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INVENTION
Patent of the Russian Federation RU2195315
METHOD FOR TREATMENT OF ARVI IN CHILDREN OF THE FIRST YEAR OF LIFE
The name of the inventor: Feklisova LV; Shebekova V.M .; Tselipanova E.E .; Gopanyuk P.Ya.
The name of the patent holder: Moscow Regional Scientific Research Clinical Institute
Address for correspondence: 129110, Moscow, ul. Shchepkina, 61/2, MONIKI, Patent Group
The effective date of the patent: 2001.02.28
The invention relates to medicine, namely pediatrics, and can be used to treat ARVI in children of the first year of life. It is suggested additionally to complex therapy to prescribe instillation in the nose of influenza 3 times a day for 1000 IU with a course of 3-5 days. The method allows to increase the level of interferon in the blood, to improve the parameters of cellular and humoral immunity and to shorten the duration of ARVI manifestations by 1-2 days.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, in particular to the treatment of infectious diseases.
There are known methods of complex treatment of ARVI with the use of antiviral chemotherapy drugs: remantadine, arbidol; Donor immunoglobulins with an increased content of antiviral antibodies (VF Uchaikin, OV Shamsheva "Vaccine prophylaxis and treatment protocol for influenza in children." Information collection Vaccine prophylaxis of influenza, M. 1998, pp. 20-27).
However, these methods of ARVI therapy are most often used in severe forms of the disease in older children, drugs are limited to a narrow spectrum of antiviral activity, enter enterally and parenterally, ie, more traumatic.
As a prototype of the claimed method, a method for treating acute respiratory infections in children under 1 year of age (VKTatochenko, 3.I. Izvolskaya, AMFedorov et al., "Principles of treatment of acute respiratory diseases in children," methodical recommendations. , 1989, page 8), which includes complex therapy, which includes vitamin therapy, water regimen, distracting procedures, intranasal administration of leukocyte interferon 5 drops per each nasal passage (500 IU single dose), 1.5-2 hours during 3 days and other symptomatic means.
Being a fairly common nonspecific way of treating ARVI in children, it has a number of drawbacks: the preparation is made from donor blood, slightly concentrated (1 ml contains no more than 1000 ME), requires prior dilution before use, frequent instillation of a sufficiently large volume of the drug (0.25 Ml).
The task set by the authors is to eliminate these shortcomings, increase efficiency and reduce the duration of ARVI treatment in children of the first year of life by intranasal administration of the drug - influferon, which increases the level of interferon in the blood and secretory immunoglobulins in saliva.
For this, in the method of treatment of acute respiratory viral infections in children of the first year of life, including complex therapy, it has been proposed additionally to administer instillation into the nose of influenza 3 times a day for 1000 ME for 3-5 days.
The drug consists of the gene-engineered alpha-2 interferon and a filler (a mixture of polyethylene oxide, polyvinylpyrrolidone and trilon B), giving the drug a high viscosity, which increases the exposure of the action of interferon on the mucosa.
Grippferon possesses all the properties of interferon, is well purified, highly concentrated (a vial of a polymer material contains 10 ml of a drug with antiviral activity of 10,000 IU in ml, 500 IU in a drop).
The essential difference between the proposed method is that for the first time for the treatment of acute respiratory viral infections in children of the first year recombinant interferon-influferon prepared without using human blood is used, containing 10 times more alpha-2 interferon in 1 ml, which has a longer duration of action on the mucosa. It does not require a preliminary dilution and the use of a pipette, has a lower multiplicity of administration - 5 times less than the volume of a single dose.
Inclusion in the complex of therapeutic agents - influferon, which has a pronounced antiviral and immunomodulatory effect, promotes an increase in the level of interferon in the blood, improvement of some indicators of cellular and humoral immunity, allows to reduce for 1-2 days the duration of local manifestations of SARS and hospital stay, to prevent hospital re-infection ARVI.
The method is carried out as follows.
A sick SARS at the age of 1 year receives a comprehensive conventional therapy (rational drinking regime, vitamins, antitussives, antihistamines, antipyretics, if necessary antibacterial drugs). In addition, in an acute period of the disease for 3-5 days, the patient is punctured from the vial dropper in each half of the nose with 1 drop (500 ME) of influenza 3 times a day at intervals of 6-8 hours. After instillation, a light massage with the fingers of the wings of the nose is carried out to distribute the drug evenly in the nasal cavity.
The use of influenza promotes the intensification of therapy and improvement of the outcome of the disease, since acute respiratory viral infections in children under one year often take place in severe form with the development of complications and often have an unfavorable outcome. One of the reasons for the severe and complicated course of respiratory infections in children under one year is the interferon-forming capacity of blood cells, which is lower than in children older than 1 year and with adults (4-11 times), less its antiviral activity, rapid depletion of the interferon system (IFN). In addition, the features of immunological status in children under 1 year: low production of immunoglobulins (IgA, IgM, IgG), low phagocytic index of completeness of phagocytosis determine the increased vulnerability of the epithelium of the respiratory tract and contribute to the generalization of the viral process.
In addition, children of the first year of life have a greater number of factors that aggravate the premorbid background of the child of the first year of factors that act suppressively on the level of IFN in the blood and the immunological status.
The introduction of exogenous IFN is accompanied by stimulation of endogenous IFN production throughout the disease and prolonged up to several months, promotes increase of T and B lymphocytes level in the blood, enhancement of absorption and digestive function of neutrophils, increase of secretory IgA level on mucous airways.
Example 1
Child K-0 A, 8 months, medical history 16721.
Clinical diagnosis: SARS, stenosing laryngotracheitis 1 tbsp.
A child from 1 pregnancy, who had a toxicosis of 1 half of pregnancy, from premature birth in 37 weeks of weight 2460. From birth on artificial feeding, on a dispensary account with a neurologist for a PEP.
She got sick on 14.10.2000 sharply: a rise in temperature to 37.5-37.7 o , a runny nose. A few hours after the onset of the disease, there was a worsening of the condition due to the development of croup syndrome on the background of acute respiratory viral infection: hoarse voices, barking coarse cough, labored breathing. The ambulance was taken to the respiratory department.
The condition with a moderate admission, subfebrile fever, jugular fossa depression and shortness of breath on inspiration, dry, unproductive cough. Mucous oropharynx is hyperemic, rhinitis, respiration is carried out in all parts of the lungs, there is no rattling. Virological examination of smears from the nose with the method of immunofluorescence gave a negative result. The level of interferon in the blood is 20 IU / ml.
The child was prescribed at the first hour of hospitalization with influenza 1 drop in each nasal passage, 3 times a day and posidrome therapy: expectorant medicine, suprastin, acipol - enteral, alkaline inhalation, UHF on the larynx.
Grippferon was used for 5 days. A single dose of influenza was 1000 ME, daily - 3000 ME. The course dose is 15000 ME. Allergic reactions and side effects of influenza are not noted.
Against the backdrop of complex therapy using recombinant alpha interferon, the condition quickly improved. Stenosis of the larynx stopped in the first day, cough and rhinitis - 4 days after the start of treatment, catarrhal changes in the oropharynx - after 5 days.
No complications were noted. The level of interferon in the peripheral blood after treatment with influinone increased by 2 times - 40 IU / ml. The girl is discharged on day 6 of the illness in a satisfactory condition.
Example 2.
Patient A. A. 1 month, medical history N1553. Clinical diagnosis: acute respiratory viral infection, obstructive syndrome.
A girl from 1 pregnancy and childbirth that had a physiologically mixed feeding was acutely ill on September 28, 2000, when the temperature was raised to 37.5, a runny nose, a cough, and shortness of breath on exhalation. On the second day of the disease, she was hospitalized in a state of moderate severity. Pallor of the skin, decreased appetite, stuffy nose, wet with a viscous sputum cough. Mucous oropharynx hyperemic. Auscultatory over the surface of the lungs listened to a few dry and wet wheezing, the exhalation is elongated. A common therapy for acute respiratory viral infection with obstructive syndrome has been started: cefazodine v / m, suprastin, potion with eufilin enteralno, chest massage. Additionally, treatment with influferon. The drug was instilled in 1 drop in each nasal passage 3 times a day at intervals of 6 hours for 5 days. A single dose was 1000 ME, daily 3000 ME, exchange rate 15000 ME of interferon activity. Against the background of the therapy, the disease progressed smoothly, without complications. The temperature normalized in the first day, the effects of intoxication were short (2 days). Rhinitis, cough, hyperemia of the mucous membranes of the oropharynx stopped on the 5th day of treatment, obstructive syndrome was noted for 3 days. The girl was discharged on the 7th day of hospital stay in a satisfactory condition.
Comparative analysis of two groups of 45 patients with acute respiratory viral infection in the first year of life who received and did not receive influferon showed that the inclusion of influenza to complex treatment of acute respiratory viral infection reduced the duration of the temperature reaction by 1 day, rhinitis by 1.5 days, catarrhal changes in the mucous oropharynx and cough 2.5 days, the number of complications decreased by 11%.
CLAIM
The method of treatment of acute respiratory viral infection in children of the first year of life, including complex therapy, which is additionally instilled into the nose with influenza 3 times a day for 1000 ME for 3-5 days.
print version
Date of publication 06.01.2007gg
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