MM Petrova, GN Borisova, LV Korchagin, AA Krasova,
Krasnoyarsk State Medical Academy, Department of propedeutics Internal Medicine, Nephrology Unit GBSMP
Inflammatory diseases of the urinary system - pyelonephritis, cystitis, are the most frequent pathologies of the genitourinary system and are second in frequency of disease after infection of the respiratory system.
The term "pyelonephritis" refers to a non-specific infectious-inflammatory process that occurs predominantly in the pelvis-plating system, kidneys and tubulointersticial zone. It is now well known that the incidence of pyelonephritis has three age peaks, coupled with the floor. Below are the main risk factors leading to the development of pyelonephritis: bacteriuria; refluxes at various levels; instrumental examination of the urinary tract, urinary tract obstruction, diseases of the prostate gland; age of the patients (especially elderly and senile), pregnancy, diabetes, hypertension with angionefrosklerozom; previous kidney disease, gout, myeloma; effects of drugs. The first peak accounted for early childhood (up to 3 years). The prevalence of pyelonephritis in children population, according to different authors, ranging from 7,3 to 27,5 in 1000.
Some authors tend to allocate pyelonephritis girls as a special form of the disease, stressing that they account for 85-90% of patients in this age group. It is believed that vesicoureteral reflux is responsible for 70-75% of cases of pyelonephritis in children.
The second peak of incidence of pyelonephritis has the most active reproductive age (18-30 years). Morbidity in this population, the population is estimated at 0,82-1,46 per 1000 people. Also retained the predominance of women over men, on average, 7:1. It has been suggested that 60-70% of all cases of pyelonephritis in women of childbearing age appear for the first time during pregnancy. Of particular importance in the genesis of gestational pyelonephritis is attached to two factors: changes during pregnancy, hormonal balance with an increase in the quantitative content of estrogen and change their relationship and mechanical stress a pregnant uterus on the urinary tract. Cystitis and pyelonephritis are at 15-55% of women undergoing gynecological surgery.
The third peak incidence of pyelonephritis accounted for elderly age and is characterized by progressive increase in the incidence of men. In this case, since the age of 60, the ratio of ailing men and women are gradually aligned.
Adenoma and prostate cancer, prostatitis, vesiculitis constitute the main group of factors predisposing men to the development of pyelonephritis.
The second group of factors are bladder cancer and rectal cancer, tumor compression of the ureter, periuretrit, urolithiasis. Recently, more and more importance among the factors predisposing to the development of pyelonephritis in patients of this group occupy diabetes mellitus complicating pyelonephritis in 30-35% of cases, gout, complicating them in 2 / 3 of cases, myeloma.
The most common causative agents of pyelonephritis are bacteria related to human intestinal microflora. Thus, E. coli, enterococci are obligate intestinal flora, and hemolytic variant of Escherichia coli, Proteus, Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa facultative flora, mainly in intestinal dysbacteriosis.
Success in the treatment of pyelonephritis is still achieved only rational use of antibiotics, the effectiveness of the same immunomodulatory and nonspecific anti-inflammatory drugs on closer examination turns out to be controversial.
The aim of our study was to examine the effectiveness of food supplements (dietary supplements) ART LIFE PHYTOREN in the treatment of pyelonephritis.
PHYTOREN - phytocomplex with high antibacterial activity against most microorganisms causing loss of human urinary tract. The drug has antispasmodic, diuretic, a common anti-inflammatory action, improves immune system function and regulates fluid and electrolyte balance in the body, as a supplier of potassium ions, regulates pH of urine.
The study included 60 patients with acute exacerbation of chronic pyelonephritis and who were treated at the Nephrology Unit of the city hospital emergency care in Krasnoyarsk in 2001.
The first group, 30 patients (average age 30.6 years) received traditional antibacterial, antispasmodic and detoxication therapy.
The second group (30 men, average age 31.2 years) in addition to the traditional combined therapy received PHYTOREN supplements at a dose of 2 tablets per day.
The groups were comparable in frequency of acute and chronic pyelonephritis, as well as the severity of the disease. Thus, in the first group of body temperature on admission averaged 38,4 ° C, while the second - 38,5 ° C. Leukocytosis of peripheral blood on admission was more pronounced in the second group (8,8 h109 / l) than in the first (7,2 x109 / l), and rates of sedimentation rate, on the contrary, in the first group were slightly higher than the second (33,5 and 31,4 mm / h, respectively). Biochemical blood parameters did not differ significantly between groups. In general, the analysis of urine at admission in the second group was significantly higher (p <0,05) was expressed leucocyturia (20,2 in n / vision) compared with the first group (14,3 in n / vision), and, in 50% patients in both groups, it was characterized by pyuria. Analysis of urine Nechiporenko also pointed to the greater activity of pyelonephritis in the second group compared to the first (white blood cells on average 35,587 and 8,431 respectively).
In the second group of patients treated PHYTOREN we have noted positive dynamics on the third day: relief of pain in the lumbar region occurred at a mean of 3.1 days, while the comparison group only on day 7 (6.63).
Normalization of the temperature in the study group occurred after 4.9 days, and in control - only 9.73 days (p <0,05). Dysuric disorders cropped by 4.5 days in the first group and by 5.3 days in the second, which is statistically insignificant.
Adding to the treatment PHYTOREN impact on laboratory parameters: ESR at discharge in the study group was 25 mm / h, on average, in the first group (comparison) - 29,5 mm / hr In general, the analysis of urine at discharge in the first group leucocyturia 6.12 in the second - 4,2; in the analysis of Nechiporenko 7059 and 5317, respectively, which indicates a high efficacy in the treatment of urinary tract infection.
Biologically active additive PHYTOREN company ARTLIFE may be recommended to patients of any age group in the treatment of pyelonephritis and cystitis in the treatment of these diseases, as well as for preventing pyelonephritis in pregnant women because of its safety, good tolerability and efficacy.
The recommended dose is: Children 4-8 years - 1 / 2 tablets 2 times a day, 9-14 years - 1 tablet 2 times a day, adults: 1-2 tablets 2 times a day.
Take the drug is recommended for 30-40 minutes before meals, during the drug - drinking plenty of fluids.