RU2188660C1 - Method for treating bacterial vaginosis - Google Patents

Abstract

FIELD: medicine, gynecology. SUBSTANCE: it is suggested to apply intravaginal suppositories, additionally prescribed to basic medicinal therapy, with an extract of dense propolis N 10-20 daily per 1 supp./night after antibioticotherapy followed by prescription of eubiotics. The method enables to prevent the development of disease relapses. EFFECT: higher efficiency of therapy. 2 ex

Description

 The invention relates to medicine, namely to gynecology, and can be used to treat bacterial vaginosis.

 A known method of treating bacterial vaginosis with the help of drugs metronidazole or dalacin C, and then eubiotics [Kira E.F. Treatment of bacterial vaginosis. // Obstetrics and gynecology. - 1993. - 5. - P.39-41].

 Disadvantages: frequent relapses of bacterial vaginosis.

 The invention is aimed at solving the problem: prevention of relapse of bacterial vaginosis.

 This problem is achieved by using, in addition to the basic drug therapy, intravaginal suppositories with propolis extract 10-20 thick daily, 1 suppository per night.

 Intravaginal suppositories with thick propolis extract, created at the Perm State Pharmaceutical Academy, have antibacterial and antimicrobial effects. For the treatment of bacterial vaginosis have not previously been used.

 In the method used, suppositories with thick propolis extract have, in addition to the above, the effect of reducing the secretion of vaginal contents (including capillary-strengthening), trophic and regenerating. These actions of a thick propolis extract are not described anywhere.

 The method is as follows. The patient is prescribed metronidazole gel or Dalacin C cream, which the patient independently injects into the vagina using the applicator for 7 days 1 time per day, after which intravaginal suppositories consisting of 0.04 g of thick propolis extract and base up to 2 g are prescribed ( solid fat: ND on the basis for the production of suppositories Loders-Kroklaan 42-8991-98) 10-20 daily, 1 pc. for the night. The course of treatment is completed by local injection into the vagina of one of the drugs based on eubiotics: lactobacterin, suppositories "Acylact", etc.

 Examples of specific performance.

 Example 1. Patient M., 25 years old, complained of copious turbid discharge with an unpleasant odor, aggravated after menstruation, reaching the maximum amount during ovulation and disappearing before the next menstruation. Worried about itching, burning of the genitals, gruel-like stool associated with the use of rich plant fiber foods, bloating, general weakness, fatigue. Menstrual function at the time of the examination is not impaired. Rhythmic sex life, in marriage, there were no pregnancies, uses a condom as contraception. Among the diseases there were sore throats, anemia, traumatic brain injury complicated by epileptic syndrome, chronic gastritis, allergy to bromhexine, salmonellosis.

 She got sick 3 years ago, when 2 months after the onset of sexual activity, abundant cheesy discharge appeared, burning sensation during urination, irregular menstrual cycle similar to algodismenorea. Over time, the discharge changed the character that remained until the time of the examination. During the previous examination, the patient and her husband excluded sexually transmitted infections. Over the past 3 years, it has been repeatedly examined and treated by gynecologists and urologists (metronidazole, erythromycin, gentamicin, penicillin, ampicillin, tetracycline, topical use of clotrimazole, celandine) with a temporary weak effect.

 Objectively, the condition is satisfactory. External genitalia without pathology. When viewed in the mirrors on the cervix, an extensive ectopy of the cylindrical epithelium was revealed, the vaginal secretion was watery, in large quantities, white, with an unpleasant odor and adhesion on the walls of the vagina. Separated from the cervical canal mucosa in a small amount. pH of vaginal secretion 6.2, amine test positive. During bimanual examination, the uterus and appendages are not changed. Extended colposcopy revealed an extensive ectopy of the cylindrical epithelium with a site of leukoplakia. When smear bacterioscopy, there were up to 7 epithelial cells, the number of leukocytes 5-7 and more than 100 "key cells" in the field of view.

 During the initial bacteriological study of the vaginal microflora, the patient revealed moderate dysbiosis, which was manifested in a decrease in the number of the main microflora - lactobacilli, an increase in the number of lactic acid streptococcus, the appearance of E. coli with hemolytic activity and Bacillus. The remaining microorganisms were determined in acceptable quantities. Analysis of the intestinal microflora showed a significant change in biocenosis, expressed in a decrease in the number of anaerobes compared to aerobes, the appearance of more than the allowable E. coli with reduced enzymatic activity.

 The patient was prescribed individual syndromic therapy. At the time of treatment, the couple was advised to refrain from unprotected sexual intercourse; a parallel correction of the intestinal and vaginal biocenoses was carried out. An oral patient took coliphage, then sorbents (lithovit with oats), then eubiotics (ferment of lactobacilli, drink "bifidok") and medical nutrition. Intravaginally administered suppositories with Trichopolum in combination with nystatin 10 1 time per day at night. This was followed by vaginal suppositories with thick propolis extract, which were recommended for use on the 1st at night 20. The final stage of treatment was the local administration of the drug “Acylact” in suppositories, 1 per day for 10 days.

 After therapy, the patient noted a clear improvement, in particular the cessation of pathological discharge, the disappearance of itching, burning of the genitals, the stool returned to normal, and flatulence was less disturbing. Gynecological examination showed the absence of pathological secretions, a positive amine test. The iodine-negative region was not determined, and the ectopia area significantly decreased with extended colposcopy. In a bacteriological study of vaginal secretion, a month after the end of therapy, an increase in the number of lactobacilli, the appearance of epidermal staphylococcus, the disappearance of hemolytic Escherichia coli and bacilli were noted. The amount of lactic acid streptococcus and Candida did not undergo any changes. Over the next 6 months of observation, recurrence of bacterial vaginosis was not noted.

 Example 2. Patient P., 26 years old, complained of moderate mucous vaginal discharge of white color, accompanied by itching and burning of the genitals for 1 year. It was treated independently by phytosouching. Menstrual function is not impaired. The sex life is rhythmic, married for 6 months, there were no pregnancies, uses a condom as contraception. Of the somatic diseases, gastritis, urolithiasis, flu, herpes labialis, hypotension, conjunctivitis, rhinitis, pharyngitis are noted; indicates contact for tuberculosis. Previously diagnosed with an ovarian cyst.

 Objectively, the condition is satisfactory. External genitalia without pathology. When viewed in the mirrors, there was a moderate amount of homogeneous gray vaginal secretion with an unpleasant odor and adhesion on the walls of the vagina. Separated from the cervical canal mucosa in a small amount. pH of vaginal secretion 5.9, amine test positive. During bimanual examination, the uterus and appendages are not changed. Extended colposcopy revealed signs of diffuse colpitis and a plot of leukoplakia. When smear bacterioscopy, there were up to 3-6 epithelial cells, the number of leukocytes up to 10 in the field of view.

During the initial bacteriological study of the vaginal microflora, the patient revealed moderate dysbiosis, which was manifested in a decrease in the number of the main microflora - lactobacilli to 10 ³ CFU / ml, an increase in the number of lactic acid streptococcus, and the appearance of Acinetobacter. The remaining microorganisms were determined in acceptable quantities. Analysis of intestinal microflora showed a significant change in biocenosis, expressed in a decrease in the number of bifidoflora, the appearance of more than the allowable epidermal staphylococcus.

 The patient was prescribed individual syndromic therapy. At the time of treatment, the couple was recommended to refrain from unprotected sexual intercourse. Conducted a parallel correction of the intestinal and vaginal biocenoses. Intravaginally administered suppositories with Trichopolum in combination with nystatin 10 1 time per day at night. This was followed by vaginal suppositories with thick propolis extract, which were recommended to be used on the 1st at night 10. The final stage of treatment was the local administration of the drug “Acylact” in suppositories, 1 per day for 10 days.

 After therapy, the patient noted a clear improvement, in particular the cessation of pathological discharge, the disappearance of itching, burning of the genitals. Gynecological examination showed the absence of pathological secretions, a positive amine test. Not determined iodine-negative area. In a bacteriological study of vaginal secretion, a month after the end of therapy, normalization of the level of lactobacilli and the disappearance of Acinetobacter were noted. Over the next 8 months of observing the recurrence of bacterial vaginosis was not noted, the planned pregnancy.

 A positive effect of the use of the proposed method is to stabilize the permeability of the vascular wall, expressed in the reduction of vaginal extravasation, trophic effect of suppositories with propolis extract dense on the vaginal and cervical epithelium, as a result of which the symptoms of uterine cervical diskeratosis disappear or decrease, which leads to a decrease in the frequency of the cervix uteri relapse of bacterial vaginosis.

Claims (1)

 A method of treating bacterial vaginosis with antibiotics and eubiotics, characterized in that the patient after antibiotic therapy is prescribed intravaginal suppositories with a propolis extract of thick 10-20 daily for 1 pc. at night, followed by the appointment of eubiotics.