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DERMATOVENEREOLOGY
INVENTION
Patent of the Russian Federation RU2215535

METHOD FOR TREATMENT OF PATIENTS WITH A PSORIASIS IN COMBINATION WITH CHRONIC HYDROCHEMISTRY IN THE RESIDUAL PERIOD

METHOD FOR TREATMENT OF PATIENTS WITH A PSORIASIS IN COMBINATION WITH CHRONIC HYDROCHEMISTRY IN THE RESIDUAL PERIOD

The name of the inventor: Khardikova SA; Beloborodova E.I .; Pesterev PN; Kalyuzhina E.V.
The name of the patent holder: Siberian State Medical University; Khardikova Svetlana Anatolievna; Beloborodova Elvira Ivanovna; Peter Pesterev; Kalyuzhina Elena Viktrorovna
Address for correspondence: 634050, Tomsk, Moscow highway, 2, SSMU, Intellectual property department, Pat. N.G.Zubareva
The effective date of the patent: 2002.02.15

The invention relates to medicine, dermatology. Six to twelve months after deworming, a course of traditional psoriasis therapy is combined with the appointment of nicodine for 21 days. After a three-week break, appoint a biologically active supplement "Glimurid" of 0.1 mg on an empty stomach for 10 days. Then, after a three-week break, a second course of Glimurid therapy is administered, 0.1 mg in the morning on an empty stomach in conjunction with a holangogum. Over the next two years, treatment courses, including the reception of "Glimurid" and cholangum, are repeated with a break of 6 months. The method reduces the number of complications.

DESCRIPTION OF THE INVENTION

The invention relates to the field of medicine, dermatovenereology, and concerns methods of treating psoriasis patients in combination with chronic opisthorchiasis in the residual period.

To date, the data accumulated in the literature, indicating a significant shift in the immune status of psoriasis patients from both immune-regulatory and immune-effector links, allowing to consider this problem from the point of view of immunopathology [1, 2].

The method closest to the proposed method is the treatment of patients with psoriasis with the use of lycopene according to a certain scheme: the drug was administered in / m (the first dose was 0.00025 g, 7 consecutive days - 0.000125 g, followed by 8 injections of 0, 000125 g 2 times a week) [3]. This method was not used in patients with psoriasis in combination with chronic opisthorchiasis, as a result of which the scope of its use is limited, traumatic, since it is associated with the administration of the drug intramuscularly.

The new technical result - increasing the effectiveness of treatment of patients with psoriasis by reducing the number of complications is achieved using a new method of treatment of psoriasis patients in combination with chronic opisthorchiasis in the residual period, which is the appointment of an immunomodulator, and 6-12 months after deworming, a biologically active food additive is prescribed " Glimurid. " 6-12 months after deworming, a course of traditional psoriasis therapy is prescribed in conjunction with the appointment of nicodine 0.5 g 3 times daily before meals for 21 days and then after a three-week break appoint a biologically active food supplement "Glimurid" at 0, 1 mg in the morning on an empty stomach for 10 days and then after a three-week break, the second course of Glimurid therapy is administered to 0.1 mg in the morning on an empty stomach for 7 days in combination with the reception of holagogum 1 capsule 3 times a day and for two years the courses Treatment, including the reception of "Glimurid" and holagogum repeat with a break of 6 months.

The method is carried out as follows

In 6-12 months after deworming, the patient receives outpatient treatment of psoriasis: desoxication therapy (30% solution of sodium thiosulfate 10 ml iv 10), antihistamine therapy (1 tablet 1x daily 7-10 days) Vitaminotherapy (multivitamins "Centrum" 1 capsule once a day for 30 days), sedatives (sibazone 1 tablet per night for 20 days). Outer: indifferent ointments and creams.

And the patient undergoes general clinical examination (general blood test, general urine analysis, biochemical blood test), immune status examination, ultrasound of the liver and gallbladder, duodenal sounding.

The patient receives nicodine 0.5 g 3 times daily before meals for 3 weeks.

After a three-week break, the patient is prescribed a dietary supplements (biologically active supplement) for food Glimurid, 0.1 mg in the morning on an empty stomach for 10 days. Then after 3 weeks the patient undergoes the second stage of treatment, which includes taking the supplements to food "Glimurid" of 0.1 mg in the morning on an empty stomach and holagogum 1 capsule 3 times a day for 7 days. Within 2 years, treatment courses involving the reception of "Glimurid" and holagogum are repeated with a break of 6 months.

Food supplements "Glimurid" is a derivative of the muramyl dipeptide (MDP) - heptylglycoside - MDP. The main component of "Glimurid" is the original synthetic derivative of peptidoglycan A of the cell wall of a number of bacteria. It has a pronounced stimulating effect on the basic cellular populations involved in the anti-infectious and antitumoral immune response. "Glimurid" is recommended for use in the treatment of diseases accompanied by inhibition of immunity. The Commission on Preparations of Natural Origin of the Pharmacological State Committee of the Ministry of Health of the Russian Federation for 135 of 11.11.1997 as a biologically active additive (BAA) for food. The products of the Glimurid LHC are certified at the Institute of Nutrition of the Russian Academy of Medical Sciences 7772.09.916.П.04 809.11.97. From 27.11.1997. Its properties are described: patent 2121363 dated 10.11.1998. "Immunomodulators and pharmacokinetic composition with antitumor activity" - authors O.V. Kalyuzhin, M.V. Scale, patent 2118497 from 10.09.1998. "Food additive" - ​​authors O.V. Kalyuzhin, M.V. Scale. Produced in the form of capsules containing 0.1 mg of active substance (heptyl glycoside-MDP) and 400 mg of maltodextrin as a filler. "Glimurid" is recommended to take courses of 1-2 capsules per day (in the morning before meals) for 10-20 days. If a longer exposure to the body is required, the intervals between doses are increased to 2-3 days.

The proposed treatment regimen, doses of drugs, sequence and mode of their use were selected on the basis of clinical observations of 11 patients.

Before the treatment and 10 days after the end of treatment, the immune status is examined.

After de-worming, it should take 6-12 months, because at this time there is a stabilization of the bile excreting and immune systems. The appointment of nicodine, which possesses choleretic and bactericidal action, allows in a short time to stop inflammatory phenomena in the gallbladder. The dose of nicodine 0.5 g 3 times daily before meals 3 weeks is necessary and sufficient for patients with psoriasis in combination with chronic opisthorchiasis. Appointment at the first stage of dietary supplements to food "Glimurid" allows you to eliminate the dysfunction of the immune system, which allows you to eliminate the inflammatory process in the bile ducts in a shorter time. The appointment of "Glimurid" 1 capsule (0.1 mg) for 10 days was selected to reduce the drug load in this category of patients. Break 3 weeks between taking medications is justified, since this time is enough to adapt the immune system. This is confirmed by clinical observations of this category of patients. After the study of the immune status in the second stage, the positive effect of the effect on both the immune system and the condition of the gallbladder is determined by the appointment of a cholagogic preparation of hologagum that does not possess a bactericidal effect, since by this time the signs of an aggravation of the inflammatory process in the biliary tract are being stopped, gallbladder. The second course of dietary supplements for food Glimurid 0.1 mg and holagogum 1 capsule 3 times a day for 7 days is necessary and sufficient for this category of patients. Conducting repeated courses of treatment, including the intake of dietary supplements for food "Glimurid" and hologagum, for two years with a break of 6 months is necessary to improve the stability of the therapeutic effect.

An example of the implementation of the method on the patient.

Patient TA, 28, appealed to the dermatologist OKB with the diagnosis: Psoriasis, drop-shaped, plaque, progressive stage, common, autumn-winter.

She has a history of psoriasis for about 6 years, 8 months ago, an effective treatment for chronic opisthorchiasis. It should be noted the tendency to frequent colds, allergy to certain drugs.

However, the patient complains of gravity in the right hypochondrium, nausea, bitterness in the mouth.

The last exacerbation of psoriasis appeared 10 days ago, after emotional and mental stress.

The patient was treated with psoriasis according to the traditional scheme:

Detoxification therapy (sodium thiosulfate 30% 10 ml 10), antihistamines (kestin 1 tablet once a day for 10 days), vitamins (Aevit 1 capsule 2 times a day for 30 days), sedatives (new-passit by 1 Table spoon 3 times a day for 30 days). Outwardly: Unna cream. At the same time, the patient received nikodin 0.5 g 3 times daily before meals for 3 weeks.

An outpatient general clinical study, an ultrasound study, a duodenal sounding, an examination of the immune status were carried out.

In the general analysis of blood and urine without changes. Biochemical blood test within normal limits.

According to chromatic minuted duodenal sounding, dyskinesia of the bile ducts was revealed in the hypomotor type: the gallbladder bleed in a large volume to 100 ml (at a rate of 60 ml) and its expiration time was extended to 41 min (at a rate of 21 min). The hypotension of the sphincter of Oddi is revealed.

According to the microscopy of bile, the eggs of opisthorchis were not found. According to ultrasound, signs of chronic acalculous cholecystitis, cholangitis are found. The volume of the gallbladder was significantly increased and amounted to 80 cm 3 (at a rate of 40-60 cm 3 ).

Immunogram: CD 3 0.89, CD72 0.34, CD4 0.50, CD8 0.39, CD4 / CD8 1.28, CEC 147, IgA -3.6, IgM 5 , 0, Ig G-19.5, NST-test-spontaneous-0.04, stimulated-0.12.

Objectively: Normostenic physique. On the skin in the region of the scalp, elbows, knees, torso of the papule are pink-brown, merging into plaques covered with silver-white scales that are easily removed when scraping. Psoriatic triad is positive (the phenomenon of stearin stain, the phenomenon of psoriatic film, the phenomenon of pinpoint bleeding). The tongue is coated with a white bloom. In the lungs and heart without pathology. The abdomen is soft, palpation in the right hypochondrium moderately painful. Positive symptoms of Keri and Murphy.

Thus, the patient is diagnosed: Chronic non-calculous cholecystitis in the stage of moderate exacerbation. Dyskinesia of bile ducts in hypomotor type. Residual period of chronic opisthorchiasis. Concomitant diagnosis: Psoriasis, teardrop-plaque, stationary stage, common, autumn-winter.

A week after the end of the trazedion therapy of psoriasis, the patient underwent the following treatment: a biologically active food supplement "Glimurid" of 0.1 mg in the morning on an empty stomach for 10 days.

In the immunogram: an increase in CD3 to 1.10, CD4 to 0.60, immunoregulatory index to 1.5, the level of the CEC decreased to 90, IgA to 3.0.

After a 3-week break, a second course of treatment with Gliimuride was carried out, 0.1 mg in the morning on an empty stomach and simultaneously holagogum 1 capsule 3 times a day for 7 days.

The patient underwent treatment well. Appearance of rashes on the skin, itching was noted. The sensations of heaviness in the right hypochondrium disappeared, there was no feeling of nausea, bitterness in the mouth. At the end of the treatment, repeated duodenal sounding, ultrasound examination, and immunogram were performed. According to fractional duodenal sounding, the volume of cystic bile and its expiration time were normalized to 61 ml (at a rate of 60 ml) and 22 min (at a rate of 21 min). According to ultrasound, the volume of the gallbladder was 54 cm 3 , which is the norm. The skin process was in the regression stage. In the immunogram: CD3 - 1.11, CD72 - 0.34, CD4 - 0.71, CD8 - 0.40, CD4 / CDS - 1.7, CEC - 75, Ig A - 2.5, Ig M - 2 , 2, Ig ​​G - 14,4, НСТ - test - spontaneous - 0,06, stimulated - 0,18.

The patient was repeated for 2 years after 6 months of the Glimurid and Holagogum reception courses. During the observation period for 2 years, the patient had no signs of exacerbation of cholecystitis and psoriasis. In the immunogram without pathological changes.

In this way 11 patients with psoriasis were treated after treatment of chronic opisthorchiasis. Treatment patients were well tolerated, there were no side effects on taking medications.

The results of the study of the immune status are presented in the table.

As can be seen from the data presented in the study group of patients, there was a significant improvement in the parameters in the immunogram: an increase in CD3, CD4, an increase in oxygen-dependent neutrophil metabolism according to the HCT test, a decrease in the level of the CIC, Ig A and Ig G. A trend towards an increase in the immunoregulatory index was noted. Thus, in the studied group of patients it was possible to achieve clinical remission of cholecystitis, as well as psoriasis.

So, the application of the proposed method of treatment of patients with psoriasis in combination with chronic opisthorchiasis allows to achieve a positive effect on cellular and humoral immunity, including on the phagocytic activity of neutrophils, which undoubtedly contributed to the coping of the inflammatory and dyskinetic process in the biliary tract and the inflammatory process in the skin of patients with psoriasis .

Thus, the proposed scheme of treatment allows to achieve the desired positive effect, namely, to increase the effectiveness of treatment of patients with psoriasis, to reduce the number of complications, to obtain a more pronounced and persistent therapeutic effect.

INFORMATION SOURCES

1. Mazina NM, Parastaev SA, Momalenko NB Immunological research in dermatology // Bulletin of Dermatology and Venereology.-1991.- 7.- С. 33-37.

2. Potekaev NS, Samgin MA, Kurdina MI Et al. Plasmapheresis in dermatological practice // Clinical medicine. 11.-P.84-86.

3. V. Yu. Udzhuhu, N.G. Short, A.E. Abdullaeva. Clinical efficacy of lycopida in patients with various varieties of psoriasis / / Diseases of the skin. Sexually Transmitted Infections. A collection of scientific works dedicated to the 80th anniversary of the Department of Dermatovenereology of the Irkutsk State Medical University. -2001. -FROM. 171-174.

CLAIM

The method of treatment of patients with psoriasis in combination with chronic opisthorchiasis in the residual period, including the appointment of an immunomodulator, characterized by the fact that 6-12 months after deworming, a course of traditional psoriasis therapy is prescribed in combination with the appointment of nicodine 0.5 g 3 times a day after meals For 21 days, then after a three-week break, appoint a biologically active food additive "Glimurid" of 0.1 mg in the morning on an empty stomach for 10 days and then after a three-week break, a repeated course of Glimurid therapy is administered 0.1 mg in the morning on an empty stomach during the fasting 7 days in combination with the reception of holagogum 1 capsule 3 times a day, and for two years the treatment courses, including the reception of "Glimurid" and holagogum, are repeated with a break of 6 months.

print version
Date of publication 01.04.2007гг