RU2428159C1 - Method of treating psoriasis vulgaris - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention relates to medicine, namely to dermatology and physiotherapy, and can be used for treatment of psoriasis vulgaris. Method of treating psoriasis vulgaris is realised by means of speleothgerapy at the background of traditional pathogenetic drug treatment by obtaining 16-18 day course in hospital ward, equipped with salt screens from natural syvinite with area not less than 2.6 m2 each per one bed, with ratio of salt surface area to total area of ward fencing surface 1:12. ^ EFFECT: increased efficiency of therapeutic treatment of psoriasis vulgaris. ^ 4 ex

Description

The invention relates to medicine, namely to dermatology, physiotherapy, and can be used to treat vulgar psoriasis.

There is a method of treating vulgar psoriasis (Khayrulin F.Ya., Virnik V.L., Bukhtiyarov R.S. Patent RU No. 2154458 dated 06/03/1997) on the basis of a comprehensive medication effect on patients and speleotherapy. The method is as follows: the patient is placed in an artificial microclimate chamber, the air environment of which is saturated with an aerosol of sodium chloride with a density of 3-5 mg per cubic meter, with a particle size of 3-8 μm in the range of 75-80%. Prior to the procedure, the aerosol is sprayed and stabilized. The time spent by the patient in the cell is determined by the doctor. At the same time, the patient is prescribed vitamins, adaptogens (for example, Eleutherococcus, Aralia Manchurian, tincture of licorice root, etc.), hepatoprotectors (methionine, essentiale, holosas, lipocaine), phosphodiesterase inhibitors (ATP, cocarboxylase, caffeine, etc.). nicotinic acid, theonicol, etc.).

The disadvantages of this method: the lack of effectiveness of the method, because the residence time of patients in an artificially created environment is not justified and finely dispersed particles of sodium chloride, usually concentrated in the upper parts of the respiratory tract, are used for treatment.

EFFECT: increased efficiency through the use of a more effective natural mineral sylvinite, which saturates the air of the treatment chamber with particles of multicomponent (potassium chloride, sodium chloride, magnesium chloride, etc.) aerosol, as well as light negative air ions, scientifically based treatment regimens.

The specified result is achieved by undergoing a 16-18-day course of treatment in the wards of the hospital, equipped with salt sylvinite screens with an area of at least 2.6 m ² per patient (for example, 1.5 × 1.7 m), with a total area of the ward of at least 12 m ² and its height 3.3 m. The optimal ratio of the salt screen area to the total surface area of the room fencing is 1:12.

The method is as follows: patients undergo treatment for 16-18 days in a room equipped with salt sylvinite screens with an area of at least 2.6 m ² per bed, with a total area of the room of at least 12 m ² and its height of 3.3 m , with the ratio of the area of the salt surface to the total surface area of the fences of the chamber 1:12, placed on the wall near the patient’s bed, along with pathogenetic drug therapy: sodium thiosulfate 30% - 10.0 w / w stream No. 10, Vit B ₁₂ 500 gamma / a / b / h day Vit B ₁ 1.0 n / a c / o day Tavegilum 2.0 / m overnight №10, AEB t 1 capsule 2 r / d, folic acid 1 tab. 3 r / d, 2% salicylic ointment + sinoflan (1: 1) 2 r / d and physiotherapy: UVD according to Potocki in a sub-erythema dose.

Examples of specific performance.

Example 1

Patient A., 27 years old.

Diagnosis: Common vulgar psoriasis, progressive stage, winter form. Sick since 2000. Repeatedly underwent outpatient and inpatient treatment. This exacerbation is about 2 weeks.

Local status: The cutaneous pathological process is island-inflammatory, symmetrical, distributed with localization on the skin of the scalp, upper extremities (extensor surfaces, elbows), lower extremities (extensor surface of the hips, knees). It is represented by papules from lenticular (shoulders, forearms) to drainage plaques (scalp, elbows, knees), silver-white scales on the surface of the elements, hyperemia rim around the periphery. The psoriatic triad is positive. Kebner's symptom is positive. The appendages of the skin are not changed.

OAK before treatment from 03/04/2010: red blood cells 5.5 × 10 ¹² / l, Нb 166 g / l, white blood cells 6.0 × 10 ⁹ / l, eosinophils 9%, stab neutrophils 2%, segmented neutrophils 51%, lymphocytes 30%, monocytes 8%, ESR 6 mm / hour.

LHC before treatment from 03/04/2010: Glucose 4.6, bilirubin 10.70, ACT 36.00, ALT 40.00, alkaline phosphatase 52.00.

Treatment: Sodium thiosulfate 30% - 10.0 w / w stream No. 10, Vit B ₁₂ 500 gamma s / c h / s day, Vit B ₁ 1.0 s / h h / s day, Tavegil 2.0 in / m at night No. 10, Aevit 1 caps 2 r / d, Folic acid 1 tab. 3 r / d, 2% Salicylic ointment + Sinoflan (1: 1) 2 r / d, UVD according to Potocki in a suberythemic dose.

During the hospital stay for 18 days, the patient was in the ward, equipped with salt sylvinite screens measuring 1.5 × 1.7 m, the ratio of the area of the salt surface to the total surface area of the fences of the chamber was 1:12.

OAK after treatment of 03/19/2010: red blood cells 5.5 × 10 ¹² / l, Нb 174 g / l, white blood cells 4.8 × 10 ⁹ / l, eosinophils 2%, stab neutrophils 2%, segmented neutrophils 55%, lymphocytes 32%, monocytes 10%, ESR 3 mm / hour.

LHC after treatment of March 19, 2010: total protein 72.00, bilirubin 9.86, ACT 25.00, ALT 31.00, alkaline phosphatase 55.00.

The results of the treatment. During the first day, the skin pathological process with weakly positive dynamics, the papules turned slightly pale. On day 2-3, blanching of the rim of hyperimia was noted. 3-5 days - a significant reduction in itching, normalization of sleep. On the 7-10th day - the papules acquire a pale pink color, foci of resolution appear in the center of the papules, peeling is insignificant. On days 10-18, papules on the upper limbs and trunk are singular at the skin level, the color of tanned skin, concentric on the lower extremities with foci of pseudoatrophy on the periphery. Discharged in a state of incomplete clinical remission.

DYSH before treatment - 19 points, after treatment - 2 points.

DICI before treatment - 24 points, after treatment - 6 points.

PASI before treatment - 16.9 points, after treatment - 2 points.

Example 2

Patient K., 55 years old.

Diagnosis: Common vulgar psoriasis, progressive stage, winter form. Sick since 1982. She underwent outpatient and inpatient treatment several times. This exacerbation is about 3 weeks.

Local status: The skin pathological process is island-inflammatory, symmetrical, spread with localization on the skin of the upper extremities (extensor surfaces, elbows), lower extremities (extensor surface of the hips, knees). It is represented by papules from lenticular (shoulders, forearms) to drainage plaques (elbows, knees), on the surface of the elements there are silver-white scales along the periphery of the rim of hyperemia. The psoriatic triad is positive. Kebner's symptom is positive. The appendages of the skin are not changed.

OAK before treatment from 02/08/2010: erythrocytes 4.77 × 10 ¹² / L, Нb 142 g / L, white blood cells 9.9 × 10 ⁹ / L, eosinophils 4%, stab neutrophils 1%, segmented neutrophils 55%, lymphocytes 54%, monocytes 6%, ESR 18 mm / hour.

LHC before treatment from 03/04/2010: Glucose 7.5, bilirubin 25.91, total protein 86.10, ACT 85.30, ALT 114.30, alkaline phosphatase 86.00.

Treatment: Sodium thiosulfate 30% - 10.0 w / w stream No. 10, Vit B ₁₂ 500 gamma s / c h / s day, Vit B ₁ 1.0 s / h h / s day, Tavegil 2.0 in / m at night No. 10, Aevit 1 caps 2 r / d, Folic acid 1 tab. 3 r / d, 2% Salicylic ointment + Sinoflan (1: 1) 2 r / d, according to Pototsky UFR in a suberythemic dose.

During the stay in the hospital for 16 days, the patient was in the ward, equipped with salt sylvinite screens measuring 1.5 × 1.7 m, the ratio of the area of the salt surface to the total surface area of the fences of the chamber was 1:12.

OAK after treatment dated 02.16.2010: RBC 4.77 × 10 ¹² / L, Нb 142 g / L, white blood cells 6.4 × 10 ⁹ / L, eosinophils 1%, stab neutrophils 4%, segmented neutrophils 53%, lymphocytes 36%, monocytes 6%, ESR 15 mm / hour.

LHC after treatment from 02.16.2010: total protein 84.00, bilirubin 24.85, ACT 43.20, ALT 52.10, alkaline phosphatase 84.

The results of the treatment. During the first day, the skin pathological process with weakly positive dynamics, the papules turned slightly pale. On day 2-3, blanching of the rim of hyperimia was noted. At 5-6 days - a significant reduction in itching, normalization of sleep. On the 7-10th day - the papules acquire a pale pink color, foci of resolution appear in the center of the papules, peeling is insignificant. On days 10-18, papules on the upper limbs and trunk are singular at the skin level, the color of tanned skin, concentric on the lower extremities with foci of pseudoatrophy on the periphery. Discharged in a state of incomplete clinical remission.

DYSH before treatment - 16 points, after treatment - 2 points.

DICI before treatment - 28 points, after treatment - 12 points.

PASI before treatment - 15.6 points, after treatment - 0.4 points.

Example 3

Patient O., 27 years old.

Diagnosis: Common vulgar psoriasis, progressive stage, winter form.

Sick since 2008. It was treated on an outpatient basis without effect. This exacerbation is about 3 months.

Local status: The skin pathological process is inflammatory, spread with localization on the skin of the scalp, in the sternum. It is represented by plaques from dark pink to brown-pink, silver-white scales on the surface of the elements, and a rim of hyperemia on the periphery. The psoriatic triad is positive. Kebner's symptom is positive. The appendages of the skin are not changed.

OAK before treatment dated January 19, 2010: RBC 5.1 × 10 ¹² / L, Hb 165 g / L, white blood cells 6.4 × 10 ⁹ / L, eosinophils 1%, stab neutrophils 2%, segmented neutrophils 53%, lymphocytes 39%, monocytes 5%, ESR 8 mm / hour.

LHC before treatment of January 19, 2010: bilirubin 29.06, total protein 72.30, ACT 60.30, ALT 50.40, alkaline phosphatase 103.00.

Treatment: Sodium thiosulfate 30% - 10.0 w / w stream No. 10, Vit B ₁₂ 500 gamma s / c h / w day. Vit B ₁ 1.0 s / c h / w day, Tavegil 2.0 v / m at night No. 10, Aevit 1 caps 2 r / d, Folic acid 1 tab. 3 r / d, 2% Salicylic ointment + Sinoflan (1: 1) 2 r / d, UVD according to Potocki in a suberythemic dose.

During his stay in the hospital for 18 days, the patient was in the ward, equipped with salt sylvinite screens measuring 1.5 × 1.7 m, the ratio of the area of the salt surface to the total surface area of the fences of the chamber was 1:12.

OAK after treatment dated 01/27/2010: Red blood cells 5.22 × 10 ¹² / L, Hb 154 g / L, white blood cells 6.7 × 10%, eosinophils 1%, stab neutrophils 2%, segmented neutrophils 61%, lymphocytes 28 %, monocytes 8%, ESR 13 mm / hour.

LHC after treatment from 02/27/2000: total protein 82.50, bilirubin 19.83, ACT 39.20, ALT 41.20, alkaline phosphatase 99.00.

The results of the treatment. During the first day, the skin pathological process with weakly positive dynamics, the papules turned slightly pale. On day 2-3, blanching of the rim of hyperimia was noted. For 3-4 days - a significant reduction in itching, normalization of sleep, papules turn pale. On the 7-10th day - the papules acquire a pale pink color, foci of resolution appear in the center of the papules, peeling is insignificant. On days 10-18, a plaque on the body at the skin level, the color of normal skin in the center of the foci of resolution. Discharged in a state of complete clinical remission.

DYSH before treatment - 18 points, after treatment - 0 points.

DICI before treatment - 4 points, after treatment - 0 points.

PASI before treatment - 4.5 points, after treatment - 0 points.

Example 4

Patient R., 18 years old.

Diagnosis: Common vulgar psoriasis, progressive stage, winter form.

Sick since 1986. She underwent outpatient treatment several times. This exacerbation since December 2009.

Local status: The skin pathological process is island-inflammatory, symmetrical with localization on the skin of the face, neck, trunk, upper extremities (extensor surfaces, elbows), lower extremities (extensor surface of the thighs, knees, extensor surfaces of the legs). It is represented by papules from miliary, lenticular (face, neck, trunk, shoulders, forearms, hips, legs) to plaque plaques (elbows, knees), on the surface of the elements are silver-white scales, on the periphery of the rim of hyperemia. The psoriatic triad is positive. Kebner's symptom is positive. The appendages of the skin are not changed.

OAK before treatment from 01/09/2010: Red blood cells 4.8 × 10 ¹² / L, Нb 144 g / L, white blood cells 6.2 × 10 ⁹ / L, eosinophils 4%, stab neutrophils 3%, segmented neutrophils 58%, lymphocytes 29%, monocytes 6%, ESR 5 mm / hour.

LHC before treatment from January 9, 2010: bilirubin 15.50, total protein 70.40, ACT 41.20, ALT 25.60, alkaline phosphatase 69.00.

Treatment: Sodium thiosulfate 30% - 10.0 w / w stream No. 10, Vit B ₁₂ 500 gamma s / c h / s day, Vit B ₁ 1.0 s / h h / s day, Tavegil 2.0 in / m at night No. 10, Aevit 1 caps 2 r / d, Folic acid 1 tab. 3 r / d, 2% Salicylic ointment + Sinoflan (1: 1) 2 r / d, according to Pototsky UFR in a suberythemic dose.

During the hospital stay for 18 days, the patient was in the ward, equipped with salt sylvinite screens measuring 1.5 × 1.7 m, the ratio of the area of the salt surface to the total surface area of the fences of the chamber was 1:12.

OAK after treatment dated January 28, 2010: RBC 5.1 × 10 ¹² / L, Нb 154 g / L, white blood cells 6.8 × 10%, eosinophils 0%, stab neutrophils 2%, segmented neutrophils 66%, lymphocytes 27 %, monocytes 5%, ESR 2 mm / hour.

LHC after treatment from January 28, 2010: total protein 76.00, bilirubin 13.78, ACT 26.80, ALT 20.60, alkaline phosphatase 58.00.

The results of the treatment. During the first day, the skin pathological process with weakly positive dynamics, the papules turned slightly pale. On day 2-3, blanching of the rim of hyperimia was noted. At 3-6 days - a significant reduction in itching, normalization of sleep. On the 7-10th day - the papules acquire a pale pink color, foci of resolution appear in the center of the papules, peeling is insignificant, on the skin of the face and neck there are single papules at the skin level, no peeling. On days 10-18, papules on the upper limbs and trunk are single at the skin level, pale pink in color, on the lower extremities with foci of pseudoatrophy on the periphery. Discharged in a state of incomplete clinical remission.

DYSH before treatment - 13 points, after treatment - 2 points.

DICI before treatment - 7 points, after treatment - 5 points.

PASI before treatment - 10.5 points, after treatment - 0.4 points.

Thus, due to the creation of a special clinical environment in the wards with salt sylvinite screens, the patients' well-being improved, there was a decrease in anxiety, a decrease in signs of autonomic changes and disorders at an earlier date. The result of all this was a decrease in skin reactivity and an improvement in the body's defenses. All these processes contributed to increasing the effectiveness of the treatment of dermatological patients, accelerating the resolution of the pathological process, and improving skin quality.

Claims (1)

A method of treating vulgar psoriasis with speleotherapy on the background of traditional pathogenetic drug therapy, characterized in that the patient is in a room equipped with natural screens of natural sylvinite, the area of each salt screen is at least 2.6 m ² per bed with a ratio of the surface area of the salt to the total surface area of the fencing chamber is 1:12, the course of treatment is 16-18 days.