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INVENTION
Patent of the Russian Federation RU2260439
METHOD OF TREATMENT OF SLUDGE-SYNDROME IN PATIENTS WITH CHRONIC
THE CHRISTMAS CHOLECISTITIS
The name of the inventor: Sizykh.
(RU); Kovaleva L.P. (RU); Songolov V.I.
The name of the patent holder: Sanatorium-and-spa establishment of trade unions of the Republic of Buryatia Resort "Arshan"
Address for correspondence: 664057, Irkutsk, pr. Zhukova, 86, ap. 86, L.P. Kovalyleva
The effective date of the patent: 2003.08.28
The invention relates to medicine, namely, to gastroenterology. Preliminarily determine the type of disturbance of the motility of contraction of the gallbladder and bile ducts, then assign a thermal, low-mineralized bicarbonate-sodium-sulphate-calcium magnesium mineral water to 200-300 ml three times a day one hour before meals, tumbles No. 3 with mineral water, baths and Shower with mineral water daily for 10-14 days. In the hypomotor type of motility, mineral water is used at 25-30 ° C, and for the hypertonic type - 38-40 ° C. The method allows to reduce pain syndrome, reduce astheno-depressive syndrome, reduce the sluggish syndrome.
DESCRIPTION OF THE INVENTION
The present invention relates to the field of medicine, namely, to physiotherapy and sanatorium treatment.
Sludge syndrome or bile sediment was first described in the 70s of the 20th century after the introduction of ultrasonic scanning into medical practice. By chemical composition, the bile precipitate consists of crystals of cholesterol monohydrate, calcium bilirubin granules or other calcium salts encapsulated in mucus bands. The formation of the sludge syndrome depends on the physicochemical relationships of the bile components, on the malfunction of the gallbladder mucosa and its contractility. The pathogenesis of the bile sediment is similar to the formation of gallstones.
A method for treating the syndrome by prescribing ursodeoxycholic acid is known (see Shiffinan ML, Kaplan GD, Brinkman-Kaplan V., Vickers FF Prophylaxis against gallstone formation with ursodeoxychohc acid in patients participating in avery-low-calorie diet program. Med. - 1995. - Vol.l22. - P.899-905.). However, the course of treatment is long, for several months and the effect of treatment is 30%.
The closest is the method by which mineral water \ Svetlanovsky \ is administered in combination with drug therapy of 200 ml 45 minutes before meals three times a day. (See Belyaev AG The effectiveness of the use of mineral water \ Svetlanovsky \ in the treatment of patients with chronic cholecystitis: clinical and biochemical, functional and morphological aspects. / Abstract of the diss ... Kan., Saratov, 2000, S. 19). However, this method has low efficiency of treatment of the sludge syndrome and is time-consuming.
The technical result of the proposed method of treatment is to increase the effectiveness of treatment.
New in achieving the set result is that the type of impairment of the motility of contraction of the gallbladder and bile ducts is predetermined.
New is also the fact that a thermal low-mineralized hydrogencarbonate-sodium-sulphate-calcium magnesium mineral water is prescribed for 200-300 ml three times a day one hour before meals, tumbles with mineral water No. 3, baths and showers with mineral water daily for 10-14 days, with the hypomotor type using mineral water 25-30 ° C, and with hypertonic motor type - 38-40 ° C.
The purpose of thermal low-mineralized hydrogencarbonate-sodium-sulphate-calcium magnesium mineral water provides an increase in the effectiveness of treatment due to elimination of the bile sediment.
The use of mineral water of elevated temperature provides a normalizing effect, and low temperature - a stimulating effect, which increases the effectiveness of treatment of the sludge syndrome.
Comparative analysis with the prototype shows that the proposed method is different in that the type of impairment of the motility of contraction of the gallbladder and bile ducts is predetermined, then a thermal low-mineralized hydrogencarbonate-sodium-sulphate-calcium magnesium mineral water is prescribed for 200-300 ml 3 times a day for one Hour before meals, tumbles with mineral water No. 3, baths and showers with mineral water daily for 10-14 days, with a hypothetical type using mineral water 25-30 ° C, and with a hypertonic type - 38-40 ° C, which Meets the criterion of invention \ novelty \.
A new set of characteristics provides an increase in the effectiveness of treatment of the sludge syndrome, which corresponds to the criterion of the invention \ industrial applicability \.
The method for treating the syndrome is as follows.
A total of 72 patients with chronic acalculous cholecystitis were treated, including 57 women, 15 men, with an average age of 40.7 ± 8.9 years. All patients on admission to treatment are ultrasonically scanned to diagnose bile sediment. The diagnosis is verified on the basis of complaints, anamnesis, examination, data of sanatorium-resort cards, traditional clinical and laboratory research. Ultrasonic scanning is performed on an empty stomach with a preliminary twelve-hour fasting. As a cholagogue stimulant, a thermal, low-mineralized, hydrocarbonate-sodium-sulphate-calcium magnesium mineral water with a low content of silicon and iron in an amount of 200 ml of room temperature is taken. The following parameters are examined before treatment and after treatment: the position, shape, magnitude, condition of the external and internal contours of the gallbladder, the thickness of the walls, additional inclusions in the cavity of the gallbladder, contractility, bile ducts. All patients are prescribed a diet according to Pevzner, the intake of mineral water, which in its chemical composition is similar to that of Kislovodsk \ Narzan \, is a slightly mineralized carbon dioxide, bicarbonate magnesium-calcium slightly iron. Hydrocarbonates predominate among the anions, and calcium and magnesium among the cations. And mineral water contains undissociated molecules - carbonic anhydride, silicic acid. Water is prescribed for 200-300 ml 3 times a day for one hour before meals. And all patients are prescribed tjubazhi №3 for treatment with mineral water and mineral showers and mineral baths every day for 10-14 days, phytotherapy, light therapy, exercise therapy according to the indications. In all patients cholecystitis is in a state of remission, so antibiotic therapy is not performed. After treatment, all patients noted pain relief, complaints of vomiting, bitterness in the mouth decreased three-fold, asthenodepressive syndrome decreased 4-fold, the sludge syndrome disappeared in every third patient and decreased by 1.5-2.0 times. The proposed method is explained by the following clinical example.
B-naya F., East. Bol. № 2550, 33 years old, was on treatment at the sanatorium \ Sayany \ with the following diagnosis: Chronic antral gastritis, remission stage, chronic cholecystitis, remission stage. She complained of gravity in the right hypochondrium after inaccuracies in the diet, constipation.
When entering the treatment of a patient, the FGD is conducted. Conclusion: erosive bulbite. UZS: liver (anteroposterior size) - 14.4 cm, structure of enhanced echogenicity, gallbladder volume before intake of mineral water 35 cm 3 , after 15 minutes 34.22 cm 3 , after 40 minutes 21.6 cm 3 , wall thickness 0,8 cm, the contents of the gallbladder - a sediment thickness of 0.8 cm. Conclusion: chronic acalculous cholecystitis, pronounced hypotension of the gallbladder, a sluggish syndrome. The treatment was carried out: Diet No. 5 for Pevzner, mineral water intake 200 ml 3 times a day for 1 hour before meals, water temperature 25 ° C, carbonate baths every day, circular shower with mineral water every day, tuberculosis No.3, LFK. The course of treatment is 14 days. After the treatment, the patient did not present any complaints, the control UZS: liver 12.8 cm, homogeneous, the volume of the gall bladder before receiving water 13 cm 3 , after 15 minutes 9.5 cm 3 , after 40 minutes 8.0 cm 3 . The thickness of the gallbladder wall is 0.7 cm, the content is homogeneous. Conclusion: chronic acalculous cholecystitis of the hypomotor type.
Example 2. Patient T., ist. Disease number 2278, 45 years old, was on treatment at the resort \ Arshan \ with the guideline diagnosis: Chronic galloping cholecystitis with hypomotor function of the gallbladder, in remission. The patient received complaints about periodic epigastric pains, pressing pains in the right hypochondrium after taking fatty, fried foods, rumbling in the abdomen. The USS revealed: a liver (anteroposterior size) of 12.8 cm, homogeneous. The gall bladder before taking mineral water \ Arshan \ 7.7 x 2.2 cm, after 40 minutes 5.5 x 2.1 cm, the wall thickness of the gall bladder is 0.5 cm, the contents are 0.7 cm thick. Conclusion: Chronic cholecystitis of the hypomotor type, sludge syndrome. The patient was treated: a diet according to Pevzner №5, reception of mineral water \ Arshan \ 300 ml for 1 hour before meals, temperature 30 ° C, mineral baths every day, circular shower with mineral water every day, tumbles with mineral water No. 3, electrophoresis with Mineral water on the right hypochondrium.
After the treatment, the patient did not present any complaints at the discharge. With UZS, the following dynamics was traced: liver 12.8 cm, homogeneous, gallbladder before receiving mineral water 7.1 x 2.3 cm, after 15 minutes 6.8 x 2.3 cm, after 40 minutes 6.0 x 2, 0 cm, wall thickness 0.5 cm, the content is homogeneous. Conclusion: chronic cholecystitis by hypomotor type.
CLAIM
A method for treating a sludge syndrome in patients with chronic acalculous cholecystitis by prescribing mineral water, characterized in that the type of impairment of the motility of contraction of the gallbladder and bile ducts is predetermined, then a thermal, low mineralized, hydrogencarbonate-sodium-sulphate-calcium magnesium mineral water of 200-300 ml 3 times a day for an hour before meals, tuffages No. 3 with mineral water, baths and showers with mineral water every day for 10-14 days, with the hypomotor type of motor used mineral water 25-30 ° C degrees, and in the hypertensive type - 38-40 ° С.
print version
Date of publication 28.01.2007gg
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