UA35450A - Method for preventing recurrence of ulcer - Google Patents

Abstract

The invention relates to the medicine, in particular to the gastroenterology and is intended for preventing the recurrence of the gastric or duodenal peptic ulcers associated with infection. The method provides for the use of the proton pump inhibitors. In addition, Amoxicillin at a dose of 1000 mg and Clarytromycin at a dose of 500 mg twice a day are used for seven days.

Description

The claimed invention relates to medicine, more precisely to gastroenterology, and is intended to prevent recurrences of peptic ulcers of the stomach or duodenum associated with N.ruogi infection.

Gastric ulcer disease or duodenal ulcer is one of the most common diseases of the gastrointestinal tract, which affects from 5 to 2095 of the entire adult population in different countries of the world.

The most important features of this disease are the propensity for constant recurrence and the occurrence of complications.

A large number (more than 500 names) of medicines and methods of treatment of peptic ulcer disease are known, which, although they contribute to the healing of peptic ulcers, but when prescribed traditionally do not prevent the occurrence of relapses and numerous complications.

Existing traditional approaches to treatment involve the appointment of various antisecretory drugs (blockers

nag-histamine receptors, proton pump inhibitors) or locally acting (colloidal bismuth, sucralfate) drugs for 3-4 weeks (11. However, even after healing of ulcers, approximately 60,905 patients have relapses during the first 6-12 months, which sharply increases the risk of life-threatening complications, requires repeated courses of treatment, often inpatient, sharply increases the cost of treatment and reduces the quality of life of patients (1,241.

Thus, traditional treatment, unfortunately, is not only not aimed at curing the patient, but also often contributes to the invalidation of patients.

There are several means of preventing the recurrence of ulcer disease. The closest analogue (prototype) of the method of prevention of peptic ulcer relapses, which is claimed, is the method of long-term maintenance anti-relapse therapy in various modifications |IZ,5). Thus, continuous maintenance therapy involves long-term continuous intake of the proton pump inhibitor omeprazole 10-20 mg per night for 10-12 months. The so-called maintenance anti-relapse therapy on weekends involves taking omeprazole 10-20 mg at night on Fridays, Saturdays and Sundays also for 1 year. But stable clinical and endoscopic remission with such a means of prevention is observed only in 80-8595 patients, it requires long-term continuous medication, which in 60-7095 patients leads to the appearance of unwanted side effects (1.21.

The task, which is solved by the claimed method, consists in the eradication (destruction) of the main factor in the occurrence and recurrence of peptic ulcer disease - the infection of N. ruiogia. The technical result achieved will be a significant reduction in the frequency of peptic ulcer recurrences (at least 10 times).

The task is solved by the well-known traditional method of treating peptic ulcer with proton pump inhibitors, according to the invention. as an antirelapse agent, 2 antihelicobacter drugs are additionally prescribed - amoxicillin 1000 mg and clarithromycin 500 mg 2 times a day for 7 days.

The signs that distinguish the method of prevention of peptic ulcer relapses, which is claimed, from the prototype method, are the short duration (7 days instead of several months) of the treatment. The synergistic effect of the proton pump inhibitor and 2 antichelicobacter antibiotics leads to the destruction of N. ruioigi infection, healing of the ulcer, restoration of the normal morphological picture of the mucous membrane and, thus, prevents the recurrence of ulcer disease.

According to the literature, such an approach to the prevention of peptic ulcer recurrence is still unknown.

The claimed method is carried out as follows: on the background of enhanced therapy with a proton pump inhibitor (omeprazole 20 mg. pantoprazole 40 mg 2 times a day), amoxicillin 1000 mg 2 times a day and clarithromycin 2 times a day are prescribed for 7 days, after which monotherapy with a proton pump inhibitor is continued for another 10 days in usual doses (omeprazop 20 mg, pantoprazole 40 mg 71 times a day). The control of the effectiveness of treatment is carried out on the basis of the eradication of the infection of H N. ruioia. with the help of "ZS-urea breath test", and later during the year - only with the help of clinical observation.

Specific examples of application.

Example Me1.

Patient C (medical history Me971) with the diagnosis: Ulcer disease: constantly recurring Helicobacter peptic ulcer of the bulb of the duodenum, severe course, exacerbation phase. The diagnosis was confirmed endoscopically and histologically. In the anamnesis of this patient, during the last 5 years, exacerbations were observed 3-4 times a year, for which he was treated as an inpatient. The last exacerbation was manifested by bleeding, which was treated conservatively. During the last 6 months, he has been taking maintenance doses of omeprazole (10 mg at night) constantly on weekends, but despite this, he has relapsed again. The prescribed treatment included a 7-day intake of pantoprazole 40 mg, amoxicillin 1000 mg IV clarithromycin 500 mg 2 times a day, followed by a 10-day intake of pantoprazole at a dose of 40 mg a day.

After 3 weeks, complete clinical and endoscopic remission was achieved. Control "ZS-breath test, carried out 4 weeks after the start of treatment, showed the absence of N. ruiogi infection. Over the past 24 months, the patient has had no exacerbations, he feels practically healthy, and repeated control 13b-breath tests record the absence of Helicobacter pylori infections

An example of Me2.

Patient K. (Individual card Me1267) with a diagnosis of: Ulcer disease: persistently recurring peptic ulcer of the bulb of the duodenum, associated with infection with Neiijsorasieg ruiogi, severe course, exacerbation phase. The diagnosis was confirmed by FEGDS and histological examination. She has been suffering from peptic ulcer disease for 4 years, exacerbations occurred twice a year in spring and autumn, for which she took ranitidine and omeprazole on an outpatient basis for 3-4 weeks. The penultimate exacerbation, 2 years ago, was complicated by bleeding, for which she was treated conservatively in an inpatient setting.

The patient was prescribed a scheme of "triple" therapy consisting of pantoprazole 40 mg, amoxicillin 1000 mg, clarithromycin 500 mg 2 times a day, followed by a 7-day intake of pantoprazole at a dose of 40 mg per day.

The patient fully completed the treatment program, the symptoms of exacerbation disappeared within the first three days.

Control "ZS-respiratory test, conducted 4 weeks after the start of treatment, showed the absence of N. ruiogia infection.

During the last 18 months, the patient had no recurrences of the disease. Repeated control 13b-breath tests record the absence of helicobacter infection.

During the period from 1997 to 1999, 545 patients were treated in the clinic of the Department of Faculty Therapy of Mei NMU using the traditional method, and 760 patients with the diagnosis of: Ulcer disease: constantly relapsing helicobacter ulcer of the bulb of the duodenum. Over the course of 2 years of observation, the percentage of relapses was 58.895 among patients treated with the traditional method, and 2.696 among patients treated with the proposed method (R. "0.001).

Thus, the proposed method of preventing relapses of peptic ulcer disease is carried out in a short time, provides a significant (more than 20 times) reduction in the number of relapses within 2 years and contributes to the complete recovery of the patient.

Literature. 1. Waddeg K., Oaiiu M, Neaiieu K.: Siipisa! esopotis hemiemu: Neiissorasieg ruiogi-azzosiaiea reriis tseg desease.

Ayitepi. Rpaptosai TNeg.. 1997, 11:273-282. 2. Nipi A.N.: Reriis tseg desease: Oeiipipu (pe igeaitepi vigagediez ip She ega oi Neiissobasieeg ruyuii. At. u.

Savzygoepiegoi. 1997,92:36-43.

Z. at 5.K, TaiMeu M.u.: Neiissobasieg ruiogi sopsepvzyv: Veroigi oi She 1997 Avia Rasiis Sopzepvzyv op She tapadetepi oi Neiissobasieg ruiogi ip'esiop. U. Szavigoeieegoi. Nerayios!., 1998.13:1-12. 4. Tne Epgoreap Neiissobasieg Ruiyugi 5Zschshaye Stocr: Sstepi Eshgoreap sopseriv ip tapadetepi oi Neiissobasieg ruiop ip'esiop. Tpe Maaviysni Sopsepzivz Neroii. Si, 1997,41:8-13. 5. MNpetviop 1.: Ocaiyu oi She apa Neiissobasieg ruiogi egadisayop. 5 sapa u). Sazigoepiegoiodu, 1996.31:18-20.

Claims (1)

A method of preventing peptic ulcer recurrences by using proton pump inhibitors, which differs in that amoxicillin 1000 mg and claritromycin 500 mg twice a day for 7 days are additionally prescribed.