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INVENTION
Patent of the Russian Federation RU2150306
METHOD FOR TREATMENT OF ATOPIC DERMATITIS
The name of the inventor: EV Grishaeva ; Kokhan M.M .; Kungurov NV; Bazarny VV; Kurilko ON; Sokolovskaya A.A.
The name of the patent holder: Ural Scientific Research Institute of Dermato-Venereology and Immunopathology
Address for correspondence: 620023, Ekaterinburg, ul. Shcherbakova 8, UrNIIDViI
Date of commencement of the patent: 1996.08.27
The invention relates to medicine, namely, to dermatology, and is intended for the treatment of atopic dermatitis. Intravascular irradiation of the blood with laser radiation is performed. Aevit is prescribed for 1 week prior to intravascular laser therapy 1 capsule 3 times a day, and 2 capsules 2 hours before the procedure. The method allows to normalize the patient's immune status.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, viz., Dermatology, intended for inpatient and outpatient treatment of atopic dermatitis.
A method of pathogenetic immunomodulating treatment of patients with allergic dermatoses is known: intravascular irradiation of blood with low-intensity laser radiation.
Patients with eczema were given a course of 10 sessions of intravenous laser therapy (VLT) and traditional hyposensitizing, external therapy.
After the end of treatment, a positive clinical effect was observed in 100% of patients, but in 30% of patients with true eczema, the clinical effect was not accompanied by normalization of T-cell immunity at the end of the course of treatment; These indicators remained low and at discharge from the hospital / IV. Prokhoronkov, A.V. Carpenters. Application of intravascular laser therapy in the treatment of patients with eczema. Bulletin of Dermatology and Venerology, 1991, N 1, p. 34-97).
When analyzing the prototype, it is clear that the restoration of the immune status has not been achieved: none of the T-lymphocyte counts have reached the normal level. In addition, to assess the immune status, an inadequate laboratory test suite based on RCC counts, which is currently not recommended for evaluation of T and B lymphocytes, has been selected. The state of the humoral link of immunity is not taken into account.
The known method of VLT in the treatment of patients with allergic dermatoses does not lead to optimal normalization of the indices of the immune status, and it is necessary to improve it.
The drug Aevit is known, in one capsule (0.2 g) of which contains retinol palmitate 100000 ME and a - tocopherol acetate 0.1 g. Retinol (vit.A) - contributes to the improvement of tissue trophism, improves the rheological properties of blood, simulates the transmission of nerve impulses In synaptic structures. Vitamin A is necessary for the normal functioning of the liver (its endoplasmic reticulum), regeneration of the gastrointestinal mucosa, for the synthesis of steroid hormones. Retinol regulates the functional activity of immunocompetent cells, the synthesis of immunoglobulins, including secretory IgA and other factors of specific and non-specific defense (including interferon, lysozyme), activates the enzymes of lysosomes in phagocytes. Its photosensitizing properties are noted: a - tocopherol is an active antioxidant that oppresses and limits free radical reactions, which protects unsaturated fatty acids in lipids from peroxidation, and consequently, cell and subcellular membranes from damage. In addition, vitamin E stimulates the synthesis of hemo-containing proteins - hemoglobin, myoglobin, cytochromes (including cytochrome P-450), catalase. As a result, the respiration of tissues improves, synthetic processes intensify (the synthesis of proteins, including enzymatic, structural) increases, peroxide depleting membranes are removed.
Vitamin E reduces the toxicity of vitamin A and contributes to its effectiveness (VA Gusel, IV Markova, Pediatrician's Guide to Clinical Pharmacology, Moscow: Meditsina, 1990, pp. 43-45, 48-49).
The aim of the invention is to increase the effectiveness of the treatment of atopic dermatitis by obtaining a more pronounced immunocorrecting effect, which is achieved, taking into account the complex effect of Aevita on the body, the appointment of intravascular irradiation of blood with low-intensity laser radiation and the administration of Aevit.
The invention is implemented as follows: a patient on the background of traditional treatment (antihistamines, desensitizing, sorption, external therapy) appoint Aevit 1 capsule 3 times a day for 7 days. Then a course of intravascular laser irradiation of blood and Aevit is prescribed for 2 capsules 2 hours before the procedure for 10 days.
To carry out intravascular laser therapy, a gas helium-neon laser ЛТН-118А with a wavelength of 0.63 μm is used, the rays of which are passed through a fiber-optic quartz fiber with a diameter of 0.95 mm. The proximal end of the light guide is connected to the laser installation through a special docking assembly, and the distal one is inserted into the ulnar vein of the patient. The exposure of laser radiation is 30 minutes, the power at the end of the fiber is 1.5-2 mW, the course of treatment consists of 10 sessions, daily.
Tab. 1, which shows the intrinsic data of the dynamics of immunological indices in the application of aevit and VLT.
Tab. 2, which reflects the dynamics of clinical indicators of evaluation of the severity of blood pressure in the international system SCORAD. The results of the comparative analysis (Table 1 and Table 2) indicate that the marked clinical efficacy was accompanied by positive shifts in the immune status in the majority of patients with atopic dermatitis.
The use of the proposed method is explained by the following examples.
Example 1
Patient S., 32 years old. Diagnosis: atopic dermatitis, diffuse neurodermatitis in the acute stage. Beginning erythroderma. Secondary pyoderma. She is sick with this disease since childhood. Since the age of 25, exacerbation is 3-4 times a year.
The patient was repeatedly treated at the clinic of UrNIIDViI. Complex treatment of blood pressure was carried out, including desensitizing, detoxification, various external therapy with the use of a variety of corticosteroid ointments. Over the past 2 years, treatment with steroid hormones has been prescribed.
Along with this, in clinico-laboratory studies, a significant deviation from the norm from the main immunological parameters was found.
In particular, there was a decrease in the absolute number of T-lymphocytes, hyperimmunoglobulinemia, an increase in FAS. In peripheral blood - a high level of eosinophils. The patient is prescribed treatment with Aevitis and VLT. 1 capsule Aevita 3 times a day for 7 days, then the course of VLT and Aevit 2 capsules 2 hours before the procedure for 10 days. After the second procedure, the patient noted a decrease in itching, an improvement in sleep. There were no adverse reactions and complications.
In a state of clinical improvement, the patient was discharged on the 29th day of hospital stay.
In the repeated immunogram after the VLT and the administration of Aevitis, normalization of the immunological parameters was observed. In peripheral blood - the normalization of the number of eosinophils. The SCORAD index (international grade score of blood pressure) decreased from 72.62 (before treatment) to 26.9 (after treatment).
Example 2
Patient B., 19 years old. Diagnosis: atopic dermatitis, diffuse form, exacerbation stage. Secondary pyoderma. BP suffers from infancy. Frequent exacerbations of the skin process were combined with relatively short periods of remission, accompanied by a secondary pyoderma, aggravating the course of the underlying disease.
The skin process became resistant to the therapy. In the clinico-laboratory study in UrNIIDViI, an increase in IgA, FAS, and imbalance of T-lymphocytes was detected in the immunogram. In peripheral blood a high percentage of eosinophils. The patient was prescribed complex treatment with Aevit and VLT in the amount of 10 procedures. After the third procedure, the hyperemia and infiltration of the skin decreased significantly, the foci of pyoderma began to be resolved, fresh rashes did not appear. The patient noted reduction of itching and improvement of sleep.
After the 10th procedure, the patient noted the complete disappearance of the itch, the foci of pyoderma regressed completely.
In the state of clinical remission the patient was discharged on the 27th day of stay in the hospital.
Dynamic study of the immunogram of patient B. showed significant normalization of immunological parameters. Ball score of severity of blood pressure (SCORAD index) decreased from 82.7 - before treatment, to 16.02 - after treatment.
15 patients were treated in the UrNIIIDVI by the proposed method. During treatment, adverse events were not identified. The state of clinical remission was achieved in 15 of 15 patients, or 100% of patients. The duration of remission was 5 months.
When using AEVIT and VLT, the immunogram indices in dynamics were studied in 10 patients.
The evaluation of the immune status was carried out on the basis of discrete-dynamic analysis, which involves consideration of not individual parameters, but their ratio: T / V LF (CD3 / CD22), helpers / suppressors (CD4 / SD8). This approach revealed a marked imbalance of immunocompetent cells before treatment with inhibition of helper potential. Allergization of the body in this disease is reflected in pronounced eosinophilia. Hyperimmunoglobulinemia and activation of phagocytic activity of neutrophils indicate the presence of an inflammatory process.
After laser therapy and taking Aevit, the T / B ratio of lymphocytes is normalized, the helper potential rises, and the number of eosinophils decreases. Ig and FAN levels are restored to normal. Thus, treatment of VLT and AEVIT normalizes the immune status of patients with atopic dermatitis.
CLAIM
A method for treating atopic dermatitis, comprising administering intravascular irradiation with low-intensity laser radiation, characterized in that patients are prescribed Aevit for a week prior to intravascular laser therapy, 1 capsule 3 times a day, and 2 days before the procedure for 2 Capsules.
print version
Date of publication 01.04.2007гг
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