RU2412684C2 - Method of treating patients with psoriasis exudativa - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely - to dermatology. A method involves administration of a sorption corrective agent presented by Lamifaren gel. Gel is taken by 50-150 g 3 times a day 30 minutes before meals. Low-mineralised nitrogenous siliceous baths of radon concentration 4-6 nCu/l at temperature 37-38°C are taken. Then wet skin of the involved regions is coated with Lamifaren gel 3-6 times a day to complete drying of gel. The therapeutic course is 10-14 baths. After termination of a course of baths, Lamifaren gel is consumed internally and applied externally to complete relief of a skin process.

EFFECT: method reduces a number of allergic reactions due to decreased drug administration and prolongs remission.

3 ex, 1 tbl

Description

The invention relates to medicine, namely to dermatology, and can be used to treat patients with exudative psoriasis.

There are various ways of treating psoriasis: to remove circulating immune complexes, methods of sorption therapy are used - hemosorption, enterosorption, and, for example, wood activated charcoal, hemodesis, polyphepan, cholestyramine are prescribed. However, only sorption therapy cannot solve all the problems in the treatment of psoriasis, since there are immunological disorders that lead to circulating immune complexes (CICs) in "fixed" immune deposits with subsequent inflammatory processes in the "target organ" - the skin of patients.

Psoriasis is an erythematous-squamous dermatosis of a multifactorial nature with a dominant value in its development of genetic factors. It is characterized by hyperproliferation of epidermal cells, disruption of the keratinization process, inflammatory reaction in the dermis, changes in various organs and systems (Mordovtsev V.N., Butov Yu.S., Mordovtseva V.V. “Psoriasis” // Clinical dermatovenereology: 2 tons. / Under the editorship of Yu.K. Skripkin, Yu.S. Butova. - M.: GEOTAR-Media, 2009.- T.II. P. 213).

Exudative psoriasis differs from ordinary psoriasis in that a significant exudation predominates in the clinical picture, as a result of which a characteristic silvery shade of scales disappears on the surface of the papules, lamellar crusts of a yellowish color form. When removing them from papular elements, a weeping, bleeding surface is exposed.

The closest analogue - the prototype - is sorption-corrective therapy with the appointment of sorbents - hemodes for intravenous administration in a progressive stage, enterosorbent - cholestyramine, dermosorbent - 5% cholestyramine ointment and immunomodulator - thymogen (Nekipelova A.V. “A complex method for the treatment of patients with psoriasis, suffering disorders of lipid metabolism "Abstract. Diss ... candidate of medical sciences M., 2000, 16 pp.).

The disadvantages of the prototype method are:

- a large number of medications taken;

- allergic reactions as a result of a large number of drugs;

- side effects from prolonged use of drugs.

Object of the invention: to propose a method for increasing the effectiveness of sorption-corrective therapy.

The technical result is an increase in the relapse period.

The technical result is achieved by appointing once a day a bath from a source of thermal mineral water, nitrogen-siliceous, slightly mineralized with a radon content of 4-6 nCi / l at t - 37-38 ° C for 10-20 minutes No. 10-14 on course (Tumninsky spring of mineral water from 01.20.1990 g / From the project of the District and sanitary protection zones, 1989 /; / License for the right to use subsoil from 08.10.05 KhAB series, number 01875, type of license МЭ /; / Result of analysis of water well No. 8 - protocol No. 72 of February 8, 07; natural water analysis well No. 9 - protocol No. 73 of February 8, 2007 /); Lamifaren gel is prescribed as an enterosorbent and immunotropic drug, 50-150 g 3 times a day, 30 minutes before meals for 10-14 days, and Lamifaren gel 3-6 times a day is applied externally to affected wet skin , Lamifaren gel is not washed off until the next bath. After the end of the course of the spa treatment, they continue to use the Lamifaren gel inside and out until the skin process is completely resolved on an outpatient basis.

The treatment was carried out by 40 patients with psoriasis and 40 patients made up the comparison group, which did not receive Lamifaren and mineral water baths, but received treatment according to the prototype. Remote observations indicate an increase in the relapse period.

The advantages of the proposed method:

- a decrease in the number of medications taken, since Lamifaren gel not only removes “fixed immune complexes” from the lesion sites, but also regulates microcirculation, the immune system, and corrects lipid and carbohydrate metabolism;

- a decrease in the number of allergic reactions due to a decrease in the number of medications taken, as well as the above reasons;

- “Lamifaren” gel dries quickly, absorbed into the skin, and does not stain clothes, and its surpluses themselves crumble when lightly shaken from the skin;

- “Lamifaren” gel is not addictive during prolonged use (Sanitary and epidemiological conclusion No. 77.99.13.008. D. 000383.01.09 from 01/26/2009; Sanitary and epidemiological conclusion No. 77.99.19.004. T. 000468.03.09 from 03.03. 2009; State registration certificate No. 77.99.4.U.1788.3.09 of 03.03.2009);

- weakly mineralized nitrogen-siliceous radon waters are well tolerated by patients with somatic diseases - peptic ulcer, gastritis, osteochondrosis, arthritis (Zavgorudko TI, Zavgorudko VN “Sanatorium-resort use of nitrogen-siliceous thermal waters of the Far East” // Khabarovsk: Publishing House of the Dagestan State Medical University, 1999. - 256 pp .; Zavgorudko V.N., Zavgorodko G.V., Zavgorodko T.I. “Tumninsky Mineral Spring” // Khabarovsk: Publishing House of the Dagestan State Medical University, 1999. - 138 p. .);

- the treatment provides a sedative, sorption, antioxidant and immunotropic effect, as the Lamifaren gel contains macro- and micro-elements, as well as polysaccharides.

Example 1

B. K. 56 years. Sick psoriasis for 20 years. Recently, exacerbations arose 2-3 times a year from various causes. He received treatment in a hospital. Upon admission to the sanatorium, the patient revealed pronounced changes in the skin status. The skin process was widespread and occupied the scalp, trunk, limbs. There was a large number of nummular psoriatic papules that formed lamellar crusts of a yellowish color, upon removal of which a moist, bleeding surface was exposed from the surface of the papules. The treatment in the inpatient and outpatient settings according to the prototype did not give the desired effect, and therefore was sent to sanatorium treatment. A course of sorption-corrective therapy was carried out: a bath with mineral water from the Tumny spring of the Khabarovsk Territory — thermal, nitrogen-siliceous, slightly mineralized, with a radon content of 4-6 nCi / l at t - 37-38 ° C for 20 minutes a day №14. “Lamifaren” gel was prescribed as an enterosorbent and immunotropic drug, daily 2-3 times a day 30 minutes before meals, 14 days half a day 100 g. “Lamifaren” gel, as a dermosorbent, 3-6 times a day, then the treatment continued at home until the resolution of the skin process. The remission period was 14 months.

Example 2

B. A. 28 years. Suffers from psoriasis for 15 years. Exacerbations of the skin process occur at any time of the year after provoking stressful factors, as well as in cold periods of the year. The patient constantly received treatment in home, outpatient and inpatient settings with a short-term effect. The remaining manifestations of dermatosis were the "basis" of new relapses when exposed to adverse factors. The patient was troubled by severe itching. Objectively: the skin process was widespread and occupied the scalp, trunk, limbs. There were a large number of lenticular and nummular psoriatic papules forming yellowish crusts, upon removal of which a moist, bleeding surface was exposed from the surface of the papules. A course of sorption-corrective therapy was carried out: a bath with mineral water of the Tumny spring - thermal, nitrogen-siliceous, slightly mineralized, with a radon content of 4-6 nCi / l at t - 37-38 ° C for 20 minutes a day №14. She took Lamifaren gel as an enterosorbent and immunotropic drug, daily 2-3 times a day, 150 g 30 minutes before meals, 14 days. She applied Lamifaren gel externally to the affected moist skin 3-6 times a day, which was not washed off until the next bath. Then the treatment was continued at home until the skin process was completely resolved without hormonal ointments. The remission period was 24 months.

Example 3

B. O. 12 years old. Sick of psoriasis for 5 years. Exacerbations are annual in the winter. A history of frequent sore throats. Objectively: the skin process was widespread and occupied the scalp, trunk, limbs. There was a large number of lenticular and nummular psoriatic papules forming yellowish plate crusts, upon removal of which a wet, bleeding surface was exposed from the surface of the papules. The patient was prescribed a bath with mineral water from the source of Tumnin - thermal, nitrogen-siliceous, slightly mineralized, with a radon content of 4-6 nCi / l at t - 37-38 ° C for 20 minutes once a day No. 14. Assigned "Lamifaren" gel as an enterosorbent and immunotropic drug, daily 50 g 3 times a day 30 minutes before meals, 14 days. Externally - Lamifaren gel as a dermosorbent 3-6 times a day, which was not washed off until the next bath. Then, treatment continued at home until the skin process was completely resolved. In order to prevent relapse, the repeated course was continued on an outpatient basis for 3 months with external use of Lamifaren gel, which extended the remission to 13 months.

The duration of the inter-relapse period in patients with exudative psoriasis, depending on the method of treatment

Table n = 80 n = 80 Psoriasis "Lamifaren" (remission period) Psoriasis Prototype (remission period) 40 25 24 months and more eleven 12 months four 3 months 40 12 9 months 21 6 months 7 3 months

Claims (1)

A method of treating patients with exudative psoriasis, including sorption-corrective agents, characterized in that as a sorption-corrective agent use Lamifaren gel orally 50-150 g 3 times a day 30 minutes before meals, and also externally on affected skin after taking a bath with nitrogen-siliceous, radon, slightly mineralized water with a radon content of 4-6 nKu / l, at t - 37-38 ° C with a course of 10-14 baths, followed by application of Lamifaren gel to the moist skin on affected areas 3- 6 times a day until the gel is completely dry; after the course of the baths, continue to use Lamifaren gel inside and out until the skin process is completely resolved.