RU2147864C1 - Method for treating female infertility of inflammatory genesis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves applying balneotherapy with hydrogen sulfide baths and supersonic frequency currents procedures. Balneation is carried out with vaginal irrigation and general hydrogen sulfide baths. Supersonic frequency currents are sequentially applied to lumbosacral region, vaginal and hypogastrium region. Total course is 10 physio- and balneoprocedures long. EFFECT: enhanced effectiveness in repairing ovary function. 3 tbl

Description

 The invention relates to medicine, namely to gynecology, and can be used in the treatment of gynecological patients with infertility of the endocrine-inflammatory genesis in resort and practical health care.

 It is known to treat infertility due to inflammatory diseases of the uterine appendages, including exposure to hydrogen sulfide balneotherapy in the form of vaginal irrigation and common baths at a concentration of hydrogen sulfide from 50 to 150 mg / l, as well as exposure to a physical factor in the form of trypsin phonophoresis according to patent No. 1777869 (1).

 However, the known method requires the use of medications (trypsin, diphenhydramine, dimexide, lanolin, peach oil), which are relatively expensive and scarce.

 The purpose of the invention is the achievement of anti-inflammatory, absorbable effect and correction of ovarian function without the use of medications.

This goal is achieved by the fact that treatment begins on the 4th day of the menstrual cycle, alternating every other day with ultraton therapy and hydrogen sulfide balneotherapy, while ultraton therapy is performed by supratonal currents from the Ultraton-TNCh-101 apparatus with a power of 4-6 W by sequential action on the lumbar the sacral region in the zone L ₁ -S ₄ , vaginally and to the hypogastric region from 5 to 8 minutes per area, for a course of 10 procedures.

 In the treatment of chronic inflammatory diseases of the genital organs in women, the use of hydrogen sulfide balneotherapy in the form of vaginal irrigation and common baths with a concentration of hydrogen sulfide from 50 to 150 mg / l is aimed at reducing the activity of the exudative and infiltrative components of the inflammatory reaction, it has a significant fibrinolytic effect, enhances the hormonal activity of the ovaries , increases blood supply to the pelvic organs and increases the secretion of follicle-stimulating hormone of the pituitary gland. And the use of physiotherapy in the form of currents of supratonal frequency, where the electric discharge that occurs during ultra-therapy, as well as the current itself, irritate the receptors of the skin and mucous membrane, reflexively affect various body systems, primarily the autonomic nervous system, and therefore improve blood and immune-forming, metabolism improves. The anti-inflammatory and analgesic effects of ultratherapy are achieved due to the local bacteriostatic effect, antispasmodic action, improved microcirculation and decreased sensitivity of nerve endings. With intravaginal exposure to a current of supratonal frequency, the formation of estrogen by the ovaries increases, the functional activity of the uterus increases, the flow and outflow of blood in the pelvic basin improves, and the increased vascular tone decreases.

 Thus, the use of natural healing factors in combination with preformed physical factors significantly increase the overall therapeutic effect of the proposed method.

 Scheme vacation procedures for the proposed method of treatment are presented in table 1.

The method is as follows. After the patient’s adaptation at the resort in 2-3 days and a preliminary examination, he is prescribed ultrasound therapy every other day with hydrogen sulphide therapy in the form of vaginal irrigation and general baths, and the ultrasonotherapy is carried out from the Ultraton-TNCh-101 serial device with 4–6 W over-tone currents in the position of the patient lying on the couch. First, the lumbosacral region in the zone L ₁ -S _{4 is} exposed to a mushroom-shaped electrode with a diameter of 50 mm, by contact, by scanning movements, covering the entire lumbosacral region for 5 minutes, then the mushroom-shaped electrode is replaced by a vaginal electrode on which a condom is put on and inserted into the vagina for 5 minutes. After this time, the electrode is removed from the vagina and replaced again with a mushroom-shaped one, with a diameter of 50 mm, and is affected for 5 minutes on the hypogastric region by contact, scanning movements - this is the first procedure.

 II procedure of ultratonotherapy is released within 6 minutes for each field (area) of exposure, III procedure - 7 minutes, IV procedure and subsequent to X procedures inclusively release 8 minutes for each field (area) of exposure. In total, 10 ultrasound therapy procedures are carried out on the course.

Hydrogen sulfide balneotherapy is released according to a known method:
- vaginal irrigation at a hydrogen sulfide concentration of 150 mg / l, lasting 15 minutes, at a water temperature of 38/40 ^o , for a course of 10 irrigation;
- 20 minutes after the release of irrigation spend a total hydrogen sulfide bath at a concentration of hydrogen sulfide: (on the course of 10 baths)
- 1 bath - 50 mg / l, 6 min; - 2 bath - 100 mg / l, 8 min;
- 3 bath - 150 mg / l, 10 min; - 4 bath - 100 mg / l, 12 min;
- 5 bath - 50 mg / l, 15 min; - 6 bath - 50 mg / l, 15 min;
- 7 bath - 100 mg / l, 15 min; - 8 bath - 150 mg / l, 15 min;
- 9 bath - 100 mg / l, 15 min; - 10 bath - 50 mg / l, 15 min.

Water temperature 36-37 ^o .

 Example. Patient S., 26 years old (medical history 1801), was admitted to the SNIIKif for treatment in September 1994 with complaints of infertility, periodic pains in the lower abdomen, painful menstruation, irritability.

 From the anamnesis: Menstruation from 14 years old, established within a year, regular after 28-30 days for 6 days, moderately painful, not abundant. With the onset of sexual activity (17 years), pains in the lower abdomen began to bother. When contacting a gynecologist at the age of 19, chronic inflammation of the appendages was discovered. It was treated on an outpatient basis only when pain intensified 1-3 times a year, the last time in May 1994.

 The last 1.5 years, the menstrual rhythm has become unstable (20/30 days).

At 25 years old, she is applying for infertility for 3 years, she undergoes an examination:
1) hysterosalpingography - pipes are partially passable, peritubular adhesions;
2) according to rectal thermometry - ovulatory cycles alternate with anovulatory.

According to observations and examinations, the diagnosis was made:
Infertility is the primary inflammatory genesis.

Upon admission to the clinic of the institute (22 day of the menstrual cycle), the symptom of the “pupil” and arborization corresponds to (++), the rectal temperature is 36.8 ^o .

Blood test: HB-113.6 g / l, erythrocytes-3.33 • 10 ¹² / l, leukocytes-9.35 • 10 ⁹ / l, ESR-14 mm / hour, stab-core -2%, C / I- 56%, eosinophils-3%, monocytes-10%, lymphocytes-25%.

 Urinalysis is within normal limits.

 ECG - sinus rhythm, the vertical position of the electrical axis of the heart.

 According to rheography of the pelvic organs, an increase in vascular tone (α / T = 26%), a decrease in blood supply in the pelvic organs (α = 0.22 sec, Ri - 0.2 ohm) were noted.

 Proteinogram: globulins - 39.7%; A / G - 1.52, α-globulins-5.9%; α-2-globulins-6.8%; β-globulins-9.6%; γ-globulins-17.4%. The molecular weight peptides (SMP) are 0.261 conv. units

 Lipid peroxidation (lipid peroxidation): serum catalase (CS) -47.19 μkat / l ceruloplasmin (CP) -0.333 g / l, erythrocyte malondialdehyde (MDA er.) - 65.97 nmol / ml erythrocytes.

 Immune status: white blood cells-8.05 thousand / μl, lymphocytes-32% (abs. 2576 / μl) monocytes-13%, T-l-72% (ab. 1854.7), B-l-12 (ab. 309.1), T-helpers-52% (1339.5), T-suppressors-0% (ab. 0), PSA-negative, immunoglobulins: M-97 g / l, G - 11.2 g / l, A -1.36 g / l.

 During the examination, the patient was diagnosed with Infertility I of inflammatory endocrine genesis.

The patient was treated according to the proposed method (table 1). After 7 days (on the 29th day of the cycle) after taking 3 balneotherapy and ultratonotherapy, menstruation began, which took 4 days, slightly painful on the 1st day. The treatment was interrupted for 3 days, from the 4th day of the cycle further treatment was carried out according to the scheme (table 1). The patient treatment was well tolerated. Positive dynamics of the studied indicators was noted. Rectal temperature rose above 37 ^o on the 18th day of the cycle and held until departure. The symptom of “pupil” and arborization on the 14th day of the cycle was (+++), which indicates normal estrogenic saturation of the body.

 Urinalysis and ECG are within normal limits.

Blood test (after treatment): HB-125.2 g / l, erythrocytes-5.83 • 10 ¹² / l, white blood cells-6.8 • 10 ⁹ / l, ESR-10 mm / h, P / I white blood cells - 2%, segmented-46%, zosinophils-4%, monocytes-9%, lymphocytes-38%.

 Evaluation of indicators of a general blood test indicates an increase in the patient's body resistance, a decrease in the inflammatory process, which is confirmed by immunological and biochemical blood tests: a decrease in the proteins of the acute phase of inflammation, normalization of the LPO system, activation of cellular and humoral immunity.

 Proteinogram: globulins-40.6% A / G-1.46; α-1-globulins-6.2% β-globulins-9.8%; γ-globulins-20.4%; SMP-0.200 conv. units FLOOR: Ks-26.52 mkkat / l, CP-0.280 g / l, MDA er.-29.96 nmol / ml eryth. masses.

 Immune status: white blood cells-7.85 thousand / μl, lymphocytes-36% (2826), monocytes-10%, T-lymph. - 50% (abs. 1413.0), B-lymph. -20% (565.2), T-helpers-52% (1775.0), T-suppressors-20% (565.2). Immunoglobulins: M-1.24 g / l, G-13.6 g / l, A-1.44 g / l.

 According to rheography of the pelvic organs after treatment, vascular tone decreased (α / T = 21%), blood supply increased (α-0.19 sec), (Ri-0.33 Ohm).

 The patient was discharged with significant improvement. According to long-term results, there was no exacerbation of the inflammatory process, the menstrual cycle returned to normal (28 days), and in May 1995 a pregnancy ensued that developed without pathology.

 The proposed method treated 42 women. The treatment results are presented in tables 2 and 3. According to the results of immunological and biochemical examination of patients in 2 groups (group I - 31 women with infertility of inflammatory genesis received treatment according to the prototype - trypsin phonophoresis against hydrogen sulfide balneotherapy; group II - 42 b-x women with the same diagnosis received treatment according to the proposed method - ultratonotherapy in alternation with hydrogen sulfide balneotherapy); it is seen that a more reliable dynamics of the indicators of the immune status, lipid peroxidation, protein spectrum obtained in the group treated by the proposed method. To date, long-term results have been obtained from five women treated with the proposed method: no one had exacerbations of the inflammatory process, pregnancy occurred in 2 (out of 5) women.

 Thus, the proposed method of treatment allows to achieve positive efficacy without medication by correcting ovarian function and achieving an anti-inflammatory and absorbable effect by using ultraton therapy (supratonal currents) in combination with hydrogen sulfide balneotherapy.

Claims (1)

A method for the treatment of female infertility of inflammatory genesis, including exposure to a physical factor and conducting hydrogen sulfide balneotherapy in the form of vaginal irrigation and shared baths, characterized in that the exposure to the physical factor is carried out from the Ultraton-TNCh-10-1 apparatus by supratonal frequency currents starting from 4 days cycle capacity of 4 - 6 watts sequential exposure to the lumbosacral region in the zone L ₁ - S _4, vaginally and hypogastrium region for 5 - 8 minutes on each area, a day with hydrogen sulfide balneoter Pia, a course of 10 physiotherapy and balneology.

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