RU2247571C2 - Anti-inflammatory agent - Google Patents

Abstract

FIELD: medicine, pharmaceutical industry.

SUBSTANCE: invention proposes applying aspen bark (Populus tremula) as an agent for treatment of inflammatory injuries of hepatobiliary system, leukocytourea and pyelonephritis. Aspen bark extract (Populus tremula) promotes to effective treatment of inflammatory injuries of hepatobiliary system, leukocytourea and pyelonephritis. Invention can be used for treatment of inflammatory injuries of hepatobiliary system, leukocytourea and pyelonephritis.

EFFECT: valuable medicinal properties of agent.

Description

The invention relates to medicine and can be used to obtain a medicinal product from plant materials with anti-inflammatory effect.

In medicine, there is a wide arsenal of antibacterial and other anti-inflammatory drugs (sulfonamides, non-steroidal anti-inflammatory drugs, etc.).

In the treatment of inflammatory diseases of the hepatobiliary system, choleretic drugs of choleretic action are used, most often - allochol, with purulent cholecystitis (inflammation of the gallbladder) - broad-spectrum antibiotics.

The disadvantage of the treatment of inflammatory diseases of the hepatobiliary system (cholecystitis, cholangitis, cholangiocholecystitis, hepatocholecystitis) with choleretics (allochol, cholenzyme, nicotinamide, oxaphenamide, dehydrocholic acid, lyobil, flaming) is that addiction quickly develops. Basically, at present, with this pathology, allohol is used (Tabulettae “Allocholum”). The tablets contain bile condensed in terms of dry matter of 0.08 g, thick garlic extract of 0.005 g, activated carbon of 0.025 g, auxiliary substances to a total weight of 0.21. The effect of the drug is due to an increase not only in the secretory function of the liver, but also in the secretory and motor activity of the gastrointestinal tract, and a decrease in the processes of decay and fermentation in the intestine.

The drug is used orally after a meal: adults are prescribed 1-2 tablets 3-4 times a day. The course of treatment is 3-4 weeks. With exacerbation of diseases, 1 tablet is prescribed 3-4 times a day for 1-2 months.

Children are prescribed a special dosage form - coated “Allohol” tablets for children (Tabulettae “Allocholum” obduktae pro infantibus) containing the above ingredients in half; the total tablet weight is 0.105 g (without shell) and 0.21 g (with shell).

Children under 7 years old are given 1 tablet, over 7 years old - 2 tablets 3 times a day (after meals) for 3-4 weeks.

When using the drug in individual patients, allergic reactions, dyspeptic disorders are possible, in these cases the drug is canceled.

Contraindications to the appointment of allochol: acute hepatitis, acute and subacute liver dystrophy, obstructive jaundice.

Addiction quickly develops to the drug, after 2 weeks it is recommended to change the choleretic agent. By this time, a slight improvement in the patient's condition is usually noted, the anti-inflammatory effect is not achieved. Given the chronic nature of this pathology, this drug does not solve the problem of removing the chronic inflammatory process from the hepatobiliary system.

Another drug, somewhat less often than allochol, used in this pathology is cholenzyme, which contains 0.1 g of dried, chopped pancreas and dried mucous membranes of small intestines of dried livestock. This drug is recommended to be prescribed to patients with inflammatory diseases of the hepatobiliary system mentioned above, accompanied by a decrease in the enzymatic activity of the digestive tract. Other choleretic drugs mentioned above have not been used in recent years, their release has been drastically reduced, possibly due to their relatively less pronounced clinical effect.

Removing the inflammatory process is impossible without other therapeutic measures, most often - physiotherapy on the liver area, and sometimes antibacterial drugs. Physiotherapy on the liver area is undesirable, especially repeated courses, as they contribute to the reduction of collagen, the development of fibrosis (Blyuger A.F., Novitsky I.N. Practical hepatology. - Riga: Zvayzzne. - 1984. - 405 p.). Inflammatory diseases of the hepatobiliary system often have a chronic course and the need for repeated courses of treatment is great.

Broad-spectrum antibacterial drugs are recommended for very pronounced exacerbations of the inflammatory process, accompanied by increased body temperature, laboratory blood counts, and bile reflect inflammation. Antibiotics for relieving the inflammatory process are prescribed for purulent complications of this pathology. It is not advisable to use antibacterial drugs (sulfonamides, antibiotics) for uncomplicated forms of inflammatory pathology of the hepatobiliary system. The liver plays a leading role in the metabolism and biotransformation of most synthetic drugs, in particular antibacterial ones. Enzymes that metabolize this group of drugs are found in the largest amount in the liver. Biotransformation occurs primarily due to enzymes of the microsomal oxidase system associated with a smooth endoplasmic reticulum of hepatocytes. Firstly, liver diseases themselves, for example, hepatocholecystitis, reduce the activity of enzymes that metabolize drugs, which may be accompanied by a decrease in plasma clearance of drugs. Secondly, antibiotics can lead to the formation of a hepatitis-like disease, which is described in the literature after taking erythromycin and even penicillin (Podymova SD, Diseases of the liver. - M. - 1993. - 183 p.). Hepatotoxic reactions are noted when relatively high doses of tetracycline are used - the clinical picture is similar to acute fatty degeneration of the liver. Possible liver damage when using drugs of this group associated with drug idiosyncrasy. Cases of hypersensitivity, which manifests itself in the form of cholangiolytic (hepatocanalicular) hepatitis while taking sulfonamides. All antibacterial drugs are haptens, therefore, allergic reactions can occur. The latter are especially common with penicillin, up to anaphylactic shock. When ingested semi-synthetic penicillin antibiotics, dyspeptic disorders are possible. So, the use of carbenicillin in patients with impaired liver function can lead to the development of hemorrhagic syndrome (due to impaired blood coagulation, since many factors of the blood coagulation system are formed in the liver). Widely used in recent years, cephalosporins, which are undoubtedly capable of killing pathogenic microflora in the biliary system, have hepatotoxicity and are contraindicated in case of impaired liver function (Mashkovsky MD Medicines. A manual for doctors in 2 volumes. Edition 14. Volume 2. - M. - “The New Wave.” - 2000. - 1.608 p.). The introduction of lincomycin can cause impaired liver function - an increase in the level of bilirubin in blood plasma, leuko- and neutropenia. It should be noted the possibility of suppressing liver function during treatment with levomycetin, which accumulates in it in high concentrations, in addition, the complication of treatment with levomycetin is common - inhibition of hematopoiesis (Markova I.V., Kalinicheva V.I. Pediatric pharmacology. A guide for doctors. - L. : Medicine. - 1987. - 496 p.). In addition to the described hepatotoxic effect, antibiotics have many other side effects (nephrotoxicity, ototoxicity, neurotoxicity, etc.)

Nonsteroidal anti-inflammatory drugs are used in the immunopathological inflammatory process.

The above confirms the inappropriateness of the use of antibacterial synthetic agents for inflammatory lesions of the hepatobiliary system (with the exception of purulent complications, where they are necessary for health reasons).

The objective of the invention is the creation of anti-inflammatory drugs from plant materials that do not have toxic effects on the body.

The technical result is achieved by using an extract of aspen bark (Populus tremila) as an anti-inflammatory agent. When applying the aspen bark extract to patients with cholecystitis, a marked anti-inflammatory effect was noted. The following clinical observations were made. Patients suffering from chronic cholecystitis (80 people), chronic cholangiocholecystitis (60 people), chronic hepatocholecystitis (60 people) were prescribed aspen bark extract obtained by various extractants. 80 pax received alcohol extract, 120 people. received water. The extracts had permission for clinical trials or permission to use in the form of dietary supplements for food. The age of patients ranged from 4 years to 70 years, the duration of the disease from 1 year to several tens of years, patients were of both sexes, all had a pronounced clinical picture of the disease. The extract was prescribed for adults 6 g, children 4-6 years old 2 g, children 7-12 years old 4 g per reception 3 times a day 30-40 minutes after eating with an interval of 6 hours. The course of treatment was 7 days. After the course of treatment, the disappearance of subfebrile condition, intoxication symptoms was noted. Symptoms of Ortner, Murphy, which were positive before treatment, became negative. In all patients, marked pain at the Kerr point was noted, at the end of treatment, 70% of patients had pain at the Kerr point, the rest became less pronounced. In some patients with cholecystitis, moderate leukocytosis was noted before treatment - 7.9 · 10 ⁹ -9.0 · 10 ⁹ . After treatment with aspen bark extract, the leukocyte count reached normal. During an ultrasound examination, before the treatment, all patients had a densification of the wall of the gallbladder; in many patients, the contents of the gall bladder looked amorphous. In all patients with cholangiocholecystitis, hepatocholecystitis, pathognomonic echoscopic signs of these diseases were recorded. After treatment, the echoscopic picture of the gallbladder was without pathology (the densification of the wall of the gallbladder disappeared, its contents became homogeneous) in 33% of patients with cholecystitis, in 50% there was a positive dynamics. The severity of the phenomena of cholangitis became much less pronounced, ultrasonic signs - increased echoes from the bile ducts, which indicated their compaction - became less pronounced, their area decreased in almost all patients. Also, in patients with hepatocholecystitis, immediately after a course of treatment with aspen bark extract, a decrease in the inflammatory process was recorded. This was evidenced by the tendency to normalize the echoscopic picture of the liver parenchyma.

The anti-inflammatory effect is also stated by other organs and systems. In some patients (25 people), leukocyturia was noted (in some patients it reached 30 leukocytes in the field of view), which was a consequence of urinary tract infection, exacerbation of chronic pyelonephritis. After a course of treatment with aspen bark extract, the results of the urine test were pathological, leukocyturia was not detected during the general analysis of urine, or when analyzing the urine according to the Nechiporenko method.

In some patients (18 people), acute bronchitis was noted in the treatment of exacerbation of cholecystitis, this pathology was recorded as concomitant. The diagnosis was made on the basis of a clinical auscultatory picture (malaise, cough, fever up to 38 ° C, hard breathing, in 7 people scattered dry rales, in 1 patient dry and wet medium bubbling rales). In this case, an X-ray was not shown and therefore was not performed. The phenomena of bronchitis disappeared towards the end of the course of treatment with aspen bark extract. All patients returned to normal temperature, their general condition and well-being improved, cough disappeared, and the auscultatory picture in the lungs returned to normal. No other therapy in all clinical groups was performed. There were no distinctive criteria regarding the anti-inflammatory effect of the alcohol and water extract.

Claims (1)

The use of aspen bark extract (Populus tremila) as a means for the treatment of inflammatory lesions of the hepatobiliary system, leukocyturia and pyelonephritis.