DOI: https://doi.org/10.26641/2307-0404.2014.4.35593

Roflumilast, ursodeoxycholic acid and nucleinate efficiency in patients with chronic obstructive pulmonary disease with accompanying chronic non-stone cholecystitis.

T. V. Dudka, O. S. Huhlina

Abstract


Global Initiative for diagnosis, treatment and prevention of COPD has recently included roflumilast (R) - an inhibitor of phosphodiesterase-4 (PDE-4) as a new therapeutic agent to the recommendations for the management of patients suffering from COPD with severe and moderate course. Objective. To investigate the efficacy of roflumilast, ursodeoxycholic and ribonucleinic acids  in patients with COPD with an accompanying chronic non-stone cholecystitis. Materials and methods. The study involved 40 patients with COPD stage II-III, in the acute phase with an accompanying CNC in the acute phase and 20 practically  healthy individuals (PHI). Patients of the control group (group 2) received berodual, UA500 mg overnight for 30 days, under the conditions of infective exacerbation of COPD - antibiotic therapy. Group 1 (study, 20 people) received roflumilast 500 mg additionally once  a day, nucleinas 500 mg 3 times daily for 30 days. Results and discussion. The results obtained in the study of the dynamics of treatment and their analysis indicate that exposure to complex therapy, amelioration, reducing the signs of exacerbation of COPD and CNC, a significant improvement of quality of life in patients of group 1 were noticed sooner. Figures of external respiration functions(FER)  in dynamics of treatment in patients with COPD with an accompanying CNC show higher efficiency of the proposed therapy too. In particular, the rate of forced expiration for the first second after treatment in patients of group 1 increased by 31,5% (p<0,05), while patients in group 2 - by 14,0% (p<0,05) probable presence of intergroup differences (p<0,05). Taking into consideration the fact that the treatment of patients of group 1 included antioxidant preparation H - dynamic performance and the intensity of lipid peroxidation were significantly different from baseline in all periods of observation. For instance, the content of MA (malonic aldehyde) in plasma after treatment in group 1 decreased by 1,7 times (p<0,05), while in group 2 - 1,2 times (p<0,05) with significant difference between groups (p<0,05). Biochemical analysis of blood and bile for bilirubin after treatment indicates its significant reduction in patients of group 1 - by 1,7 times in blood (p<0,05) and 27,7% (p<0,05) in  bile.In patients of group 2, due to the influence of the UA, bilirubin in bile decreased by 7,8% (p<0,05), and the content of bilirubin in  blood decreased by 13,0% (p<0,05). Conclusions. The use of roflumilast in combination with berodual, ursodeoxycholic and ribonucleinic acids in patients with COPD and in acute CNC promoted faster, than under conventional therapy (6-7 days), elimination of symptoms of both acute comorbid conditions. Combined therapy of patients with COPD stage II-III of the CNC in the acute phase, which included inhalation therapy with berodual, ursodeoxycholic acid, roflumilast and nuclineas helped to reduce the intensity of oxidative stress, endotoxemia, renewed the activity of the components with antioxidant protection and natural detoxification system.

Keywords


chronic obstructive pulmonary disease; chronic non-stone cholecystitis; oxidative and nitrose stress; antioxidant protection

Full Text:

PDF

References


Глобальная стратегия диагностики, лечения и профилактики хронической обструктивной болезни легких (пересмотр 2011 г.) / [пер. с англ.] / под ред. А.С. Белевского // Рос. респираторное общество. – M., 2012. – 80 с.

Данилин А.В. Структура сопутствующей пато¬логии у пациентов с тяжёлой хронической обструк¬тивной болезнью лёгких в пульмонологическом ста¬ционаре/ А.В.Данилин, М.Л.Штейнер, И.И.Штейнер // Казанский мед. журнал.- 2011.-№ 3.-С.318-322.

Клестер Е.Б. Хроническая обструктивная бо¬лезнь легких и сочетанная патология / Е.Б.Клестер // Проблемы клинич. медицина. – 2008.– № 2. – С.76-80.

Максимов В.А. Дуоденальное исследование / В.А. Максимов, А.Л. Чернышев, К.М.Тарасов. – М.: Мед. газета, 1998. – 192 с.

Опыт применения Нуклеината в лечении часто и длительно болеющих пациентов / Ж.Д. Семидоцкая, И.А. Чернякова, Т.В. Бездетко [и др.] // Новости ме¬дицины и фармации.- 2007.- № 16 (222).- С. 10-11.

Основы компьютерной биостатистики: анализ информации в биологии, медицине и фармации ста¬тистическим пакетом MedStat / Ю.Е. Лях, В.Г. Гурья¬нов, В.Н. Хоменко [и др.].- Донецк: Папакица Е.К., 2006.- 214 с.

Перцева Т.А. Противовоспалительная терапия больных ХОБЛ – результаты клинических иссле¬дований / Т.А.Перцева // Укр. пульмонол. журнал. – 2011. – № 2. – С. 17-18.

Римський консенсус III, 2006. Стандарти діагностики та лікування: Дисфункції жовчного мі¬хура та сфінктера Одді / J. Behar, E. Corazziari, M. Guelrud [et al.] // Сучасна гастроентерологія.- 2007.- № 1 (33).- С.94-109.

Солошенко О. Даксас: новые горизонты в ле¬чении ХОБЛ / О.Солошенко // Аптека.- 2011.- № 12 (783).- C. 7-8.

Association between fibroblast growth factor 7 and the risk of chronic obstructive pulmonary disease / Si-cheng Xu, Jiang-ying Kuang, J.Liu [et al.] // Acta Phar¬macol. Sinica.- 2012.- Vol.33.- P. 998–1003.

Fabbri L.M. Roflumilast improves lung function in patients with moderately severe chronic obstructive pulmonary disease treated with long acting bron¬cho¬dila¬tors / L.M.Fabbri // Lancet.- 2009.- Vol. 374.- P. 695-703.

Field S.K. Roflumilast, a novel phosphodiesterase 4 inhibitor, for COPD patients with a history of exa¬cerbations / S.K. Field // Clinical Med. Insights: Cir¬culatory, Respiratory and Pulmonary Medicine. - 2011. - Vol. 5. - P. 57-70.

Long-term ursodeoxycholic acid therapy is as¬sociated with reduced risk of biliary pain and acute cholecystitis in patients with gallbladder stones: a cohort analysis / S.Tomida, M.Abei, T.Yamaguchi [et al.] // Hepatology. – 1999. – Vol. 30, N 1. – Р. 6-13.

REFERENCES

[Global strategy for the diagnosis, treatment and pre¬vention of chronic obstructive pulmonary disease (Review 2011)]. Translation from English edited by AS Belevsky. Rossiyskoe respiratornoe obshchestvo. 2012;80. Russian.

Danilin AV, Shteyner ML, Shteyner II. [The structure of comorbidity in patients with severe chronic obstructive pulmonary disease in pulmonology hospital]. Kazanskiy meditsinskiy zhurnal.2011;3:318-22. Russian.

Klester EB. [Chronic obstructive pulmonary di¬sease and combined pathology]. Problemy klinicheskoy meditsiny. 2008;2:76-80. Russian.

Maksimov VA, Chernyshev AL, Tarasov KM. [Duodenal study]. Meditsinskaya gazeta, 1998;192. Russian.

Semidotskaya ZhD, Chernyakova IA, Bezdetko TV. et al. [Experience of Nucleinat use in treatment of frequently ill patients]. Novosti meditsiny i farmatsii. 2007;16(222):10-11. Russian.

Lyakh YuE, Gur'yanov VG, Khomenko VN. et al. [Fundamentals of computer biostatistics: analysis of in¬formation in biology, medicine and pharmacy with statistical package MedStat]. Donetsk. Papakitsa E.K., 2006;214. Russian.

Pertseva TA. [Anti-inflammatory therapy in COPD patients - results of clinical trials]. Ukrainskiy pul'monologicheskiy zhurnal. 2011;2:17-18. Russian.

Behar J, Corazziari E, Guelrud M. et al. [Rome Consensus III, 2006. Standards of diagnosis and treatment: dysfunction of the gallbladder and sphincter Oddi]. Suchasna gastroenterologija. 2007;1(33):94-109. Ukrainian.

Soloshenko O. [Daxas: New horizons in the treatment of COPD]. Apteka. 2011;12(783):7-8. Russian.

Si-cheng Xu, Jiang-ying Kuang, Liu J. et al. Association between fibroblast growth factor 7 and the risk of chronic obstructive pulmonary disease. Acta Pharmacol. Sinica. 2012;33:998–1003.

Fabbri LM. Roflumilast improves lung function in patients with moderately severe chronic obstructive pulmonary disease treated with long acting bron¬cho¬dilators. The Lancet. 2009;374:695-703.

Field SK. Roflumilast, a novel phosphodiesterase 4 inhibitor, for COPD patients with a history of exa¬cerbations. Clinical Med. Insights: Circulatory, Respi¬ratory and Pulmonary Medicine. 2011;5:57-70.

Tomida S, Abei M, Yamaguchi T. et al. Long-term ursodeoxycholic acid therapy is associated with re¬duced risk of biliary pain and acute cholecystitis in patients with gallbladder stones: a cohort analysis. Hepatology. 1999;30(1):6-13.


GOST Style Citations


—




 

This work is licensed under a Creative Commons Attribution 4.0 International License