RU2306134C2 - Method for basic treatment of chronic viral hepatitis c - Google Patents

Abstract

FIELD: medicine, gastroenterology.

SUBSTANCE: additionally to general scheme of basic therapy it is necessary to apply FISHant-C preparation once weekly at the quantity of 200.0 g 60 min after light breakfast. Course duration corresponds to about 2-6 mo. Therapy should be carried out once annually. The innovation provides normalization of clinico-biochemical parameters without applying anti-viral therapy.

EFFECT: higher efficiency of therapy.

2 ex, 2 tbl

Description

The invention relates to medicine, and more particularly to the field of infectology. The method is intended for the treatment of chronic viral hepatitis C.

A known method for the basic treatment of chronic viral hepatitis C using drugs such as 5% glucose, acesol, isotonic sodium chloride solution, hemodesis, reopoliglukin, ascorbic acid, potassium chloride, albumin, amino acid mixtures (hepasol, etc.), heptral, contracal, roncoleukin, vikasol, lasix, riboxin, immunofan, donor immunoglobulin, derinat, papaverine, platifillin, B vitamins, potassium orotate, aevit, ascorutin, milk thistle preparations (hepatene and others), enzymes (pancreatin and others) .), galstena, enterosorbents (duf ak), probiotics (bacterin bifidum and the like), endogenous interferon inducers (amiksin etc.), ozone [1, 2].

The disadvantage of this method is the lack of complex therapy that prevents fatty liver.

The prototype of the invention is a basic treatment method for chronic viral hepatitis C, which includes the following syndromic therapy: detoxification (5% glucose solution, saline, hemodesis), hepatoprotective (vitamins A, C, B ₂ , B ₁₂ , rutin, Riboxinum, Heptral, Essential Forte, Karsil), hemastatic (Vikasol, calcium preparations, ascorbic acid), immunocorrective (GCS, immunoglobulin, thymogen), antispasmodic (papaverine, no-shpa) and choleretic drugs - bile (allohol, lye NZim) or herbal preparations (immortelle flowers, corn stigmas, choleretic fees, flacumin, tanacechol, holosas) [3].

The disadvantage of the above method of treatment is the lack of effectiveness on lipid metabolism.

The aim of the invention is to increase the effectiveness and quality of treatment of chronic viral hepatitis C (CVH C).

This goal is achieved by the fact that in the general scheme of basic therapy an additional medication “FISHant-S preparation” is used, which is taken 1 time per week in the amount of 200.0 grams 60 minutes after a light breakfast for 2-6 months with a course of 1 time per year.

The method is implemented as follows: the drug FISHant-S begins to be taken simultaneously with the basic therapy of CVH C, which lasts on average 2-4 weeks, 60 minutes after a light breakfast, the contents of the package (200 g) are eaten at a time 1 time per week, but the duration taking the drug FISHant-S is from 2 to 6 months, a course of 1 time per year.

FISHant-S is an oil-pectin microemulsion. White oil (a mixture of highly purified saturated hydrocarbons), pectin and agar (from seaweed) are mixed according to a special technology with the formation of microcapsules of oil coated with a shell of pectin and agar. After oral administration, the action of FISHant-S begins already in the stomach, where pectin and agar absorb toxic substances (salts of heavy metals, if any) and remove them from the body. The emulsion is resistant to the action of hydrochloric acid of the stomach and does not lose its healing properties.

In the small intestine, FISHant-S mixes with intestinal contents and covers the intestinal mucosa with a thin layer that does not interfere with the absorption of food components, thereby increasing the intestinal absorption surface. Bile is actively dissolved in white oil, kept in a soluble state inside the capsule of the emulsion and moves into the colon. As a result, cholesterol contained in bile and cholesterol supplied with food do not enter the bloodstream and are evacuated from the body along with feces. The resulting normal small deficiency of bile (as in a healthy body) is compensated by the liver in the form of a new portion of bile, for this surplus of cholesterol comes from the blood from the liver stocks in various tissues, including the liver, gall bladder and vascular wall. As a result, the liver gets rid of obesity, the gall bladder restores contractility, the arteries become smooth and elastic. The natural mechanism for controlling blood cholesterol is gradually being restored.

At the same time, digestive enzymes located in the intestine and receiving additional energy from the surface of the emulsion are activated. Normal digestion is restored. Moving along the intestines, pectin and agar inhibit the growth of pathological microorganisms and, being an ideal nutrient medium for beneficial microflora, restore the microbiological population. In addition, toxins of pathogenic microbes are sorbed, which greatly helps the liver restore metabolism and exercise control over cholesterol production and removal of its most dangerous fractions. In the colon, bile along with pectin serve as a good nutrient medium for beneficial microorganisms and prevent the growth of pathogens. The microflora of the colon, which has powerful regulatory and metabolic bonds, is normalized.

In the examined group (20 people) with a confirmed diagnosis of chronic viral hepatitis C, a feeling of heaviness and discomfort in the right hypochondrium bothered 9 patients. Dyspeptic symptoms of the disease were established in 11 patients and were manifested by a feeling of discomfort, heaviness in the epigastrium, belching, and nausea.

After a 3-week course of basic therapy, to which FISHant-S was added, and after 2 months of treatment only with FISHant-S, 8 patients noted the disappearance of a feeling of heaviness in the epigastric region and in the right hypochondrium. In the 10 patients observed by us, the clinical symptoms of CVH C were not detected after 4 months of therapy, and 2 patients required 6 months of treatment to achieve a positive clinical effect.

Antiviral therapy was not performed for patients. The claimed method of treatment is illustrated by the following examples.

Example 1. Patient R., 24 years old, and / b No. 13506/1992, was admitted for treatment to the clinic of infectious diseases with a preliminary diagnosis of acute viral hepatitis on the 3rd day of illness with complaints of jaundice of the skin and sclera, dark urine, light feces

Objectively expressed jaundice of the skin and sclera were observed. On the skin of the chest - single vascular "stars", palmar erythema. In the lungs - vesicular breathing, no wheezing, heart sounds are loud, the rhythm is correct.

The abdomen is soft, painless. The liver is palpated 2.0 cm below the edge of the costal arch, a dense consistency. The spleen is the lower pole.

Blood test from 30.IX.04 g .: Hb - 138 g / l, Le - 5.4 · 10 ⁹ / l, ESR - 7 mm / h.

Urinalysis: 1.015, protein - traces, epithelium - 1-2 in the field of view, Le - 15-19-21 in the field of view.

The absence of a disease cycle, the absence of an infectious-toxic syndrome, as well as the recording of objective examination data: a tight liver texture, biliary signs, a history of blood transfusion (4 years ago), the presence of antibodies to HCV in the blood (total) (ELISA) made it possible to diagnose : chronic viral hepatitis C (antiHCV +) with a moderate degree of activity of the process. Concomitant disease: gastric ulcer, remission. Chronic cholangitis, cholecystitis, remission. Chronic pyelonephritis, exacerbation. Confirmation of the diagnosis was reflected during an additional examination: according to ultrasound, the structure of the parenchyma is heterogeneous, unevenly compacted, echogenicity is increased, the gall bladder with thickened walls, parietal sediment. Spleen - enlarged. When scintigraphy marked diffuse changes in the liver, blood flow with a tendency to decrease.

The patient was prescribed basic therapy: a glucose solution of 5% - 400.0 in a vein drip, a solution of ascorbic acid 5% - 5.0 in a vein, a physiological solution of 400.0 in a vein drip, benzylpenicillin sodium (due to exacerbation of pyelonephritis).

The improvement of pigment metabolism occurred quite quickly, but in terms of mesenchymal inflammation and cholestatic syndrome, the tendency to increase continued. At the same time as basic therapy, FISHant-S was added to the treatment - 200 g once a week, 1 hour after a light breakfast. After 1 month, the color of the skin and urine returned to normal, after 2 months of treatment with FISHant-S alone, the size of the liver decreased, and there was a positive dynamics in the performance of liver functional tests (Table 1). The patient was discharged in satisfactory condition after two months with a recommendation to continue taking FISHant for another 2-4 months.

Table 1. Indicators of liver metabolism during basic therapy of CVH C for 3 weeks with the simultaneous administration of the drug "Fishant" and its further administration for 4 months in patient R. Indicators Norm Before treatment 2 months of treatment 4 months of treatment Total cholesterol g / l 1.2-2.3 3.8 2.9 1.7 Triglycerides g / l 0.5-1.5 2.9 2.2 1,5 HDL g / l 0.35-0.70 0.1 0.25 0.4 LDL g / l 0.6-1.7 3,5 2.19 1,6 ALAT Unit / L 40 620 210 60 Alkaline Phosphatase Unit / L 32-92 185 121 88 GGTP Unit / L 92-220 810 405 202 Total bilirubin μmol / L 8.5-20.5 171 47 21 Total protein g / l 65-76 52 65 71

Example 2. Patient D., 48 years old, and / b No. 9791/1366, was admitted for treatment to the clinic of infectious diseases on the 9th day of illness, 5th day jaundice with complaints of general weakness, malaise, loss of appetite, discomfort in the right hypochondrium, heaviness in the epigastrium, nausea, yellowness of the skin and sclera, dark color of urine.

He gradually became ill with growing asthenovegetative (general weakness, malaise) and dyspeptic (loss of appetite, stooling) syndromes, from the 4th day of the disease the color of urine (the color of "dark" beer) and the color of the skin and sclera (yellowness) changed.

In the epidemiological history - intravenous injection of narcotic substances over the past three years. An objective examination of the state of moderate severity, body temperature 36.8 ° C. Skin, sclera - icteric (icteric). In the lungs, vesicular breathing. Heart sounds are quiet, rhythmic, 64 beats / min. HELL 160 and 80 mm Hg The abdomen is soft, painless. An increase in the liver by 2.0 cm, a dense-elastic consistency. The spleen is the lower pole.

Blood test from 07/10/03: Hb - 110 g / l, Le - 4.5 · 10 ⁹ / l, ESR - 10 mm / h.

Urinalysis: yellow, turbid, acidic, protein - negative, sugar (-), bile pigments (+), flat epithelium - single in the field of view, Le - 2-3 in the field of view, oxalates - single in the field of view.

The main clinical diagnosis: Exacerbation of chronic viral hepatitis C with a high degree of activity of the process, the phase of virus replication (HCV + RNA).

Treatment: table 5a-9, bed rest, Acesol solution - 400.0 in a vein for 10 days drip, a solution of ascorbic acid 5% - 5.0 in a vein for 10 days, a solution of riboxin 2% - 1.0 in a vein, solution Solcoseryl 2.0, Essential Forte 5.0 into a vein, Papaverine 2% - 2.0 intramuscularly at night. Inside, lipoic acid is 0.2 × 3 times a day, folic acid is 0.001 × 3 times a day.

The patient refused antiviral therapy.

Within 2 weeks, the patient's condition improved: general weakness decreased, the skin lightened, urine became lighter.

However, on the 17th day of illness (the 10th day of stay in the clinic), there was a tendency to exacerbate the disease: AlAT 198 U / L → 540 U / L, β-lipoproteins - 12.0 g / L → 17.7 g / L , and from the 24th day of the disease there were clinical signs of deterioration of health: itching of the skin, heaviness in the right hypochondrium, bitterness in the mouth. An ultrasound study revealed signs of chronic pancreatitis, biliary dyskinesia of the hypomotor type. Fatty hepatosis II. The preparation “FISHant-S” was included in the prescription list - 200 g once a week, 1 hour after a light breakfast. Over the next 3 weeks, the patient's condition improved: the pain syndrome disappeared, the color of the skin and urine normalized, overall health improved, the size of the liver decreased, and along with clinical improvement, there was a good dynamics of biochemical parameters (Table 2).

Table 2. Indicators of liver metabolism during basic therapy of CVH C for 3 weeks with the simultaneous administration of the drug "Fishant" and its further administration for 6 months in patient D. Indicators Norm Before treatment 2 months of treatment 4 months of treatment 6 months of treatment Total cholesterol g / l 1.2-2.3 5.5 4.1 3.3 2.2 Triglycerides g / l 0.5-1.5 2.9 2,4 2.1 1,6 HDL g / l 0.35-0.70 0.15 0.2 0.26 0.45 LDL g / l 0.6-1.7 3,1 2.6 1.9 1.4 ALAT Unit / L 40 540 210 115 52 Alkaline Phosphatase Unit / L 32-92 311 220 144 87 GGTP Unit / L 92-220 880 660 310 215 Total bilirubin μmol / L 8.5-20.5 110 67 41 21 Total protein g / l 65-76 52 60 66 71

Using the proposed method can significantly improve the quality and increase the effectiveness of the treatment of chronic viral hepatitis C.

The method is advisable to use in the treatment of chronic viral hepatitis C in infectious hospitals and infectious diseases departments of hospitals.

Information sources

1. Mayer K. - P. Hepatitis and the effects of hepatitis: Practical. hands: Per. with him. Ed. A.A.Sheptulina. - M .: Geotar Medicine. - 1999 .-- 432 p.

2. Podymova S.D. Liver disease. - M.: Medicine. - 1998.

3. Sorinson S. N. Viral hepatitis. - St. Petersburg: Thesa. - 1996. - 314 p.

Claims (1)

A method for the basic treatment of chronic viral hepatitis by taking medications for basic therapy, characterized in that in the general scheme of basic therapy they use an additional medication “drug FISHant-S”, which is taken once a week in an amount of 200.0 g 60 minutes after lung breakfast for 2-6 months, once a year.