RU2163822C1 - Method for treating patients suffering from kraurosis of vulva - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves additionally locally administering electromagnetic radiation of extremely high frequency to vulva area with 20-30 min long exposure time 8-10 treatments per course on the background of health resort treatment including radon therapy. EFFECT: enhanced effectiveness of treatment; stable remission. 3 tbl

Description

 The invention relates to medicine, namely to gynecology, and for the treatment of women suffering from vulvar kraurosis.

A known method of treating kraurosis of the vulva using radon therapy with a concentration of radon water of 40 nCi / l and phonophoresis of hydrocortisone ointment (L. P. Lugovaya, M. M. Evseeva, A. B. Ovsienko. "A method for the treatment of patients suffering from kraurosis vulva you ", patent N 2082468 from June 27, 1997). The method provides for the appointment of radon baths at a temperature of 36 ^o With a duration of 15 minutes, 8-10 procedures according to the scheme: 2 days of a bath, 3 days rest or every other day, as well as gynecological irrigation on days of bathing at a temperature of 36 ^o C for 10 minutes during the 1st procedure and with an exposure of 15 minutes, subsequent procedures, for a course of 8-10 procedures. For all procedures, radon water of a concentration of 1.5 kBq / l (40 nCi / l) is used. On days free from balneotherapy, or with an interval of 2 hours from receiving balneotherapy, phonophoresis of hydrocortisone ointment (125 mg of hydrocortisone, 30 g of petroleum jelly, 30 g of lanolin) is prescribed for areas affected by kraurosis. The frequency of ultrasonic vibrations is 830 kHz, the intensity is 0.2-0.4 W / cm ² , the useful area of the vibrator head is 4 cm ² , the mode is continuous, the contact is direct. Duration of exposure - 10 minutes, 6-7 procedures per treatment course. Sounding exposed: pubis, inguinal and perianal region, vulva, perineum.

 This method of treatment has a positive effect both on the central links of etiopathogenesis - impaired homonal relationships, and on locally altered peripheral innervation, pathologically altered reception of target organ tissues, on lymph and blood circulation, tissue trophism of the vulva and pelvic organs. However, with significant dystrophic changes in the vulva tissue with a high degree of trauma to the almost constant intense vulvar itching, the effect of the local use of phonophoresis of hydrocortisone in combination with radon therapy at a radon concentration of 1.5 kBq / l (40 nCi / l) was significantly lower than in patients with a lesser degree of severity of the pathological process. The term of remission when using this method of treatment in patients with severe kraurosis was significantly shorter than the period of remission in patients with a milder course of kraurosis of the vulva.

The essence of the invention lies in the fact that with kraurosis of the vulva, radon baths, gynecological irrigation with a concentration of radon water of 1.5 kBq / l (40 nCi / l) are used, which have a pronounced antipruritic, sedative, regenerative effect, in combination with local exposure to EHF-therapy . The course of treatment is 24 days. Prescribe a radon bath at a temperature of 36 ^o With a duration of 15 minutes, the number of 8-10 procedures according to the scheme: 2 days of bath, 3rd day of rest or every other day. Gynecological irrigation is prescribed on the days of taking baths at a temperature of 36 ^o C for 10 minutes during the 1st procedure and with an exposure of 15 minutes subsequent procedures. The course is prescribed 8-10 procedures. For all procedures, radon water of a concentration of 40 nCi / L is used. EHF-therapy was prescribed on days free from balneotherapy or with an interval of 2 hours from receiving radonotherapy. EHF-therapy was carried out, for example, by the Yav-1 apparatus with a wavelength of 7.1 mm or 5.6 mm (individually), a power flux density of 10 mW / cm ² . A device horn with an aperture of 2 cm ^{2 was} located in the vulva (kraurotic triangle); exposure time 20-30 min. The exposure was carried out daily or every other day, on a course of 8 to 12 procedures.

The method is illustrated by the following examples:
Extract from the medical history N 245.

 Patient Elizabeth P-kaya, 59 years old, was admitted to the hospital with a diagnosis of vulvar kraurosis. The patient was disturbed: constant vulvar itching, intensifying to intense, dry skin of the external genitalia, discomfort and difficulty during sexual intercourse, feeling of constriction of the external genitalia, cracks, abrasions of the vulvar mucous membranes, poor sleep, increased irritability, fatigue, decreased ability to work . Considers herself a patient for 4 years, when for the first time after a series of stressful situations, itching of the external genitalia appeared on the background of menopause. The itching was intermittent, moderately intense, then it became severe and after 2 years - permanent, intolerable at night. After 2 years from the onset of the disease, vulvar and perineal kraurosis was first diagnosed. Lorinden ointment, flucinar were applied topically in the treatment, the patient felt after that a short-term decrease in vulvar itching.

 Visual examination revealed atrophicity of the clitoris, labia minora and labia minora, whitishness and swelling of the affected areas, multiple scratches and abrasions, bruising, dryness of the organs and tissues of the vulva, narrowing of the vaginal opening. When vaginal examination: the cervix, uterus and appendages - without features. Hyperemia of the vaginal mucosa, milky discharge, very scarce.

 With vulvoscopy: whiteness and atrophy of the labia minora, clitoris, swelling of the submucosal and subcutaneous tissues, atrophy and thinning of the vulva tissue, initial sclerotic changes in the vaginal opening, numerous cracks, bruising. Malignant tissue transformation and leukoplakia with extended vulvoscopy (using 2% acetic acid, Lugol's solution and a “color” test with methylene blue) were not detected.

 Researches: clinical tests of blood and urine - without pathology. ECG - without features. Blood sugar, prothrombin index, blood coagulation time are normal. No helminthic invasion. Wasserman's response to HIV is negative. Fluorography without pathology. Cytological smear of the vulva - without atypia, from the cervix and cervical canal - without pathology. Gonorrhea was not found in smears for the purity of the vaginal flora, there is a moderate coccal flora and a single rod.

 Treatment. The treatment complex consisted of the appointment of gynecological radon irrigation (36 degrees, 15 minutes), general radon baths (36 degrees, 15 minutes). Radon waters of a concentration of 40 nCi / L were used. All procedures were performed on the same day, 3-4 procedures per week (2 consecutive days, 1 day break or every other day), 10 courses per course. In combination with balneotherapy, the patient was prescribed EHF-therapy on days free of balneological procedures or before them for 4-5 hours, for a course of 6 procedures. At the end of the course therapy (10 radon baths and irrigation and 10 EHF treatment procedures), the general condition improved: headaches, irritability, general weakness disappeared, sleep normalized, the itching of the vulva and perineum in intensity decreased significantly, the sensations of itching began to appear less often and less weak in intensity. Clinical blood and urine tests are within normal limits, the purity of the vaginal flora is II (upon admission to the clinic III-IV). The patient was discharged from the clinic with an improvement in general condition, gynecological status. After 1 year, the patient was re-examined in the clinic. From the 1st month to the time of observation (after 12 months), vulvar itching rarely appeared and was insignificant in intensity. The nature of the itch has not changed to date (at the time of re-admission to the clinic). Visually and with vulvoscopy after 12 months with repeated admission to the clinic, a less pronounced than before the first course of treatment decrease in degenerative processes of the vulvar and perineal tissues, swelling of the affected tissues, and trauma were absent.

 Summary. Thus, the patient with vulvar kraurosis took a clinic course of treatment with radon water with a radon concentration of 40 nCi / L and EHF-therapy, tolerated the procedures well, after a short-term reaction to the received procedures (amplification of the vulvar itch), positive dynamics were observed against the background of receiving the procedures and during analysis data of long-term results of treatment after 1 year.

According to this method (radon baths, gynecological irrigation, microclysters with a radon concentration of 1.5 kBq / l (40 nCi / l) in combination with EHF-therapy for the vulva, 15 patients suffering from vulvar kraurosis were treated. All patients observed had unidirectional positive effect of treatment: The control group consisted of 32 patients with a similar clinical and morphological picture, who were treated using radon therapy (baths and gynecological irrigation) with a concentration of radon water of 1.5 kBq / l (40 nCi / l) and phonophoresis hydra cortisone ointments, power flux density of 0.2-0.4 W / cm ^2. Both groups were identical clinical terms. All patients revealed an almost constant vulvar pruritus, poor general health, diagnose degenerative changes in skin and mucous vulva a haze tissues, atrophy and / or sclerosis, secondary hyperemia, numerous fissures, scratching, hemorrhages.The general characteristics of patients are presented in Table 1.

 In the majority of patients (92%), menstruation was established after the age of 17 years, and in the rest, aged 14-16 years. In the past, 41 women had childbirth and abortion. Infertility (secondary) affected 6 women.

 After complex treatment with radon waters of a concentration of 1.5 kBq / l and EHF-therapy on the vulva, vulvar itching significantly decreased in intensity and began to appear less often even in the evening after the first 2-3 sets of procedures. In the control group, vulvar itching gradually decreased in intensity over the entire course of treatment, a marked decrease in the patient’s vulvar itching was noted after 6-7 complex procedures (radon baths, gynecological irrigation with a radon concentration of 1.5 kBq / l and phonophoresis of hydrocortisone ointment). The general condition in both groups improved in 28 patients (88.5%). In women of the main group, a colpocytological study showed a decrease in the number of atrophic cells in all examined patients. In the control group, the positive dynamics of the colpocytological picture — a decrease in the number of atrophic cells in smears — was detected in more than half of the patients (17). The dynamics of clinical indicators and vulvoscopy data are shown in table. 2.

 When studying the electrodermal stimulation test (determining the threshold of tactile and pain sensitivity in the 13th Zakharyin-Ged zone) in patients receiving radon therapy with a radon concentration of 1.5 kBq / L in combination with EHF therapy, the sensitivity threshold decreased more noticeably than in patients in the control group in comparison with standards (table. 3).

 In the analysis of long-term results in patients of the main group for 11-12 months there was a persistent remission: the disappearance or reduction of vulvar itching, improvement of the vulvoscopic picture, good general health. In patients of the control group, remission lasted up to 8 months (Table 4).

 Thus, the effectiveness of the treatment of the proposed method in patients with vulvar kraurosis compared with the use of radon therapy with a concentration of radon water of 1.5 kBq / l in combination with phonophoresis of hydrocortisone ointment was 32% higher and indicated the possibility of using the above treatment method in patients with vulvar kraurosis.

Claims (1)

A method for the treatment of vulvar kraurosis patients, including the use of radon water, characterized in that radon water is used in combination with EHF therapy for the vulva, while radon baths are prescribed at a temperature of 36 - 37 ^o C for a duration of 10 - 15 minutes every other day, gynecological irrigation and microclysters prescribed on days of bathing, the same temperature and exposure; on days free from balneotherapy procedures or with an interval of 2 hours from receiving balneotherapy, EHF-therapy is locally performed on the vulva area (kraurotic triangle) with an exposure of 20 minutes, for a course of 8 to 10 procedures.

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