EA025550B1 - Method of treating alopecia - Google Patents

Abstract

A method of treating alopecia relates to medicine, particularly dermatology, and may be applied to treatment for different clinical forms. Objectives of the invention are increasing treatment efficiency in different clinical forms of alopecia, achieving stable clinical amelioration via action upon main pathogenetic elements of the dermatosis. The objectives are solved by that the treatment of alopecia including clinical and laboratory examination of patients in order to clarify cause-and-effect mechanism of alopecia development and pathogenetic therapy of detected disorders is combined with additional administration of L-arginine in 100.0 ml intravenous doses daily No. 10, followed by its oral intake 0.5 g twice a day, and levocarnitine 5.0 ml twice a day during 20 days, in one or more courses.

Description

The invention relates to medicine, namely to dermatology, and can be used in the treatment of various clinical forms of alopecia.

A known method of treating alopecia with the mesotherapeutic method [1]. In this case, drugs that improve microcirculation (pentoxifylline, novocaine, lofton, nicotinic acid, etc.), metabolism (riboxin, aloe, plancentex, kerative, solcoseryl, alflutop, glycolic acid, embryoblasts, etc.), antioxidants (emoxipin, histochrome, mexidol, etc.), minoxidil, vitamins and minerals. The drugs are administered intradermally, in the form of monotherapy or in the form of mixtures (cocktails). The proposed treatment regimen: 5-6 sessions 1 time per week, then 4-6 sessions 1 time per 2 weeks, then 3-4 sessions once a month.

The disadvantage of this method is the inability to assess its clinical effectiveness, the need for a large number of sessions and the drugs used, which can lead to the development of drug allergies, and sometimes infectious complications, in addition, it is difficult to assess their biological and chemical compatibility with tissues and with each other.

A known method of treating alopecia due to a decrease in nutrition, hypovitaminosis, anemia, when tonic, biostimulants are used: phytin 0.25-0.5 g three times / day., 5-7 days; aloe extract, 1 ml subcutaneously, daily (No. 20-30), placenta extract, 1 ml, subcutaneous (No. 30) [2], etc.

The disadvantage of this method of treatment is that its effectiveness is relatively low, since there is a slow hair growth and relapse of baldness.

The prototype is a method of treating alopecia, including complex therapy with daytime tranquilizers (Novo-Passit) and cerebral metabolites (vinpocetine) in combination with vitamin-mineral complexes (Oligovit, Olamin). For external treatment, a 4% aqueous solution of mumiye is used in the form of electrophoresis to lesions with a current strength of 1.5-2 mA, a current density of 0.050.08 mA / cm ² for 10-15 minutes daily, for a course of 10-15 procedures. The method allows to achieve hair restoration after 6 months [3].

The disadvantage of this method is the duration of complex therapy (up to 6 months), the inability to regularly use the physiotherapeutic treatment method in parallel with the drug. In addition, to achieve visible results, it is necessary to use several types of drugs.

The objectives of the invention are to increase the effectiveness of the treatment of various clinical forms of alopecia, obtaining persistent clinical improvement, by affecting the main pathogenetic links of dermatosis.

The tasks are solved in that after a clinical and laboratory examination of patients to determine the causal mechanism for the development of alopecia - examination of patients for hereditary syndromes, functional pathology of the hematopoietic and hepatobiliary systems, endocrine organs, the presence of viral, parasitic and bacterial infections, as well as pathogenetic treatment of identified pathologies is additionally prescribed b-arginine intravenously in 100.0 ml daily for 10 days of treatment, cial with its oral administration of 0.5 g twice a day for 20-30 days, levocarnitine Combination with one vial (5.0 ml) twice a day for 10-15 days.

L-arginine is an amino acid, an active and versatile cellular regulator of the vital functions of the body, has a protective effect. It has antihypoxic, cytoprotective, membrane stabilizing, antiradical, antioxidant, detoxification activity, is an active regulator of intermediate metabolism and energy supply processes, is involved in supporting hormonal balance and in the urea synthesis cycle in the liver. In addition, it has a hepatoprotective and acid-forming effect, contributes to the correction of acid-base balance.

L-arginine inhibits the synthesis of an endogenous stimulator of oxidative stress, stimulates the activity of the thymus gland, regulates blood glucose during exercise, improves cerebral circulation and innervation of the central area of the scalp and face.

Levocarnitine is a natural substance related to B vitamins. It participates in the metabolism as a carrier of fatty acids through cell membranes from the cytoplasm to mitochondria, where these acids undergo a β-oxidation process with the formation of a large amount of energy (in the form of ATP). By releasing coenzyme A, levocarnitine enhances the metabolism of the Krebs cycle. By the same mechanism, it stimulates the activity of pyruvate dehydrogenase in skeletal muscle and the oxidation of branched amino acids. Levocarnitine normalizes protein and fat metabolism, restores the alkaline reserve of blood, inhibits the formation of keto acids and anaerobic glycolysis, reduces the degree of lactic acidosis, and also increases motor activity and increases exercise tolerance, while contributing to the economical use of glycogen and an increase in its reserves in the liver.

In various clinical forms of alopecia, white dermographism and a decrease in the sensitivity of the scalp skin, a violation of peripheral blood supply and outflow of blood from the brain vessels are often observed. There is a violation of the regulation of the tone of blood vessels, the scalp and other skin integuments. Changes in indicators of carbohydrate and lipid metabolism are noted. The above changes are a direct indication for the appointment of L-arginine.

The following examples illustrate the implementation of the method of the invention.

Example 1. Patient M., born in 1987 Complaints: hair loss in the parietal region for 6 months, their distribution to the occipital and temporal areas. Before the onset of the disease, low-grade fever was worried - 37.3 ° С, weakness, elbow hyperkeratosis, nausea. The onset of the disease is associated with the above symptoms. As prescribed by a dermatologist, used tincture of capsicum, garlic, vitamins, the effect is negligible.

Anamnesis of life: viral hepatitis A, chickenpox in childhood, traumatic brain injury in 2007, SARS. Population B - analgin, hemodez, food allergens. Menses regular, after 21 days. There were no pregnancies.

Objective status: no complaints. The osteoarticular system without features. Sick of a normal diet. Peripheral lymph nodes are not palpable.

Local status: dermatosis of non-inflammatory genesis, there are 4 foci of baldness: in the parietal zone (5x6 cm), two foci in the parietal-occipital (4x4 cm and 3x4 cm) and in the occipital (6x7 cm). Hair follicles in the foci are preserved. An area of shattered hair is noted along the periphery of the foci.

During the examination: ECHO ES: displacements of the median structures of the brain in the temporoparietal region were not detected. 3 ventricle is not dilated. Many additional signals. MRI - a study in T2, T1-VI modes, in the axial and sagittal planes, data for the presence of pathological focal changes in the brain were not obtained.

Biochemical analyzes: ALT - 7.23 U / L; AST - 3.43 U / L; alkaline phosphatase - 43.7 and / 1; cholesterol - 5.5 mmol / l; total protein - 76.8 g / l; T ₃ -1.61 nmol / L; T ₄ -135.1 nmol / L; TSH -2.99 mMU / L; GGT 8.4 and / 1; a / t to Giardia - neg .; a / t to toxocara - pos. (titer 1/100); a / t to opisthorchiasis - neg .; a / t to the roundworm - neg.

Clinical blood test: hemoglobin - 118 g / l; erythrocytes - 4.0x10 ¹² / l; platelets - 253x10 ⁹ / l; white blood cells - 4.9x10 ⁹ / l; PO neutrophils - 3%; s / I neutrophils - 55%; eosinophils - 1%; basophils - 1%, lymphocytes - 35%, monocytes - 5%; ESR - 4 mm / h.

Recommended: aevit - one capsule three times a day; albendazole -1 tablet 2 times a day for 14 days (1st course of treatment), cholenzyme - 1 tablet 2 times a day with meals, zinc oxide (0.05) 2 times a day, after meals for 20 days Levocarnitine, one vial twice daily, with meals, orally No. 10; B-arginine in a dose of 100.0 ml intravenously, daily No. 10, followed by switching to oral b-arginine - 1 tablet (0.5 g) 2 times a day after meals for 20 days. Outwardly: betamethasone ointment - rub into the foci.

Three pathogenetic courses of treatment were carried out in combination with levocarnitine, L-arginine, lasting 20 days, and an interval of 20 days. After the first course of treatment, growth of vellus (vellus) hair in the foci was noted. The area of rickety hair after the second course of treatment was not detected. The lesion foci were completely overgrown 1 month after the end of treatment. The patient was taken again after four months — she noted an improvement in her general condition, the foci of the previous hair loss were completely overgrown, and they were not subjectively disturbed. It is monitored for one year, no relapses were noted.

Example 2. Patient N., born 2006 The disease began 15 months ago, when hair began to fall out in the frontotoparietal region, then the lesion spread throughout the scalp, gradually all hair fell out, and the lesion spread to the area of the eyebrows and eyelashes. The onset of the disease does not associate with anything. They went to the doctor at the place of residence - prescribed vitamins, without effect.

Anamnesis of life. Social conditions are satisfactory. He denies severe past and infectious diseases. The second child in the family.

Objective status: no complaints. The osteoarticular system without features. Sick low nutrition. Peripheral lymph nodes are not palpable.

Local status: chronic dermatosis is not inflammatory, there is a total loss of hair on the head, the appearance of bristled hair in the eyebrows and eyelashes.

Examination data: in a clinical blood test: hemoglobin -105 g / l; erythrocytes - 4.31x10 ¹² / l; hematocrit - 31%; SIT - 22 pg / l; MCHC -35 g / l; MSU - 79 Fl; ΡΌ \ ν - 10%; platelets - 370.5x10 ⁹ / l; leukocytes -9.0x10 ⁹ / l; PO neutrophils - 3%; agricultural neutrophils - 55%, eosinophils - 3%, basophils - 1%; monocytes - 9%; lymphocytes - 29%, ESR - 25 mm / h.

Biochemical analyzes: iron - 4.02 mmol / L; T ₃ - 3.05 nmol / L; T ₄ -177.52 nmol / L; TTG - 2.65 mMU / L; lamblia a / t - neg .; toxocara - 1: 100; opisthorchia a / t - neg .; roundworm - 1:50.

Ultrasound of the abdominal cavity: biliary dyskinesia.

Recommended: aevit - one capsule three times a day; albendazole - 1 tablet 2 times a day, 10 days (1st course of treatment), zinc oxide - 0.05-2 times a day, after meals 20 days, cholensim - 1 tablet 2 times a day with meals. Levocarnitine, one bottle twice daily, with meals, orally; L-2 025550 arginine - one tablet (0.5 g) 2 times a day after meals. Outwardly: betamethasone ointment - rub into the skin of the head and eyebrows.

Three pathogenetic courses of treatment were carried out in combination with L-arginine and levocarnitine, lasting 20 days and an interval of 20 days.

After the first course of treatment, growth of vellus (vellus) hair was observed throughout the scalp. After the second course of treatment, the appearance of vellus hair in the temporal and frontotemy zones was observed, as well as the growth of vellus hair on the eyebrows and eyelashes. The lesion foci were completely overgrown 1.5 months after the end of treatment. The patient noted improvement in general condition, increased appetite, regular physiological administration.

Survey data after treatment. Clinical blood test: hemoglobin - 121 g / l; erythrocytes - 4.7x10 ¹² / l; platelets -273x10 ⁹ / l; white blood cells - 5,4x10 ⁹ / l; PO neutrophils - 4%; s / I neutrophils - 64%; eosinophils - 2%; basophils - 0, lymphocytes - 18%; monocytes - 12%; ESR - 9 mm / h.

Biochemical analysis of blood: iron - 11.4 mmol / l; T ₃ - 3.21 nmol / l; T ₄ - 147.8 nmol / L; TSH 2.27 mMe / L; toxocars a / t - neg.

It has been monitored for 9 months, no relapses were observed.

The treatment method was tested on 40 patients. The observation period of 1.5-2 years, recurrence of dermatosis is not marked.

Using the proposed method allows to obtain a clinical cure in 75-80% of patients. The term of 1 course of treatment is 20 days. Subsequent preventive courses (2-3) are 20 days with an interval of 20 days.

The method does not require high material costs, in clinical use it is highly effective, does not give side and negative effects characteristic of other methods of treating alopecia.

References.

1. O.S. Ozerskaya. Natural Pharmacology and Cosmetology, 2005, No. 1, p. 16-18.

2. I.M. Romanenko, V.V. Kulaga, S.L. Afonin. Treatment of skin and sexually transmitted diseases. - T. 2. Moscow. 2006, from 15-31.

3. E.A. Gorbunov, L.S. Zhitkova, E.A. Zakomernaya, L.N. Khimkina A method for the treatment of focal alopecia in children. Patent for invention (KI) 2159638 C, 11/27/2000

Claims (1)

CLAIM A method of treating alopecia, including conducting clinical and laboratory examination of patients to determine the causal mechanism of alopecia and conducting pathogenetic treatment of identified pathologies, characterized in that additionally injected with arginine in a dose of 100.0 ml intravenously, daily 10 days, and then 0.5 g orally twice a day, and 5.0 ml levocarnitine twice a day for 20 days in one or several courses.