Method of treating chronic duodenal obstruction
SUBSTANCE: invention relates to medicine, in particular to gastroenterology, and applies to treatment of chronic duodenal obstruction. For this purpose erithromicin is introduced on account of 3.0 mg/kg of body weight 3 times a day. Additionally Alfadol-Ca is introduced in case of initial normocalcemia in dose 1 capsule 1 time a day. In case of initial hypocalcemia Alfadol-Ca dose is 1 capsule 2 times a day. Course of treatment is 3 months.
EFFECT: method ensures elimination of symptoms of chronic duodenal obstruction in patients with functional form of chronic duodenal obstruction in combination with syndrome of disturbed absorption and normalisation of calcium balance in organism.
2 dwg, 1 tbl, 2 ex
The present invention relates to medicine, namely to a gastroenterologist, and can be used in the conservative treatment of duodenostasis with chronic duodenal obstruction functional nature (KS 1.5 ICD. 10).
Secondary hyposmocoma dyskinesia duodenal ulcer chronic duodenitis is manifested by secondary phenomena duodenal stasis observed in 15-25%and in some cases and in 50% of cases on the background of peptic ulcer of the duodenum (Apersaud. Duodenal stasis. - L.: 1976. - 176 S.); pronounced duodenostasis developed with involvement in the pathological process of the gall bladder and pancreas (Ivew, Ass. Chronic duodenitis: a Training manual. - M: go girls VUNMTS and CF, Russia, 2005. - 160 C.). At present compensated and subcompensated the duodenostasis with malabsorption syndrome used high-calorie diet that contains easily digestible foods rich in vitamins, with little fiber, and drugs affecting the motor-evacuation function of the stomach and duodenum: prokinetics (reglan, motilium), a synthetic analogue of somatostatin - octreotide and antibiotic macrolide possessing madelinemadeline effect - erythromycin. But conservative treatment is successful in the compensated stage chronic the Russian duodenal obstruction, and under sub - and decompensation therapeutic measures give an unstable effect (Linvatec, Oieonteva. Clinical enterology, SPb.: Hippocrates, 2001. - 288 S.; Iveu, Ass. Chronic duodenitis: a Training manual. - M.: necr MH and CF, Russia, 2005. - 160 S.; Acerola, Tsepov, Gavva, Nsaleshop. The syndrome of intestinal failure in emergency abdominal surgery (from theory to practice). - M.: Medexpress, 2005. - 460 C.). However, to date, the programs of remedial measures is not taken into account the fact that in many diseases in gastroduodenostomy-pancreatic area, combined with malabsorption syndrome, is the malabsorption of calcium (CA) and vitamin D, which in turn may decrease neuromuscular conductivity of the gastrointestinal tract and cause duodenostasis. This fact is a significant drawback, since violations of the calcium metabolism completing the vicious circle of functional intestinal obstruction in this category of patients and are one of the reasons of failure of conservative therapy with subcompensated stage of chronic duodenal obstruction.
Well-known traditional method of medical treatment compensated and subcompensated duodenostasis with chronic duodenoileostomy, in which stimulation and normalization of motor function of the stomach and duodenum is performed using a drug that blocks peripheral dopamine receptors - domperidone (motilium). Motilium is the inside of 10 mg (1 tablet) 3 times a day for 3-4 weeks. In the absence of clinical effect in 7-10 days prokinetic it is recommended to remove (Assumerlo, Yes. The syndrome of chronic duodenal obstruction. // The wedge. the honey. - 2000. No. 6. - P.51-54).
The disadvantage is that the technique motilium can in rare cases cause transient spasms of the intestine; with increased permeability of the blood-brain barrier - extrapyramidal disorders; endocrine system to cause hyperprolactinemia, which are galactorrhea, gynecomastia and amenorrhea (Vidal visit. 2006. - S-520), the drug is not effective in severe motor disorders of the small intestine.
There is a method of correction of chronic duodenal ileus (intestinal pseudoobstruction) octreotide (150-300 mg/day), admission to which there is a phase III migrating motor complex in patients with absence (Ivew, Ass. Disease of the duodenum. - M.: Medpress-inform, 2005. - S-453).
The main disadvantage of this method is that the smart drug which increases the blood flow to the visceral organs, may cause nausea, vomiting, anorexia, abdominal cramping, flatulence, diarrhea, steatorrhea, symptoms of acute intestinal obstruction, liver function disorders, acute pancreatitis, Hyper - or hypoglycemia, loss of hair (drug Register, 2005. - S), high cost of treatment.
There is a method of treatment of chronic duodenal ileus (intestinal pseudoobstruction), which is characterized by appointment erythromycin with in addition to antibacterial, and even prokineticin action through stimulation of receptors motilin - putting important hormone that regulates motor function of the stomach and duodenum. Erythromycin given orally 250 mg 3 times a day for 5-7 days, when gastroscope dose can be increased in 2 times, and duration of treatment up to 4 weeks (Quigiey E.M.M. Intestinal Pseudo-obstruction // Champion M.C., Orr WC (Foreword) Gastrointestinal Motility. - Oxford, 1996. - P.171-199 and Champion M.C. Treatment of Gas-troparesis // Champion M.C., Orr WC (Foreword) Gastrointestinal Motility. - Oxford, 1996. - P.108-147). We found that the test with erythromycin during manometry allows you to specify the severity of the motor disorder of the small intestine and determines compensatory ability of the intestinal wall. Check the contractile response to type III phase motor activity, as well as increasing the amplitude of the EIT the events compared to the background activity should be construed in favor of the appointment of erythromycin. The closest analogue accepted the results of our previous studies, which showed that comparable prokinetics action with motilium is a single dose of erythromycin at the rate of 3 mg/kg of body weight 3-4 times a day (Tmeminifile, VII, Nevarakka, Rgih, Kuenenia. The role of intracavitary manometry in the diagnosis and treatment of chronic duodenal obstruction. // Izvestiya Vuzov. The North Caucasus region. The natural Sciences. Topical issues of gastroenterology. - 2006. - Special issue. - P.58-60).
The disadvantages of this method are the assignment of erythromycin in patients without a prior assessment of the initial functional state of milinovich receptors, the degree of motor disorders of the small intestine, and without regard to the presence of the syndrome of impaired absorption, in which the proposed treatment may not be as effective.
Object of the invention is the normalization of motor-evacuation function of the duodenum in patients with functional form of chronic duodenal obstruction in combination with the syndrome of impaired absorption, reducing the cost of treatment.
The invention consists in the use as prokinetic erythromycin calculation of 3.0 mg/kg of body weight 3 times a day and differs in that erythromycylamine within 3 months in combination with Alpazolam-CA 1 capsule 1 time per day when the original normocalcaemia or 1 capsule 2 times a day course for 3 months at the source hypocalcemia, to the content of the calcium level in the blood of 2.1-2.55 mmol/l, under the control of the change of gauge performance relative to the source. The technical result of this method is the normalization of motor-evacuation function of the duodenum in patients with chronic duodenal obstruction in combination with the syndrome of impaired absorption due to the use of combinations of drugs that stimulate the contractile activity of the duodenum and normalizing the metabolism of calcium in the body.
To substantiate the results of treatment in this way the clinical study, the main results are presented in the table and drawings to the invention.
The method is as follows. A patient with chronic duodenal obstruction is assigned erythromycin calculation of a single dose of 3.0 mg/kg of body weight 3 times a day in combination with Alpazolam-CA 1 capsule 1 time per day when the original normocalcaemia and 1 capsule 2 times a day, a course of 3 months, when the original hypocalcemia.
As a means of correcting the level of CA in the blood of patients with gastroenterological profile was selected drug "Alphadol-Sa, as this medicine contains at the same time not only the active form of vitamin D3but 200 mg of elemental calcium in the form of carbonate, to provide iwaisako smooth creation prolonged therapeutic concentrations with a low risk of hypercalcaemia. Alfacalcidol, included in its composition, it has a wide range of biological effects as a precursor to the active metabolite of Vitamin D3restores a positive balance of calcium in the treatment of calcium malabsorption (Reference Vidal, 2006. - S), increases the absorption of calcium and phosphate from the lumen of the small intestine and their concentration in the blood, increases muscle strength and improves neuromuscular conductivity (encyclopedia of drugs. 2005. - P.95). For osteoporosis prevention drug administered 1 time per day for treatment - 2. (Instructions for use of the drug Reg. the number P # 13997/01-2002).
The reproducibility of the method there is no doubt, as used to be known equipment and is available for the medical staff process. The method implementation can significantly improve laboratory and gauge indicators and quality of life of patients.
This method is based on the results of examination and treatment of 36 persons, 9 of them are male and 27 females, aged 19 to 62 years who have previously comprehensive examination she was diagnosed with the functional form of chronic duodenal obstruction. Assessment of the severity of disorders of motor function of the small intestine was based on generally accepted clinical, ultrasonographic and radiographic criteria, then clarification is alas during intracavitary manometry on the method developed by us (Tmeminifile, Regraga, VII, Appetiser. Test with erythromycin when intracavitary manometry of the small intestine. // Russian journal of Gastroenterology, Hepatology, Coloproctology. Materials Twelfth Russian Gastroenterological week - 2006. No. 5, T.XVI, Annex 28. - S). The analysis of the obtained sensogram most attention has been paid to the phenomenon of rhythmic activity (III intermediate phase of a migrating motor complex), which normally presents a complex continuous regular contractions that occur with maximum frequency 12-13 per minute. The duration of this phase 4-9 minutes. For the generation and distribution of the migrating motor complex responsible intestinal nervous system and hormonal control of intermediate phase III, which is the promotion of intestinal contents in the distal direction, is carried out mainly by motilium. Anomalies in the phase of rhythmic activity in the form of configuration changes, duration, amplitude pressure waves indicate motor disorders of the small intestine and can be caused by decreased absorption of calcium in the phase I of peace, when there is absorption of fluids and nutrients.
To substantiate the validity of the results of the proposed method was used to control the impact of drugs on the results of therapy. Before Leche is tion, after 2 and 6 months were determined biochemical parameters (CA, parathyroid hormone (PTH), alkaline phosphatase), conducted interventions, small intestine, quality of life was assessed before and 6 months after starting treatment on the questionnaire SF-36.
Before inclusion in the study patients according to the testimony therapy enzymes (CREON, panzytrat, Mezim Forte); antisecretory drugs (omez, famotidine); the eradication of Helicobacter pylori (nexium, amoxicillin, clarithromycin); to suppress bacterial infection in the duodenum and lower intestine, patients received Interix, then to restore the normal microflora Bifiform and hilak Forte. Before therapy in 13 (37%) were diagnosed with hypocalcaemia. Then patients were randomly allocated into 4 groups of 9 people each, including malabsorption of calcium were 6 patients of the 1st and 2nd groups, and 7 from the 3-rd and 4-th, PTH levels in all patients were within normal limits.
To stimulate intestinal motility in the 1st group of conservative prokinetics therapy was performed by motilium; in the 2nd - erythromycin (two conditionally control group); in the 3rd to the standard prokinetic added Alphadol-Sa and the 4th in addition to erythromycin appointed Alphadol-Sa. Motilium (10 mg) and erythromycin (3.0 mg/kg of body weight) patients were treated for 20 minutes before meals 3 times a day; Alphadol-Sa when the original normocalcaemia 1 capsule in the morning, when hypocalcemia - 1 capsule in the morning and evening. The follow-up period of 6 months.
The normal level of calcium in the background of therapy hypercalcaemia was observed. Change the content of calcium in patients with baseline gipokaltsiemiey presented in figure 1. The norm of the content of CA in the blood taken values of 2.1-2.55 mmol/l, rationale lab RZQHG.
As shown by our study (table 1), within 2 months from the start of treatment in all groups showed a significant increase in the average amplitude of pressure waves through 6 months in most patients, in addition to receiving prokinetics Alphadol-Sa, indicators correspond compensated stage of the disease.
Evaluated and other characteristics of the contractile activity of the intestinal wall. In all groups, we observed a significant increase in the amplitude of contractions, improving antroduodenal coordination, reducing the number of retrograde waves and waves of stationary character. We observed that motilium causes contractile activity by type phase arrhythmic activity, which is largely responsible for the mixing of chyme and to a lesser extent for its promotion through the intestines. The erythromycin causes the contractile response to type III (rhythm is achieved) phase of a migrating motor complex and improves the evacuation of food chyme in the underlying sections of the gastro-intestinal tract. The result is a more favorable environment for the absorption of vitamin D and calcium in the small intestine that helps to normalize motor skills. This is evidenced by a significant increase in the average amplitude of the pressure waves as after 2 and 6 months after initiation of therapy in the group of patients receiving erythromycin and Alphadol-Sa.
We have analyzed the quality of life of patients with chronic duodenal obstruction to conservative therapy (figure 2).
Before therapy the quality of life for all patients was low, after 6 months in all groups significantly increased rates of physical, role and emotional functioning, vitality and mental health, but only in patients receiving the combined treatment, indicators of the role-physical and role-emotional functioning approached the parameters of healthy people.
Clinical example 1. Patient Am 32 years old, was admitted in RZQHG (March 2006) with complaints of pain in the upper abdomen moderate in nature, aggravated after eating, feeling of heaviness after eating, nausea, mild heartburn, loss of body weight.
From the anamnesis it is established that sick for a year and a half. Last month marks the deterioration of health, manifested by increase in pain, loss of weight n is 4 kg Hereditary history of peptic ulcer disease burdened.
Objective: height 168 cm, weight 54 kg (BMI of 19.2 kg/m2. Rate by gender and age 20-25,9 kg/m2).
Interpassage barium in the stomach: Gastritis. Gastro, duodenostasis. Duodenogastric reflux. Chronic duodenal obstruction, subcompensation stage.
Fibrogastroduodenoscopy: the Failure of the cardia. Erosive gastritis. Erosive duodenitis. Duodenogastric reflux. HP - negative.
Ultrasound examination of abdominal cavity organs: ULTRASONIC signs of gastro-duodenostasis. The extension of the duodenum with the "pendulum-like" peristalsis, diffuse changes in the pancreas.
Manometric study of gastroduodenal complex: incomplete antroduodenal coordination, hypotonic-hyperkinetic type of motility antrum, hypotonic-hypokinetic type of motility DNA, observed changes in the third phase: a sharp decrease in the amplitude and frequency, a large number of asymmetrical cuts, reducing the duration of phase. Reduced propulsive ability of the KDP. A positive test for erythromycin.
PH meter: in the basal period kislotoobrazovanie reduced concentration, reduced intensity. Duodenogastric reflux. The blood calcium - 1,72 mmol/l (↓), Parathyroid hormone - 86,2 ng/l (N).p> Ultrasound examination of the thyroid and parathyroid glands. Conclusion: ULTRASOUND signs of diseases of the thyroid and parathyroid glands were not found.
Consultation of the endocrinologist: data for the pathology of the parathyroid glands is not received. The patient has a syndrome of impaired absorption, clinically manifested and malnutrition (BMI of 19.2 kg/m2and gipokaltsiemiey.
Clinical diagnosis: chronic duodenal obstruction, functional form, subcompensated stage. Chronic gastritis is not associated with HP. Erosive duodenitis. Syndrome of impaired absorption: low power (BMI of 19.2 kg/m2), hypocalcemia.
After a comprehensive examination of the patient were appointed: diet therapy, Maalox (not having prokineticin effect), erythromycin dose of 160 mg (480 mg/day) and Alphadol-CA 1 capsule in the morning and evening.
At follow-up after 2 months the patient remained complaints about feeling light heaviness in the epigastrium after eating, weight loss was not noted, the chair was decorated 1 every 1-2 days.
Fibrogastroduodenoscopy: data for erosive gastritis and duodenitis is not received.
Ultrasonography: there is positive dynamics, peristalsis of the duodenum is active. Diffuse changes of the pancreas.
The man who Tria: antroduodenal coordination udovletvoritelnaya, normostenichesky-normokinetic type motility antrum, normostenichesky-normokinetic type of motility of the duodenum, the average amplitude of the waves in the duodenum was 40-47 mm RT. Art.
The blood calcium of-2.1 mmol/L.
Considering the obtained data, Maalox was cancelled, it is recommended to continue taking erythromycin and Alfadale-Sa.
After 6 months of active patient had no complaints, it was noted that increased efficiency. The blood calcium - 2.2 mmol/L. According to fibrogastroduodenoscopy and ultrasonography pathological changes were found; the results manometric studies of the amplitude of the pressure waves corresponded to the compensated stage of the disease, which indicated that the patient did not require surgical correction of chronic duodenal obstruction.
Clinical example 2.
Patient K., 25 years old, enrolled in RZQHG (February 2006) with complaints of heaviness, discomfort after eating, occasionally nausea and moderately severe pains in the epigastrium "arching" of nature, the body weight loss of 2 kg over the last 8 months, a delay of a chair up to 3-4 days, sometimes after errors in diet pasty stool. From the anamnesis it is known that suffer from chronic pancreatitis for about 6-8 years, about which repeatedly held stationary examination and treatment. Hudsen is being the last 2-3 months.
Objectively height 161 cm weight : 50 kg (BMI of 19.4 kg/m2. Rate by gender and age of 19.5-22.9 kg/m2).
The radiological examination of the passage of the barium through the GI tract detected: bathygastry, gastritis, duodenostasis. Conclusion: chronic duodenal obstruction. Subcompensated duodenostasis. Visceroptosis.
Fibrogastroduodenoscopy: focal atrophic gastritis, gastroduodenitis, erosive duodenitis.
Ultrasound: ULTRASOUND signs of dilatation of the duodenum, gastroduodenoscopy, diffuse changes of the pancreas, biliary dyskinesia on hypotonic type.
Gastroduodenal motility complex: hypotonic-hyperkinetic type of motility antrum. Hypotonic-dyskinetic type motor with reduced propulsive ability of the KDP. A positive test with erythromycin.
PH meter: in the basal period kislotoobrazovanie reduced concentration, reduced intensity, duodenogastric reflux. The blood calcium - 2.02 mmol/l (N), Parathyroid hormone - 96,4 ng/l (N).
Clinical diagnosis: Chronic duodenal obstruction, functional form, stage of subcompensation. Chronic atrophic gastritis. Chronic pancreatitis with moderate exocrine insufficiency. Chronic kolotas, impenetrably diet. Low power (BMI of 19.2 kg/m2).
After a comprehensive evaluation of the patient were appointed: diet therapy, enzyme therapy CREON 10,000 IU 3 times a day during meals rate for 2 weeks), Maalox (not having prokineticin effect), erythromycin dose of 150 mg (450 mg/day).
At follow-up after 2 months of active patient had no complaints, chair furnished 1 time per day.
Fibrogastroduodenoscopy: data for atrophic gastritis and erosive duodenitis is not received.
Ultrasonography: dynamics of a positive, peristalsis of the duodenum is active. Diffuse changes of the pancreas.
Manometry: Antroduodenal coordination stored. In the duodenum: the rest period is increased to 160 minutes, the period of arrhythmic activity 48-55 minutes, waves of normal amplitude (49-55 mm RT. century), the period of rhythmic activity lasting up to 8 minutes submitted by waves normal frequency, amplitude up to 50-60 mm RT. senior Test with erythromycin, has caused the emergence of rhythmic motor activity duration (7 minutes), frequency (10-13/min) and amplitude (up to 65 mm RT. Art.).
Clinical examples indicate that the use of erythromycin in small doses (subject to the availability of positive samples with erythromycin during manometric studies) as isolated when source is th normocalcaemia, or in combination with Alpazolam-Sa with the source hypocalcemia, well tolerated; gives a positive clinical effect, helps to eliminate duodenostasis and normalization of calcium balance in the body. The method is economically feasible, does not require economic costs, because its implementation is accompanied by the use of domestic drugs erythromycin and Alfadale-Sa. The method is recommended for wide use in medical practice.
|The average amplitude of the pressure waves of the small intestine in patients on pharmacotherapy for the treatment of chronic duodenal ileus (n=36, M±M)|
|The wave amplitude pressure mm Hg||group 1 (n=9)||group 2 (n=9)||group 3 (n=9)||group 4 (n=9)|
|Control||Motilium + Alphadol-Sa||Erythromycin + Alphadol-Sa|
|After 2 months|
|After 6 months|
|Note: P<0.05 compared with the 1st group (*), with 2 - (◆); P<0.05 to and two (Oh) and six (•) months after the start of treatment.|
A method for the treatment of functional chronic duodenal obstruction, including the introduction of erythromycin from the calculation of 3.0 mg/kg of body weight 3 times a day, characterized in that it further impose Alpazolam-Sa, and when the original normocalcaemia at the dose of 1 capsule 1 time a day, and when the source hypocalcemia - 1 capsule 2 RA is but a day, the course of treatment is 3 months.
FIELD: medicine; gastroenterology.
SUBSTANCE: antibacterial therapy is presented with selective decontamination using antiklebsiellic bacteriophage within 10 days. After that prebiotic therapy including Hylak Forte, enzymatic agent and Linex in therapeutic dosage is combined with probiotic introduction. For dysbacteriosis of I stage Bifiform is introduced in dose 1 capsule 2 times a day, for dysbacteriosis of II and III stages dose is 2 capsules 2 times a day, combined with Lactobacterinum 5 doses once a day. Thus medicinal plant tincture is introduced including silverweed rootstock, salvia leaves, milfoil herb, St. John's wort herb, elecampane rootstock with roots, tickseed herb, mint leaves, fennel fruits and buckthorn bark at component ratio respectively 2:2:2:2:2:2:2:2:1 dosed 1\3 of glass 3 times a day, 30 min before meal, within 4 weeks.
EFFECT: method has no contraindications and provides fast normalisation of gastrointestinal tract microflora.
1 tbl, 1 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention concerns medicine. A soft drink on the basis of herbs consists of the concentrated vegetative extract obtained from an admixture of herbs, chosen of Sida sps., Boerhaavia diffusa, Vitis vinifera, Tinospora cordifolia and Withania somnifera, along with green palm sugar, the agent causing a fermentation, and carbonised water, in which proportion Sida sps.: Boerhaavia diffusa: Vitis vinifera: Tinospora cordifolia: Withania somnifera in a powdery admixture makes (15-20 : (5-10 : (15-20 : (5-10 : (5-10); Proportion of wt/wt: green palm sugar: the concentrated vegetative extract makes from 1 : 3 to 1 : 4; wt/wt, a proportion of carbonised water: the admixture of the concentrated vegetative extract, green palm sugar and the agent causing a fermentation, makes from 1 : 3 to 1 : 5. Perform: (a) obtaining of parts of Sida sps., Boerhaavia diffusa, Vitis vinifera, Tinospora cordifolia and Withania somnifera; (b) crushing of parts of plants and their mixing with obtaining of a powdery admixture; (c) water addition to a powdery admixture from a stage (b) for obtaining of a water extract; (d) concentration of a water extract from the stage (c); (e) filtration of the concentrated extract from the stage (d); (f) admixture of green palm sugar to the filtered extract from the stage (e); (g) addition of Sacromyces strain and the agent causing fermentation, to the admixture from the stage (f); (h) fermentation of the admixture from the stage (g) during the period of time from 3 till 6 days; (i) filtration of the fermented admixture from the stage (h); (j) concentration of the fermented filtrate from the stage (i) with obtaining of the basic solution and (k) mixing of the basic solution (j) with the carbonised water in wt/wt proportion from 1 : 3 to 1 : 5 with obtaining of a soft drink on the basis of herbs.
EFFECT: creation of a soft drink on the basis of herbs.
11 cl, 5 tbl, 8 ex
FIELD: medicine; pharmacology.
SUBSTANCE: invention concerns production of herbal tea for prevention and complex treatment of intestinal disbacteriosis. The herbal tea includes cinquefoil rootstocks, salvia leaves, milfoil grass, St. John's wort grass, elecampane rootstock and roots, sticktight grass, mint leaves, fennel fruit and buckthorn bark in the ratio of 2:2:2:2:2:2:2:2:1 respectively.
EFFECT: extended medicine range for prevention and complex treatment of intestinal disbacteriosis by sanitation of opportunistic intestinal microflora.
FIELD: medicine; pharmacy.
SUBSTANCE: first version implies that pharmaceutical formulation contains antibiotic and prebiotic - oligosaccharide selected from: fructooligosaccharides, galactooligosaccharides, xylooligosaccharides, maltooligosaccharides and isomaltooligosaccharides by degree of polymerization from 2 to 10, and particles sizes up to 0.3 mm and purity not less than 95%, and antibiotic with particles sizes from 20 to 200 mcm; antibiotic and oligosaccharide are included in mass proportion from 1:1 to 1:100 respectively. Second version implies that pharmaceutical formulation contains powder antibiotic with particles from 20 to 200 mcm selected from: beta-lactamase, including combinations of beta-lactams and bacterial beta-lactamases inhibitors; azalides, fluoroquinolones, amphenicoles, glycopeptides, ansamicynes, nitrofurans, phosphonic acid derivatives, cycloserine, trimetoprym, and as a prebiotic - powder oligosaccharide by degree of polymerization from 2 to 10, particles sizes up to 0.3 mm and purity not less than 95%; antibiotic and oligosaccharide are included in mass proportion from 1:1 to 1:100 respectively; mentioned compositions are intended for oral introduction and applied for bowel disbios prevention caused by antibiotic therapy.
EFFECT: stimulates lactobacilli and bifidus bacteria action.
4 cl, 9 ex
SUBSTANCE: method involves introducing ozonized physiologic saline once a day during 30 min in addition to traditionally applied drugs. The ozonized solution has ozone in concentration of 100-150 mcg/l in the amount of 100-150 ml when treating children younger than 3 years. Children being elder then 3 years, ozone concentration is 200-250 mcg/l, its amount is 200-250 ml. The total therapy course is 5 days long. The traditionally applied drugs are not to be used within 30 min before and after ozonized physiologic saline application.
EFFECT: accelerated treatment course; no antibiotics being used; reduced risk of adverse side effects.
FIELD: medicine, biochemistry, pharmacy.
SUBSTANCE: invention relates to drugs used in treatment and prophylaxis of diseases associated with deficiency or absence of enzyme lactase in human body. Agent comprises enzyme lactase isolated from cultural fluid of microscopic fungus Penicillium canescens with activity 10000 U/g, not less, and shows stability in the pH range from 2.5 to 7.0 and temperatures from 4°C to 60°C. Agent provides effective cleavage of lactose in milk and dairy foodstuffs to a mixture of easily assimilable monosuccharides: glucose and galactose that results to availability of dairy foodstuffs for their using by humans suffering from lactose intolerance. Enzyme is stable that allows its using both for dosing orally with simultaneous using dairy foodstuffs and for their preliminary treatment.
EFFECT: valuable medicinal and nutrient properties of agent.
2 cl, 2 tbl, 2 dwg, 2 ex
SUBSTANCE: method involves applying dietotherapy containing nutrient fibers at a dose of 10-20 g/day. De-nol is additionally introduced at a dose of 120 mg 3-4 times 30 min before taking meals and Mezyme forte at a dose of 1 tablet 3 times a day while eating.
EFFECT: enhanced effectiveness in normalizing intestinal flora; reduced number of adverse side effects; excluded disease recurrence.
FIELD: medicine, pharmacology, biochemistry, enzymes.
SUBSTANCE: invention relates to an enzyme-containing medicinal agent wherein enzymes are chosen from a group consisting of hydrolases, lipases, amylases, glycosidases, phospholipases, phosphodiesterases, phosphatases prepared from infusoria. Also, invention relates to a method for using indicated enzymes in improving digestion or in treatment of digestion disorders. Invention enhances resistance to stomach acid media and preparing from safety microorganism.
EFFECT: valuable medicinal properties of enzymes.
7 cl, 2 tbl, 7 dwg, 2 ex
FIELD: medicine, surgical oncoproctology.
SUBSTANCE: one should introduce laevomycetin and furasolidon or bactrim and furasolidon 5 d before operation. Then, on the 3d d after operation it is necessary to perorally introduce 300 ml low-methoxylated 1%-pectin extract (LPE) - per 100 ml thrice daily, and then 600 ml - per 200 ml thrice daily, 10 d totally. Starting since the 4th d after operation one should fulfill peroral introduction of sorbed probiotic (SP) per 10 dosages thrice daily for 10 d. Moreover, 1 dosage of SP corresponds to 1·107 bifidobacterial CFU. In 21 d SP introduction mentioned should be repeated. Due to matched dosages and the mode of introduction of medicinal preparations the present innovation provides complex reconstruction of motor-evacuator function of gastrointestinal tract and microecological balance of large intestine and, thus, the prophylaxis of purulent-septic complications in this particular category of patients.
EFFECT: higher efficiency of correction.
2 ex, 3 tbl
FIELD: veterinary, in particular agents for prophylaxis and treatment of gastric diseases in calves.
SUBSTANCE: the fist foremilk of calved in summer cows is collected, filtered, bottled in sterile 1 l vessels and frozen in freezing apparatus at 20-22°C. In winter-spring period foremilk is defrosted and conserved with potassium sorbate in ratio of 2.5 ml of 40 % potassium sorbate solution per 1 l of foremilk.
EFFECT: environment friendly method for stimulation of calves immunity.
SUBSTANCE: it is offered: Ivermectine application for obtaining of a pharmaceutical composition for local application for treatment of pink eels, a pharmaceutical composition for the local drawing, intended for the person, containing Ivermectine both certain dissolvents and water, and also its application in dermatology.
EFFECT: invention is distinguished by Ivermectine high stability in compositions at different value pH and good acceptability for a skin.
24 cl, 10 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention concerns pharmaceutical industry, particularly means of cerebral cardiovascular disease treatment and prevention. Pharmaceutical composition for cerebral cardiovascular disease treatment and prevention includes definite steroid saponins in definie amount. Method of pharmaceutical composition preparation involves weighing furostanol saponin and spyrostanol saponin, mixing them at definite ratio, adding pharmaceutically acceptable adjuvants. Method of obtaining pharmaceutical composition involves cutting or breaking of rhizome of definite plants, extraction, extract filtering and passing through a column with absorbing resin, eluate disposal, column flushing with water, flush water disposal, column elution, eluate collection and concentration, adding alcohol to concentrated solution, filtrate collection after filtration, filtrate concentration and drying, adding pharmaceutically acceptable adjuvates. Pharmaceutical composition is applied in pharmaceutical medicine production for cerebral cardiovascular disease treatment and prevention.
EFFECT: highly stable composition efficient for cerebral cardiovascular disease treatment and prevention.
17 cl, 4 dwg, 8 tbl, 8 ex
SUBSTANCE: invention concerns crystalline azithromycin L-malate monohydrate of formula (I) with high stability, solubility and non-hygroscopicity. Also invention concerns pharmaceutical composition for microbe infection treatment, based on compound of the formula (I), and method of obtaining compound of the formula (I), involving: a) interaction of azithromycin with malic acid in aqueous organic solvent, or b) recrystallisation of water-free azithromycin L-malate from aqueous organic solvent.
EFFECT: obtaining crystalline azithromycin L-malate monohydrate of formula (I) with high stability, solubility and non-hygroscopicity.
15 cl, 7 tbl, 7 dwg, 18 ex
FIELD: medicine; venereology.
SUBSTANCE: treatment of urogenital Chlamidia infection in women is ensured by subcutaneous introduction of betaendolysin dosed 7-8 ng/kg/day within 5 days, 5-6 days before menstruation, combined with antibacterial therapy prescribed 3-4 days before menstruation.
EFFECT: klendusity activation before physiological immunodeficiency and optimum for causative agent elimination.
FIELD: medicine; gastroenterology.
SUBSTANCE: method includes introduction of omeprazol and mixture of the following antibacterial medications - clarithromycin and amoxicillin in almagel suspension. Additionally 30 minutes before introduction of suspension, 20 mg of buscopan are introduced orally. At that doses of antibacterial medications used are 6 times less than the recommended ones.
EFFECT: reduction of antibacterial medications dose due to slowdown of stomach peristaltic activity and clearance of stomach mucous membrane.
FIELD: chemistry; pharmacology.
SUBSTANCE: present invention relates to new non-steroidal anti-inflammatory compounds represented with the formula I: , where M is a macrolide subunit of the formula , D is a non-steroidal subunit, obtained from a non-steroidal anti-inflammatory drug, L is a connecting group with the formula X1-(CH2)m-Q-(CH2)n-X2, or their pharmaceutically permissible salts or separate diastereoisomer. Apart from that, this invention relates to the method of obtaining compounds of the formula I (versions), to the pharmaceutical composition on the basis of the compounds of formula I or their pharmaceutically permissible salts and also to the administration of formula I or their pharmaceutically permissible salts to obtain medicine (versions). The values of the substitutes R1-R6, A, B, E, U, Y, Z, W, S1, M, D, X1, X2, Q, m, are shown in the formula of the device.
EFFECT: obtaining new non-steroidal anti-inflammatory compounds.
11 cl, 1 tbl, 7 dwg, 23 ex
SUBSTANCE: basic treatment includes preparations of antisecretory, antispasmodic, antihelicobacter actions with diet. On the 4-5 day basic therapy is combined with prescribed herbal medicine in the form of herbal infusion including chamomile blossom, licorice roots, fennel fruits, cudweed herb, knotgrass herb, inula rhizome with roots, plantain leaves, ashberries, motherwort herb, nettle leaves at ratio of components 2:2:1:2:2:2:2:1:1:1. Infusion is taken up 1\3 glass 3 times a day, 30 min before meal within 4 weeks.
EFFECT: provides reduced terms of normalization of clinical-laboratory indicators, prevents complications of gastric and duodenal ulcer, prevents relapses, increases duration of remission.
3 cl, 1 tbl, 1 ex
SUBSTANCE: invention concerns macrolide compounds of the formula I , where R is hydrogen or methyl; R1 is hydrogen, N,N-di(C1-C3)alkylamino, N,N-di(C1-C3)alkylamino-N-oxide, N-(C1-C3)alkyl-N-benzylamino, N-(C1-C4)acyl-N-(C1-C3)alkylamino, N-[N,N-dimethylamino-(C1-C4)alkylamino]acetyl-N-(C1-C3)alkylamino or a chain of the formula: , where A is hydrogen, phenyl or thiazolyl; X is O or NR6 where R6 is hydrogen; Y is thiazolyl, pyrinidyl or NR6 where R6 is hydrogen; r is a whole number of 1 to 3; m is a whole number of 1 to 6; n is a whole number of 0 to 2; R2 is hydrogen; or R1 and R2 together form a link; R3 is a hydroxygroup or forms a =N-O-R5 group together with R4, where R5 is hydrogen, alkyl or a chain of the formula -(CH2)r-X-(CH2)m-Y-(CH2)n-A where r, m, n are the whole number as defined above; A is hydrogen, thiazolyl, furanyl or thiophenyl; X is NR6 where R6 is hydrogen; Y is a phenylene group or NR6 where R6 is hydrogen; R4 is hydrogen or forms =N-O-R5 group together with R3, with the same R5 as defined above; and its pharmaceutically acceptable salts, on the condition that R1 is not a dimethylamino group when R3 is a hydroxy group, and both R2 and R4 are hydrogen; R1 is not a dimethylamino group when in the =N-O-R5 substitute in 9 position R5 is hydrogen, linear or branched (C1-C5)alkyl; R1 is not a methylamino group when in the =N-O-R5 substitute in 9 position R5 is hydrogen, linear or branched (C1-C5)alkyl. The invention also concerns a method of obtaining the claimed compounds by elimination of L-cladinose residuum in the 3 position in compounds of the general formula II , where R, R1, R2, R3 and R4 are the same as defined above. Besides, the invention also concerns compounds of the general formula II, where R is hydrogen or methyl; R1 is hydrogen, N,N-di(C1-C3)alkylamino, N,N-di(C1-C3)alkylamino-N-oxide, N-(C1- C3)alkyl-N-benzylamino, N-(C1-C4)acyl-N-(C1-C3)alkylamino, N-[N,N-dimethylamino(C1-C4)alkylamino]acetyl-N-(C1-C3)alkylamino or a chain of the formula: where A is hydrogen, phenyl or thiazolyl; X is O or NR6 where R6 is hydrogen or C1-C3alkoxycarbonyl; Y is thiazolyl, pyrinidyl or NR6 where R6 is hydrogen or C1- C3alkoxycarbonyl; r is a whole number of 1 to 3; m is a whole number of 1 to 6; n is a whole number of 0 to 2; R2 is hydrogen; or R1 forms a link together with R2; R3 is a hydroxy group; R4 is hydrogen; and their pharmaceutically acceptable salts; on the condition that (i) R1 is not N,N-dimethylamino or (ii) R1 is not N,N-dimethylamino-N-oxide when R is hydrogen. The invention also concerns pharmaceutical composition based on the compound of the formula I, exhibiting anti-inflammatory effect.
EFFECT: obtaining of compounds with anti-inflammatory effect.
29 cl, 78 ex
SUBSTANCE: troxevazin (Troxerutin) is offered as agent for sports efficiency improvement. Some sportsmen showed maximal oxygen consumption increased after troxevazin application. Invention is distinguished that troxevazin has various action for sports efficiency, and it depends on individual physiological behaviour of sportsman.
EFFECT: improved productivity of cardio-vascular system and increased level of muscular aerobic productivity.
1 tbl, 4 ex
SUBSTANCE: invention refers to medicine, gastroenterology and concerns methods of stomach ulcer treatment. For this purpose, patient with suffering from mediagastral localisation of ulcer defect which is not cicatrising within six weeks, or from piloroduodenal ulcers which are not cicatrising within four weeks, in addition to traditional pharmacotherapy is prescribed with fluconasol. Single dose of fluconasol is 150 mg. Preparation is introduced once a week, within three weeks. Method provides effective utilisation of antithymicotic agents within stomach ulcer therapy based on first formulated specific indications for introduction, without preliminary examination of stated categories of patients.
EFFECT: development of effective method of stomach ulcer treatment due to antithymicotic agents.
7 tbl, 3 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention concerns method of obtaining composition, preferably ointment, including microdosaged and dispersible agent, involving the following production stages: - agent weighing inside input tank coated with Vaseline from inside; - agent capsulation by adding extra Vaseline; - adding input tank with Vaseline and agent to mixer containing excipient mix at 70°C to 90°C; - agent dispersion in mixer.
EFFECT: enhanced agent homogenisation degree in ointment excipients, prevented agent oxidation due to capsulation by Vaseline, limited exudation of paraffin oil included in excipient mix.
7 cl, 2 ex, 10 dwg