Method of treating non-alcoholic fatty liver disease. RU patent 2473342.
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Method of preventing vertical transmission of hepatitis b and c viruses in pregnant women with reactivation of viruses in third trimester / 2473341 Invention relates to field of medicine, namely to infectious diseases and obstetrics, and can be used for prevention of vertical transmission of hepatitis B and C viruses in pregnant women. For this purpose in pregnant women with term of pregnancy from 28 to 30 weeks with reactivation of chronic viral hepatitis B and C, level of viral load is determined and if its value is higher than 105 copies/ml, preparation Kipferon is introduced in dose 2 suppositories 2 times per day rectally with 12 hour interval during 14 days, and starting from 36 weeks of pregnancy repeated course is carried out in accordance with the same scheme. |
 Method of treating non-alcoholic steatohepatitis with application of dalargin magnetophoresis / 2473325Invention relates to medicine, gastroenterology. Method includes dietotherapy in accordance with diet No 5, exercise therapy. Additionally intake of low-mineralised carbonaceous chloride-hydrocarbonate-sulfate-sodium-calcium mineral water "Essentuki-Novaya" is realised. Water is taken in in dose 3.5 ml per 1 kg of patient's body weight, 3 times per day, 30-40 minutes before meal. Carbonaceous-hydrogen sulfide mineral baths with content of hydrogen sulfide 15-20 mg/l are carried out every second day. Baths are taken with water temperature 36-37°C. Course includes 8-10 procedures. Dalargin magnetophoresis on liver projection is performed daily. Pulsing travelling magnetic field from apparatus AMO-ATOS is used. Magnetophoresis is carried out with induction 45 mT, with modulation frequency 10 Hz for 15 minutes, course includes 10 procedures. |
 Agent normalising liver mitochondria / 2470655Invention refers to medicine, more specifically pharmacology. Grape seed extract is presented as an agent normalising liver mitochondria. |
 Agent possessing antiarrhythmic and hepatoprotective properties / 2469720Invention refers to the use of 9-(2-diethylaminomethyl)-2-(3,4-dioxyphenyl)imidazo[1,2-a]benzimidazole dihydrobromide of formula I: as an agent possessing antiarrhythmic and hepatoprotective properties. The invention also refers to the use of 9-(2-diethylaminomethyl)-2-(3,4-dioxyphenyl)imidazo[1,2-a]benzimidazole dihydrobromide for preparing pharmaceutical compositions. |
 Use of polydatine for treating hepatic diseases and polydatine pharmaceutical composition / 2468803There are presented the use of polydatine for treating toxic (including drug-induced) and alcoholic hepatic diseases, as well as based oral compositions. What is shown is reduction of a degree of hepatocyte adipose degeneration in sub-acute alcoholisation, reduction of glycemia and lactate-acidosis. Polydactine promoted reduction of synthesis and accumulation of glycosaminoglycans. |
 Method of preventing chronic toxic hepatopathy / 2468446In order to prevent chronic toxic hepatopathy melaxen is introduced to animals in experiment one time per day in dose 10 mg/ml through probe into stomach. Simultaneously intragastric introduction of cobalt chloride solution in dose 2 mg/kg, in terms of metal, is performed daily, to create cobalt intoxication in organism. |
 Method for preparing agent showing cholagogue action / 2465000Invention refers to pharmaceutical industry, specifically to an agent showing cholagogue action. A method for preparing the agent showing cholagogue action consisting in the fact that ground sandy everlasting blossom, nosebleed herb and peppermint leaves are mixed with coriander fruit, extracted in 40% ethanol by multistage counterflow extraction, settled, filtered, condensed under certain conditions. |
 Quinazoline derivative and pharmaceutical preparation / 2464263Invention relates to a quinazoline derivative of general formula [1], or a pharmaceutically acceptable salt thereof [1], where R1-R6 assume values given claim 1, except compounds in which R5 is hydrogen and R6 is -NH2. The invention also relates to a pharmaceutical composition having the activity of an antipruritic agent, containing as an active ingredient said quinazoline derivative or pharmaceutically acceptable salt thereof. |
 Agent of saussurea ds plants possessing hepatoprotective action / 2464036Invention refers to pharmaceutical industry, particularly to an agent possessing hepatoprotective activity and an ability to normalise the hepatic function. The use of a ground elevated part of Saussurea plants or an aqueous or aqueous-alcoholic or supercritical fluid extract of the elevated part of Saussurea plants as the agent possessing hepatoprotective activity and the ability to normalise the hepatic function. |
 Use of modified cyclosporines / 2463071Group of inventions refers to medicine, particularly the use of non-immunosuppressive cyclophilin-binding cyclosporine for preventing or treating transplantation-related cirrhosis wherein cyclosporine (I) binds to human recombinant cyclophilin with a binding constant (BR) making less than 0.7 wherein BR represents a common logarithm of IC50 cyclosporine to IC50 cyclosporine A relation in concurrent experiment when evaluating by ELISA procedure; and (II) has activity in lymphocyte assay in the mixed culture making no more than 5% as compared with cyclosporine A activity (cl. 1) of the patent claim. There are also disclosed a pharmaceutical composition and a pharmaceutical combination containing cyclosporine under cl. 1. |
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Therapeutic antimalaria drug based on antimalaria agent and probiotic / 2472505 Invention refers to medicine and biotechnology and represents a therapeutic antimalaria drug containing an antimalaria agent and excipients differing by the fact that it additionally contains a biomass of the Bacillus subtilis probiotic strains in the amount of CFU not less than 1×108 cell/tablet (dose) with the ingredients in the preparation taken in certain proportion, wt %. |
 Bacterial extract for gastrointestinal or urinary disorders and method for preparing it / 2457848Invention refers to medicine and pharmacy and represents an immunostimulating extract of one or more bacterial strains Escherichia coli wherein the process of preparing the extract involves lysing one or more bacterial strains at pH more than 12 and processing the extract to separate nucleic acids, and wherein the extract: causes no risk of a prion disease when introduced into the patient, contains less than 100 mcg/ml of nucleic acid, contains chemically modified saccharides, including chemically modified lipopolysaccharide, and contains at least one amino acid which is specified in aspartic acid, glutamic acid, serine, histidine, alanine, arginine, tyrosine, methionine, phenylalanine and lysine; and it is racemised at least by 10%. |
 Bacterial extract for respiratory disorders and method for preparing it / 2456007Invention refers to medicine and pharmacy and represents an immunostimulating extract of one or more bacterial species specified in Moraxella catarrhalis, Haemophilus influenzae, Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes and Streptococcus sanguinis, wherein while preparing said extract one or more bacterial strains are lysed at pH more than 12, and the extract is processed in order to remove nucleic acids; and wherein the extract dies not cause the onset of a prion disease if introduced into a patient wherein the extract contains less than 100 mcg/ml of nucleic acid, wherein the extract contains chemically modified saccharide, including chemically modified lipopolysaccharide, and wherein at least one amino acid which is specified in aspartic acid, glutamic acid, serine, histidine, alanine, arginine, tyrosine, methionine, phenylalanine and lysine, is racemised at least by 10%. |
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Method of treating patients suffering pulmonary tuberculosis / 2456006 Invention refers to medicine, namely to phthisiology, and may be used for treating patients with pulmonary tuberculosis. That is ensured by conducting the tuberculosis therapy in compliance with the standard schedules and additionally prescribing the probiotic biologically active additive SimBiovital 9.0 g in a single dose every second day with food for two months, and also the Hepel 1 tablet once a day sublingually daily for four months. |
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Oral composition containing nonpathogenic microorganisms showing ability to normalise intestinal microflora (versions) / 2453320 Group of inventions refers to pharmaceutical industry and medicine and is applicable for producing and using medical immunobiological preparations containing nonpathogenic microorganisms. The compositions (versions) represent a powder containing substances containing nonpathogenic microorganisms dried up in a culture medium specified in a number: Bifidobacterium bacteria and/or Lactobacillus bacteria, and/or species-specific virulent bacteriophages, and/or species-specific bacteriophages with induced virulence or their combinations with the composition containing target additives able to form a stable foam structure, is characterised by porous structure and fragility, has a relative disintegration shrinkage at least 10 %, equivalent pore diameter 10-110 mcm at particle size no more than 100 mcm and a resting angle less than 50° in the following proportions in 1.0 g of the composition: Bifidobacterium bacteria 106-1010 CFU and/or Lactobacillus bacteria 106-1010 CFU, and/or species-specific virulent bacteriophages of Appelman's lytic activity at least 10-4 with respect to test strains and bacterial isolates recovered from a human body, and/or species-specific bacteriophages of induced virulence of Appelman's lytic activity at least 10-4 with respect to test strains and bacterial isolates recovered from a human body, target additives - the rest. |
 Method for prevention of cattle technological stresses / 2446813Invention relates to veterinary science. A method involves in the fact that the biological preparation lactoenterol 50 g per a head is introduced in animals before stress exposure. |
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Using actinomycetes lysate for preparing dermatics for treating acne and method of treating acne / 2445968 Invention refers to dermatology and represents using lysate of strains Actinomyces R/3.88, L/1.89 or their mixtures for preparing dermatics for treating acne, as well as a method for treating acne characterised by the fact that actinomycetes lysate according to cl.1 is applied on skin of a patient in need thereof. |
 Mean chain length dicarboxylic acid, their derivatives and metabolic disorders / 2445955Invention refers to medicine and pharmacology and represents using a composition containing sebacic acid and/or its derivatives selected from salts and esters for making a product for oral and enteral introduction which is applicable for: (i) treating or preventing peripheral insulin resistance, impaired glucose tolerance, diabetes, hyperglycemia and related disorders, such as nephropathy, retinopathy, cardiac and cardiovascular diseases (ii) increased glucose clearance and/or insulin responsitivity; (iii) hepatic glucose formation inhibition or (iv) reduced endogenous glucose production. |
 Method of obtaining biologically active substance from embrionic-egg mass for preparation of anti-burn plate and anti-fire plate on its base / 2433171Non-infected fresh hen eggs are selected with their further incubating for 9 days. On 5, 6, 7 days hen egg is radiated for 30 s at frequency of modulation 9 Hz and radiation voltage 9 mW with further cooling of eggs for 6-7 days at temperature 2-4°C and homogenisation of eggs. Obtained homogenate is subjected to processing by ultrasound in ultrasonic dispersant. To homogenate, processed with ultrasound, added is mixture, containing 0.1% solution of sodium benzoate and 0.1% of solution of potassium sorbate in equal parts, in weight ratio 1:1 respectively with further ultramicrofiltration through filters with 0.2 mcm diameter, obtaining biologically active substance for embryonic-egg mass. Homogeneous mass is prepared in the following way. Medical gelatin is covered with decoction, containing calendula decoction and chamomile decoction in weight ratio 1:1, keep at temperature 20-25°C for 55-60 minutes with further placement of decoction with gelatin on water bath at temperature 65-70°C until complete dissolusion of gelatin is obtained. Into obtained decoction with gelatin added are amikacin, furacilline, anesthesin, amaranth oil, glycerol and brilliant green with further mixing in homogeniser for 4-5 min obtaining homogeneous mass. To obtained homogeneous mass biologically active substance from embryonic-egg mass is added in specified ratio and mixed in homogeniser for 5-7 min. Obtained mass is poured into special vessels and are placed in thermostat for 3.5-4 hours at temperature 37-39°C with further cooling for 1-2 days until plates solidify in form of plates. |
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Method of mink coccidiosis treatment and prevention / 2425678 Invention relates to veterinary science. A method involves oral introduction of a therapeutic dosage of Toltrazuril 30 mg/kg to minks for two days or a preventive single dosage, and Subalin 20 mg/head for three days running. |
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Method for increasing degree of ecdysteroid extraction from herbal objects / 2472519 Invention refers to pharmaceutical industry, particularly a method for ecdysteroid extraction. The method for ecdysteroid extraction from an elevated part of Serratula cupuliformis involving raw material extraction in 70% ethanol simultaneously exposed to ultrasound under certain environment. |
FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to gastroenterology and can be used for treatment of non-alcoholic fatty liver disease. For this purpose administered are metronidasol 250 mg 4 times per day, alpha-normix 200 mg 2 tablets x 2 times per day during 7-10 days.After that, treatment is performed with further administration of bifiform in dose 2 capsules in the morning, probifor in dose 25-30 doses 3 times per day, linex in dose 2 capsules 3 times per day, hylak forte 40-60 drops 3 times per day, sporobacterin 2-4 ml. Duration of intake constitutes 3-4 weeks, also administered is dufalak in dose 5-10 ml per day. Drug therapy of lipid metabolism disorders is performed in dependence of biochemical parameters: in case if ultrasonic signs of steatosis are present and level of transaminases is normal, statins in combination with ezetimibe are administered. If transaminases increase to 3 normal values, essential phospholipids are applied during 3 months. If transaminases increase higher than 3 normal values, ursodeoxycholic acid in dose 15-20 mg/kg is applied; if ultrasonic signs of non-alcoholic steato hepatitis are present and transaminases increase to 3 normal values, statins are administered in dose 20 mg and ursodeoxycholic acid in dose 15-20 mg/kg for 3-6 months. If transaminases increase higher than 3 normal values, treatment is performed with statins in dose 20-40 mg/day and ursodeoxycholic acid in dose 15-20 mg/kg, ezetimibe in dose 10 mg 1 time per day.
EFFECT: method ensures increased efficiency of treatment of non-alcoholic fatty liver disease with reduction of side effects.
6 ex, 12 tbl
The invention relates to medicine, namely to a method of treatment of nonalcoholic fatty liver disease.
Known method of treatment of nonalcoholic fatty liver disease hypolipidemic drugs (1 - Guide to atherosclerosis and coronary heart disease. Ed. .., .., ..Б. M: Media Medica, 2007). This method is taken to be similar.
The prototype of the invention is a method of treatment of nonalcoholic fatty liver disease through the use of statins (2 - Oganov .., Aronov D.M., Bubnova MG Statins paradigm prevention and treatment of atherosclerotic diseases. . Ter. and prevention. 2006; 5(6):4,8). This method is taken as a prototype.
However, isolated statins may cause an increase in transaminaz (gepatotoksichesky effect).
The aim of the invention is to increase the efficiency of treatment of nonalcoholic fatty liver disease while reducing adverse reactions.
The technical result is achieved by appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times a day for 7-10 days, followed by the appointment of 2 capsules in the morning, 25-30 doses 3 times daily, 2 capsules 3 times a day, Forte 40-60 drops 3 times a day, 2-4 ml, duration of reception 3-4 weeks and in a dose of 5-10 ml / day; drug therapy of disorders of lipid metabolism is carried out in depending on the biochemical indices: in the presence of ultrasound signs steatosis and normal level transaminaz shall statins in combination with ; with increasing transaminaz up to 3 standards apply essential phospholipids 2 capsules 3 times a day for 3 months; if the transaminaz more than 3 standards - acid at a dose of 15-20 mg/kg; in ultrasound signs of nonalcoholic steatohepatitis and raising transaminaz up to 3 norms prescribed statins at a dose of 20 mg and acid at a dose of 15-20 mg/kg for 3-6 months; with increasing transaminaz over 3 standards - statins in the dose of 20-40 mg/day and acid dose of 15-20 mg/kg dose of ezetimibe 10 mg 1 time per day.
The method is implemented as follows.
Patients arrive with a diagnosis of liver steatosis, nealkogolny steatogepatit. Complaints at entering: pain in the right hypochondrium whining character, the right iliac region, belching air, bloating, obesity 2-3 article, arterial hypertension, complaining of pain in the spine.
We know from history that they had hepatitis A, or there were complaints about belching and heartburn. For many years, chronic gastroduodenitis, a chronic cholecystitis. History of erosive gastritis.
Ultrasound examination of abdominal cavity: fatty liver or steatohepatitis. form gallbladder, diffuse changes of the pancreas. Did re persistent pain in the right hypochondrium. Due to development of acute thyroiditis were treated with corticosteroids.
Objectively (on admission): a satisfactory Condition. The skin clean, regular color. No edema. Pulmonary respiration vesicular, wheezing no. Muffled heart sounds, rhythmic. Abdomen soft, moderately painful in the right upper quadrant, right iliac region. The liver is not increased or acts under the edge of a costal arch.
At objective inspection: a satisfactory condition.
A chest x-ray: Light , without lesions and infiltrates. Pulmonary the drawing is traced back to the edge of the brim. In the average percentage on the right there is an increased pulmonary pattern and decrease . The contours of the diaphragm clear. Sinuses are free. Aorta condensed, expanded. Increased outflow tract of the right half of the heart and the arc of the pulmonary artery.
CONCLUSION: On the background of emphysema and right-sided middle lobe pneumonia. . Visible to the driver rhythm.
EGD: When viewed esophageal mucosa light pink. Socket cardia merges completely or not at all. The mucous membrane of the stomach seats in the antrum thinned, has a mottled appearance. Folds air assault. Peristalsis is observed. Gatekeeper freely pass. The mucosa of the duodenal bulb light pink folds elastic. CONCLUSION: Chronic antral gastritis.
Ultrasound of abdominal organs and kidneys, the Liver slightly increased at the expense of the right lobe. Echostructure homogeneous. Echogenicity of the liver tissue is increased. Vascular figure saved. The gallbladder may be shifting in the body or the presence of polyps. The contents of homogeneous. Pancreas: contours of the flat, clear. Echostructure diffusely impure. Echo tissue diffusely moderately increased. Lien is not enlarged. Parenchyma homogeneous.
CONCLUSION: diffuse changes of the liver, a cholesterosis of a gall bladder, form, diffuse changes of the pancreas.
ECG: position of the electrical axis of heart. Rhythm sinus correct.
Can be observed cicatricial changes in the myocardium. Prothrombin 100.0.
Found a significant increase in the level of nitric oxide in the blood serum of patients with to 207,64±15,06 umol/l, which is 6.4 times higher control level, amounting to 32.5±0,51 umol/L. Levels of nitric oxide is directly proportional to the activity of enzymes ALT, AST, GGT. When treating levels of nitric oxide in decreased to 124,1±6,24 umol/L.
Activity of endotoxin in patients non-alcoholic was 2.2±0,04 EE/ml, which is 7 times higher than in control; the treatment of endotoxin activity decreased to 0.9±0,01 EE/ml
Appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times a day for 7-10 days, followed by the appointment of 2 capsules in the morning, 25-30 doses 3 times daily, 2 capsules 3 times a day, Forte 40-60 drops 3 times a day, 2-4 ml / day, the duration of treatment 3-4 weeks and in a dose of 5-10 ml / day; drug therapy of disorders of lipid metabolism exercise depending on the biochemical indices: in the presence of ultrasound signs steatosis and normal level transaminaz shall statins in combination with ; with increasing transaminaz up to 3 norms apply essenziale cures 2 capsules 3 times a day for 3 months; if the level transaminaz more than 3 standards - acid at a dose of 15-20 mg/kg; in ultrasound signs of nonalcoholic steatohepatitis and raising transaminaz up to 3 norms prescribed statins at a dose of 20 mg and acid at a dose of 15-20 mg/kg for 3-6 months; with increasing transaminaz over 3 standards - statins in the dose of 20-40 mg/day and acid at a dose of 15-20 mg/kg and with at a dose of 10 mg 1 time per day.
Way to further clarify examples of its implementation.
Example 1
Patient B., born 1948, came with the diagnosis-a cholesterosis of a gall bladder, form. Gall bladder dysfunction. Chronic gastroduodenitis. Fatty liver. IBS: myocardial infarction. Hypertension W Art. Paroxizmalnaya form of atrial fibrillation. Right-sided middle lobe pneumonia. Emphysema. Pneumosclerosis.
Complaints at entering: pain in the right hypochondrium whining character, belching air, bloating, periodically disruption of the heart, heart palpitations, increased blood pressure max to 150/100 mm Hg ( to 120/80 mm Hg).
From an anamnesis: In 14 years he had hepatitis A. For many years, chronic gastroduodenitis, a chronic cholecystitis. History of erosive gastritis. Treated as an outpatient, inpatient. In may 2006, was treated with a diagnosis of Gastroesophageal reflux disease endoscopically negative. SDS: chronic gastroduodenitis. Ultrasound examination of abdominal cavity: fatty liver. form gallbladder, diffuse changes of the pancreas. Did re persistent pain in the right hypochondrium. Since 1990 IHD: exertional angina 2 .. In 2004 acute thyroiditis. Were treated with corticosteroids. Observed by an endocrinologist with a diagnosis of Autoimmune thyroiditis (hormones currently the norm). A history of chronic prostatitis.
Objectively (on admission): a satisfactory Condition. The skin clean, regular color. No edema. Pulmonary respiration vesicular, wheezing no. Muffled heart sounds, rhythmic, HELL 100/70 mm Hg, heart rate 70 min. Abdomen soft, moderately painful in the right upper quadrant, right iliac region. The liver is not enlarged. At objective inspection: a satisfactory condition. Cough is moderate amount of sputum, weakness (on the eve of the patient were phenomenon catarrhal rhinitis, pharyngitis in the background ARI), the temperature is normal. Auscultation of the lungs to the right in the lower divisions to listen to breath, wheezing is not . When lung x-ray diagnosed right-sided middle lobe pneumonia. Treatment holenzim, Mezym Forte, Raglan, amoxicillin, then 1.0 x 2 R/a, in/M.
A chest x-ray: Light , without lesions and infiltrates. Pulmonary the drawing is traced back to the edge of the brim. In the average percentage on the right there is an increased pulmonary pattern and decrease . The contours of the diaphragm clear. Sinuses are free. Aorta condensed, expanded. Increased outflow tract of the right half of the heart and the arc of the pulmonary artery.
CONCLUSION: On the background of emphysema and right-sided middle lobe pneumonia. .
EGD: When viewed esophageal mucosa light pink. Socket cardia interlocked. The mucous membrane of the stomach seats in the antrum thinned, has a mottled appearance. Folds air assault. Peristalsis is observed. Gatekeeper freely pass. The mucosa of the duodenal bulb light pink folds elastic. CONCLUSION: Chronic antral gastritis.
CONCLUSION: Diffuse changes of the liver, a cholesterosis of a gall bladder, form, diffuse changes of the pancreas.
ECG: position of the electrical axis of heart. Rhythm sinus, correct, HR 68. Cicatricial changes in the anterior-septal area.
Laboratory researches:
HB
.
Ht
A blood clot.
.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
15.2
4.76
45.2
174.0
11.5
5.0
59.0
1.0
29.0
6.0
30.0
The General analysis of blood on discharge:
HB
.
Ht
A blood clot.
.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
12.3
3.97
37.2
188.0
7.7
2.0
60.0
2.0
30.0
6.0
37.0
Biochemical blood test:
..
ALB.
Bilir.
Glitch.
Cholest.
ALT
ACT
ALP
GGT
Amyl.
.
75.2
44.7
12.1
5.44
3.54
24.6
24.1
111.6
34.8
80.1
6.55
Prothrombin 100.0, MPE 0.94, NV-s-antigen - neg. AT the NSO - negativity.
General urine test: relative density of 1015, acidic reaction; protein, glucose none; leukocytes one.
Appoint metronidazole 250 mg x 4 rubles a day, Alfa normix 200 mg 2 tab. x 2 times a day for 7 days, followed by the appointment of 2 capsules in the morning, on 25 doses 3 times daily, 2 capsules 3 times a day, Forte 40 drops 3 times a day, 2 ml / day, the duration of 3 weeks and duphalac in the dose of 5 ml per day.; (20 mg/day) in combination with at a dose of 10 mg/day.
Discharged in a satisfactory condition. Clinical manifestations of steatosis no.
Example 2
Patient B. born 1948, was admitted with a diagnosis steatosis. Gastroesophageal reflux disease in endoscopically negative stage. A cholesterosis of a gall bladder, form. Biliary pancreatitis, remission stage. IBS: Myocardial infarction. Rhythm disturbance by type of atrial fibrillation, paroxysmal form. Hypertensive disease III stage. Autoimmune thyroiditis is very. Complaints at entering: on burps, dry mouth, bitter taste in the mouth, flatulence, chair with a tendency to constipation.
From an anamnesis: in patients receiving glucocorticoids about autoimmune thyroiditis having diarrhoeal phenomenon. Identified EGD atrophic gastritis with single erosions in the antrum, ultrasound break gallbladder, diffuse changes of the pancreas, diffuse changes . When examining outpatient ultrasound revealed diffuse changes in the liver, pancreas, chronic cholecystitis. Took Cholagogues drugs, enzymes with a slight positive clinical . Was admitted for examination and treatment. Objectively: a satisfactory condition, the skin and visible mucous regular color, clean, dim erythema. Peripheral edema is not defined. Breathing hard, is held in all the departments, wheezing no. BH - 16. Muffled heart sounds, rhythmic. AD - 120/80, heart rate 64 minutes Belly of the usual form, soft, sensitive to palpation in epigastralna area. The liver acts under the edge of a costal arch 1 see the Lien is not palpated. Symptom of a beating negative on 2 sides.
Survey: ultrasound examination of abdominal organs: Liver: the thickness of the right lobe of 126 mm, the thickness of the left lobe of 63 mm Echo parenchyma significantly improved, vascular figure saved. Portal vein 11 mm bile ducts are not extended. Gall bladder 4 x 1.9 cm, with an excess in the body, not thickened wall, the wall of the polyp 3 mm Contents of homogeneous. The contours of the pancreas jagged, fuzzy. Dimensions: the head of the 30 mm, body 11 mm, tail 19 mm frame impure. Echo tissue significantly increased in all departments. The main pancreatic duct is not expanded. Volumetric education were not identified. The common bile duct is not expanded, 4-5 mm, its walls are not thickened, concrements no. Lien is not enlarged, echo is average. not expanded in the left kidney cyst 41 mm CONCLUSION: the fatty degeneration of the liver, the deformation of the gallbladder, a cholesterosis of a ( form), diffuse changes of the pancreas, a cyst of the left kidney.
EGD: esophageal Mucosa pink all over. Cardia meets periodically. In the stomach cavity moderate amount unclear fluid and mucus with admixture of bile. The folds of medium-caliber, elastic. Mucous his spotty areas thinned in the output Department with traces of erosions and plots hyperplasia. The angle of the stomach is not modified. Antral Department is free. Peristalsis is satisfactory. The porter closed. Onion duodenum average. Mucous its diverse. Conclusion: chronic gastroduodenitis, urease test is negative. ECG: position EOS, sinus rhythm, correct, HR 68, ruble changes in the anterior-septal area.
Laboratory researches:
HB
.
A blood clot.
Lake.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
149
4,52
231
8,7
1
53
2
38
6
28
Biochemical blood test:
Indicator
Norm
Total protein
70,3
67,0-87,0 g/l
Total bilirubin
10
5,0-19,0 mkmol/l
Glucose
6
3,9 of 6.4 mmol/l
Cholesterol
4,6
a 3.1-5.2 mmol/l
Urea
8,5
2,8-7,2
HDL-C
0,84
of 0.91-2
LDL-C
2,5
2,3-4
Triglycerides
2,9
0-1,7
ALT
78
5-45
ACT
73
5-35
ALP
145
30-120
GGT
82
7-55
General urine test: relative density of 1012, acidic reaction, protein, glucose neg., leukocytes 0-3 in s/WR.
Treatment appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times daily for 8 days, followed by the appointment of 2 capsules in the morning, on 27 doses 3 times daily, 2 capsules 3 times a day, Forte 50 drops 3 times a day, 3 ml, duration of reception 3.5 weeks and at a dose of 8 ml / day; apply Essentiale Forte 2 capsules 3 times daily for 3 months. The treatment was allowed to normalize the size of the liver, reduce the degree of damage of hepatocytes. The patient was released in satisfactory condition.
Example 3
The patient,, born 1938, was admitted with a diagnosis of Fatty liver. Gastroesophageal reflux disease in the stage of healing of erosive esophagitis. Chronic gastroduodenitis. Jelchnokamennaya disease: chronic calculous cholecystitis.
«Wrinkled» the gallbladder. Chronic pancreatitis. Dyskinesia of large intestine hypotonic type. Combined hemorrhoids out of aggravation.
IBS: atherosclerotic cardiosclerosis. Hypercholesterolemia. Hypertensive disease of II degree of Bronchial asthma light flow, remission.
Complaints at entering: on heartburn, bitterness in a mouth, regurgitation of bile in the morning, the pain in the right side of whining character, nausea, constipation (chair only with laxatives). From history: More than 15 years GSD, attacks biliary colic was not. Takes gastal, but silos. More than 2 years heartburn. Not examined. Deterioration of health notes for 6 months, when heartburn began to be permanent.
Supporting and diseases: More than 10 years IHD: exertional angina pectoris, the AD Max. up to 230/120 mm Hg (adapted to 150/90 mm Hg).
Objectively: a satisfactory Condition. High power (growth of 165 sm, weight of 90 kg). The skin clean, regular color. No edema. Pulmonary respiration vesicular, wheezing no. The NPV 16 minutes muffled heart sounds, rhythmic, BP 140/90 mm Hg, heart rate 64 minutes Abdomen soft, pain in epigastria, right hypochondrium. Liver +2 see Peripheral edema no.
EGD: Esophagus freely pass. Mucous its pink. Terminal division on background of linear erosion of 0.3-0.4 cm 0.8-1.0 cm with partial fibrin. Socket cardia merges not completely. In the stomach cavity moderate amount of fluids and bile. The folds of medium caliber: elastic. Mucous his spotty, with moderate hyperemia in the output section. The angle of the stomach is not modified. Antral Department is free. Peristalsis is satisfactory. The porter closed. Onion duodenum average. Mucous its diverse.
CONCLUSION: Erosive reflux esophagitis. Failure of the cardia. Chronic gastroduodenitis.
Ultrasound of abdominal organs and kidneys, the Liver increased echogenicity parenchyma diffusely raised, sound conductivity saved. Vascular figure has not changed. Choledoch 4.5 mm in D. Gall bladder , 6 x 1,5 cm; the wall is about 4 mm, is blurred, the space is filled with calculus (plural calculi) up to 10 mm in D, shadow. Pancreas of the usual form, the head of the 34 mm (norm up to 30 mm), echo is parenchyma finely-cellular heterogeneous. CONCLUSION: Diffuse changes of the liver. Chronic cholecystitis. . Wrinkled gallbladder. Chronic pancreatitis. Rectoromanoscopy: When viewed from the anal area, use of the study, - exterior gemorroidalnye fringe, sphincter tone normal, internal mild hemorrhoids, without signs of inflammation. A proctoscope is introduced on 25 cm (because of the pain syndrome). Slimy pink, vascular figure clear. Ulcers, polyps, tumors were revealed.
CONCLUSION: Combined hemorrhoids out of aggravation. Colonoscopy: Endoscope held in the descending colon. Sigmoid elongated forms a loop. In the lumen of the intestine large number of content. The mucosa of the colon at the inspected sites pink, smooth, shining. Vascular figure clear. Folds low. The tone of the ulcer is sharply reduced. Ulcers, polyps, tumors were revealed. CONCLUSION: organic pathology was revealed. Dyskinesia of large intestine hypotonic type.
ECG: the Deviation of the electrical axis of heart left. Rhythm sinus, correct, HR 63. Vnutrijeludockova blockade. Expressed diffuse changes of the myocardium. Surgeon: GSD: chronic calculous cholecystitis. Recommended elective surgery (cholecystectomy).
Laboratory tests: the General analysis of a blood:
HB
.
Ht
A blood clot.
.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
148
4.92
43.0
321.0
8.8
1.0
53.0
2.0
38.0
6.0
20.0
Biochemical blood test:
About. Bel.
Bilir.
Glitch.
Cholest.
Urea
ALT
ACT
ALP
GGT
Amylase
75.8
5.3
5.9
7.0
5.0
146
165
378
173
63,5
Prothrombin 97.8%. MHO 1,01 Ed.
General urine test: relative density of 1012, acidic reaction, protein, glucose no, leukocytes one. in n/view.
Appoint metronidazole 250 mg 4 R. in the day, Alfa normix 200 mg x 2 times a day for 10 days, followed by the appointment of 2 capsules in the morning, 30 doses 3 times daily, 2 capsules 3 times a day, Forte 60 drops 3 times a day, 4 ml for the duration of 4 weeks and at a dose of 10 ml / day; acid at a dose of 20 mg/kg
Discharged in satisfactory condition.
Sick B., 1955 year of birth, came with the diagnosis-Nealkogolny steatogepatit, minimal activity. Chronic gastroduodenitis, aggravation. Peptic ulcer remission. Hiatal hernia. Cholelithiasis: cholecystectomy. Chronic pancreatitis. Adhesive disease of organs of abdominal cavity. IHD: exertional angina 2 FC. Atherosclerotic cardiosclerosis. HI. Arterial hypertension 3 tbsp. Adenoma of the two adrenal glands. spine. Common osteochondrosis of the spine. Obesity 2 tbsp. Complaints at entering: nagging pain in epigastria, arising on an empty stomach, heartburn, unpleasant taste in the mouth, bitter taste in the mouth, chair daily, independent, weight stable. From an anamnesis: considers himself to be patient for a long time (observed about GSD). Had laparoscopic . Condition after the operation good, occasionally takes courses choleretic herbs. Worse, when I went for inpatient treatment in the neurology Department about dorsopathy spine, took the course in/in therapy (Ketonal, , aminophylline, trental), on the background of this therapy complaints appeared on the expressed pain in the upper abdomen, at endoscopy revealed ulcer antrum 0.5 cm, were treated pariet 1 tab. a day for 14 days, followed by omeprazole. Currently therapy is available.
Past medical history: the WPPT. the increase in the shield. gland, .
During the test, ultrasound of the abdomen, the Liver increased thickness of the right lobe of 129 mm, left lobe of 60 mm Echostructure impure, attenuation echo in the distal. Vascular figure significantly depleted. Portal vein 9 mm Gall bladder removed. Choledoch 6-8,6 mm Pancreas: the contours of a clear, smooth. Dimensions: the head of the 30 mm, body 12 mm, tail 21 mm Echostructure heterogeneous. Echo is significantly enhanced. CONCLUSION: diffuse changes of the liver. Diffuse changes of the pancreas.
EGD: Esophagus freely pass. Mucous its pink. Socket cardia merges incompletely. In the stomach cavity much bile. The folds of medium-caliber, elastic. Mucous chamber redness, swollen. The angle of the stomach is not modified. Antral Department is free. Peristalsis is satisfactory, the porter closed. Onion duodenum average. Mucous its diverse. Conclusion: Chronic gastroduodenitis. Duodeno-gastric reflux. Failure of the cardia. Conclusion: Chronic mild esophagitis. Chronic mild inactive gastritis body. HP-.
X-ray examination of the stomach. The act of swallowing is not broken. The esophagus and cardia freely passable. Cardia in mediastinum. Reduced tone of the cardiac sphincter. The stomach is usually located. Fasting a little liquid. . Mucosa is edematous, presents longitudinal folds. When a tight filling clear contours. Peristalsis is traced in all departments. Evacuation function is not impaired. The mucous of the duodenal bulb, and proximal half swollen. Passage of proximal loops jejunum is not broken. Conclusion: cardiac HH, gastroduodenitis, signs of chronic pancreatitis. . direct, colon bowel, Department terminal ileum. The outlines are clear. well defined, signs of filling defects and ulcerations is not defined. The dome of the caecum is shifted to the ridge of the iliac bone. After emptying when you double- of pathological formations of the mucosa of the colon is not revealed. Fixed the distal portion of the sigmoid Department. Conclusion: failure valve, adhesive process in the distal part of the sigmoid colon, Caecum mobile. ECG. position of the EOS. Rhythm sinus, correct, HR 73. Expressed diffuse changes of the myocardium.
Laboratory tests: the General analysis of a blood:
HB
.
A blood clot.
Lake.
P.O.
With/I
Eosin.
.
Erythrocyte sedimentation rate
127
4,35
409,0
9,2
1,0
65,0
2,0
28,0
4,0
28,0
124
4,22
360,0
8,1
2,0
66,0
2,0
26,0
4,0
16,0
Biochemical blood test:
Indicator
Norm
Commonly. protein
78,2
67,0-87,0 g/l
Total bilirubin
8,9
5,0-19,0 mkmol/l
Cholesterol
5,4
a 3.1-5.2 mmol/l
LDL
3,2
the 2.1 and 3.4 mmol/l
HDL
1,4
the 1.1-2.3 mmol/l
Triglycerides
1,8
0,0-1.7 mmol/l
Glucose
5,7
of 3.9 to 5.9 mmol/l
Urea
7,4
of 1.7 to 8.3 mmol/l
ALT
76,1
5,0-32,0 IU/l
ACT
50,3
5,0-31,0 IU/l
ALP
139,6
30,0-120,0 u/l
GGT
181,4
a 7.0-42,0 u/l
Amylase
48,5
28,0-220,0 u/l
Prothrombin 97,3%. General urine test: relative density of 1012, acidic reaction; protein, glucose - no, leukocytes 0-2-3 in the field of view. RV negativity. HBsAr, AT the HCV negativity. Treatment appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times daily for 7 days, followed by appointment 2 capsules in the morning, on 25 doses 3 times daily, 2 capsules 3 times a day, Forte 40 drops 3 times a day, 2 ml, duration of taking 3 weeks and in a dose of 5 ml / day; statins in the dose of 20 mg and acid in a dose of 15 mg/kg / within 3 months. The treatment resulted in normalization of sizes and echo patterns of the liver.
Example 5
Patient K., 1938), came with the diagnosis-nealkogolny steatogepatit, the average degree of activity. Gastroesophageal reflux disease, stage of esophagitis. Hiatal hernia. Chronic gastroduodenitis. Chronic cholecystitis with the presence of biliary sludge. Chronic pancreatitis. Obesity 3 tbsp. Arterial hypertension. dyslipidemia. Common osteochondrosis of the spine.
Complaints at entering: on a pain in epigastria, left hypochondrium, worse in the evening and after eating, heartburn, feeling of bitterness in the mouth, constipation up to 4-5 days (enema), bloating, loss of appetite saved.
History: Considers himself to be patient, when there were complaints about belching air. In outpatient examination EGD: HH, Failure of the cardia, DR. From the attendant and diseases: appendectomy; the AD 180/100 mm Hg, adapted to 100/70 mm Hg (therapy); common osteochondrosis (Movalis in/m, );
On examination: Abdominal ultrasound: the Liver is not enlarged: the thickness of the right lobe of 160 mm, left lobe of 83 mm Echostructure heterogeneous. Echo is significantly enhanced. Vascular figure depleted. Portal vein 11 mm gallbladder deformed. Dimensions 6,3 x 2.6 cm, a wall not changed 2 mm, content is patchy. Choledoch 34 mm Pancreas: the contours of a clear, smooth. Dimensions: head 30-31 mm, body 15 mm Echostructure impure, wire mesh. Echo is mixed, significantly expressed echogenic component. Lien is not enlarged. Parenchyma homogeneous. CONCLUSION: diffuse changes of liver steatosis, pancreas, deformation and heterogeneous bile in a gall bladder.
EGD. Esophagus freely pass. Mucous its pink. Socket cardia merges incompletely. In the lumen of the stomach moderate amount unclear liquids with admixture of mucus and bile. The folds of medium size, elastic. Mucous his pink, with moderate alopecia hyperemia. The angle is not changed. Antral Department is free. Peristalsis is satisfactory. The porter closed. Onion duodenum average, mucous its diverse. Conclusion: Chronic gastroduodenitis. Duodeno-gastric reflux. Failure of the cardia. Urease test negativity. Biopsy. Chronic esophagitis. Chronic gastritis of the antrum with plots atrophy glands. HP(-).
ECG. position of the EOS. Rhythm sinus, correct, HR 76.
Laboratory researches:
analysis of blood:
HB
.
A blood clot.
Lake.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
145
4,76
250,0
4,7
1,0
54,0
2,0
38,0
5,0
8,0
Indicator
Norm
Commonly. protein
70,1
67,0-87,0 g/l
Total bilirubin
11,7
5,0-19,0 mkmol/l
Cholesterol
7,05
3,1-5,2 mmol/l
LDL-C
4,9
the 2.1 and 3.4 mmol/l
HDL-C
0,96
the 1.1-2.3 mmol/l
TG
2,61
0,0-1.7 mmol/l
Glucose
5,39
of 3.9 to 5.9 mmol/l
Urea
4,7
of 1.7 to 8.3 mmol/l
ALT
87
5,0-32,0 IU/l
ACT
92
5,0-31,0 IU/l
ALP
280
30,0-120,0 u/l
GGT
118
a 7.0-42,0 IU/l
Amylase
44,7
28,0-220,0 u/l
General urine test: relative density 1013, acidic reaction, protein, glucose - no, leukocytes in 2-3 s/WR.
Appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times a day for 10 days, with followed by the appointment of 2 capsules in the morning, 30 doses 3 times daily, 2 capsules 3 times a day, Forte 60 drops 3 times a day, 4 ml for the duration of 4 weeks and in a dose of 10 ml per day; with increasing transaminaz over 3 standards - dose statins 20 mg/day and acid in a dose of 15 mg/kg for 6 months.
The patient was discharged in satisfactory condition, the size of the liver decreased, clinical manifestations steatohepatitis no.
Example 6
Sick P., born 1958, was admitted with the diagnosis:
EGD: Esophagus freely pass, mucous his pale pink, in the output Department with the bloom. Socket cardia merges not completely. In the lumen of the stomach moderate amount unclear fluid and mucus. Folds stomach medium calibre, elastic. The mucosa of the stomach chamber redness, swollen. The angle of the stomach is not modified. Antral Department is free. Peristalsis is traced in all departments. Gatekeeper . duodenum average, deformed with the presence of scar. Mucous hyperemic with the presence of erosions to 0.2 cm with fibrin. Mucous Department pink. Conclusion: Chronic gastritis. Erosive . Cicatricial deformity of the duodenal bulb. Failure of the cardia. Biopsies of the esophagus. Urease test is negative. Biopsy: Chronic mild esophagitis.
CONCLUSION: Chronic gastritis. Cicatricial deformity of the duodenal bulb. Failure of the cardia.
Ultrasound examination of abdominal cavity and kidneys. The liver is enlarged: the thickness of the right lobe of the 143 mm (norm up to 120 mm), the left lobe of 78 mm (norm 60). Echostructure diffusely impure. Echo is increased. Vascular figure depleted. Portal vein 10 mm
Gallbladder 7.8 x 2.2, see the Wall is 2.5 mm Contents of homogeneous. Choledoch 5 mm, is free. Pancreas - normal shape, the head of 36 mm (rule 30). Echostructure diffusely impure, wire mesh. Echo is diffusely raised. Lien is not increased (113 x 35 mm). Parenchyma homogeneous. CONCLUSION: to Increase and diffuse changes in the liver. Diffuse changes of the pancreas (chronic pancreatitis).
Consultation of endocrinologist: diabetes mellitus type 2, for the first time detected. Obesity article 3, exogenous-constitutional. ECG: position of the EOS. Rhythm sinus correct. HR in 90 minutes
Clinical blood analysis:
HB
.
Ht
A blood clot.
Lake.
P.O.
With/I
Eosin.
.
.
Erythrocyte sedimentation rate
152
4,5
41,6
235,0
8,5
2,0
59,0
2,0
30,0
7,0
5,0
152
4,52
41,6
212.0
5,7
1,0
57,0
2,0
35,0
5,0
5,0
Biochemical blood test:
Norm
Total protein
71,0
66,0-87,0 g/l
Total bilirubin
15,4
3,4-21,0 mkmol/l
Glucose
9,68
4,1 to 5.9 mmol/l
Cholesterol
5,75
the 1.4-5.2 mmol/l
HDL
1,18
1,1-2,3
LDL
3,6
2,1-3,3
TG
2,14
0-1,7
Creatinine
61,8
58-96
Urea
4.73
of 1.7 to 8.3 mmol/l
ALT
142
5,0-34,0 U/l
ACT
121
5,0-31,0 U/l
ALP
373
30,0-120,0 U/l
GGT
84
a 7.0-24,0 U/l
Amylase
62,1
28-100 U/l
Glycemic profile 30.01.08: fasting - 7,05 mmol/l; 11.00 - 7,96; 14.00 - by 7.2 mmol/L. PETIT 100%. General urine test: Rel. density 1016, acidic reaction, protein, glucose no, lake. 2-3 in s/WR. Diastasis urine 178 UNITS (up to 240 norm). Feces analysis: the reaction occult blood test negative.
Treatment appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg x 2 times a day for 10 days, followed by the appointment of 2 capsules in the morning, 30 doses 3 times daily, 2 capsules 3 times a day, Forte 60 drops 3 times a day, 4 ml for the duration of 4 weeks and in a dose of 10 ml per day; statins in the dose of 40 mg/day and acid dose of 20 mg/kg dose of ezetimibe 10 mg 1 time per day. The patient is discharged in satisfactory condition. The forecast is favorable.
According to the main method of treatment of 76 patients and 58 patients with steatosis of the liver. It shows the efficiency of the proposed method in the treatment of the stated diseases. Used complex therapy reduces the adverse reactions that can improve the treatment of nonalcoholic fatty liver disease.
The method of treatment of nonalcoholic fatty liver disease, including drug therapy, wherein as drugs appoint metronidazole 250 mg 4 rubles a day, Alfa normix 200 mg 2 tab. x 2 times a day for 7-10 days, followed by the appointment of 2 capsules in the morning, 25-30 doses 3 times daily, 2 capsules 3 times daily, Forte 40-60 drops 3 times a day, 2-4 ml, duration of reception 3-4 weeks and in a dose of 5-10 ml / day; drug therapy of disorders of lipid metabolism exercise depending on the biochemical indices: in the presence of ultrasound signs steatosis and normal level transaminaz shall statins in combination with ; with increasing transaminaz up to 3 standards apply essenziale cures for 3 months; if the level transaminaz more than 3 standards - acid at a dose of 15-20 mg/kg; in ultrasound signs nonalcoholic steatohepatitis and raising transaminaz up to 3 prescribed statins at a dose of 20 mg and acid at a dose of 15-20 mg/kg for 3-6 months; with increasing transaminaz over 3 standards - statins in the dose of 20-40 mg/day and acid dose of 15-20 mg/kg dose of ezetimibe 10 mg 1 time per day.