RU2217156C2 - Method for correcting microflora in gastrointestinal tract - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: the suggested innovation deals with treating disbacterioses and other intestinal disfunctions to improve biological balance of human gastrointestinal flora. The method deals with diagnostics and correction of patient's state based upon the diagnostics carried out. There are four stages of disbacteriosis depending upon patient's microflora state; one should prescribe its individual correction and perform complex impact upon patient's body due to detoxication with the help of enterosorbents, then comes correction with the help of probiotics, hepatic protection against toxic substances with the help of pectins and preparations made out of medicinal plants and maintenance-drug therapy with the help of antibacterial preparations of plant origin. Intake scheme and dosage vary depending upon the degree of patient's body microflora deviation against the norm. The method enables to perform individual approach to every patient and exclude relapses. EFFECT: higher efficiency of therapy. 4 ex

Description

 The invention relates to medicine, more specifically to dysbiosis and intestinal dysfunctions, and relates to a method for improving the biological balance of the flora of the gastrointestinal tract (GIT) of a person.

 Currently, the problem of dysbiosis and intestinal dysfunctions is especially urgent, which is due to a variety of reasons of a different nature: deterioration of the environmental situation, growth of immunodeficiency states, increased allergization, gross violations of microbiocenosis as a result of antibacterial, hormone or radiation therapy, as well as various negative social factors. According to scientific studies, more than 90% of the population suffers from some form of dysbiosis and intestinal dysfunction. This, in turn, entails a whole range of diseases associated with metabolic disorders, the functioning of the immune system, the synthesis of vitamins and essential amino acids, their absorption, as well as the intake of micro and macro elements, etc.

 The functions of normal microflora in the body are vital and very extensive: synthesizing, regulatory, desensitizing, detoxifying, enzymatic, protective and immunostimulating.

 To correct deviations of the microbiocenosis from the normal state, preparations of live bacterial cells were widely used: bifidobacteria (WO 85/03848, MKI A 23 C 9/12, 1985) and lactobacilli (EPO 0154614, MKI A 23 C 9/123, 1985 - prototype) . The principle of action of such drugs is based on the use of the effect of microbial antagonism, since it was found that the presence of a significant population of lactic acid bacteria greatly limits the development of putrefactive species and, therefore, the production of toxic substances that adversely affect health. The disadvantage of this method of correcting microflora is that exogenous bifid bacteria can hardly be firmly introduced into the intestines of a person, especially in cases when intestinal equilibrium is absent. This method is not complex, since the action of probiotics to achieve the effect of treatment and to avoid relapse requires support and consolidation, for example, using cleansing enterosorbents and / or herbal medicine based on herbal and antibacterial drugs.

 The present invention posed and solved the problem of creating an original method of correction of the microflora of the gastrointestinal tract, including the diagnosis and correction of the patient's condition based on the diagnosis.

 The technical result of the claimed invention is a developed diagnostic scheme for the severity of dysbiosis, as well as a comprehensive method for the correction of disorders of the microflora of the gastrointestinal tract, which allows for an individual approach to each patient. Treatment with several drugs sequentially or simultaneously taken by patients according to the developed scheme eliminates relapses and increases the effectiveness of treatment even in the most difficult cases of the state of the gastrointestinal microflora.

 The specified technical result is achieved by the fact that the method of correction of disorders of the microflora of the gastrointestinal tract includes the diagnosis and correction of the patient’s condition on the basis of the diagnosis, four stages of dysbiosis are distinguished: the first is latent, the second is subcompensated, the third is characterized by a significant decrease in the level of bifidoflora in combination with a reduced level of lactoflora and a sharp change in the level of Escherichia coli, the fourth - characterized by the absence of bifidoflora, a significant decrease iem number of lactobacilli and the reduction or increase in the number of E. coli, no increase in the characteristic of a healthy person conditionally pathogenic microorganisms. Depending on the state of the microflora, its individual correction is prescribed and a complex effect on the body is carried out by detoxification with the introduction of enterosorbents (for example, pectin preparations), microflora proper correction with the help of probiotics, for example, liquid concentrates of live lactobacilli and bifidobacteria, protection of the liver from action toxic substances are carried out with the help of pectins and preparations from medicinal plants, for example, milk thistle, calendula and chamomile, and maintenance therapy is carried out using antibacterial herbal preparations.

 At the same time, Pecto bactericidal natural preparation or Pekcekom cellulose complex pectin can be used as enterosorbents, liquid concentrate of live lactobacillus Euflorin-L or liquid concentrate of live bifidobacteria Euflorin-B can be used as probiotics. for the protection of the liver, pectin preparations can be used, as well as the preparation “Mariol” in the form of a powder or “Mariol-MK” in the form of an oil. An antibacterial herbal preparation for phytotherapy can be used. collection "Plastofarm". The dosage regimen and dosage of drugs may vary depending on the degree of deviation of the body microflora from the norm established in the diagnosis.

 The clinical manifestations of dysbacteriosis are characterized by great diversity, nonspecificity and are primarily due to: a decrease in colonization resistance of the intestinal mucosa; violation of the digestive system; trophics (gastrointestinal dyspepsia, anorectal syndrome, irritable bowel syndromes, group B hypovitaminosis, intestinal absorption disorders, skin manifestations, etc.). The nature of changes in the intestinal microbiocenosis (the degree of dysbiosis) is determined on the basis of clinical manifestations and bacteriological studies of intestinal microflora.

 For the purpose of diagnosis, as well as monitoring the patient’s condition and the effectiveness of the proposed correction scheme, clinical, laboratory and instrumental methods of analyzing the microflora of the body are used, which include: the study of clinical symptoms of disorders, bacteriological studies, sigmoidoscopy, lipidograms, fecal crystallography, coprology.

To diagnose the severity of dysbiosis, we used the modified clinical and microbiological classification proposed by G. Kuznetsova. Depending on the nature of the changes in the luminal microflora of the large intestine, we distinguished four degrees of dysbiosis:
1 degree - latent, compensated form is characterized by minor changes in the aerobic part of the microbiocenosis (increase or decrease in the number of Escherichia coli); bifidobacteria and lactoflora are not changed; usually intestinal dysfunction is not recorded.

 2 degree - subcompensated form. Amid a slight decrease in the quantitative content of bifidobacteria, quantitative and qualitative changes in Escherichia coli or other opportunistic microorganisms are detected. This condition is borderline and indicates that the subject can be assigned to a risk group.

Grade 3 - characterized by a significant decrease in the level of bifidoflora (10 ⁵ - 10 ⁷ CFU / g) in combination with a decrease in lactoflora and a sharp change in the level of Escherichia coli. Following a decrease in bifidoflora, the ratios in the composition of the intestinal microflora are violated, conditions are created for the manifestation of the pathogenic properties of opportunistic microorganisms. Dysbacteriotic disorders (to a given degree), as a rule, are accompanied by symptoms of intestinal dysfunction.

 Grade 4 - characterized by the absence of bifidoflora, a significant decrease in the number of lactobacilli and a change in the number of E. coli (decrease or increase), an increase in both obligate and optional conditionally pathogenic microorganisms in associations. All of the above leads to severe damage to the gastrointestinal tract, bacteremia and sepsis.

 Depending on the degree of state of microflora, an individual correction scheme for deviations of microflora from the norm is prescribed individually.

 Since the human microecological system is a self-regulating system that can be restored with some support and correction, it is important to use natural preparations of biological and plant origin from these positions, as well as those with bifidogenic, lactogenic, coligenic effects. This postulate is the basis of this correction method.

 One of the most important aspects of the correction of gastrointestinal microflora disorders is the detoxification of the body, that is, the suppression of the development of pathogenic and restoration of the human microflora, the neutralization and elimination of toxins and conditionally pathogenic organisms. This is achieved by regulating the digestion process and the appointment of enterosorbents, which help cleanse the body of toxins, radionuclides, heavy metals and toxins. As natural enterosorbents, pectin preparations "Pecto" or "Pekcek" with the above properties are used, manufactured according to TU 9175-011-01962942-97 and RU MH RF 000236.P.643.11.98, respectively.

 In order to restore bifidobacteria and lactoflora, various types of probiotics are used, the most effective of which are the liquid concentrates of bifidobacteria and lactobacilli: Euflorin-B and Euflorin-L, respectively. The advantage of these drugs is that, firstly, the bacteria they contain are in a biologically active state and begin to work from the first minutes of contact with the mucous membranes. Secondly, in addition to live bacteria, "Euflorin-L" and "Euflorin-B" contain products of their metabolism, namely: organic acids (including lactic, succinic, acetic, propionic), amino acids, low molecular weight proteins (peptides), antibiotics of natural origin , vitamins C, E, PP, H and group B, enzymes (in particular lysozyme, lactase), as well as trace elements: Ca, Na, K, Mg, Se, Fe, Cu, etc. This unique biocomplex, consisting of two active began, by creating an acidic environment and pronounced antimicrobial antagonism inhibits the development of pathogenic , putrefactive and gas-forming microflora and are actively involved in digestion processes. These drugs are produced by the domestic industry: liquid concentrate of lactobacilli "Euflorin-L" according to the Ministry of Health of the Russian Federation 0001870.R. 643.09.2000, and the liquid concentrate of bifidobacteria "Euflorin-V" according to RU Ministry of Health of the Russian Federation 001724.P.643.09.2000.

 Another condition for the correction of deviations of the gastrointestinal tract microflora is the protection of the liver from the action of toxic substances formed in the intestine with the help of pectins, as well as the enhancement of biliary and biliary functions. One of the most important medicinal plants contributing to the protection of the liver is Milk Thistle - a plant containing essential oils and flavonoids (silibin, silicocristine, silidiamine), which have a powerful detoxifying, hepatoprotective, antioxidant effect, is indispensable in restoring human microflora. 2 preparations were obtained from milk thistle: “Mariol” in the form of a powder with the properties of a flavanoid (silymarin), manufactured according to the Republic of Uzbekistan Ministry of Health of the Russian Federation 000554.P.643.11.98; and "Mariol-MK" in the form of milk thistle, calendula and chamomile oil, produced in accordance with RU Ministry of Health of the Russian Federation 001625.P.643.06.2000. The main active ingredients of the oil are essential (essential) polyunsaturated acids (at least 55 g / 100 ml), biogenic amines, phospholipids, tocopherols, carotenoids, essential oils; vitamins A, D, E, K, F. It should be noted that the separate use of Mariol powder and Mariol-MK oil makes it possible to purposefully use two differently acting principles.

 Supporting herbal medicine is carried out by the use of antibacterial herbal preparations, for example, Plastofarm phytosorbing, produced according to the Republic of Uzbekistan Ministry of Health of the Russian Federation 000661. P.643.05.99.

 The following are examples of the compositions of the proposed integrated method for the correction of gastrointestinal microflora disorders.

 Example 1. Patient R. N.P., 25 years old.

 Diagnosis: chronic gastroduodenitis, duodenal ulcer, biliary dyskinesia of the hypertonic and hyperkinetic type, intestinal dysbiosis of the 3rd degree.

 Clinic: objectively, the tongue is coated with a yellowish coating, soreness at the point of the gallbladder, compaction and spasms of the large intestine. Burning complaints in the epigastric region, bitterness in the mouth, bloating, discomfort, unstable stool, with a tendency to constipation (up to 2-3 days).

 Diagnosis: 1) endoscopy - the phenomenon of gastroduodenitis, cicatricial changes in the duodenum.

2) microbiological analysis of feces: the total number of Escherichia coli - 88 million / g, 20% - lactose-negative enterobacteria, 10% - coccal flora, the number of bifidobacteria is reduced to 10 ⁶ , there are no lactobacilli and bacteroids.

 3) Ultrasound - a picture of the anatomical kink of the gallbladder, stagnation of bile, spasm of the gallbladder.

 Appointments: "Pekcek" 20 g 3 times a day 15 minutes before meals (the consumption rate should be diluted in a glass of kefir, juice, water, can be added to food), intake for 4 weeks; liquid probiotics "Euflorin-L" (2 tablespoons 2 times a day - in the morning and / or afternoon, regardless of food intake; it is allowed to add to food liquid), "Euflorin-B" (1 tablespoon in the evening for 30 min before meals; it is allowed to dilute with water 1: 3), taking probiotics for 6 weeks; hepatoprotector "Mariol" (1 tsp. 4 times a day 30 minutes before meals, for 3 weeks), oil "Mariol-MK" (1 tsp. 3 times a day, for 30 minutes before meals, for 4 weeks) and Plastofarm (50 ml infusion 3 times a day, after meals for 3 weeks).

 The results of treatment (after 4 weeks of biofitocorrection course): restoration of anaerobic microflora to normal numbers.

 The stool returned to normal, bitterness in the mouth, burning, flatulence disappeared.

 Recommended: to maintain maintenance therapy for three months in the form of taking Plastofarm infusion (50 ml 4 times a day).

 Example 2. Kirillina Lena, 9 years old. Diagnosis: neurodermatitis in the acute stage, reactive pancreatitis, dysbiosis 2-3 degrees.

 Clinic: dryness, peeling of the skin of the whole body, hyperemia, weeping of the skin of the face (cheeks, forehead), and the back of the hands (deep cracks in the skin of all the phalanges of the fingers), accompanied by severe itching; pain in the right hypochondrium, an increase in the size of the liver (+2 cm); constipation for 2-3 days; increased irritability, tearfulness, poor sleep.

Diagnosis before the course of biofitocorrection: 1) Ultrasound of the abdominal organs: increased echogenicity of the liver, a picture of cholepathy (stagnation of bile and loose sediment in the gallbladder); 2) microbiological analysis of feces: the content of pathogenic microflora is increased (Staphylococcus aureus 10 ⁸ , Proteus 10 ⁷ , Candida> 10 ⁵ ), against the background of a reduced amount of normoflora; lactobacilli <10 ⁵ , bifidobacteria> 10 ⁶ .

 Appointments: enterosorbent "Peksekom" in the amount of 5-15 g at a time, 1-3 times a day 15 minutes before meals. Dilute the consumption rate in a glass of water, kefir, juice. The course is 1 month. Liquid probiotics "Euflorin-L", "Euflorin-B" in the amount of 1 tbsp. 2-3 times a day, regardless of food intake. Hepatoprotector "Mariol" 1 tsp. 3 times a day 30 minutes before meals for 3 weeks. Phytotea "Plastofarm" 50 ml of infusion 3-4 times a day before meals for 2-3 weeks according to indications, including fitovanny and phyto-ointments, skin applications with "Euflorin-L".

 Results of treatment: after 7 days from the start of treatment, the skin of the hands cleansed, a daily formed stool formed; after 15 days, the skin of the face and body cleared, sleep normalized. By the end of the course of therapy (30 days), the patient's condition was completely satisfactory.

 Control examination after 3 months showed a good condition of the patient, stable daily stool, clean skin of the face, hands. There were no complaints.

 Example 3. Patient Sh-va O.Ya., 40 years old.

 Diagnosis: chronic chlamydia with Reuters syndrome, intestinal dysbiosis of the 4th degree.

 Clinic: joint pain, unstable stool, abdominal pain, flatulence, irritability, sleep disturbances.

Diagnosis (before biofitocorrection course): Ultrasound - signs of chronic cholecystopancreatitis were detected. RRS - atrophic erosive proctosigmoiditis, sphincteritis. Bacteriological analysis of feces: the total number of Escherichia coli - 8 million / g, no bifidobacteria, lactobacilli - 10 ⁴ .

 Appointments: "Euflorin-L" for 2 tbsp. in the morning and in the afternoon, "Euflorin-V" for 2 tbsp. l in the evening, Pecto 50 ml 3 times a day, Mariol 1 tsp. 3 times a day 30 minutes before meals, "Mariol-MK" 1 tsp. 3 times a day 30 minutes before meals, Plastofarm 50 ml 3 times a day before meals. The course is scheduled for 6 weeks.

The results of treatment (after 1 month): the pain in the joints disappeared. Bacteriological examination of feces: total number of Escherichia coli - 350 million / g, lactose-negative enterobacteria - 5%, bifidobacteria 10 ⁸ , lactobacilli 10 ⁶ , bacteroids 10 ⁶ , cocci-10%. In the future, the patient recommended follow-up examination after 3 months.

 Example 4. Titov Andrey, 5 years old.

 Diagnosis: FDB (often and long-term sick child: SARS more than 6 times a year), salmonellosis convalescence, functional digestive disorders. Dysbacteriosis of the 3rd degree.

 Clinic: dry skin of the body, an increase in the submandibular and anterior cervical groups of lymph nodes, hypertrophy of the tonsils, difficulty in nasal breathing, mucopurulent discharge from the nasal passages, episodic pain in the epigastrium and right hypochondrium. Enlarged liver (+3 cm), constipation for 2-3 days. Complaints of physical malaise, increased fatigue, superficial night's sleep.

Diagnosis (before the course of biofitocorrection): in the microbiological analysis of feces: hemolysing Escherichia coli, Proteus in the titer of 10 ⁷ , a sharp decrease in the titer of the common Escherichia coli (less than 10 ² ), a reduced content of lacto- and bifidobacteria by 10 ⁵ and 10 ^7, respectively. Coprology: a lot of undigested muscle fibers, fiber, neutral fat.

 Appointments: "Peksekom" 1/4 tsp. in food 4 times a day for 4 weeks. "Euflorin-L" from 1 to 15 days to 1 tbsp. 20 minutes before meals with boiled water in the morning and at lunch. "Euflorin-B" from 16 to 30 days to 1 tbsp. 30 minutes before meals, morning and evening. "Mariol" from 1 to 21 days to 1/3 tsp 3 times a day 30 minutes before meals. "Plastofarm" 1 tbsp. 4 times a day as follows: 4 weeks admission, 70 days break, then re-admission for 4 weeks.

 Rinsing the throat with a solution of "Euflorin-L" 3 times a day 1 tbsp. 1/2 cup boiled water. Instillation in the nasal passages 1 dose in 2 doses of boiled water, 3 drops in each nasal passage 3 times a day.

 Treatment results: the skin is smooth, elastic, restoration of nasal breathing, lack of secreted secretion, normalization of the digestive and motor functions of the digestive system, absence of pain, reduction in liver size (+1 cm), the appearance of a daily independent stool without pathological impurities.

Diagnosis (1 month after the course of biofitocorrection): in the microbiological analysis of feces, the absence of pathogenic microflora, an increase in the content of lacto- and bifidobacteria to 10 ⁸ and 10 ^9, respectively. Coprology: a significant reduction in the amount of undigested muscle fibers, fiber, lack of neutral fat.

 Observations: During the observation period (6 weeks), no cases of respiratory infections were recorded.

Claims (1)

A method for the correction of disorders of the microflora of the gastrointestinal tract, characterized in that it includes diagnosis and correction of the patient’s condition on the basis of the diagnosis, four stages of dysbiosis are distinguished: the first is latent, the second is subcompensated, the third is characterized by a significant decrease in the level of bifidoflora in combination with a reduced the level of lactoflora and a sharp change in the level of Escherichia coli, the fourth - characterized by the absence of bifidoflora, a significant decrease in the number of lactobacteria RI and a decrease or increase in the number of Escherichia coli, an increase in conditionally pathogenic microorganisms that are not characteristic of a healthy person, depending on the state of the microflora, they prescribe its individual correction and carry out complex effects on the body through detoxification with enterosorbents, proper correction with probiotics, and protection of the liver from toxic substances with the help of pectins and drugs from medicinal plants and supportive therapy with antibacterial herbal preparations comrade, while with second-degree dysbiosis, the pectin preparation Pekcek is prescribed for 4 weeks, the probiotics Euflorin-L and Euflorin-B for 6 weeks, the hepatoprotector Mariol for 3 weeks or Mariol-MK ”For 4 weeks, as well as phytosorption“ Plastofarm ”for 3 weeks, with dysbacteriosis of the second or third degree, appoint“ Peccek ”, for 1 month,“ Euflorin-L ”,“ Euflorin-B ”,“ Mariol ”for 3 weeks, “Plastofarm” for 2-3 weeks, including phyto-baths, phyto-ointments and skin applications with “Euflorin-L”, For dysbacteriosis of the third degree, “Pekcek” is prescribed for 4 weeks, “Euflorin-L” from 1 to 15 days, “Euflorin-B” from 16 to 30 days, “Mariol” from 1 to 21 days, “Plastofarm” - 2 courses 4 weeks each with an interval of 70 days, as well as rinsing of the pharynx and instillation of “Euflorin-L” solution into the nasal passages, and for fourth-degree dysbiosis, “Euflorin-L”, “Euflorin-B”, “Pecto”, “Mariol”, “Mariol-MK” and “Plastofarm” for 6 weeks, while the dosage regimen and dosage of drugs vary depending on the patient’s grade nor deviations of the microflora of the body from the norm.