CN114306346A - Application of lamotrigine in treatment of systemic lupus erythematosus - Google Patents

Abstract

The invention discloses an application of lamotrigine in treatment of systemic lupus erythematosus, which belongs to the technical field of medicines, and the key points of the technical scheme are as follows: treatment of systemic lupus erythematosus with lamotrigine; using lamotrigine with the dosage of 75-400 mg/day for treating systemic lupus erythematosus; the application method of lamotrigine comprises the following steps: s1, the patient started with lamotrigine at a dose of 75 mg/day with a tid of 25 mg; s2, increasing the dose of lamotrigine to 200-400 mg/day by one week; s3, when the immune system index of the patient is recovered to be normal and the symptom disappears, after the dosage of the step S2 is maintained for 2 months, the dosage of lamotrigine is decreased month by month, and the medicine is stopped within 2 years. The invention is mainly used for treating the SLE patient; the lamotrigine does not cause obvious adverse reaction like hormone medicines after being taken for a long time, and does not require lifelong administration; can effectively reduce adverse reaction of patients caused by taking medicines and reduce pain of patients taking medicines for life.

Description

Application of lamotrigine in treatment of systemic lupus erythematosus

Technical Field

The invention relates to the technical field of medicines, and particularly relates to application of lamotrigine in treatment of systemic lupus erythematosus.

Background

Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease, and is characterized clinically by involvement of multiple systemic organs, repeated relapse and remission, and the presence of a large amount of autoantibodies in vivo, which can cause irreversible damage to the involved organs and ultimately death of the patient if not treated in time.

The current consensus for SLE disease treatment is that the disease condition should be controlled to be in an ideal state of clinical remission (drug withdrawal is not guaranteed), and if clinical remission cannot be achieved, the disease activity should be controlled to be at the lowest possible disease activity level. In SLE patients with a disease course of less than 4 years, about 25% of patients are treated to achieve clinical remission, and 45% of patients develop organ damage. Relapse is a common clinical feature in SLE patients and studies have shown that the overall risk of relapse in SLE patients is 60% within 4 years.

All treatment methods under the current standard of SLE are lifelong medicine taking, and the current treatment of SLE comprises a plurality of medicines such as glucocorticoid, antimalarial, immunosuppressant and biological agent. The most common medicine taken for life, namely hormone, can cause a series of serious adverse reactions after being used for a long time, the symptoms of diabetes, peptic ulcer and similar coxsacin syndrome are easily caused by a larger dosage, the inhibition effect on the hypothalamus-pituitary-adrenal axis is stronger, the infection is the main adverse reaction, and the influence on the life quality of a patient is great. Prevention, reduction of recurrence and control of organ damage caused by disease, reduction of patient mortality, improvement of survival and quality of life are long-term goals for SLE treatment. Therefore, new treatment methods and treatment medicines are actively sought.

In order to solve the problems, the application of lamotrigine in the treatment of systemic lupus erythematosus is provided on the basis of the prior art.

Disclosure of Invention

The invention aims to provide application of lamotrigine in treating systemic lupus erythematosus, and provides a method for treating SLE patients by adjusting the intrinsic rhythm of organisms by using lamotrigine through novel interpretation of chronic non-infectious diseases from the rhythm; the lamotrigine does not cause obvious adverse reaction like hormone medicines after being taken for a long time, and does not require lifelong administration; can effectively reduce adverse reaction of patients caused by taking medicines and reduce pain of patients taking medicines for life.

The technical purpose of the invention is realized by the following technical scheme:

application of lamotrigine in treatment of systemic lupus erythematosus and application of lamotrigine in treatment of systemic lupus erythematosus.

Further: the lamotrigine is used for treating systemic lupus erythematosus by adjusting the immune rhythm.

Further: lamotrigine is used for treating systemic lupus erythematosus, and the dosage of lamotrigine is 75-400 mg/day.

Further: the application method of the lamotrigine comprises the following steps:

s1, the patient started with a dose of said lamotrigine of 75 mg/day with a dose of 25mg tid;

s2, increasing the dose of lamotrigine to 200-400 mg/day by one week;

s3, when the immune system index of the patient is recovered to be normal and the symptom disappears, after the dosage of the step S2 is maintained for 2 months, the dosage of the lamotrigine is decreased month by month, and the medicine is stopped within 2 years.

By the technical scheme, stress and heredity are theoretically the common causes of all chronic non-infectious diseases. The key of stress is causing human body biological and mental rhythm disorder, the biological and mental rhythm is the basis and guarantee of the normal operation of the human body, and the essence of different chronic non-infectious diseases is various rhythm disorders; such as blood pressure, blood glucose, endocrine, immune, neuroelectrophysiological, mood, sleep-wake, etc.

Rhythm disruption should be the most fundamental cause and basis common to chronic non-infectious diseases. Maslow, a famous psychologist, summarizes the multiple needs of humans, and whether these needs are met or not is the root cause of "stress" in humans; for example, the occurrence of 'contextual insomnia' for developing the 'cause' or going on business required for completing the work causes the influence on the sleep rhythm; travel for self-pleasure needs, or "night life", or eating produces effects on sleep rhythms, glucose metabolism rhythms, lipid metabolism rhythms; influence on sleep rhythm, blood pressure rhythm, immune rhythm and emotional rhythm is brought to competition of survival and self development; trauma, infection, natural disasters and the like have comprehensive influence on human psychosomatic rhythms.

Of course, it must also be mentioned that some individuals are based on a background of poor genetic predisposition, and that certain intrinsic rhythms are more easily disrupted under the influence of the above-mentioned stressors.

Bipolar disorder belongs to emotional dysrhythmia, and the consistent change trend of the HPT axis (an index reflecting intrinsic biological rhythm) and the same therapeutic effect of bipolar disorder and other chronic non-infectious diseases suggest that there is biological and psychological homology in terms of dysrhythmia in bipolar disorder and other chronic non-infectious diseases.

The occurrence, development and outcome of chronic non-infectious diseases essentially undergo such processes: stress in a certain genetic background → local abnormality → dysrhythmia. Such as stress → anxiety disorder (local abnormality) → exhaustion and release of anxiety (rhythm tendency disorder) → bipolar disorder (dysrhythmia) → psychosomatic complications resulting from the bipolar disorder (dysrhythmia).

From the perspective of dysrhythmia, all chronic noninfective diseases are gradually decompensated under the influence of stress, which means that each stage is reversible by turning the rhythm, and the SLE should be abnormal in immune rhythm and can be treated by adjusting the immune rhythm. Lamotrigine is a drug which ameliorates dysrhythmia of bipolar disorder; because of biological and psychological homology of chronic non-infectious diseases such as bipolar affective disorder, systemic lupus erythematosus and the like, the lamotrigine is adopted to treat systemic lupus erythematosus patients, so that the immune rhythm abnormality of the patients can be effectively adjusted, other symptomatic medicines are supplemented to improve symptoms, and further, the gradual stopping of the medicines can be realized.

In conclusion, the invention has the following beneficial effects:

1. by a novel understanding of chronic non-infectious diseases from a rhythm perspective, it is proposed that SLE patients can be treated with lamotrigine by methods that modulate the intrinsic rhythm of the organism.

2. The long-term administration of lamotrigine does not cause significant adverse reactions like hormonal drugs and does not require lifelong administration.

3. Can effectively reduce adverse reaction of patients caused by taking medicines and reduce pain of patients taking medicines for life.

Detailed Description

The present invention will be described in further detail by way of embodiments:

example 1: application of lamotrigine in treating systemic lupus erythematosus, and application of lamotrigine in treating systemic lupus erythematosus.

Example 2: application of lamotrigine in treating Systemic Lupus Erythematosus (SLE) is disclosed, wherein lamotrigine is used for treating SLE by adjusting immune rhythm.

Example 3: application of lamotrigine in treatment of systemic lupus erythematosus is characterized in that lamotrigine with the dosage of 75-400 mg/day is used for treating systemic lupus erythematosus.

Example 4: the application of lamotrigine in treating systemic lupus erythematosus comprises the following steps:

s1, the patient started with lamotrigine at a dose of 75 mg/day with a tid of 25 mg;

s2, increasing the dose of lamotrigine to 200-400 mg/day by one week;

s3, when the immune system index of the patient is recovered to be normal and the symptom disappears, after the dosage of the step S2 is maintained for 2 months, the dosage of lamotrigine is decreased month by month, and the medicine is stopped within 2 years.

This example used the above formulation to treat the following typical cases:

patient one, female, 47 years old.

The results of examination before 3 years showed that HGB 82g/L, ANA 1:160, SSA positive, SSB positive, TSH 0.012mU/L, and the patients were treated in local hospitals without special treatment after improving anemia.

The migratory multiple joint swelling and pain caused by no obvious inducement before 2 years begins to be the swelling and pain of the double knee joints, gradually develops the swelling and pain of the interphalangeal joints of the middle fingers of the right hand, the proximal interphalangeal joints of the 4 th fingers of the right hand, the interphalangeal joints of the left thumb, the double knees, the double elbows, the double shoulders and the double ankles, and has no symptoms and signs of oral ulcer, dry mouth, dry eyes, erythema and the like.

The examination results show that: HGB 99g/L, C30.4g/L, C40.03g/L, UI-nRNP antibody, anti-SM antibody, anti-double-stranded DNA antibody, anti-ribosomal P protein antibody were positive, and "systemic lupus erythematosus" was diagnosed.

After physical treatment such as traditional Chinese medicine and acupuncture, symptoms are not obviously improved, migratory joint swelling and pain repeatedly occur, and only a few days are in a normal state in 1 year basically. Except the symptoms, persistent chest pain with dry cough and fever, red eyes and swollen right eyes almost cannot be opened before 1 year.

The doctor visits the hospital, and the examination result is as follows: blood routine: HGB 75g/L, WBC 5.55109/L, urinary routine: urinary protein (1+), leukocyte 27/HP, erythrocyte 22/HP; the urine protein amount is 1.42g/24h after 24 h; 93.0 of blood sedimentation; c-reactive protein 9.83 mg/L; PCT negative, GM, G test negative; EB-DNA and CMV-DNA are negative; negative for TB-IGRA; electrolyte: 3.29mmol/L of potassium; liver function: albumin 22.9 g/L; no abnormality of kidney function is found; first work: TSH 4.23 mU/L; RF, anti-CCP antibody negative; AKA is negative; antinuclear antibodies +1:1000 spot plasma type, anti-double-stranded DNA antibodies +1:320, anti-RNP antibodies + +, anti-SM antibodies + +, anti-SSA antibodies (60KD) + +, anti-SSA antibodies (52KD) + +, anti-Rib antibodies +, anti-neutrophil cytoplasmic antibodies +1:10p-ANCA positive, lactoferrin 1.1; ACA negative; positive in direct anti-human globulin test; IGG 17.80g/L, IGA 5230.00mg/L, C30.3740 g/L, C40.0544g/L.

Chest CT: inflammation of both lungs; effusion in pericardium; a small amount of effusion in the left pleural cavity and local atelectasis of the lower lobe of the left lung; the mediastinal and bilateral axillary lymph nodes are increased, and part of the lymph nodes is slightly enlarged; abdominal color ultrasonography: spleen growth, uterus-substantial occupation: myoma sicca syndrome color ultrasound: bilateral parotid gland, submandibular gland, sublingual gland lacrimal gland are not uniformly changed; imaging of ocular salivary glands: bilateral salivary glands have a moderate-severe impaired intake function and normal excretion function; ophthalmic examination: eyesight: right eye 0.25, left eye 0.25, binocular conjunctiva (-), corneal transparency, sodium corneal fluorescein staining: right eye (+), left eye (+), BUT right eye 2s, left eye 2s, tear secretion in both eyes: the right eye is 13mm and the left eye is 7 mm.

The diagnosis result is as follows: 1. systemic lupus erythematosus, lupus nephritis 2, sjogren's syndrome, 3 pulmonary infection, 4 hypokalemia, 5 spleen growth, 6 uterus solid space occupation: the myoma is to be diagnosed.

After the medicine is used for treating symptoms such as anti-infection, stomach protection and eye moistening of methylprednisolone, hydroxychloroquine sulfate, moxifloxacin and the like, 50mg qd of prednisone, 0.2g bid of pule (hydroxychloroquine sulfate tablets) and 500mg bid of seocrelidin (mycophenolate mofetil dispersible tablets) are maintained after discharge to control symptoms of systemic lupus erythematosus, 20mg bid of famotidine (famotidine tablets) to protect stomach, a proper amount of qid eye drops to moisten eyes, 0.5ug qd of alfacalcidol tablets, 600mg qd of Callqi to supplement calcium and 100mg qn of aspirin enteric-coated tablets. After that, prednisone gradually decreased to 17.5mg, and the rest of the drug remained unchanged.

Before 10 months, the patient goes to the doctor of my department to consult and take a medicine, the doctor recommends not to stop using other medicines such as prednisone and the like, maintains 0.2g bid of dispute and 500mg bid of seiko unchanged, and adds 0.25g qid of magnesium valproate (starting from 0.25g bid), 10mg qd of celebrate and 1.25mg qn of respule. After adjusting the medication, the symptoms are not reoccurred all the time, the patient feels slight symptoms before 6 months, and the result of the immunity index is rechecked: ANA +1:1001 spotted plasma type, suspected (. + -.) of anti-double-stranded DNA antibody, anti-RNP antibody, anti-SM antibody, anti-SSA antibody (60KD), anti-SSA antibody (52KD) showed ++, anti-Rib antibody +, anti-SSB antibody, anti-SCL-70 antibody, anti-Jo-1 antibody were negative.

The modification scheme is as follows: bid 0.2g, seidenz 500mg, tiadin (lamotrigine) 100mg tid (starting from 25mg tid), Cyletide sustained release tablet 50mg qd, and Repule 2.5mg qn.

The symptoms of the patients improve, the medication is maintained until 2 months ago, the patient is advised to stop taking the medicines, the rest medicines are maintained unchanged, and the immune indexes are rechecked before 1 week: ANA +1:1001 Spotted plasma type, anti-RNP antibody, anti-SM antibody, anti-SSA antibody (60KD), anti-SSA antibody (52KD) showed ++, anti-double-stranded DNA antibody, anti-SSB antibody, anti-SCL-70 antibody, anti-Jo-1 antibody, anti-Rib antibody were negative. C30.58g/L, IGA, IGM, IGG, IGE, CRF, PFB, C4 were not abnormal. At present, the symptoms are smooth, and pain and discomfort are not complained.

In the above examples of the present invention, by a novel reading of chronic non-infectious diseases from a rhythm perspective, it was suggested that SLE patients could be treated with lamotrigine by a method of modulating the intrinsic rhythm of the organism; the lamotrigine does not cause obvious adverse reaction like hormone medicines after being taken for a long time, and does not require lifelong administration; can effectively reduce adverse reaction of patients caused by taking medicines and reduce pain of patients taking medicines for life.

The present embodiment is only for explaining the present invention, and it is not limited to the present invention, and those skilled in the art can make modifications of the present embodiment without inventive contribution as needed after reading the present specification, but all of them are protected by patent law within the scope of the claims of the present invention.

Claims (4)

1. Use of lamotrigine for the treatment of systemic lupus erythematosus characterized by: the lamotrigine is used for the treatment of systemic lupus erythematosus.

2. Use of lamotrigine as claimed in claim 1 for the treatment of systemic lupus erythematosus wherein: the lamotrigine is used for treating systemic lupus erythematosus by adjusting the immune rhythm.

3. Use of lamotrigine as claimed in claim 1 for the treatment of systemic lupus erythematosus wherein: lamotrigine is used for treating systemic lupus erythematosus, and the dosage of lamotrigine is 75-400 mg/day.

4. Use of lamotrigine as claimed in claim 3 for the treatment of systemic lupus erythematosus wherein said lamotrigine is administered by a method comprising:

s1, the patient started with a dose of said lamotrigine of 75 mg/day with a dose of 25mg tid;

s2, increasing the dose of lamotrigine to 200-400 mg/day by one week;

s3, when the immune system index of the patient is recovered to be normal and the symptom disappears, after the dosage of the step S2 is maintained for 2 months, the dosage of the lamotrigine is decreased month by month, and the medicine is stopped within 2 years.