RU2477118C2 - Method of treating atopic dermatitis with impairment of main links of immunity - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to dermatology and venerology and can be used for treatment of atopic dermatitis with impairment of main links of immunity. For this purpose foam licorice baths with thick extract of licorice root (TELR) are made and foamy intragastric cocktail is introduced. For preparation of cocktail TELR is used as disperse phase, with nitrous oxide being used as disperse medium. For preparation of foam-licorice bath 50.0-150.0 ml of TELR are used. Foam formation is carried out before patient submergence under air pressure 300-400 kPa for 3-5 minutes, with its further reduction to 100-150 kPa and its preservation during entire procedure for 10 minutes. Patient is placed in bathtub in such a way that their body is in formed foam. Foamy intragastric cocktail is introduced in dose 200-250 ml 15 minutes before meal one time per day.

EFFECT: method implementation ensures differentiated highly effective immunomodelling impact on main links of immunity, as well as expressed regress of dermatosis manifestations.

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Description

The invention relates to medicine, namely to dermatovenerology.

A known method of conducting a foam-licorice bath, using a thick extract of licorice root (HEX), in an amount of from 50 to 150 ml with a content of glycyrrhizic acid from 12% to 14%, while air pressure of 300-400 kPa is used to form the foam prior to immersion of the patient in the bath, followed by its reduction to 100-150 kPa and preservation throughout the procedure after the patient is immersed in the bath, while in the presence of secondary immunodeficiency in patients with allergic diseases, the duration of the procedure is up to 10 minutes, and with pathology due to secondary immunodeficiency without allergic diseases - 10-15 minutes [1].

However, the use of a foam-licorice bath with HEX is limited for patients with atopic dermatitis (AD) with impaired basic immunity (phagocytic, T- and B-immunity) [2, 3, 4, 5].

The purpose of this solution is to provide a differentiated, highly effective immunomodulatory effect on the basic immunity in patients with blood pressure.

This goal is achieved by holding a foam-licorice bath and an additional intake of a foamy intragastric cocktail with a thick extract of licorice root and nitrous oxide.

The method is as follows:

Stage 1. Preparation of a concentrated solution of GEX.

1.1. Depending on the glycyrrhizic acid content, according to the certificate of conformity, measure 50.0-150.0 ml of HEX with a volumetric flask.

1.2. Dissolve a measured amount of HEX with stirring with a wooden spatula in one liter of water for 5-10 minutes until a homogeneous solution of dark brown color is obtained.

Stage 2. Installation of a device for forming a foam bath.

2.1. At the bottom of the stationary tank (treatment bath) with a capacity of 200 l, a metal grate is laid for sparging the solution in the bath, consisting of a system of thin tubes. On the entire surface of the tubes there are holes with a diameter of 0.5 to 2 mm, which has a significant effect on the dispersion of the foam system. To obtain monodisperse stable foam, the diameter of the holes in the tubes should be less than 2 mm.

2.2. The grate for sparging the solution in the bath is connected via a fitting to a flexible hose from the compressor, which is introduced into the bath through the hole for draining the waste device or through the upper edge of the bath and is fixed with a sleeve to the edge of the bath or wall.

2.3. On top of the metal grate at a height of 10 cm from the bottom of the bath, a wooden (plastic) grate is placed, which excludes contact of the patient's body with the grating for sparging.

Stage 3. Preparation of the composition of the foam bath.

3.1. In the bath prepared for the holiday procedure, 40-50 liters of tap water are supplied, reaching the level of the lower surface of the wooden grate.

3.2. A concentrated concentrated HECS solution is mixed in parts with water until a homogeneous dark brown liquid is obtained.

3.3. The compressor is turned on, a solution of a thick extract of licorice root is sparged with a pressure of 300-400 kPa for 3-5 minutes until the foam is completely filled in the bath. Without shutting down the compressor, the patient is placed on a wooden grill so that his body is exclusively in the resulting foam. Reduce the air pressure on the pressure gauge of a running compressor to 100-150 kPa and keep this indicator throughout the procedure. Additionally, a foamy cocktail with nitrous oxide is prescribed. For its formation, a glass vessel is used from the Otsos active aspiration apparatus (Micropribor JSC, Moscow, Khimavtomatika Design Bureau, Voronezh; according to the State Register of Medical Products - No. 78 / 626-3), AZ1 cocktail (Health apparatus) without an oxygen cylinder) or analogues: Cyprid, OxyM, Penguin, Fantasy 1000 and others, which are used together with a cylinder for nitrous oxide B3-2-2UL PPTD.5887.160TU ”(GOST 949).

The technique for the formation of foam with nitrous oxide is that 400.0-800.0 ml of a 1.5% (6-12 g) GEX solution are poured into a cocktail vessel, then through a rubber stopper (nylon, metal cap), which ensures tightness, two 25 cm long stainless steel tubes are introduced. One of them with a bubbler in the end part is lowered into the solution almost to the bottom, and the free part is connected to a carbon dioxide cylinder. The second tube serving for foaming is not immersed in the solution. The valve on the cylinder reducer is turned off, regulating the gas supply by the pressure gauge, at a pressure of 120 kPa to bubble it through the liquid and form a stable finely dispersed foam mass. At one time use 200.0-250.0 ml of foam, depending on the age of the patient, 15-20 minutes before meals once a day. The course of treatment is 10 procedures.

To evaluate the effectiveness, the complex we developed was studied in 29 patients with blood pressure. The main group consisted of 19 patients, the control group - 10. Itching was insignificant in intensity, mainly at night, 2 (10.5 ± 1%) of the observed main and 2 (20.0 ± 2%) people of the control group, expressed paroxysmal in any the time of day is 5 (26.3 ± 2%) and 4 (40.0 ± 4%), respectively, constant, intensive before the biopsy - 3 (15.8 ± 1%) and 4 (40.0 ± 4%). Slight lichenification was observed in 6 (31.6 ± 3%) and 5 (50.0 ± 5%) patients, moderate - in 2 (10.5 ± 1%) and 3 (30.0 ± 3%), pronounced - in 2 (10.5 ± 1%) and 2 (20.0 ± 2%); abundant bran-like or small-lamellar peeling occurred in 4 (21.0 ± 2%) and 4 (40.0 ± 4%) of the studied, scanty in 3 (15.8 ± 1%) and 4 (40, 0 ± 4%), and was absent in 3 (15.8 ± 1%) and 2 (20.0 ± 2%).

The number of eosinophils was increased to 6 ± 2% in both groups. Phagocytic indices were significantly reduced. So, the FA was 11.1 ± 1.2% and 11.4 ± 0.8%, the PHI was 0.26 ± 0.03 and 0.28 ± 0.06, the AF was 1.53 ± 0.24, and 1.56 ± 0.13. Similar changes were recorded with data characterizing the state of the T-link of immunity: T-lymph. rel. were at the level of 45.6 ± 3.1% and 43.2 ± 2.4%, T _h - 30.2 ± 1.04% and 31.1 ± 1.2%, T _s - 16.0 ± 1 , 1% and 16.7 ± 1.8%. Along with this, it was found that the amount of B-lymph. rel. exceeded normal values, respectively, 19.8 ± 1.1% and 19.7 ± 1.2%. The concentration of IgM immunoglobulins (1.2 ± 0.08 and 1.3 ± 0.05 g / l) and IgE (249.4 ± 18.4 and 252.9 ± 22.3 IU / ml) was increased while IgA - 1.1 ± 0.09 and 1.2 ± 0.1 g / l and IgG - 12.1 ± 1.3 and 12.3 ± 2.6 g / l were within normal limits.

When staging allergy scarification samples, sharply positive (++++, +++) reactions with household, epidermal, pollen, food allergens (library dust, sheep’s wool, timothy, milk) were recorded in 3 (15.8 ± 1%) and in 3 (30.0 ± 3%), positive and weakly positive (++, +) in 5 (26.3 ± 2%) and 4 (40.0 ± 4%), and negative were found in 2 (10.5 ± 1%) and 3 (30.0 ± 3%) people. During intradermal allergic tests, sharply positive (++++, +++) reactions with bacterial allergens were determined in 1 (5.3 ± 1%) and 1 (10.0 ± 1%), positive and slightly positive (+ +, +) - in 4 (21.0 ± 2%) and 5 (50.0 ± 5%), and negative were detected in 5 (26.3 ± 2%) and 4 (40.0%) patients . Moreover, sensitization to E. coli was most often detected, respectively 6 (31.6 ± 3%) and 6 (60.0 ± 6%).

Observed in both groups were appointed foam baths with a thick extract of licorice root, foam temperature of 35 ° C, lasting 10 minutes, in the amount of 10 procedures. Patients of the main group additionally received 10 foam intragastric cocktails with nitrous oxide (200.0-250.0 ml 15 minutes before meals 1 time per day).

Under the influence of this therapy, a positive dynamics of the clinical picture of the disease was established: the intensity of itching was reduced, lichenification, infiltration, and peeling in the lesions were reduced. An excellent result was recorded in 11 (57.9 ± 5%) people of the main and in 3 (30.0 ± 2%) patients in the control group (P <0.001). Although the number of eosinophils decreased to 4 ± 1% in both groups, this difference remained unreliable (P> 0.05). Phagocytic indices increased, respectively, FA to 26.1 ± 0.2% (P <0.001) in the main and 13.2 ± 0.7% to the control group (P> 0.05), PHI - 0.5 ± 0.06 (P <0.001) and 0.3 ± 0.02 (P> 0.05), PS - 2.2 ± 0.3 (P <0.001) and 1.7 ± 0.2 (P> 0.05) . A similar trend was noted with data characterizing the T-link of immunity. So, the amount of T-lymph. rel. it became 55.6 ± 1.6 (P <0.01) and 48.1 ± 1.2% (P> 0.05), T _h - 45.2 ± 1.1% (P <0.001) and 32 , 0 ± 1.2 (P> 0.05), T _s - 19.9 ± 1.2% (P <0.05) and 19.1 ± 1.1% (P> 0.05). The amount of B-lymph. rel. in the main group it reached normal values - 11.8 ± 1.1% (P <0.001), while in the control group it remained almost unchanged - 15.5 ± 1.2% (P> 0.05). The concentration of IgM decreased to a normal level of 0.81 ± 0.08 (P <0.001) in the main group and remained at a higher level - in the control (1.2 ± 0.05 g / l, P> 0.05). A similar situation was recorded with IgE - 109.4 ± 12.4 (P <0.001) and 192.9 ± 20.3 (P> 0.05) IU / ml. Immunoglobulins of IgA classes - 1.2 ± 0.09 and 1.1 ± 0.1 g / l, as well as IgG - 12.3 ± 1.3 and 12.7 ± 2.6 g / l remained at the same level ( P> 0.05).

When staging allergy scarification samples after treatment, sharply positive (++++, +++) reactions with household, epidermal, pollen, food allergens were not found. Positive and slightly positive (++, +) tests were determined in 2 (10.5 ± 1%) (P <0.001) of the main group and in 4 (40.0 ± 4%) people (P <0.001), who were prescribed exclusively foam baths with hex. During repeated intradermal allergic tests, sharply positive (++++, +++) reactions with bacterial allergens were also not recorded. Positive and slightly positive (++, +) were found in 2 (10.5 ± 1%) patients (P <0.001) who received a cocktail with nitrous oxide and in 3 (15.8 ± 1%) of the observed control group (P < 0.001). Moreover, sensitization to E. coli persisted in 4 (21.0 ± 2%) and 5 (50.0 ± 5%) people (P <0.001).

Thus, the inclusion in the treatment complex of patients with AD, along with foam-licorice baths, an intragastric cocktail with a thick extract of licorice root as a dispersed phase and nitrous oxide, a dispersion medium, provides effective targeted immunomodulation of all the main immunity units (phagocytic. T- and B links), which leads to a decrease in sensitization with household, epidermal, pollen, food and bacterial allergens, as well as regression of dermatosis.

Information sources

1. Starokozhko, L.E., Therapeutic bath / L.E. Starokozhko, I.A. Muravyev, I.Yu. Mikhalev, Z.D. Khadzhieva // Patent for invention, 1998. - No. 1759426. - 4 p.

2. Starokozhko, L.E. Foam-licorice bath / L.E. Starokozhko // Decision on the grant of a patent for an invention according to application No. 201004806/14 (006770 of 02/11/10). - 5 sec.

3. Starokozhko, L.E. Immunomodulator / L.E. Starokozhko, G.S. Guteneva, I.Yu. Korobko et al. // Patent for invention, 2003. - No. 2202358. - 6 p.

4. Starokozhko, L.E. The creation of highly effective foam delivery systems with licorice root preparations is a decisive step in 21st century medicine. Stavropol, 2000 .-- 147 p.

5. Starokozhko, L.E. Directional modulation of the pharmacological properties of licorice root preparations of the gas component of the foam intragastric cocktail is a paradigm for a differentiated approach to the rehabilitation treatment of patients with common pathology. Stavropol, 2003 .-- 174 p.

Claims (1)

A method of treating atopic dermatitis with a violation of the basic components of the immune system, including a foam-licorice bath with a thick extract of licorice root (GEX), the introduction of an intragastric cocktail, characterized in that 50.0-150.0 ml of GEX is used for a foam-licorice bath the formation of foam is carried out before immersion of the patient at an air pressure of 300-400 kPa for 3-5 minutes, followed by its reduction to 100-150 kPa and keeping throughout the procedure for 10 minutes, when the patient is in the bath so that his body nah dilos in forming the foam, and the foam intragastric administration is performed cocktail 200-250 ml for 15 minutes before eating once a day, while as the dispersed phase exc is used, and as a dispersion medium - nitrous oxide.