Method of treating secondary lactase deficiency

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly gastroenterology, and may be applied in treating secondary lactase deficiency. For this purpose, with underlying diet and drug-induced therapy, bifiform 1 tablet 2-3 times a day and No-spa 1-2 tablets 3 times a day are additionally administered. The therapeutic course makes 14 days.

EFFECT: method enables higher clinical effectiveness in secondary lactase deficiency.

3 ex

 

The invention relates to medicine and can be applied in the treatment of secondary lactase deficiency.

There is a method of treatment of lactase deficiency with the help of enzymes in the background diet (1 - Aigebra, Vperson., Mvisto and other Effectiveness of permettere and diet with lactase deficiency in newborns. Issues in pediatric nutrition, 2003, vol. 1, No. 4, 21-25). The method is accepted as equivalent.

There is a method of treatment of lactase deficiency, namely, that the treatment was carried out with the purpose of the drug Lactase Enzyme in a dose of 7 mg (700 units). (1 capsule child forms) per 100 ml of expressed breast milk (or 350 per 50 ml); the drug interfered in milk at each feeding (2 - Aigebra, N.V. Stepanova drug Use Lactase Baby for the treatment of lactase deficiency in newborns. Found by: Google http://www.lactase.ru/publications/using-lactase-baby.html). This method is adopted for the prototype.

However, the effectiveness of the prototype method is limited.

The aim of the present invention is to improve the effectiveness of treatment secondary lactase deficiency.

The technical result is achieved by the fact that in the treatment of patients with secondary lactase deficiency add as a daily dose Bifiform 1 tab. 2-3 times and no-Spa - 1-2 table. 3 times the rate of the m treatment within 14 days.

The method is implemented as follows.

Patients with a diagnosis of secondary lactase deficiency come with complaints of bloating, rumbling, periodic pains in the abdomen, moderate-intensity, without irradiation, not associated with eating; constipation to 2-4 days, which are regulated by diet. Chair decorated load and with poor without admixture of mucus and blood. Appetite saved. Weight stable.

From the anamnesis it is known that the patients suffer from long-term pains in the epigastrium after eating, it was noted spring/autumn exacerbation.

Objectively: the patient is in satisfactory condition, HELL 110-130/70-90 mm RT. senior HR 60-80 per min BH 16-18 in minutes muffled heart sounds, regular rhythm. In the lungs wheeze no, vesicular breathing. Tongue moist, coated with white bloom. The abdomen is soft, moderately painful in the paraumbilical region. The results of the survey:

ECG: poluvirtualnogo position of the EOS. Sinus rhythm, right. Weakly expressed diffuse changes of a myocardium.

Endoscopy: Esophagus pass. Mucosa of the esophagus pink, kardia interlocks. In the cavity of the stomach moderate amount of mucous content; mucous pink, moderately thinned. Folds of medium size, elastic. Peristalsis is seen in all departments. The angle of the stomach is not modified. The pylorus is closed, pass. The bulb of the duodenum is medium in size, not Defoe the commands. The mucosa of the duodenal bulb and mucosa postbulbar Department pink. Folds of medium size, elastic. Jejunum b/O. Urease test is negative. Lactase test positive.

Biopsy: the fragments of the mucous membrane of the duodenum from the proximal in the submucosal layer brunerovy cancer, intestinal villi of normal height, crypt shallow. The number of MEL in the normal range. In its plate small lymph plasmocytoma infiltration. The mucous membrane of the duodenum normal structure.

According to respiratory hydrogen test revealed excessive bacterial growth.

Ultrasound of abdominal organs: Liver stands out from the edge of the costal arch. The edge is smoothed, the surface is smooth, contour clear, capsule thickened. The size of the liver is not enlarged. The structure is homogeneous. Overall echogenicity of the parenchyma average. The diameter of the portal vein and inferior Vena cava normal lumen is homogeneous. Vascular drawing is saved. Gallbladder irregular shape, the size is not increased. The bladder wall is thin, smooth, homogeneous structure. In the cavity of the bubble is determined by the homogeneous content of concretions no. Intrahepatic ducts are not expanded, walls smooth, segmental and lobar significantly expanded lumen homogeneous. The common bile duct is not R is schirin, wall smooth lumen homogeneous. The pancreas is visualized satisfactorily, fuzzy contour, the surface is smooth. The structure is homogeneous, the echo is average. Pancreatic duct is not expanded, the walls are sealed. Lesions not identified. The spleen is visualized adequately outline a clear, smooth surface. Free fluid in the abdominal cavity no. Conclusion: the deformation of the gall bladder.

Sigmoidoscopy: at external examination, finger research, anoscopy - internal hemorrhoids are not expressed. The tone of the sphincter saved. Tube proctoscope introduced on 25 see Mucous pink, smooth, shiny. Vascular pattern distinct. Ulcers, polyps, tumors not detected. Conclusion: organic pathology was not detected.

Consultation of the endocrinologist: thyroid goiter 1 Art. Autres.

EMA tract: hypermotor dyskinesia stomach, hyposmocoma - ascending part of the colon.

Breathing hydrogen test with lactulose (duphalac): excessive bacterial growth periodically detected.

Treated secondary lactase deficiency, including lactose-free diet. As the drugs used daily as a daily dose Mezim Forte 1 tab. × 2-3 times, Bifiform 1 tab. 2-3 times and no-Spa - 1-2 table. 3 times a course of treatment in those who giving 14 days.

After treatment bloating, rumbling, pain in the paraumbilical area disappeared. The chair was normalized.

During the follow-up observation period of 1 year in spring and autumn exacerbation are not observed.

The implementation method is further illustrated by the following examples.

Example 1

Patient S., born in 1983, was admitted with complaints on a periodic aching pain in the paraumbilical area, moderate-intensity, without irradiation, not associated with eating, bloating, rumbling in the stomach; constipation to 4 days regulates diet (prunes, apricots), decorated load and with poor daytime, without admixture of mucus and blood. Appetite saved. Weight stable.

From the anamnesis: considers herself a patient 10 years, when first appeared aching pain in the epigastrium after eating, was seen by the gastroenterologist diagnosed with chronic gastroduodenitis, noted exacerbation spring/autumn. Dieted, took antacids with positive effect. 3 years ago there was constipation to 4 days. Not surveyed, were not treated. Recently, the patient appeared periodic aching pain in the paraumbilical region. Took trimedat with little positive effect.

Objectively: the patient is in satisfactory condition, BP 110/70 mm RT. senior HR 78 in BH minutes 18 minutes muffled heart sounds, regular rhythm. In the lungs wheeze no, vesicular breathing. Tongue moist, coated with white naleo is. The abdomen is soft, moderately painful in the paraumbilical region. The chair was not. The results of the survey:

ECG: poluvirtualnogo position of the EOS. Sinus rhythm, right. Weakly expressed diffuse changes of a myocardium.

Endoscopy: Esophagus pass. Mucosa of the esophagus pink, kardia interlocks. Stomach: in the cavity of the stomach moderate amount of mucous content. The mucosa of the stomach pink, moderately thinned. Folds of medium size, elastic. Peristalsis is seen in all departments. The angle of the stomach is not modified. The pylorus is closed, pass. The bulb of the duodenum is medium in size, not deformed. The mucosa of the duodenal bulb and mucosa postbulbar Department pink. Folds of medium size, elastic. Urease test is negative. Conclusion: chronic gastritis. Lactase test weakly positive.

Biopsy: the fragments of the mucous membrane of the duodenum from the proximal - into the submucosal layer brunerovy cancer. Intestinal villi of normal height. Crypt shallow. The number of MEL in the normal range. In its plate small lymph plasmocytoma infiltration. Conclusion: the mucous membrane of the duodenum normal structure.

Breathing hydrogen test revealed excessive bacterial growth (91 ppm).

Ultrasound is lanow abdomen: orthostasis is logged ptosis of the abdominal cavity. Liver: visualized adequately; stands from under the edge of the costal arch. The edge is smoothed, the surface is smooth, contour clear, capsule thickened. The size of the liver is not enlarged (PZR right lobe 125 mm, thickness of the left lobe 58 mm). The structure is homogeneous. Overall echogenicity of the parenchyma average. The diameter of the portal vein 9 mm, the diameter of the NIP 17 mm; the ground clearance homogeneous. Vascular drawing is saved. Gall bladder: irregular shape. The sizes are not increased: 53×17×27 mm, volume 17 ml. of the bladder Wall thin, smooth, homogeneous structure. In the cavity of the bubble is determined by the homogeneous content of concretions no. In the lower third of the body closer to the neck - wall exogenou education dimensions of 6.2×2.9 mm, homogeneous structure, avascular when the scanning mode of the DRC. Intrahepatic ducts are not expanded, walls smooth, segmental and lobar significantly expanded lumen homogeneous. The common bile duct is not expanded (3.5 mm), wall smooth, light uniform. The pancreas is visualized satisfactorily, fuzzy contour, the surface is smooth. Dimensions: 19×15×17 mm Structure is homogeneous, the echo is average. Pancreatic duct is not expanded, the walls are sealed. Lesions not identified. The spleen is visualized adequately outline a clear, smooth surface. Dimensions: 94×39 mm Echogenicity of the parenchyma is increased, the structure of homogeneous who I am. Splenic vein diameter 6 mm, ground clearance homogeneous. Free fluid in the abdominal cavity no. Conclusion: ultrasound signs of visceroptosis, deformation of the gallbladder, gallbladder polyp.

If rektoromanoskopii internal hemorrhoids are not expressed. The tone of the sphincter saved. Tube proctoscope introduced at 25 cm - next bend, pain. Mucous pink, smooth, shiny. Vascular pattern distinct. Ulcers, polyps, tumors not detected. Conclusion: organic pathology was not detected. Consultation of the gynecologist: undo oral contraceptives, consultation of the endocrinologist. Consultation of the endocrinologist: thyroid Goiter 1 Art. Autres.

EMA tract: hypermotor dyskinesia stomach, hyposmocoma - ascending part of the colon.

Consultation of therapist: circular shower No. 5, AVERS lamp No. 5. Colonoscopy: the device is held in the dome of the caecum. Bauhinia flap polypoid form, somknuti oriented in the dome. In the lumen of the moderate quantity of liquid. The loops of the colon is omitted, the tortuous. The sigmoid colon forms a loop. The mucosa of the colon on the inspected areas of pink, smooth, shiny. Vascular pattern distinct, correct. The folds of the mucous average, elastic. The lumen of the intestine is not deformed. The tone of the intestine is reduced. Ulcers, polyps, tumors not in the manifest. Conclusion: on the inspected areas of organic diseases of the colon is not identified.

Final diagnosis: Chronic gastritis, in a stage of constant aggravation. The syndrome of bacterial overgrowth. Lactase deficiency moderate severity. Visceroptosis. The gallbladder cholesterosis, polypoid form. Thyroid goiter 1 Art. Autres.

Laboratory data:

CBC:

IndexNormaIndexNorma
Hemoglobin13,214P/nuclear11-6
Erythrocytes4,493,9-4,7Segment.5847-72
Haematocrit39,839-50Eosinophils20-5
Leukocytes 7,34-9Lymphocytes3319-37
Platelets370150-400Monocytes63-11
Erythrocyte sedimentation rate83-15

Biochemical blood test:

Index24.11.1013.12.10Norma
About. protein73,466-87
The total bilirubin14,83,4-21
Bilirubin Ave2,7
Cholesterol7,276,911,4-5,2
Triglycerides1,70-1,7
LDL-C4,12,1-3,3
Glucose4,464,1-5,9
Urea4,58of 1.7 to 8.3
Iron32,110,7-32,2
MPE0,980,9-1,2
Prothrombin10070-130
IndexResultDate
HIVa negative.29.11.10
RWa negative.29.11.10

Blood - HBs-Ag and anti-HCV not detected. Urine analysis Kleene is a mini - transparent, protein neg., ID/weight 1019, leukocytes, erythrocytes, ketones, glucose is not. Fecal reaction occult blood is negative.

Treatment. Lactose-free diet. Add as a daily dose Mezim Forte 1 tab. × 2 times, Bifiform 1 tab. 2 times and no-Spa - 1 table. 3 times a course of treatment within 14 days.,

The patient was carried out physiotherapeutic treatment: Avermes-lamp No. 5, circulatory shower No. 5. On the background of therapy the patient noted improvement: reduction in abdominal pain, normalization of stool up to 1 times per day, decorated, without pathological impurities. Work disability is not. The prognosis is favorable. During the follow-up observation period of 1 year in spring and autumn exacerbation are not observed.

Example 2

Patient J., born in 1985, was admitted with complaints on a periodic aching pain in the paraumbilical area, moderate-intensity, growing before defecation, intractable after defecation, bloating, rumbling in the abdomen, bloating; occasionally burping air. Chair pasty, up to 3-4 times a day, in the daytime load and with poor, without admixture of mucus and blood. The reduced appetite, lost weight over the last 4 months. 5 kg

History of present illness: considers himself ill within 1 year, when amid the stress appeared rapid pasty stool up to 3 times per day, if the s aching pain in the abdomen, mainly in the paraumbilical region. Took enzymes with a positive effect. Were not surveyed. Appeared dragging pain in the paraumbilical region, predominantly in the right half of the abdomen, nausea, and therefore along the NSR was hospitalized.

Ultrasound abdominal ultrasound signs of diseases of the digestive system is not detected. With colonoscopy organic pathology of the colon is not revealed. In General, the analysis of blood leukocytes 9 (upper limit of normal), in the blood - without pathological changes. Conducted antispasmodic therapy with a positive effect, recommended acceptance of CREON, the supervision of a gastroenterologist at m/residence. However, the patient remained pain in the abdomen, the chair was 3-4 times a day, pasty, without admixture of mucus and blood.

Was admitted for examination and treatment. Objectively upon receipt: satisfactory condition, BP 120/70 mm RT. senior HR 70 in BH minutes 18 minutes muffled heart sounds, regular rhythm. In the lungs wheeze no, vesicular breathing. Tongue moist, coated with white bloom. The abdomen is soft, moderately painful to palpation in the paraumbilical and left iliac region. The chair was 1 times in the day, paleovalley, without admixture of mucus and blood.

The results of the survey:

ECG: poluvirtualnogo position of the EOS. HR 67. Sinus rhythm, right.

Endoscopy: Esophagus prog is dim. Mucosa of the esophagus pink, kardia interlocks. Stomach: in the cavity of the stomach moderate amount of mucous content and bile. The mucosa of the stomach pink, hyperemic on the tops of the folds. Folds of medium size, elastic. Peristalsis is seen in all departments. The angle of the stomach is not modified. The porter there, go. The bulb of the duodenum is medium in size, not deformed. Mucosa duodenal Department pink. Folds of medium size, elastic. Jejunum b/O. Urease test is negative. Lactase test positive. Conclusion: superficial gastritis, duodeno-gastric reflux.

Biopsy: chronic mild duodenitis. Signs of celiac disease in the studied material no.

Breathing hydrogen test with lactulose (duphalac): excessive bacterial growth detected.

Sigmoidoscopy: at external examination, finger research, anoscopy internal hemorrhoids are not expressed. The tone of the sphincter saved. Tube proctoscope introduced on 20 cm - next bend, pain. Mucous pink, smooth, shiny. Vascular pattern distinct. Ulcers, polyps, tumors not detected. Conclusion: organic pathology was not detected.

Ultrasound of abdominal organs: Liver: visualized adequately; does not protrude from the edge of the rib on the guy. The edge is smoothed, the surface is smooth, contour clear, capsule thickened. The size of the liver is not enlarged (PZR right lobe 140 mm, thickness of the left lobe 76 mm). The structure is homogeneous. Overall echogenicity of the parenchyma average. The diameter of the portal vein 10 mm, the diameter of the NIP 19 mm; the ground clearance homogeneous. Vascular drawing is saved. Gall bladder: the correct form. The sizes are not increased: 60×23×35 mm, volume of 30 ml. of the bladder Wall thin. In the cavity of the bubble is determined by the homogeneous content of concretions no. Intrahepatic, segmental and lobar not extended, smooth wall, the lumen of the uniform. The common bile duct is not expanded (5.0 mm), wall smooth, light uniform. The pancreas is visualized satisfactorily, the surface is smooth. Dimensions: 24×16×22 mm Structure is homogeneous, fine-grained. General echo is average. Pancreatic duct is not expanded. Lesions not identified. The spleen is visualized adequately outline a clear, smooth surface. Dimensions: 94×40 mm Echogenicity of the parenchyma average, homogeneous structure. Splenic vein diameter 6 mm, ground clearance homogeneous. Free fluid in the abdominal cavity no. Right kidney: orthostasis is logged nephroptosis 1 tbsp. Dimensions 101 x 49 mm, cortical layer diffuse homogeneous, uniform thickness (14 mm). Extension CLS not registered. Concretions no. Respiratory ACC is a possibility saved. Left kidney: the typical location. Dimensions 100×52 mm, cortical layer of homogeneous thickness up to 15 mm CLS not extended, the pelvis extrarenal. Concretions no. Respiratory mobility stored. Conclusion: right nephroptosis 1 tbsp.

Colonoscopy: the device is held in the terminal ileum 20 see the Mucosa of the small intestine pink, velvety, peristalsis it active. Defines a single hypertrophied lymphoid follicles sizes up to 0.2 cm in diameter. Bauhinia flap polypoid form, somknuti oriented in the dome. In the lumen of the moderate quantity of liquid. The sigmoid colon forms a loop. The mucosa of the colon on the inspected areas of pink, smooth, shiny. Vascular pattern distinct, correct. The folds of the mucous average, elastic. The lumen of the intestine is not deformed. The tone of the intestine saved. Ulcers, polyps, tumors not detected. Conclusion: organic diseases of the colon is not identified.

Laboratory data:

CBC:

IndexNormaIndexNorma
Hemoglobin 14,8the 17.3P/nuclear11-6
Erythrocytesequal to 4.97of 3.9 to 5.7Segment.6147-72
Haematocrit4339-50Eosinophils20-5
Leukocytes5,84-9Lymphocytes3019-37
Platelets282150-400Monocytes63-11
Erythrocyte sedimentation rate43-15

Biochemical blood test:

IndexNorma
About. protein74,866-87
The total bilirubin18,63,4-21
Cholesterol3,791,4-5,2
Glucose4,784,1-5,9
Ureato 5.21of 1.7 to 8.3
MPE1,030,9-1,2
prothrombin96,470-130
IndexResultDate
HIVa negative.18.11.10
RWa negative.18.11.10

Blood - HBs-Ag and anti-HCV - not found.

Urine analysis of clinical - transparent, protein neg., ID/weight 1014, leukocytes, erythrocytes, ketones, glucose is not. Fecal reaction occult blood test - neg. Diastasis of urine in norm, 311,1 IU/l Treatment: lactose-free diet. Additionally used as a daily dose m the winters Forte 1 tab. × 3 times, Bifiform 1 tab. 3 times and no-Spa - 2 table. 3 times a course of treatment within 14 days.

On the background of therapy, the patient noted improvement: abdominal pain cropped, the chair was normalized to 1 times per day, decorated load and with poor, without pathological impurities. The prognosis is favorable.

Example 3

Patient K., born in 1960, complaints received at a periodic aching pain in the paraumbilical area, not associated with food intake, increasing after lifting heavy, growing before defecation, decreasing after defecation, pain, worry in the daytime and nighttime; periodic burning epigastric pain that occurs after eating 15-20 min, burning of the tongue and palate after eating 15-20 minutes, occasionally bitter taste in the mouth, heartburn after eating, bloating and rumbling in the abdomen; diarrhea up to 2 times per day, pasty stool, brown load and with poor, with oily luster, without admixture of mucus and blood. Notes intolerance to dairy and sour-milk products. Appetite saved. Weight stable.

History of present illness: considers himself ill with 2008, when first appeared aching pain in the left hypochondrium, burning palate and tongue, appeared pasty stool up to 2 times per day. He began to notice the intolerance of dairy products. Outpatient at endoscopy showed signs of lack is technote cardia, erosive gastritis. When abdominal ultrasound - gallbladder cholesterosis. Took rabeprazole within 4 weeks with a positive effect. Underwent in-patient treatment. At endoscopy - signs of chronic gastritis, failure of the cardia, urease test is negative. When abdominal ultrasound - liver steatosis, deformation of the gallbladder, lipomatous pancreas. With colonoscopy - dyskinesia colon on hypermotor type. Treatment: omeprazole, famotidine, duspatalin, furazolidone, powders with white clay with weak positive effect. Out in the x-ray examination of the stomach and small intestine revealed cicatricial deformity of duodenal ulcer. The deterioration since February this year, when heartburn and a burning sensation in the palate and tongue increased again appeared pasty stool up to 2 times per day. Consulted, ds: GERD under reflux esophagitis. Rivers-but: welcome Epicurus on 1 t×2 R./D. with little positive effect.

Objectively upon receipt: satisfactory condition, HELL 115/78 mm RT. senior HR 70 in BH minutes 18 minutes muffled heart sounds, regular rhythm. In the lungs wheeze no, vesicular breathing. Tongue moist, coated with white bloom. The abdomen is soft, not swollen, moderately painful epigastric and paraumbilical area. The chair was 1 times in the day, decorated load and with poor, without pathologists is a mini impurities. Marked enlargement of the umbilical ring.

The results of the survey:

ECG: normal position of the EOS. HR 61. Sinus rhythm, right.

Sigmoidoscopy: at external examination, finger research, anoscopy - 12 h - skin fold - sentinel bump", is rendered Muco-cutaneous defect anus, moderately painful to palpation. Determined rectocele 1-2 tbsp.; internal hemorrhoids moderately expressed in the typical places, not tense, hypertrophied anal papillae. The tone of the sphincter saved. Tube proctoscope introduced on 20 cm due to the presence of feces in the lumen of the normal color. On the visible areas mucosa pink, smooth, shiny, vascular pattern is traced. At a distance of 15 cm from the anal verge on sarneliai wall is visualized polyp with a diameter of up to 0.4 cm wide base with an unmodified tip of the biopsy. Other pathology it is not revealed. Conclusion: Chronic anterior anal fissure, in the acute stage. Rectocele 1-2 stuntmania hemorrhoids, remission. Polyp of the rectum. Biopsy: tubular adenoma of the colon.

EMA tract: hypermotor dyskinesia stomach choledochus and the descending part of the colon. Consultation of the neurologist: Dorsopathy cervical spine, glossalgia.

Endoscopy: Esophagus pass. Mucosa of the esophagus pale pink, kardia not Smyk is to be the reflux. Stomach: in the cavity of the stomach moderate amount of mucous content. The mucosa of the stomach pale pink, hyperemic in bands in the antrum. Folds smooth and elastic. Peristalsis is seen in all departments. The angle of the stomach is not modified. The pylorus is closed, pass. The bulb of the duodenum is medium in size, moderately deformed. The mucosa of the duodenal bulb pale pink, swollen. Folds of medium size, elastic. Jejunum whitish on the tops of the folds. Urease test is negative. Lactase test weakly positive. Conclusion: chronic gastritis, cardia insufficiency, moderate deformity of the duodenal bulb. Biopsy: chronic poorly defined Bullit and duodenitis.

Ultrasound SSB: Liver: visualized adequately; does not protrude from the edge of the costal arch. The edge is smoothed, the surface is smooth, contour clear, capsule thickened. The size of the liver is not enlarged (PZR right lobe 152 mm, the thickness of the left lobe 67 mm). The structure is homogeneous. Overall echogenicity of the parenchyma is increased, expressed in the fat component. The diameter of the portal vein 12.0 mm, the diameter of the NIP 22,0 mm; the ground clearance homogeneous. Vascular drawing is saved, not deformed. Gall bladder: the correct form. The sizes are not increased: 62×29×34 mm, volume of 33 ml of the bladder Wall are sealed, utilse the s (up to 3.3 mm), homogeneous structure. In the cavity of the bubble is determined sludgey sediment (suspended), concrements are not. Intrahepatic ducts are not dilated lumen is homogeneous. The common bile duct is not expanded (4,7 mm), wall sealed lumen is homogeneous. The pancreas is visualized satisfactorily, fuzzy contour, the surface is uneven. Size: 33,0 x 19,2 x 22.7 mm Structure is heterogeneous, unevenly compacted. General echo is increased. Pancreatic duct is not expanded. The spleen is visualized adequately, fuzzy contour, the surface is smooth, the capsule is sealed. Dimensions: 114 x 54 mm R 40 cm2. (N47 cm2). The structure of inhomogeneous (in the middle segment is determined by the accumulation of calcium, the average plotnosti up to a diameter of 3.4 mm), the echo is average. Splenic vein diameter of 7.8 mm, ground clearance homogeneous. Free fluid in the abdominal cavity no.

Final diagnosis: Secondary lactase deficiency moderate severity. Chronic gastroduodenitis, unassociated with N. pylori, in the stage of constant aggravation. Gastroesophageal reflux disease in stage neurosignal reflux esophagitis. Peptic ulcer disease duodenal ulcer in remission. Cicatricial deformity of the duodenal bulb. Emerging umbilical hernia. Steatosis of the liver. Chronic anterior anal fissure in which Tadei constant aggravation. Rectocele 1-2 tbsp., Internal hemorrhoids, remission. Polyp (tubular adenoma) of the rectum. Dorsopathy cervical spine, glossalgia. The enlargement of the thyroid gland 1 Art. autres.

Ultrasound: steatosis of the liver, gallbladder cholesterosis, diffuse changes in the pancreas, calcification of the parenchyma of the spleen. Colonoscopy: the device is held in the dome of the caecum. Bauhinia flap somknuti oriented in the dome. In the left parts of the colon moderate amount of liquid contents. When svarivanii intestine marked pain syndrome. The mucosa of the colon on the inspected areas of pink, smooth, shiny. Vascular pattern smoothed. The folds of the mucous average, elastic. The lumen of the intestine is not deformed. The tone of the intestine saved. Conclusion: organic pathology was not detected.

Consultation of the endocrinologist: ds: Enlargement of the thyroid gland 1 tbsp., autres. Recommended outpatient thyroid ultrasound, blood tests (TSH and free T4.). The surgeon ds: tubular adenoma of the colon. Recommended surgical removal of the adenoma. Breathing hydrogen test with lactulose (30 ml): detected excessive bacterial growth (62 ppm). EGD (control): chronic gastritis, cardia insufficiency, moderate deformity of the duodenal bulb. Lactase test neg is local. Breathing hydrogen test with lactulose (30 ml): excessive bacterial growth was not detected (12 ppm). Laboratory data:

CBC:

IndexNormaIndexNorma
Hemoglobin13,216P/nuclear21-6
Erythrocytes4,583,9-5,3Segment.5447-72
Haematocrit40,439-50Eosinophils20-5
Leukocytesa 3.94-9Lymphocytes3619-37
Platelets232150-400M is nocity 63-11
Erythrocyte sedimentation rate63-15

Biochemical analysis of blood

Index09.03.11Norma
About. protein68,366-87
The total bilirubin7,83,4-21
Glucosethe 6.064,1-5,9
Cholesterol5,941,4-5,2
Urea5,56of 1.7 to 8.3
MPE0,950,9-1,2
Prothrombin10070-130
IndexResultDate
HIV a negative.14.03.11
RWa negative.14.03.11

Glucose tolerance test - glucose to load the 5.45 mmol/l, after load return of 6.58 mmol/L. Markers of hepatitis b and C is not found.

Urine analysis of clinical - transparent, protein neg., ID/weight 1032, leukocytes neg., erythrocytes neg., ketones, glucose is not. Fecal occult blood is negative. Treatment: lactose-free diet, daily - Mezim Forte 1 tab.×3 times, Bifiform 1 tab. 2 times and no-Spa - 1 table. 3 times a course of treatment within 14 days.

Electromyographically reduction EMA duodenum. Hypermotor dyskinesia of the descending part of the colon.

On the background of the treatment, the patient noted improvement: reducing heartburn, disappearance of pain in the paraumbilical region, the normalization of stools up to 1 R/d, furnished, without admixture of mucus with blood.

The treatment of 96 patients with secondary lactase deficiency. The research confirmed the goal of the invention is improving the treatment of secondary lactase deficiency.

A method for the treatment of secondary lactase deficiency, including diet and drug therapy, characterized in that the quality of medicines use in ka is este daily dose Bifiform 1 tab. 2-3 times and no-Spa - 1-2 table. 3 times a course of treatment within 14 days.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention provides using a prepared compound of a ghrelin splicing version for preparing an effective drug preparation activating body weight and food intake gain and/or stimulating growth hormone release, as well as for treating or preventing cachexia, lipodystrophy and muscle atrophy.

EFFECT: higher clinical effectiveness.

6 cl, 6 dwg, 13 ex

FIELD: medicine.

SUBSTANCE: what is presented is the use of the strain Lactobacillus johnsonii in preparing a probiotic composition for prevention of postoperative abdominal and pelvic infections caused by pelvic liquid accumulation, anastomosis leakage, or caused by bacterial translocation.

EFFECT: colonic L Johnsonii Lai colonisation in the patients underwent colectomy for colorectal adenocarcinoma.

11 cl, 1 dwg, 1 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: there are offered: application of a water-soluble indigestible saccharide for preparing a composition wherein the composition is introduced in a pregnant woman for improving the developing intestinal microflora of an expected newborn; reinforcing the immune system and/or preventing the diseases associated with the immune system of the expected newborn; or reinforcing the immune system of the foetus (versions). What is also presented is the application of the water-soluble indigestible saccharide wherein the saccharide is a galactose-containing saccharide containing at least 50% of galactose units of the total amount of monosaccharide units found in the saccharide for preparing the composition for reinforcing the immune system of the pregnant woman; improving the vaginal flora of the pregnant woman wherein the composition is introduced in the pregnant woman.

EFFECT: increased percentage of bifidus bacteria and lactic acid bacilli in the intestinal flora of pregnant women, intestinal colonisation of the newborn by lactic acid bacilli and reinforcement of the immune system.

11 cl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to veterinary science. A method includes the administration of a medicinal agent. The medicinal agent is presented by 0.25% alcohol solution of Chlorophyllipt 3 ml in normal saline 57 ml which is introduced intravenously twice a day for 2-3 days in dose of 60 ml per a calve if observing simple dyspepsia and four times if observing toxic dyspepsia. It is combined with the oral introduction of 1% alcohol solution of Chlorophyllipt 10 ml at 900 ml in normal saline prescribed twice a day in dose 1000 ml in both forms of dyspepsia.

EFFECT: method provides higher therapeutic effectiveness, reduces length of treatment, has no side action on calve bodies, eliminates recurrences.

1 ex

FIELD: medicine.

SUBSTANCE: strain Bifidobacterium longum B-NH is recovered from a healthy infant, actively propagates in a nutrient medium with accumulation of an production biomass in a short 12-18-hour period of cultivation time of the high bifidus bacteria concentration, is able to sour milk. The Bifidobacterium longum B-NH strain exhibits acid-forming activity, pathogen and opportunistic pathogen antagonist activity. It makes it possible to use the strain Bifidobacterium longum B-NH as an ingredient of bifidus products - bacterial preparations, biologically active food additives, fermented and non-fermented foodstuff, toiletry and care preparations enabling normalised human body microbiocenosis, including gastrointestinal and urogenital tracts, skin and mucous membranes, and extends the range of products for correction of human microflora. The strain Bifidobacterium longum B-NH is deposited in Russian National Collection of Industrial Microorganisms, No. VKPM Ac-1876.

EFFECT: invention provides higher activity of bifidus products.

2 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to balneology, physiotherapy. First, individual sensitivity of patient to radon procedures is estimated. For this purpose, arterial pressure and heart rate are measured on empty stomach. After that, patient takes bath with mineral water from thermal radon springs with natural water temperature about 38°C (radon water). Patient rests for 30 minutes. After that, patient's arterial pressure and heart rate are re-measured. If heart rate does not change or changes by ±10 beats/min, and systolic and/or diastolic arterial pressure changes by ±10 mm Hg, I type of response is determined in patient. If heart rate changes by ±20 beats/min, and systolic and/or diastolic arterial pressure changes by ±15 mm Hg, II type of response is determined in patient. If heart rate changes by ±30 beats/min, and systolic and/or diastolic arterial pressure changes by ±20 mm Hg, III type of response is determined. In case of I type of response bath is taken according to the scheme: first procedure - 5 minutes, second - 8 minutes, third - 10 minutes, after that all procedures last 15 minutes. In case of II type of response bath is taken according to the scheme: first procedure - 5 minutes, second - 8 minutes, third - 10 minutes, after that all procedures last 12 minutes. In case of III type of response bath is taken according to the scheme: first procedure - 3 minutes, second - 5 minutes, third - 8 minutes, after that all procedures last 10 minutes. Course includes 10-15 baths. Bath with radon water is taken two days running, which are followed by one-day break. Treatment is performed at the background of diet No 4 b. In the first part of the day, two hours after breakfast, patient drinks 200 ml of radon water in swallows at a measured pace. On one of the days with baths, going one after another, microclysters with pantohematogen are performed. Detensor-therapy is carried out. In the second part of the day, two hours after dinner, patient drinks 200 ml of radon water in swallows at a measured pace. After that, patient takes bath with radon water. Then, procedure in accordance with programme of resonance-acoustic fluctuations (PRAF) is performed. On the days without baths in the first part of the day intestinal lavage is performed and in the second part of the day - thalassotherapy of face and body.

EFFECT: method ensures increased efficiency of treatment of patients with dysbacteriosis at resort stage due to ensuring elimination of pathogenic and opportunistic microorganisms, and increase of immunologic reactivity of organism.

4 cl, 2 tbl

FIELD: medicine.

SUBSTANCE: 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.

EFFECT: invention provides maximally achieved isotropic filling of the set volume of drug containers that provides accurate dosage of nonpathogenic microorganisms.

7 cl, 9 ex

FIELD: medicine.

SUBSTANCE: the invention relates to creation of pharmaceutical composition in the form of suspension with antacidic action. The said pharmaceutical composition contains calcium carbonate, polysaccharide sodium salt and excipients, where calcium carbonate is presented by “Micellate of calcium carbonate and magnesium”, polysaccharide sodium salt is sodium hyalurate. The composition additionally contains dimephosphon (dimethyloxobuthylphosphonilmethylate) and water. The excipients are alcohol, Nipagin and fructose. Offered pharmaceutical composition has specific pharmacological expressed effect, it showed atacidic action on the model of experimental gastritis. The composition has no expressed toxic effect with various doses and routes of experimental animals.

The composition has no irritant effect, sensibilizing action was not expressed.

EFFECT: the composition can be used for treatment of digestive tract pathologies and is suitable for treatment of patients additionally suffering from diabetes mellitus.

2 cl, 1 tbl, 3 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceuticals and concerns a controlled release pharmaceutical composition containing an oral dosage form of pancreatine, and an enterosoluble coating which contains a) a film-forming agent; b) a plasticiser representing mixed cetyl alcohol and triethyl citrate, and c) optionally at least one adhesion-blocking agent. The invention also concerns a method for preparing said composition and applying it for producing a pharmaceutical for digestive disorders, pancreatic exocrine insufficiency, pancreatitis, mucoviscidosis, insulin-dependent and/or insulin-independent diabetes.

EFFECT: invention provides the composition having the improved release profile and storage stability.

11 cl, 4 tbl, 14 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to pharmaceutical industry and can be applied for increase of therapeutic-preventive properties of medicinal vegetable mixture for treatment of gastrointestinal tract diseases. Gastrointestinal herbal tea contains leaves of mint, rhizomes of sweet flag, flowers of chamomile, root of licorice and fennel fruits in defined component ratio.

EFFECT: high efficiency of herbal tea in treatment of neglected forms of disease and complications, developed before beginning of intake.

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

FIELD: medicine, pharmaceutics.

SUBSTANCE: 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 %.

EFFECT: invention provides antiprotozoal action with probiotic effect.

7 ex, 2 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention 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%.

EFFECT: invention provides maximum safety and efficacy.

52 cl, 9 ex, 6 tbl, 7 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention 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%.

EFFECT: invention does not cause a risk or eliminates a risk of the prion disease when introduced into the patient that provides maximum safety and efficacy.

48 cl, 12 ex, 10 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: 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.

EFFECT: method provides higher clinical effectiveness in pulmonary tuberculosis as indicated by infiltration resolution, cavity closure and abacillation with reduced rate of developing adverse hepatotoxic reactions and disbiotic intestinal disorders.

3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: 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.

EFFECT: invention provides maximally achieved isotropic filling of the set volume of drug containers that provides accurate dosage of nonpathogenic microorganisms.

7 cl, 9 ex

FIELD: medicine.

SUBSTANCE: invention 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.

EFFECT: method provides reduced loss of animal products.

4 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: 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.

EFFECT: invention provides higher bioavailability of actinomycetes lysate, effective local concentration of the drug in focus of disease, reduced side effects.

2 cl, 5 ex, 2 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention 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.

EFFECT: invention provides regulation and control of the glucose and insulin levels in healthy individuals and diabetic patients.

22 cl, 3 tbl, 5 dwg

FIELD: medicine.

SUBSTANCE: non-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.

EFFECT: inventions make it possible for injuries to regenerate quickly, increase immune reactivity of the organism and make it possible to simplify method of obtaining anti-burn plate.

2 cl, 6 dwg, 2 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to neurology, restorative medicine, and can be applied in treatment of consequences of infantile cerebral paralysis. For this purpose reflex low temperature impact on nerve plexuses of peripheral artery is performed. Said impact is performed first in lower third of forearm, and after three months in first interdigital space of foot. Cryoapplicator with diameter 2 mm is installed on exposed peripheral artery and double cryogenic impact with duration 10 seconds is performed at temperature minus 186°C. In the period between low temperature impacts complex drug therapy is carried out: in the first two weeks administered are detralex in dose 1 capsule 2 times per day, nicospan in dose 1 tablet 3 times; in the second two weeks grandaxin in dose 0.05 in the morning; spasgan in dose 1 tablet in the afternoon; atarax in dose 1/2 tablet before going to bed.

EFFECT: method ensures definite consistency, which makes it possible to compensate vegetative dystonia syndrome, normalise neuromuscular transmission, reduce muscle spasticity, optimise motor functions of upper and lower extremities and, therefore, improve coordination of movements and supportability of lower extremities.

1 ex

Up!