Method for normalisation of thrombocyte aggregation in patients suffering from arterial hypertension with impaired glucose tolerance

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to haematology, cardiology and endocrinology, and concerns normalisation of thrombocyte aggregation in patients suffering from arterial hypertension with impaired glucose tolerance. It is ensured by integrated treatment including graduated physical exercise, and introduction of pioglitazone in a dose 30 mg once a day in the morning and lisinopril in a dose 10 mg once a day in the morning during not less than 1.5 months.

EFFECT: such complex of specific medical products and physical exercise combined with empirically selected duration of treatment provides effective correction of thrombocyte aggregation and, thereby reduced risk of thrombotic complications in given group of patients.

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The invention relates to medicine, namely to Hematology, cardiology and endocrinology.

Analogues of the proposed method of correction of platelet aggregation in patients with arterial hypertension (AH) with impaired glucose tolerance (IGT) does not exist.

In the literature there are recommendations for the purpose of physical training for the correction of metabolism in the elements of the metabolic syndrome (Diamond, VA, Supportive AV, Shlyakhto E.V., Krasilnikova H. Metabolic cardiovascular syndrome. SPb.: Ed. SPb. (MCM). 1999. - 208 S.).

Sick AG with IGT often prescribed for the correction of insulin resistance pioglitazone.

Moreover, among patients with hypertension with IGT large number of persons in need of antihypertensive therapy with ACE inhibitor on the background of the dosed physical activity and drug pioglitazone.

Never before medical complex consisting of dosed physical activity and drugs pioglitazone and lisinopril, were not used in hypertensive patients with impaired glucose tolerance to normalize platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, epinephrine -, and combinations of inductors - ADP + epinephrine, ADP + collagen, adrenaline + collagen.

The aim of the invention is to increase the efficiency of correction of violations aggregation t is ambiatol in patients with IGT.

The essence of the proposed method lies in the fact that for the correction of platelet aggregation sick AG with IGT at least 1.5 months assigned to dosed physical load, drugs pioglitazone 30 mg 1 every morning and lisinopril 10 mg 1 time in the morning.

The method allows to adjust the aggregation of platelets of patients with arterial hypertension with IGT for 1.5 months., putting it on a level close to that of healthy people. Subject to the subsequent recommendations of the proposed method it is possible the maintenance of platelet aggregation at an optimal level of functioning, which will significantly reduce the risk of thrombotic complications, reduce the number of cases of temporary disability, to accelerate and improve the quality of patient treatment, reduce disability, and also to prolong the life and reduce mortality of patients with arterial hypertension with IGT from heart attack and stroke.

The inventive method is carried out as follows.

The first component of the proposed method is feasible regular physical exercise.

In real life you can implement the three forms of physical activity: 1) morning hygienic gymnastics (charging); 2) health care gymnastics; 3) fractional exercise during the day.

1. Morning hygienic gymnastics (charging).

Morning gymnastics should sanimat the SJ after waking up to Breakfast in a ventilated room. Under the influence of training the body is released from the state of inhibition of the physiological processes taking place during sleep.

The sequence of the exercises involves the alternation of load on different muscle groups (arms, legs, body). Exercises are performed with gradually increasing excursion breathing, stretching, limited use of power conditions. Breathing exercise should be free, rhythmic, without delay, mainly through the nose; the exhalation should be longer than the inhale (breath in 2-3 sec, exhale 3-5).

In good health the load, you can increase the number of repetitions faster, increase range of motion and shorter pauses between exercises.

When fatigue should reduce the load, increase the duration of pauses between exercises, to fill their quiet breathing.

After gymnastics, you must go to the rubbing or take a shower.

Morning exercises should evoke a sense of vitality, increase activity, improve well-being and health.

If you feel unwell, develop shortness of breath or pain in the heart and behind the sternum should be temporarily suspend classes and consult a doctor.

During the day, sick AG with IGT recommended treatment and preventive exercises. Depending on the initial fitness in which you can use at the start of a lightweight variant of physical activity, and later reinforced option.

2. Complexes of preventive and curative gymnastics for persons suffering from hypertension with IGT.

2.1. The lightweight version of preventive and curative gymnastics.

Exercise 1. Standing. A quiet walk with a gradual acceleration and deceleration 1-2 minutes on the exercise of the gradual deepening of the breath.

Exercise 2. Circular motion in the shoulder joints. When breeding - breath, when the note - exhale with a slight tilt of the torso and retraction of the abdominal wall 6-8 times. The fingers touch the shoulders, elbows close to the torso.

Exercise 3. Standing, hands on his belt. Alternately shifting the weight of the body from one foot to the other with a small bending the legs at the knee joint without lifting the feet from the floor. Exercise done 10-16 times with the muscles of the legs.

Exercise 4. Standing, feet apart at shoulder width, hands on his belt. Bending the trunk forward, touch right hand to left toe. 4-6 times alternately. When straightened position - breath, when the tilt - exhale. To look ahead.

Exercise 5. Standing with arms along the body. At the same time to take straight arm and one leg to the side with alternating lead leg. 4-6 times in each direction in turn. A wave of the hands and feet, breathe freely, do not delay.

Exercise 6. Standing, feet apart, hands in front of chest with palms down. With a turn of the body to dissolve the Roux is in hand with turning the palms up - the breath. To return to the original position with a small tilting forward, exhale. 3-5 times in each direction in turn. Breathing to harmonize with the movement of hands and body. By the end of exhalation to engage the wall of the abdomen.

Exercise 7. Standing, hands free. The walk free - 1 min, then with high flexion of the hips - 10-20 movements with subsequent transition to a peaceful walk 1-2 minutes Breathing rhythmic, medium depth.

Exercise 8. Sitting on the edge of the chair, hands on the waist. The bowing of the back and bending forward of the body. Repeat 6-10 times. Breathing is not to delay.

Exercise 9. Sitting on the edge of the chair, the emphasis tassels on the edge of a chair, and your feet slightly in front of the chair. Squats with a focus hands on the edge of a chair - 4-6 times. When you squat exhale.

Exercise 10. Standing sideways to the back of the chair to hold it with one hand. Swing free straight arm with leg pulling back. To return to the original position. Repeat 4-6 times for each leg and arm. Breathing is not to delay.

Exercise 11. Standing, legs apart widely, hands on waist. Turns the body right and left - 6-10 times alternately. The head does not turn, to look forward.

Exercise 12. Standing, feet together, hands down. Move the hands to the sides, inhale, bend the leg at the knee and pressed his hands to his stomach exhale. 3-5 times each leg alternately. Strive to maintain balance; on the exhale, draw your abdomen

Exercise 13. Standing, feet together, hands pubescent. The side slopes of the case with flexion of the opposite hand ("pump"). Breathing is not to delay, to strive for greater excursion of movement.

Exercise 14. Standing. A quiet walk with a uniform average depth of breathing. 1-2 minutes

Exercise 15. Lying on the Mat to put under your head with a pillow. Go to a half-sitting position and bent to hug the hips, exhale, return to the starting position and inhale. Breath hold. Strive in a semi-sitting position to maintain balance. Run 4-6 times.

Exercise 16. Lying down, arms at sides, legs apart. A semi-circular motion right straight leg to the left with the rotation of the pelvis - exhale - return to the starting position and inhale. 3-5 times in each direction. Alternately left and right, with the greatest possible excursion movement of the leg, keeping the emphasis brushes the floor.

Exercise 17. Sitting on the floor; a) to stand on all fours; b) to move into position on his knees; hands up - breath, torso, and hands to take back - exhale. When the tilt pull the stomach. Repeat 4-6 times; d) to go into a standing position, and then in the supine position; (e) self-massage of the abdomen small polukrugom movements clockwise - 1-2 minutes Rest 2 min; W) quiet breathing; C) exercise the protrusion (calm) and retraction (active) abdominal wall. Retraction alive is and combined with exhale through the mouth. Repeat 4-6 times.

Exercise 18. Standing with arms bent. Energetic walking on the spot or area of high flexion of the hips and waving of hands - 20-30 steps. Breathing is not to delay.

Exercise 19. Sitting on a chair, legs apart, hands on the waist or rest against the edge of a chair. The circular motion of the pelvis with the retraction of the abdomen when moving the pelvis back. 4-6 times in each direction.

Exercise 20. Standing. A peaceful walk with the breath of the average depth of 2-3 minutes

When the source sufficient trained or arising in the course of the practice of tolerance to physical loads you can use the following set of exercises.

2.2. Enhanced preventive and curative gymnastics.

Exercise 1. Standing. The quiet walk with rubbing the palms of the thorax, abdomen, lower back. Runs 1-2 minutes

Exercise 2. Standing, hands down. Simultaneous bending with tension and free "throwing" hand forward, sideways and upwards of 12-16 times. When you bend exhale, when the alignment of breath.

Exercise 3. Standing, hands on waist, legs shoulder-width apart. Lateral motion of the pelvis to the right and left, back and forth. Is 6-10 times alternately. Breathe freely.

Exercise 4. Standing, feet shoulder-width apart, hands pubescent. Circular motion direct hand in the shoulder joints, 6-10 times with a maximum excursion, breathing, do not delay.

Exercise 5. Standing, hands in front of chest, bent at the elbows. Walking with high flexion of the hips, with a touch of the hand. 6 to 10 times for each leg alternately. Motion of energetic, hip flexion - exhale through the mouth.

Exercise 6. The quiet walk 1-2 minutes

Exercise 7. Sitting on the edge of the chair, hands on the waist. Bending and bowing of the body. The exercise is performed 8-10 times. The energetic movement. When straightening - breath, bending exhale.

Exercise 8. Standing sideways to the chair, to hold back, the other hand on the waist. Alternate sweeps straight leg forward, with the greatest possible tour. Swing legs to be combined with the exhalation. Runs 4-6 times.

Exercise 9. Standing, feet apart, hands at sides. Bending the body forward, touch right brush left toe of the feet, the other hand is allotted up. To return to the original position. Tilt combined with exhalation, by straightening the breath by 4-6 times.

Exercise 10. Walking the quiet breathing of medium depth. 1-2 minutes

Exercise 11. Standing, hands in a fist and lowered: (a) bending of the arms at the elbows with the power and extension of their diverting ago, with possibly large rectification and voltage and delay in the stress state within 2-3 C. Standing, hands on waist; b) proprietary with subsequent lifting in socks and tension legs. The exercise is performed 4-6 times with possibly large vypryamlenii voltage and delay in the stress state within 2-3 C.

Exercise 12. Sitting on the edge of the chair. In the raised position and bent knee leg to make alternate shaking the hands of the calf muscles and thighs. To reduce muscle tension. 1-2 minutes

Exercise 13. Sitting on the edge of the chair, straight leg divorced. Pinch open and direct the hands and feet. When breeding breath, when the note - exhale. Is 4-8 times.

Exercise 14. Standing. The quiet walk with the transition to the rhythmic quiet running (Jogging) on the spot or moving. For fatigue to go on a peaceful walk with the breath of medium depth. 2-5 minutes

Exercise 15. Lying on the Mat. Simultaneous lifting of the body and legs on the exhale. 4-6 times. Arms and legs should be straight, to keep the balance.

Exercise 16. Lying on the Mat, the emphasis brushes the floor. Cross movement straight leg - scissors. 4-8 times. Breathing is not to delay.

Exercise 17. With a quick straightening of the legs to move into a sitting position, then to lie down. You can help stroke 4-6 times.

Exercise 18. Lying on your back, legs bent. Calm breathing 4-6 times.

Exercise 19. Lying on his back, hands diluted with emphasis brushes the floor. With the rotation of the pelvis to the left to bend the legs, rotate the pelvis with legs crossed to the right and stretch the legs. To repeat such a circular motion feet 3-6 times in each direction alternately. Hands not off the floor. Breathing is not saderia the ü.

Exercise 20. Lying on your back, arms and legs separated. Alternate turns the body right and left laying one hand to the other. Feet are not slipping. When divorced hands - breath, turning exhale. Performed 3-6 times.

Exercise 21. Lying on your back, arms along the body: a) turn on your left side; b) to turn on the right side; C) switch to lying on his stomach; to kneel; d) to move in a standing position; (e) walking on the spot with high flexion of the hips and the movement of the hand - 20-30 steps; g) to sit on the Mat; C) lie on your back, relaxing breath. The whole complex repeat 3-4 times.

Exercise 22. Standing. Walking the quiet breathing of the average depth of 1-2 minutes

Exercise 23. Standing, feet apart on the width of the foot, hands on waist. Circular motion of the pelvis to the right and left 6-8 times. Breathing is not to delay.

Exercise 24. Standing with legs wide apart, hands in front of chest. Alternately bending the legs with the transfer to it of gravity of the body with stretching hand to toe of the bent leg. 4-6 times in each direction. The other leg is straight. When straightening - breath, when the tilt - exhale.

Exercise 25. Standing, feet apart at shoulder width, hands on waist. Circular head movements by 4-10 times in each direction.

Exercise 26. Standing, feet apart at shoulder width, hands on waist. Bend trunk to the right, pulling his left hand up in the Oh. Return to starting position - exhale. 4-6 times alternately.

Exercise 27. The same hands to the shoulders. Circular motion of the brushes with the maximum excursion in the shoulder joints, when breeding - breath during the mixing and retraction of the abdominal wall exhale. Breathing deep.

Exercise 28. Standing. A peaceful walk and breath the average depth. The reduction of the total load. 1-2 minutes

3. Fractional exercise during the day.

Sick AG with IGT is sick with a number of related disorders, primarily the cardiovascular system. This circumstance limits the simultaneous application of a high physical load during morning exercises, as well as in the main lesson, curative gymnastics. This is why increasing the physical activity of persons suffering from hypertension with IGT should be implemented by the distribution of physical activity in small doses throughout the day. This method of increasing physical activity in patients with hypertension with IGT should be considered as a method of fractional loads.

Depending on the conditions of real life AH patients with IGT, suffering from varying degrees of abdominal obesity, you can recommend various exemplary embodiments of the fractional loads to increase physical (motor) activity during the day.

Option 1.

Exercise 1. Sitting - dilute OCTI in hand inhale, extend hands forward voltage exhale, 4-6 times.

Exercise 2. Sit - to stand with the deflection of the housing and land - 8-10 times.

Exercise 3. Sitting mimicking the movements of a boxer with possibly a large turn of the body is 10-12 times.

Option 2.

Exercise 1. Standing - walking with high flexion in the hip - 16-30 times.

Exercise 2. Standing - circular head movements to the right and left - 3-8 times in each direction.

Exercise 3. Standing legs apart widely imitated the movements of Costa - 10-12 times.

Exercise 4. Sitting - transition into the standing - 10-12 times.

Option 3.

Exercise 1. The quiet walk - 1 min

Exercise 2. Walking fast - 1 minute

Exercise 3. Walking with high flexion of the hips and alternate wave of the hands 20-30 times.

Exercise 4. Walking the quiet breathing of 1-2 min; quiet running on the spot or move around the room - 2-5 minutes

Option 4.

Walk the pedestrian varying length.

Option 5.

Physical work in different ways and with different duration depending on the conditions (cleaning, home services, cleaning, gardening work, and others).

The second component of the proposed method - the purpose of pioglitazone 30 mg 1 every morning and lisinopril 10 mg 1 time in the morning.

Example. Patient B., 42 years old, suffering from arterial hypertonia violation Tole is astnosti to glucose for 6 years, the examination revealed increased aggregation activity (ADP - 20, with collagen 16, thrombin - 30, ristomycin 22, with H2About2- 28 with adrenaline - 75 with ADP + adrenaline - 16, with ADP + collagen - 21 with adrenaline + collagen - 13 (C) if the sensitivity of platelets to aggregation inducers (when a stand-alone application of the minimum necessary concentration of inducers was not higher than for ADP of 6.0×10-6M adrenaline of 5.0×10-7M, for collagen 1:3.5 dilution of the primary suspension for thrombin 0,110 IU/ml, with a dual combination of inductors are not higher for ADP of 6.0×10-8M, for adrenaline 4,0×10-9M, for collagen 1:7 dilution of the primary suspension for thrombin 0,082 IU/ml).

The patient had been assigned to dosed physical load, pioglitazone 30 mg 1 every morning and lisinopril 10 mg 1 time in the morning. The patient was regularly looked after the start of treatment. Simultaneously with the inspection was carried out biochemical and hematological analysis of blood.

To 5 weeks of treatment, the patient was normalized sensitivity of platelets to aggregation inducers: when a stand-alone application of the minimum necessary concentration of inducer was for ADP 5,0×10-4M adrenaline of 5.0×10-6M, for collagen 1:2 dilution of the primary suspension for thrombin with 0.125 IU/ml, with double the combination of the Indus is Ktorov for ADP 10 -6M adrenaline of 2.5×10-7M, for collagen 1:4 dilution of the primary suspension for thrombin 0,100 u/ml, which corresponded to the normative values.

By week 6 of treatment, the patient returned to normal platelet aggregation with ADP - 41, collagen - 42 C, thrombin - 56, ristomycin - 43, hydrogen peroxide - 43, adrenaline - 102 C and combinations of inductors - ADP + adrenaline - 37 ADP + collagen - 29, adrenaline+collagen - 32). The patient is asked to comply with these recommendations in future.

The use of the proposed method of correction of platelet aggregation in Hematology, cardiology and endocrinology will help to avoid many of vascular complications in patients with IGT, they reduce the number of cases of temporary disability, to reduce the duration of hospitalization, reduce morbidity and mortality.

The method of normalization of platelet aggregation in hypertensive patients with impaired glucose tolerance, including the use of dosed physical activity, pioglitazone 30 mg 1 every morning and lisinopril 10 mg 1 every morning at least 1.5 months.



 

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14 cl, 18 dwg, 1 tbl, 10 ex

FIELD: chemistry.

SUBSTANCE: invention concerns novel compounds of the formula (I): , where R1 is -COOH or -(CH2)n-R14; R2 is or , where X is -CH or -N; each of R3, R4, R5 and R6 is selected out of group including -H, -(lower) alkyl, -N(CH3)2, -O-(lower) alkene, -(lower) alcoxy, or where R5 and R6 are substitutes in adjoining carbon atoms in ring, R5 and R6 optionally form 5- or 6-member saturated carbocyclic ring together with adjoining carbon atoms, R14 is unsaturated 5-member substituted or non-substituted heterocyclic ring including 1 to 4 heteroatoms selected out of N, O and S, n is 0 or 1, or their pharmaceutically acceptable salts or complex ethers. Invention also concerns pharmaceutical composition.

EFFECT: obtaining new bioactive compounds and pharmaceutical composition based on them, with inhibition effect on glutamine fructose-6-phosphate amidotransferase (GFAT).

16 cl, 16 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely haematology, and covers thrombocyte normalisation of ADP and ATP secretion in patients with arterial hypertension and impaired glucose tolerance. It is ensured by integrated treatment including graduated physical exercise, introduction of pioglitazone in a dose 30 mg once a day in the morning and lisinopril in a dose 10 mg once a day in the morning.

EFFECT: such complex of specific pharmacological preparations and drug-free modalities provide complete thrombocyte normalisation of ADP and ATP secretion within 1,5 months that in turn allows normalising thrombocyte function in this group of patients.

1 ex

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