RU2231357C2 - Method for treating cardiovascular diseases in patients with erosive-ulcerous lesions of esophago-gastroduodenal area - Google Patents

Abstract

FIELD: medicine, cardiology, gastroenterology.

SUBSTANCE: for treating combined pathology it is suggested to apply anti-ulcerous preparations together with Ascolong. In 1 mo in case of no erosive-ulcerous mucosal defects it is necessary to continue Ascolong-therapy per either 1 or 2 lozenges daily as gingival application for prolonged period of time. Moreover, Ascolong could be prescribed in combination with anti-anginal and other cardiovascular preparations. The method provides shortened terms for scaring erosive-ulcerous mucosal alterations in gastroduodenal area along with anti-ischemic effect due to improved tissue microcirculation.

EFFECT: higher efficiency of therapy.

1 cl, 1 ex

Description

The invention relates to methods for treating cardiovascular diseases by the use of preparations containing acetylsalicylic acid, and can be used in cardiology and neurology, as well as in gastroenterology. The invention is particularly important for the effective treatment of cardiovascular diseases in patients with erosive and ulcerative lesions of the esophagogastroduodenal zone.

Patients with coronary heart disease (CHD) and erosive-ulcerative changes in the esophagogastroduodenal zone (EGDZ) make up more than half of all patients with combined pathology of internal organs. The incidence of coronary heart disease with peptic ulcer of the stomach and duodenum in recent years has increased significantly.

In cardiovascular diseases, including the most common form of coronary heart disease, there is a high risk of developing arterial thrombosis. Along with this, about half of cases of erosive-ulcerative changes in the mucosa of EGDZ are caused by circulatory disorders in the system of abdominal arteries.

In this regard, the treatment of these diseases requires the use of drugs that normalize hemorheological parameters, primarily antiplatelet agents, among which acetylsalicylic acid (ASA) is the drug of choice. Unfortunately, traditional tableted, including enteric-soluble forms of ASA are contraindicated in patients with peptic ulcer of the stomach and duodenum and, even if it is absent, can cause stomach and intestinal bleeding due to locally irritating action.

Known means to reduce platelet aggregation in the blood, including acetylsalicylic acid immobilized on a carrier polymer (RF patent No. 2095064, CL A 61 K 31/60, 47/48, 1995). The tool is an adhesive with a plate containing 12.5 mg of acetylsalicylic acid.

There is a method of treating patients with erosive and ulcerative lesions of the esophagogastroduodenal zone with cardiovascular diseases by laser therapy aimed at improving microcirculation in the mucosa of this zone by reducing blood viscosity, stabilizing the vascular wall and increasing blood oxygen saturation (Information Letter from Moscow Department of Health “Features of the clinical picture of the course and treatment of peptic ulcer in individuals with coronary heart disease”, M., 1995, p.4).

A limitation of the use of this method is its high cost and low availability of special equipment for the general population.

Closest to the invention is a method of treating cardiovascular diseases in patients with concomitant erosive-ulcerative lesions of the esophagogastroduodenal zone by using drugs that improve microcirculation and prevent the development of thrombosis, such as trental, dipyridamole, prescribed in combination with anti-ulcer and cardiovascular drugs ( Information letter from the Moscow Department of Health “Features of the clinical picture of the course and treatment of peptic ulcer in patients with ischemic heart disease ”, M., 1995., p.6).

When using this method, it is possible to develop serious side effects of the above drugs. So, dipyridamole and trental are contraindicated in patients with coronary artery disease due to the possibility of the appearance of “stealing syndrome”.

The aim of the invention is to increase the effectiveness of the method of treatment due to the use of a new dosage form - Ascolong. A small amount of ASA in it has an antiplatelet effect, entering the systemic circulation through the mucous membrane of the oral cavity without direct contact with the mucosa of the esophagus and stomach and duodenum. In this case, ASA does not cause a damaging effect on the mucosa of the gastrointestinal tract.

This goal is achieved by the fact that in the method of treating cardiovascular diseases in patients with erosive-ulcerative lesions of the esophagogastroduodenal zone, including the use of drugs that improve microcirculation and prevent the development of thrombosis, use Ascolong. After the course of ascolong in combination with antiulcer drugs, esophagogastroduodenoscopy is performed and, in the absence of erosive-ulcerative lesions, continue treatment with ascolong. He is prescribed one plate per day in the form of an application to the gum. In addition, ascolong can be prescribed in combination with antianginal and other cardiovascular drugs.

The proposed method is as follows.

Prior to treatment, all patients with cardiovascular diseases requiring prescription of drugs that improve microcirculation and prevent the development of thrombosis, undergo esophagogastroduodenoscopy.

This study allows us to determine the presence of erosive-ulcerative changes in the mucous membrane and the degree of its infection with the bacterium Helicobacter pylori.

In case of detection of erosive-ulcerative changes in the mucous membrane, according to the proposed method, the drug ascolong is prescribed in combination with antiulcer therapy.

The nature of anti-ulcer therapy depends on the degree of infection with Helicobacter pylori. After 1 month of treatment, a control esophagogastroduodenoscopy is performed. In the absence of erosive-ulcerative changes in the mucous membrane, antiulcer therapy is canceled and treatment with Ascolong is continued.

Monitoring the condition of the gastroduodenal zone is carried out at least 1 time in 3 months.

The choice and conduct of antiulcer therapy are carried out by the following method.

1. If there is infection with Helicobacter pylori, “triple therapy” is used (two antibiotics - clarithromycin, amoxicillin in combination with a proton pump inhibitor), excluding bismuth and metronidazole.

After the end of this therapy, a control esophagogastroduodenoscopy is performed.

2. In case of repeated detection of Helicobacter pylori, "quadrotherapy" is carried out, including preparations containing bismuth and metronidazole (1. Proton pump inhibitors 2. Antibiotics: clacid, formimed, tetracycline 3. Metronidazole 4. Bismuth).

Example

82 patients with cardiovascular diseases were examined, including 45 people with the presence of erosive-ulcerative changes in EGDZ, 25 people with the absence of such changes and 12 patients with the presence of reflex gastroesophageal disease.

Patients underwent esophagogastroduodenoscopy initially, after 1.2 and 3 months of treatment according to the proposed method. The study was conducted in a randomized, placebo-controlled manner.

Ascolong, used in combination with standard antiulcer therapy, has a positive effect on the healing time of erosive-ulcerative changes. Subsequent treatment with one ascolong does not lead to negative changes in the mucous membrane of the esophagus, stomach and duodenum due to the improvement of microcirculation caused by this drug.

The ability of platelets to aggregate was reduced by 30-37%.

The use of a combination of Ascolong with antianginal and other cardiovascular drugs gives a positive effect due to the fact that not only ischemic, but also antiplatelet effect is achieved.

Claims (2)

1. A method for the treatment of cardiovascular diseases in patients with concomitant erosive-ulcerative lesions of the esophagogastroduodenal zone, which consists in the use of drugs that improve microcirculation and prevent the development of thrombosis, prescribed at the initial stage of their use in combination with antiulcer drugs, characterized in that as a drug , improving microcirculation and preventing the development of thrombosis, use ascolong, and one month after the appointment of ascolong in combination with otivoyazvennymi preparations esophagogastroduodenoscopy performed in the absence of erosive-ulcerous lesions askolongom assigned long-term treatment for one or two plates per day in the form of application to the gums. 2. A method of treating cardiovascular diseases in patients with erosive and ulcerative lesions of the esophagogastroduodenal zone according to claim 1, characterized in that ascolong is prescribed in combination with antianginal and other cardiovascular drugs.