RU2309755C2 - Method for treating bronchial asthma - Google Patents

Abstract

FIELD: medicine, pulmonology.

SUBSTANCE: it is necessary to carry out basic therapy including the intake of euphyllin, magnesium sulfate, 0.9%-NaCl solution, benacort, salbutamol, saltos, dexamethasone, mildronat. Additionally, one should introduce thymogen in combination with ruzamum, moreover, ruzamum should be injected intramuscularly at the dosage of 200 mg once daily every 4-5 d, about 600-800 mg/course. The innovation enables to increase the efficiency of basic therapy of bronchial asthma due to selective impact upon certain links of immune system: induction of specific immune response to ruzamum intake and increased immunological and curative effect of ruzamum due to thymogen.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to pulmonology.

There is a method of eliminating secondary immune deficiency in bronchial asthma using thymogen, which was administered intramuscularly 1 time per day, 100 μg, in one course lasting 5 or 10 days (V.I. Zoloedov, A.M. Zemskov, A.A. Stupnitsky , T. A. Goryainova. Treatment with thymogen and myelopid in patients with bronchial asthma // Clin. Honey. - 1995. - N6. - P.43-45).

However, the disadvantage of thymogen therapy is the possibility of developing allergic reactions, given that individual intolerance and pregnancy are contraindications to the appointment of the drug.

Secondly, the empirical use of individual immunomodulators, such as thymogen, often does not reduce or completely eliminate secondary immune deficiency (A.M. Zemskov, V.M. Zemskov, Yu.V. Sergeev, V.A. Vornovsky, A. V.Karaulov. 1000 formulas of clinical immunology. - M .: Medicine for everyone. - 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, in addition to thymogen, against the background of the usual basic therapy, rusam is administered intramuscularly at a dose of 200 mg once a day after 4-5 days for a course of treatment - 600-800 mg. The combination of thymogen and ruzam was included in the usual therapy of the disease 3-5 days after hospitalization, after examining the immune status and determining the degree and nature of secondary immune deficiency.

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 s.).

Combined immunotropic 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 (A.M. Zemskov, V.M. Zemskov, A.V. Karaulov. Clinical immunology. / Ed. A. V.Karaulova. - M .: MIA. - 1999. - 604 p.).

The basis for the selection of the terms of combined modulation are the features of violations of the immune status and the combined action of modulators (A.M. Zemskov, V.M. Zemskov, Yu.V. Sergeev, A.V. Karaulov. Non-pharmacological immunocorrection. - M.: Acad. Mycology, 2002 .-- 264 p.).

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

Example. Extract from the medical history N3683. Patient T., 43 years old, was hospitalized at City Clinical Hospital No. 20 of Voronezh from 10/13/2004 to 10/26/2004, diagnosis: bronchial asthma, mixed form, moderate, stage of exacerbation, DN _II . Emphysema. Pneumosclerosis

From anamnesis morbi: suffers from bronchial asthma for 5 years. I took steroid hormones intravenously during hospital treatment. It is treated stationary once a year. Since 1998, she has been using inhaled steroids (becotide - up to 6-8 doses per day). Real deterioration over the past month. Upon admission, she complained of asthma attacks, up to 6 times a day, including up to 2-3 times at night, poorly stopping with salbutamol intake, shortness of breath when climbing to the 3rd floor, difficulty breathing out, chest tightness, dry cough, weakness. Objectively: the general condition is satisfactory. NPV = 24-26 per minute. The chest is barrel-shaped, both halves are equally involved in the act of breathing. With percussion - a pulmonary sound, with a boxy tint. In the lungs during auscultation: weakened breathing, scattered dry wheezing in all pulmonary fields, expiration is elongated. Pulse - 72 beats per minute, rhythmic, satisfactory filling and tension. HELL - 160/100 mm Hg Heart sounds are rhythmic, muffled, noises are not heard. 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, diffuse changes in the myocardium; FVD - significant violations of the ventilation ability of the lungs in obstructive type; Chest x-ray - pneumosclerosis, pulmonary emphysema. An immunological examination of the patient revealed a second degree of immune deficiency. The treatment was carried out: aminophylline + magnesium sulfate + 0.9% sodium chloride solution, benacort, salbutamol, saltos, dexamethasone, mildronate. To correct immune deficiency, a combination of immunomodulators was prescribed, first, thymogen was administered intramuscularly 1 time per day, at a dose of 100 mcg, every other day for a course of treatment - 1000 mcg in parallel with it was administered intramuscularly to ruse at a dose of 200 mg 1 time per day after 4-5 days the course of treatment is 600-800 mg. Treatment was started from 4 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 13th day of hospital stay. 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 combined immunotherapy.

The inclusion of a combination of thymogen with ruzam in the treatment of bronchial asthma increases the effectiveness of the usual basic therapy of a mixed form of bronchial asthma. The use of a thymogen 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 allows to reduce the patient’s hospital stay by 2-3 days.

Claims (1)

A method of treating bronchial asthma, including basic therapy and administration of thymogen, characterized in that amufillin, magnesium sulfate, 0.9% NaCl solution, benacort, salbutamol, saltos, dexamethasone, mildronate are introduced as basic therapy, and thymogen is administered in combination with ruzam, which is administered intramuscularly at a dose of 200 mg once a day after 4-5 days for a course of treatment of 600-800 mg.