RU2070076C1 - Method of chronic opisthorchiasis treatment - Google Patents

Abstract

FIELD: medicine, parasitology. SUBSTANCE: method involves administration of chloxyl at the dose 0.06 g/kg body mass per 24 hr and then - biltricid (threefold). Treatment is carried out after microwave stimulation at decimeter range at the following regime: power - 30-40 W, seance duration - 10-15 min, treatment course - 10-15 seances. EFFECT: improved method of treatment, enhanced effectiveness.

Description

 The invention relates to medicine, namely to internal medicine, and can be used in parasitology in the treatment of chronic opisthorchiasis.

 Known methods for the treatment of opisthorchiasis, based on the use of anthelmintic drugs; chloroxyl or biltricide (Plotnikov, Yaldygina, 1962; Bronstein, Ozeretskovskaya et al. 1981; Bronstein, Ozeretskovskaya et al. 1988). The main disadvantages of these methods of treatment of opisthorchiasis are lack of effectiveness, the need for their repeated appointment, the likelihood of side effects.

 A known method of treating chronic opisthorchiasis, based on the separate, course use of chloxil or biltricide (Bronstein, Ozeretskovskaya et al. 1981; Bronstein, Ozeretskovskaya et al. 1988).

The main disadvantages of the applied variants of the known method are
insufficient effectiveness of the separate use of chloxil and biltricide (27.9 75%);
the need for repeated course treatment with a hepatotoxic drug (chloroxyl);
poor tolerance to repeated administration of the drug and a high probability of developing side effects;
the absence in the known method of correction elements for biliary dyskinesia;
The aim of the invention is to increase the effectiveness of anthelmintic treatment due to the combined, sequential use of chloroxyl and biltricide against the background of microwave and drug effects on the biliary tract.

 The essence of the proposed method for the treatment of chronic opisthorchiasis and its distinguishing features from the prototype is the preventive correction of biliary dyskinesia using the Volna-2 apparatus and conventional medications, and then 0.06 g of chloxia is used for 5 days against this background kg per day; then three times (at 22.00, 2.00 and 6.00 they give biltricide inside at a dose of 60 mg / kg. To reduce the side effects of treatment from the 6th day prescribed tubage (for example, according to Demyanovich) and intestinal irrigation.

 This goal is achieved by the fact that at the first stage of treatment due to the effects of microwave, kinetic and antispastic therapy, patency of the biliary tract is corrected and conditions are created for better tolerance of anthelmintic drugs. The appointment against this background of therapeutic doses of chloxil (0.06 g / kg of patient weight per day for 5 days, but not more than 25 g per course) ensures the death of sexually mature forms of parasites. Subsequent use of biltricide at 22.00, 2.00 and 6.00 at a dose of 60 mg / kg of the patient’s mass causes the death of chloxyl-resistant parasites. The stimulation of the passage of bile and intestinal contents conducted against this background enhances the effectiveness of anthelmintic treatment.

 The method is as follows.

 After the diagnosis is established, the patient is prescribed microwave therapy, for example, with the Volna-2 apparatus in the following mode: Patient position on the back. A cylindrical emitter is placed over the region of the right hypochondrium with a gap of 3–4 cm. The exposure dose is thermal power 30–40 W. The duration of the procedure is 10 15 minutes daily. The course of treatment is assigned 10 15 procedures. At the same time, drugs are prescribed that correct the manifestations of biliary dyskinesia. For example, no-shpu 0.04 on 1 table. 2 times a day after meals; 30% sorbitol solution for 1 tbsp. l 3 times a day; Tubes with sorbitol once a week; antihistamines (tavegil). After stopping the manifestations of biliary dyskinesia daily for 5 days, a course of chloxil is prescribed at a dose of 0.06 g / kg body weight per day, but not more than 25 g per course. On the 6th day in the morning they carry out a tubage according to Demyanovich and intestinal irrigation, after which at 22.00, 2.00 and 6.00 a biltricid is prescribed at a dose of 60 mg / kg of the patient's mass. At the end of the course of deworming, it is advisable for patients to continue medication and physiotherapy stimulation of the biliary tract, focusing on the clinical criteria for the manifestation of biliary dyskinesia.

 Example 1 (treatment using the prototype).

 Patient I. 57 years old, body weight 74 kg, medical history A-12195, was admitted to the clinic on March 17, 91 with a diagnosis of chronic opisthorchiasis, relapse, chronic persistent hepatitis, chronic pancreatitis. Considers herself ill since 1960. The disease was accompanied by fever, urticaria rash, arthralgia, pain in the right hypochondrium. A general blood test showed eosinophilia 16. He was treated in a hospital. Opisthorchis eggs were found. Chloxyl was used according to a two-day procedure. Checked out in improvement. In 1965, jaundice, skin itching, and low-grade fever appeared. Again eggs of opisthorchis were found. He was treated with chloxyl according to a 3-day technique. In 1979, icteric staining of the sclera reappeared, weakness, flatulence, and itching were noted. In blood tests, an increase in total bilirubin, eosinophilia was noted. Again eggs of opisthorchis were found. The treatment was carried out according to a 5 day technique. The patient claims that since 1975 he did not eat fish from the cyprinid family. Thus, the use of even repeated courses of therapy does not allow for the treatment of chronic opisthorchiasis with clinically significant effectiveness.

 Example 2. (Treatment by the proposed method).

 Patient K., 50 years old, body weight 65.5 kg, medical history N A-17035. Was admitted to the clinic on February 27, 1992. Repeatedly since 1975 she underwent a course of treatment with chloxyl. In the clinic, using ultrasound, scintigraphy, as well as duodenal examination, the relapse of chronic opisthorchiasis is confirmed. In portions of bile I, II, III, 1 2 eggs of opisthorchis are registered. The severity of the condition is indicated by the following biochemical data: total bilirubin 32.0; direct 8.5; indirect - 23.5 μmol / l, as well as white blood cells, 8,600; eosinophilia 6.0.

 At admission, the patient was prescribed preventive pathogenetic therapy: table 5p, diazolin 0.1, 1 table. 2 times a day after meals, nicodine, sorbitol solution 30%, 1 tbsp. l 3 times a day, tubing with sorbitol once a week, a festival of 1 tablet 3 times a day with meals, microwave therapy to the right hypochondrium (apparatus "Wave-2") in a mode of 40 watts, 12 treatments per treatment course, electrophoresis with sulfate magnesia on the right hypochondrium.

 As a result of treatment, the patient's condition improved: skin itching and pain in the right hypochondrium and epigastrium disappeared, bloating decreased, the temperature returned to normal. Bilirubin: total 17, direct 4 and indirect 17. In the study of blood eosinophils 2.

The positive dynamics of the 1st stage of treatment made it possible to prescribe anthelmintic therapy in the following sequence: chloroxyl at a dose of 0.06 g / kg daily and 19.5 g per course of treatment and biltricide in three doses of 60 mg / kg in a total dose of 3950 mg. The treatment was well tolerated: on the 5th day of taking chloroxil, the appearance of skin itching was noted. The dose of diazolin was increased by 1 table. which allowed to remove skin itch. On the second day after taking biltricide, a headache was noted. Continued activities to stimulate the function of the intestines and gall bladder. The patient was discharged in satisfactory condition. Data from laboratory tests at discharge: general blood test: Er. 4.3.10 ¹² g / l, HB 134, L 4.9 • 10 ⁹ / l, e 1 s 62 l 29, m 8, s 75 mm / h. Bilirubin total 15, direct 4.5, indirect 11.5 millimol / l AST 0.42 ALT 0.36. Total protein 72.3 g / l. Albumin 57, alpha ₁ -3, alpha ₂ 8, beta 12, gamma-globulins 17. After 5 months, the patient was duodenal sounding three times, coproovoscopic examination. No eggs of opisthorchis were found in the study. General condition is good.

Thus, the essence of the distinctive features of the prototype of the features of the invention is as follows:
1. Depending on the manifestations of the syndromes of chronic opisthorchiasis, preventive physiotherapeutic and medication correction of biliary dyskinesia is prescribed.

 2. As a means of pathogenetic therapy at the preparatory stage of treatment and while taking two anthelmintic drugs, the effects of microwave therapy are used (anti-allergic, anti-inflammatory, antispastic, vasodilator and trophic).

 3. Two anthelmintic drugs are prescribed sequentially, first chloroxyl, then biltricid.

 4. After carrying out chloxyl-i-biltricidotherapy, along with tubages, receptions for increasing the passage of bile and intestinal contents are carried out.

 5. Repeated course treatment using one of the drugs is excluded.

Claims (1)

 A method of treating chronic opisthorchiasis, including the use of medications, characterized in that the patient is first subjected to microwave therapy in the decimeter range with a power of 30-40 W for 10 15 minutes, then chloroxyl is administered inside for 5 days in a daily dose of 0.06 g / kg body, then spend tyubazha according to Demyanovich and intestinal irrigation, after which biltricide is administered three times in a daily dose of 0.06 g / kg body weight.