RU2419427C1 - Method of prevention and complex treatment of urolithiasis after distant lithotripsy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to urology and rehabilitation medicine, and deals with prevention and complex treatment of urolithiasis after distant lithotripsy. For this purpose after distant-shock-wave lithotripsy carried out is litholytic, antibacterial, antispasmodic, analgesic therapy with administration of a diet. Additionally introduced is infusion of medicinal plants, which contains bearberry leaves, leaves of Indian kidney tea, knotweed grass, dill fruits, burdock root, nettle leaves, rowan fruits, taken in equal component ratio. Infusion is introduced in dose 100 ml 3 times for day 30 min before meal for 10 days at the background of carried out basic therapy and for 4 weeks after its withdrawal, basic therapy.

EFFECT: method ensures efficient prevention and treatment due to complex impact on all links of urolithiasis pathogenesis.

3 cl, 1 tbl, 1 ex

Description

The invention relates to medicine, namely to urology and rehabilitation medicine, and can be used for the prevention and comprehensive treatment of urolithiasis after distance lithotripsy (DLT).

Urolithiasis or urolithiasis is one of the leading places in the structure of urological diseases in terms of frequency of distribution. This disease affects people of all ages. In the onset and development of urolithiasis, a major role is played by urinary tract infections, impaired urodynamics of the upper urinary tract and various types of metabolism, especially water-salt, decreased blood flow and ureter in the kidneys, and a change in the chemical composition of blood. Treatment of urolithiasis should be complex, individual, following the appropriate diet and using phytotherapy, which can be quite effective if the action of medicinal plants is aimed at activating diuresis, fighting infection, restoring urodynamics, loosening and breaking down stones, normalizing metabolic processes in the body, increasing the solubility of salts and relieving spasms [Pastushenkov L.V., Lesiovskaya E.E. Pharmacotherapy with the basics of herbal medicine. - St. Petersburg .: SPKHFI, 1995. - S.124-126].

Known methods of treating urolithiasis using complex herbal preparations: "Olimetin" - a preparation containing in 1 g peppermint oil 0.017 g, purified turpentine oil 0.0341 g, sweet oil 0.025 g, olive oil 0.9205 g, purified sulfur 0 , 0034 g, is administered orally by 2 capsules 3-5 times a day, with the prophylactic purpose of 1 capsule per day for a long time; “Pinabin” - a 50% solution of the heavy fraction of essential oils in peach oil, obtained from pine and spruce needles, is prescribed orally 5 drops 3 times a day, the course of treatment is 3-4 weeks, with renal colic up to 20 drops once [Sokolov S. I AM. Herbal Medicine and Phytopharmacology: A Guide for Physicians. - M.: Medical News Agency, 2000. - S.501-502].

The above methods have some disadvantages and contraindications for use: for "Olimetin," these are urinary disorders, acute and chronic glomerulonephritis, hepatitis, gastric ulcer; for Pinabin - jade, nephrosis.

The closest analogue of the invention according to the technical essence and the achieved result is a method for the prevention and treatment of urolithiasis using prolite, which includes the following medicinal herbs: curly silk, kidney tea, phyllanthus nerurium, garden sow, fruits of cubeba pepper, green leaves and peel papaya fruit [M.E. Sitdykova, F.M. Kuzmina. The effectiveness of the use of the drug "PROLIT" for urolithiasis in complex treatment with DLT. - http://netkamney.ru/public/pub3.html]. The method provides prevention of urolithiasis, however, it is known that when using herbal medicines, it is necessary to give preference to herbal remedies growing in the area.

Therefore, an important problem is the creation of a rational phytocomposition, which combines medicinal plants growing and cultivated in the Russian Federation, in particular Bashkortostan, and capable of restoring the urodynamics of the kidneys, bladder (bearberry, kidney tea), and affect the microbial factor (bearberry, mountain ash), increase the solubility of salts, loosening and destruction of stones (birdman, corn stigmas, kidney tea), restore colloidal trukturu urine (nettle, knot-grass), to improve metabolic processes (burdock, corn silk) increase the organism resistance (mountain ash, nettle) to remove ureteral spasm (garden dill, renal tea).

The technical result is the prevention of relapse, an increase in the duration of remission and an increase in the effectiveness of treatment by reducing its time.

The specified technical result is achieved by the fact that in the method of prevention and complex treatment of urolithiasis after remote lithotripsy, including basic therapy with litholytic drugs, uroseptics, analgesics, antispasmodics, diet, oral administration of a collection of medicinal herbs containing kidney tea leaves according to the invention as a collection enter the infusion of the collection, which additionally contains bearberry leaves, bird of the mountaineer, corn stigmas, dill fruits, burdock roots, nettle leaves, p fruits ordinary apples, taken with an equal ratio of components, 100 ml 3 times a day 30 minutes before meals for 10 days and an additional 4 weeks after the abolition of basic therapy. In this case, as uroseptics and antispasmodics, respectively, nolicin is administered. 400 mg 2 times a day for 10 days and platifillin 0.2% - 1.0 ml subcutaneously with renal colic and spasms of the ureters. At the same time, analgin 50% - 1.0 ml / m and ketans 3% - 1.0 ml / m are administered as analgesics.

The proposed method is as follows: after distance-shock wave lithotripsy (ESWL), basic therapy is carried out, which includes the appointment of litholytic drugs for 10 days, namely blemar (the granulate is dissolved in a liquid, the daily dose of 6-18 mg depends on the pH of the urine) , cystone (2 tablets. 3 times a day), analgesics for pain (analgin 50% - 1.0 ml IM, ketans 3% - 1.0 ml IM), antispasmodics for renal colic and ureteral spasms ( platifillin 0.2% - 1.0 ml s / c), as an antibacterial therapy of uroseptics (nolicin table. 400 mg 2 times a day) for 10 days. From the first day, the patient is prescribed an infusion from a collection of medicinal plants containing bearberry leaves, kidney tea leaves, bird mountain grass, corn stigmas, dill fruits, burdock roots, nettle leaves, common rowan fruits, taken with an equal ratio of components (1: 1: 1 : 1: 1: 1: 1: 1), 100 ml 3 times a day 30 minutes before meals for 10 days. To prevent complications of urolithiasis, the infusion from the collection is prescribed additionally within 4 weeks after the abolition of basic therapy. Water infusion is prepared in a ratio of 1:10, in a boiling water bath in the mode of 15 minutes of heating and 45 minutes of cooling at room temperature, filtered, water is added to the required volume [State Pharmacopoeia of the USSR: Issue 2. General methods of analysis. Medicinal plant material. - 11th ed., Ext. - M .: Medicine, 1989. - S.147-148].

The proposed method treated 16 patients. Under observation were two groups of patients. The first group of 16 people: men 11 people (69%), women 5 people (31%) received basic therapy using phyto collection. The average age is from 30 to 82 years. The second group (control) - 20 people aged 28 to 74 years, received treatment without the use of fees.

Clinical symptoms included: an attack of renal colic (acute lower back pain, with typical radiating along the front wall of the abdomen, down the ureter; with stones in the lower third of the ureter, the pain radiates to the genitals, scrotum, and in the prebubble department is characterized by imperative urination when empty bladder), nausea, vomiting, dysuria, macrohematuria.

In the first group, 9 (56.2%) patients were with kidney stones up to 1.2 cm in size and 7 (43.8%) patients with ureteral stones up to 0.9 cm in size. Leukocyturia was detected in 11 before 68 of leukemia (68, 7% o), and averaged 10-20 leukocytes in sight. In the second (control) group, 12 (60%) had kidney stones, and 8 (40%) had ureteral stones. Leukocyturia in the control group was detected in 14 (70%) patients and averaged 5-25 leukocytes in the visual field. In the first group of patients with kidney stones, fragment discharge after ESWL was noted on the 3rd – 7th day in 9 patients. In 5 patients, discharge occurred on the 11-14th day after ESWL. A repeat ESWL session was required in 2 patients. In the control group of patients with kidney stones, fragment discharge after ESWL was noted on the 9-15th day in 9 patients. In 3 patients, the passage of fragments after ESWL was noted on days 20-21. A repeat ESWL session was required in 8 patients. Normalization of urine tests in the first group was noted on the 10-12th day after the appointment of phytobarget, and in the control group on the 18-25th day after ESL. In the first group of patients with ureteral stones, the passage of fragments after ESWL was observed on the 1st – 5th day in 5 patients, in 2 patients, the passage occurred on the 11th day. In the control group, calculus discharge occurred on the 5th – 9th day in 3 patients; in 5 patients, the discharge occurred on the 11–14th day. Normalization of urine tests in the first group was noted on the 7-12th day, and in the control group on the 15-23rd day after ESL.

The results of the study, presented in the table, show that in the first group receiving complex treatment using basic therapy and phyto-collection, the indicators exceeded the results of the second (control) group, receiving only basic treatment.

According to the control examination, it was found that the phytobox does not violate the functional state of the kidneys, and the effect of the infusion from the harvest on the serum concentration of potassium, sodium and total calcium was also not revealed. At the same time, a statistically significant increase in urine volume, a decrease in the level of nitrogenous slags (creatinine, urea), a decrease in the level of hypercalciuria from 9.23 ± 0.78 to 5.73 ± 0.44 mmol / day in 100% of cases occurred as well as a decrease in urine pH from 6.04 ± 0.07 to 5.79 ± 0.12 in 75% of cases. In addition, there was a tendency to a decrease in the increased concentration of uric acid in the blood serum and the content of oxalates and uric acid in the urine (see table).

The invention is illustrated by the following clinical example: Patient A., 1979, was admitted to the hospital with complaints of sudden cramping pain in the right lumbar region with irradiation along the front wall of the abdomen, down to the bladder, frequent urination, nausea, dryness in the mouth.

Blood test: red blood cells 3.42 × 10 ¹² / l, white blood cells 4.8 × 10 ⁹ / l, Hb 109 g / l, ESR 25 mm / h.

Urinalysis: light s / f, ph-acid., Ud.1009 protein 0.066 ‰, white blood cells 2-5-7, red blood cells in b / c.

Biochemical analysis of blood: total protein 72 g / l, creatinine 138 μmol / l, urea 7.4 mmol / l.

Ultrasound MVS: Urolithiasis. Stone of the proximal section of the right ureter with dimensions of 7 mm. Ureterohydronephrosis on the right 2 tbsp.

On the survey and a series of excretory urograms: the excretory function of the left kidney is not disturbed, on the right it is sharply reduced. Occlusal stone in the proximal segment of the right ureter 7 mm in size.

The treatment was performed: DUVL of the upper third of the right ureter, analgesics (analgin 50% - 1.0 v / m, ketans 3% - 1.0 ml / m), antispasmodics (platifillin 0.2% - 1.0 ml s / c ), litholitics (cystone, 2 tablets. 3 times a day), uroseptics (nolicin 400 mg 2 times a day). An infusion of the proposed phytosport of 100 ml 3 times a day for 10 days was added to the treatment, and after the abolition of the basic therapy, treatment was continued only using herbal collection for up to 4 weeks.

Results: discharge of calculus from the right ureter after 7 days.

Analyzes after 2 weeks of treatment.

Blood test: red blood cells 4.12 · 10 ¹² / l, white blood cells 4.7 · 10 ⁹ / l, Hb 119 g / l, ESR 13 mm / h.

Urine analysis after 10 days: light-s / f, ph-acid., Ud. 1018, protein - negative., White blood cells 0-2-1, red blood cells were not found.

Biochemical analysis of blood: total protein 78 g / l, creatinine 97 μmol / l, urea 3.2 mmol / l.

Ultrasound MVS: Sonogram of the kidneys within normal limits.

On the survey urogram - shadows of calculi in the projection of the urinary tract were not detected.

The above example of the complex treatment of urolithiasis after ESWL and the prevention of its complications by the proposed method shows a high therapeutic effect, allows to reduce treatment time, extend the period of remission and prevent relapse. The method is harmless, does not cause side effects, has no contraindications.

Table
Comparative characteristics of the metabolic status in patients treated with phytosborder and the control group with urolithiasis after distance lithotripsy Biochemical parameters of blood and urine Average value before treatment after treatment
main group After treatment
control group Diuresis, ml 1673 ± 374 1854 ± 369 1687 ± 358 Blood creatinine, µmol / l 132 ± 24 112 ± 18 123 ± 17 Blood urea, mmol / l 7.70 ± 0.34 5.43 ± 0.41 6.94 ± 0.38 Creatinine clearance, ml / min 95.9 ± 3.6 94.5 ± 3.2 95.4 ± 3.4 Potassium of blood, mmol / l 4.68 ± 0.27 4.59 ± 0.19 4.62 ± 0.23 Blood Sodium, mmol / L 144.8 ± 3.3 144.2 ± 2.7 144.6 ± 3.1 Blood Calcium, mmol / L 2.38 ± 0.12 2.40 ± 0.09 2.42 ± 0.11 Blood uric acid, mmol / l 0.452 ± 0.088 0.370 ± 0.096 0.439 ± 0.079 Urine oxalates, mg / kg per day 0.53 ± 0.09 0.46 ± 0.08 0.50 ± 0.07 Urinary uric acid, mmol / day 4.67 ± 1.39 3,59 ± 1,09 4.23 ± 1.07 Inorganic urine phosphates, mmol / day 25.7 ± 8.3 23.5 ± 5.7 24.7 ± 5.4 Total urine calcium, mmol / day 9.23 ± 0.78 5.73 ± 0.44 7.43 ± 0.65 Urine specific gravity 1022 ± 6 1021 ± 8 1020 ± 7 urine pH 6.04 ± 0.07 5.79 ± 0.12 6.02 ± 0.09

Claims (3)

1. A method for the prevention and comprehensive treatment of urolithiasis after distance lithotripsy, including basic therapy with litholytic drugs, uroseptics, analgesics, antispasmodics, diet, oral administration of a collection of medicinal herbs containing kidney tea leaves, characterized in that the collection is infused with the collection, additionally containing bearberry leaves, highlander grass, corn stigmas, dill fruits, burdock roots, nettle leaves, fruits of mountain ash, taken at an equal ratio of comp 100 ml 3 times a day for 30 minutes before meals for 10 days and an additional 4 weeks after the abolition of basic therapy. 2. The method according to claim 1, comprising administering nolicin tablets as uroseptics and antispasmodics in tablets of 400 mg 2 times a day for 10 days and platifillin 0.2% in 1.0 ml subcutaneously with renal colic and ureteral spasms. 3. The method according to claim 1, comprising introducing as analgesics analgin 50% - 1.0 ml / m and ketans 3% - 1.0 ml / m.