RU2132192C1 - Method of human organism adaptation in pathological processes accompanying with metabolic disorders - Google Patents

Abstract

FIELD: medicine, therapy of metabolic disorders. SUBSTANCE: method involves administration of the ozonized sodium chloride solution at ozone concentration 2-6 mg/l by a single dose in volume 200-400 ml. Before and after administration glutathione and nonprotein group levels in blood plasma are determined. Solution is administrated again if values of these indices are not decreased as compared with the initial levels but not early after 4 days. In bacterial infections the ratio of diene conjugates to an average molecular peptides is determined additionally and the solution is administrated again if value of this index is above 2. EFFECT: relief of severity of disease course. 2 cl, 2 ex

Description

 The invention relates to medicine, namely to methods for correcting the functional state of an organism, for example, in pathological processes of various etiologies.

 In order to correct the functional state of the body during pathological processes of various etiologies, methods are used: desensitizing therapy, diffuse therapy, detoxification therapy, stimulation of nonspecific body protection, immunomodulators, etc.

 A known method of correcting the functional state of the body by intravenous administration of irradiated ultraviolet rays of blood (under the editorship of Ganelina I.E., Samoilova K.A. The mechanism of influence of irradiated ultraviolet rays of blood on the human body and animals. / Leningrad, Publishing House Nauka, 1976, S. - 11, 18). The method allows to stimulate nonspecific defense of the body, energy metabolism, detoxification and regeneration processes, stabilize the immune-hormonal status and antioxidant defense of the body. However, the use of ultraviolet radiation has a negative effect on the structural and functional state of cytoplasmic membranes. During the migration of energy, photodegradation of proteins, inactivation of SH-groups, which reduce the enzymatic activity and transport function of proteins, are noted. Moreover, the formation of molecular oxygen radicals and long-lived radicals of lipid and protein nature is possible, which may be the reason for the prolonged activation of free radical lipid peroxidation processes. This can lead to a change in the structural and functional properties of membranes, mechanisms of regulation of metabolic processes in the body, a decrease in the functional reserve of antioxidant protection, which causes disruption of microcirculation processes, stimulation of microsomal oxidation, a decrease in the efficiency of oxidative processes, and can cause a deepening of the hypoxic state and degenerative changes in organs . Structural and metabolic disorders can be the cause of multiple organ failure, exacerbation of chronic diseases and chronic inflammatory processes.

 There is also a method of correcting the functional state of the body (V. I. Sergienko, A. K. Martynov, Yu. B. Vasiliev, etc. Indirect electrochemical oxidation using active oxygen carriers in modeling the detoxifying function of the liver / Issues of medical chemistry. - 1990. - N 3. - p. 28-31). The method consists in the fact that a solution of sodium hypochlorite at a concentration of 1200 mg / l is injected into the patient’s body with purulent-septic complications and with acute septic diseases. Sodium hypochlorite allows you to correct the hypoxic state of the body, reduces the level of endogenous intoxication, stimulates the mechanisms of nonspecific defense of the body, allows you to simulate the molecular mechanisms of phagocytosis, antioxidant defense and the processes of repair and regeneration. Sodium hypochlorite has a bactericidal effect on strains sensitive and insensitive to antibiotics.

 However, the known method has a number of significant drawbacks: stimulating phagocytosis, contributes to the accumulation in the interstitium of active forms of oxygen, chlorine, bromine, iodine, sodium hypochlorite formed in macrophages during activation of phagocytosis, which can be the cause of the induction of free radical processes. This is also facilitated by the fact that hypochlorite is a carrier of reactive oxygen species into cytoplasmic membranes, because this low molecular weight compound passes easily through the membrane.

 Sodium hypochlorite produced by industry is not suitable for medical use due to the presence of a large amount of impurities and an excess of elemental chlorine, and sodium hypochlorite obtained in clinics during the electrolysis of physiological solution also contains excess elemental chlorine and hydrogen peroxide, which can lead to stimulation of peroxidation of non-esterified fatty acids, membrane phospholipids, the accumulation of lipid peroxidation products (lipid peroxidation) and degenerative changes in organ tissues new, may affect the conformational state of cytomembranes. Thus, sodium hypochlorite not only models the functions of monooxygenases and phagocytosis, but can also cause structural and functional changes in membranes. Due to physicochemical changes in the properties of membrane phospholipids, a change in water-electrolyte, lipid-carbohydrate and protein exchanges can occur. Changes in the adenylate cyclase activity of membranes decrease the reactivity of hormone receptors, can lead to disruption of the regulation mechanisms of functional and regulatory systems, and can cause various diseases: allergic, atherosclerosis, diabetes mellitus, cardiovascular diseases.

 As a prototype, a method for parenteral administration of a therapeutic dose of ozone using autogenous therapy (S. Rilling, R. Wiebahn Praxis der ozon sanerstoss Therapie. V.F.M. Heidelberg, 1985, p. 62) was adopted.

 The method includes intravenous administration 1-2 times a week of 50-100 ml of autologous blood pre-enriched with ozone by mechanical shaking of blood in a vessel containing a certain volume of a gas mixture of oxygen with ozone. The therapeutic dose of ozone is 1-2 mg per 70 kg of body weight.

 However, the known method has several significant disadvantages. Special hardware is required for taking and ozonizing blood, it is difficult to determine the concentration of ozone in the blood, possibly an undesirable effect on blood cells due to an increase in the concentration of superoxide-onion radical and hydroperoxide radical and mechanical damage to red blood cells on the wall of the dishes, which causes hemolysis and stimulates LPO . An increase in lipid peroxidation affects the structural and functional state of the cytoplasmic membranes, leads to a change in the reactivity of the receptor apparatus of the membranes, and, consequently, to a violation of the neuro-endocrine regulation of metabolic processes leading to exacerbation of chronic diseases: bronchial asthma, pyelonephritis, rheumatoid arthritis, etc.

 The objective of the invention is the creation of a highly effective way of correcting the functional state of the body, which allows to increase functionality, accelerate recovery, expand the boundaries of adaptation.

 The essence of the invention lies in the fact that in the method of correcting the functional state of the body, including intravenous administration of an ozonized solution, a solution of 0.9% sodium chloride containing ozone in a concentration of 2-6 mg / l, which is administered once in a volume of 200, is used as an ozonized solution - 400 ml, and before and after administration on days 3, 7, 14 in the patient’s blood, the concentration of glutathione or non-protein SH plasma groups is determined and, in the absence of a decrease in these indicators relative to the initial level, repeated administration e, but not earlier than after 4 days.

 In case of bacterial infections in the patient’s blood, the ratio of diene conjugates to the average molecular polypeptides is additionally determined, and when the value of this indicator is above 2 units, the ozonized solution is repeated.

 Using the invention allows to obtain the following technical result.

 The method allows to reduce the treatment time for pathological processes of any etiology. At the same time, the severity of the course of the disease is reduced, the percentage of disability and deaths is reduced.

 The consumption of expensive medicines is reduced, incl. the amount of antibiotics used, which prevents the occurrence of side effects, allergic reactions.

 Using the method allows you to expand the functionality of ozone therapy - allows you to correct metabolic disorders in diabetes, stimulate the process of phagocytosis, increase the effectiveness of antibiotic therapy for pyelonephritis, peritonitis, osteomyelitis, stomatitis, inflammatory diseases of the genitals, stimulate non-specific protection and cellular immunity in viral diseases, pancreatitis.

 The method is a powerful prophylactic of purulent-septic complications in surgical treatment. It can be used to prevent coronary heart disease, bronchial asthma, allergic diseases, anemia, to restore and improve performance.

 It is known that in pathological processes in the human body with functional insufficiency of the physiological adaptation potential, energy-intensive excitational reactions develop. As their intensity increases, the positive value of reactions of an excitatory nature decreases and the metabolic system changes from a physiological level of functioning to a compensatory one, which indicates the development of nonspecific reactions to protect the body in response to a damaging factor.

Clinical studies have shown that ozone has a powerful adaptogenic effect, homeostasizing the powerful redox potential of the body. Ozone, qualitatively changing the metabolism of oxygen and energy substrates, increasing the energy efficiency of oxidative processes, determines the orientation of metabolic processes, the hormonal-vegetative and immune status of the body, ensures the integration of homeostatic reactions of different levels. The totality of these changes is metabolic adaptation, which is the basis of stereotypically developing therapeutic effects. The basis for increasing physiological adaptation is the metabolic correction of the redox potential of the body with an ozonated solution of sodium chloride. Metabolic correction occurs due to the energy efficiency of oxidative processes. Intravenous administration of ozonized saline leads to an increase in oxygen concentration in the blood, simulates the function of liver monooxygenases, enhances the glucose metabolism along the pentose phosphate pathway, which contributes to an increase in the NADPH ₂ pool, providing stabilization of detoxification and antioxidant defense processes and intensification of steroidogenesis and plastic metabolism (reparative regenerative process) . A change in the oxidative potential of the body is the basis of the restructuring of regulatory and metabolic adaptation processes. Maintaining the metabolic potential within the limits of adaptation is especially important in the conditions of pathology, when, as the intensity of the excite response of the metabolic system increases, their positive value decreases and the system switches from a physiological level of functioning to a compensatory one, which can cause various complications and chronic diseases.

 The method is as follows.

 A patient with a low level of nonspecific protection of the body or with a chronic disease with the aim of treating or preventing a disease or preventing complications and other pathological conditions is injected intravenously with an ozonized solution of 0.9% sodium chloride containing ozone in a concentration of 2-6 mg / l in a volume of 200 - 400 ml. For this purpose, through a solution of 0.9% sodium chloride, which is in a standard bottle with a capacity of 0.5 l, a needle having several side openings is inserted through a hermetically sealed stopper, through which an oxygen-ozone gas mixture obtained at an ozonizer installation, for example, of a company Medozone, with an ozone concentration of 50 mg / l for 5 minutes, which makes it possible to obtain an ozone concentration in solution of 2-6 mg. A stable concentration of ozone in the solution is maintained for 15-30 minutes; therefore, intravenous injection is administered at this time interval. The drug solution is injected into the ulnar vein at a speed of 40-50 drops per minute. The therapeutic dose of ozone is 0.8 - 2.4 mg per 70 kg of body weight. Moreover, before and after administration on the 3rd, 7th, 14th day, the concentration of glutathione or non-protein SH plasma groups is determined in the patient’s blood and, in the absence of a decrease in these indicators relative to the initial level, repeated administration is carried out, but not earlier than after 4 days.

 In bacterial infections (purulent-septic complications and acute inflammatory diseases), the ratio of diene conjugates (DCs), the primary products of LPO to the average molecular polypeptides (SM), is additionally determined. When the value of this indicator (DK / CM) is higher than 2 units, the ozonized solution is reintroduced.

 As a screening test, ozone therapy is used for chronic diseases and functional disorders of the SH-group or glutathione. In case of purulent-septic complications and acute inflammatory diseases, the coefficient of endogenous intoxication is used, which is defined as the ratio of diene conjugates (DC - primary LPO products) to medium molecular weight polypeptides (SM) - (DC / SM).

 The authors found that the value of the ratio of 1.5-2 is an indicator of adequate therapy and indicates the stimulation of the detoxification processes of the body.

 Example 1

 Patient P., 52 years old, was admitted with complaints of acute stitching pain in the right hypochondrium, vomiting.

 Diagnosis at admission: exacerbation of chronic calculous cholecystitis. Type I diabetes mellitus in the decompensation phase.

 On examination: Patient normosthenic physique, increased nutrition. The skin is pale, with a yellowish tinge, dry.

 Respiratory system: No complaints. The chest is conical in shape, symmetrical, evenly involved in breathing. In the lungs, vesicular breathing, weakened, no wheezing.

 Cardiovascular system: no complaints. The area of the heart is not changed. Heart sounds are rhythmic, muffled, accent of the 2nd tone over the aorta. HELL - 125/80 mm Hg Heart rate - 84 beats / min.

 Digestive system: on examination, the tongue is dry, with a pale yellow bloom. When examining the anterior abdominal wall, no changes were detected. With superficial palpation of the abdomen, marked pain is noted in the area of the projection of the gallbladder.

 Blood biochemical parameters: glycemia 15.3 mmol / L, phosphatase activity of 150 IU, γ-glutamyltranspeptidase - 73 ME, activity of aspartate and alanine transaminases - 58 ME.

 The general condition of the patient and indicators of biochemical blood tests indicated a decrease in the functional reserves of the body and the likelihood of a decrease in the mechanisms of nonspecific protection, cellular immunity and stimulation of the processes of free radical oxidation of phospholipids of cytoplasmic membranes and the possibility of the development of purulent-septic complications in the postoperative period.

 Treatment: in order to prevent purulent-septic complications and stabilize the level of glycemia in the preoperative period, we performed one session of ozone therapy. An ozonized solution of 0.9% sodium chloride solution containing ozone at a concentration of 2 mg / l in a volume of 200 ml was once introduced intravenously into the patient's body. The solution was injected into the ulnar vein at a rate of 40 drops / min.

Before the introduction of the solution, as well as on days 3, 7, and 14, the concentration of non-protein SH groups was determined in the patient’s blood, which was respectively: 2.3; 1.8; 2.7; 3.5 mmol / l
Due to the decrease in this indicator by 3 days compared with the initial level (1.8 mmol / l), repeated administration was not carried out.

 As a result of the therapy, an increase in the functional reserve of the body was noted, which was facilitated by the stimulation of oxidative processes and an increase in their energy efficiency, stabilization of lipid peroxidation and antioxidant defense processes, strengthening detoxification mechanisms, plastic metabolism and non-specific defense reactions and the body's immune status.

 The patient's pain decreased, intestinal motility was normalized. Blood biochemical parameters recorded a decrease in glycemia from 15.3 to 6.5 mmol / L, phosphatase activity decreased from 150 to 100 ME, GTPP decreased from 73 to 60 ME, however, ACT and ALT activity remained slightly increased (56 and 58 ME), respectively. .

 The relative normalization of the condition allowed surgical treatment (cholecystectomy) to be performed on the 5th day.

 The postoperative period was uneventful. Suture healing took place by primary intention. The patient was discharged 12 days after surgery.

Example 2
Patient S., 48 years old, was admitted with complaints of acute abdominal pain.

 On examination: Moderate severity. The patient is conscious. The skin is pale, moist.

 A history of duodenal ulcer. On examination, the tongue is dry, coated with a white coating. Visually determined abdominal muscle tension. Palpation of the anterior abdominal wall seems inappropriate. Heart sounds are rhythmic, muffled, heart rate - 120 beats / min, blood pressure 95/60 mm RT.

 Preliminary diagnosis: Perforating duodenal ulcer, complicated by common peritonitis.

 The patient is shown an emergency laparotomy with an audit of the abdominal organs.

Biochemical blood test before surgery:
DK - 2.65 units; SM - 0.48 UNITS; the concentration of SH groups - 1.95 mmol / l ACT - 105 ME; ALT - 96 ME
The patient underwent resection and suturing of the duodenal ulcer with subsequent rehabilitation and drainage of the abdominal cavity. In order to reduce endogenous intoxication and stop the spread of bacterial flora, an ozone therapy session was conducted: 400 ml of an ozonized solution with an ozone concentration of 6 mg / l was dripped into the cubital vein.

 On the 3rd day after the operation, a decrease in the concentration of SH groups to 0.97 began to be noted; on the 7th day - 2.6; on the 14th day - 3.5 (mmol / l). The dynamics of DC and SM are shown in the table at the end of the text.

The dynamics of DC / SM showed a decrease in endogenous intoxication due to a decrease in the concentration of lipid peroxidation products and medium molecular weight polypeptides. The use of ozone therapy has reduced the number and duration of antibiotic use
The postoperative period was uneventful. On the 21st day after surgery, the patient was discharged in satisfactory condition.

Claims (2)

 1. The method of adaptation of the human body in pathological processes accompanied by metabolic disorders, including intravenous administration of an ozonized solution into the body, characterized in that a solution of 0.9% sodium chloride containing ozone in a concentration of 2-6 mg / l, which is administered once in a volume of 200 - 400 ml, and before and on day 3 after administration in the patient's blood, the concentration of glutathione or non-protein SH-groups of plasma is determined and, in the absence of a decrease in these indicators, at the initial level, repeat administration is performed, but not earlier than after 4 for.  2. The method according to claim 1, characterized in that in case of bacterial infections in the patient’s blood, the ratio of diene conjugates to average molecular peptides is additionally determined, and if the value of this indicator is above 2, the solution is repeated.

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