RU2312673C1 - Method for treating pulmonary tuberculosis patients - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves administering antibacterial chemotherapy and treating biologically active points. The treatment is carried out by daily applying electric neurostimulation with 77 Hz frequency within 30-35 min. The total treatment course is 20 procedures long. The points of 4GI, 5TR, 6MC, 14VG and zones of posterior median line, right and left paravertebral lines and direct dorsal and direct anterior lung projection region are treated. Homeopathy preparations are additionally applied in combination comprising Apis mellifica 6, China officinalis 6, Chelidonium majus 6, stannum 6, Sanguinaria coandensis 6, potassium bichromicum 6, Carbo vegetabilis 6. The preparations are given at a dose of 5 granules three times a day irrespectibly of meals.

EFFECT: accelerated bacilli elimination and closing decay cavities.

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Description

The invention relates to medicine, namely to phthisiology, and can be used in the complex treatment of pulmonary tuberculosis.

Pulmonary tuberculosis currently continues to be one of the most acute socio-economic problems. Despite the experience gained in the treatment of pulmonary tuberculosis patients, the problem of treatment effectiveness is the most relevant. In recent years, the number of patients with pulmonary tuberculosis due to drug-resistant strains of mycobacterium tuberculosis has increased significantly, which significantly reduces the effectiveness of treatment and in many cases causes death.

The leading method in the treatment of pulmonary tuberculosis is antibiotic therapy with anti-TB drugs, which determines the main direction in the future in the fight against tuberculosis (order of the Ministry of Health of the Russian Federation dated March 21, 2003 No. 109). However, many years of experience in the use of etiotropic therapy for tuberculosis allowed domestic and foreign researchers to note certain limits on the possibilities of chemotherapy in achieving a clinical effect. Modern chemotherapy for pulmonary tuberculosis has expanded and approved the pathogenetic direction in the treatment of patients, since an increase in the body's defenses creates favorable conditions for acting directly on the pathogen.

A disadvantage of the known methods of treatment is the rapid emergence of drug resistance of tuberculosis mycobacteria to these drugs, the appearance of various toxic reactions from the liver, gastrointestinal tract and nervous system, and weakening of the immune status. A particularly significant drawback is the lack of bioavailability of anti-TB drugs to the lung tissue due to extensive fibrotic changes. Significant disadvantages include the development of dysbiotic disorders of the gastrointestinal tract, which leads to a further decrease in immunity.

All this makes us look for various, new ways to treat pulmonary tuberculosis, which reduce the above disadvantages. Numerous studies aimed at studying the immunological state of patients with pulmonary tuberculosis in order to increase the body's defenses show that the use of drugs that correct the body's immune status creates favorable conditions for influencing mycobacterium tuberculosis. Conducted research of medical, scientific and patent literature identified various methods of treatment of pulmonary tuberculosis.

So in the work of S.S. Arshinova and B.V. Pinegin. Immunomodulators in the treatment of patients with active pulmonary tuberculosis (Journal of the attending physician, October 2002, No. 10, p. 36-37) describes a method for the treatment of pulmonary tuberculosis, including the inclusion of polyoxidonium in complex chemotherapy.

In the work of E.S. Ovsyankin and V.G.Dobkin. Laser therapy in the complex treatment of pulmonary tuberculosis in adolescents (the journal "Problems of Tuberculosis", 2005, No. 1, pp. 56-60) describes a method for the treatment of pulmonary tuberculosis, which includes the inclusion of laser therapy in complex therapy.

In the work of A.S. Svistunov and B.V. Pinegin. The use of an immunomodulator of lycopid in the complex treatment of pulmonary tuberculosis (the journal "Problems of Tuberculosis", 2002, No. 3, pp.21-25) describes a method of treating tuberculosis using lycopid - a synthetic analogue of the component of the cell wall of all bacteria.

In the work of KK Gaybarov "The possibilities of using reflexology in the complex treatment of patients with pulmonary tuberculosis" (Materials of the seminar / September 12-16, 1988 /, Central Research Institute of Reflexology) describes a method of treating tuberculosis using acupuncture.

By the order of the Ministry of Health of the Russian Federation No. 109 dated 03/21/03, "On the improvement of anti-TB measures in the Russian Federation," standard chemotherapy regimens for tuberculosis patients were defined.

Chemotherapy is the main component of the treatment of tuberculosis and consists in the use of drugs that inhibit the multiplication of mycobacterium tuberculosis or destroy them in the patient's body.

The chemotherapy course consists of 2 phases with different tasks:

1) the intensive care phase is aimed at eliminating the clinical manifestations of the disease, maximizing the impact on the mycobacterium tuberculosis population in order to stop bacterial excretion and prevent the development of drug resistance, reduce infiltrative and destructive changes in organs;

2) the phase of continued therapy is aimed at suppressing the persisting mycobacterial population. It provides a further reduction in inflammatory changes and involution of the tuberculosis process, as well as restoration of the patient’s functional capabilities.

RF Patent No. 2188644, IPC 7 A61K 33/00, protects the "Method for the treatment of pulmonary tuberculosis", which provides for the introduction into the complex therapy of silica in a daily dose of 10-20 mg with a single oral dose of 60-90 days.

RF patent No. 2217137 C2, IPC 7 A61P 31/06, protected "Method for limiting complications and adverse reactions in the treatment of pulmonary tuberculosis", which provides for the inclusion of iron oxide sulfate in therapeutic doses in complex treatment.

RF patent No. 2242222 C1, IPC 7 A61P 31/06 protects the "Method for the treatment of focal and infiltrative pulmonary tuberculosis", which provides for an additional administration of amixin at a dose of 0.125 g for 36 days.

Common disadvantages of standard chemotherapy regimens for patients with pulmonary tuberculosis are lack of effectiveness, the rapid formation of drug resistance of tuberculosis mycobacteria to anti-TB drugs, the presence of pronounced hepatotoxic, neurotoxic and allergic reactions.

The closest in nature and taken as a prototype is the "Method for the treatment of pulmonary tuberculosis", described by the RF Patent No. 2071326, IPC 6 A61K 33/00, 33/18, providing for the additional introduction of homeopathic remedies: hydrastis in combination with calca iodine.

The disadvantage of this method is the weak effect on the timing of the closure of the decay cavities, abacillation and the elimination of side effects from anti-TB drugs.

The purpose of the invention:

increasing the efficiency of treatment of patients with pulmonary tuberculosis by reducing the time of abacillation and closing of decay cavities, preventing the occurrence of adverse reactions.

This goal is achieved by prescribing standard anti-tuberculosis chemotherapy regimens with simultaneous administration of transcutaneous dynamic electroneurostimulation in the areas of the anterior and posterior projection of the lungs, as well as in areas of general stimulation and the simultaneous inclusion of homeopathic remedies in treatment - Apis Mellifica 6, China officalinalis 6, Helidonium mayus 6, Stannum 6, sanguinarium canadensis 6, potassium bichromicum 6, carbo vegetabilis 6 5 grains 3 times a day, regardless of food intake.

The method is as follows.

After examination and diagnosis, the patient is prescribed antibiotic therapy according to standard chemotherapy regimens. At the same time, the complex treatment of pulmonary tuberculosis includes TENS (percutaneous electroneurostimulation), for example, with the Dia-DENS-DT apparatus, in the direct (posterior and anterior) projection of the lungs, the central universal zone and systemic strengthening zones (points 4GI, 5TR, 6MS, 14VG), in a comfortable energy mode, at a frequency of 77 Hz, daily, duration of exposure is 30-35 minutes, on a treatment course of 20 sessions and a combination of homeopathic remedies: apis mellifika 6, quina officinalis 6, helidonium mayus 6, stannum 6, sanguine canadensis 6, Kalium bichrom Ikum 6, carbo vegetabilis 6 5 grains 3 times a day for the entire treatment period.

Percutaneous electroneurostimulation (TENS) is a therapeutic effect of mono- and bipolar current pulses of rectangular and triangular shape, with a duration of 0.05-5 ms, followed by a frequency of 77-150 Hz. The impact on the skin of a certain part of the body with the help of electrical impulses is accompanied by functional changes in organs and tissues belonging to the same metamer as the irritated skin surface. TENS (percutaneous electroneurostimulation) can have the following therapeutic effects: improved microcirculation in organs and tissues; anti-inflammatory; painkiller; increased immunity and resistance to infections; normalization of the ratio and increased formation of certain types of neurohumoral substances (endorphins, cortisone, dopamine, etc.); antispastic effect; decongestant action. The use of TENS (percutaneous electroneurostimulation), the action of which is based on the principle of permanent monitoring of the surface impedance of the skin, through reflex and neurochemical reactions triggers the body's own adaptive mechanisms, which allows to increase the effectiveness of treatment for patients with pulmonary tuberculosis, due to the reduction in the closing time of decay and abacillation cavities.

Homeopathic medicines have the ability to restore impaired homeostasis at the level of regulation of the higher parts of the central nervous system and the immunological state of the body.

Description of exposure zones.

Hardware exposure is carried out in areas of direct projection of the lungs (posterior and anterior), the central universal zone and areas of systemic amplification. The impact in the direct projection of the lungs and the central universal zone is carried out in a constant mode at a comfortable energy level (the patient experiences a slight tingling or vibration) at a frequency of 77 Hz, the apparatus is moved with massage movements (rectilinear or spiral) in the direction of the ribs to the spine, that is, from outside to inside and from the bottom up from the beginning on one side, and then on the other side. The device should be moved over the skin surface at a speed of 1-2 cm per second. The impact in areas of increased systemic effect is carried out in a stable way, in each zone for 1-2 minutes. During the procedure, the patient is sitting, the effect is on dry clean skin.

Direct rear projection of the lungs:

the upper border is at the level of the body of the 1 thoracic vertebra, the lower is horizontally at the level of the 11 thoracic vertebra, the lateral borders are the middle axillary lines on both sides.

Direct anterior projection of the lungs:

the upper border is horizontally at the level of the clavicle, the lower border is the line connecting the front edges of the axillary hollows, the lateral border is the grooves passing between the deltoid and pectoralis major muscle.

Universal zone:

posterior median line, right and left paravertebral lines.

Zones for enhancing systemic action:

a) in the projection of the point 4GI (he gu);

b) in the projection of the 5TR point (wai-guan);

c) in the projection of the point 6MS (nei-guan);

d) in the projection of the point 14VG (da-jui).

Contraindications to carrying out CHENS:

1) the presence of an implanted pacemaker;

2) status epilepticus;

3) neoplasms;

4) individual intolerance to electric current.

Examples of the implementation of the claimed method

1. Patient S., born in 1964, was admitted for inpatient treatment to the pulmonary therapy unit of the State Regional Healthcare Institution “Tuberculosis Dispensary” in Rostov-on-Don for infiltrative tuberculosis of the upper lobe of the right lung in the phase of decay and seeding , Office +.

Pulmonary tuberculosis was detected 6 years ago, and was treated on an outpatient basis. Her health worsened a month ago, cough, shortness of breath, weakness, pain in the liver appeared, fever, and lost weight.

Survey data at admission:

R-gram - in the upper lobe of the right lung, inhomogeneous infiltration of the lung tissue of the focal structure with a decay cavity up to 2 cm in diameter, with an uneven wall and small destruction around, in the upper lobe on the left, inhomogeneous lung tissue infiltration, in S6 of both lung foci of dissemination without clear contours .

Blood test - HB-138 g / l, Er-4.4 × 10 / l, L-6.6 × 10 / l, E-1, P-3, S-75, L-20, M-1, ESR-14 mm.

Sputum culture gave rise to 5 colonies of the office (Mycobacterium tuberculosis).

The patient received treatment according to intensive phase 2 chemotherapy regimens. At the same time, CHENS (percutaneous electroneurostimulation) was added to the treatment with the DiaDENS-DT device according to the method described above, for a treatment course of 20 sessions, daily, in the morning and homeopathic medicines: Apis Mellifica 6, China officinalis 6, Helidonium majus 6, Stannum 6 canadis, sangensvina 6, sangensvina 6, potassium bichromicum 6, carbo vegetabilis 6 5 grains 3 times a day for 3 months.

Control Examination Data:

R-grams and T-grams - on the right, against the background of pneumosclerosis, focus up to 2.5 cm in diameter of medium intensity, homogeneous structure with clear contours and foci of medium intensity around and in S1-2 on the left. In comparison, resorption and compaction of infiltration, closure of the decay cavity, compaction of foci.

Blood test - HB-138 g / l, L-6.6 × 10 / l, E-1, P-5, S-64, L-28, M-2, ESR-14 mm.

Sputum analysis from 06 and 07.03.06 (by the method of bacterioscopy) - CMC (acid-resistant mycobacteria) were not found. Sputum culture gave a negative result.

The patient was discharged for outpatient treatment in satisfactory condition. Spent in the department 109 hospital.

2. Patient G., born in 1955, was admitted to the hospital for treatment in a pulmonary therapy unit of the State Regional Healthcare Institution “Tuberculosis Dispensary” in Rostov-on-Don for disseminated pulmonary tuberculosis in the phase of infiltration and decay, MBT ( Mycobacterium tuberculosis) +. Multiresistance.

He had contact with his son with tuberculosis, his health worsened two months ago, his temperature rose, weakness appeared, coughing, shortness of breath, and lost weight. The patient consulted a doctor and pulmonary tuberculosis was detected during an R-examination.

Survey data at admission:

F-grams and T-grams - in the lungs against the background of pneumosclerosis, predominantly in the upper lobes of both lungs are unevenly distributed polymorphic foci, sometimes confluent, with wide vascular "paths" to the roots.

Blood test - HB-154 g / l, Er-5.0 × 10 / l, L-8.2 × 10 / l, E-0.5, P-4, S-78.5, L-22, M-2, ESR-18 mm.

Mantoux test with 2 TE PPD-L - 20 mm.

Sputum culture gave rise to 5 colonies of MBT (mycobacterium tuberculosis), mycobacteria are resistant to streptomycin and rifampicin.

The patient received treatment according to standard chemotherapy regimens. At the same time, CHENS (percutaneous electroneurostimulation) was added to the treatment with the DiaDENS-DT device according to the method described above, for a treatment course of 20 sessions, daily, in the morning and homeopathic medicines: Apis Mellifica 6, China officinalis 6, Helidonium majus 6, Stannum 6 canadis, sangensvina 6, sangensvina 6, potassium bichromicum 6, carbo vegetabilis 6 5 grains 3 times a day for 3 months.

Control Examination Data:

R-grams and T-grams - in S1,2 of both lungs, scattered foci of different intensity of medium intensity on the background of cellular fibrosis.

Blood test - HB-143 g / l, Er-4.6 × 10 / l, L-8.1 × 10 / l, E-0.5, P-2, S-70.5, L-25, M-2, ESR-3 mm.

Sputum analysis (by bacterioscopy method) - CMC (acid-resistant mycobacteria) not found.

Sputum culture gave a negative result.

The patient was discharged for outpatient treatment in satisfactory condition. Spent in the department 119 hospital.

Under our supervision were 23 people. Of these, 12 people received anti-tuberculosis therapy according to standard chemotherapy regimens (control group). The second group consisted of 11 people (the main group), in this group of patients homeopathic preparations of 5 grains three times a day for 4 months and TENS (percutaneous electroneurostimulation) with the Dia-DENS-D device were included in the complex treatment of pulmonary tuberculosis direct projection of the lungs, the central universal zone and zones of systemic effect enhancement, to the treatment course of 20 sessions, daily, in the morning, once a day. By gender, age, forms of tuberculosis and prevalence of the tuberculosis process, the main and control groups were identical.

The treatment results were evaluated after 4 months.

As a result of the treatment in the main group, an increase in the effectiveness of treatment was revealed: closing the cavities 3.6 times higher, abacillation 1.8 times, the disappearance of clinical symptoms - coughing 4 times, weakness 2 times, sputum production 2,4 times, shortness of breath 2.4 times. The results are shown in tables 1 and 2.

Table 1.
Treatment effectiveness Group / Indicator Cavity closure Abacillation Main 90.9% one hundred% Control 25% 55.5% Table 2.
Clinical symptoms disappear after 4 months Clinical symptoms Main group Control group Coughing up one hundred% 25% The disappearance of weakness one hundred% fifty% Stopping sputum production one hundred% 41.6% The disappearance of shortness of breath one hundred% 41.6%

The proposed method for the treatment of pulmonary tuberculosis can improve the effectiveness of treatment, reduce the time it takes to close the decay and abacillation cavities, accelerate the improvement of the condition of patients and the disappearance of clinical symptoms, as well as reduce the length of the patient’s hospital stay.

Claims (1)

A method of treating pulmonary tuberculosis, including anti-tuberculosis antibiotic chemotherapy and exposure to points, characterized in that the exposure is performed by transdermal electroneurostimulation of frequencies of 77 Hz, lasting 30-35 minutes, daily, for a course of 20 sessions, while affecting 4GI, 5TR, 6MS points , 14VG and to the zones of the posterior median line, the right and left paravertebral lines and the areas of the direct posterior and direct anterior projections of the lungs, and additionally, during the entire treatment period, a combination of the following homeo is introduced pathic drugs: - apis mellifica 6, quina officinalis 6, helidonium mayus 6, stannum 6, sanguinarium canadensis 6, Kalium bichromicum 6, carbo vegetabilis 6 5 grains 3 times a day, regardless of food intake, for the entire treatment period.