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Method of conservative treatment of lithic stage of cholelithiasis. RU patent 2490017.

IPC classes for russian patent Method of conservative treatment of lithic stage of cholelithiasis. RU patent 2490017. (RU 2490017):

A61P1/16 - for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
A61K33/10 - Carbonates; Bicarbonates
A61K31/575 -
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FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly gastroenterology, and may be used for treating the lithic stage of cholelithiasis. For this purpose, ursodeoxycholic acid is administered for the night with underlying the mineral water Uvinskaya heated to 40-45°C.

EFFECT: method enables increasing the clinical effectiveness ensured by reducing high lithogenicity of bile with improved gallbladder contractility.

2 cl, 1 tbl, 2 ex

 

The invention relates to medicine, in particular to gastroenterology and for the treatment of the first () stage of a bile stone disease (GSD).

In accordance with the classification of a bile stone disease, her stage is characterized by «biliary sludge» based on ultrasound. When conducting ultrasound changes in the structure of bile can be in the form of an inhomogeneous bile or different variants of biliary sludge.

It is also known that patients with stage GSD often detected chronic gastritis, stomach varying degrees of severity.

There are the following pathogenic approaches to the correct medication stage GSD:

- decrease the synthesis of cholesterol in ;

- increased secretion cholesterol in bile;

- restoration of the contractile function of the gallbladder;

- reduction of cholesterol intake in the intestine;

- restoration of intestinal transit.

Known method of treatment stage of a bile stone disease, including the use of the drug ursodeoxycholic acid (AA Ilchenko «Diseases of the gallbladder and biliary tract», M: Anacharsis, 2006, .111-115). The effectiveness of treatment is monitored by ultrasound, the first study conducted after 1 month of therapy.

The disadvantages of the method include the fact that the drug ursodeoxycholic acid (UDCA) to a small extent improves a contractile ability of the gallbladder, does not have effective anti-inflammatory effects on gallbladder and on the mucous membrane of stomach body.

Known method of treatment stage of a bile stone disease with the help of mineral water. The known method of treatment of patients is carried out with the help of medical-dining room drinking sulphate-magnesium-calcium mineral water resort «Keys» ( VG, Vladimir E.V., Gordeeva DUDKA, Rybolovlev E.V. / Efficiency of treatment of patients with chronic cholecystitis without stones drinking mineral water resort «Kluchi» / Modern aspects of rehabilitation medicine, balneology and physiotherapy. - Izhevsk. - 2008. - .236-238). It is shown that the mineral water in these patients (especially in combination with gallbladder) has , , spasmolytic effect and helps to reduce properties of bile.

Disadvantage of this method, taken as a prototype, is the absence of its positive influence in the GSD on the mucous membrane of stomach body.

The aim of the claimed invention is to improve the quality of treatment and expanding the scope of its application.

This goal is achieved by the fact that according to the method of conservative treatment stage of a bile stone disease, including internal use of mineral water, additionally use the overnight drug acid and mineral water use mineral water «Uvinskaya»heated to 40-45°N Gastric acidity mineral water are taken 20-30 minutes before a meal, and at normal and elevated acidity of the stomach 1 hour - 1 hour 30 minutes before a meal.

Application of the claimed method allows to reduce the impact of factors leading to the development stage of a bile stone disease, such as increased bile, reduced contractility of the gall bladder, chronic inflammation of the gall bladder. In addition, the proposed method of treatment stage GSD with concomitant chronic gastritis has a beneficial effect on the structural components of gastric mucosa (GM), reduces inflammatory activity, changes the proliferative activity of cells of coolant and probably reduces the phenomenon of cell apoptosis.

The advantage of this method is the positive effect of the combined use of UDCA and MB «Uvinskaya» when stage GSD, more pronounced compared with monotherapy UDCA, due to the improvement of biochemical composition of the gallbladder bile after the treatment in the form of lower cholesterol in bile, increase the content of bile acids in the bile, and increase -cholesterol ratio. Unexpected effect was rendering favorable influence on the structural components of the coolant, a decrease of inflammatory activity in all patients, and some of the change of proliferative activity of the coolant.

The method is as follows.

Inside is assigned to the drug ursodeoxycholic acid (in particular, «») in a daily dose of 10-15 mg/kg of body weight for the night in combination with the reception of mineral water «Uvinskaya» in the initial dose of 50 ml 3 times a day (before Breakfast, lunch and dinner) temperature of 45 C. Mineral water take 30 minutes before meals at low and 1-1,5 hours before the meal with the raised acidity of a stomach against the diet №5 MI Pevsner. Under normal portability of mineral water for 3 days, increase the dose to 200 ml 3 times a day and continue in a combination with taking ursodeoxycholic acid (UDCA) in the same way. This combination treatment is continued for 24 days, and then a monotherapy UDCA within 2 months inside of calculating the daily dose of 10-15 mg/kg of body weight for the night.

The physical properties of mineral water «Uvinskaya characterized as colorless, transparent, taste somewhat salty, without odor, stable chemical composition and high daily production rate. Chemical composition of mineral water are presented in table 1.

Table 1.

The chemical composition of drinking mineral water «Uvinskaya»

CATIONS

ANIONS

Sodium - 1.86

Sulfate - 4.58

Calcium - 0.31

chlorine - 0.23

Magnesium - 0.1

Hydrogen - 0.12

potassium - 0.01

fluorine - 0.0009

Strontium - 0.002

Ammonium 0.001

lithium - 0.0004

MOLECULES

silicon acid - 0.005

acid - 0.08

Example 1:

Patient T., 53 years.

Within 24 days against the backdrop of diets, №5 MI Pevsner received treatment ursodeoxycholic acid (2 capsules at night)+MB «Uvinskaya» temperature of 45 C. Given the lowered acidity of a stomach (pH of gastric = 4,0) took mineral water for 30 minutes before a meal. On the 5th day from the start of treatment marked decrease in pain and dyspeptic phenomena, and mild syndromes on the 11th day of treatment. After the completion of hydrotherapy, continued ursodeoxycholic acid therapy for 2 months.

FGS (before treatment) Conclusion: Atrophic-hyperplastic gastritis.

Histological conclusion: Chronic superficial gastritis, gastric body. Infiltration propria of the mucous high. Activity reasonable. N.R. not detected. Ultrasound of the gallbladder (before treatment): the gallbladder () dimensions: 9,3 x 2.9 cm, a wall not thickened, in the lumen -

After the treatment:

Ultrasound: the gallbladder () dimensions: 7,8 x 2.7 cm, a wall not thickened, in the lumen of the bladder and concretions were found.

FGS: Conclusion: Atrophic gastritis, gastric body moderate activity.

Histological conclusion: Chronic superficial gastritis, gastric body in the stage of moderate activity.

Conclusion: high effectiveness of the combined treatment.

Example 2.

Patient W., 60 years.

Within 24 days against the backdrop of diets, №5 MI Pevsner received treatment ursodeoxycholic acid (2 capsules at night) and MB «Uvinskaya» temperature of 45 C. based on normal acidity (pH=1,8) took mineral water 1 hour before a meal. On the 7th day from the start of treatment celebrated reducing the symptoms of dyspepsia and relief of symptoms on 16 day. After the completion of hydrotherapy continued ursodeoxycholic acid therapy for 2 months.

FGS (before treatment) Conclusion: the Surface .

Ultrasound (before treatment): Conclusion: Signs of chronic cholecystitis with the presence of .

After the treatment:

Ultrasound: In the lumen of the gallbladder stones . Clearance .

FGS: Conclusion: Chronic gastritis.

The control study of 10 months after a course of treatment in a patient complaints of the bitterness in the mouth, skin itch no.

1. A method of conservative treatment stage of a bile stone disease, including internal use of mineral water, wherein additionally used in the night of the drug ursodeoxycholic acid and mineral water use mineral water «Uvinskaya»heated to 40-45°N

2. The method according to claim 1, wherein the gastric acidity mineral water are taken 20-30 minutes before a meal, and at normal and elevated acidity of the stomach 1 hour - 1 hour 30 min before a meal.


 

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