RU2347575C1 - Method for treatment of patients with destructive forms of pulmonary tuberculosis - Google Patents

Abstract

FIELD: medicine; phthisiology.

SUBSTANCE: in addition to standard antituberculous therapy, hydrogen peroxide is injected to patient from the first day of treatment in homeopathic potency 6 CH by 5 granules 3 times per day for four months.

EFFECT: reduction of abacillation terms and closure of decay cavities due to higher activity of catalase, lower level of endogeneous hydrogen peroxide level and production of destructive factors, and activation of isoniazid under effect of potentiated hydrogen peroxide.

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Description

The invention relates to medicine, namely to phthisiology, and can be used in the complex treatment of pulmonary tuberculosis.

The problem of etiotropic therapy of pulmonary tuberculosis in recent years has sharply worsened due to an increase in the incidence of this severe chronic infection and an increase in the number of destructive forms of pulmonary tuberculosis, accompanied by massive excretion of mycobacteria.

The main method for treating pulmonary tuberculosis is antibiotic therapy with anti-TB drugs (Order No. 109 of March 21, 2003 of the Ministry of Health of the Russian Federation “On improving anti-TB measures in the Russian Federation”). However, many years of experience in the fight against tuberculosis indicates the insufficient clinical effectiveness of the use of antibiotic therapy. A significant disadvantage of this method is the rapid development of drug resistance. In addition, antibacterial anti-tuberculosis therapy is accompanied by various kinds of toxic reactions that significantly complicate the treatment.

Conducted research of medical, scientific and patent literature identified various methods of treatment of pulmonary tuberculosis. Methodical recommendations of the Ministry of Health of the Russian Federation "Methodology for the differential use of antioxidants and other pathogenetic agents in the complex treatment of patients with pulmonary tuberculosis" (Appendix No. 4 to the order of the Ministry of Health of the Russian Federation No. 291 of 07/19/1996) provide for the use of sodium thiosulfate and alpha-tocopherol in the complex treatment of lung tuberculosis . It was noted that the use of these drugs helps to stop bacterial excretion, reduces the healing time of decay cavities and prevents the formation of pronounced fibrotic changes in the lung tissue. Alpha tocopherol is one of the most powerful natural antioxidants. But when using alpha-tocopherol for therapeutic purposes, it must be borne in mind that when interacting with radical structures, fairly active chromanoxyl radicals of tocopherol itself are formed, capable of leading further free-radical oxidation chains. Alpha tocopherol enhances the anticoagulant effect of vitamin K, so taking large doses of alpha tocopherol (vitamin E) together with anticoagulants can lead to hemorrhage.

Patent RU No. 2200562 protected "Method for the treatment and prevention of diseases", which provides for the use of hydrogen peroxide as a therapeutic agent in a concentration of from 0.01 to 1.5%, introduced into the body in the form of an aerosol by inhalation. However, there is no information about its effect on the course of pulmonary tuberculosis.

Patent RU No. 2197984 protected "A method for the treatment of various forms of pulmonary tuberculosis, including those resistant to antituberculous chemotherapy", which provides for the introduction of Glutoxim immunomodulator into the complex therapy of pulmonary tuberculosis. The method significantly reduces the hepatotoxic effect of anti-TB drugs and increases the effectiveness of anti-TB chemotherapy. The disadvantage of this method is that it provides for the treatment of a predominantly productive type of pulmonary tuberculosis and is ineffective in destructive processes.

RF patent No.RU 2188644 protected "A method for the treatment of pulmonary tuberculosis", which provides for the introduction of silica in a complex therapy in a daily dose of 10-20 mg with a single oral dose of 60-90 days, the method allows to reduce the duration of chemotherapy.

The closest in essence and taken as a prototype is the "Method for the treatment of pulmonary tuberculosis", protected by RF patent No. 2071326, which provides for the additional introduction of homeopathic remedies: hydrastis in combination with calcari iodine, which improves the efficiency of treatment of patients. The disadvantage of this method is the low efficiency in relation to closing the decay cavities and eliminating adverse reactions of chemotherapy.

A significant drawback of the above and known methods of treating pulmonary tuberculosis is the lack of influence on the drug resistance of mycobacterium tuberculosis. It is known that the resistance of mycobacteria to isoniazid, one of the main antibacterial anti-TB drugs, is due to the ability of mycobacteria to inhibit the conversion of isoniazid to its active form. This process is realized by catalase, which oxidizes the reduced isoniazid (prodrug form), converting it into an active form capable of inhibiting the activity of enzymes that synthesize the main component of the cell wall of mycobacteria - mycolic acid. We found that the homeopathic preparation of hydrogen peroxide in 6CH potency increases catalase activity (application for a patent of the Russian Federation, registration No. 2007108606, 03/07/2007), which suggests that it is possible to activate isoniazid under the influence of potentiated hydrogen peroxide.

The purpose of the invention is to increase the effectiveness of treatment of tuberculosis patients by reducing the time of abacillation and closing of the decay cavities, preventing the occurrence of adverse reactions.

This goal is achieved by the inclusion of hydrogen peroxide prepared according to homeopathic technology in the potency of 6CH in the standard anti-tuberculosis chemotherapy.

The method is as follows: after examination and diagnosis, a patient with pulmonary tuberculosis is prescribed antibiotic therapy according to standard anti-tuberculosis chemotherapy regimens and, at the same time, includes hydrogen peroxide in homeopathic potency of 6 CH, 5 granules 3 times a day for 4 months. The homeopathic preparation of hydrogen peroxide by activating catalase eliminates the excess of endogenous hydrogen peroxide generated by phagocytic lung cells and reduces the activity of myeloperoxidase, which forms the most powerful destructive active form of oxygen - hypochlorite ion.

Examples of the implementation of the claimed method.

1. Patient M., 18 years old, was admitted to the pulmonary therapy department of the State Health Institution “Tuberculosis Dispensary” in Rostov-on-Don for the first detected infiltrative tuberculosis S 1-2 of the left lung in the phase of decay and contamination, MBT (Mycobacterium tuberculosis) ) +. The patient's condition upon admission to the moderate department, nutrition is reduced, symptoms of tuberculous intoxication are expressed.

Survey data at admission:

On the R-gram and T-grams - on the left in S 1-2 the infiltration of the lung tissue of the focal structure with small areas of lung tissue decay and foci of seeding around without clear contours.

Blood test - HB-126 g / l, Er-3,6х10 / l, L-7,1х10 / l, E-1, P-3, S-76, L-17, M-3, ESR-18 mm / h

Sputum analysis - CMC (acid-resistant mycobacteria) found (0-1 in the field of view). Sowing sputum gave rise to 10 colonies of the Office (Mycobacterium tuberculosis).

The patient received treatment according to the intensive phase I regimen of chemotherapy (streptomycin, isoniazid, rifampicin, ethambutol), in addition to the treatment regimen, homeopathic hydrogen peroxide in the sixth hundredth potency of 5 granules three times a day every day for 4 months was included.

The data of the control examination (after 4 months):

On the R-gram and T-grams - on the left in S 1-2 small individual clearly contoured foci, the decay cavity is not determined.

Blood test - HB-126 g / l, Er-3.8 × 10 / l, L-4.6 × 10 / l, E-1, P-3, S-62, L-32, M-2, ESR-4 mm / h.

Sputum analysis (twice) - CMC (acid-resistant mycobacteria) not found. Sputum culture gave a negative result.

The patient's condition improved, gained weight, the symptoms of tuberculous intoxication were removed. In satisfactory condition, the patient was discharged for outpatient treatment. Diagnosis at discharge: infiltrative tuberculosis S 1-2 of the left lung in the phase of resorption and compaction, MBT-.

2. Patient X., 46 years old, was admitted to the hospital for treatment in the pulmonary therapy department of the GOU “Tuberculosis Dispensary” in Rostov-on-Don in a planned manner. Considers himself ill for three months, when there were pains in the right half of the chest, cough with sputum. The patient went to the clinic, where, after the examination, he was diagnosed with infiltrative tuberculosis S 1-2 of the right lung in the decay phase, MBT (Mycobacterium tuberculosis) +. The condition of the patient upon admission is moderate, the skin is pale. Food is moderate. Auscultation in the lungs can be heard vesicular breathing, moist rales after coughing on the right under the collarbone. NPV-24 in 1 minute. AD-130/80 mm. PE-78 in 1 minute.

Survey data at admission:

On the R-gram and T-grams - on the right in S 1, against the background of pneumosclerosis, heterogeneous infiltration of lung tissue with a decay cavity up to 2.0 cm in diameter, with polymorphic foci around and a wide broncho-vascular "path" to the root of the lung.

Blood test - HB-146 g / l, Er-4.5 × 10 / l, L-8.9 × 10 / l, E-2, P-6, S-68, L-20, M-4, ESR-15 mm / h.

Sputum analyzes (by direct bacterioscopy, twice) - CMC (acid-resistant mycobacteria) were found (2-5 in the field of view). Sputum culture (two cultures) gave a negative result. Mantoux test with 2 TE - 19 mm.

The patient received treatment according to the intensive phase I regimen of chemotherapy (streptomycin, isoniazid, rifampicin, pyrazinamide), in addition to the treatment regimen was included homeopathic hydrogen peroxide in the sixth hundredth potency of 5 granules three times a day every day for 4 months.

The data of the control examination (after 4 months):

On the R-gram and T-grams - on the right in S1-2 pneumofibrosis, groups of clearly contoured foci. In the dynamics - resorption of infiltration and densification of foci, closing the cavity of decay.

Blood test - HB-148 g / l, Er-4.8 × 10 / l, L-6.1 × 10 / l, E-1, P-3, S-66, L-28, M-2, ESR-4 mm / h.

Sputum tests (by direct bacterioscopy, twice) - CMC (acid-resistant mycobacteria) not found. Sputum culture (two cultures) gave a negative result.

The patient's condition improved, nutrition was moderate, he gained weight, the skin was of a normal color. No complaints. With auscultation - vesicular breathing in the lungs, catarrhal phenomena are not heard. In satisfactory condition, the patient was discharged for outpatient treatment. Diagnosis at discharge: infiltrative tuberculosis S 1-2 of the right lung in the phase of resorption and compaction, MBT (Mycobacterium tuberculosis) -.

We observed 40 patients with pulmonary tuberculosis, which were divided into two groups. The main group included 20 patients, among them 17 men (85.0%) and 3 women (15.0%). The average age of patients was 36.4 ± 2.8 years. Patients were distributed according to the forms of tuberculosis as follows: infiltrative tuberculosis - 16 people, disseminated - 2 people, fibro-cavernous - 2 people. The comparison group included 20 patients, of which 16 were men (80.0%) and 4 women (20.0%). The average age of patients in the comparison group was 35.8 ± 3.6 years. According to the forms of tuberculosis, the sick comparison groups were distributed as follows: infiltrative tuberculosis - 15 people, disseminated - 3 people, fibro-cavernous - 2 people. Mycobacterium tuberculosis was detected in all patients in sputum, tuberculosis intoxication phenomena were observed - weakness, sweating, fever, cough with sputum production, dyspnea in 12 patients, focal, infiltrative changes and decay cavities in the lungs were revealed in all X-ray studies . According to age, sex, prevalence of tuberculous changes in the lungs, severity of clinical symptoms, the formed groups are homogeneous. Statistical data processing performed using the Microsft Offis Excel 2003 computer program in the Windows XP system did not reveal differences in the studied features (p> 0.05). To conduct a comparative analysis, 10 healthy donors were examined.

All patients in the observation groups were prescribed anti-tuberculosis therapy according to standard regimens. Patients of the main group in the treatment regimen additionally included hydrogen peroxide in the homeopathic potency of 6CH, 5 granules 3 times a day. The treatment results were evaluated after 4 months according to the indicators of the closure of the decay cavities, abacillation (table 1) and the state of the lipid peroxidation system (table 2).

Table 1
The effectiveness of treatment of patients with pulmonary tuberculosis standard and combination therapy Contingent of patients Abacillation (abs. /%) P ± mp Closure of decay cavities (abs. /%) P ± mp The main group (n = 20 people) 17 pax 85.00 ± 7.89% ∗ 16 pax 80.00 ± 8.94% ∗ Comparison group (n = 20 people) 10 pax 50.00 ± 3.62% ∗ 8 pax 40.00 ± 11.23% ∗ Note:
∗ - p <0.05.

table 2
The state of lipid peroxidation in patients with pulmonary tuberculosis before and after standard and combination therapy Indicator The main group (n = 20) M ± m _m Comparison Group (n = 20) M ± m _m Healthy donors (n = 10) M ± m _m before treatment after treatment before treatment after treatment Chemiluminescence (imp./b sec) 4535.64 ± 673.12 3337.53 ± 482.64 ∗ 4521.63 ± 672.17 4584.23 ± 571.43 ∗ 3310.00 ± 219.04 Superoxide dismutase in red blood cells (c.u./mgNv) 5.87 ± 1.67 11.37 ± 1.47 ∗ 5.89 ± 1.94 6.16 ± 1.89 ∗ 11.46 ± 0.83 Red blood cell catalase (μM H ₂ O ₂ / min * mg HB) 94.64 ± 8.85 129.68 ± 6.63 ∗ 93.68 ± 12.11 107.36 ± 13.74 ∗ 133.5 ± 1.77 Myeloperoxidase (c.u. / mg * min) 2.423 ± 0.28 1.388 ± 0.76 ∗ 2,362 ± 0,53 2.386 ± 0.95 ∗ 1.163 ± 0.29 Note
∗ - p <0.05.

Thus, it can be seen from the above data that in patients of the main group a more pronounced positive dynamics of the tuberculosis process was achieved. The treatment efficiency in terms of closure of decay cavities increased by 2 times, in terms of abacillation - by 1.7 times. In addition, the patients of the main group significantly improved indicators of the state of the lipid peroxidation system and after treatment did not significantly differ from those in healthy donors.

Information on the use of the homeopathic preparation of hydrogen peroxide as a medicine for the treatment of pulmonary tuberculosis is not available in the literature, which indicates that our product is distinguished by the novelty of the cause-effect relationship “distinctive features - technical result”.

The technical result of the invention is to achieve a therapeutic effect in various forms of pulmonary tuberculosis. The tool can be prepared in homeopathic pharmacies based on the pharmacological preparation of hydrogen peroxide.

New in achieving the technical result is that the proposed homeopathic remedy stimulates its own regulatory mechanisms without the danger of harming the drug therapy. Acting on the basis of the main law of homeopathy “The like is eliminated by the like”, the product increases the activity of catalase, which helps to reduce the level of endogenous hydrogen peroxide, reduce the production of destructive factors and activate isoniazid.

Thus, the proposed technical solution meets the criteria of the invention of "novelty", "inventive step", "industrial applicability".

Claims (1)

A method of treating patients with destructive forms of pulmonary tuberculosis, providing for anti-tuberculosis therapy according to standard modes, characterized in that in addition to the course of treatment from the first day include a homeopathic preparation of hydrogen peroxide in 6CH potency of 5 granules 3 times a day for four months.