Method of treating patients with destructive forms of pulmonary tuberculosis

FIELD: medicine.

SUBSTANCE: with underlying antituberculous therapy from the first day of treatment, a therapeutic course is added with an oral administration of preparations Wobenzym and Thiotriazoline; Wobenzym is administered for 4 months in a dose of 1 tablet once a day 30 minutes before breakfast, while Thiotriazoline is administered for the first 15 days in a dose of 100 mg 2 times a day, from the 16th to 45th day in a dose of 100 mg 1 time a day, on the 46th day, Thiotriazoline is withdrawn.

EFFECT: method enables higher clinical effectiveness and reduced rate of an adverse hepatotoxic response to the antituberculous preparations due to improving the immune status and peroxidation values.

6 tbl, 2 ex

 

The invention relates to medicine, namely to Phthisiology, and can be used in complex treatment of patients with destructive forms of pulmonary tuberculosis.

The incidence of tuberculosis in Russia remains high and almost twice the epidemic threshold. In this regard, a particularly urgent problem of increasing the effectiveness of TB treatment, especially tuberculosis, as it is this form of tuberculosis is most often accompanied by a bacteria and is the most dangerous epidemic. The reduction effect of the antibacterial anti-TB drugs necessitates polychemotherapy (Mishin WORKED For and the effectiveness of treatment of infiltrative tuberculosis of the lungs. / VY Mishin, N. Nazarov, A.S. Kononets etc. // Problems of tuberculosis and lung diseases. - 2006. No. 10. - P.7 - 12; Novikova TI Peculiarities of the course and the effectiveness of treatment of pulmonary tuberculosis in patients emitting multidrug-resistant Mycobacterium tuberculosis: author. dis. ... Dr. med. Sciences / TI Novikov. - M., 1998. - 38 C.). This contributes to the development of adverse toxic reactions from different organs and systems (Novozhilov I.A. the Importance of determining drug resistance of Mycobacterium tuberculosis to the successful treatment of tuberculosis / I.A. Novozhilov // Problems of tuberculosis and lung diseases. - 2004. No. 4. - P.29 - 30.) and proves approval Khomenko A.G. that orientation only on antibiotic therapy in the treatment of tuberculosis is wrong (Khomenko A.G. TB yesterday, today, tomorrow. / Khomenko A.G. // Problems of tuberculosis and lung diseases. - 1997. No. 6. - P.9-11; Khomenko A.G. current views on the pathogenesis of TB / Khomenko A.G. // Russian medical journal. - 1998. - V.6, №17.- P.23-26). Prolonged use of anti-TB drugs leads to decreased immune functions of the body and to deepen immunodeficiency syndrome (Immunological aspects of pulmonary pathology. / M. Auerbach, V.I. Litvinov, V.L. Herbert and others - M.: Medicine, 1980. - 279 S.; Immunoregulation in immunopathology caused by tuberculosis infection / RI shenderova, O.A. Acunova, NS Novikova and others // Immunology. - 1998 - No. 6 - S).

There are many methods of treatment of destructive forms of pulmonary tuberculosis, the main of which is the standard anti-TB medication, regulated by the Ministry of health of the Russian Federation No. 109 dated 21.03.2003, "On improving TB control in the Russian Federation".

The disadvantages of existing methods of treatment are: the rapid emergence of drug resistance in Mycobacterium tubes is of rulesa to these drugs (Mishin VY The modern strategy for the treatment of drug-resistant tuberculosis. / VY Mishin // Attending physician. - 2000. No. 3. - P.4 - 9); the occurrence of adverse hepatotoxic reactions (Mishin VY TB today: problems and prospects. / VY Mishin // Scientific works of the Moscow city). are the practice. Central TB. - M., 2000. - Ñ.38 - 40), depression of the immune status (komogorov EE Features of immunological parameters in patients with different forms of pulmonary tuberculosis. / EA komogorov, E.V. Kostenko, V.A. Stakhanov, etc. // Clinical immunology. - 2005. No. 1. - P.45-50).

This makes necessary the development of new methods of treatment of patients with destructive forms of pulmonary tuberculosis, with which it is possible to avoid the above drawbacks and to significantly improve the effectiveness of the treatment.

Conducted research on the medical-scientific and patent literature revealed various methods of treatment of pulmonary tuberculosis.

So, M.V. Sidicinum (the dissertation on competition of a scientific degree of candidate of medical Sciences "Application tipatina in complex treatment of patients with pulmonary tuberculosis"., -M., 2007, S) described a method of treatment of pulmonary tuberculosis patients, including those with destructive forms of TB drugs with an additional appointment in the treatment of drug g is Taksim. Treatment Glutoxim begin in the first week of the intensive phase of chemotherapy and finish before the first follow-up examination, i.e. within 2 months from the start of chemotherapy. Daily dose of Glutoxim 60 mg

In the work of S. Arshinova and BV Pinegina "Immunomodulators in the treatment of patients with active pulmonary tuberculosis" (magazine "the doctor", October 2002, No. 10, p.36-37) described a method for the treatment of destructive forms of pulmonary tuberculosis, which would include TB treatment polyoxidonium 6 mg intramuscularly 2 times a week, for a treatment course of 10 injections.

In the work GO Vasilyeva and G.S. Balasanyan: "the Experience of using bestial in the complex treatment of infiltrative destructive forms of pulmonary tuberculosis" (magazine "Family doctor", 2003, No. 3, pp.17-19) described a method of treatment of pulmonary tuberculosis patients, including comprehensive treatment of the immunomodulator Bestim 0.1 mg intramuscularly, every day, for a treatment course of 5 injections.

RF patent №2219939 (BIPM No. 36, 2003) protected "Method of treatment of tuberculosis involving the use in the treatment of patients with destructive pulmonary tuberculosis drug - probiotic, Backspin containing live cultures of bacteria Bacillus subtilis 3H in the complex therapy. The drug is administered 4 doses 3 times a day for 5-7 days, followed by 1 dose times a day for 10-15 days 30 minutes before the start of treatment.

The disadvantages of the above methods of treatment of destructive forms of pulmonary tuberculosis are their lack of effectiveness in relation to the closure of decay cavities, resorption of infiltration and conversion.

RF patent №2302251 (TPMF No. 19, 2007) protected "Method of treatment of pulmonary tuberculosis" allowing for the appointment of a complex homeopathic medicines - APIs, mellifica 6, Hina officinalis 6, Chelidonium majus 6, stannum 6, Sanguinaria canadensis 6, calium bichromicum 6, carbó vegetabilis 6 5 grains 3 times a day for 3-4 months, regardless of the meal.

RF patent №2318515 (TPMF No. 7, 2008) protected "Method of treatment of pulmonary tuberculosis" providing for more on the background of standard therapy, the appointment of a complex homeopathic preparations and Wobenzym 1 tablet 3 times a day throughout the treatment period.

The disadvantage of these treatments is to limit the number of patients who consent to the use of homeopathic medicines.

RF patent №2380113 (TPMF No. 3, 2010) protected "Method of treatment of pulmonary tuberculosis patients" allowing for the appointment of patients with destructive forms of pulmonary tuberculosis drug Viferon, rectal suppositories 1000000 ME (the human interferon is recombinantly alpha-2), one candle twice a day, with a 12-hour intervals, within 10 days - every day from 11 th to 60 th day after day.

RF patent №2450820 (TPMF No. 14, 2012) a protected Method of treatment of destructive pulmonary tuberculosis" providing for the introduction on the background of standard therapy, drug Bestim intratrahealno at a dose of 1.0 mg 3 times a week, on a course of treatment is 6 introductions.

The disadvantages of the above methods of treatment of pulmonary tuberculosis are their lack of effectiveness in relation to the closure of decay cavities, resorption of infiltration and conversion.

The closest in its essence, and is taken as a prototype is a method of treatment of pulmonary tuberculosis patients, provided by the Ministry of health of the Russian Federation No. 109 from 21.03.03, "On improving TB control in the Russian Federation". The method provides for TB treatment according to the standard modes.

The disadvantage of the prototype is its lack of efficacy in closure of decay cavities, resorption of infiltration and conversion, development of adverse hepatotoxic reactions and reduced immune status due to the use of anti-TB drugs.

The objective of the invention is to increase the efficiency of treatment of patients with destructive forms of tubers is found in the lungs.

The technical result is to increase the effectiveness of treatment, namely the closure of decay cavities, resorption of infiltration and abacillation, reducing the frequency of adverse hepatotoxic reactions, the improvement in the immune status and processes of free radical oxidation.

The technical result is achieved by assigning the patient a destructive form of tuberculosis TB treatment according to the standard modes. From the first day in the course of treatment include oral medications Wobenzym and Thiotriazoline. Wobenzym appointed within 4 months 1 tablet 1 time a day, 30 minutes before Breakfast. Thiotriazoline appoint: for the first 15 days at a dose of 100 mg 2 times a day, from the 16th on the 45th day in a dose of 100 mg 1 time per day, on the 46th day drug Thiotriazoline overturned. Following days of therapy treatment according to the standard modes.

Thiotriazoline (registration number - LSR-002165/10) - generic name: morpholine-methyl-triazolyl-thioacetate. One tablet contains Thiotriazoline 0.1 g other ingredients : potato starch, gelatin, white, 4000 polyethylene oxide, stearic acid. Thiotriazoline has hepatoprotective, anti-ischemic, anti-oxidant, membrane and immunomodulatory properties. Teatria the Olin removes from the blood and tissue products of free-radical oxidation, leading to cytolysis of hepatocytes. Of particular interest is the antioxidant effect of Thiotriazoline, as in destructive forms of TB intensified lipid peroxidation (LPO), increases the concentration of oxygen free radicals. Thiotriazoline activates antioxidant enzymes: superoxide dismutase, catalase. It is also important immunomodulatory properties, due to the fact that immunological imbalance is detected in most patients with destructive forms of pulmonary tuberculosis. Thiotriazoline reduces the activity of b-lymphocytes and decrease the content of Ig in the blood, increases the number of T-lymphocytes.

Wobenzym (registration number - P # 011530/01) is a balanced blend of enzymes are hydrolases of animal and vegetable origin, which added rutin. Part of the preparation Wobenzym include trypsin, chymotrypsin, bromelain, papain, amylase, Pancreatin and rutin, mutually complementary and reinforcing. Wobenzym reduces the activity of the inflammatory processes and modulates physiological protective response of the body: reduces infiltration interstitial plasma cells, improves elimination of protein debris and deposits of fibrin in the area of inflammation. This ensures the restoration of microcirculation, and disposal of the products of inflammation and str is cSet supply the tissues with oxygen and nutrients (Sizechina L.P. Systemic enzyme therapy in the treatment of allergic and immunopositive diseases. / -SPb.: Ed. "Tactics-Studio", 2006). Wobenzym has an impact on the immunological reactivity of the organism, increases the functional activity of macrophages and phagocytic activity of cells.

Practical feasibility of the claimed method is illustrated by examples from clinical practice:

Example 1: patient R., aged 34, case history No. 986/21, was admitted for inpatient treatment in state "TB clinic" Rostov region about the destructive tuberculosis of the upper lobe of the left lung. The patient's condition at admission - medium gravity, expressed in the phenomenon of tuberculosis intoxication, pale skin, power reduced, the temperature is raised up to 37,6°C. Auscultation: in the lungs, on the background of the vesicular respiration, in the upper left dry and isolated moist rales. Respiratory rate (BH) - 24 in 1 minute, blood pressure (BP) is 135/85 mm Hg, pulse rate (PE) - 74 in 1 minute.

Survey data at entry:

The radiographs and tomograms in the upper lobe of the left lung infiltration of the lung tissue is heterogeneous, patchy patterns, S1-2, the cavity decay of 3.5×4.0 cm, with infiltrated the walls, around the polymorphic lesions, in S6 of the left lung and S1 of the right lung foci obsama is to be placed, wide broncho-vascular "path" to the root of the lung.

Blood analysis: hemoglobin - 128 g/l, erythrocytes - 3,2×1012/l, leukocytes - 10,2×109/l, eosinophils - 1%, stab neutrophils - 10%, segmented neutrophils - 68%, lymphocytes - 18%, monocytes - 3%, ESR - 32 mm/hour.

Analysis of sputum smear method of direct microscopy - acid-fast bacilli (AFB) found: 10-20 in the field of view.

The sputum gave rise 15 colonies of Mycobacterium tuberculosis (MW).

Mantoux test with 2 tuberculin units (TU) - 18 mm

Sample preparation Diaskintest 14 mm

The immunological - CD4+lymphocytes - 35,8%, CD8+lymphocytes - 36,7%, CD20+lymphocytes 18.5%of circulating immune complexes (CIC) - 101,0%. Superoxide dismutase activity in erythrocytes - 4,13 $ /mgnv, the catalase activity of plasma - 45,64 μm H2About2/min × L.

Based on the survey data the patient was diagnosed with infiltrative tuberculosis of the upper lobe of the left lung in the phase of decay and contamination, office+.

The patient had received treatment according to the claimed method. Treated under intensive phase standard anti-TB therapy - streptomycin 1 g, isoniazid 0.6 g, rifampicin 0.6 g, pyrazinamide 1.5 g, multivitamins, vitamin B6. From the first day in the course of treatment consisted of oral administration of drugs Wobenzym and Thiotriazoline. Wobenzym was administered within 4 months 1 tablet 1 time a day, 30 minutes before Breakfast. The drug Thiotriazoline appointed: during the first 15 days at a dose of 100 mg 2 times a day, from the 16th on the 45th day in a dose of 100 mg 1 time per day; on the 46th day drug Thiotriazoline been canceled. Following days of therapy, the treatment was performed according to standard mode.

After 4 months the patient was performed control tests:

The radiographs and tomograms. in the upper lobe of the left lung diffuse pneumosclerosis, pockets of small and medium caliber, medium intensity, infiltrative changes resorbed, the cavity decay is not determined, in its place area limited fibrosis, foci resorbed.

Blood analysis: hemoglobin - 136 g/l, erythrocytes - 4,3×1012/l, leukocytes - 5,4×109/l, eosinophils 2%, and the stab neutrophils - 4%, segmented neutrophils - 67%, lymphocytes - 24%, monocytes - 3%, ESR - 9 mm/hour.

Two analyses of sputum smears by microscopy method - BACILLI not found.

Two sputum - culture growth of the office no.

Mantoux test with 2 Tu - 12 mm

Sample preparation Diaskintest 5 mm

The immunological - CD4+lymphocytes to 46.7%, CD8+lymphocytes with 25.9%, CD20+lymphocytes 14.2 percent, CEC - 89.4 per cent.

Superoxide dismutase activity in erythrocytes - $ 10,84/mgnv, the catalase activity in plasma 29,97 μm H2About2/min × L.

As a result of treatment according to the claimed method was dosign is the positive dynamics. The patient's condition has improved, infiltrative changes resorbed, the cavity decay closed, decreased the number and size of lesions, achieved abacillation in the lungs catarrhal phenomena were not heard. For the treatment of hepatotoxic reactions were not. Improved immunological indicators and indicators of free radical oxidation. After 4 months in a satisfactory condition the patient was discharged to continue treatment on an outpatient basis.

Example 2: patient S., 46 years old, medical history, No. 973/12, was admitted for inpatient treatment in state "TB clinic" Rostov region destructive lung tuberculosis. The patient's condition at admission - heavy, expressed in the phenomenon of tuberculosis intoxication, pale skin, low power, temperature is increased to 38.2°C. Complaints coughing emitting a moderate quantity of sputum, shortness of breath, weakness, sweating, decreased appetite, insomnia. Auscultation: in easy listening vesicular hard shade of breath, scattered dry rales in the upper sections on both sides - a few fine bubble moist rales in the lower divisions breathing somewhat weakened. Respiratory rate (BH) - 28 in 1 minute, blood pressure (BP) - 115/75 mm Hg, pulse rate (PE)- 84 in 1 minute.

Survey data at entry:

The radiographs and tomograms in the upper lobes of both lungs massive heterogeneous infiltration of lung tissue focal patterns, S1-2 both lung cavity decay from 1.0 to 1.8 cm in diameter, with infiltrated walls around small plots of destruction and polymorphic lesions, in S6, 10 of the left lung and S6 of the right lung foci of dissemination, the roots of the lungs infiltrated, not structural.

Blood analysis: hemoglobin - 119 g/l, erythrocytes - 3,1×1012/l, leucocytes - 11,4×109/l, eosinophils - 0%, stab neutrophils -11%, segmented neutrophils - 68%, lymphocytes - 17%, monocytes - 4%, ESR - 36 mm/hour.

Analysis of sputum smear method of direct microscopy - KUM found: 10-15 in the field of view.

The sputum gave rise 25 colonies of the office.

Mantoux test with 2 Tu - 21 mm

Sample preparation Diaskintest 16 mm

The immunological - CD4+lymphocytes - 36,4%, CD8+lymphocytes - 35,9%, CD20+lymphocytes - 19.7%of circulating immune complexes (CIC) - 106,2%.

Superoxide dismutase activity in erythrocytes - 4,22 $ /mgnv, the catalase activity in plasma of 42,63 μm H2O2/min × L.

Based on the survey data the patient was diagnosed with disseminated pulmonary tuberculosis in the phase of infiltration and decay, office+.

The patient had received treatment according to the claimed method. Treated coz the ACLs intensive phase standard anti-TB therapy streptomycin 1 g, isoniazid 0.6 g, rifampicin 0.6 g, ethambutol 1.6 g, multivitamins, vitamin B6. From the first day in the course of treatment consisted of oral administration of drugs Wobenzym and Thiotriazoline. Wobenzym was administered within 4 months 1 tablet 1 time a day, 30 minutes before Breakfast. The drug Thiotriazoline appointed: during the first 15 days at a dose of 100 mg 2 times a day, from the 16th on the 45th day in a dose of 100 mg 1 time per day: at the 46th day of the drug Thiotriazoline been canceled. Following days of therapy, the treatment was performed according to standard mode.

After 4 months the patient was performed control tests:

The radiographs and tomograms. in the lungs diffuse pneumosclerosis, in the upper sections, in the upper lobes of both lungs infiltrative changes resorbed and fragmentirovana pockets of small and medium caliber, medium intensity, the cavity decay and areas of destruction are not defined, the structural roots of the lungs.

Blood analysis: hemoglobin - 128 g/l, erythrocytes - 4,1×1012/l, leucocytes - 6,8×109/l, eosinophils - 1%, stab neutrophils - 5%, segmented neutrophils - 67%, lymphocytes - 23%, monocytes - 4%, ESR - 10 mm/hour.

Two analyses of sputum smears by microscopy method - BACILLI not found.

Two sputum - culture growth of the office no.

Mantoux test with 2 Tu - 11 mm

Sample preparation Diaskintest 6 mm

The immunological - CD4+lymphocytes - 45.9%, and CD8+lymphocytes, while 26.1%, CD20+lymphocytes and 12.7%, CEC - 88,1%.

Superoxide dismutase activity in erythrocytes - becomes 9.97 USD/mgnv, the catalase activity in plasma of 28,59 μm H2About2/min × L.

As a result of treatment according to the claimed method was achieved positive dynamics. The patient's condition has improved, infiltrative changes resorbed, disintegration cavity closed, decreased the number and size of lesions, achieved abacillation in the lungs catarrhal phenomena were not heard. For the treatment of hepatotoxic reactions were not. Improved immunological indicators and indicators of free radical oxidation. After 4 months in a satisfactory condition the patient was discharged to continue treatment on an outpatient basis.

Under our supervision there were 30 patients with destructive pulmonary tuberculosis, who were divided into two groups with different ways of conducting therapy. By sex, age, prevalence of tuberculous changes in the lungs, the presence of decay and bacteria formed the groups were homogeneous. Patients of the main group of 15 people were treated according to the claimed method. Patients in the comparison group, in the amount of 15 people who received treatment according to the prototype. The results of the treatment considering the Lee 4 months, the presence of clinical symptoms, as well as in terms of closing cavities collapse, resorption of infiltration, conversion, presence of adverse hepatotoxic reactions, dynamics of immune indicators and indicators of free radical oxidation. Comparative analysis of results of treatment of these two groups of patients are presented in tables 1-6.

Table 1
Dynamics of the main clinical symptoms of tuberculosis
Clinical symptoms ofThe main group (n=15) abs./%The comparison group (n-15) abs./%
before the treatmentafter 4 monthsbefore the treatmentafter 4 months
Weakness13 people to 86.7%2 people 13,3%12 people 80,0%8 people 53,3%
The temperature rise15 people 100,0%1 person 6,7%15 people 100,0%7 people 46,6%
Cough12 people 80,0%4 people 26,7%11 people 73,3%5 people 33,3%
Sputum10 people 66,7%3 people 20,0%8 people 53,3%4 people 26,7%

From the data presented in table 1 shows that the patients of the main group as a result of treatment carried out according to the claimed method, obtained a pronounced positive dynamics of clinical symptoms of tuberculosis. Patients in the comparison group, which received treatment according to the prototype, the disappearance of clinical symptoms of tuberculosis were observed less frequently.

Table 2
Indicators of successful treatment of tuberculosis
The monitoring groupResorption of infiltrationThe closing of decay cavitiesAbacillation
The main group (n=15) abs./%13 people
86,7%
12 people
80,0%
11 people
73,3%
The comparison group (n=15) abs./%6 people
40,0%
5 people
33,3%
5 people
33,3%

As can be seen from the data presented in table 2, the patients of the main group, who were treated according to the claimed method, the effectiveness of the treatment is significantly higher than patients in the comparison group that received treatment according to the prototype: in terms of resorption infiltration is almost 2.2 times, closing cavernous 2.4 times, abacillation - 2.2 times.

Table 3
Dynamics of clinical manifestations of hepatotoxic reactions
Clinical symptoms ofThe main group (n=15) abs./%The comparison group (n=15) abs./%
before the treatmentafter 4 monthsbefore the treatmentafter 4 months
Abdominal pain1 person 6,7%0 person
0,0%
1 person 6,7%5 people 33,3%
Nausea, vomiting1 person 6,7%0 people 0,0%1 person 6,7%5 people 33,3%
Pain in liver region1 person 6,7%0 people 0,0%1 person 6,7%7 people 46,7%
Ultrasound signs of liver damage1 person 6,7%0 people 0,0%1 person 6,7%7 people 46,7%
Loss of appetite13 people to 86.7%2 people 13,3%14 people 93,3%8 people 53,3%

After treatment, carried out according to the prototype, some patients in the comparison group appeared adverse toxic reactions to antituberculosis drugs in the form of abdominal pain, nausea, vomiting, pain in the liver. The development of hepatotoxic reactions was also confirmed by the results of ultrasound examination (sonography), according to which at 46.7% of patients in the comparison group were identified ultrasound signs of liver damage (table 3).

Table 4
Dynamics of biochemical indices of blood
IndicatorsThe main group (n=15)The comparison group (n=10)
before the treatmentafter 4 monthsbefore the treatmentafter 4 months
Bilirubin (µmol/l)to 8.57±0,198,64±0,178,59±0,1321,63±0,16
ALT (mmol/l×h)0,23±0,040,24±0,030,22±0,061,52±0,04
ACT (mmol/l×h)0,21±0,040,22±0,050,21±0,071,61±0,05

Patients in the comparison group that received treatment according to the prototype, after 4 months it was found increased levels of bilirubin, ALT, AST, testified to the development side of hepatotoxic reactions to antituberculosis drugs in the treatment according to the prototype (table 4). After treatment, conducted in accordance with the present method, the patients of the main group uravneniya, alanineaminotransferase (ALT), aspartate aminotransferase (ACT) has not increased, indicating the absence of hepatotoxic reactions.

Table 5
Dynamics of immune indices
IndicatorsThe main group (n=15)The comparison group (n=10)
before the treatmentafter 4 monthsbefore the treatmentafter 4 months
CD4+lymphocytes (%)35,8±2,946,3±2,237,0±2,734,2±2,1
CD8+lymphocytes (%)36,7±2,625,6±2,834,9±2,429,9±2,4
CD20+lymphocytes (%)14,5±1,710,1±1,814,1±2,016,7±2,5
CEC (%)104,7±0,895,0±0,910,2±1,8 134,6±2,8
Immunoregulatory index1,0±0,021,8±0,041,1±0,031,1±0,02

As can be seen from the data presented in table 5, patients in the comparison group that received treatment according to the prototype, formed immunodeficiency: the level of CD4+lymphocytes decreased, but the levels of CD8+lymphocytes, CD20+lymphocytes and CEC increased, immunoregulatory index remained below normal.

While, the main group of patients treated according to the claimed method, revealed positive dynamics of the immune indices. Decreased levels of CD8+lymphocytes, CD20+lymphocytes, CEC, increased level of CD4+lymphocytes and normal immunoregulatory index.

Table 6
Dynamics of indicators of free radical oxidation
IndicatorsThe main group (n=15)The comparison group (n=10)
before the treatmentafter 4 monthsbefore the treatment after 4 months
Superoxide dismutase in erythrocytes ($/mhnw)to 4.38±1,97to 11.79±1,884,46±1,854,99=2,03
Catalase plasma (µm H2O2/Minh l)46,79±2,2330,52±2,6146,51±2,4745,76±1,83

When estimating parameters characterizing the processes of free radical oxidation (CPO), were identified (table 6)that the patients in the comparison group that received treatment according to the prototype, the indicators characterizing the state of the SRO had not expressed positive changes; disturbances in antioxidant defense system of the body was preserved: the SOD activity remained low, and catalase plasma - enhanced. These violations contributed to the preservation of destructive changes in the lung tissue and the development of hepatotoxic reactions in patients in the comparison group, as products of free radical oxidation caused cytolysis of cells of the lung tissue and hepatocytes.

The main group of patients treated according to the claimed method, the activity of superoxide dismutase (SOD) increased to normal values, and the catalase activity of the plasma fell is up. Dynamics SRO showed improvement of the antioxidant defense system in the treatment of patients with destructive pulmonary tuberculosis according to the claimed method.

Thus, the claimed method of treatment of pulmonary tuberculosis patients can significantly improve the effectiveness of treatment in terms of resorption infiltration, closing cavities of decay and conversion, as well as to reduce the frequency of adverse hepatotoxic reactions to antituberculosis drugs, improve immune status and free radical oxidation.

A method for the treatment of patients with destructive pulmonary tuberculosis, providing TB treatment according to the standard modes, characterized in that from the first day in the course of treatment include oral medications Wobenzym and Thiotriazoline, with Wobenzym appointed within 4 months 1 tablet 1 time a day, 30 minutes before Breakfast, Thiotriazoline within the first 15 days at a dose of 100 mg 2 times a day, from the 16th to the 45th day at the dose of 100 mg 1 time per day, on the 46th day drug overturned.



 

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3 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to chemical-pharmaceutical industry, namely to pharmaceutical compositions and pharmaceutical kits for treating bacterial infections, and a new method for treating the diseases associated with bacterial infections, including tuberculosis. A pharmaceutical composition containing Rifalazil as rifamycin and Cycloferon as an interferon inducer in pharmacologically effective doses. The invention also concerns a pharmaceutical kit for treating the diseases caused by bacterial infections. The kit comprises rifamycin in pharmaceutically effective doses in the form of tablets, capsules or injections. Cycloferon is presented in the form of tablets, capsules or injections; instructions for administering the ingredients of the same pharmaceutical kit are also provided.

EFFECT: preparing the pharmaceutical compositions and pharmaceutical kits for treating bacterial infections, and presenting the new method of treating the diseases associated with bacterial infections, including tuberculosis.

4 cl, 2 dwg, 8 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to medicine and pharmaceutical engineering, and concerns a combined antituberculous remedy containing isonicotinic acid hydrazide (isoniaside) and 2-benzylbenzimidazole (dibazol), and a polymer carrier that is an interpolymer complex of poly(meth)acrylic acid and polyethylene glycol, as well as a method for preparing it.

EFFECT: antituberculous remedy according to the invention has bacteriostatic and bactericidal action on tuberculosis mycobacteria; it provides the continuous maintainance of the active substance concentration at the therapeutically effective level; it causes no considerable blood variations; it is 2,5 times less toxic than isoniaside, and 10 times more active than isoniaside.

7 cl, 1 dwg, 11 tbl, 16 ex

FIELD: medicine.

SUBSTANCE: invention refers to veterinary science. Using ORF-2 PCV-2 protein for preparing an immunogenic composition applicable for relieving concurrent infections caused by one or more viral (e.g. PRRS), bacterial and/or fungal pathogens (e.g. Actinobacillus pleuropneumoniae, Haemophilus parasuis, Mycoplasma hyrhinis, Mycoplasma hyopneumoniae, Pasteurella multocida, Salmonella spp., or Strepococcus suis) different from PCV2 in pigs or pig herds with a percent of the concurrent infections in relation to one or more infections are reduced by more than 10% as compared to an unvaccinated reference group.

EFFECT: relieving the concurrent infections caused by one or more viral (eg PRRS), bacterial and/or fungal pathogens.

8 cl, 2 tbl, 1 ex, 11 dwg

FIELD: chemistry.

SUBSTANCE: invention relates to chemical-pharmaceutical and food industry and specifically to production of powdered and encapsulated forms of preparations, having antihypoxic and antioxidant action. The molecular complexes are capable of solubilisation in water and are more stable (protected from oxidation) compared to water-insoluble and rapidly oxidisable free reduced coenzyme Q10. Also disclosed is a method of producing said substance, which contains "reduced coenzyme Q10 - β-cyclodextrin" complexes, which comprises consecutive steps of (i) obtaining a reduced form of coenzyme Q10 in the presence of excess ascorbic acid; (ii) mixing the reaction solution obtained at step (i) with aqueous solution of β-cyclodextrin to obtain molecular inclusion complexes; (iii) cooling and crystallising the mixture obtained at step (ii) and removing solvent and water.

EFFECT: substance obtained according to the present invention is a biologically active powdered form of sufficiently stable molecular inclusion complexes of the reduced coenzyme Q10 in β-cyclodextrin with particle size of up to 70-100 mcm, which is tenfold less capable of oxidation compared to free reduced coenzyme Q10 and is easily transferred in an aqueous solution into a solubilised form with particle size of 200-700 nm.

15 cl, 5 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: group of inventions refers to medicine and chemical-pharmaceutical industry. The group of inventions refers to pharmaceutical composition for local application and containing an active ingredient presented by superoxide dismutase as a part of cross-linked methoxy-poly(ethylene glycol)-poly(L-lysine) block copolymer nanoparticles, as well as to a method of treating inflammatory eye diseases using the given pharmaceutical compositions. The active ingredient content in the composition makes 50-500 kUnit/ml. The composition can be presented in the form of eye drops or a spray. In addition, the composition contain antibiotics, steroids, adrenoreceptor blocking agents, macro- and microelements, and vitamins.

EFFECT: group of inventions provides the intensified and prolonged anti-inflammatory action of superoxide dismutase on the eye diseases related to inflammatory processes.

7 cl, 1 dwg

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceutical industry and represents a composition for treating wounds, ulcers, erosions, burns, freeze burns adhesions, as well as infections caused by the gram-positive and gram-negative bacteria Staphylococcus spp., Streptococcus spp., Enterococcus spp., Shigella spp., Escherichia spp., Salmonella spp., Proteus spp., Acinetobacter spp., Citrobacter spp., Pseudomonas spp., Serratia spp., Klebsiella spp., Antracoides spp., Cryptococcus spp., pathogenic fungi of the genera Microsporum, Trichophyton, Nocardia, Aspergillus, yeast-like fungi of the genus Candida (including the multiresistant strains), as well as Actinomycetes and some pathogenic protozoa (Entamoeba histolytica, Trichomonas vaginalis), containing an active ingredient in the form of 0.001-5.0 wt % of collagenase, 0.001-5.0 wt % of lysozyme and/or 0.001-5.0 wt % of sangvitirine, and an carrier in the form of 0.05-1.0 wt % of p-cyclodextrine or liposomes, and acceptable excipients.

EFFECT: invention provides stability and maintained enzymic activity for a long period of time, deep penetration into an affected skin area, potentiated complex antimicrobial and anti-adhesion action.

2 cl, 10 ex, 4 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to medicine and deals with pharmaceutical composition for local application in form of gel, which contains enzyme deoxyribonuclease (DNA-ase) and/or ribonuclease (RNA-ase) and liposomes, which can be applied in medicine for treatment and prevention of viral infection.

EFFECT: invention ensures obtaining stable pharmaceutical compositions.

1 cl, 7 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to oncology and can be used to determine progression of cancer of abdominal cavity organs. For this purpose dynamic examination of patient after surgical treatment is carried out. Change of patient's body composition is determined at the background of nutritive-metabolic therapy 1 time per not less often as 28-30 days by means of bioimpedance analysis. Body weight, index of body weight, fat mass, as well as mass of extracellular liquid are assessed. If body weight, index of body weight decrease and/or fat mass decreases with simultaneous increase of extracellular liquid mass in comparison with the previous results of bioimpedance analysis, progression of cancer of abdominal cavity organs in patient is determined.

EFFECT: method ensures 100% accuracy of early determination of tumour progression in patients before X-ray manifestation, which provides possibility of earlier start of chemo-radiotherapy and prolong patient's life span.

2 tbl, 2 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to medicine and concerns a composition for local application containing the enzyme ribonuclease and stearyl glycyrrhetinate or a glycyrrhetinic acid or a salt thereof: ammonium or dipotassium or trisodium glycyrrhizinate, and acceptable carriers or excipients to be used in medicine for treating and preventing viral infections.

EFFECT: invention provides preparing the stable compositions maintaining the enzymatic activity for five years.

1 cl, 7 ex, 1 tbl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to pharmaceutics and medicine, namely to a pharmaceutical composition for topical administration used to prevent the viral infections caused by DNA-containing viruses. As active ingredients, the pharmaceutical composition contains 0.001-5.0 wt % of deoxyribonuclease (DNA-ase) and 0.000001-5.0 wt % of alpha-fetoprotein and 0.001-5.0 wt % of glycyrrhizinic acid or a salt thereof: ammonium or dipotassium or trisodium glycyrrhizinate; the carriers are as follows: β-cyclodextrins 0.001-5.0 wt %, 0.05-1.0 wt % of a polymer carrier, and pharmaceutically acceptable carriers or excipients. In addition, the composition can contain 0.001-5.0 wt % of dexpanthenol or sangviritrin, 0.001 -5.0 wt % of ascorbyl palmitate or escin.

EFFECT: invention provides improved stability, potentiated complex antiviral effect.

2 cl, 6 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to ophthalmology, and deals with treatment of acute optic neuritis. Method includes introduction of traumeel sublingually in dose 1 pill three times per day, lymphomyosot in dose 10 drops in 50-100 ml of water three times per day for 3 weeks. Also made are 10 injection cpurses of the following medications: traumeel in dose 2.2 ml every second day, cerebrum compositum in dose 2.2 ml two times per week with 3 day interval, coenzyme compositum in dose 2.2 ml two times per week with 3 day interval, hepar compositum in dose 2.2 ml two days per week with 3 day interval. Method includes carrying out hirudotherapy by application of 2-3 leeches on the region of temple and behind ears two times per week for two weeks.

EFFECT: method ensures recovery of vision acuity, elimination of absolute and relative scotomas, recovery of colour perception, normal picture of eye fundus, as well as elimination of all signs of inflammation, elimination of pain during movement of eye balls, improvement of health state.

1 ex

FIELD: medicine.

SUBSTANCE: hyaluronidase immobilised on polyethylene glycol is introduced into laboratory animals intranasally in a dose of 16 units. Hyaluronidase is introduced once a day on 1st, 3rd, 7th and 10th day after administering bleomycin that is a pulmonary fibrosis simulation factor.

EFFECT: higher pulmonary tissue resistance to fibrotic depositions, including prevents a reverse process of fibrosis formation ensured by the properties of pegylated hyaluronidase and developed mode of its administration that leads to a prolonged antifibrotic effect with low toxicity and immunogenicity of the effects on the body.

1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely neurology, and may be used for treating lumbar and cervical intervertebral hernias. That is ensured by conducting a dispersion therapy by injections of drug preparations exhibiting the enzymatic properties. That is followed by a combined exposure to a constant magnetic field and low-power pulse visible and near-infrared light emission. The dispersion therapy involves arresting an acute pain with diprospan 2 ml. Further, a mixture of Traumeel C 10 ml and Chymotrypsin 10 mg or Lydase 64 IU with Chymotrypsin and Lydase alternated is administered 7-10 times twice a week. Herewith, the epidural puncture is slow for 30-60 seconds at the level of a cicatrical process and a hernia-involved disc segment to provide the infiltration of the scar epidural subcutaneous fat at the level of epiduritis. What is used therefor is a fine needle with the skin pre-anaesthetised. The anaesthetic solution is administered intermittently in a dose of 2-3 ml every 40-60 sec.

EFFECT: method enables making the process of hernia dispersion as fast as possible and reducing a probability of a recurrence accompanying the non-operative treatment of the intervertebral hernia.

1 cl

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to the field of pharmaceutics, namely represents compositions for treating nail and nail bed diseases and methods of treating nail diseases.

EFFECT: claimed compositions do not form a film when applied on the nail surface and contain a carrier, in which suspended, dispersed or emulsified are all components of the composition, a non-volatile solvent, a moistening preparation and a pharmaceutically active ingredient, soluble in the non-volatile solvent and/or in a mixture of the carrier and the non-volatile solvent, with the composition being efficient in treatment of nail or nail bed diseases.

30 cl, 2 dwg, 4 tbl, 5 ex

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