RU2159626C2 - Method for treating intestinal dysbacteriosis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves applying preparative procedures before implanting normal intestinal microflora preparations containing living organisms. Cleaning enemas containing neutral electrically activated anolyte solution of 6-6.5 pH are applied during 2 days. Intestine enteroclysis is carried out during the next 5 days with catholyte solution of 9-9.5 pH. The solution temperature is equal to 18-20 C in the cases of hypomotor disease form and 35-40 C in the cases of hypermotor disease form. Cleaning catholyte solution enema being done, electrically activated aqueous solutions are to be rectally introduced through catheter. The solutions contain Ca⁺⁺ ions in the cases of hypermotor disease forms, and C⁺⁺,K⁺,Mg⁺⁺ ions in the cases of hypomotor disease forms. EFFECT: enhanced effectiveness of treatment; favorable conditions increasing intestine mucosa absorption capability. 2 cl, 1 tbl

Description

 The invention relates to medicine, namely to gastroenterology, and can be used in the treatment of dysbiosis of varying severity.

 Known methods for treating dysbacteriosis by restoring normal intestinal biocenosis using preparations made from microorganisms that are representatives of the normal microflora of the human intestine: colibacterin, bifidumbacterin, lactobacterin, bificol (Krasnogolovets V.N. intestinal Dysbacteriosis. - M .: Medicine, 1989, p. 186-187).

 There is a method of treating dysbacteriosis by introducing live colon bacilli into the rectum (Blokhina I.N., Drofeichuk V.G. Dysbacteriosis. - L .: Medicine, 1979, p. 87): the patient is given a cleansing enema, after which the pear is culture live bacteria are implanted in the rectum with a frequency of 8-10 procedures during the course of treatment. The disadvantage of this method is that the bacterial culture is introduced into the descending part of the rectum, which does not contribute to the sufficient fixation of bacteria on the mucosa, their rapid elimination with feces.

 Known methods of treating dysbacteriosis, including as a mandatory treatment procedure, intramuscular administration of human gamma globulin containing antibodies to the E-coli strain.

 All known methods of treating dysbacteriosis have one significant drawback: the effectiveness of treatment is significantly reduced due to the fact that the administration of drugs does not take into account the growth activity of bacteria exposed to various adverse factors (gastric juice, bile, pancreatic and duodenal passage through the gastrointestinal tract) juice, small intestinal enzymes), due to which the antagonistic properties of bacteria are reduced, which lengthens the treatment time and reduces its result.

The prototype is a method of treating intestinal dysbiosis, based on preliminary preparation of the intestine by means of cleansing enemas and subsequent separate implantation of preparations from living microorganisms of the normal intestinal microflora in the logarithmic phase of bacterial growth using a colonoscope, while lactobacilli are placed in the ascending colon, in the transverse section - bifidobacteria, in the descending section - colibacteria (20 ml in each section). Moreover, the logarithmically active phase of the growth of microbes is in the range from 26 to 38 hours from the start of cultivation (US Pat. RF N 2092167, MKI ⁶ A 61 K, 35/74 "Method for the treatment of intestinal dysbiosis").

 However, in the treatment of dysbiosis, as well as a number of other gastrointestinal diseases similar in symptoms and course, it is important to pay attention to both etiological and pathogenetic factors, primarily stimulation of the immune system due to activation of metabolic processes in the body, normalization of secretory, motor and intestinal absorption function, saturation of the body with minerals. This effect can be achieved if the patient’s intestines are purposefully prepared for the implantation procedure to improve the fixation of bacteria on the intestinal mucosa.

 The aim of the present invention is to increase the effectiveness of treatment by activating processes that contribute to the normalization of bowel function, creating the most favorable conditions at the stage of preparation for implantation, increasing the absorption capacity of the intestinal mucosa.

This goal is achieved by the fact that prior to the implantation of intestinal microflora separately into the ascending, then into the transverse, then into the descending sections of the colon, respectively, cultures of lactobacilli, bifidobacteria and colibacteria, 20 ml each in the intestine in the logarithmic phase of bacterial growth, at the preparation stage antiseptic treatment of the intestine is prescribed for treatment in the form of cleansing enemas with a neutral electroactivated aqueous solution of anolyte (EVR) with a pH of 6-6.5 for the first 2 days, in the next 5 days - processed in the intestine with a catholyte solution (EVR-K) with a pH of 9-9.5, and the pathogenetic therapy includes the treatment procedure of anti-inflammatory, analgesic and hydromassage treatment of the intestine by means of rectal administration of electroactivated aqueous solutions through a catheter 30 minutes after each cleansing enema with catholyte for five days; the composition of therapeutic aqueous solutions is prepared depending on the form of the disease: with a hypomotor form, solutions with t = 18-20 ^o C saturated with Mg ⁺⁺ , K ⁺ , Ca ⁺⁺ ions are used, and with a hypermotor form, solutions with t = 35 -40 ^o C, saturated with Ca ⁺⁺ ions. All therapeutic electroactivated aqueous solutions are prepared using the Espero-1 bioelectroactivator approved for use by the All-Russian Research Institute of Medical Technology (Moscow, 06/15/90).

 In the pathogenesis of intestinal dyskinesia, the leading place belongs to impaired motor function of the large intestine. Patients with dysbiosis show complaints of paroxysmal or persistent pain, flatulence, increased gas formation in the intestines, a feeling of pressure in the upper abdomen. The hypomotor form of the disease is characterized by chronic constipation of various durations, increased stool hardness. With a hypermotor form, patients suffer from frequent debilitating diarrhea, sometimes leading to a sharp dehydration of the body. Separate implantation of preparations from living microorganisms of normal intestinal microflora in the logarithmic phase of bacterial growth within 26-38 hours from the start of cultivation allows you to create optimal conditions for the rapid growth and reproduction of microorganisms. The inclusion in the preparatory phase of cleansing enemas with neutral anolytes with a pH of 6-6.5, and in the treatment cycle - rectal administration through the catheter of electro-activated aqueous solutions saturated with ions due to the high regenerating and anti-inflammatory activity of the EVR allows to obtain a more significant therapeutic effect than is the case when using ordinary methods of treatment of dysbiosis in its various stages due to the greatest fixation of microorganisms on the intestinal mucosa. Thus, the inclusion in the preparatory and initial treatment course of electro-activated aqueous solutions, differing in composition depending on the forms of the disease, allows us to conclude that the invention meets the criterion of "significant differences".

 The method is as follows.

Initial preparation of the intestine is carried out from the first days of the patient's stay in the hospital. 200 ml of distilled water with the addition of 2.5 g of sodium chloride (NaCl) is poured into the anode zone of the Espero apparatus (small capacity), 1-1.5 l of distilled water with t = 35-40 is poured into the cathode zone (large capacity) ^o C. Activate 10 min, then the contents of the small container are poured into a large container, mix and get anolyte - a neutral solution with a pH of 6-6.5. A warm solution is used for cleansing enemas, which are administered to the patient once in the evening during the first 2 days of hospital stay for the purpose of antiseptic treatment of the intestine. Then, in the next 5 days, the patient is washed with intestinal solution of catholyte (EVR-K) with a pH of 9.5-10 from a large capacity of the device after activation for 10 minutes, but without mixing with a solution of small capacity (in a volume of 1-1.5 l ) After 30 minutes, a treatment procedure is carried out, for which 30 ml of a 10% solution of calcium chloride (CaCl ₂ ), 20 ml of a 3% solution of potassium chloride (KCl) and 15 ml of a 5% solution of magnesium sulfate (MgSO ₄ ) are added to the small capacity of the device - for patients with a hypomotor form, for patients with a hypermotor form, 50 ml of a 10% chloris solution are added to a small capacity th calcium (CaCl _2).

 A warm solution from a large capacity is administered to the patient 1 time per day in a volume of 100 ml in the evening rectally through a catheter. This contributes to both anti-inflammatory, analgesic treatment, and hydromassage of the intestinal mucosa and improve blood microcirculation. After such targeted treatment, the intestinal mucosa is most prepared for the implantation of live bacterial cultures due to the possibility of better engraftment of bacteria on the intestinal mucosa tissue. Treatment of the intestine with the help of electroactivated aqueous solutions also promotes local anesthesia activity in pain syndromes. Already on the 6-7th day, the condition of the patients improves significantly, flatulence decreases, pain decreases, stool normalizes, and the general condition improves.

 On the 9-10th day of hospital stay, a single implantation of pre-prepared liquid cultures of lactobacilli, bifidobacteria, colibacteria in the logarithmic growth phase is carried out according to the method described in RF patent N 2092167 by the method of colonoscopy: endoscope staples are inserted into the cecum in stages, through the biopsy channel into the intestinal cavity a catheter is carried out and a pre-prepared liquid culture of lactobacilli in an amount of 20 ml is implanted through a syringe through it; then the staples of the colonoscope, gently pulling out, lead to the transverse section of the colon, where the culture of bifidobacteria in the amount of 20 ml is implanted in the same way; in the descending part of the colon implantation of colibacillus culture is also carried out in an amount of 20 ml.

 The proposed method of treatment, including preliminary preparation of the intestine using electroactivated aqueous solutions, was used by us in 527 patients with dysbiosis of varying severity. In 521, improvement (stool normalization, the disappearance of flatulence and bouts of pain) occurred on the 7-8th day, in 6 patients with dysbiosis 3-4 tbsp. the endoscopic picture improved significantly on days 13-14: edema and hyperemia of the mucosa decreased, and overall health improved. Most patients were transferred to a regular diet on days 10-12.

Example 1. Patient K., 38 years old, turned to the gastroenterological department with complaints of frequent loose stools (5-6 times a day), flatulence, pain during physiological administration, general weakness. On palpation, pain along the colon was noted. The result of endoscopic examination is significant edema and hyperemia of the intestinal mucosa. Bacteriological analysis of feces for dysbiosis: E-coli - 10 million / g, lactobacilli - growth of 10 ⁶ , bifidobacteria - growth of 10 ⁹ . Dysbacteriosis 3 tbsp., Hypermotor form.

 On the first day of stay, a microclyster is prescribed with anolyte solution (with a pH of not more than 6.5), the same wash is prescribed the next day before bedtime.

Starting from the 3rd day, 30 minutes after washing the intestines with a solution of catholyte (pH 9.5) ct = 35-40 ^o C, the patient underwent daily treatment procedures with solutions saturated with Ca ⁺⁺ ions of the following composition: in both zones of the Espero 1 "distilled water was poured, 50 ml of a 10% solution of calcium chloride was added to the anode zone. Activation - within 10 minutes. Then a warm solution of large capacity through a catheter was administered to the patient rectally (100 ml).

The procedure was repeated 5 times (within 5 days). Treatment was combined with a diet that included mashed cereals, jelly, hot tea, cottage cheese, and cheese. Already on the 6th day of hospital stay, the general condition of the patient improved, stool became more regular. Endoscopic examination showed a decrease in edema and hyperemia of the intestinal mucosa. On day 8, the patient was assigned separate implantation of omnoflora. An endoscope bracket was inserted into the rectum. A catheter was inserted through the biopsy channel into the intestinal cavity, using which a culture of lactobacilli (20 ml) was implanted, then a liquid culture of bifidobacteria (20 ml) was implanted in the transverse part of the colon using the same technology, and then colon bacillus was implanted in the descending section of the colon (20 ml). 4 days after implantation, the patient’s condition improved significantly - the stool became regular, formed, pain, flatulence disappeared, on the 12th day of hospital stay the patient was transferred to a normal diet. Discharged on the 20th day in satisfactory condition. A month later, a control bacteriogram was performed: E-coli - 220 million / g, the growth of lactobacilli in a dilution of 10 ⁸ , bifidobacteria in 10 ¹¹ .

Example 2. Patient G., 46 years old. I turned to the gastroenterological department with complaints of irregular stools (1 time in 3 days). A history of long-term treatment with antibiotics, sulfa drugs. There is a decrease in appetite, heartburn, nausea, increased gas formation in the intestines, pain in the abdomen. Bacteriological analysis of feces for dysbiosis: E. coli - up to 1 million, lactobacilli - growth of 10 ⁴ , bifidobacteria - no growth was noted. No pathogenic flora has been identified. Diagnosis: dysbiosis of the colon 4 tbsp., Hypomotor form.

 Bowel cleansing started in the hospital from the 2nd day of stay.

Purification enemas (within 2 days) were prescribed with an electroactivated aqueous solution prepared as follows: distilled water 18-20 ^o C was poured into both zones of the Espero-1 apparatus. 2.5 g of sodium chloride was added to the anode zone (small capacity) (NaCl). After 10 minutes of activation, the liquid from the small tank was mixed with the solution from the large tank and the resulting mixture with a pH of 6.5 was used to conduct a cleansing enema. The next day, the procedure was repeated.

Thus, an antiseptic effect was achieved - the primary cleansing of the intestinal mucosa, after which the patient, on the background of a strict diet enriched with vitamins (pomegranate bark, decoctions of dogwood) and including mashed soups and cereals, conducted a 5-day course of anti-inflammatory, analgesic treatment of the intestine with the use of electroactivated aqueous solutions salts of Mg, Ca, K, prepared on the apparatus "Espero-1". Before each treatment procedure, for 30 minutes, bowel cleansing was carried out with a solution of catholyte with a pH of 9.5 (t = 18-20 ^o C). The treatment procedure was carried out with a warm solution of large capacity, obtained by adding 30 ml of a 10% solution of CaCl ₂ , 20 ml of a 3% solution of KCl, 15 ml of a 5% solution of MgSO ₄ to distilled water of small capacity, but without mixing with a solution of small capacity. A large-capacity solution was used for daily medical procedures: a warm solution with a pH of 9.5 with a complete set of microelements was administered to the patient rectally through a catheter in a quantity of 100 ml for 5 days once a day in the evening. This procedure contributed not only to cleansing the intestines, but also hydromassage of the mucosa, improvement of blood microcirculation, restoration of the mucosa. The patient already on the 5th day after the start of the treatment, the EVR procedure noted an improvement, a decrease in pain, a more regular stool.

 On day 8, treatment of dysbiosis was started by implanting live bacterial preparations by analogy with example 1.

When re-examined 5 days after implantation, the chair was formed, 1 time per day. Pain, flatulence disappeared. On day 13, the patient was transferred to a normal diet. Discharged on the 19th day in satisfactory condition. A month later, feces were analyzed: E. coli 200 million / g, the growth of lactobacilli in a dilution of 10 ⁶ , bifidobacteria - 10 ¹¹ .

 The table shows a comparative analysis of the proposed method and the prototype method.

Claims (2)

1. A method of treating intestinal dysbiosis, based on preliminary preparation of the intestine by means of cleansing enemas and subsequent separate implantation of preparations from living microorganisms of the normal intestinal microflora in the logarithmic phase of bacterial growth by colonoscopy (lactobacilli into the ascending colon, bifidobacteria into the transverse, into the descending department - colibacteria of 20 ml in each department), characterized in that the preliminary antiseptic preparation of the intestine in the form of cleansing enemas during the first two days with a neutral electroactivated aqueous solution of anolyte (EVR) with a pH of 6-6.5, for the next five days appoint intestinal lavage with a solution of catholyte (EVR-K) with a pH of 9-9.5, while the temperature of the solution for patients with a hypomotor form of the disease 18-20 ^o C, for patients with a hypermotor form - 35-40 ^o C. 2. The method according to claim 1, characterized in that for five days after each cleansing microclyster with a catholyte solution, an analgesic, anti-inflammatory and hydromassage treatment procedure is performed rectally through a catheter for the introduction of electroactivated aqueous solutions saturated with Ca ⁺⁺ ions for patients with hypermotor form and ions Ca ⁺⁺ , K ⁺ , M ⁺⁺ - for patients with a hypomotor form of the disease in proportions depending on the severity of the condition.

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