RU2175869C1 - Agent for treatment of patients with chronic cholestatic hepatitis - Google Patents

Abstract

FIELD: medicine, hepatology, phytotherapy. SUBSTANCE: invention proposes an agent as a herbal species containing the following components, wt.%: violet pensy herb, 14-16; sandy common immortelle flowers, 5-7; maize stigmas, 8-10; medicinal sweet clover, 9-11; pot-marigold flowers, 6-8; medicinal matricary flowers, 9-11; milfoil herb, 5-7; perforated Saint-John's-wort herb, 7-9; common pine buds, 4-6; dandelion roots, 7-9; sweet flag rhizomes with roots, 5-7; tall elecampane roots, 8-10; tansy flowers, 4-6; linden flowers, 15-17; common barberry leaves, 10-12; cowberry leaves, 8-10. Agent recoveries many liver function, among them, cholagogic formation and secretion, Also, agent decreases inflammatory process in liver, decreases intrahepatic cholestasis, shows prophylactic effect of further pathological process in liver and normalizes its size. EFFECT: enhanced effectiveness of agent, absence of adverse effects. 1 cl, 2 tbl, 4 ex

Description

 The invention relates to medicine and is an herbal collection that can be used to treat chronic cholestatic hepatitis.

 Known drugs used to treat chronic cholestatic hepatitis, helping to reduce intrahepatic cholestasis, regeneration and normalization of liver function.

 Noteworthy is cholestyramine, which has a selective agent for bile acids, binding them in the form of a durable complex in the intestine, and excreted in feces. Under the influence of the drug, itching of the skin weakens, the level of bile acids, cholesterol, bilirubin in the blood serum decreases. The daily dose of cholestyramine is 10-16 g / day. The duration of the course is from 1 month to several years. At the same time, the use of cholestyramine is impractical for hepatic cell failure. Its prolonged use can contribute to the development of osteoporosis, since it increases the excretion of calcium in the urine (Podymova SD, Diseases of the liver., M., 1993, p. 361).

 D-penicillamine (cuprenyl) enhances renal excretion of excess copper, which is a factor stimulating the development of fibrosis in the liver. The drug, along with inhibition of collagen synthesis, has immunosuppressive properties: it normalizes the levels of IgM and circulating immune complexes. The dose ranges from 300 to 900 mg / day. There are reports in the literature about possible complications of D-penicillamine: inhibition of bone marrow hematopoiesis with cytopenia and sepsis, nephropathy, fever, arthralgia. The drug does not have a significant effect on the life expectancy of patients (Podymova S.D. Liver diseases: M .: Medicine, 1993, p. 362).

 Rifampicin is a semi-synthetic broad-spectrum antibiotic that is well absorbed from the gastrointestinal tract. The highest concentration of the drug is created in the liver and kidneys. It is excreted from the body with bile and urine. In the treatment of cholestatic hepatitis, a dose of 600 mg / day is prescribed for several months. While taking the drug, itching of the skin decreases. However, treatment with rifampicin should be carried out under close medical supervision due to the fact that allergic reactions, dyspepsia, liver and pancreas dysfunction, leukopenia are possible (Mashkovsky M. D. Medicines (manual for doctors): Part II. M .: Medicine, 1993, p. 380).

 In some cases, for the treatment of chronic cholestatic hepatitis, a collection consisting of valerian root 20.0, hawthorn flowers 20.0, barberry bark 30.0, peppermint leaves 30.0 is used. Infusion is used in 1 glass in the morning and in the evening. However, this collection does not always contribute to clinical improvement (Sokolov S.Ya., Zamotaev IP Handbook of medicinal plants (herbal medicine). M., 1989, p. 332).

 The prototype of the present invention is a collection consisting of sandy immortelle (flowers) 10.0, corn columns with stigmas 10.0, chamomile (flowers) 10.0, dandelion roots 10.0, fennel 10.0, wormwood herb 10 , 0, calendula flowers 10.0, peppermint (grass) 10.0, tansy flowers 10.0, large celandine (grass) 10.0. The infusion is used in 1/3 - 1/2 cup 30 minutes before meals 3 times a day (Sokolov S.Ya., Zamotaev I.P. Handbook of medicinal plants (herbal medicine). M., 1989).

 The disadvantage of this collection is not always a pronounced therapeutic effect - there is no exit of bile from the liver passages and, as a result, the biochemical parameters of the liver do not normalize. In patients with increased secretion of gastric juice, nausea and heartburn sometimes appear due to the relative high content of tansy. Due to the increased amount of celandine, toxic reactions in individual patients are possible.

 The objective of the invention is to reduce the inflammatory process in the liver, reduce intrahepatic cholestasis, prevent further progression of the pathological process in the liver, reduce its size.

The problem is solved in that the tool, which is a herbal collection, including flowers of the sandwort immortelle and dandelion root additionally contains the following components, wt.%:
Violet tricolor, grass - 14-16
Immortelle sandy, flowers - 5-7
Corn stigmas - 8-10
Melilotus officinalis - 9-11
Calendula, flowers - 6-8
Chamomile, flowers - 9-11
Yarrow, grass - 5-7
Hypericum perforated, grass - 7-9
Common pine, kidneys - 4-6
Dandelion, root - 7-9
Rhizome with calamus roots - 5-7
Elecampane high, root - 8-10
Tansy, flowers - 4-6
Linden, flowers - 15-17
Barberry ordinary, leaves - 10-12
Lingonberry, leaves - 8-10
Violet tricolor grass has anti-inflammatory and hyposensitizing effects, helps to densify cell membranes, slows down the absorption of toxic substances, and reduces the permeability of blood vessels in the skin. In addition, it has antispasmodic, choleretic and diuretic effects. Violets tricolor grass increases the motor activity of the ciliary epithelium of the mucous membranes.

 Immortelle sand flowers enhance the secretion of bile and have a pronounced antispasmodic effect, thereby improving the metabolic function of the liver, reduce the viscosity and relative density of bile. In addition, immortelle sand flowers have anti-inflammatory, antibacterial, choleretic and antispasmodic effects.

 Corn stigmas have pronounced choleretic properties, reduce the viscosity of bile, its relative density, accelerate the blood coagulation process, increase diuresis, promote the release of sand and stones from the bile ducts and gall bladder.

 Melilotus officinalis has pronounced detoxifying properties, increases the phagocytic activity of leukocytes, improves peripheral blood supply and blood supply to the abdominal organs, exhibits antibacterial properties, improves liver function and enhances choleresis.

 Calendula flowers have an anti-inflammatory effect, enhance secretory activity, increase bile formation and bile secretion, and activate regeneration processes. Due to the high content of carotenoids, flavanoids, ascorbic acid and organic acids in marigold flowers, it causes an increase in the metabolic function of the liver, improves the composition of bile, and increases the secretory and excretory function of the liver. The therapeutic effect is especially pronounced when combined with the appointment of calendula with other herbs.

 Chamomile officinalis flowers relieve spasm of the bile ducts, increase biliary excretion, and reduce inflammation. They also have anti-inflammatory, antiseptic and mild analgesic effects.

 Yarrow grass has an antispasmodic effect on the smooth muscles of the intestines, urinary and biliary tracts, in connection with which it expands the bile ducts and increases bile secretion into the duodenum. In addition, it has anti-inflammatory, bactericidal, anti-allergic and regenerative effects. Yarrow grass increases blood coagulability due to an increase in platelet count and accelerated bleeding time, which is very important for hepatitis, accompanied by hemorrhagic syndrome, fibrosis.

 Hypericum perforatum grass has a regenerative, anti-inflammatory, antiseptic and astringent effect. It can also cause a local anesthetic effect, improve trophic tissue and promotes the passage of bile during inflammation of the bile ducts due to antiseptic and choleretic effects. Its diuretic effect is noted in case of kidney stone disease and impaired mineral metabolism.

 The buds of Scots pine show anti-inflammatory and antimicrobial properties in the tissues of the liver, bile ducts and gall bladder. They also contribute to a decrease in the viscosity of bile, an increase in its current along the bile ducts and normalize the exit of bile from the gallbladder.

 Dandelion root can have a choleretic effect, enhancing the secretion of gastric juice and pancreas, has antispasmodic and laxative properties, normalizes the composition and flow of bile, enhances diuresis, promotes and improves fluid flow through the intestines, stimulates appetite, acting on the food center and causes a laxative effect.

 Rhizome with calamus roots has anti-inflammatory, bacteriostatic, antifungicidal properties and have some antispasmodic effect. Improves digestion in the stomach, increases the tone of the gallbladder, enhances the biliary function of the liver.

 Elecampane root has a variety of properties, including increasing bile formation and biliary excretion into the duodenum, regulates intestinal motility, enhances diuresis, and has antimicrobial properties. Restores the normal process of digestion, reduces inflammatory manifestations in the gastrointestinal tract, in the bile ducts and gall bladder. It accelerates the regenerative processes in the gastrointestinal tract and in the liver.

 Tansy flowers cause an antibacterial, anti-inflammatory, antihelminthic effect, enhance the secretion of bile in the liver and its exit from the hepatic ducts, and also reduce the amount of mucus in it. They tone the muscles of the intestinal tract and enhance the secretion processes, as well as suppress the pathogenic flora.

 Linden flowers have an antimicrobial, anti-inflammatory and anti-edematous effect, and with increased excitability, they have a calming effect. They contribute to an increase in bile formation and facilitate the flow of bile into the duodenum, stimulate the secretion of gastric juice, increase diuresis, and enhance exocrine pancreatic function.

 Barberry ordinary leaves have an antispasmodic effect, manifested in a decrease in the tone of the gallbladder and a decrease in the rhythm of its contraction. Thus, they improve the outflow of bile from the bile ducts and gall bladder. Barberry ordinary roots cause liquefaction of bile and a decrease in its relative density, without a noticeable increase in composition; and further contribute to reducing the size of the enlarged liver, improve its functional state.

 Lingonberry leaves have a disinfectant, diuretic, choleretic, antiseptic, bactericidal and anti-inflammatory effect. The positive effect is due to the ability of lingonberry leaves to reduce the permeability and fragility of the capillaries of the liver.

 These herbs and roots when used together in the proposed doses give a well-defined clinical effect in the treatment of patients suffering from chronic cholestatic hepatitis.

 The proposed tool is prepared for use in the following ratio wt. %: tricolor violets, grass 14-16, sandwort immortelle, flowers 5-7, stigmas of corn 8-10, sweet clover 9-11, calendula, flowers 6-8, yarrow, grass 5-7, St. John's wort perforated, grass 9- 11, buds of common pine 4-6, dandelion root 7-9, rhizome with calamus roots 5-7, elecampane root 8-10, tansy, flowers 4-6, linden, flowers 15-17, barberry ordinary, leaves 9- 11, lingonberries, leaves 8-10.

 The mixture is ground to a powdery consistency, then 2/3 of a teaspoon is brewed in 300.0 ml of boiling water, infused for 15 minutes. Take 100.0 ml 3 times a day after meals, with normal and high acidity, and with a low one according to the same scheme before meals. The course of treatment lasts 2 months, then a break of one month is made. Depending on the condition of the patient, it is recommended that 2 to 3 courses be given.

Example 1
The history of the disease N 12746. Patient B.

 Diagnosis: chronic cholestatic hepatitis with moderate activity.

 Complains of itching of the skin, yellowness of the skin and mucous membranes, heaviness in the right hypochondrium, unstable stool, bloating.

 Sick for about 4 years. It was treated on an outpatient basis without significant effect. Recently, itching of the skin, yellowness of the skin has increased.

 Objectively: the condition is satisfactory, the skin and mucous jaundice, traces of scratching on the skin, the abdomen is swollen, an enlarged liver is palpated, the lower edge of which is 5 cm from the edge of the costal arch, the spleen is not enlarged.

In the analyzes, Hb 122 g / l, Er 3.7 • 10 ¹² / l, platelets 169.0 • 10 ⁹ / l, white blood cells 3.6 • 10 ⁹ / l, ESR 40.0 mm / h, total protein 70, 0 g / l, albumin 40.0%, gamma globulins 24.0%, thymol sample 47.0 ALL, sublimate titer 1.9 units, AlAT 1.65 mmol / l, AcAT 1.70 mmol / l, bilirubin 70.0 mmol / l, cholesterol 9.1 mmol / l, alkaline phosphatase 550.0 units / l, prothrombin index 66.5%.

 The patient underwent treatment: corsil, aminophylline, mezim-forte, helestyramine, vitamins A, D, E without a significant effect. In the future, as a medicinal product, a collection was used, which included a sandy immortelle (flowers) 10.0; stalks of corn with stigmas 10.0; pharmacy chamomile (flowers) 10.0; dandelion roots 10.0; fennel fruits 10.0; wormwood herbs 10.0; calendula flowers 10.0; peppermint (herb) 10.0; tansy flowers 10.0; large celandine (grass) 10.0. This collection was used as an infusion of 1 / 3-1 / 2 cups 30 minutes before meals 3 times a day. The collection was taken for 2 months, then a month-long break was taken. Conducted 2 courses of treatment.

 After the therapy, the condition improved - itching of the skin, yellowness of the skin, heaviness in the right hypochondrium, bloating decreased.

In the analyzes: Hb 126 g / l, Er 3.8 • 10 ¹² / l, white blood cells 3.8 • 10 ⁹ / l, platelets 172.0 • 10 ⁹ / l, ESR 34 mm / h, total protein 71.0 g / l, albumin 41.0%, gamma-globulins 24.0%, thymol sample 48.0 ALL, sublimate titer 1.8 units, AlAT 1.4 mmol / l, AcAT 1.3 mmol / l, bilirubin 45.0 μmol / L, cholesterol 8.5 mmol / L, alkaline phosphatase 480.0 U / L, prothrombin index 69.0%.

 After the course of treatment, clinical remission was observed for 4 months.

Example 2
The history of the disease N 3872. Patient L.

 Diagnosis: chronic cholestatic hepatitis with moderate activity.

 Complains of severe itching of the skin, yellowness of the skin. Weakness, pain in the right hypochondrium, bloating, unstable stool.

 Sick for about 3 years. Not treated. This deterioration occurred about 2 months, when itching of the skin intensified, yellowness of the skin and mucous membranes intensified, weakness increased, and bloating appeared.

 Objectively, the condition is satisfactory, icteric integuments and visible mucous membranes, traces of scratching on the skin, the abdomen is swollen, and the liver is enlarged. Leaves from under the costal arch by 4 cm, spleen enlarged by 1 cm.

In the Hb analyzes, 116.0 g / l, Er 3.75 • 10 ¹² / l, white blood cells 3.8 • 10 ⁹ / l, platelets 180.0 • 10 ⁹ / l, ESR 43 mm / h, total protein 69, 0 g / l, albumin 40.0%, gamma globulins 26.0%, thymol sample 46.9 ALL, sublimate titer 1.8 units, AlAT 1.90 mmol / l, AcAT 1.65 mmol / l, bilirubin 82.0 μmol / l, cholesterol 8.7 mmol / l, alkaline phosphatase 510.0 u / l, prothrombin index 70%.

 Treatment: corsil, aminophylline, phenobarbital, festal, vitamin A, D, E - without a significant effect. Subsequently, as a medicine, a collection was used, consisting of tricolor violet, herb 14.0; immortelle sandy, flowers 5.0; stigmas of corn 8.0; Melilotus officinalis 9.0; calendula flowers 6.0; Chamomile officinalis, flowers 9.0; yarrow, herbs 5.0; Hypericum perforatum, herb 9.0; kidneys of ordinary pine 4.0; dandelion root 7.0; rhizome with calamus roots 5.0; Elecampane root high 8.0; tansy, flowers 4.0; linden flowers 5.0; barberry ordinary, leaves 9.0; lingonberries, leaves 8.0.

 The mixture was crushed to a powdery consistency, 2/3 teaspoon of the mixture was steamed in 300 ml of boiling water, insisted for 15 minutes, then the patient took 100 ml 3 times a day after meals for 2 months, then a month-long break was carried out, the treatment was repeated.

 After the therapy, the condition improved - itching of the skin, yellowness of the skin, weakness, pain in the right hypochondrium, bloating, reduction in the size of the liver by 2 cm and spleen by 1 cm disappeared.

In the analyzes, Hb 128 g / l, Er 4.1 • 10 ¹² / l, leukocytes 4.4 • 10 ⁹ / l, platelets 195 • 10 ⁹ / l, ESR 25 mm / h, total protein 77 g / l, albumin 46%, gamma-globulins 21%, thymol sample 33 ALL, sublimate titer 2 units, AlAT 0.8 mmol / L, AcAT 0.66 mmol / L, bilirubin 25.7 mmol / L, cholesterol 6.2 mmol / l, alkaline phosphatase 200 u / l, prothrombin index 78%. After a course of treatment, remission is observed for 10 months.

Example 3
The history of the disease N 4539. Patient C.

 Diagnosis: chronic cholestatic hepatitis with moderate activity.

 Complains of yellowness of the skin, itching of the skin, worse at night, in a warm room, pain in the right hypochondrium, bloating, weakness.

 Sick for about 6 years. Repeatedly treated in hospitals of the city. For about a month, itching of the skin intensified, yellowness of the skin, bloating, pain in the right hypochondrium increased.

 Objectively: satisfactory condition, yellowness of the skin and mucous membranes, traces of scratching on the skin of the body, pulse 62 beats. per minute, rhythmic. HELL 110/60 mm Hg Heart sounds are muffled, vesicular breathing, the abdomen is swollen, painful in the right hypochondrium, an enlarged liver is palpated, the lower edge of which is 3 cm out from the edge of the costal arch.

In the analyzes, Hb was 120 g / L, Er 3.9 • 10 ¹² / L, platelets 190 • 10 ⁹ / L, ESR 43 mm / h, total protein 70 g / L, albumin 38.5%, gamma globulins 25, 6%, thymol test 50 ALL, sublimate test 1.85 units, AlAT 1.70 mmol / L, AcAT 1.56 mmol / L, bilirubin 84 μmol / L, cholesterol 9.4 mmol / L, alkaline phosphatase 490 units ./l, prothrombin index 69.5%.

 Treatment: corsil, riboxin, phenobarbital, aminophylline, festal, vitamins A, D, E, K - without a significant positive effect. A collection was added to the therapy, including tricolor violets, herbs 16.0; Helichrysum sand, flowers 7.0; stigmas of corn 10.0; Melilotus officinalis 11.0; calendula flowers 8.0; Chamomile officinalis, flowers 11.0; yarrow, herbs 7.0; Hypericum perforatum, herb 11.0; kidneys of ordinary pine 6.0; dandelion root 9.0; rhizome with calamus roots 7.0; Elecampane root high 10.0; tansy, flowers 6.0; linden flowers 17.0; barberry ordinary, leaves 11.0; lingonberries, leaves 10.0.

 The mixture was ground to a powdery consistency, 2/3 teaspoon of the mixture was brewed in 300 ml of boiling water, insisted for 15 minutes, then the patient took 100 ml 3 times a day after meals for 2 months, followed by a month-long break. The course of treatment was repeated. After provident therapy, the condition improved - itching of the skin, yellowness of the skin, pain in the right hypochondrium, bloating, weakness, and a decrease in the size of the liver by 3 cm disappeared.

In blood tests: Hb 128 g / l, Er 4.42 • 10 ¹² / l, white blood cells 4.2 • 10 ⁹ / l, platelets 215.0 • 10 ⁹ / l, ESR 20.4 mm / h, total protein 78.3 g / l, albumin 48.6%, gamma globulins 19.8%, thymol sample 34.1 ALL, sublimate sample 2.22 units, AlAT 0.64 mmol / l, AcAT 0.58 mmol / l, bilirubin 27.5 μmol / l, cholesterol 6.6 mmol / l, alkaline phosphatase 180.0 units / l, prothrombin index 71.9%. After a course of treatment, remission is observed for 12 months.

Example 4
The history of the disease N 12116. Patient L.

 Diagnosis: chronic cholestatic hepatitis with moderate activity.

 Complains of itching of the skin, yellowness of the skin and mucous membranes, bloating, heaviness in the right hypochondrium, increased bleeding.

 Sick for about 6 years. She was treated in a hospital.

 Objectively: the condition is satisfactory, the skin is icteric, traces of scratching and a few bluish spots on the skin. Ps 60 bpm per minute, rhythmic, blood pressure 110/70 mm Hg Heart sounds are muffled, systolic murmur at the apex, vesicular breathing, abdominal distention, painful in the right hypochondrium, an enlarged liver is palpated, the edge of which extends from under the costal arch by 5 cm, the spleen is not palpated.

In blood tests: Hb 116 g / l, Er 3.8 • 10 ¹² / l, white blood cells 3.98 • 10 ⁹ / l, platelets 180 • 10 ⁹ / l, ESR 44 mm / h, total protein 68 g / l , albumin 41%, gamma globulins 25%, thymol sample 50 ALL, sublimate sample 1.8 units, AlAT 1.9 mmol / L, AcAT 1.58 mmol / L, bilirubin 80 μmol / L, cholesterol 8.8 mmol / L, alkaline phosphatase 520 U / L, prothrombin index 66%.

 Treatment: corsil, aminophylline, mesim forte, phenobarbital, vitamins A, D, E, K - without a significant effect. A collection was added to the therapy, including tricolor violets, herbs 16.0; Helichrysum sand, flowers 7.0; stigmas of corn 10; Melilotus officinalis 11.0; calendula flowers 8.0; Chamomile officinalis, flowers 11.0; yarrow, grass 7.0; Hypericum perforatum, grass 11.0; kidneys of ordinary pine 6.0; dandelion root 9.0; rhizome with calamus roots 7.0; Elecampane root high 10.0; tansy, flowers 6.0; linden flowers 17.0; barberry ordinary leaves 11.0; lingonberries, leaves 10.0. The mixture was ground to a powdery consistency, then 2/3 of a teaspoon was brewed in 300 ml of boiling water, insisted for 15 minutes, then the patient took 100 ml 3 times a day after meals for 2 months with a monthly break. Subsequently, the course of treatment was repeated.

 After the therapy, the patient's condition improved: itching of the skin, yellowness of the skin and mucous membranes, bloating, heaviness in the right hypochondrium, increased bleeding disappeared, the size of the liver decreased by 3 cm.

In the analyzes: Hb 130.0 g / l, Er 4.3 • 10 ¹² / l, leukocytes 4.4 • 10 ⁹ / l, platelets 198.0 • 10 ⁹ / l, ESR 24 mm / h, total protein 78 g / l, albumin 48%, gamma globulins 21%, thymol sample 34 ALL, sublimate sample 2.0 units, AlAT 0.86 mmol / l, AcAT 0.61 mmol / l, bilirubin 26.0 μmol / l , cholesterol 6.3 mmol / L, alkaline phosphatase 140.0 units / L, prothrombin index 78%.

 After treatment, remission for 14 months.

 Thus, the cited extracts from the medical records show that when taking the proposed collection, a positive effect was obtained in all patients. The data obtained in the treatment of patients using the proposed collection are presented in table 1, after the end of treatment, the absence of clinical signs, normalization of biochemical signs of the disease was established. Data on the prototype method are presented in table 2.

 Thus, a positive therapeutic effect was obtained in all of our patients who received the above collection in comparison with the collection of the prototype. Remission in the observed patients increased by 2–3 times (prototype - remission 4 months), according to the claimed method, up to 14 months. The processes of normalization of biochemical blood parameters are presented in tables 1 and 2.

 The advantage of the proposed collection is also the absence of side effects (allergic reactions, toxic effects on the liver) compared with other drugs. There is a restoration of many functions of the liver, including biliary and biliary, a decrease in the size of the liver and spleen.

Claims (1)

An agent for the treatment of chronic cholestatic hepatitis, which is a collection of medicinal plants, including sandwort flowers, dandelion root, characterized in that it additionally contains tricolor violet grass, corn stigmas, calendula flowers, ordinary pine buds, medicinal chamomile flowers, yarrow grass, grass Hypericum perforatum, tansy flowers, linden flowers, medicinal sweet clover, rhizome with calamus roots, common barberry leaves, elecampane root and bru leaves syniki in the following ratio of components, wt.%:
Violet tricolor, grass - 14 - 16
Immortelle sand, flowers - 5 - 7
Corn stigmas - 8 - 10
Melilotus officinalis - 9 - 11
Calendula, flowers - 6 - 8
Chamomile, flowers - 9 - 11
Yarrow, grass - 5 - 7
Hypericum perforated, grass - 7 - 9
Common pine, kidneys - 4 - 6
Dandelion, root - 7 - 9
Rhizome with calamus roots - 5 - 7
Elecampane high, root - 8 - 10
Tansy, flowers - 4 - 6
Linden, flowers - 15 - 17
Barberry ordinary, leaves - 10 - 12
Lingonberry, leaves - 8 - 10

Images