RU2083203C1 - Antiulcer agent - Google Patents

Abstract

FIELD: medicine, gastroenterology. SUBSTANCE: invention proposes the use of phenolphthalein that can be effective for treatment of gastritis, cholecystitis, pancreatitis and for prophylaxis of these diseases. EFFECT: enhanced effectiveness of treatment.

Description

 The invention relates to gastroenterology, and in particular to basic drugs for the treatment of diseases of the gastrointestinal tract: gastritis, gastroduodenal ulcers, concomitant (reactive) cholecystitis, pancreatitis, colitis, as well as for the prevention of relapse of these diseases.

 Currently, gastritis, gastroduodenal ulcers and relapses of these diseases are treated with drugs approved for use. The range of antiulcer drugs used is quite wide. Since the effectiveness of treatment with individual drugs is insufficient, they are prescribed in combination.

 Almagel antacid is prescribed in 1 2 dosage spoons 4 times a day after meals, plus selective M-anticholinergic gastrocepin, 0.05 g 2 times a day. In cases of increased pain due to increased motility of the stomach and duodenum, an antispasmodic of the myotropic row of no-shpu is prescribed at 0.04 0.08 g in tablets. With a decrease in the motor activity of the stomach, metaclopramide is prescribed at 0.01 0.02 g orally 2 3 times a day. De-nol is prescribed 1 tablet 3 times a day 30 minutes before meals and at bedtime. In case of media gastric ulcers, solcoseryl is prescribed by injection of 6-8 ml per day and cytoprotector Sucralfate 2 tablets 3 4 times a day between meals.

However, the effectiveness of treatment with these drugs is insufficient, gastroduodenal ulcers can heal quite quickly, but a relapse of the disease can also occur quickly. In addition, many drugs have negative side effects [2]
A known method of treating chronic constipation with a synthetic laxative drug (phenolphthalein), systematically and regularly taken for many years, selectively irritating and stimulating receptors of the colon, not significantly affecting the absorption of nutrients in the small intestine [1]
The effectiveness of phenolphthalein was also found in the treatment of gastritis, gastroduodenal ulcers, concomitant cholecystitis, pancreatitis, colitis.

 The justification for the use of phenolphthalein for a new purpose was the revealed ability of this medication to relieve duodenostasis, to relax the valve (sphincter) between the duodenum and small intestine with the restoration of the motor-evacuation function of the duodenum and, as a consequence, the duodenogastric reflux (reflux) that does not occur then Vater's nipple, one of the main factors in the pathogenesis of ulceration.

 The contents of the duodenum thrown during duodenostasis and valve spasms, changing the reaction of the medium and the enzyme composition at the points of casting, leads to the fact that the protective mucus of the gastroduodenal walls, which is less resistant to the action of an alkaline environment with bile and pancreatic enzymes, is more intensively hydrolyzed, liquefied and washed off locally to be washed off epithelium, and the regeneration of mucus to protect the walls does not keep pace with the processes of hydrolysis and flushing. Locally exposed membranes of epithelial cells are chemically fired with alkali, and with a fairly rapid change in the reaction of the medium, when the mucous barrier has not yet been regenerated, an acid burn occurs, which constantly occurs during reflux episodes. A chemical burn, like thermal, leads to pain, inflammation and swelling (gastritis). The bile and lipase located here also emulsify and hydrolyze the phospholipids of the cell membranes of the epithelium and, after the destruction of the cell membranes, a cellular erosive manifestation occurs, which increases with increasing intensity and duration of reflux. Inflammation and ulceration of the mucous membranes of the gastroduodenal walls can lead to concomitant inflammations and diseases: cholecystitis, pancreatitis, colitis.

 The purpose of the invention: improving the efficiency and reducing the treatment of gastritis, gastroduodenal ulcers, concomitant cholecystitis, pancreatitis, colitis, prevention of relapse of these diseases.

 To achieve this goal, it is proposed to use phenolphthalein strictly necessarily with each meal in standard single doses.

 The course of treatment is 14 28 days, with complicated and long-term forms of diseases, the course of treatment is extended until a stable remission is achieved.

 To prevent relapse, the course of treatment can be reduced to 7 days.

 Traditional treatment is not compatible with the proposed one (gluing of ulcer defects, laser irradiation through an endoscope is allowed).

 During treatment, 1.5 1.5 liters of water per day (or soft drinks) are required. It is not recommended to lie down on the right side 4 5 hours after eating (during the evacuation of the chyme from the duodenum). During physical exertion on the abdominal press, it is recommended to take a single dose of the drug in advance for 1 2 hours (to exclude reflux). A strict diet, multiple meals multiple meals are not required. With a delay in the evacuation of pancreatic juice, the drug intake can be shifted after meals by 1 2 hours.

 The pain syndrome is removed quickly enough (up to 2 4 hours). In some cases, with a significant duration of the disease, frequent exacerbations, large ulcerative defects, multiple erosions, the pain syndrome stops after a few weeks.

 In the presence of candidal dysbacteriosis, the effective connection of levorin (nystatin) in 2 million units. per day for 10 days.

 Contraindications to the proposed therapy is cholelithiasis with a size of stones more than 2 3 mm, complicated course of peptic ulcer requiring surgical treatment.

 Example 1. Patient Ch. 20 years old, a student at a medical school complained of intense pain in the gastroduodenal zone at night and after 1 1.5 hours after eating. Such pains were disturbed for 6 years, night pains last 2.5 years, aggravating in spring and autumn. Another deterioration within 3 months. The sick father suffers from peptic ulcer. FGS 07/15/94 on the medial wall of the duodenum, an ulcer of 0.2 x 0.5 cm in diameter, the pylorus is gaping. Received treatment: diet resp. Art. 1, almagel, ranitidine, solcoseryl, actovegin. When FGS 10/21/94 G. erosive bulbitis, deformity of the bulb of the duodenum, chronic erosive gastritis. 10.24.94, prescribed monotherapy with phenolphthalein 0.1 g 4 5 times with meals during normal diet. November 9, 1994 there are no complaints, the pain disappeared on the 4th day of treatment, palpation of the gastroduodenal zone is painless. There is no erosion control FGS, the inflammatory process in the duodenal bulb subsides. Phenolphthalein monotherapy for another 2 weeks.

 Example 2. Patient O. 42 years old, the doctor complained of nightly hunger pains that occur 40-60 minutes after eating. Similar pains for 4 years, recent deterioration in health for 2 months. She took antispasmodics (no-spa, papaverine), antacids (almagel, vicalin), gastrocepin without noticeable improvement. FGS 11/15/94, the stomach contains bile, the mucous membrane is hyperemic, in the bulb of the duodenum on the medial wall, stellate scars of the mucous membrane are edematous around, hyperemic with linear erosion. The mucous membrane of the descending section of the duodenum with a plaque in the form of "semolina". On palpation, soreness and moderate protective muscle tension in the gastroduodenal zone. Diagnosis: peptic ulcer of the duodenum, chronic gastroduodenitis in the acute stage with erosion in the bulb of the duodenum. Phenolphthalein monotherapy was prescribed at 0.1 g 3 times a day with meals on a normal diet. On the 5th day of treatment, the pain completely stopped, upon examination, palpation of the gastroduodenal zone is painless. On FGS after two weeks, erosion and signs of inflammation were not detected.

 Example 3. Patient C., 35 years old, complained of intense pain in the gastroduodenal zone. Has been registered in the dispensary for duodenal ulcer since the fall of 1991. The conclusion of the FGS dated 04.09.91 is that the duodenal bulb is deformed, on the front wall of the ulcer 0.8 cm in diameter, opposite the ulcer to 0.3 cm in diameter with erosions around. Conservative treatment with traditional drugs was prescribed until remission is achieved. A year later, the disease recurred. Conclusion on FGS from 09/22/92, cicatricial and ulcerative deformity of the duodenal bulb, bulbite with erosion. Conservative treatment with traditional drugs was prescribed until remission is achieved. After a year, the disease recurred again. Conclusion on FGS from 09/28/93, bile was detected in the stomach, up to 0.5 cm in the duodenal bulb on the lower wall of the ulcer, erosion around. Phenolphthalein monotherapy was prescribed at 0.1 g 3 4 times a day with meals during normal food regimen. Repeated FGS from 10.15.93, in the antrum, point erosion, the pylorus gaping, on the posterior wall of the duodenal bulb ulcer 0.6 x 2.0 cm in the stage of scarring. Phenolphthalein treatment continued. When FGS from 10/22/93, in the bulb of the duodenum, positive dynamics, in place of an ulcer (on the back wall) a fresh scar. Phenolphthalein monotherapy was continued for 2 weeks after which there was a persistent remission. A year later, with signs of relapse, she independently conducted a two-week course of phenolphthalein monotherapy. No complaints.

 Example 4. Bolshoi Z. 60 years old, in the spring of 1987 with recurrence of FGS peptic ulcer from 05.29.87, the gastric mucosa is edematous, hyperemic, is presented in the form of small-point hemorrhagic hemorrhages throughout the entire length, lymphoid granularity, pylorus, duodenal bulb in the antrum deformed, there are scars, the mucous membrane of the descending section is thin. Diagnosis: chronic hemorrhagic gastritis, chronic duodenitis, cicatricial deformity of the duodenal bulb, pylorus. For the first time, a "niche" in the bulb of the duodenum was discovered in 1961. It was dispensary registered for duodenal ulcer, chronic cholecystitis. Gastritis was ill earlier. Peptic ulcer disease continuously recurred. He constantly received traditional antiulcer treatment, was treated in specialized sanatoriums, followed a diet, did not smoke, did not drink alcohol, but the disease progressed. After FGS, phenolphthalein monotherapy was prescribed at 0.1 0.2 g 4 5 times a day with meals at a normal diet. The pain syndrome was stopped in a week. After 1.5-month monotherapy with phenolphthalein, there was a persistent remission of peptic ulcer, concomitant cholecystitis. In the future, with signs of relapse, it independently conducts both normal and shortened phenolphthalein monotherapy. Relapse of the disease was not more than 7 years.

 Example 5. Patient P., 25 years old, complained of intense pain in the gastroduodenal zone. Similar pains bothered for 4 years. FGS from 10.12.90, the duodenal bulb is filled with bile, in some places the mucous membrane is thickened with single erosions. Conclusion: erosive bulbitis. A course of conservative drug treatment has been prescribed. Improvement is not noted. In April 1991, exacerbation of chronic gastritis, pancreatitis. Conservative treatment has been prescribed. In January 1992, exacerbation of chronic cholecystic pancreatitis. Prescribed conservative drug treatment. In November 1992, exacerbation. In December 1992 she underwent a course of treatment in a day hospital with a diagnosis of chronic erosive duodenitis, reactive pancreatitis, hypokinetic gallbladder dyskinesia. Aggravation in the winter of 1993. Was treated in a hospital from 01/19/93 to 02/12/93. The condition did not improve. Directed for examination at the regional medical diagnostic center. Conclusion: chronic gastritis, duodenitis, pancreatitis. An outpatient conservative treatment was prescribed. Aggravation in the spring of 1993. I was treated in the gastrointestinal department of the regional clinical hospital from 04/16/93 to 04/27/93 with a diagnosis of chronic gastroduodenitis, chronic pancreatitis, chronic cholecystitis, secondary colitis, and dysbiosis. Treatment: aminocaproic acid, contracal, antispasmodics, pancreatic enzymes. Discharged for family reasons. Continued outpatient treatment for 3 weeks. Improvement is not noted. In June 1993, phenolphthalein monotherapy was prescribed at 0.1 0.2 g 3 4 times a day during meals with a normal diet, after 10 days, treatment with levorin 4 x 500 thousand units was connected. per day for 10 days. After 1.5 months, phenolphthalein monotherapy did not cause pain. The condition is satisfactory. In December 1993, with signs of relapse, she independently conducted a monthly course of phenolphthalein monotherapy with levorin. In the spring of 1994, she independently conducted a course of phenolphthalein monotherapy. No complaints.

 The use of phenolphthalein for a new purpose expands the range of medicines for the treatment and prevention of relapse of gastritis, gastroduodenal ulcers, concomitant cholecystitis, pancreatitis, colitis, can improve the efficiency and reduce the time of treatment and prevention of relapse of these diseases with a significant reduction in material costs of treatment, normal diet, without significant adverse side effects of the drug on the patient’s body.

Claims (1)

 The use of phenolphthalein as an antiulcer agent.