RU2147884C1 - Method for treating the cases of duodenal and gastric peptic ulcer - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves applying Dimephosphon at a daily dose of 50 mg/kg of body mass in addition to traditionally administered drugs when ulcer defect size is less than 0.6 cm, during one week before and 2 weeks after hospital treatment course. Ulcer defect size being greater than 0.6 cm, Dimephosphon is given during two weeks before and 2 weeks after hospital treatment course. EFFECT: enhanced effectiveness of treatment; influencing various mechanisms of gastric juice regulation. 3 cl, 1 tbl

Description

 The invention relates to medicine, in particular to gastroenterology.

In modern gastroenterology, a large number of antiulcer drugs are used, each of which has certain positive properties with respect to the healing of gastroduodenal ulcers. Among the most active antiulcer drugs are blockers of gastric secretion. The group of gastric secretion blockers is quite extensive: these are the "classic" and selective peripheral M and M ₁ cholinergic blockers, H ₂ histamine receptor blockers, and finally omeprazole. For over 20 years the most popular are blockers of H ₂ histamine receptors (A.L.Grebenev, L.P.Myagkova, A.M.Khorshed "blockers of histamine H ₂ -receptors: application capabilities and potential in internal medicine IV generation drugs" / Clin. Honey. - 1991 - N 3. - S. 23-34).

For the most part, gastric secretion blockers are not able to prevent relapses of the disease that occur shortly after their cancellation, which serves as the basis for their prolonged or even year-round use. Until recently, the most common was maintenance therapy with H ₂ -blockers, which included a daily intake of 150 mg of ranitidine at bedtime. In this regard, there is a "habituation effect" to the drug with prolonged use and a "withdrawal effect", the risk of adverse reactions (Y. S. Zimmerman, Y.B.Budnik "Prerequisites for the use of calcium antagonists in the treatment of digestive diseases" / Ros gastroenter. journal, hepat., coloproct. - 1995 - N 3 - S. 22-28; A.A. Sheptulin "Modern principles of peptic ulcer pharmacotherapy" / Clin. honey. - 1996 - N 8 - S. 17- 19).

 At the same time, it is known to use monotherapy with dimephosphone (1,1-dimethyl-3-oxobutylphosphonic acid dimethyl ether) for the treatment of patients with acute erosive and ulcerative lesions of the gastroduodenal zone of a stressful nature (V.N. Tsibulkina "Optimization of the clinical use of dimephosphone based on a study of leading mechanisms of its action ": Abstract. Dis. Doct. Medical Sciences. - 1997 - 44 s). Given the increasing requirements for the safety and tolerability of drugs, it is no coincidence that there is interest in drugs that have a “milder” effect on gastric acid secretion and affect various mechanisms of regulation of gastric secretion.

 The purpose of the invention is the prevention of relapse of the disease.

The method is as follows. Patients with peptic ulcer of the stomach and duodenum were treated with a traditional set of drugs, including antacids, H ₂ histamine receptor blockers, antispasmodics, enveloping and astringent drugs. Some patients, in addition to this, received a 15% aqueous solution of dimephosphone orally 3 times a day after meals at a rate of 50 mg / kg weight per day for peptic ulcers of less than 0.6 cm 1 week before and 2 weeks after treatment, for peptic ulcers more than 0.6 cm 2 weeks before and 2 weeks after the end of treatment, i.e. depending on the size of the ulcer.

 Example.

 Patient Masgutov Yu. M., 40 years old, N case history 181/45 was hospitalized in the mountains. hospital N 8, Kazan from 17/1 to 11/11-1997 with a diagnosis of peptic ulcer of the duodenum with localization of ulcers of size 0.8x1.0 cm on the front wall of the duodenal bulb. Increased acid secretion of the stomach.

 Received complaints of aching pains in the epigastric region that occur on an empty stomach, sometimes at night. Pain is accompanied by heartburn, weakness worries.

 Sick for 2 years, heredity burdened: his father has a stomach ulcer.

 On examination, pain on palpation in the epigastric and pyloroduodenal zones was noted. An endoscopic examination: an ulcer with a fibrinous bottom of 0.8 x 1.0 cm on the front wall of the duodenal bulb. A fractional study of gastric juice showed an increased gastric acid secretion.

 The patient received the following treatment: general regimen, diet, platyphyllin, alugastrin, ranitidine, thiamine bromide, solcoseryl, multivitamins, hyperbaric oxygenation, electrophoresis from hen to the collar zone. 2 weeks before the end of treatment, a 15% aqueous solution of dimephosphone was administered orally at a dose of 50 mg / kg body weight per day. It was recommended to continue taking dimephosphone for another 2 weeks after discharge from the hospital (end of treatment).

 At discharge, the patient's condition is satisfactory. No complaints. At endoscopic examination: a completely epithelized retracted scar at the site of the ulcer.

 During the observation period for 6 months there was no relapse of the disease.

The proposed method allows to prevent relapse caused by the "cancellation syndrome" of H ₂ histamine receptor blockers. The results of observations of patients within 6 months after discharge are shown in the table:

Claims (3)

 1. A method of treating gastric ulcer and duodenal ulcer, including treatment with a traditional set of drugs and dimephosphone, characterized in that dimephosphon is administered at a rate of 50 mg / kg per day, the duration of administration depends on the size of the ulcer defect.  2. The method according to claim 1, characterized in that the dimephosphon is administered for peptic ulcers with a diameter of less than 0.6 cm 1 week before and 2 weeks after the end of treatment in a hospital.  3. The method according to claim 1, characterized in that the dimephosphon is administered for peptic ulcers with a diameter of more than 0.6 cm 2 weeks before and 2 weeks after the end of treatment in a hospital.

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