RU2460522C2 - Method of treating atopic dermatitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically dermatology, and may be used for treating atopic dermatitis. For this purpose, during the first 2-3 weeks of hospital treatment, 0.9% solution chloride 400 ml, is introduced intravenously every second day No.3-5; there are also prescribed chrolopyramine 0.025 g three times a day for 10 days, valerian infusion 20-30 drops per of 30 minutes after meals 2-4 times a day; it is combined with the administration of the protective-prophylactic drug Kartalin with its thin layer slightly rubbed in an involved area with no film or occlusive dressing on, twice a day. During the following 3-4 weeks of out-patient care, the patients keep taking valerian infusion 20-30 drops per of 30 minutes after meals 2-4 times a day and coating the involved area with the protective-prophylactic drug Kartalin.

EFFECT: method provides higher clinical effectiveness.

2 ex, 1 dwg

Description

The invention relates to medicine, specifically to dermatology, and is intended for the treatment of atopic dermatitis erythematous-squamous with lichenization and lichenoid forms, mild and moderate.

Atopic dermatitis (AD) is a widespread chronic skin disease. According to epidemiological studies in different countries, atopic dermatitis affects from 10 to 20% of the population. The severity of the problem of blood pressure in dermatology is due to the early onset of the disease, the rapid development of chronic forms, leading to a decrease in social adaptability and disability.

The pathogenesis of blood pressure is based on the genetically determined characteristics of the immune response. Among the most significant immunological disorders in AD are the imbalance of Th ₁ and Th ₂ cells, increased mast cell degranulation and altered antigen-presenting activity of Langerhans cells. Specific factors causing exacerbations of blood pressure include food and aeroallergens, as well as allergens from certain bacteria and fungi. Irritants (clothes made of wool and synthetic fabrics, detergents, tobacco smoke), psychoemotional stresses, climatic factors (cold season, abrupt climate change), pollutants are among the non-specific trigger factors that provoke exacerbations of blood pressure.

Treatment of blood pressure includes exposure to the main links in the pathogenesis of allergic inflammation and elimination of the allergen. Recommendations for the treatment of atopic dermatitis should contain the following positions: measures to eliminate the effects of a causally significant allergen (elimination diet and changes in the allergenic environment) and other trigger factors; pharmacotherapy (local and systemic); skin care.

The skin of patients with AD is extremely dry, and this is combined with impaired keratinization processes, which leads to a violation of its barrier function. To normalize the functional state of the skin, it is necessary to maintain hydration of the epidermis and ensure the supply of a sufficient amount of lipids in order to form intercellular compounds between keratinocytes.

The closest to the claimed method analogue (prototype) is the "Method for the treatment of psoriasis" (RF Patent No. 2382638, A61K 31/00). The essence of the method lies in the fact that in the first 3 weeks of inpatient treatment, a complex of drugs is administered, which includes a solution of sodium chloride 0.9% 400 ml intravenously every other day No. 3-5, sodium thiosulfate 30% 10 ml intravenously daily No. 20, pyridoxine 5% 2 ml intramuscularly every other day No. 10, thiamine 6% 2 ml intramuscularly every other day No. 10, cyanocabalamine 500 mg intramuscularly every other day No. 10 and at the same time the protective and prophylactic agent “Kartalin” is applied to the lesion area, in the next 2-3 weeks outpatient treatment patients continued ayut applied protective and preventive agent "Kartalin" on region lesions gently rubbing a thin layer without covering film and occlusive bandage, 2 times a day.

The disadvantages of this method are:

- lack of indications for use in atopic dermatitis;

- the lack of an objective assessment of positive clinical and morphological changes in the skin in patients with atopic dermatitis using the SCORAD index and Hanifin scoring system (Hanifin J.M., 1989);

- lack of data on the use in combination with other means in a hospital setting for patients with atopic dermatitis.

The problem to which the invention is directed is to increase the effectiveness of the treatment of atopic dermatitis.

The problem is solved by using the proposed method for the treatment of atopic dermatitis. The essence of the method lies in the fact that patients are prescribed a complex of medications and a protective and preventive agent “Kartalin” is applied to the lesion site with a thin layer, lightly rubbing, without covering with a film and an occlusive dressing, 2 times a day. The novelty of the proposed method lies in the fact that in the first 2-3 weeks of inpatient treatment, a complex of drugs is administered, which includes a solution of sodium chloride 0.9% 400 ml intravenously every other day No. 3-5, chloropyramine 0.025 g 3 times a day for 10 days, tincture of valerian 20-30 drops inside 30 minutes after eating 2-4 times a day and at the same time use the protective and prophylactic agent "Kartalin" on the affected area, in the next 3-4 weeks of outpatient treatment, patients continue to take tincture of valerian 20-30 drops inside 30 minutes after eating 2-4 times a day and apply the protective and prophylactic agent "Kartalin" on the affected area.

To study the clinical effectiveness of the invention, 46 patients with atopic dermatitis were examined and treated in the clinic of skin diseases of GOU VPO Roszdrav SibGMU. The criteria for inclusion in the groups were: clinically confirmed diagnosis; informed consent of patients; adolescence and adulthood; clinical forms lichenoid and squamous with lichenification. The exclusion criteria from the studied groups were: diffuse form of blood pressure; severe course; infant and child age; individual intolerance to the components of the ointment; complications in the form of pyoderma.

All patients were divided into two groups. The first group (n = 26) consisted of patients who received treatment by the proposed method. The second group (n = 20) consisted of patients who received treatment according to the prototype method. To determine the severity of the course of atopic dermatitis, the SCORAD index was used. At the beginning of the course of therapy, the SCORAD index was equal: in the first group - 59 points, in the second group - 60 points. After the treatment, he was equal in group 1 - 14 points, in the second group - 18 points (figure).

To assess the degree of response to therapy by treated and untreated areas before and after treatment, the Hanifin scoring system was used (Hanifin J.M., 1989). When assessing the severity of atopic dermatitis (pruritus, erythema, infiltration) in both groups, the scores were the same and amounted to 6 points. After a two-week treatment period, this index in both groups decreased to 1.5 points.

Based on the foregoing, the following conclusions can be drawn:

1. The proposed method can be used to treat mild to moderate severity of atopic dermatitis with squamous manifestations and lichenification in stationary, outpatient and outpatient settings;

2. The proposed method is effective in the treatment of atopic dermatitis (a decrease in the SCORAD index by 76% and Hanifin index by 75%);

3. The proposed method can be recommended for the treatment of patients with atopic dermatitis during remission.

For the first time, a method for treating atopic dermatitis has been proposed, which consists in the complex administration of drugs and the application of a therapeutic ointment to the lesion site, using the protective and prophylactic Kartalin agent. The authors clinically selected the optimal treatment time for atopic dermatitis inpatiently and then on an outpatient basis. In addition, medicines were selected, their duration of administration and dose, as well as optimal conditions and terms for applying the protective and prophylactic drug Kartalin were selected.

Studies on patent and scientific and technical sources of information showed that the proposed method is unknown and meets the criteria of "novelty" and "inventive step".

The invention is illustrated by the following examples of specific performance.

Example 1. Patient K., 18 years old (case history No. 1641), was admitted to the clinic of skin diseases of Siberian State Medical University with a diagnosis of mild atopic dermatitis (SCORAD index _{at admission} = 26 points).

During treatment, complex therapy was used for 2 weeks with drugs, which were used as a solution of sodium chloride 0.9% 400 ml intravenously every other day No. 3, chloropyramine 0.025 g 3 times a day for 10 days, tincture of valerian 20 drops inside 30 minutes after eating 2 times a day and local treatment in the form of a daily two-fold application of Kartalin on the affected areas for 3 weeks. Then, for 3 weeks, on an outpatient basis, the patient received tincture of valerian inside, 20 drops inside 30 minutes after eating 2 times a day and twice daily applied Kartalin to the problem areas.

After treatment, the SCORAD index was 16 points. Thus, after the treatment, the index decreased by 38%.

Example 2. Patient B., 12 years old (case history No. 976), was admitted to the clinic of skin diseases of Siberian State Medical University with a diagnosis of atopic dermatitis of moderate severity (SCORAD _{upon admission} = 35 points).

During treatment, complex therapy was used for 3 weeks with drugs, which were used as a solution of sodium chloride 0.9% 400 ml intravenously every other day No. 5, chloropyramine 0.025 g 3 times a day for 10 days, tincture of valerian 30 drops inside 30 minutes after eating 4 times a day and local treatment in the form of a daily two-time application of Kartalin funds to problem areas for 3 weeks. Then, for 4 weeks on an outpatient basis, the patient received tincture of valerian 30 drops 30 minutes after eating 4 times a day and twice a day applied Kartalin to the problem areas.

After treatment, the SCORAD index was 21.3 points. Thus, after the treatment, the index decreased by 39.2%.

The proposed method for the treatment of atopic dermatitis is more effective compared to the known method.

Claims (1)

A method of treating atopic dermatitis, which consists in prescribing a complex of drugs to patients and applying the protective substance “Kartalin” to the lesion site slightly rubbing it without covering it with a film and occlusive dressing, 2 times a day, characterized in that in the first 2-3 weeks of inpatient treatment, a complex of drugs is administered, which includes a solution of sodium chloride 0.9% 400 ml intravenously every other day No. 3-5, chloropyramine 0.025 g 3 times a day for 10 days, tincture of valerian 20-30 cape inside 30 minutes after eating 2-4 times a day and at the same time use the protective and prophylactic agent Kartalin on the affected area, in the next 3-4 weeks outpatient treatment, patients continue to take tincture of valerian 20-30 drops inside 30 minutes after food 2-4 times a day and apply the protective and prophylactic agent "Kartalin" on the affected area.

Images