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INVENTION
Patent of the Russian Federation RU2133610
METHOD OF TREATMENT OF PSORIATIC ERYTHERDROME
The name of the inventor: R. Chilingirov; Molochkov VA; EM Lezvinskaya; Mostakova N.N.
The name of the patent holder: Moscow Regional Research Clinical Institute (MONIKI)
Address for correspondence: 129110, Moscow, Schepkina 61/2, MONIKI, Patent Group
Date of commencement of the patent: 1996.01.30
The invention relates to medicine, namely, to dermatology. The essence of the invention consists in the introduction of a proteolysis inhibitor in an amount of 10,000 to 150,000 units in combination with heparin in an amount of 2500 to 5000 units per one puncture daily for at least 5 to 7 days. The medicinal mixture is introduced into the lymphatic system. The method allows to restore the functions of the lymphatic system, to stop total intoxication, while the patient's stay in the hospital is reduced. The method has no contraindications and allows to achieve long-term results.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely, to dermatology.
A method for the treatment of patients with frequently relapsing psoriasis is known, including the administration of intravenous autoplasm (Authorship of the USSR No. 1220661, IPC A 61 K 35/16, published in 1986).
The disadvantage of this method is the absence of influence on the increased level of tissue and plasma proteases, on severe general intoxication of the body, on rheological disorders and changes in the coagulating system of lymphatic blood. The introduction of previously harvested autoplasm can lead to an autoimmune reaction to components specific for the psoriatic process. This method has no anti-inflammatory and antiproliferative effect.
There is also a known method for treating disseminated psoriasis, including treatment of lesions with a cryoprotectant and sectoral cryodestruction alternating with hemosorption (Patent of the Russian Federation No. 2,036,667, IPC A 61 M 1/36, published in 1995).
The drawback of this method is that most of the sorbents used with hemosorption are highly selective, and this leads to the elimination of blood components. Sorbents inactivate the uniform elements (erythrocytes, platelets, lymphocytes) of blood, create the danger of embolism. The use of sectoral cryodestruction stretches the duration of treatment for a long time. The method has no anti-inflammatory and antiproliferative effect.
The closest is the method of treating psoriatic erythroderma through the administration of medications (see Skin and Sexually Transmitted Diseases, edited by Yu.K. Skripkin, vol.2.225).
The disadvantage of the known method is that with prolonged corticosteroid therapy, along with the anti-inflammatory effect, there is pronounced immunosuppression, which leads to severe complications. In addition, with prolonged use of corticosteroids, after withdrawal of drugs, there is a "withdrawal syndrome". In this regard, a gradual, prolonged for a long time, a reduction in the dose of the drug is necessary. Corticosteroids have a number of contraindications, do not provide long-term remission.
The task set by the authors is to eliminate these drawbacks due to the possibility of implementing a pathogenetically grounded therapy that allows the development of a destructive process to create conditions in which interstitial tissue is flooded with releasing enzymes, protein and bacterial prostheses and biologically active substances (histamine, serotonin, kinin), most From which they enter the lymphatic microcirculatory channel.
It is proposed in the method of treating psoriasis by administering drugs, using a proteolysis inhibitor in an amount of 10,000 - 150,000 units (in a volume of 1-15 ml) in conjunction with heparin in an amount of 2500-5000 units (in a volume of 0.5-1.0 ml) per One puncture daily for at least 5 to 7 days, with the drug being introduced into the lymphatic system.
The fact that the medicinal mixture is injected directly into the lymphatic system (endolymphatic-intranodular), allows to restore the barrier, metabolic, immune, and drainage functions of the lymphatic system. This leads to a reduction in total intoxication and an increase in the content of trypsin-like proteases in the region of altered keratinocytes, and leads to the normalization of blood and lymph coagulation, fibrinolysis, kininogenesis, immune reactions, and the formation of biologically active peptides and hormones.
The method is carried out as follows
When a patient is diagnosed with psoriatic erythroderma, the administration of a medicinal mixture of a proteolysis inhibitor, which is predominantly gordox or countercane, with heparin, is administered, the mixture being administered endolymphatically (intranodularly).
For this purpose, the best, as practice shows, is the use of the lymph node of the inguinal region. The patient is placed on his back in a horizontal position. After processing the inguinal antiseptic, the forefinger and the thumb fix the palpable inguinal node. The latter is punctured with a needle perpendicular to the skin. The solution of the drug mixture is slowly added 1.0 ml for 4-5 minutes. At a small size of the lymph node the drug partially falls outside its limits. Nevertheless, as experimental studies have shown, it is always possible to create a sufficient therapeutic concentration of the drug in the regional lymphatic system. The dose of proteolysis inhibitor should be 10,000 - 150,000 units with the addition of 2,500-5,000 units of heparin per one puncture. Heparin makes it possible to enhance the antiproteolytic effect of injectable inhibitors. The course of treatment is carried out for at least 5 to 7 days.
Example 1
Patient N., 33 years old (patient number 6655/401) was diagnosed with psoriatic erythroderma. The condition is extremely difficult. The lymph nodes in the axillary and both inguinal areas, the acute-inflammatory erythema of the entire skin, the expressed skin infiltration with the phenomena of peeling, are enlarged. The ulnar, knee and ankle joints are enlarged in size, the movements are painful, the right lobe of the liver is increased by 5-6 cm.
The patient underwent a course of intranodular administration of a drug mixture of contrikal with heparin for 10 days. Contrikal was administered at a dose of 20,000 units, together with 5000 units of heparin per injection in the inguinal lymph node. In the course of treatment on the 2nd day, the total intoxication of the body was significantly reduced, which was expressed in the normalization of the liver, a decrease in erythema on days 3 to 4, and on the 4th-5th day, the infiltration and flaking of the skin decreased. After 10 days, the acute phase of erythroderma is almost eliminated. The patient was discharged in a satisfactory condition, with repeated examinations at 6 and 9 months, no impairment was observed.
Example 2
Patient S., 49 years old (historical bulle No. 16839) entered the diagnosis of psoriatic erythroderma, a state of moderate severity, a patient retarded, and adynamic. The patient is sick for 30 years, the exacerbation process is annual, remission is usually several months. The entire skin, Erythema of an inflammatory nature, infiltration and peeling are expressed. Enlarged inguinal lymph nodes.
The patient received a course of 10 injections daily. Intranodularly in the inguinal lymph node, 100,000 ED of GORDOX were administered along with 5,000 units of heparin per administration. On the 2nd day the general intoxication is removed, the patient is active, contact. On day 3 - 4, erythema significantly decreased, on the 5th - 6th day, the peeling ceased and the skin infiltration decreased. After 10 days, erythema is practically eliminated. The patient was discharged after 3 weeks in a state of recovery. With a dynamic observation during 6 months of relapse or exacerbation of the disease was not observed.
It should be noted that the proposed method allows to achieve a positive result in the treatment of psoriatic erythroderma of an extremely severe degree of the disease, the treatment is gentle, reduces the patient's stay in the hospital, has no contraindications and allows to achieve a long-term result.
CLAIM
A method for treating psoriatic erythroderma by administration of medicaments, characterized in that a patient is injected into the lymphatic system with a mixture of a proteolysis inhibitor of 10,000 to 150,000 units with heparin at 2,500 to 5,000 units per puncture daily for at least 5 to 7 days.
print version
Date of publication 01.04.2007гг
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