CN1439369A - Levoimidazole for treating nasal polyp - Google Patents
Levoimidazole for treating nasal polyp Download PDFInfo
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- CN1439369A CN1439369A CN 02100690 CN02100690A CN1439369A CN 1439369 A CN1439369 A CN 1439369A CN 02100690 CN02100690 CN 02100690 CN 02100690 A CN02100690 A CN 02100690A CN 1439369 A CN1439369 A CN 1439369A
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- Medicinal Preparation (AREA)
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Abstract
A medicine decaris in the form of spray, aerosol, powder and nose drops for treating nasal polyp and associated diseases is disclosed.
Description
The present invention relates to treat levamisole nasal drop, levamisole nasal mist and levamisole nasal aerosol and their application of polyp of nasal cavity.
Nasal polyp is a kind of commonly encountered diseases, and adult sickness rate is about 1%-2%.According to clinical observation, it is 30% that the polypous sickness rate of patient of endogenous bronchial asthma is arranged, and patient's polyp sickness rate that aspirin do not tolerate (bronchus type) is arranged up to 50%.The polypous cause of disease is not clear so far, in respect of theories such as infection, allergy, wound, chemical stimulation, metabolic disease, Nervous and Mental Factors.
Polypous treatment is difficulty relatively, and operative treatment easily recurs, and relapse rate is up to 15%-20%.Its Drug therapy adopts various steroid medicines usually, but after adopting steroid medicine, can cause the dependency to the about thing of steroid.These reasons make polypous research and treatment come into one's own day by day, find the new polypous medicine of treatment, are effective, and do not produce dependency simultaneously, become the focus that people pay close attention to.
One, polypous pathogenic factor:
From histopathology, nasal polyp is canescence, an obstructive massive texture in nasal cavity or the nasal sinuses, contains the liquid of edema, originates from the complete top layer epithelium of nasal cavity, mostly is both sides and multiple.Histologic classification 80%-90% is the acidophil polyp, is to be the inflammatory cell infiltration of feature with the eosinophilia, and other inflammatory cell has mastocyte, hugely has a liking for cell, plasma cell and lymphocyte etc.The nasal polyp that merges bronchial asthma and aspirin sensitive belongs to acidophil.Merging fiber cystis degeneration, Kartagener ' s syndrome (ciliary dyskinesia) and antro-choanal polyp is that to increase with neutrophil cell be feature.
According to clinical and pathological manifestations analysis, allergy may be the polypous cause of disease.Polypous formation is that the stimulation owing to multiple reason or unknown cause causes the damage of nasal mucosa top layer, exuviation, make fibroblast proliferation justacrine cytokine, promote mastocyte differentiation and growth, mastocyte takes off the granule reflection under non-specific factor stimulates, the release and the acidophil that cause inflammatory mediator soak into, media such as histamine, LTC4, LTB4 increase, and cause and ooze out and edema; MBP, the ECP that acidophil discharges etc. destroy the nerve of nasal mucosa vessels, and vascular permeability is increased, and have further increased the weight of inflammatory reaction.Because the inflammatory reaction that continues forms polyp.
On the other hand, owing to nasal membrane inflammatory cell infiltration, edema, pressure increases, cause epithelium to break, lamina propria is from damaged outstanding, and mucosa continuity is on every side grown, the top layer epithelial cellization of organizing of deviating from is given birth to, and forms polyp the base of a fruit, and blood vessel is grown into, and set up vessel pedicle, body of gland is elongated, in the polyp of growing into, and shape elongated tubular body of gland, under the effect of inflammatory reaction and gravity, polyp constantly increases.
Two, polypous treatment present situation:
Polypous modern treatment is advocated the method that the employing glucocorticoid combines with operative treatment.(1) operative treatment principle
Extract comparatively simply for little single-shot polyp, should adopt operation more widely for the polyp with recurrence of pilosity, the functional endoscopic sinus surgery (FES) that adopts is comparatively measured at present, the sieve room of each exposure can be removed totally.For the polyp that repeatedly recurs, advocate to sieve widely hole and part sphenoidectomy.Also optionally adopt YAG laser ablation nasal polyp, go out insufficiency of blood, patient is painful light, but inapplicable and serious intractable nasal polyp patient.
Patient with bronchial asthma and aspirin sensitive is also advocated row nasal polypectomy completely, operation not only can not cause and increase the weight of asthma, and, recovered normal BITONG airway dysfunction and the asthma state of an illness is clearly better because the focus of nasal cavity and nasal sinuses has been removed in operation.But the patient's recurrence after operation rate that merges asthma is higher, and operation can not change patient to the sensitivity of aspirin and the high response of air flue, therefore should carry out glucocorticoid treatment after the operation.
(2) glucocorticoid treatment
In recent years, a large amount of data proof glucocorticoids have significant curative effect in polypous treatment.Because nasal polyp is the persistence diseases associated with inflammation of nasal cavity, any operation completely all can not be removed the polypous cause of disease, has only the glucocorticoid of employing and operation therapeutic alliance, just can delay and prevent the recurrence of polyp.
The Therapeutic Principle who takes at present is, the less polyp for just sending out adopts intranasal to spray into glucocorticoid treatment merely, polyp is dwindled or disappears; For bigger polyp, can add with oral, intramuscular injection or concha nasalis inferior mucosa systemic administration such as injection down, adopt the local medicine that sprays of intranasal to keep treatment, can make the part patient exempt operative treatment; To cases with severe, should after accepting glucocorticoid treatment, perform the operation, and adhere to that after operation the nose part more than a year sucks treatment, though can not stop recurrence fully, can avoid recurrence in a long time.Nasal spray commonly used has beclometasone (BDP, beclomethason dipropionate, trade name Beconase), budesonide (budesonide, trade name Rhinocort), fluticasone propionate (fluticasone propionate, trade name Flonase), third scorching pine (the triamcinolone acetonide, trade name Nasacort), 9-removes fluorine fluocinonide (flunisolide, trade name Rhinalar), Triamcinolone acetonide acetate etc., local application does not influence the function of nasal cavity cilium system, but all need long-term prescription, though send out even there is the report observation also to have no side effect to 5 years; But a lot of bibliographical informations are also arranged, continue the local glucocorticoid that uses and to cause pharyngeal fungal infection.For there being steroid to use contraindication person,, can not use the corticosteroid treatment nasal polyp as osteoporosis, peptic ulcer, serious hypertension, diabetes, psychiatric department disease, epilepsy, glaucoma, cataract etc.
Also there is report to adopt plug for sending (thiotepa) in the polypous report of operation back auxiliary treatment.Plug is an antineoplastic agent for group, participates in the immunoreation of body, suppresses the induction period and the propagation phase of immunologic process, suppresses cell proliferation and allergy, the hyperemia of alleviating is arranged, stop regenerated effect (new drug and clinical, 1996; 15 (5): 318).
Levamisole is the wide spectrum anthelmintic of using always, and it makes Fumaric acid can not be reduced to succinic acid, thereby influence the anaerobic metabolism of polypide muscle by optionally suppressing the succinate dehydrogenase in the worm human body, makes the polypide muscular paralysis get rid of external with feces.Levamisole also has immunomodulating and immunostimulation function, can strengthen the chemotactic response of person monocytic cell or polymorphonuclear leukocyte, can also strengthen monocytic phagocytic function, it is immunomodulator, but this regulating action only is being adjusted to normal level with repressed immunologic function, and can not cause that immunity is hyperfunction.Levamisole can be used for auxiliary treatment, autoimmune disease, the chronic and recurrent infection of tumor.
The present invention is made into compound recipe with levamisole as independent effective ingredient or with other medicines, makes the dosage form of nasal-cavity administration, and these dosage forms include, but are not limited to: nasal drop, spray, aerosol and powder spray.
Indication with levamisole or the nasal drop made from the compound recipe that contains levamisole, spray, aerosol and powder spray of the present invention includes, but are not limited to following disease: nasal polyp or nasal polyp, rhinitis, pharyngitis, tracheitis and bronchitis.
Use of the present invention with levamisole or the nasal drop made from the compound recipe that contains levamisole, spray, aerosol and powder spray, for nasal polyp or nasal polyp patient, directly nasal-cavity administration can make big nasal polyp dwindle effectively, and little nasal polyp is disappeared; Or administration behind nasal polypectomy, can stop polypous recurrence; For rhinitis, pharyngitis, tracheitis and bronchitis, can the amelioration of inflammation symptom.
Nasal drop of the present invention, spray and aerosol all meet the definition of the Pharmacopoeia of the People's Republic of China (version was two ones in 2000) about nasal drop, spray and aerosol.
Nasal polyp of the present invention is that those skilled in the art is known, has it to define accurately in the modern medical book, refers to canescence, the Fructus Litchi shape neoplasm of nasal cavity.Its pathological change as previously mentioned.Rhinitis of the present invention, pharyngitis, tracheitis and bronchitis also are that the ordinary artisan of this area is known, have it to define accurately in the modern medical book.
By following examples levamisole nasal drop of the present invention, spray, aerosol and powder spray treatment nasal polyp or nasal polyp, rhinitis, pharyngitis, tracheitis and bronchitic application are described.It should be noted that, following embodiment just is used for explanation and unrestricted the present invention, well-known to those skilled in the artly by other administration route levamisole is used for the treatment of nasal polyp or nasal polyp, rhinitis, pharyngitis, tracheitis and bronchitic technology all within the scope of the invention.Embodiment 1 levamisole spray treatment nasal polyp
(1) case and method:
Not underwent operative and corticosteroid treatment nasal polyp first visit case, totally 18 examples.
The judgement of nasal polyp size: with reference to method [Johansen LV, et al.Clin Otolaryngol, 1993 of Johansen etc.; 18:524], through the prenasal sem observation, be that object of reference is kept the score with concha nasalis.Nasal polyp surpasses middle nasal concha edge person and remembers 0.5 fen, does not reach concha nasalis inferior upper limb person above the middle nasal concha edge and remembers 1 fen, and the person remembers 2 fens not reach at the lower edge above the concha nasalis inferior upper limb, and the person remembers 3 fens to reach the lower edge.Reduce 1.5 and be divided into produce effects, 1 is divided into effectively.
The nasal obstruction degree by light, in, severe 3 point-score records, reduce 2 and be divided into produce effects, 1 is divided into effectively.
Male 12 examples among the 18 routine nasal polyp patients, women 6 examples.42 years old mean age (26～56 years old).Asthma history person's 3 examples (women 2 examples, male 1 example) are wherein arranged, and to aspirin (tablet for alleviating pain) allergy sufferers 2 examples (male), nasal polyp reaches 3 fens person's 3 examples, 2 fens person's 7 examples, 1 fen person's 8 example.Severe 8 examples of having a stuffy nose, moderate 8 examples of having a stuffy nose, 2 examples of slightly having a stuffy nose.
The patient is divided into treatment group (10 example) and matched group (8 example) at random, and the treatment group contains 3 fens person's 2 examples of nasal polyp, 2 fens person's 4 examples, 1 fen person's 4 example, severe 5 examples of having a stuffy nose, moderate 3 examples of having a stuffy nose, 2 examples of slightly having a stuffy nose; Matched group contains 3 fens person's 1 examples of nasal polyp, 2 fens person's 3 examples, 1 fen person's 4 example, severe 3 examples of having a stuffy nose, moderate 5 examples of having a stuffy nose.Matched group adopts the treatment of beclometasone spray, and every day, the nasal-cavity administration spray was three times, continued for two weeks after, changed in the 3rd week and spray secondary every day, change spray every day into once around the, be one month the course of treatment; The treatment group adopts the levamisole spray to treat, and sprays the nasal-cavity administration spray every day once, continues spray after 5 days, does not spray medicine in 2 days at interval, and then sprays once a day 5 days, and the interval is 2 days again, and so medication is one month.
In the beclometasone spray, the dosage of beclometasone is the every spray of 50ug/0.14ml: in the levamisole spray, the dosage of levamisole is the every spray of 70ug/0.14ml.
Check after one month in two weeks of medication and medication, observation nasal polyp size, the variation of keeping the score, nasal obstruction alleviate degree and have no side effect generation etc.
(2) result:
The change that the nasal polyp size is kept the score: matched group is after treating January, and nasal polyp is all seen obvious retraction, and nasal polyp had been crossed the intranasal hole after wherein 3 fens persons treated and finish, and the person had 1 routine nasal polyp to disappear in 1 minute.Treatment group nasal polyp also all obviously bounces back, and person's 2 examples all bounced back to the concha nasalis inferior upper limb when treatment finishes in 3 minutes, and the person had 1 example, 1 fen person to have 2 routine nasal polyps to disappear in 2 minutes.
The improvement of nasal obstruction symptom: patient's nasal obstruction symptom all has improvement in various degree in treatment group and the matched group.In the 5 routine severes nasal obstruction of treatment group, have 3 routine medications after 1 month olfactory sensation recover to some extent; Have in the 3 routine severes nasal obstruction of matched group 1 routine medication after 1 month olfactory sensation recover to some extent.Nasal obstruction is improved not obvious person's 2 examples in the treatment group, and nasal obstruction is improved not obvious person's 1 example in the matched group.
Conclusion: for polypous Drug therapy, external nasal spray or the aerosol treatments of adopting corticosteroid more.Adopt levamisole
Spray, its curative effect is similar to the beclometasone spray or be better than the beclometasone spray slightly.Embodiment 2 levamisole treatment by aerosol nasal polyps
Repeat " embodiment 1 " described experiment, what adopt except that curative is that patient's state of an illness of left-handed rice azoles aerosol (dosage is the every spray of 70ug/0.14ml) and observation is with quantity is different, patient goes into group standard, therapeutic scheme, curative effect judging standard all with " embodiment 1 ", experimental result is similar with " embodiment 1 ", promptly adopt levamisole treatment by aerosol nasal polyp, its curative effect is similar to the beclometasone spray or be better than the beclometasone spray slightly.Embodiment 3 levamisole nasal drop treatment nasal polyp
Repeat " embodiment 1 " described experiment, what adopt except that curative is left-handed rice azoles nasal drop (concentration is 350ug/ml), administrated method patient's state of an illness of changing each collunarium and observation for the every spray with spray into quantity is different, patient goes into group standard, therapeutic scheme, curative effect judging standard all with " embodiment 1 ", experimental result is similar with " embodiment 1 ", promptly adopt levamisole nasal drop treatment nasal polyp, its curative effect is similar to the beclometasone spray or be better than the beclometasone spray slightly.Embodiment 4 levamisole powder sprays treatment nasal polyp
Repeat " embodiment 1 " described experiment, patient's state of an illness that what adopt except that curative is left-handed rice azoles powder spray (dosage is every spray 70ug), observe is with quantity is different, patient goes into group standard, therapeutic scheme, curative effect judging standard all with " embodiment 1 ", experimental result is similar with " embodiment 1 ", promptly adopt levamisole powder spray treatment nasal polyp, its curative effect is similar to the beclometasone spray or be better than the beclometasone spray slightly.Embodiment 5 levamisole sprays treatment nasal polyp recurrence
65 years old women is diagnosed as multiple nasal polyp, adopts the sieve room polypectomy of functional endoscopic sinus surgery with each exposure, postoperative 10 days, and nasal polyp recurrence, the functional endoscopic sinus surgery of going is once more extractd the polyp of recurrence.After 10 big back checks, nasal polyp recurs again.Go operative treatment this moment again, use that the capable nose of " embodiment 1 " described levamisole spray is local to suck treatment instead, once a day, continue 5 days, drug withdrawal continues 5 days after 2 days more once a day, check, and the nasal polyp of recurrence diminishes.Continuation is used the levamisole spray with method, check after 10 days, and nasal polyp disappears.Embodiment 6 levamisole treatment by aerosol nasal polyp recurrences
An adult male, the nasal polyp recurrence after operation is treated with local suction of the capable nose of " embodiment 2 " described levamisole aerosol, once a day, continues 5 days, and drug withdrawal continues 5 days after 2 days more once a day, check, the nasal polyp of recurrence diminishes.Continuation is used the levamisole spray with method, check after 10 days, and nasal polyp disappears substantially.Embodiment 7 levamisole powder sprays treatment nasal polyp recurrence
An adult female, the nasal polyp recurrence after operation is treated with local suction of the capable nose of " embodiment 4 " described levamisole powder spray, once a day, continues 5 days, and drug withdrawal continues 5 days after 2 days more once a day, check, the nasal polyp of recurrence diminishes.Continuation is used the levamisole spray with method, check after 10 days, and nasal polyp disappears substantially.Embodiment 8 levamisole nasal drop treatment nasal polyp recurrence
An adult male, the nasal polyp recurrence after operation with the capable nose dropping treatment of " embodiment 3 " described levamisole nasal drop, once a day, continues 5 days, and drug withdrawal continues 5 days after 2 days more once a day, check, the nasal polyp of recurrence diminishes.Continuation is used the levamisole nasal drop with method, check after 10 days, and nasal polyp diminishes.
Claims (5)
1. the dosage form of the nasal-cavity administration that levamisole is made as effective ingredient, these dosage forms comprise:
1. nasal drop;
2. spray;
3. aerosol;
4. powder spray.
2. the described nasal drop of claim 1, spray, aerosol, powder spray are used as the medicine of treatment nasal polyp and nasal polyp.
3. the described nasal drop of claim 1, spray, aerosol, powder spray are used for the treatment of nasal polyp and nasal polyp.
4. after surgical interventions such as nasal polyp operative treatment, laser therapy, the described nasal drop of claim 1, spray, aerosol, powder spray are used to prevent nasal polyp recurrence.
5. with the described nasal drop of claim 1, spray, aerosol, powder spray, as the medicine that after surgical interventions such as nasal polyp operative treatment, laser therapy, prevents nasal polyp recurrence.
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| CN 02100690 CN1236765C (en) | 2002-02-22 | 2002-02-22 | Levoimidazole for treating nasal polyp |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN100364530C (en) * | 2003-10-14 | 2008-01-30 | 江苏先声药物研究有限公司 | Novel levamisole formulation for chronic rhinitis |
| WO2008028324A1 (en) * | 2006-08-28 | 2008-03-13 | Jiangsu Simcere Pharmaceutical R & D Co., Ltd | Novel levamisole formulation for allergic rhinitis |
| CN108125910A (en) * | 2017-12-29 | 2018-06-08 | 南宁市共健源健康科技有限公司 | Treat powder spray of nasal polyp and preparation method thereof |
-
2002
- 2002-02-22 CN CN 02100690 patent/CN1236765C/en not_active Expired - Fee Related
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN100364530C (en) * | 2003-10-14 | 2008-01-30 | 江苏先声药物研究有限公司 | Novel levamisole formulation for chronic rhinitis |
| WO2008028324A1 (en) * | 2006-08-28 | 2008-03-13 | Jiangsu Simcere Pharmaceutical R & D Co., Ltd | Novel levamisole formulation for allergic rhinitis |
| CN108125910A (en) * | 2017-12-29 | 2018-06-08 | 南宁市共健源健康科技有限公司 | Treat powder spray of nasal polyp and preparation method thereof |
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| CN1236765C (en) | 2006-01-18 |
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