RU2014063C1 - Method for treatment of patients with genital subinflammations - Google Patents

Abstract

FIELD: gynecology. SUBSTANCE: 1.0 of 0.01 % solution of thymogen (100 micro g) is injected intramuscularly to patient during the adaptation period, and subsequent course of treatment is carried out by hydrosulfide hydrotherapy as the general baths and vaginal irrigations. EFFECT: shorter treatment time. 3 tbl

Description

 The invention relates to medicine, namely gynecology, and can be used in the treatment of patients with a long and erased (subacute) course of the inflammatory process of the internal genital organs in spa and out-of-resort conditions.

 Known methods of treating patients with acute and chronic inflammation of the appendages by physiotherapy and medications.

 Patients with subacute inflammation of the appendages make up 2/3 of women with a gradual and slightly symptomatic course of the inflammatory process. This course of the process is largely due to a change in the body's defenses.

 Closest to the proposed method is the mitigation of the use of hydrogen sulfide baths, vaginal irrigation and microclyster.

 However, the known method requires a 27-28-day stay of patients in the resort, if necessary, a 4-5-day adaptation period to its conditions. Treatment in a known manner is carried out by means of hydrogen sulfide baths, starting with a minimum (25-50 mg / l) concentration of hydrogen sulfide. Gradually, common baths are supplemented with vaginal irrigation and microclysters, which requires constant monitoring of the gradual increase in balneological load and strict control. However, in patients treated in a known manner, in 1/3 of cases there are balneoreaction (pathological).

 The purpose of the invention is the reduction of treatment time and the expansion of the therapeutic capabilities of hydrogen sulfide balneotherapy.

 This goal is achieved by the fact that patients during the adaptation period are prescribed intramuscularly thymogen with 1 ml of 0.01% solution (100 μg) daily for 5 days, then hydrogen sulfide balneotherapy in the form of common baths at a concentration of 50-150 mg / l of hydrogen sulfide and vaginal irrigation, for a course of 10 procedures. The treatment regimen is given in table 1.

 The method is as follows. From the 2nd day from the receipt of patients for treatment, 1 ml of a 0.01% thymogen solution (100 μg) is intramuscularly administered daily for 5 days. Thymogen is a synthetic thymus peptide. When studying its pharmacological properties, activity, a stimulating effect on the reactions of cellular and humoral immunity, as well as nonspecific resistance of the body, was established.

After 5 daily injections timogena (with carrying out both before and after the required clinical and laboratory examination) patients spend hydrosulphuric balneotherapy in a common bath at a concentration of 50-150 mg / l, temperature 36-37 ^{° C} water vaginal irrigations at a concentration of 150 mg / l. The procedures are carried out two days in a row with the day of a break (rest). The concentration of hydrogen sulfide of the common baths, as well as their duration, as well as the water temperature for vaginal irrigation, are selected individually at first, and during treatment, they are dosed according to the principle of increasing the therapeutic load. On menstruation days (1-3), only vaginal irrigation is canceled.

 From the presented treatment regimen (see table. 1) it can be seen that the number of hydrogen sulfide procedures when using the proposed method is 10, while when using the prototype 14-18, that with the known features of the effect of hydrogen sulfide on ovarian function, other endocrine glands and extragenital systems , does not exclude negative reactions of the body to treatment at a longer time. The duration of treatment when using the proposed method is 20 days, which is optimal for a 24-day period of spa treatment.

 PRI me R 1. Patient B., 30 years old, educator d / garden. He suffers from pains in the lower abdomen from the age of 26 and secondary infertility, which is associated with medaborts. The intensification of pain, deterioration of health notes 2-3 times a year, stay on sick leave from 30 to 60 days a year. The resort was not treated. Last hospital treatment - 5 months ago.

 Diagnosis: subacute 2-sided salpingoophoritis, metroendometritis, dysmenorrhea, infertility II. Hypochromic anemia, mycopenia. Asthenoneurotic syndrome.

General blood test: HB 103.3 g / l; c.p. 0.67; Er. 4.17x10 ¹² / l; white blood cells 3,5x10 ⁹ / l; eos. 4; mon 7; s / I 54; lymph 33; ESR 15 mm / h. T-lymph. 46%; B-lymph. twenty%; JgG 14.2 g / l; JgA 1.12 g / l; JgM 3.1 g / l. From the 2nd day of the patient’s arrival at the resort (23rd day of the cycle), Timonen 1.0 v / m N 5 was prescribed daily. The next menstruation began on the 26th day. Treatment continued with a 3-day cycle, hydrogen sulfide balneotherapy assigned two consecutive days with the day of break (vaginal irrigation 150 mg / l ^of hydrogen sulfide 38-40 C for 15 min and total hydrogen sulfide baths at a concentration 50-100-150 mg / l, for a course of 10 balneological procedures).

 After a five-day course of thymogen, the patient noted a surge of strength, an improvement in overall well-being. Balneotherapy was carried out against the background of exercise therapy in a sparingly-training mode. Discharged in good condition.

Blood test: HB 129.1 g / l; c.p. 0.9; er. 4.33 x 10 ¹² / l; white blood cells 4.9x10 ⁹ / l; eosin 4; mon 4; s / s 65; lymphocytes 27; ESR 9 mm / h; T-lymph. 58% B-lymph. 9%; JgG 13.6 g / l; Jg 2.2 g / l; JgM 2.1 g / l.

 Long-term results after 6 months. She feels well. After 2 normal menstruation, uterine pregnancy began, progressing. There are no complaints.

 PRI me R 2. Patient N., 28 years old, doctor. Suffers from inflammation of the uterus and secondary infertility 3 years after self-abortion in the period of 16-17 weeks. She was treated in a hospital and outpatient up to 4 times a year, there was a spa treatment in Krasnousolsk with a temporary effect.

 Diagnosis: Subacute 2-sided salpingo-oophoritis, right-sided sactosalpinx. Hypofunction of the ovaries, algomenorrhea. Euthyroid goiter, 1st stage, hypothyroidism.

Blood test: HB 129.0 g / l; CPU 0.94; er. - 4.67 x 10 ¹² / l; white blood cells 4.7x10 ⁹ / l; eosin 4; mon 4; PO Box 3; s / I 55; lymphocytes 34; ESR 17 mm / h; T-lymph. 32%; B-lymph. 9% JgG 11.8 g / l; Jg 2.6; JgM 4.2 g / l. Absorption of iodine-131 after 2 hours 5%; after 4 hours 6.3%; after 24 hours, 11.2% (normal 31%, hypothyroidism 69%).

From the 2nd day of admission (the 17th day of the cycle), the patient was prescribed thymogen of 1.0 v / m N 5, after which she noted a slight improvement in well-being. On the 6th day of treatment designated balneotherapy hydrogen sulfide (vaginal irrigation 150 mg / l of hydrogen sulfide, T 38 ^o C for 10-15 minutes and shared bath 50-100-150 mg / l of hydrogen sulfide, then 100-50 mg / l, T . 36-37 ^{° C} for 6-15 min balneotherapy was conducted on the system for two consecutive days with the day of break adverse reactions to treatment the patient has not marked the patient was discharged with a significant improvement of blood Analysis: 133.5 g Hb / l; 0.92 CPU... ; Er 4.33x10 ¹² / l; leukocytes 5.9x10 ⁹ / l; eosin 3; mon. 3; p / 3; s / I 52; lymph. 34; ESR 9 mm / h. T-lymph. 76% ; B-lymph. 12%; JgG 17.6; JgA 1.22; JgM 1.08 g / l.

 Long-term results after 6 months: feeling good, feels a surge of strength, increased efficiency. Menstruation returned to normal. In the 2nd month after treatment, a uterine pregnancy occurred, in the first trimester there was a threat of interruption, then it progresses normally.

 The proposed method was applied in 28 women with subacute genital inflammation, the results are compared with those in the group of identical 28 patients who received only hydrogen sulfide balneotherapy.

 In the table. Figure 2 shows the indicators of immunological examination in both groups before and after treatment, and those obtained in the laboratory showed healthy women aged 20-35 years.

 In the group of patients treated with the proposed method, the studies were carried out 3 times, i.e. before treatment, after a course of thymogen and at the end of treatment with hydrogen sulfide balneotherapy. The data presented indicate a specific immunomodulating effect of hydrogen sulfide balneotherapy, which is clearly potentiated by thymogen. In this group, the number of T-lymphocytes significantly and within physiological limits increased mainly due to an increase in the level of a subpopulation of T-suppressor cells. At the same time, the O-lymphocyte count decreased against the background of a tendency to a decrease in the number of B-lymphocytes and immunoglobulin M. A moderate increase in the dynamics of the level of T-helper cells is noteworthy. The stated shifts in the immune system indices of the examined patients are generally assessed as positive. There is a gradual "soft" correction of indicators of immune homeostasis in patients, including both the cellular and the humoral link. On the one hand, the revealed dynamics of immune shifts indicates the normalizing effect of the treatment on the initial imbalance in the immune system of patients. On the other hand, given the encouraging long-term clinical results, it is highly probable that a specific mechanism for the implementation of the achieved immunocorrection in the form of suppression of immune responses contributing to the development of sensitization to sperm antigens can be argued.

 The noted results of the immunological examination clearly correlate with the direct data of the clinical examination and the long-term results from the field according to special questionnaires, all of which are summarized in Table 3.

 From table 3 it is seen that the immediate results of treatment when applying the proposed method have a lower percentage of cases of significant improvement, which can be attributed to the difference in the evaluation criteria, while long-term results convince the distinct advantage of the proposed method. The restoration of reproductive function in women with concomitant infertility after applying the proposed method is the most objective criterion for cure.

 Providing immunocorrective effect, this method allows you to stop the subacute course of the inflammatory process of the genitals while reducing the treatment period by 7-8 days.

Claims (1)

 METHOD FOR TREATING SUBSTANT INFLAMMATORY GENITAL DISEASES, including balneotherapy, characterized in that, in order to reduce treatment time, a 0.01% thymalin solution in the amount of 1.0 ml intramuscularly is administered per course of 5 injections during the adaptation period.

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