Method of treatment of patients with infiltrative pulmonary tuberculosis

FIELD: medicine; phthisiology.

SUBSTANCE: against spent complex antituberculous therapy carry out lymphotropic administration of the admixture consisting of Isoniazidum in a dose of 10 mg/kg of mass of a body, a heparin of 2.5-5 thousand UN and 0.25 % of a solution of Novocainum in volume of 5-7 ml. Admixture interawned intervals of 1-4 thoracal vertebra administer subcutaneously consistently on one zone in day in postensiform, bulbar, parasternal zone, in addition including in a combination of zones of administration. Then the administration zone is exposed to an electromagnetic irradiation of the highest frequency with a wavelength by of 5.6 mm within 10 minutes in a continuous regimen of 3-5 times in a week. The quantity of lymphotropic introductions on course of treatment makes 20-60 injections.

EFFECT: increase of efficiency of treatment of patients with infiltrative tuberculosis at the expense of substantial growth of concentration of Isoniazidum in a pulmonary tissue.

4 ex

 

The invention relates to medicine, namely to Phthisiology, and can be used for the treatment of patients with infiltrative tuberculosis of the lungs and other forms of specific inflammation adolescents and adults.

There is a method of treatment of patients with infiltrative tuberculosis of the lungs with the use of lymphotropic the introduction of anti-TB drugs (Cherkasov, VA, Palenia IM, Buruhina L.V., gariaev N.A. "Method of treatment of patients with infiltrative pulmonary tuberculosis". Patent for invention No. 2234320 dated 20.08.2004).

The disadvantages of this method: use to create conditions for entry of drugs into the lymph stream only medical way, which is not enough to create high concentrations of the drug in the target organs (lungs). Required expansion of the list of possible areas for lymphotropic the introduction of anti-TB drugs in patients with pulmonary tuberculosis.

Effect: increased efficiency of treatment of patients with infiltrative tuberculosis of the lungs by increasing concentrations of anti-tuberculosis drug isoniazid in pulmonary tissue.

This result is achieved by lymphotropic introduction papadimitrou, jugular, allogrooming zone a mixture consisting of 10 mg/kg of body weight of isoniazid, 2.5 to 5 thousand UNITS of heparin and 5-7 ml of 0.25% solution navakai is a, consistently subcutaneously with 1 area a day on the background of a comprehensive anti-TB therapy. Additionally, in combination lymphotropic zones enter megastate intervals 1-4 thoracic vertebrae, then the area of introduction is subjected to electromagnetic radiation of extremely high frequency with a wavelength of 5.6 mm for 10 minutes in continuous mode, 3-5 times per week, rate of 20-60 injection.

Experimentally proved, that the irradiation zone lymphotropic the introduction of EHF EMR with a wavelength of 5.6 mm significantly increases the polymer concentration in the lung tissue compared with irradiation of EHF EMR with a wavelength of 7.1 mm and lymphotropic the introduction of a 10% solution of isoniazid chest lymphotropic without irradiation and traditional intramuscular injection of the drug (53,2±3,9; 37,4±5,6 and 49.2±9.1 mg/g, respectively, p<0,05, t). These experimental data indicate infostealers effect of EHF EMR with a wavelength of 5.6 mm

This is due to the fact that the EHF EMR with a wavelength of 5.6 mm has the greatest impact on lymphatic vessels tissue zone lymphotropic introduction, increases the amount of drug entering the lymphatic channel accelerates its progress toward radical lymph nodes and lungs through the lymphatic vessels, non-vascular paths importantpart, through the right lymphatic the pigs and the thoracic duct in the pulmonary circulation. As a drug take a mixture consisting of 10 mg/kg of body weight of isoniazid, 2.5 to 5 thousand UNITS of heparin and 0.25% solution of novocaine. Lymphotropic medicinal mixture in the area egotistic spaces of the upper thoracic vertebrae allows the drug to act on paravertebral tissue in the lymphatic vessels, and then in the paravertebral lymph nodes, and from there, along with the flow of lymph into the right lymphatic duct or the thoracic duct, right half of the heart, which significantly accelerates the flow of drugs into the lungs.

For justification of the invention were treated 22 patients with infiltrative tuberculosis of the lungs. We used the following statistical methods: student test t, the criterion angular conversion Fisher φ*the goodness of fit distribution χ2.

The method is as follows: 10% solution of isoniazid per kg of body weight mixed with 2.5 to 5 thousand UNITS of heparin (total amount of drug compound is not less than 15.0 ml've 0.25% novocaine) enter lymphotropic subcutaneously in allogrooming zone; jugular fossa, xiphoid process, megastate intervals of the upper thoracic vertebrae (Th1-Th4), sequentially by 1 point per day, with the irradiation area of introduction of EHF EMR with a wavelength of 5.6 mm using, for example, apparatus "Adaptor-EHF-5,6" production ENT is I "Adaptor" (Ekaterinburg) for 10 minutes in continuous mode, 3-5 times a week, from 20 to 60 injections on the course, on the background of a comprehensive anti-TB therapy.

Examples of specific applications.

Example 1. Patient M., 34 years old, not working. Changes in the lungs identified during the periodic health examination. Complaints were not filed, objective signs of disease were not found. Clinico-radiologically diagnosed with infiltrative tuberculosis1-2the left lung, the office is. Immediately in the comprehensive anti-TB therapy was included lymphotropic isoniazid at a daily dosage sequentially in 4 points, one of which is Marostica, followed by irradiation of the introduction of EMR EHF-5,6 mm Were produced 60 injections. The radiological control after 2 months was determined significant resorption of infiltration, the disappearance of inflammatory paths to the root of the lung, restoring the normal structure of the roots of the lungs. After 1 month of starting treatment normalized acute-phase tests in serum.

Example 2. Patient W., 21 years old, does not work. In the detection method fluoro had no complaints. Diagnosed with infiltrative tuberculosis of the upper lobe of the right lung, MW. Radiographically determined pneumonic infiltration 1,5×2.5 cm with pockets around and inflammatory path to the root of the lung. Initiated comprehensive treatment, but from Yazid was introduced lymphotropic in the composition of the above mixture in the jugular, allogrooming, papadimitrou and megastate zone and exposure to their EMR EHF-5.6 mm (60 injection). This allowed 2 months to achieve positive clinical and radiological improvement: the inflammatory focus dropped to 1-1,2 cm, the foci and the path to the root resorbed.

Example 3. Patient, 20 years disability group II TB. Changes in the lungs revealed when referring to the physician with complaints of productive cough, fever up to 38°s With weight loss. Objective examination the patient was lowered food, pale, light listen to hard breathing without wheezing. Clinico-radiologically was diagnosed with infiltrative tuberculosis C1-2the right lung in the phase of disintegration, the office+. Drug resistance of mycobacteria to rifampicin, kanamycin, ethionamide. The first two months were treated for 1 standard chemotherapy regimen (Ministry of health Order No. 109). The radiological control registered the progression of the process. After receiving information about drug sensitivity correction was carried out in treatment. Therapy was continued for another 4 months. Radiographically was achieved stabilization process with preservation of the cavity destruction to 2 see Then intramuscular administration of isoniazid was replaced by lymphotropic in combination with immunomodula what ora. One of the used areas was megastate intervals of the upper thoracic vertebrae. Used EMR EHF-5.6 mm each time after lymphotropic introduction (course 30 injections). After 2 months of treatment achieved better health, normalization of temperature, disappearance of cough. The radiological control was noted partial resorption of infiltrative component and reducing the destruction cavity to 1 see Was discontinued patients. Normalized acute-phase tests in the hemogram and serum. Decreased negative changes in immunological parameters. Next, the patient was discharged to outpatient treatment and further surgery (resection With1-2the right lung) in view of the continuing disintegration cavity.

Example 4. Patient S., 22, did not work. Was in the hospital with a diagnosis of infiltrative tuberculosis1-2the right lung in the phase of decay and contamination, office+. Drug resistance of mycobacteria to rifampicin, kanamycin, ethionamide, ethambutol, and streptomycin. Were treated with the traditional method for 2 months to no avail. Upon receipt of the results of the study drug susceptibility treatment was adjusted, was carried out for another 2 months is not effective: continued infiltration up to 4 cm, the cavity decay to 2 cm in diameter, multiple who's pockets dropout, continued allocation of Mycobacterium tuberculosis from sputum. Then it was applied lymphotropic isoniazid and immunomodulators in the above scheme with EMR EHF-5.6 mm (20 injections per course). After 2 months of treatment achieved significant resorption and focal infiltrative changes and scarring cavity destruction, bacteriological conversion.

The positive results of the applied method for the treatment of patients with infiltrative tuberculosis of the lungs obtained from 21 patients (95%) in the earlier period than traditional therapy.

The positive effect from the use of the proposed method lymphotropic therapy is to: improve the efficiency lymphotropic the introduction of isoniazid due infostealers effect of the irradiation zone of injection of EHF EMR with a wavelength of 5.6 mm and including in combination lymphotropic points egotistic gaps, which leads to faster resorption of inflammatory changes, reduction and scarring destruction cavities, smear conversion, significant and rapid improvement of the patients ' health; good effect of the treatment of patients with exacerbations and relapses of tuberculosis, including postoperative; possible use in drug resistance; reducing toxic effects of antibacterial drugs.

Method for the treatment of patients with infiltrative pulmonary tuberculosis by lymphotropic introduction papadimitrou, jugular, allogrooming zone a mixture consisting of 10 mg/kg of body weight of isoniazid, 2.5 to 5 production of heparin and 5-7 ml of 0.25%solution of novocaine, consistently subcutaneously with 1 area a day on the background of a comprehensive anti-TB therapy, characterized in that the combination lymphotropic zones impose additional megastate intervals 1-4 thoracic vertebrae, then the area of introduction is subjected to electromagnetic radiation of extremely high frequency with a wavelength of 5.6 mm for 10 min in a continuous mode, 3-5 times per week, rate of 20-60 the injection.



 

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