peroxidation, reduces cholesterol in the blood, normalizes lipid ratio of high and low density. Activates cellular immunity, Ig G antibody production, phagocytosis.

A method for the treatment of children with inflammatory diseases of the upper gastrointestinal tract, associated with Helicobacter pylori, including the use of drugs aimed at the eradication of Helicobacter pylori, characterized in that a treatment with the additional use of the drug VETORON dose: 7 to 12 years - 6-8 drops from 13 to 17 years - 8-10 drops 1 time per day for 7-10 days.



 

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EFFECT: improved tolerance to transmeridional flight loads.

7 cl

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