CLINICAL EFFICACY OF USE OF PHYTOPREPARATION "NOKAMEN" IN THE COMPLEX TREATMENT OF PATIENTS WITH UROLITHIASIS
Hoshenko Y.A., ** Rossihin V.V., *Osipov P.G., ** Bukhmin A.V.
Belgorod State National Research University *, Kharkiv Medical Academy of Postgraduate Education **
According to data of different authors, patients with urolithiasis make a large part of (30 to 45%) patients in urology hospitals, and their amount continues to grow [1,2,3]. In Ukraine, over the past decade, the incidence of urolithiasis has been increased from 305.6 cases per 100 000 of adults in 1989 to 535.8 cases in 2009 [4,5].
The introduction of lithotripsy into the urological practice has fundamentally changed the approaches for urolithiasis therapy, and opened new prospects to decrease morbidity and disability, allowing to refuse a surgery and an anesthesia [6,7].
The ultimate success of lithotripsy is determined by auxiliary therapeutic measures aimed at acceleration of the discharge of fragments, as well as the prevention of stone formation, that allows to avoid re-lithotripsy and other endoscopic procedures.
The herbal complex Nokamen manufactured by the pharmaceutical company "Ananta Medicare", United Kingdom, is registered and approved for use as a food supplement in Ukraine. Nokamen is an uroprotector with an accent on litholytic effect.
The Nokamen’s copmosition contains the following active ingredients:
- Сrataeva nurvala bark - 100 mg,
- Saxifraga ligulata rhizomes - 60 mg,
- Butea frondosa flowers - 40 mg,
- Dolichos biflorus seeds - 40 mg
- sodium bicarbonate - 20 mg,
- Boerhavia diffusa roots - 70 mg,
- Asphaltum - 70 mg,
- Tribulus terrestis fruits - 100 mg,
- Rozmarinus officinalis extract - 20 mg,
- Rubia cardifolia extract - 20 mg.
The purpose of study is the determination of the possibility of use of Nokamen phytopreparation in the complex treatment of patients with nephrolithiasis treated with remote lithotripsy. In the period from November 2014 to February 2015 were examined and treated 42 patients with calculi in the kidneys and ureters. Nokamen was indicated in 2 tablets, 2 times a day after meal. The course of treatment made 45 days.
Research tasks:
1. To assess the Nokamen’s effectiveness for the prevention of infectious and inflammatory complications after remote lithotripsy.
2. To assess the Nokamen’s effect on the time limits of the discharge of calculi after lithotripsy.
3. To study the possibility of Nokamen’s effect on microcirculation of renal parenchyma to reduce trauma risks in remote lithotripsy.
Complex examination of patients with nephrolithiasis was carried out with the use of modern methods of diagnosis:
1. Plain and excretory urography (to confirm the presence of calculi and determine the functional state of the kidneys).
2. Renal ultrasound with Doppler sonography (to determine the blood flow state in the parenchyma) before and at different stages after lithotripsy.
3. General analysis of blood and urine (detection of hidden leukocyturia).
4. Bacteriological urine examination.
5. Biochemical blood tests.
The comparative analysis of the results of the treatment of the patients with nephrolithiasis was carried out in two groups of patients.
First, the control group, consisted of 20 patients with localized calculi in the renal pelvis of the ureter, was treated with remote lithotripsy followed by conventional post-operative conservative therapy. The second group was the main group consisted of 22 patients with comparable localization and clinical disease. But unlike the first group of patients, after lithotripsy therapy these patients were administered with Nokamen only in the dose of 2 tablets 2 times a day after meal. Dynamic observation was carried out for 45 days.
The main group consisted of 9 men (41%) and 13 women (59%). The average age of patients was 42 years (16 to 71 years).
According to calculi localization the patients were classified as follows (Table 1.)