RU1776411C - Method for therapeutic treatment of rosacea - Google Patents

Abstract

The invention relates to medicine, namely to dermatology and can be used in the treatment of rosacea. The aim of the invention is to achieve a stable remission. The goal is achieved by the administration of Trichopolum, angiotropic drugs, as well as ointments. containing trichopolum, camphor oil, adrenaline, tincture of valerian, a solution of retinol acetate and ichthyol paste, the treatment being carried out in 4-6 courses with 10 day breaks. The invention reduces the treatment time from 100 days to 25-30 days. The terms of remission are more than 5 years.

Description

The invention relates to medicine, namely to dermatology.

Currently, there is no single approach to the treatment of rosacea, since the etiologies and pathogenesis of dermatosis have not been fully elucidated.

A known method of treating rosacea (L.N. Trut et al., 1984) by desensitizing therapy (sodium thiosulfate, calcium chloride, antihistamines), administration of ascorutin. In persistent cases, trichopol 0.25 mg 2 times a day for 2–3 weeks (2–4 courses) with a break of 2–3 weeks was included in the complex therapy. In addition to general therapy, topical treatment was prescribed with a 2% solution of boric acid, 1% solution of resorcinol. decoctions of herbs (chamomile, linden blossom, field horsetail, sage), Yam ointment in pure form or on zinc paste, sulfur-degum ointment. In addition, cryotherapy and electrocoagulation were used. The method is not effective enough. At 23

patients underwent complete clinical recovery, in 43 - a significant improvement, in 17 - an improvement.

A known method of treating rosacea (D.A. Orazymbetova, 1987) by oral administration of trichopolum (fazijin) 4 tablets at a time for 3-5 days, erythromycin or kanamycin 1 ml per day for 10 days in combination with external therapy including exposure to the vascular component, i.e. alternation of iontophoresis with 4% potassium iodide solution (10 procedures) with applications of liquid nitrogen (6-7 procedures), and application of drugs (Vidal milk, Yam ointment, 2-10% bismuth ointment) to the lesion site.

However, the method is not effective enough, because of the 24 patients treated by this method, 14 showed a clinical recovery, 9 - a significant improvement, 1 - no effect. The duration of remission in 2 patients was 8 months, in 10 - 1.5 years, in 12 - 2 years.

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The prototype is a method of treating rosacea, which consists in the administration of sedative, antiparasitic, multivitamin, antiprotease drugs, immunomodulators and local exposure to drugs (10-15% aqueous solution of Trichopolum with 20-30% Dimexide and 5% of antibiotics for pustulization, 2-3% of metronidazole ointment). A milk-vegetable diet, simultaneous treatment of the gastrointestinal tract, physiotherapy, spa treatment, as well as anti-relapse treatment are also recommended. The method is not effective enough and does not provide stable remission.

The aim of the invention is to achieve a stable remission.

The goal is achieved by administering sedative, antiparasitic, multivitamin preparations, trichopolum to rosacea patients for 4-6 months in a decreasing dose, starting with a daily dose and up to 0.25 mg, additionally administering angiotropic drugs and applying ointment containing trichopolum, camphor oil, adrenaline, valerian tincture, retinol acetate solution and ichthyol paste in the following ratios of components (May.%).

Trichopol 2.0-5.0

Camphor oil 10.0-20.0

Adrenaline Solution 1.0-3.0

Tincture of Valerian 7.5-15.0

Retinol Solution

acetate 5.0-10.0

3% of ichthyol paste is the rest, with general therapy being carried out in 4-6 courses with 10-day breaks, and external therapy daily.

The method is as follows .-

During the first course of treatment (30 days), Trichopolum is prescribed daily: with erythematous - 0.25 mg 2 times a day, with erythematic-papular and papular-pustular - 0.25 mg 3 times a day. At the same time, calcium preparations are prescribed daily during the first 20 days: 10% calcium chloride solution intramuscularly or 10% calcium chloride solution intravenously (10 ml each, course - 10 injections). Administration of calcium preparations is combined with 1% nicotinic solution (1 ml each) and 5% ascorbic acid solution (2 ml each), administered intramuscularly (course - 10 injections, a series of them every other day). Inside, during the first 20 days, a routine of 0.25 mg 3 times a day is prescribed, Doxium 0.25 mg 3 times a day after meals.

External therapy during the first 7 days is carried out according to the Novice Novice method:

in the presence of less pronounced inflammatory effects on the skin lesion sites, a 30% sodium thiosulfate solution and a 3% hydrochloric acid solution are used sequentially 2 times a day, morning and evening, with more pronounced edema, multiple papular neoplastic rash, the above solutions are used in a concentration, respectively 60% and 6%. In the following days, Wilkinson's ointment is prescribed externally daily, then Wilkinson's ointment is removed with a tampon with sunflower oil and a therapeutic ointment is applied with a thin layer.

The second course of treatment lasts 30 days and is prescribed as an outpatient. During the entire course of treatment, Trichopolum is prescribed daily at 1.5 or 2.5 tablets per day (the dose is reduced by 0.5 tablets), depending on the clinical form of rosacea. At the same time, calcium gluconate is prescribed for the first 20 days, 0.5 tablets 3 times a day, xanthinol-nicotinate OO, 15 mg 3 times a day after meals, rutin 0.02 mg 3 times a day, belloid or bellaspon, or bellataminal 1 tablet 2 times a day, valerian 2 tablets per night. External therapy remains the same. It is carried out during the entire 2nd course of treatment.

The 3rd course of treatment lasts 30 days. During the entire course of treatment, Trichopolum is prescribed daily at 1 or 2 tablets per day (the dose is reduced by another 0.5 tablets) and external treatment is carried out with Wilkinson ointment every other day, a therapeutic ointment is applied daily at night . During the first 20 days, theonicol is prescribed at 0.15 mg 3 times a day after meals, 10-12 injections of 5% ascorbic acid, 2 ml intramuscularly, 10 injections of 5% vitamin Be, 1 ml intramuscularly, 1 bellataminol. for the night and 2 dragee valerian.

The 4th course of treatment lasts 30 days. During the entire course of treatment, Trichopolum is prescribed daily at 0.5 and 1.5 tablets. (the daily dose is reduced by another 0.5 tab.), Wilkinson's ointment is applied to the lesions 2 times a week, therapeutic ointment - daily. During the first 20 days, calcium gluconate is administered orally at 0.5 tablets, 3 times a day, ascorutin at 1 table. 3 times a day, nicoshpan 1 table. 3 times a day after meals.

The 5th course of treatment lasts 30 days. During the entire course of treatment, Trichopolum is continued daily in a daily dose of 1/2 and 1 table, external treatment for erythematous form is carried out using Wilkinson's ointment once a week and daily - therapeutic ointment, for more severe forms of rosacea external treatment

corresponds to the 4th course of treatment. During the first 20 days, patients are prescribed vitamin C, 1 tablet each. 3 times a day, Doxium 0.25 mg 3 times a day after meals, Valerian - 2 tablets per night.

The 6th course of treatment lasts 30 days and is prescribed if necessary for patients with more severe clinical forms of rosacea. Throughout the course, Trichopolum is prescribed daily at 0.5 tablets. Wilkinson ointment is applied once a week to the lesion site and once a week, and a therapeutic ointment with Trichopolum is applied daily at night. In the first 20 days, an additional calcium gluconate of 0.5 tablets is prescribed. 3 times a day, rutin 0.02 mg 3 times a day, trental 0.2 mg 3 times a day, bellataminal 1 table. 2 times a day.

The duration of treatment for patients with erythematous form of rosacea is 4 months, with more severe forms 5.5 to 6 months.

All patients received general and external therapy in accordance with the treatment regimen.

An example of a specific implementation.

Example 1. Sick T., 50 years old (and. B. No. 15130), was admitted with a diagnosis of rosacea, papular-pustular form. She considers herself to be a patient for about 15 years, during which she was constantly treated in the ICD, using various corticosteroid ointments (Sinalar, Flucinar, fluorocort, geoxizone, etc.) alternately. At the beginning, a pronounced effect was noted. In recent years, despite the use of hormonal ointments, the course of the disease worsened, hyperemia gradually increased, swelling increased, in the beginning, nodular and then pustular elements developed in large numbers. Upon admission, the entire face of a stagnant-cyanotic color against a background of severe skin infiltration shows an abundant papular-pustular rash. In the analysis of sebum, mites were found in large numbers. The first and second courses were held at the clinic, and the subsequent ones were outpatient.

For the first 7 days, the clinic conducted external therapy according to the Dem Novichi method (60% sodium thiosulfate solution and 6% hydrochloric acid solution), on the following days, Wilkinson ointment was applied to the skin during the first course of treatment and a therapeutic ointment was applied in the following proportions, weight . %:

Trichopol5

Camphor oil20

Adrenaline3

Tincture of Valerian 15

Retinol Solution

acetate in oil 10

Ichthyolova

3% paste

For 2 courses, Wilkinson ointment and therapeutic ointment were applied daily.

Marked improvement occurred after 2 courses of treatment: skin hyperemia was significantly reduced, infiltration was simplified, the number of papular rashes decreased, pustules disappeared.

During the 3rd course of treatment, Wilkinson's external ointment was applied to the lesions every other day, and the therapeutic ointment was applied daily. A marked improvement was noted on the skin: only erythema stamina remained at the lesion sites due to telangiectasias and single papules.

During the 4th course of treatment, Wilkinson's ointment was applied 2 times a week, and the therapeutic ointment was applied daily.

During the 5th course of treatment, external therapy remained the same. After the 5th course of treatment, single telangiectasias and papules remained on the skin.

During the 6th course of treatment, Wilkinson's ointment was applied once a week, and the therapeutic ointment was applied daily in a thin layer at night.

Clinical recovery occurred after the 6th course of treatment. On follow-up, remission has been observed for 5 years.

Example 2. Patient S., 57 years old (IB No. 5047) was admitted to the hospital with a diagnosis of rosacea, erythematous-papular form. On admission, she complained of redness and swelling of the skin of the face in the region of the nasolabial triangle and the 1st chin. She was sick for 9 years, during which she was treated in the high blood pressure (took sulfur, and externally used sulfur-containing agents, and then - constantly corticosteroid ointments.

Upon admission to the patient at the site of skin lesions on the background of congestive hyperemia, severe swelling, an abundance of papular elements, single pustules. In the analysis of sebum, ticks were found in a significant amount.

She received 2 courses of treatment at the clinic. In the first 7 days, external therapy was performed according to the Dem Novichi method (60% sodium thiosulfate solution and 6% hydrochloric acid). In the following days, Wilkinson ointment was applied to the lesions. Then apply a therapeutic ointment in the following ratios of components (May.%):

Trichopol3

Camphor oil15

Adrenaline2

Adrenaline2

Tincture of Valerian 10

Retinol Solution

acetate in oil 7.5

Ichthyolova

paste 3% Else

As a result of general and external therapy, a marked improvement came after the 2nd course of treatment: the face skin became paler, pustules disappeared, papular elements became much flattened, the mite was found in a small amount.

At follow-up after 2.5 months. a tick in sebum is not found.

After 4 courses of treatment, slight swelling in the area of the lesions, single nodules, and multiple telangiectasias persisted. Complete remission occurred after the 5th course of treatment, when erythema resolved completely.

Subsequent regular monitoring since 1985 indicates complete recovery. The duration of remission is more than 5 years.

Example 3. Patient N., 23 years old (IB No. 16914) was admitted to the hospital with a diagnosis of rosacea, a telangiectatic form. Sick for 3 years. Not treated. Upon admission, the patient against a background of pronounced congestive erythema in the face, isolated nodular elements on the chin.

The first course of treatment was carried out in a hospital. The initial intake of Trichopolum-2 tablets. per day.

The first 7 days of the lesion were treated according to the Deminovich method (sequential treatment of lesions with 30% sodium thiosulfate solution and 3% hydrochloric acid solution) 2 times a day, morning and evening,

Then, until the end of the 1st course, daily, first, Wilkinson ointment was applied to the lesions, then a therapeutic ointment, in the following proportions (May.%):

Trichopol2

Camphor oil10

Adrenaline1

Tincture of Valerian 7.5

Retinol Solution

acetate in oil5

Ichthyol paste 3% Else

After 2 weeks and further in the analysis of sebum, a tick was not found, K

at the end of the 1st course, against the background of general and external therapy, the inflammatory phenomena on the skin decreased, the papular rash became more flat and the patient received further treatment on an outpatient basis, having gone for a follow-up examination once every 3 weeks. After the second course of treatment, erythema remained only on the skin of the chin and in the region of the upper lip. Clinical recovery occurred after the fourth course of treatment, when erythema resolved completely. The treatment lasted 4.0 months. Remissi for over 5 years.

The clinic monitored 46 patients: 5 patients with a diagnosis of erythematous form of rosacea, 20 patients with a diagnosis of erythematous-papular form of rosacea and 21 patients with a diagnosis of papular-pustular form of rosacea. All patients are currently experiencing remission, and in 6 - more than 5 years. Thus, the developed method for the treatment of rosacea in comparison with the prototype has the following advantages:

- high treatment efficiency (clinical recovery of patients, regardless of the clinical variety and duration of the disease);

Claims (1)

- the presence of persistent re-transmission in all patients (more than 5 years now). SUMMARY OF THE INVENTION A method for treating rosacea comprising administering sedative, anti-parasitic, multivitamin preparations and topical ointments, characterized in that, in order to achieve a stable remission, Trichopolum is administered for 4-6 months in a decreasing dose starting with a daily dose and up to 0.25 mg, angiotropic preparations are additionally administered and an ointment containing trichopolum, camphor oil, adrenaline rastaor, valerian tincture, retinol acetate solution and ichthyol paste is applied, in the following ratios of components, wt .%: Trichopol 2.0-5.0; Camphor oil 10.0-20.0; Adrenaline solution 1.0-3.0; Tincture of valerian 7.5-15.0; Rastaor Retinol acetate 5.0-10.0; 3% on ichtaolooa pasta else,