RU2306145C1 - Preparation for treating chronic prostatitis - Google Patents

Abstract

FIELD: medicine, urology.

SUBSTANCE: it has been suggested to apply medicinal mixture that includes 50 mg caripazym enzymatic preparation, 5 mg hydrocortisone and 2 ml 20%-Dimexid solution as a calculus-destructing preparation being introduced due to rectal electrophoresis in patients in case of chronic calculosis prostatitis. After the course of therapy conducted previously US-detected rounded prostatic formations were not determined or their size was decreased by more than 50%, prostatic size achieved the norm and reproductive function was improved.

EFFECT: higher efficiency of therapy.

3 ex, 1 tbl

Description

The invention relates to medicine, namely to urology, and can be used for the complex treatment of patients with chronic prostatitis.

A widely known method of treating chronic non-infectious prostatitis using the herbal medicine Prostanorm, which has an anti-inflammatory, antispasmodic and reparative effect, and also improves venous circulation in the prostate gland. In chronic prostatitis, the drug is prescribed 2 tablets 3 times a day 30 minutes before meals or 40 minutes after meals. The continuous course of treatment is 6 months [Maso EB, Popov SV // Therapeutic archive. - 2005. - T.77. - No. 10. - S. 65-68]. The disadvantages of this method are the inconvenient regimen of taking the drug, as well as the long duration of the course of treatment.

Currently, it is known the use of the drug "Terazosin" in the treatment of patients with chronic abacterial prostatitis. This drug belongs to the group of alpha ₁ - adrenergic blockers. The drug is taken orally at 5 mg / day for 8 weeks daily [Sivkov A.V., Oshchepkov V.N., Egorov A.A. // Urology. - 2005. - No. 1. - S. - 47-53]. The disadvantages of the method are the duration of the drug, which causes inconvenience to patients, low efficiency with monotherapy.

The use of cytokine therapy in the treatment of chronic prostatitis is known. Cytokines are stimulants of specific immunity, its development and implementation. In particular, beta-leukin is used, one of the main properties of which is its ability to stimulate the functions of many types of white blood cells and lymphocytes during the development of inflammation and the immune response. The drug is used as subcutaneous injection at a dose of 5 n / g per 1 kg of patient weight. Patients receive 1 injection per day for 3-5 days [O. Ziganshin et al. // Venereologist. - 2004. - No. 9. - S. - 36-39]. The disadvantages of the method are its invasiveness and low efficiency in monotherapy.

In modern literature, there are indications of the use of the drug "Permixon", which has anti-inflammatory (due to its ability to inhibit phospholipase A ₂ ) and decongestant (affects the vascular phase of inflammation, permeability of capillaries and reduces vascular stasis) properties for the treatment of chronic prostatitis. The drug is available in 80 mg tablets or in 160 mg capsules. A single daily dose of Permixon is 320 mg. For sufficient clinical efficacy of this drug in the treatment of chronic abacterial prostatitis, a treatment course of at least 6 months is required [Sivkov A.V., Oshchepkov V.P., Medvedev A.M. // Consilium medicum. - 2005. - Volume 7. - No. 7. - S. 582-586]. The disadvantage of this method is the long duration of the course of treatment.

A known method of treating chronic prostatitis using the enzyme preparation "Lidase" and magnetolaser therapy [Reshetov PP, Reshetov SP, Sedov ON, Bolshakov DL // Issues of balneology, physiotherapy and physiotherapy. - 2004. - No. 6. - S. 41]. This method includes two steps:

1) abdominal magnetic laser therapy, which is carried out in advance, 1 hour before the introduction of microclysters in the rectum;

2) medicinal microclysters, which include 20 ml of a 20% Dimexidum solution, 64 units of the enzyme preparation Lidaza, 300 mg of vitamin E, with a total volume of 50-60 ml. Microclysters are carried out daily at a temperature of 36-38 ° С [Reshetov P.P., Reshetov S.P., Sedov O.V., Bolshakov D.L. // Issues of balneology, physiotherapy and physiotherapy. - 2004. - No. 6. - S. 41].

The disadvantages of this technique are:

- inefficiency in the presence of stones in the prostate gland;

- lack of the most complete introduction of drugs into the prostate gland, because with this technique, a significant part of the drugs is absorbed into the systemic circulation, thereby exerting a systemic effect.

There is a method of treating chronic prostatitis using endourethral electrophoresis of the enzyme preparation Collalizin. 500 KE of Collalizine is dissolved in 3 ml of a 0.5% solution of novocaine and administered by endourethral electrophoresis (from the positive pole at a current of 1 mA per 1 cm ² ). The duration of each procedure is 20 minutes, for a course of 8-10 procedures [Suvorov S.A. // Issues of balneology, physiotherapy and physiotherapy. - 2003. - No. 6. - S. 32; RF patent No. 2139726]. The disadvantage of this method is the constant trauma of the urethra by the electrode, which can lead to the development of urethritis, urethral strictures.

Due to the formation of stones in the prostate gland with chronic prostatitis, mechanical obstruction of the excretory ducts of the glandular acini, stagnation of the secret and, thereby, the constant maintenance of the inflammatory process in the gland tissue are observed. In addition, stones formed in the tissue of the prostate gland can become infected, which leads to further progression of the disease. We first discovered the property of the enzyme preparation “Karipazim” to dissolve in more than 50% of the stones formed in the prostate gland in chronic prostatitis. Karipazim is used as follows. Prepare a medicinal mixture of the following composition: 50 mg of the enzyme preparation “Karipazim”, 10 ml of physiological saline, 5 mg of hydrocortisone sodium succinate and 2 ml of a 20% solution of dimexide, which is heated to a temperature of 37-39 ° C. Before the introduction of the mixture into the rectum, the patient is given a cleansing enema. Then, in the position of the patient on the abdomen with a roller placed under the pelvic region, the prepared drug mixture is introduced in the form of microclysters in full. After that, a rectal electrode connected to the positive pole of the Potok-1 apparatus is inserted into the rectum to a depth of 5-7 cm. A hydrophilic pad 10 × 15 cm in size is placed on the suprapubic region, onto which an electrode is attached, connected to the negative pole of the Potok-1 apparatus. Subsequently, rectal electrophoresis is performed from the positive pole at a current strength of 1 mA for 15 minutes. After that, the rectum is freed from the rectal emitter, a cleansing enema is performed, and 2 rectal suppositories “Methyluracil” are introduced into the rectum. A course of treatment consisting of 10 daily procedures described above is carried out.

- The enzyme preparation “Karipazim” is the sum of the proteolytic enzymes contained in the milk juice of papaya (melon tree). The active components of this amount are enzymes: papain, chymopapain A, chymopapain B, peptidase A, peptidase B, lysocin. This drug is traditionally used for the following diseases: spinal osteochondrosis, intervertebral hernias, joint contractures, keloid scars, large joint arthroso-arthritis, shoulder-scapular periarthritis, cerebral and spinal arachnoiditis, as well as for 3rd degree burns as a means of accelerating rejection scabs and cleansing granulating wounds from purulent necrotic tissues. There is evidence of the possibility of electrophoretic administration of this drug [Institute of Pharmacochemistry im. I. Kutateladze of the Academy of Sciences of Georgia. - Normative documentation ND 42-10325-99]. Thus, the enzyme preparation “Karipazim” has the ability to soften and dissolve scars, cysts that are present in the tissue of the prostate gland with chronic prostatitis, in addition, we first revealed the ability of Karipazim to resorb stones formed in the prostate gland in chronic prostatitis.

- Hydrocortisone sodium succinate has an anti-inflammatory property and is a water-soluble drug, which allows its electrophoretic administration, as a result, the anti-inflammatory effect of the drug is directly in the prostate gland.

- Dimethyl sulfoxide has the inherent ability to enhance the effect of many drugs and increase the body's resistance to damaging effects. It has a pronounced transporting property and is considered bipolar, however, the transfer is more pronounced towards the cathode [Bogolyubov V.M. // Technique and methods of physiotherapeutic procedures. - M. - 2002. - S. 24].

- The saline solution in this case is the connecting link for the two preparations described above and a suitable contact medium for electrophoresis.

- “Methyluracil” is a drug that has an immunostimulating, anti-inflammatory effect, accelerating the processes of cell regeneration, wound healing. Rectal suppositories “Methyluracil” are issued (in 1 suppository - 500 mg of methyluracil). Indications for the use of this drug are: rectitis, sigmoiditis, ulcerative colitis, sluggishly healing wounds [Borisova OA, Polovinko A.E., Zhiglyavskaya O.A. // Modern medicines, vitamins and minerals. - SPb .: Owl; M .: Eksmo, 2003. - S. 365]. The use of the drug daily after electrophoresis of the above-described drug mixture is aimed at reducing the phenomena of rectal irritation.

Under our supervision, there were 30 patients aged 32 to 56 years with chronic calculous prostatitis. Depending on the treatment, we identified 3 groups (10 people each) of patients:

- 1 group received treatment with our proposed remedy.

- group 2 received magnetic laser therapy and microclysters with the enzyme preparation “Lidase” according to the described method [Reshetov P.P., Reshetov S.P., Sedov O.P., Bolshakov D.L. // Issues of balneology, physiotherapy and physiotherapy. - 2004. - No. 6. - S. 41].

- group 3 received endourethral electrophoresis of the enzyme preparation “Collalysin” according to the described method [Suvorov S.A. // Issues of balneology, physiotherapy and physiotherapy. - 2003. - No. 6. - S. 32; RF patent No. 2139726]. We monitored clinical and laboratory parameters in the treatment process.

The results are presented in the table.

Clinical and laboratory indicators The dynamics of clinical and laboratory parameters (in days) during treatment by groups 1 group 2 group 3 group The disappearance of subjective symptoms 3-4 5-6 3-4 Lack of tenderness on palpation of the prostate gland 8-10 18-20 10-11 Reduction of the size of stones in the prostate gland by more than 50% 8-10 Not marked Not marked Approximation of the size of the prostate gland to normal 8-10 18-20 11-12 Restoration of sexual function 6-8 16-18 7-8

As can be seen from the table, the result of the use of the enzyme preparation “Karipazim” as a means of treating chronic prostatitis results in a decrease in the size of stones formed in the prostate gland by more than 50% and a reduction in the time needed to improve the quality of life compared to known methods.

Example 1. Patient U., 36 years old, a driver of motor vehicles, suffers from chronic prostatitis for 8 years. I went to the urology clinic with complaints of dull aching pain in the perineum, sometimes in the inguinal region and in the testicles, impaired potency, decreased libido. Urination is frequent, nocturia 1-2 times. Repeatedly treated on an outpatient basis under the supervision of a urologist at the place of residence. Used antibacterial drugs, uroantiseptics, plant diuretics, rectal suppositories, microclysters with medicinal herbs, vegetable oils and other medicines. The therapeutic effect was short-term, the period of remission did not exceed 3-4 months. The patient was hospitalized. As a result of a clinical and laboratory examination, the diagnosis was made: Chronic calculous prostatitis. With transrectal ultrasound, the asymmetry of the prostate gland due to an increase in the left lobe was confirmed, the gland tissue - heterogeneous echo density. In the central part of the left lateral lobe, 2 rounded formations of increased echo density are determined, with a diameter of 0.4 and 0.6 cm. The patient was prescribed the treatment with our proposed remedy: we prepared a medicinal mixture of the following composition: 50 mg of the enzyme preparation Karipazim, 10 ml of physiological solution, 5 mg of hydrocortisone sodium succinate and 2 ml of a 20% solution of dimexide, which was heated to a temperature of 37-39 ° C. Before the introduction of the mixture into the rectum, the patient underwent a cleansing enema. Then, in the position of the patient on the stomach with a roller placed under the pelvic region, the prepared drug mixture was introduced in the form of microclysters in full. After that, a rectal electrode connected to the positive pole of the Potok-1 apparatus was inserted into the rectum to a depth of 5-7 cm. A hydrophilic pad 10 × 15 cm in size was placed on the suprapubic region, onto which an electrode connected to the negative pole of the Potok-1 apparatus was placed. Subsequently, rectal electrophoresis was performed from the positive pole at a current strength of 1 mA for 15 minutes. After that, the rectum was freed from the rectal emitter, a cleansing enema was performed, and 2 rectal suppositories “Methyluracil” were introduced into the rectum.

After 3 procedures of electrophoresis, the patient noted the disappearance of pain, after 4 procedures, normalization of urination was noted. After the 7th procedure, the patient noted restoration of sexual function. At the end of treatment, a control transrectal ultrasound of the prostate was performed. At the same time, the sizes of the left lobe approached normal, in the central part of the left lateral lobe, 1 round formation of heterogeneous echo density, 0.2 cm in diameter, is determined. The result of the treatment was monitored for 9.5 months. The patient's condition is satisfactory, no complaints.

Example 2. Patient V., 43 years old, unemployed. I went to the urology clinic with complaints of a significant decrease in potency, pain in the sacrum and glans penis, frequent urination. Sick for 3 years. Over this period of time, the above complaints appeared within 12 times. I did not seek medical help, I used herbal medicine. As a result of a clinical and laboratory examination, the diagnosis was made: Chronic calculous prostatitis. Transrectal ultrasound of the prostate revealed uneven echo density of its tissue, an increase in the right lobe due to the round formation of increased echo density, 0.4 cm in diameter. The patient was prescribed treatment with the remedy we proposed. A drug mixture of the following composition was prepared: 50 mg of the Karipazim enzyme preparation, 10 ml of physiological saline, 5 mg of hydrocortisone sodium succinate and 2 ml of a 20% dimexide solution, which was heated to a temperature of 37-39 ° С. Before the introduction of the mixture into the rectum, the patient underwent a cleansing enema. Then, in the position of the patient on the stomach with a roller placed under the pelvic region, the prepared drug mixture was introduced in the form of microclysters in full. After that, a rectal electrode connected to the positive pole of the Potok-1 apparatus was inserted into the rectum to a depth of 5-7 cm. A hydrophilic pad 10 × 15 cm in size was placed on the suprapubic region, onto which an electrode connected to the negative pole of the Potok-1 apparatus was placed. Subsequently, rectal electrophoresis was performed from the positive pole at a current strength of 1 mA for 15 minutes. After that, the rectum was freed from the rectal emitter, a cleansing enema was performed, and 2 rectal suppositories “Methyluracil” were introduced into the rectum. After carrying out 4 procedures, the complete disappearance of pain in the sacrum and glans penis was noted, urination normalized. After the 5th procedure, restoration of potency, increased libido was noted. At the end of the treatment, a control transrectal ultrasound of the prostate was performed. Conclusion: the size of the prostate gland is within normal limits, a slight heterogeneous echo density of gland tissue is determined. The treatment result was monitored for 9 months - the patient's condition is satisfactory, no complaints.

Example 3. Patient K., 54 years old, a bank employee. He went to the urology clinic with complaints of pain in the perineum, decreased potency, impaired urination in the form of frequent urination. Occasionally noted the appearance of these complaints over the past 10 years. He was treated by a urologist at the place of residence with a slight short-term effect. In the clinic of urology, a clinical and laboratory examination of the patient was performed. Transrectal ultrasound of the prostate revealed an increase in the right lobe due to the round formation of increased echo density with a diameter of 0.7 cm and the left lobe due to 2 round formations of increased echo density with a diameter of 0.2 and 0.5 cm, inhomogeneous echo density of the prostate tissue. The patient was prescribed treatment with the remedy we proposed. A drug mixture of the following composition was prepared: 50 mg of the Karipazim enzyme preparation, 10 ml of physiological saline, 5 mg of hydrocortisone sodium succinate and 2 ml of a 20% dimexide solution, which was heated to a temperature of 37-39 ° С. Before the introduction of the mixture into the rectum, the patient underwent a cleansing enema. Then, in the position of the patient on the stomach with a roller placed under the pelvic region, the prepared drug mixture was introduced in the form of microclysters in full. After that, a rectal electrode connected to the positive pole of the Potok-1 apparatus was inserted into the rectum to a depth of 5-7 cm. A hydrophilic pad 10 × 15 cm in size was placed on the suprapubic region, onto which an electrode was attached, connected to the negative pole of the Potok-1 apparatus. Subsequently, rectal electrophoresis was performed from the positive pole at a current strength of 1 mA for 15 minutes. After that, the rectum was freed from the rectal emitter, a cleansing enema was performed, and 2 rectal suppositories “Methyluracil” were introduced into the rectum. After 4 procedures, the disappearance of pain in the perineum was revealed. Urination recovered after 6 treatments. After the 8th procedure, a significant increase in sexual function was noted. When conducting a control transrectal ultrasound of the prostate after the end of the course of treatment, a decrease in the size of the right and left lobes was revealed, in the right lobe, a round formation of inhomogeneous echo density of 0.3 cm was determined, in the left lobe, a round formation of inhomogeneous echo density of 0.2 cm was determined. The treatment result was traced within 8 months - the patient's condition is satisfactory, no complaints.

As can be seen from the description and clinical examples, we first revealed a new property of Karipazim, which consists in:

• the ability of the enzyme preparation "Karipazim" to resorb stones formed in the prostate gland with chronic prostatitis.

The main technical result is the ability to expose to resorption with the help of our proposed remedy stones formed in the prostate gland with chronic prostatitis.

Claims (1)

The use of a medicinal mixture, including 50 mg of the enzyme preparation caripazim, 5 mg of hydrocortisone and 2 ml of a 20% solution of dimexide, as a means of absorbing stones when administered by rectal electrophoresis in patients with chronic calculous prostatitis.