RU1821214C - Method for treating disseminated sclerosis - Google Patents

Abstract

The invention relates to medicine, namely to neurology. The goal is to shorten the duration of treatment and reduce the side effects of therapy while enhancing the dehydrating and immunocorrecting effects. To do this, the crushed fibrous carbon sorbent Vaulen is introduced at a dose of 50-60 mg / kg 3 times a day between meals for 15-20 days. The method is affordable, simple to implement, and can be widely recommended for practice. 1 tab.

Description

The invention relates to medicine, namely to neurology.

The purpose of the invention is to shorten the duration of treatment and reduce the side effects of therapy while enhancing the dehydrating and immunocorrective effects.

The method is carried out as follows.

The goal is achieved in that according to the invention, a patient with multiple sclerosis is orally administered with a crushed fibrous carbon sorbent in an amount of 50-60 mg per 1 KF of body weight 3 times a day between meals for 15-20 days.

The claimed invention uses activated carbon fibers obtained by carbonization of cellulose fiber hydrate, followed by activation of water vapor or CO2 in an atmosphere to burn 30-55 wt.%. The porosity of such materials is 0.40-0.90 cm3 / g. specific surface area 700-2000 m2 / g. This drug was adopted by the pharmacological committee and permission was obtained for its oral use as an enterosorbent.

This provides the following effect:

accelerates the regression of neurological disorders compared with the prototype;

practically eliminates the side effects of therapy caused by taking corticosteroid drugs and immunosuppressants;

significantly (about 2 times) reduces the time of treatment of patients.

Significant differences of the claimed method: in the scientific, technical and patent literature, the use of the method for the treatment of multiple sclerosis is not described.

Observation of patients showed that the use of the method can significantly accelerate the regression of neurological disorders, achieve stable remission, and also to avoid the complications that you w

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in patients treated with corticosteroid hormones and immuno-depressants.

In order to illustrate the high efficiency of the claimed method, the following examples are given.

PRI me R 1. Patient G.V. Ya., 21 g was on treatment with a diagnosis of multiple sclerosis, the onset of the disease. Complaints of double objects when looking right, a feeling of weakness and numbness of the left limbs. He considers himself sick since 10/05/87., When in the morning he felt numbness and weakness of his left limbs, 10/07/08. Doubling appeared when looking up to the right. For 10 days it was treated with outpatient general strengthening agents without effect.

A history of chronic tonsillitis, other diseases are not noted.

Neurological status upon admission to the clinic: paresis of the right abdominal nerve; when trying to turn the ophthalmic block to the right, it experiences double vision. In other directions, the movement of the ocular block is in full. Nystagmus when looking up in both directions. The face is symmetrical, the deviation of the tongue to the left. Muscle strength is reduced to 123-X points in the left extremities. There are no pathological symptoms. Abdominal reflexes are low. Left-sided hemigipesthesia with a decrease in vibration sensitivity to 8 s (at a rate of 12 s). Coordination tests are normal, in the Romberg position is stable.

From 10.17.87. treatment with a carbon fiber sorbent with a porosity of 0.90 cm3 / g, beats was started. surface of 200 m2 / g at 50 mg per 1 kg of muscle 3 times a day. After 3 days (10.20.87.), A decrease in weakness and an improvement in sensitivity in the left extremities began to be noted, 5 days after the start of treatment, doubling decreased when looking up to the right. The positive dynamics of neurological status continued to increase every day. K 11/01/87. there was only a slight gipesthesi left at the tips of the Maltese left hand. By the time the patient was discharged from the hospital, the neurological status was fully normalized. According to the scale (Slpe et al, 1984), the neurological status of hospital admissions was rated 75 points, after the end of the course of treatment with the carbon fiber sorbent 100 points. - ;. .

So, in a patient with 21 g in the onset of multiple sclerosis diseases, the use of a carbon fiber sorbent for 15 days completely normalized the neurological status. The patient was discharged from the school to work practically healthy.

PRI me R 2.

A patient born in 1937 was in a clinic with a diagnosis of Multiple Sclerosis. Unstable complaints

when walking, leg fatigue with long walking, a feeling of onemia of the left half of the body, awkwardness in the left hand when performing movements. A history of rheumatism and rheumatic heart disease. This disease since 1977. In 1977, it was treated with corticosteroid hormones, there was an improvement. In 1984, an exacerbation of the disease with paresis of the left limbs. Again treated with corticosteroid hormones,

5 I took hormones for 8 months. The improvement is incomplete.

Neurological status at admission to the clinic: cranial nerves are normal. The muscular strength in the limbs is full. The reflex background is low. Left-sided hemihyposthesis, Intentional tremor with coordinated tests on the left, and left-sided adiadokhokinesis. Ataxi in legs from two sides. Unstable in the Romberg position

5 and when walking in a straight line. Symptoms of Babinsky are bright on both sides. Treatment: the patient orally took crushed carbon fiber enterosorbent with a porosity of 0.50 cm3 / g, bpm.

0 700 m2 / g for 20 days at 55 mg per 1 kg of body weight 3 times a day. On the third day of taking the sorbent, an improvement in sensitivity on the left half of the body began to be noted, then a complete increase in muscle

5 forces in the left extremities, she began to walk around the institute’s yard, she began to walk much better, her legs almost did not get tired. On discharge: only slight hypesthesia remains in the region of the left half of the face, on the left hand

0 and leg sensitivity is normal. Almost ataxi coordinating tests and walking disappeared. There are some mild Babinsky symptoms on both sides. On a scale (Sipe et al., 1984) neurological statue

5 on admission, he was evaluated at 60 points; at discharge, he became 86 points.

So, sick, suffering from multiple sclerosis. For 10 years, currently received treatment with a carbon fiber sorbent after 2-fold multi-month treatment with corticosteroid hormones, which gave incomplete restoration of functions. The patient received a disability of the 2nd group, due to the precariousness of

5 . walking and weak legs walked very poorly. 20 days after treatment with enterosorbent, a significant improvement in the neurological status is visible: the shakiness of walking and weakness of the legs practically disappeared, the patient began to walk well, is about to remove

disability and get to work. Upon examination of the patient after 8 months, the neurological status was fully normalized, according to the scale (Sipe et a ,, 1984) - 100 points. The patient has a disability, does a good job.

Example 3.

A patient born in 1937 was admitted to the clinic with a diagnosis of Multiple Sclerosis. Complaints: a feeling of tightness, cooling and weakness of the right leg, while walking it drags the right mogu, a feeling of numbness and lumbar region on the right.

He considers himself a patient since 1978, when visual impairment appeared in both eyes. Vision recovered completely within a month. Since January 1983, a taste disorder and weakness of the left leg and arm appeared. She was treated in a hospital. Discharged with full recovery, In the spring of 1986 a feeling of desolation in the thoracic region and heaviness in the legs appeared. This sensation quickly passed, but in August 1986 it appeared again, legs became weak, it became difficult to climb the stairs. These symptoms lasted a month and a half. Then, everything was completely restored. 26.01.87, a feeling of numbness appeared in the right iliac region, its area expanded, and soon the weakness of the right leg appeared. Neurological status upon admission; to the clinic: smoothness of the right nasolabial fold, tongue deviation to the right, muscular strength in the arms is full, tone is normal. Reflexes on the hands are living without a difference of sides, Symptoms of Rossolimo-Benderovich on both sides. Sensitivity on the hands is normal. The abdominal reflexes are low without a difference of sides, the muscular strength of the right leg is reduced: in the extensor x of the right thigh - 4 points, in the extensor x of the right thigh - 3 points, in the extensor x of the right lower leg - A point, in the extensor x of the right foot - 3 points. Reflexes on the legs are high, higher on the right. There are pathological stop signs on the right foot. Decrease in superficial sensitivity on the right from the 11th thoracic segment to the 1st on the spermatic, on the left from the 1st on the lumbar to the 1st sacral. The gait is spastic, unstable in the complicated position of Romberg. On the fundus of the eye, the uniformity of the optic disc is noted. The composition of the cerebrospinal fluid is normal. High blood levels of C-reactive protein are detected in the blood. From 17.11.87, began to receive a carbon fiber sorbent with a porosity of 0.7 cm3 / g, beats. pov. 1200m / g. A dose of 60 mg per 1 kg of body weight, 3 times a day. The next day, 11/17/87 noted an increase in strength in the right leg.

On physical examination: the strength in the right leg is almost complete, the increase in reflexes to the right leg and pathological stop signs are kept. 11.23.87 - on the 7th day of taking the sorbent: leg strength is full, pathological stop reflexes become less bright, stable in the complicated position of Romberg. 11/25/87, the smoothness of the right nasolabial fold disappeared, the deviation of the tongue to the right is kept. The muscular strength in the right leg is full, the reflexes are still elevated on the right. Sensitive disorders have passed. A pathological symptom of Babinsky on the right leg is held. From 11.27.87 the gait became normal. 01 / 111-87, the reflexes on the legs were aligned. The Babinsky symptom on the right remains. So, in a 49-year-old patient with a rapidly remmitting course of the disease, the last exacerbation in the form of central right-side lower monoparesis and sensitivity disorders on the two-sided level occurred on January 26, 87. After 17 days of taking the carbon fiber sorbent, the central paresis of the right leg disappeared, the sensitivity was restored completely, only Babinsky's symptom on the right with an objective examination of the patient. The patient was discharged to work, almost healthy.

Neurological status on a scale (Supe et ai., 1984) was evaluated by 61 points upon admission to the clinic, and upon discharge - 85 points (with a norm of 100 points), as the pathological symptom of Babinsky on his right leg remained.

This is an example of the relatively benign course of multiple sclerosis, when periods of exacerbation are replaced by good periods of remission. However, the patient already showed a tendency to longer periods of exacerbation, a bracing treatment that helped with previous exacerbations of the disease, the last exacerbation has not been removed. Recovery occurred only after taking the sorbent.

A method for treating multiple sclerosis with carbon fiber enterosorbelt has been tested at the Department of Nervous Diseases, 1 LMI named after Academician I.P. Pavlova. The treatment of 10 patients with multiple sclerosis in the stage of exacerbation of the disease was tested at the age of 21 to 43 years (9 women, 1 man).

Patients were divided into the following groups:

1) at the onset of the disease, 1 person - the onset of the disease one week before the start of treatment; 2) a group of patients with a second exacerbation -4 people; 3) a group of patients with a disease duration of 5 to 10 years and frequent exacerbations or a continuously progressive course - 5 people.

As a control group, there were 10 people who were in the clinic of nervous diseases treated with steroid hormones or immunosuppressants.

Neurological status was assessed on a scale (Supe etal., 1984). In this case, normal neurological status was taken as 100 points, Y of all patients had motor disorders in the form of spastic paresis or paralysis, 7 patients had coordination of the trunk and limbs; in 8, sensitivity disorders in the form of parasthesia, numbness, tingling of the trunk and extremities, 1 patient had paresis of the abdominal nerve, and in some patients, disorders of the pelvic organs were noted.

On a scale (Supe et al .. 1984), patients were divided as follows:

When applying the method of enterosorption, improvement began on the 4th – 5th day of taking the sorbent. Patients noted an improvement in the function of the pelvic organs, a decrease in sensitive disorders, a decrease in limb weakness, and an improvement in gait. An objective study determined an increase in muscle strength in the extremities, a decrease in tone, normalization of deep reflexes, the disappearance of pathological reflexes, and an improvement in coordinated tests. This effect constantly increased. In a patient with a disease onset by the 3rd week of treatment, all pathological symptoms on a scale disappeared (Supe et al., 1984), his neurological status was rated with 1QQ points. In patients with a long term of the disease and the presence of persistent focal symptoms, indicating damage not only to the myelin sheath, but also to the axial cylinders of the nerve conductors, the latter did not completely disappear, but their quantitative dynamics were noted, the pathological symptoms of the disease that arose during the last exacerbation disappeared. According to the scale (Supe et al., 1984), they had a neurological status after treatment of 55 points. In all patients, the functioning of the pelvic organs returned to normal.

Complications in the treatment of enterosorption with a hydrocarbon fiber sorbent in patients were not noted.

There were no exacerbations of the disease after treatment with “erosorption per year.”

In patients of the control group, regression of neurological symptoms began a few weeks after the start of treatment, neurological status did not fully normalize in one patient by the time they were discharged from the hospital, in some cases, regression did not occur at all. Half of the patients experienced a new exacerbation of the disease,

The dehydration effect was determined

by the method of intravital registration of the size of the ventricular system of the brain by ECHO. The width of the 111 ventricle was determined, normally equal to 4.84 ± 0.07 mm, the value of the index of the cerebral cloak, right norm 2.24 ± 0, HMW mm and the size of the reserve spaces. It was found that in patients with multiple sclerosis in the acute stage before treatment, all these indicators were increased. Thus, the width of the 111 ventricle was 8-10 mm, the index of the brain cloak and the size of the reserve spaces also increased. When taking vaulen, a statistically significant decrease in these values occurred in all

sick. (, 01), This confirms the dehydrating effect of the drug.

Studied in the dynamics (before the moment of vaulen and after the course of treatment) immunological parameters of blood serum and

cerebrospinal fluid (cerebrospinal fluid). The distinct immunocorrective effect of vaulen has been revealed. These data are also statistically significant (, 05). The following immunological parameters were studied:

the content of T and B lymphocytes in blood and cerebrospinal fluid, the phagocytic activity of peripheral blood neutrophils, the hemolytic complement activity, the number of circulating immune complexes, the content of immunoglobulins of class A, G and M, the functional activity of granulocytes and mononuclear cells. In most patients, in the exacerbation phase of multiple sclerosis, a decrease in the relative and absolute numbers of T and B lymphocytes in the blood was found. Some patients showed an increased content of B-lymphocytes. At the same time, there was a significant increase in the content of T-lymphocytes and a normal amount of B-lymphocytes in the cerebrospinal fluid. The functional activity of B-lymphocytes was increased both in the blood and in the cerebrospinal fluid.

All patients showed a significant increase in neutrophilic phagocytosis and complement hemolytic activity. In most patients, an increase in the migration activity of granulocytes and mononucleiars was observed.

In this patient, the content of T and B lymphocytes in the cerebrospinal fluid and neutrophilic phagocytosis in the cerebrospinal fluid were determined:

the content of T-lymphocytes was 63%

the content of b-lymphocytes 19%

neutral phagocytosis 11,

This confirms the observation that with a decrease in T and B lymphocytes in the blood, the content of these cells in the cerebrospinal fluid increases. In dynamics, after a course of treatment in a patient, cerebrospinal fluid was not studied. The normalization of cellular and humoral immunity coincided with an improvement in neurological status and the disappearance of hypertension syndrome, which confirms the dehydrating effect of the fibrous carbon sorbent along with its sorption effect.

The claimed method for the treatment of multiple sclerosis allows:.

reduce treatment time by reducing bed days by 30-50%;

reduce the complications associated with glucocorticoids and immunosuppressants;

achieve a more lasting treatment effect;

quickly relive the newly emerging symptoms of neurological disorders in the next exacerbation of the disease;

extend the patient work period.

Claims (1)

The claims A method for treating multiple sclerosis, including the administration of corticosteroids, characterized in that, in order to shorten the treatment time and reduce the side effects of the therapy while enhancing the rehydrating and immunocorrecting effects, the crushed fibrous carbon sorbent Vaulen is administered at a dose of 50-60 mg / kg 3 times a day between meals for 15-20 days.