RU2274467C2 - Agent for treatment of stomach and duodenum ulcer disease with eradication of helicobacter pylori occurring on background of liver chronic diseases - Google Patents

Abstract

FIELD: medicine, gastroenterology, phytotherapy.

SUBSTANCE: invention relates to the development of agent used in treatment of stomach and duodenum ulcer disease with eradication of microorganism Helicobacter pylori occurring on the background of liver chronic diseases. Agent represents a species of medicinal plants and comprises common milfoil, fenestrate Saint-John's-wort, medicinal matricary, sweet flag rhizome with roots, common wormwood, sandy immortelle, black elder flowers, medicinal pot-marigold, peppermint, sage, dioecious nettle, umbellate centaury, medicinal sweet clove, medicinal dandelion roots, great burnet rhizomes, gum-tree leaves, tansy, maize stigmas, creeping thyme, cowberry leaves, flax seeds, tormentil rhizomes, linden flowers, common bear berry taken in the therapeutic dosage and in the definite mass ratio of components. The agent reduces the toxic effect of hepatobiliary system and prolongs the remission periods.

EFFECT: improved, enhanced and valuable medicinal properties of agent.

2 tbl, 4 ex

Description

The invention relates to the field of pharmacy, in particular to herbal medicine, and can be used for the eradication of Helicobacter pylori in patients with peptic ulcer of the stomach and duodenum, proceeding against the background of chronic liver diseases.

Helicobacter pylori is the leading etiological agent for gastric and duodenal ulcer (Ivashkin V.T., Megro F., Lapina T.L. Helicobacter pylori: revolution in gastroenterology. - M .: Triada-X Publishing House. - 1999 - 255 p .; Barkalov SV, Tsukalov VV Features of association and peptic ulcer in Caucasians and Mongoloids of Siberia. - Russian Journal of Gastroenterology, Hepatology and Coloproctology. - M., 2000. - T. 10. - No. 1. - S.34-38).

A known method of eradicating Helicobacter pylori with the so-called classical therapy, consisting of a colloidal preparation of bismuth, metronidazole and tetracycline, in which the frequency of side effects is 32% (Tytgat GNJ Treatment of peptic ulcer // Digestion. - 1998. - Vol. 59. - N 5 - P.446-452). The most effective way was considered a combination with macrolide antibiotics josamycin and clarithromycin.

But the greatest effect in the treatment of Helicobacter pylori was obtained with the use of metronidazole, bismuth oxide, tetracycline and omeprazole (quadrotherapy). A high percentage of quadrotherapy is accompanied by a high frequency (up to 63%) of side effects (Tetera S., Berstad A., Bang C. Bismuth based combination therapy for Helicobacter pylori - associated peptic ulcer disease. Metronidazole for eradication, ranitidine for pain / Amer. J. Gastroenterol. - 1996. - Vol. 91. - N 5. - P.935-941).

Most side effects were noted on the 5-6th day of anti-Helicobacter therapy and is expressed as gastric dyspepsia - decreased appetite, nausea, vomiting, stomatitis, glossitis; intestinal dyspepsia - diarrhea, flatulence and skin allergic reactions in the form of an itchy rash and urticaria.

Some patients developed symptoms of damage to the hepatobiliary system, which were more pronounced in patients suffering from chronic hepatitis or cirrhosis. Their activity of blood aminotransferases significantly increased: AsAT - 150.3 ± 14.5 U / L, AlAT - 80.3 ± 12.9 U / L, GGTP - 392.4 ± 22% U / L (Vertkin A.L. ., Martynov A.I., Kolobov S.V., Bezborodny S.D. Side effects of anti-helicobacter therapy: prognostic criteria for their development and correction / Russian Journal of Gastroenterology, Hepatology and Coloproctology. - M., 2000. - T. 10. - No. 1. - S.34-38).

Numerous literature data confirm the legitimate liver damage in diseases of the gastrointestinal tract and vice versa (J. Joseph, M., Hendermon. Pathophysiology of the digestive system. Transl. From English. - M. - St. Petersburg: Binonnevsky dialect, 1997. - 287 p. ) According to I. Domaradsky Issues of pathogenicity of Helicobacter pylori // Materials of the IX Thematic session of the Russian group for the study of Helicobacter pylori. - Saratov, 2000. - P.8-13 in patients with CKD more often than in the population, erosive and ulcerative lesions of the stomach and duodenum are observed. At the same time, a number of researchers indicate the influence of Helicobacter pylori as a factor that aggravates the course of CKD and increases the risk of their complications (Shebrun A.B., Aleksandrova V.A., Goncharova L.B., Tkachenko EI Diagnosis, prevention and treatment diseases associated with Helicobacter pylori - infections Helicobacter pylori - infections. - St. Petersburg. - 2002. - C.3-24).

Some authors use 5-8% infusion of tansy flowers to expel parasites and Helicobacter pylori (1.5 cups on an empty stomach in the morning, and a saline laxative is prescribed after 4-5 hours).

For other schemes, a concentrated tansy infusion (20%) of 1 tbsp is recommended. spoon 3-4 times a day or inflorescence powder for 1 teaspoon 2-3 times a day.

Sometimes prescribed powder of tansy flowers with honey in a ratio of 3: 100 (1 tbsp.spoon after 2 hours) only 3 times a day, after which a mild laxative is used (Lavrenova G.V. Medicinal herbs. M., 1996. - Book. 2. - S.221-222).

The prototype of the present invention is a herbal collection, consisting of bitter wormwood grass 20.0, leaves of a three-leafed watch 45.0, centaury umbelliferous grass 30.0, dandelion roots 35.0, Hypericum perforatum 40.0, licorice root 40.0 , rhizomes with calamus roots 20.0, flax seed 55.0, tricolor violet grass 60.0, yarrow grass 25.0, elderberry flowers 35.0, rhizome rhizome 30.0, corn stigmas 40.0, sandy immortelle flowers 20.0, eucalyptus leaves 15.0, tansy flowers 10.0, Ledum marsh herbs 20.0, herbs creeping thyme 30.0, lingonberry leaves 35.0.

This collection is used to treat patients with peptic ulcer of the stomach and duodenum associated with Helicobacter pylori, which occurs against the background of CKD. The collection is crushed to a powdery consistency, then 2/3 of a teaspoon is brewed in 300 g of boiling water and insisted for 15 minutes. Take 100 g 3 times a day after meals with normal and high acidity, and with low - before meals for 1-1.5 months (RU 2225719 C2, 03/20/04).

But in the treatment of patients with peptic ulcer of the stomach and duodenum with eradication of Helicobacter pylori, proceeding against the background of chronic liver diseases, this collection does not cause a pronounced clinical effect.

In addition, a three-leaf shift has a direct local effect on increasing the secretion of gastric juice, which does not contribute to the healing of gastric ulcers. (Sokolov S.Ya., Zamotaev I.P. Handbook of medicinal plants. M., 1990, pp. 181-182).

Licorice root does not always give a clinical effect in patients with gastric ulcer and in the presence of inflammation of the mucous membrane in patients with reduced acidity of gastric juice. Due to the fact that it has a relaxing effect on smooth muscle, its use is not recommended for patients with hypotension of the gallbladder (Pastushenkov L.V., Pastushenkov A.L., Pastushenkov V.L. Medicinal plants. St. Petersburg, 1998, p. 244- 246).

Despite the many positive properties of tricolor violet, in some patients with peptic ulcer of the stomach and duodenum occurring against a background of liver diseases, it can increase nausea, and in rare cases, provoke vomiting (Sokolov S.Ya., Zamotaev I.P. M ., Handbook of medicinal plants. M., 1990, S. 217-218).

The use of marsh rosemary is not indicated for the treatment of patients with gastric ulcer, since it has an irritating effect and can increase inflammation of the gastric mucosa (Lavrenova G.V. Medicinal herbs. M., 1996. Book 1, p.182).

The objective of the invention is to enhance the antimicrobial, anti-inflammatory, antispasmodic, analgesic effects, achieve complete eradication of Helicobacter pylori and reduce toxic effects on the hepatobiliary system, as well as increase the timing of remission.

The problem is solved in that the tool, which is a collection of medicinal plants, including Umbrella centaury grass, ordinary yarrow grass, St. John's wort grass, dandelion roots, calamus roots, rhizomes rhizome, eucalyptus leaves, tansy flowers, bitter wormwood grass, rye wormwood, corn, immortelle sand flowers, creeping thyme grass, lingonberry leaves, black elderberry flowers, flax seed, additionally contains medicinal chamomile flowers, melilot Gov., rhizome Potentilla erect, the flowers of Calendula officinalis, peppermint leaves, salvia officinalis, nettle, linden flowers, bearberry with the following weight ratio of components:

centaury umbrella, grass 4-6

yarrow, grass 5-7 Hypericum perforatum, grass 5-7 medicinal dandelion, roots 6-8 rhizome with calamus roots 3-5 hemorrhage, rhizome 5-7 eucalyptus leaves 2-4 tansy, flowers 1-3 wormwood, grass 3-5 corn stigmas 7-9 immortelle sandy, flowers 3-5 creeping thyme, grass 5-7 lingonberry leaves 6-8 black elderberry, flowers 6-8 flax seed 10-12 chamomile, flowers 9-11 Melilotus officinalis 8-10 cinquefoil erect, rhizome 10-12 calendula officinalis, flowers 8-10 peppermint leaves 7-9 salvia officinalis 6-8 Stinging nettle 5-7 linden flowers 17-10 bearberry 3-5

Umbrella centaury grass improves digestion in the stomach and intestines, stimulates the function of the digestive glands, enhances intestinal motility, reduces flatulence and has some laxative effect. It also has antimicrobial and anthelmintic properties, inhibits the growth of certain microorganisms.

Yarrow herb has anti-inflammatory, bactericidal, anti-allergic and wound healing effects. It helps to normalize the secretion and motility of the digestive tract, relieves pain caused by spasms in the intestine. It causes a hemostatic effect, which is based on an increase in the number of platelets and a decrease in the time to stop bleeding. In connection with wound healing properties, it promotes scarring of a stomach ulcer and duodenal ulcer.

Hypericum perforatum has an antimicrobial, bactericidal, anti-inflammatory and astringent effect, improves bile secretion in the duodenum, restores normal peristalsis, enhances the digestive capacity of the gastrointestinal tract, relieves spasm of blood vessels, especially capillary, improves blood flow, improves blood flow whole blood supply to the stomach. The herb of St. John's wort perforated increases the regenerative properties of tissues, thereby contributing to scarring of ulcers of the stomach and duodenum.

The roots of dandelion drug normalize the secretory and motor function of the stomach and intestines, increasing bile secretion and secretion of the digestive glands. They have antispasmodic, diuretic and laxative effects, stimulate appetite, improve digestion and normalize the evacuation of food from the stomach.

Calamus roots and rhizomes are capable of exerting anti-inflammatory, bacteriostatistical, fungistatic and some antispasmodic effects. They also have a weak analgesic effect and contribute to the cure of chronic gastritis, especially in cases with low acidity of gastric juice, and also accelerate the scarring of gastric and duodenal ulcers.

Rhizomes of the hemorrhage have an astringent, anti-inflammatory, vasoconstrictive and hemostatic effect, therefore they lead to a beneficial effect in the healing of bleeding ulcers. In addition, they have significant phytoncide activity, which allows them to be prescribed for some infectious diseases.

Eucalyptus leaves have a pronounced antiseptic and anti-inflammatory effect. They are active against gram-positive, gram-negative microorganisms, and also have a detrimental effect on fungi and protozoa, inhibit the growth of Staphylococcus aureus, Escherichia tuberculosis, Mycobacterium tuberculosis, dysentery amoeba and Trichomonas. Eucalyptus leaves contribute to the epithelization of the mucous membranes with erosive lesions and improve the healing of stomach ulcers and duodenal ulcers.

Tansy flowers have a pronounced antiseptic and antimicrobial effect, including on mycobacteria. They exhibit a pronounced therapeutic effect in case of helminthic invasion (roundworm, pinworm, whipworm, tapeworm), giardiasis and helicobacteriosis. The ability of tansy flowers to reduce increased gastric secretion and accelerate the healing of stomach ulcers and duodenal ulcers is noted.

Bitter wormwood grass has anti-inflammatory, bactericidal and fungicidal properties, and also helps to stabilize immune responses, enhances the proliferative phase in places of stomach ulcers or duodenal ulcers, thereby exerting an antiulcer effect. It relieves dyspeptic symptoms, improves digestion, and also has antiparasitic and anthelmintic effects.

Corn stigmas can cause a pronounced choleretic effect by regulating the secretion of bile from the gallbladder and the outflow of pancreatic juice, thereby normalizing the evacuation of food from the stomach. They help to stop nausea and vomiting, and also accelerate blood coagulation and cause a hemostatic effect in peptic ulcer of the stomach and duodenum.

Sandy immortelle flowers have an anti-inflammatory, antibacterial, antispasmodic and choleretic effect. They stimulate the secretion of gastric juice and activate the secretory ability of the pancreas, have an antispasmodic effect on the blood vessels, helping to improve blood circulation of the stomach and duodenum.

Creeping thyme herb has a bactericidal effect on cocci pathogenic flora and bacteriostatic on gram-negative organisms, and its high antimycotic activity against pathogenic fungi is also noted. It enhances the separation of gastric juice, relieves spasms of the gastrointestinal tract, inhibits the development of pathogenic microflora and other infections of the gastrointestinal tract.

Lingonberry leaves have a bactericidal, antiseptic, anti-inflammatory, astringent, diuretic and choleretic action. They reduce the permeability and fragility of capillaries, improve blood supply to the gastric mucosa, thereby contributing to the epithelization of gastric and duodenal ulcers.

The flowers of black elderberry have anti-inflammatory and diuretic properties, reduce the sensitization in the body, reduce the permeability of the vascular walls, weaken the phase of inflammation and reduce exudation, thereby promoting the healing of stomach and duodenal ulcers.

Flax seeds have anti-inflammatory, enveloping and minor analgesic properties. When ingested per os, flax seeds cover a thin layer of the mucous membrane of the stomach and duodenum, protecting it from irritation. This action is especially effective for gastric ulcers, accompanied by hypersecretion. Under the influence of enveloping agents, the absorption of infectious toxins from the intestine, which can cause the phenomena of general intoxication of the body, also decreases.

Chamomile flowers can exhibit anti-inflammatory, antimicrobial and antiviral properties, exhibit choleretic effect, promote the release of bile from the liver passages, improve choleresis, normalize bile viscosity, reduce inflammation in the liver and improve biochemical parameters in it.

Melilotus officinalis has a pronounced detoxification property, increases the phagocytic activity of leukocytes, improves peripheral blood supply to liver tissues, exhibits antibacterial properties, improves liver function, and enhances choleresis.

The rhizome rhizome erect manifests multiple therapeutic effects, including antimicrobial, antiviral and astringent. It reduces the viscosity of bile, promotes its outflow and reduces inflammatory manifestations in the gallbladder, and also normalizes the biochemical functions of the liver.

Calendula flowers have an anti-inflammatory effect, enhance secretory activity, increase bile formation and bile secretion, and activate regeneration processes in the liver. Due to the high content of carotenoids, flavonoids, ascorbic acid and organic acids in the marigold flowers, it causes an increase in the metabolic function of the liver, improves the composition of bile, and increases the secretory and excretory function of the liver.

Peppermint leaves can cause soothing, antispasmodic, analgesic and choleretic effects. They enhance the secretion of digestive glands, increase bile secretion, normalize the viscosity of bile, and promote the regeneration of liver cells.

Salvia officinalis has a multifaceted effect on the skin and internal organs, sage preparations reduce the permeability of the walls of blood vessels and capillaries, exhibit disinfectant and finocidal properties, and have a positive effect in the treatment of gastritis, gastric ulcer and duodenal ulcer in individuals with low stomach acidity. Its activity in relation to gram-positive strains of bacteria is noted, and it also increases the secretory and excretory function of the liver.

Stinging nettle has a diuretic, anti-febrile, hemostatic effect. In chronic liver diseases, it enhances choleresis and stimulates the release of bile from their gallbladder, and also acts bacteriostatically for cholecystitis and exhibits blood purifying and regenerating properties, and improves liver cell regeneration processes. Stinging nettle stimulates the production of prothrombin, one of the most important coagulation factors in the liver, normalizes liver function, restores lipid metabolism in the body, has a stimulating effect on erythropoiesis and has homeopathic properties.

Linden flowers have an antimicrobial, anti-inflammatory and anti-edematous effect, have a calming effect. In addition, linden flowers increase bile formation and facilitate the flow of bile into the duodenum, stimulate the secretion of gastric juice, increase diuresis, and enhance exocrine pancreatic function.

European bearberry causes a diuretic and antibacterial effect, in addition, it has an antispasmodic and choleretic effect, positively affects the vessels of the microvasculature and enhances the regeneration of liver cells. Due to its disinfecting properties, it relieves inflammation in the biliary tract and partially the gallbladder.

The proposed tool is prepared for use in the following mass ratio of components: centaury umbrella 4-6; yarrow, grass 5-7; St. John's wort perforated, grass 5-7; medicinal dandelion, roots 6-8; calamus, rhizome with roots 3-5; hemorrhage medicinal, rhizome 5-7; eucalyptus leaves 2-4; tansy, flowers 1-3; wormwood, grass 3-5; stigmas of corn 7-9; Helichrysum sandy, flowers 3-5; creeping thyme, grass 5-7; lingonberry leaves 6-8; black elderberry, flowers 6-8; flax seed 10-12; chamomile, flowers 9-11; Melilotus officinalis 8-10; cinquefoil erect, rhizome 10-12; Calendula officinalis, flowers 8-10; peppermint, leaves 7-9; Salvia officinalis 6-8; dioica nettle 5-7; linden flowers 17-19; bearberry ordinary 3-5.

The mixture is ground to a powdery consistency, then 2/3 of a teaspoon is brewed in 300 ml of boiling water, insisted for 15 minutes. Take 100 ml three times a day after meals with normal and high acidity, and with low - before meals for one and a half months.

Extracts from case histories are given as examples.

Example 1 (prototype)

Medical history No. 1016. Patient D., 37 years old.

Diagnosis: peptic ulcer in the acute phase. Duodenal ulcer. Helicobacter pylori (++). Chronic cryptogenic hepatitis with moderate activity.

Complains of aching pains in the epigastric region that occur 1.5-2 hours after eating, at night, heartburn, vomiting, itching and yellowness of the skin. Sick for about 4 years. It was treated on an outpatient basis, without a significant effect. Recently, pain in the epigastric region has intensified, itching and yellowness of the skin have increased.

Objectively: satisfactory condition, skin integuments and mucous icteric. Traces of scratching on the skin. Pulse 80 beats. in 1 min, rhythmic. HELL 120/80, heart sounds are muffled, vesicular breathing, the abdomen is soft, painful in the epigastric region, an enlarged liver is palpated, the lower edge of which extends 2 cm from the costal arch, spleen, kidneys are not palpated. In blood tests: HB 120 g / l, er. 3.9 · 10 ¹² / l, white blood cells 8.0 · 10 ⁹ / l, platelets 180.0 · 10 ⁹ / l, ESR 25 mm / h. Urinalysis: urine is light, acidic, specific gravity 1015, protein 0.033 g / l, urobilin (+), leukocytes 1-2 in par. Total protein 70 g / l, albumin 46%, globulins 54%, cholesterol 5.0 mmol / l. AsAT 1.25 mmol / L. AlAT 1.75 mmol / L, thymol sample 5.0 units, bilirubin 30.0 μmol / L, alkaline phosphatase 150.0 U / L, prothrombin index 70.0%. FTDS - peptic ulcer, peptic "niche" of the bulb 12 p.k., 1.0 · 2.0 cm, urease test for N.R. (+++), ultrasound of the abdominal organs - hepatoligonium, diffuse liver damage, the liver leaves the costal arch by 2 cm. HB _s A _g (-) HCVABIgM (-).

The patient was treated: quamatel 20 mg 2 times a day for 7 days, metronidazole 250 mg 4 times a day for 7 days, clarithrimycin 250 mg 2 times a day for 7 days, essence 2 capsules 3 times a day. Against the background of the therapy, the pain in the epigastric region decreased slightly, however, the itching and yellowness of the skin intensified, and weakness increased. In the analyzes: HB 118 g / l. Er 3.8 · 10 ¹² / L, white blood cells 9.0 · 10 ⁹ / L, platelets 170.0 · 10 ⁹ / L. ESR 30 mm / hour. Urinalysis: urine with icteric color, acidic, UV 1013, protein 0.033 g / l, urobilin (++), white blood cells 0-1-2 in n.p. Total protein 70 g / l, albumin 44%, globulins 56%, cholesterol 6.0 mmol / l, AcAT 1.5 mmol / l, AlAT 2.05 mmol / l, thymol sample 5.5 units, bilirubin 40, 0 μmol / l, alkaline phosphatase 200.0 U / l, prothrombin index 70.0%, control FGDS - ulcerative "niche" slightly decreased, 0.6 · 0.9 cm, urease test for N. P (++) . On ultrasound of the abdominal organs, the liver is diffusely enlarged, it leaves the costal arch by 3 cm.

The patient in the future, instead of anti-ulcer therapy, an herbal collection was prescribed, including wormwood grass 4.0 (20 g); leaves of a three-leaved watch 9.0 (45 g); Umbrella centaury grass 6.0 (30 g); roots of dandelion officinalis 7.0 (35 g); St. John's wort grass perforated 8.0 (40 g); licorice root naked 8.0 (40 g); rhizomes with calamus roots 4.0 (20 g); flax seed 11.0 (55 g); tricolor violet grass 14.0 (70 g); yarrow grass 5.0 (25 g); black elderberry flowers 7.0 (35 g); rhizome of hemorrhage 6.0 (30 g); corn stigmas 8.0 (40 g); Sand immortelle flowers 4.0 (20 g); eucalyptus leaves 3.0 (15 g); tansy flowers 2.0 (10 g); Ledum marsh grass 4.0 (20 g); creeping thyme grass 6.0 (30 g); lingonberry leaves 7.0 (35 g). The mixture was ground to a powdery consistency, then 2/3 of a teaspoon was brewed in 300 ml of boiling water, insisted for 15 minutes. The prepared mixture was defended and used in 100 ml 3 times a day after meals for 1.5 months.

After the treatment, the condition improved, hungry night pains in the epigastrium decreased, burping, vomiting disappeared; itchy skin, yellowness changed minimally.

In blood tests, HB 120 g / l, er. 4.0 · 10 ¹² / l, white blood cells 8.4 · ⁹ / l, platelets 190.0 · 10 ⁹ / l. ESR 28 mm / hour. Urinalysis: urine is light, acidic, specific gravity 1017, no protein, urobilin (+), white blood cells 0-1-2 in P. Total protein 72.0 g / l, albumin 47%, globulins 56%, cholesterol 5.4 mmol / l. AsAT 1.40 mmol / L, AlAT 1.9 mmol / L, thymol sample 5.5 units, bilirubin 37.5.0 µmol / L, alkaline phosphatase 150.0 U / L, prothrombin index 72.0%. FGDS - ulcerative "niche" is not determined, urease test for N. R negative. Ultrasound of the abdominal organs: the liver is diffusely changed, leaves the costal arch 2.5 cm, the spleen is not visualized.

Remission after therapy is 5 months.

Example 2

Case history No. 1120. Patient V., 47 years old.

Diagnosis: peptic ulcer in the acute phase. 12-pt ulcer bulb, Helicobacter pylori (+++). Chronic cryptogenic hepatitis with moderate activity.

Complains of weakness, pain in the epigastric region that occurs on an empty stomach, 1.5-2 hours after eating, at night, heartburn, belching, itching and yellowness of the skin. Sick for about 5 years. Treated on an outpatient basis. He took no-shpa, almogel. Recently, weakness, epigastric pain, heartburn, itching and yellowness of the skin have intensified. Sent to the clinic for examination and treatment.

Objectively: satisfactory condition, skin integuments and mucous membranes, traces of skin scratches. Pulse 76 beats in 1 min, rhythmic BP 115/75, heart sounds are muffled, vesicular breathing, no wheezing. The tongue is covered with a white coating, the abdomen is soft, painful in the epigastrium and right hypochondrium, the enlarged liver is palpated, the lower edge of which extends 1.5 cm from the costal arch, the spleen, the kidneys are not palpated.

Blood test: HB 118 g / l, er 4.0 · 10 ¹² / l, white blood cells 80 · 10 ⁹ / l, platelets 180.0 · 10 ⁹ / l. ESR 20 mm / h, urinalysis: urine is light, acidic, specific gravity 1013, protein - traces, urobilin (+), white blood cells 0-1-2 in par. Total protein 72 g / l, albumin 45%, globulins 55%, cholesterol 5.8 mmol / l. AcAT 1.15 mmol / L. AlAT 1.50 mmol / L, thymol sample 6.5 units, bilirubin 27.0 μmol / L, alkaline phosphatase 160 U / L, prothrombin index 71.04, FGDS - peptic ulcer, ulcer "niche" of the bulb 12-p .to. (1.1 × 2.1 cm), urease test for N.R (+++), ultrasound of the abdominal cavity: hepatomegaly is determined, the liver is diffusely changed, 1.5 cm out of the costal arch, spleen, kidneys , the pancreas is not palpable. HBsAg (-), HCVABIgM (-)

In the clinic, the patient was treated with: quamatel, 20 mg 2 times a day for 7 days, metronidazole 250 mg 4 times a day, 7 days, clarithromycin 250 mg 2 times a day, 7 days, essence 2 capsules 3 times a day. Against the background of the therapy, the pain in the epigastrium, heartburn, belching decreased. At the same time, weakness, yellowness and itching of the skin increased. In the blood test, HB 115 g / l, er 3.85 · 10 ¹² / l, white blood cells 8.5 · 10 ⁹ / l, platelets 180.0 · 10 ⁹ / l. Urinalysis: urine is acidic, light, specific gravity 1015, protein 0.033 ‰, urobilin (++), white blood cells 0-1 in par. Total protein 70 g / l, albumin 42%, globulins 58%, cholesterol 5.7 mmol / l, AcAT 1.57 mmol / l, AlAT 1.72 mmol / l, thymol sample 5.1 units, bilirubin 35 μmol / l, alkaline phosphatase 190 U / l, prothrombin index 70.0%, FGDS - ulcerative "niche" of the bulb 12 pp. decreased slightly (0.6 × 1.0 cm), urease test (+). Ultrasound of the abdominal organs: the liver is diffusely compacted, enlarged, out of the costal arch by 3 cm, the pancreas, spleen, and kidneys are not palpable.

Due to the lack of a positive result for the therapy, the patient was prescribed a herbal collection, including Umbrella centaury 4.0 (20 g); yarrow grass 5.0 (25 g); Hypericum perforatum 5.0 (25 g); roots of dandelion medicinal 6.0 (30 g); rhizome with calamus roots 3.0 (15 g); rhizome of hemorrhage 5.0 (25 g); eucalyptus leaves 2.0 (10 g); tansy flowers 1.0 (5 g); wormwood grass 3.0 (15 g); stigmas of corn 7.0 (35 g); Sand immortelle flowers 3.0 (15 g); creeping thyme grass 5.0 (25 g); lingonberry leaves 6.0 (30 g); black elderberry flowers 6.0 (30 g); flax seed 10.0 (50 g); chamomile flowers medicinal 9.0 (45 g); Melilotus officinalis 8.0 (40 g); the rootstock rhizome erect 10.0 (50 g); Calendula officinalis flowers 8.0 (40 g); peppermint leaves 7.0 (35 g); medicinal sage 6.0 (30 g); dioica nettle 5.0 (25 g); linden flowers 17.0 (85 g); bearberry ordinary 3.0 (15 g).

The mixture was ground to a powdery consistency, then 2/3 of a teaspoon was brewed in 300 ml of boiling water, insisted for 15 minutes. The prepared mixture was defended and taken 100 ml three times a day after meals for a month and a half.

After this therapy, the patient's condition improved. The weakness and pain in the epigastrium, heartburn, belching, itching and yellowness of the skin disappeared. With an objective study, the skin is yellow, mild icteric sclera, pulse 80 beats. in 1 min, rhythmic. HELL 120/80, heart sounds are clean, vesicular breathing, no wheezing. The tongue is clean, the stomach is soft, painless on palpation, the liver exits 0.5 cm from the costal arch, the pancreas, spleen, and kidneys are not palpated.

Blood test: HB 120 g / l, er 4.0 · 10 ¹² / l, white blood cells 6.0 · 10 ⁹ / l, platelets 180.0 · 10 ⁹ / l, ESR 15 mm / hour, urinalysis: light urine , acid, specific gravity 1014, no protein, no urobilin, white blood cells 0-1 p.p. Total protein 74 g / l, albumin 48%, globulins 52%, cholesterol 5.2 mmol / l, AcAT 0.68 mmol / l, AlAT 0.72 mmol / l, thymol sample 4.5 units, bilirubin 21, 0 μmol / L, alkaline phosphatase 100 U / L, prothrombin index 73.0%. FGDS - ulcerative "niche" is not determined, urease test for N.R. (-), Ultrasound of the abdominal organs: the liver has significantly decreased in size, it leaves the costal arch by 0.5 cm, the pancreas, spleen, and kidneys are not changed. Remission after therapy is 10 months.

Example 3

Case history No. 1890. Patient S., 44 years old.

Diagnosis: peptic ulcer in the acute phase. Onion ulcer 12 p.k. Helicobacter pylori (+++). Chronic cryptogenic hepatitis with moderate activity.

The patient complained of dull epigastric pain that occurs 1.5-2 hours after eating, at night, heartburn, vomiting at the height of the pain, bringing relief, weakness, yellowness and itching of the skin and mucous membranes. Sick 5 years. Repeatedly treated on an outpatient basis and in hospitals of the city. Recently, pain, itching and yellowness of the skin intensified, weakness has grown.

Objectively: satisfactory condition, low nutrition, skin and mucous membranes icteric, traces of scratching, pulse 68 beats. in 1 min, rhythmic. HELL 110/78, cardiac sounds are muffled, vesicular breathing, the tongue is covered with a white coating, the abdomen is soft, pale at palpation in the epigastrium and right hypochondrium, the enlarged liver is palpated, the lower edge of which extends 3 cm from the costal arch, the spleen, the kidneys are not palpated.

In blood tests: HB 115 g / l, er 3.8 · 10 ¹² / l, white blood cells 8.5 · 10 ⁹ / l, platelets 170.0 · 10 ⁹ / l, ESR 25 mm / hour.

Urinalysis: urine is light, acidic, specific gravity 1013, protein 0.033 g / l, urobilin (+), white blood cells 0-1-2 in par. Total protein 68 g / l, albumin 44%, globulins 56%, cholesterol 5.8 mmol / l. AcAT 1.45 mmol / L. AlAT 1.68 mmol / L, thymol sample 5.8 units, bilirubin 320 μmol / L, alkaline phosphatase 160 U / L, prothrombin index 69.0%. FGDS: peptic ulcer, peptic "niche" of the bulb 12 p.k. (1.0 × 2.1 cm), urease test for N.R. (+++), Ultrasound of the abdominal organs: hepotomegaly, liver diffusely compacted, 3 cm out of the costal arch, pancreas, spleen, kidneys unchanged, АсsAg (-), HCVAвIgM (-).

The patient was treated in the clinic: 20 mg quantotel 2 times a day, metronidazole 250 mg 4 times a day for 7 days, clarithrinicin 250 mg 2 times a day for 7 days, 2 capsules of essentials 3 times a day. Against the background of the therapy, the patient's condition improved slightly - the pain syndrome decreased, however, yellowness of the skin, itching, and weakness intensified. In blood tests: HB 116 g / l, er 3.8 · 10 ¹² / l, white blood cells 7.5 · 10%, platelets 180.0 · 10%, ESR 20 mm / hour. Urinalysis: urine is light, acidic, specific gravity 1014, protein 0.033 g / l, urobinin (++), leukocytes 0-1-2 in p.z., total protein 69 g / l, albumin 44%, globulins 56% , cholesterol 5.9 mmol / L, AcAT 1.88 mmol / L, AlAT 1.80 mmol / L, thymol sample 6.0 units, bilirubin 35.0 μmol / L, alkaline phosphatase 160 U / L, prothrombin index 67.0%. FGDS - ulcerative "niche", bulb 12 p.k. decreased slightly (0.6 × 0.9 cm), urease test (+), ultrasound of organs: the liver is diffusely compacted, leaves the costal arch by 3.5 cm.

Instead of anti-ulcer therapy, the patient was prescribed a herbal collection, including Umbrella centaury 5.0 (25 g); yarrow grass 6.0 (30 g); Hypericum perforatum 6.0 (30 g); roots of dandelion officinalis 7.0 (35g); rhizome with calamus roots 4.0 (20 g); rhizome of hemorrhage 6.0 (30 g); eucalyptus leaves 3.0 (15 g); tansy flowers 2.0 (10 g); wormwood grass 4.0 (20 g); corn stigmas 8.0 (40 g); Sand immortelle flowers 4.0 (20 g); creeping thyme grass 6.0 (30 g); lingonberry leaves 7.0 (35 g); black elderberry flowers 7.0 (35 g); flax seed 11.0 (55 g); Chamomile flowers 7.0 (35 g); Melilotus officinalis 9.0 (45); the rootstock rhizome erect 11.0 (55 g); Calendula officinalis flowers 9.0 (45 g); peppermint leaves 8.0 (40 g); Salvia officinalis 7.0 (35 g); Stinging nettle 6.0 (30 g); linden flowers 18.0 (90 g); bearberry ordinary 4.0 (20 g).

The mixture was ground to a powdery consistency, then 2/3 of a teaspoon was brewed in 300 ml of boiling water, insisted for 15 minutes. The prepared mixture was defended and taken 100 ml three times a day after meals for a month and a half. After this therapy, the patient's condition improved significantly, weakness, pain, heartburn, belching, itching and yellowness of the skin disappeared. Objectively: the skin and mucous membrane are light, clean. Pulse 78 beats. in 1 min, rhythmic. HELL 118/80, heart sounds are clean, vesicular breathing, no wheezing. The tongue is clean, the stomach is soft, painless, with palpation, the liver is not palpated. Blood test: HB 120 g / l, er 4.0 · 10 ¹² / l, white blood cells 6.0 · 10 ⁹ / l, platelets 200.0 · 10 ⁹ / l, ESR 12 mm / hour. Urinalysis: urine is light, acidic, specific gravity 1015, no protein, no urobilin, white blood cells 0-1-2 in P. Total protein 74.0 g / l, albumin 49%, globulins 51%, cholesterol 5.1 mmol / l. AsAT 0.40 mmol / L. AlAT 0.42 mmol / L, thymol sample 3.5 units, bilirubin 17 μmol / L, alkaline phosphatase 70 U / L, prothrombin index 76.0%. FGDS - ulcerative "niche" of the bulb 12 p.k. not determined, urease test for N.R. (-). Ultrasound of the abdominal organs: the liver has decreased in size, does not go out from under the hypochondrium, the pancreas, spleen, and kidneys are not changed.

Remission after ongoing therapy lasts 14 months.

Example 4

Case history No. 1521. Patient Yu., 37 years old.

Diagnosis: peptic ulcer in the acute phase. Onion ulcer 12 p.k. Helicobacter pylori (+++). Chronic cryptogenic hepatitis with moderate activity.

The patient complained of aching pains in the epigastrium, right hypochondrium, occurring on an empty stomach 1.5-2 hours after eating, at night, heartburn, vomiting, bringing the patient relief, weakness, unstable stool, itching and yellowness of the skin and mucous membranes. Sick for 3 years. Repeatedly treated in a clinic. Two weeks before admission to the clinic, the pain syndrome intensified, weakness, yellowness and itching of the skin increased.

Objectively: the condition is satisfactory, the skin and mucous membranes are icteric, traces of scratching on the skin, pulse 66 beats. in 1 min, rhythmic. HELL 115/70. Heart sounds are muffled, vesicular breathing, no wheezing, tongue is covered with whitewash, the abdomen is regular in shape, painful on palpation in the epigastrium, right hypochondrium, enlarged liver is palpated, the lower edge of which extends 2 cm from the costal arch, spleen, kidneys are not palpated .

In blood tests: HB 110.0 g / l, er 3.7 · 10 ¹² / l, white blood cells 8.2 · 10 ⁹ / l, platelets 175.0 · 10 ⁹ / l, ESR 22 mm / hour.

Urinalysis: urine is light, acidic, specific gravity 1014, protein - traces, urobilin (+), leukocytes 1-3 in par. Total protein 66.0 g / l, albumin 45%, globulins 55%, cholesterol 5.9 mmol / l. AcAT 1.40 mmol / L. AlAT 1.70 mmol / L, thymol sample 5.6 units, bilirubin 30.0 μmol / L, alkaline phosphatase 150.0 U / L, prothrombin index 68.0%. FGDS: peptic ulcer, peptic "niche" of the bulb 12 p.k. (1.0 × 2.0 cm), urease test for N.R. (+++), Ultrasound of the abdominal organs: the liver is enlarged, diffusely changed, leaves the costal arch by 2 cm, the pancreas, spleen, kidneys are not changed, АсsAg (-), HCVIgM (-).

In the patient’s clinic, treatment was carried out: quamatel 20 mg 2 times a day, metronidazole 250 mg 2 times a day for 7 days, essentials 2 capsules 3 times a day. Against the background of the therapy, the patient's condition improved slightly - the pain syndrome in the epigastrium decreased, while the pain in the right hypochondrium was causal in nature, and weakness, itching, and yellowness of the skin increased. In blood tests: HB 112 g / l, er 3.6 · 10 ¹² / l, white blood cells 8.4 · 10 ⁹ l, platelets 170.0 · 10 ⁹ l, ESR 25 mm / hour. Urinalysis: urine is light, acidic, specific gravity 1013, protein - traces, urobilin (++), leukocytes 0-1-2 in p.z., total protein 64 g / l, albumin 44%, globulins 56%, cholesterol 6.0 mmol / L, AcAT 1.6 mmol / L, AlAT 1.80 mmol / L, thymol sample 5.8 units, bilirubin 34.0 μmol / L, alkaline phosphatase 170 U / L, prothrombin index 68, 0% FGDS - ulcerative "niche", bulb 12 p.k. decreased (0.6 × 0.9 cm) in size, urease test for N.R. (+), ultrasound of organs: the liver is diffusely enlarged, goes out from under the costal arch by 3 cm, spleen, kidneys are not changed.

The patient was prescribed herbal collection, including centaury umbrella 6.0 (30 g); yarrow grass 7.0 (35 g); St. John's wort grass perforated 7.0 (35 g); roots of dandelion officinalis 8.0 (40 g); rhizome with calamus roots 5.0 (25 g); rhizome of hemorrhage 7.0 (35 g); eucalyptus leaves 4.0 (20 g); tansy flowers 3.0 (15 g); wormwood grass 5.0 (25 g); stigmas of corn 9.0 (45 g); sandy immortelle flowers 5.0 (25 g); creeping thyme grass 7.0 (30 g); lingonberry leaves 8.0 (40 g); black elderberry flowers 8.0 (40 g); flax seed 12.0 (60 g); chamomile flowers 11.0 (55 g); Melilotus officinalis 9.0 (45 g); the rootstock rhizome erect 12.0 (60 g); Calendula officinalis flowers 10.0 (50 g); peppermint leaves 9.0 (45 g); Salvia officinalis 8.0 (40 g); Stinging nettle 6.0 (30 g); linden flowers 19.0 (95 g); bearberry ordinary 5.0 (25 g).

The mixture was ground to a powdery consistency, then 2/3 of a teaspoon was brewed in 300 ml of boiling water, insisted for 15 minutes. The prepared mixture was defended and taken in 100 ml three times a day for a month and a half. After the therapy, the patient's condition improved, the pain in the epigastrium and right hypochondrium, heartburn, vomiting, weakness, itching and yellowness of the skin disappeared. With an objective examination, the skin and mucous membrane are clean, clean. Pulse 78 beats. in 1 min, rhythmic. HELL 120/80, heart sounds are muffled, vesicular breathing, no wheezing, tongue is clean, abdomen is soft, painless, palpation of the liver out of the costal arch by 0.5 cm, the pancreas, spleen, kidneys are not palpated. Blood test: HB 118 g / l, red blood cells 3.9 · 10 ¹² / l, white blood cells 6.5 · 10 ⁹ / l, platelets 180.0 · 10 ⁹ / l, ESR 14 mm / hour. Urinalysis: urine is light, acidic, specific gravity 1013, no protein, no urobilin, white blood cells 0-1 in n.p. Total protein 72.0 g / l, albumin 47%, globulins 53%, cholesterol 5.3 mmol / l. AcAT 0.60 mmol / L. AlAT 0.70 mmol / L, thymol sample 4.1 units, bilirubin 20.0 μmol / L, alkaline phosphatase 90 U / L, prothrombin index 71%. FGDS - ulcerative "niche" of the bulb 12 p.k. not determined, urease test for N.R. (-). Ultrasound of the abdominal organs: the liver has decreased in size, does not go out from under the costal arch by 0.5 cm, the pancreas, spleen, and kidneys are not changed.

Remission after ongoing therapy lasts 10 months.

Thus, the cited extracts from medical records indicate that when taking the proposed collection, a positive effect was obtained in all patients.

After the treatment of patients with the proposed collection (table 1), healing of the ulcerative "niche" of the bulb 12 p.c., normalization of liver tests and functional state of the liver, the absence of N.R. The treatment data using the prototype are presented in table 2. The advantage of the proposed collection is the absence of side effects (liver damage) compared with other drugs. Remission in the observed patients increased by 2-3 times (prototype method - remission of 5 months), and according to the claimed method for 14 months.

Table 1
The effectiveness of the proposed herbal collection in the treatment of patients with peptic ulcer of the stomach and duodenum with eradication of helicobacter, occurring on the background of CKD Indicators Before treatment After treatment In the hospital R In 6 months R Hemoglobin g / l 115.0 ± 2.9 119.5 ± 3.0 > 0.05 119.6 ± 2.8 > 0.05 Red blood cells × 10 ¹² l 3.8 ± 0.3 3.96 ± 0.25 > 0.05 3.98 ± 0.28 > 0.05 White blood cells × 10 ⁹ L 8.2 ± 0.5 6.15 ± 0.6 <0.05 6.1 ± 0.5 <0.05 Platelets × 10 ⁹ / L 176.0 ± 14.0 186.0 ± 15.0 > 0.05 192.0 ± 15.0 > 0.05 ESR mm / hour 22.0 ± 3.0 13.0 ± 2.5 <0.05 12.0 ± 2.3 <0.05 The size of the ulcerative "niche" of the bulb cm 1.0 × 2.0 0.6 × 0.9 - Urease test +++ + - Total protein g / l 68.0 ± 2.0 72.0 ± 2.1 > 0.05 74.0 ± 2.2 > 0.05 Albumin,% 43.0 ± 1.5 48.0 ± 1.6 <0.05 49.0 ± 1.6 <0.05 Globulins,% 57.0 ± 1.5 52.0 ± 1.4 <0.05 51.0 ± 1.3 <0.05 AsAT mmol / L 1.33 ± 0.15 1.56 ± 0.10 <0.05 0.41 ± 0.11 <0.05 AlAT mmol / l 1.62 ± 0.14 1.62 ± 0.10 <0.05 0.43 ± 0.10 <0.05 Thymol test, units 5.95 ± 0.41 4.0 ± 0.39 <0.05 3.6 ± 0.40 <0.05 Cholesterol mmol / L 5.85 ± 0.60 5.6 ± 0.50 > 0.05 5.2 ± 0.52 > 0.05 Alkaline phosphatase, E / L 156.0 ± 10.0 165.0 ± 11.0 <0.05 75.0 ± 0.6 <0.05 Bilirubin μmol / L 29.6 ± 2.2 36.0 ± 2.7 <0.05 18.1 ± 1.5 <0.05 Prothrombin index,% 69.5 ± 6.3 68.3 ± 6.0 > 0.05 75.0 ± 6.7 > 0.05 Duration of remission (months) - - 13.0

table 2
The effectiveness of the collection of the prototype in the treatment of patients with peptic ulcer of the stomach and duodenum with eradication of helicobacter, occurring on the background of CKD Indicators Before treatment After treatment In the hospital R In 6 months R Hemoglobin g / l 120.0 ± 2.5 118.6 ± 3.0 > 0.05 125.0 ± 2.5 > 0.05 Red blood cells × 10 ¹² l 3.93 ± 0.4 3.90 ± 0.27 > 0.05 4.0 ± 0.35 > 0.05 White blood cells × 10 ⁹ L 8.2 ± 0.5 9.0 ± 0.6 > 0.05 7.5 ± 0.6 > 0.05 Platelets × 10 ⁹ / L 180.6 ± 16.0 176.7 ± 16.5 > 0.05 190.0 ± 17.3 > 0.05 ESR mm / hour 25.4 ± 1.6 30.0 ± 2.1 <0.05 22.0 ± 1.7 <0.05 The size of the ulcerative "niche" of the bulb cm 1.0-2.0 0.6-0.9 - Urease test +++ ++ - Total protein g / l 69.0 ± 2.1 70.0 ± 2.3 > 0.05 71.0 ± 2.0 > 0.05 Albumin,% 45.0 ± 1.6 46.0 ± 1.4 > 0.05 47.0 ± 1.5 > 0.05 Globulins,% 54.0 ± 1.4 57.0 ± 1.6 > 0.05 52.0 ± 1.4 > 0.05 AsAT mmol / L 1.2 ± 0.12 1,60 ± 0,14 > 0.05 1.15 ± 0.11 > 0.05 AlATmmol / l 1.78 ± 0.13 2.16 ± 0.17 > 0.05 1.4 ± 0.10 <0.05 Thymol test, units 5.8 ± 0.42 5.6 ± 0.40 > 0.05 5.4 ± 0.43 > 0.05 Cholesterol mmol / L 5.7 ± 0.59 6.0 ± 0.60 > 0.05 5.1 ± 0.53 > 0.05 Alkaline phosphatase, E / L 156.0 ± 12.0 206.0 ± 10.0 > 0.05 150.0 ± 0.10 > 0.05 Bilirubin μmol / L 30.0 ± 2.3 40.0 ± 2.5 <0.05 24.0 ± 2.0 <0.05 Prothrombin index,% 70.6 ± 6.4 70.8 ± 7.0 > 0.05 70.0 ± 6.9 > 0.05 Duration of remission (months) - - 5,0

Claims (1)

A remedy for the treatment of peptic ulcer of the stomach and duodenum with eradication of Helicobacter pylori, which occurs against a background of chronic liver diseases, which is a collection of medicinal plants, including Umbrella centaury grass, ordinary yarrow grass, perforated St. John's wort grass, medicinal dandelion roots, and rhizome root hemorrhages, eucalyptus leaves, tansy flowers, wormwood grass, stigmas of corn, flowers of sandwort immortelle, creeping thyme grass, lingonberry leaves iki, black elderberry flowers, flax seed, characterized in that it additionally contains medicinal chamomile flowers, medicinal sweet clover, erect rhizome rhizome, medicinal calendula leaves, peppermint leaves, medicinal sage, dioecious nettle, linden flowers, bearberry ordinary in the following weight ratio of components : Centaury umbrella, grass 4-6 Yarrow, grass 5-7 Hypericum perforatum, grass 5-7 Medicinal dandelion, roots 6-8 Rhizome with calamus roots 3-5 Hemorrhage, rhizome 5-7 Eucalyptus leaves 2-4 Tansy, flowers 1-3 Wormwood, grass 3-5 Corn stigmas 7-9 Immortelle sandy, flowers 3-5 Creeping thyme, grass 5-7 Lingonberry leaves 6-8 Elderberry black, flowers 6-8 Flax seed 10-12 Chamomile officinalis, flowers 9-11 Melilotus officinalis 8-10 The cinquefoil is erect, rhizome 10-12 Calendula officinalis, flowers 8-10 Peppermint leaves 7-9 Salvia officinalis 6-8 Stinging nettle 5-7 Linden flowers 17-19 Bearberry ordinary 3-5