RU2178304C1 - Method for multiple therapy of chronic pancreatitis - Google Patents

Abstract

FIELD: medicine, phytotherapy. SUBSTANCE: at a background of traditional therapy a patient is prescribed to apply a herb species infusion that includes common burdock roots, everlastings grass, althea roots, common licorice roots, an oak-tree bark, sweet clover grass, leonorus grass, prostrate knotweed grass, purple echinacea grass, coltsfoot leaves, walnut leaves at the ratio of components in parts being 2: 1: 2: 2: 2: 2: 1: 1: 1: 2: 1. Infusion should be applied at a subacute stage thrice daily per one third of a glass 30 min before meals for 4 wk to normalize clinic laboratory data. EFFECT: higher efficiency and shortened period of therapy. 1 tbl

Description

 The invention relates to medicine, namely to herbal medicine in the complex treatment of patients with chronic pancreatitis.

 The significant prevalence of chronic pancreatitis (XII) among people of working age causes the development of new, more effective treatments.

 According to various authors, chronic recurrent pancreatitis is from 8-9 to 35% in the structure of diseases of the digestive system (Ivashkin V.T. Current issues of clinical pancreatology // Vestnik RAMS, 1993, N 4, pp. 29-34; Okhlobystin A. B. New evidence on the pathogenesis of chronic pancreatitis // Russian Journal of Gastroenterol Hepatol., 1999, No. 4, pp. 18-23; Lowenfels et al. Prognosis of pancreatitis: an international multicenter study // Amer. J. Gasroenterol. 1994, Vol. 89, p. 1467-1471).

 Herbal medicine is attracting increasing attention due to the fact that herbal preparations are often safer than synthetic ones and can be used for the treatment and prevention of chronic diseases (Kukes V. G. Phytotherapy with the basics of clinical pharmacology, M.: Medicine, 1999, 192 pp.) , and when combined, they can significantly reduce the toxicity of chemotherapeutic agents, the frequency of side effects and drug-related diseases (Barnaulov O. D. Introduction to herbal medicine, St. Petersburg, 1999, 159 pp.). Secondly, this combination increases the therapeutic effect of the use of traditional drugs, which can be associated both with summation and potentiation, as well as with an increase in the sensitivity of patients to these drugs.

 A known method of treating chronic pancreatitis using the collection of medicinal plants: wormwood herb - 1.5 hours; pharmacy chamomile flowers - 2 hours; St. John's wort grass perforated - 2 hours; marsh grass marsh - 2 hours; peppermint leaf - 1.5 hours; the roots of elecampane high - 2 hours; water to get 200 ml of medicine, which is taken in 1 tablespoon 3 times a day 15 minutes before meals. The collection has a disinfecting, astringent, stimulating activity of the glands actions. (Nogaller A.M., Nikolaeva V.G., Alekseev V.F. Phytotherapy of diseases of the digestive system, Ryazan, 1987, p. 86-89).

 There is also known a method of treating infusion of yarrow herbs - 1 hour, wormwood - 5 hours, St. John's wort - 1 hour, motherwort - 1 hour, peppermint leaves - 3 hours, large plantain - 1 hour, tansy flowers - 5 hours, chamomile - 5 hours, rose hips - 3 hours, corn stigmas - 1 hour, 1/2 cup 15 minutes before meals and at bedtime (Treskunov K.A. Clinical phytology and herbal medicine for diseases of the hepatopancreatic system Chernogolovka, 1988, p. 34-35).

 The above methods are ineffective in the treatment of chronic pancreatitis during the exacerbation, as they have a pronounced stimulating effect on the secretory activity of the gastrointestinal tract, which can worsen the course of the disease.

 As a prototype, a method of treating chronic pancreatitis is taken, which consists of taking 1/3 cup of infusion from the collection of medicinal plants 30 minutes before meals 3 times a day, including the roots of burdock 10 grams, marsh grass pine grass 10 g, wormwood grass 10 g , St. John's wort grass perforated 10 g, field horsetail grass 10 g, elecampane roots 10 g high, chamomile flowers and calendula officinalis 10 g each, three-part succession grass 10 g, sage herb 10 g (Sokolov S. Ya., Zamotaev I. P. Handbook of medicinal plants, M.: Nedra, 1989, p. 361-363, p. 490).

 The disadvantage of this method is that wormwood, St. John's wort perforated, chamomile, calendula officinalis have pronounced choleretic and sokogonnye actions (Kukes V.G. Herbal medicine with the basics of clinical pharmacology, M., Medicine, 1999, 192 S.). Bile and gastric juice stimulate pancreatic secretion (Korotko G.F. Regulation of pancreatic secretion // Ross. G. gastroenterol. Hepatol., 1999, N 4, pp. 6-15). As a result, intraductal pressure rises, pancreatic enzymes inside the organ are activated, edema and necrosis of the gland develop.

 Thus, the inflammatory process is constantly maintained. In addition, the authors do not specify how long to use the described infusion.

 The technical result is an increase in therapeutic effectiveness by reducing treatment time, preventing complications.

 The proposed method is as follows: against a diet (refusal to drink alcohol, frequent meals in small portions, low animal fat in foods, the fight against vitamin deficiency) and drug therapy, including antisecretory drugs (proton pump inhibitors, histamine H2 receptor blockers , antacids), protease inhibitors (analogues of somatostatin, gordox, contracal, etc.) anticholinergics, antispasmodics, antibiotics (Zlatkina A. R. et al. Modern enzyme therapy of chronic pancreas atita // Ross.zh. gastroenterol.hepatol., 1997, pp. 109-112; Zimmerman Y. S. Pharmacotherapy of chronic pancreatitis // Clin. honey., 1991, N 2, P. 99-104) at 4-5 the day from the onset of the disease, i.e., in the subacute stage, the patient takes an infusion from the collection of medicinal plants containing large burdock roots - 1 hour, swamp grass - 1/2 hour, medicinal marshmallow roots - 1 hour, bark common oak - 1 hour, leaves of coltsfoot - 1 hour, grass of clover medicinal - 1 hour, grass of motherwort - 1/2 hour, leaves of walnut - 1/2 hour, roots and rhizomes of licorice - 1 hour, grass of the mountains chicken bird - 1/2 h., Echinacea purpurea grass - 1/2 h. according to the scheme: 1/3 cup 3 times a day 30 minutes before meals for 4 weeks. The infusion is prepared as follows: take 2 tablespoons of the collection and pour 600 ml of boiling water in a thermos, leave for 2 hours, then pour all the contents into a jar, cool and filter.

The advantages of the above method are that the pathogenesis of the disease, clinical syndromes, complications and concomitant conditions of the gastrointestinal tract are taken into account, plants with choleretic and sokogonny effects are excluded. In this regard, the collection contains medicinal plants that have anti-inflammatory (all components), antacid (marshmallow, oak, burdock, licorice), astringents (bird highlander, cinnamon, walnut), antispasmodic (coltsfoot, licorice, bird highlander , sweet clover), painkiller (marshmallow, coltsfoot, licorice, cinnamon, sweet clover), hepatoprotective (licorice, sweet clover), soothing (motherwort, licorice, bird highlander, sweet clover), hypoglycemic (oak, motherwort, licorice, cinnamon, walnut, echinacea) and immunomodulatory (oak, coltsfoot, licorice, mountaineer bird th, echinacea) actions. (Nikitina T. I. Medicinal plants / Application. Contraindications. Fees (phytotherapist's reference book). Ufa, 2000, 234 pp.)
The proposed method treated 36 patients with chronic pancreatitis.

 Results: all patients underwent a general clinical study of blood and urine, an ultrasound examination of the abdominal organs, a CT scan according to indications, and a coprological examination.

 Exocrine pancreatic function was assessed by the level of elastase 1 in the feces and by changes in a coprological study. Hyperfermentemia was determined by the content of amylase, lipase, trypsin in the blood, diastases in the urine. Diagnosis of the inflammatory syndrome was carried out by a general blood test and the content of pro-inflammatory cytokines (interleukin 1 and 8, tumor necrosis factor). Intracretory pancreatic function was determined by the content of C-peptide, insulin in the blood.

 For comparison, a control group was taken that received only medication (30 patients with chronic pancreatitis).

 The anti-inflammatory effect of phyto harvests was evaluated by reducing the intensity of pain, normalizing pro-inflammatory cytokines in the blood.

 In patients receiving complex treatment with the inclusion of phyto-collection, the pain syndrome was stopped on average 3 days earlier than in the control group. On average, after 10 days, the first symptoms of edema of the head of the pancreas disappeared, after 15 days dyspeptic syndrome decreased. In the control group - after 13 and 17 days, respectively.

 Against the background of application of the collection of medicinal plants, after 3 weeks the levels of interleukin 1 β decreased by 3.34 times, interleukin 8 - by 3.53 times, tumor necrosis factor - by 2.3 times, which is shown in table 1. In the control group, this decrease was negligible. Despite the subsidence or disappearance of the clinical manifestations of the disease, the levels of pro-inflammatory cytokines remained elevated in both groups, which indicates the incompleteness of the pathological process in the pancreas.

 The duration of treatment was 3-4 weeks until the clinical data, proinflammatory cytokines in the blood, and the disappearance of neutral fat, starch and muscle fibers in the feces were completely normalized.

 Example 1: patient A., 44, was admitted to the hospital with complaints of girdle pain in the upper abdomen, nausea, vomiting once, intolerance to greasy and spicy foods, frequent, mushy stool up to 5 times a day, "fat" stool, rumbling in the stomach, poor sleep. The above complaints appeared after a diet violation 2 days ago, took pancreatin, no-shpu, allochol, platifillin / muscle, the pain did not decrease. Suffers from chronic pancreatitis since 1996, after cholecystectomy for gallstones, the last exacerbation 1.5 months ago, was treated on an outpatient basis with a short-term effect, the last hospital treatment 1 year ago.

 Upon admission, a moderate condition, tongue is overlaid, pain in the pancreas was determined by palpation.

Blood test: red blood cells -4.3 • 10 ¹² / l, hemoglobin - 129 g / l, white blood cells - 6.4 • 10 ⁹ / l, ESR - 12 mm / h. Biochemical analysis of blood: total protein - 80.7 g / l, alkaline phosphatase - 80 units / l, cholesterol - 4.7 mmol / l, ACT - 11.9 units / l, ALT - 30 units / l, total bilirubin - 19 μmol / L, amylase - 42.3 units / L, glucose - 4.8 mmol / L, lipase - 32 units. During a coprological examination, the stool sample is unformed, ointment consistency, altered muscle fibers +++, neutral fat ++, extracellular starch + are found. Urine diastasis 108 g / h • l (normal 64 g / h • l). In the blood serum, the levels of C-peptide are 0.666 nmol / L (normal 0.23-0.85 nmol / L), insulin 74.6 ng / ml, trypsin 314.8 ng / ml (normal 100-400 ng / ml), interleukin 1 β - 184 pmol / L (normal up to 50 pmol / L), tumor necrosis factor - 122 pmol / L (normal up to 50 pmol / L). Treatment with omeprazole 20 mg 2 times a day, novocaine 50 ml + atropine 2 ml + isotonic solution 200 ml iv drip 3 times, a solution of platifillin hydrotartrate 1 ml iv muscle, creon 2 capsules during meals. An infusion from the proposed collection of 1/3 cup 3 times a day 30 minutes before meals for 4 weeks was added to the treatment in the subacute stage.

 After 3 days, the intensity of pain, belching, rumbling in the abdomen decreased, on the 14th day after the start of herbal medicine, the number of bowel movements per day was 3 times a day. After prolonged treatment for 3 weeks, the patient's state of health improved, pain in the upper abdomen disappeared, appetite, sleep improved, and stool returned to normal. Interleukin 1 levels decreased by 3 times, tumor necrosis factor - by 2.4 times. After 5 weeks, the content of pro-inflammatory cytokines and elastase did not differ from the norm.

 The above example of the treatment of chronic pancreatitis by the proposed method shows a high therapeutic effect that cannot be achieved by known methods of treatment.

 The treatment method is harmless, does not cause side effects, has no contraindications.

Claims (1)

 A method for the complex treatment of chronic pancreatitis, which consists in taking the infusion from the collection of medicinal plants, including the roots of burdock, grass of the cinnamon swamp, against the background of traditional therapy, characterized in that the collection additionally contains the roots of the marshmallow, licorice, bark of the common oak, and the herb of the melilot , motherwort grass, mountaineer bird grass, purple coneflower leaves, coltsfoot leaves, walnut leaves with their ratio 2: 1: 2: 2: 2: 2: 1: 1: 1: 2: 1, and the infusion is taken into the subacute stage beyond pain for 4 weeks.

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