RU2288741C2 - Method for treating bronchial asthma cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves administering intravenous hemodesis injections at a dose of 200 ml every other day as a part of traditional therapy after having studied patient immunity status. The total treatment course requires 600-1000 ml for 3-5 infusions. Rusam is concurrently administered at a dose of 20 mg once a day with 4-5 days long pauses. The total treatment course requires 600-800 mg of the drug.

EFFECT: enhanced effectiveness of selective treatment directed to given immune system chains.

Description

The invention relates to medicine, namely to pulmonology.

Bronchial asthma is often accompanied by the development of secondary immune deficiency, which is manifested primarily by insufficiency of the T- and B-links of the immune system (AMZemskov, V.M. Zemskov, A.V. Karaulov, etc. Immunopathology and immunocorrection of non-specific inflammatory lung diseases. - Voronezh: ASD, 2000 .-- 440 p.).

In pharmacological immunocorrection, there is a known method for treating a mixed form of bronchial asthma using hemodesis, which is administered intravenously at a dose of 400 ml for 2 consecutive days (A.G. Chuchalin et al. Immunocorrection in pulmonology. - M .: Medicine, 1989. - P. 48- fifty).

However, the disadvantage of hemodesis therapy is the possibility of complications from the heart, kidneys, liver, allergic reactions, given that contraindications to the appointment of the drug are individual intolerance and decompensated heart failure.

Secondly, the empirical use of individual immunomodulators, for example, hemodesis, often does not reduce or completely eliminate secondary immune deficiency (AMZemskov, V.M. Zemskov, Yu.V. Sergeev, V.A. Vornovsky, A.V. Karaulov . 1000 formulas of clinical immunology. - M .: Medicine for all. - 2003. - 336 p.), Which is one of the serious drawbacks of this type of therapy.

Thirdly, the disadvantage of monotherapy with immunomodulators is that the persistence of secondary immunological deficiency in patients with bronchial asthma leads to a chronic process and an increase in relapse, which significantly reduces the effectiveness of the usual basic treatment of mixed forms of bronchial asthma.

The technical result of the invention is to increase the effectiveness of the usual basic treatment of bronchial asthma.

The technical result is achieved by the fact that it is proposed to administer intravenous hemodesis at a dose of 200 ml every other day for a course of treatment - 600-1000 ml (3-5 infusions) with a parallel injection of Ruzam intramuscularly at a dose of 200 mg once a day after 4-5 days per course treatment - 600-800 mg.

The combination of drugs was included in the usual treatment of the disease 3-5 days after hospitalization, after examining the immune status and determining the degree and nature of secondary immune deficiency (AMZemskov, V.M. Zemskov, A.V. Karaulov, L.A. Novikova. Reference information on clinical immunology and allergology. - Voronezh: Publishing house of Voronezh State University, 1997. - 161 p.).

The rationale for this scheme to eliminate secondary immune deficiency in a mixed form of bronchial asthma is the need to study a specific drug to predict its effect in the face of many diverse breakdowns of the immune system (D.N. Lazareva, E.K. Alekhin. Immunity stimulants. - M .: Medicine, 1985 .-- 256 p.).

Combined immunocorrective therapy is understood to mean the sequential or simultaneous use of several immunomodulators with a different mechanism of action in order to eliminate immunological disorders (AMZemskov, V.M. Zemskov, A.V. Karaulov. Clinical immunology / Ed. By A.V. Karaulov. - M.: MIA. - 1999. - 604 p.).

Indications for combined immunocorrection are as follows: 1) chronic course (more than three months) of the main pathological process, its frequent relapses, concomitant complications, secondary diseases; 2) severe intoxication syndrome, metabolic disorders, protein loss by the kidneys, etc .; 3) unsuccessful immunocorrective therapy with a separate drug for a month; 4) a high degree of immune deficiency (third) or a combined lesion of the T- and B-links of the immune system, T- and B-lymphocytes and macrophages, multidirectional disorders of the immune system - stimulation of some and a decrease in other indicators from the normal level. The basis for the selection of the terms of combined modulation are the features of violations of the immune status and combined action of modulators (AMZemskov, V.M. Zemskov, Yu.V. Sergeev, A.V. Karaulov. Non-drug immunocorrection. - M .: National Acad. Mycology, 2002 .-- 264 p.).

The effectiveness of the complex therapy of bronchial asthma with the inclusion of a combination of hemodesis with Ruzam can be illustrated by the following example.

Example. Extract from the medical history No. 1471. Patient E., 20 years old, was hospitalized at City Clinical Hospital No. 20 of Voronezh from 04/13/2004 to 04/28/2004, diagnosis: bronchial asthma, mixed form, moderate, cortical dependent , stage of exacerbation. NAM _I.

From anamnesis morbi: suffers from asthma for 6 years. I have taken steroid hormones intravenously and polcortolone at a dose of 2 to 4 tablets per day; I have been receiving inhaled steroids (beclodget) over the past 5 years. Currently taking polcortolone at a dose of 2 tablets per day and inhaled corticosteroids (beclodget 2 doses 2 times a day). Upon admission, she complained of asthma attacks, up to 3-4 times a day, mainly at night, poorly stopped by taking berodual, shortness of breath when climbing to the 3rd floor, shortness of breath, dry cough, weakness. Objectively: the general condition is satisfactory. NPV = 20-22 per minute. The chest is of the usual form, both halves are equally involved in the act of breathing. With percussion - a pulmonary sound. In the lungs during auscultation: breathing is weakened, scattered dry wheezing in all pulmonary fields, expiration is elongated. Pulse - 80 beats per minute, rhythmic, satisfactory filling and tension. HELL - 120/80 mm Hg The abdomen is soft, painless on palpation. The liver and spleen are not palpable. No peripheral edema.

Laboratory and instrumental data: general analysis of blood and urine - without pathology; ECG - sinus rhythm, EOS is not rejected; FVD - significant obstructive bronchial obstruction.

An immunological examination of the patient revealed a second degree of immune deficiency. The treatment was performed: aminophylline + 0.9% sodium chloride solution, berodual, beclodget, intravenous dexamethasone, polcortolone. For the correction of immune deficiency, a combination of immunomodulators was prescribed, first hemedes was administered at a dose of 200 ml every other day for a course of treatment - 600-1000 ml (3-5 infusions) in parallel with the use of ruzam intramuscularly at a dose of 200 mg once a day after 4-5 days the course of treatment is 600-800 mg. The treatment was started from 2 days from the moment of hospitalization. A week after the start of immunomodulation, the patient's condition improved significantly, asthma attacks, coughing stopped, and wheezing disappeared. Discharged with improvement on the 15th day of hospitalization. In this case, the elimination of the main symptoms of the disease occurred by the middle of the second week of inpatient treatment, which indicates a good effect of combination immunotherapy.

As a result of the inclusion of a combination of hemodesis with Ruzam in the treatment of bronchial asthma, it was found that the use of a combination of drugs increases the effectiveness of traditional basic therapy of a mixed form of bronchial asthma. The use of hemedesis composition with Ruzam is accompanied by a faster normalization of the main manifestations of bronchial asthma compared with conventional treatment, on average by 2-3 days, which reduces the patient’s hospital stay by 1-2 days.

Claims (1)

A method for the treatment of bronchial asthma by traditional therapy, including the introduction of hemodesis, characterized in that it is proposed to administer hemodesis intravenously at a dose of 200 ml every other day for a course of treatment of 600-1000 ml (3-5 infusions) with a parallel administration of ruzam intramuscularly at a dose of 200 mg 1 time per day after 4-5 days for a course of treatment of 600-800 mg.