RU2195249C2 - Method for treating chronic salpingoophoritis - Google Patents

Abstract

FIELD: medicine, gynecology. SUBSTANCE: after adaptation period a EHF-therapy is conducted at 5.6 mm wave length to affect paired points R 12 and BM 46. Since the second procedure an iodine- bromine therapy is applied as vaginal irrigations and common baths. EFFECT: higher efficiency of therapy. 1 ex, 2 tbl

Description

 The invention relates to medicine, namely to gynecology, and can be used in medical practice in the treatment of women suffering from inflammatory diseases of the internal genital organs.

 Inflammatory diseases of the pelvic organs (VZOT) in women are the leading nosological form in gynecology. The outcome of VZOT depends on how early treatment was started and how effective it is. Difficulties in timely detection of PID are caused by a large number of erased forms of the disease, which initially acquires a chronic course and is already registered at the stage of complications, such as infertility, ectopic pregnancy, chronic pelvic pain, or menstrual dysfunction. Difficulties in achieving a complete and timely cure of VZOT are associated not only with their late diagnosis, but also with the polyetiological nature of the process, in the pathogenesis of which, as its duration is involved, almost all the systems of the female body are involved. The role of the microbial factor, which is not very pronounced in the early stages of inflammation, does not always manifest itself during an exacerbation of the current inflammatory process.

 Identification of the leading causative agent of VZOT has become practically impossible due to the presence of many different associations of pathogens, including protozoa and viruses.

 In connection with the foregoing, antibacterial and other drug therapy is not always justified and effective, and the treatment of women with PID requires a multi-component and staged effect on the body with the obligatory correction of the immune and endocrine systems. This is precisely the reason for the interest in non-drug methods of treating women with VZOT, among which natural and preformed physical factors are of major importance.

 A known method for the treatment of inflammatory diseases of the genitals of EMF EHF (electromagnetic waves of extremely high frequency) (Strugatsky V. M., WF "Questions of balneology and physiotherapy, 5, 1996, p. 43, 45). However, this method does not indicate the wavelength EHF radiation, and the Yav-1 apparatus is designed for various fixed wavelengths (7.1 mm, 5.6 mm, 4.8 mm).

 The objective of the invention is the development of a new comprehensive spa treatment of women with VZOT using iodine-bromine water and EHF-therapy. The effectiveness of this method was achieved by reducing the inflammatory process, the disappearance of pelvic pain, normalizing the function of the autonomic nervous system, increasing the nonspecific resistance of the body, normalizing cellular and humoral immunity, improving central hemodynamics, as well as reducing the duration of treatment.

 The task is achieved in that after an adaptation period, EHF-therapy is performed daily from the Yav-1 apparatus with a wavelength of 5.6 mm to paired reflexogenic points of the uterus (R-12 on the right and left) and ovaries (VM-46 on the right and left ) 10 minutes for each point, changing the localization of exposure every other day, and from the second EHF procedure, iodine-bromine balneotherapy is connected every other day, for a course of 8 balneotherapy and 10 physiotherapy procedures.

 The method is as follows.

From the third day from admission, the patient is prescribed daily EHF therapy from the Yav-1 apparatus with a wavelength of 5.6 mm
- the mouthpiece of the installation is applied to the area of the skin point R-12 (da-he), 2-2.5 cm above the pubic joint, retreating 1.5-2 cm from the midline to the right; exposure time 10 min. Then the horn is transferred to a similar position on the left, exposure time 10 minutes. The total procedure time is 20 minutes;
- the next day, the mouthpiece of the installation is applied to the area of the point of the uterine appendages, located 4-5 cm above the middle of the right inguinal ligament, approximately on the line separating the hypo- and mesogastrium and the corresponding acupuncture extrameridian point VM-46; exposure time 10 min, then the mouthpiece is transferred to a similar position on the left - exposure time - 10 minutes The total procedure time is 20 minutes.

 Procedures are carried out daily, every other day changing the localization of exposure (uterus - appendages), for a course of 10 procedures.

From the second EHF procedure, iodine-bromine balneotherapy is connected in the form of vaginal irrigation and common baths every other day, for a course of 8 irrigation and baths: vaginal irrigation according to Yagunov; water temperature 39-40 ^o C, exposure time 15 min; 15-20 minutes after the patient’s rest, they carry out general iodine-bromine baths, the water temperature is 36-37 ^o , 10-15 minutes.

 EXAMPLE.

 Patient B., 32 years old, was admitted to the clinic on January 17, 2000, and left on February 2, 2000 (medical history 59).

 From the anamnesis: VZOT was first diagnosed in 1997 according to GHA data (pipes are partially passable, peritubular adhesions). There was no exacerbation, 1-2 times a year received physiotherapy courses. Infertility 7 years.

 Upon admission to the clinic complaints of periodic pain in the lower abdomen, aggravated by hypothermia. Painful menstruation on days 1 and 2 of the cycle. Headaches, dizziness, lability of the psyche, weather sensitivity, instability of blood pressure. The examination was diagnosed with chronic left-sided salpingo-oophoritis in the stage of persistent remission. Residual effects of right-sided salpingoophoritis. Infertility 1. VSD mixed type.

Before treatment: blood test: HB - 142 g / l, red blood cells 4.25 × ^{10 12} / l, white blood cells 8.1 × ^{10 9} / l, ESR - 8 mm / h, segmented nuclear neutrophils 46%, rod-nuclear neutrophils - 2% , eosinophils - 5%, monocytes - 10%, lymphocytes - 37%.

 Urinalysis is within normal limits.

 Blood protein fractions: total protein 85.6 g / l, globulins - 48.8%, albumin - 51.2%, A / G coefficient - 1.05, alpha-1-globulins - 5.8%, alpha-2 -globulins - 9.5%, beta-globulins - 10.8%, gamma globulins - 22.7%.

Immunogram: white blood cells 9.0x10 ⁹ / l, lymphocytes 33% - 2970 / μl, monocytes 7%, T-lymphocytes 48% - 1425.6 / μl, B-lymphocytes 15% - 445.5 / μl T-helper cells - 27 % - 801.9 / μl, T-suppressors - 21% - 623.7 / μl, PSA - negative. Immunoglobulins M - 0.7 g / l, G - 13.6 g / l, A - 0.82 g / l.

Lipid peroxidation system:
Serum catalase - 43.6 mkkat / l.

 ceruloplasmin - 0.315 g / l.

total lipids - 3.76 g / l
diene conjugates of blood plasma lipids - 2.33 units
lipid malondialdehyde - 15.9 nmol / ml lipid
erythrocyte malondialdehyde - 59.9 nmol / mg erythrocytes. mass
Pelvic rheography: the intensity of blood supply to the pelvis is slightly reduced (0.13), the remaining indicators are within normal limits.

 According to the initial examination: relative neutrophilopenia, dysproteinemia due to an increase in the fraction of globulins, insufficiency of both cellular and humoral immunity, disturbances in the LPO system.

 The patient was prescribed a course of treatment according to the proposed method. During treatment, the patient felt good. No complaints. In dynamics noted improvement in well-being. Blood pressure during the observation was stable, headaches were not disturbed, weather sensitivity decreased. Towards the end of treatment, she felt cheerful, active, and rested. By the middle of the course, pains in the lower abdomen disappeared. By the end of treatment, pain was completely absent in the study of the genitals.

 At the end of treatment, according to a general blood test, hemoglobin increased slightly - 146 g / l, decreased: ESR up to 3 mm / h, monocytes - up to 6%, eosinophils - up to 2%. Segmented nuclear neutrophils increased slightly to 49% and lymphocytes to 40%.

 According to a biochemical study of blood serum, the A / G coefficient (1.32) and alpha-1 - (4.9%), alpha-2 - (8.7%) and gamma - (19.8%) globulins normalized.

 The performance in the lipid peroxidation system improved: the amount of serum catalase decreased to 35.6 mkat / l, as well as erythrocyte malondialdehyde to 56.5 nmol / ml and lipid malondialdehyde to 13.7 nmol / mg, the number of total lipids increased to 4 11 g / l

According to the immunogram, a distinct positive dynamics of the indicators of both cellular and humoral immunity is noted:
white blood cells - 8.4x10 ⁹ , lymphocytes - 39% - 3.276 / μl, monocytes - 8%, T-lymphocytes 52% - 1703.5 μl, B-lymphocytes - 22% - 720.7 μl, T-helpers - 37% - 1212.1 μl, T-suppressors - 15% - 491.4 μl, PSA - negative.

 According to rheography of the pelvic organs, there is an increase in their blood supply (Ri - 0.20).

 Thus, after the treatment, an anti-inflammatory, analgesic effect was achieved, normalization of the immune status indicators, lipid peroxidation and antioxidant defense, and improvement of pelvic hemodynamics.

 The patient was discharged with significant improvement.

 A total of 66 patients in 2 groups were examined and treated in the clinic of the center.

 Group 1 - 32 women aged 20 to 40 years with chronic inflammation of the uterus and its appendages (VZOT), disease duration from 2 to 10 years and infertility in 46% received treatment by the proposed method (table. 1).

 Group 2 - 34 women received treatment according to the prototype by EHF-therapy for organ-specific zones of the uterus and its appendages.

 At the end of treatment, all patients noted an improvement in their general condition, almost all patients in both groups stopped lower abdominal and lower back pain, decreased pain during menstruation was observed in 90% of patients in group 1 and 82% in group 2, hypermenorrhea decreased from 28% to 6 % in the 1st group and from 17% to 9% in the second group. A bimanual study at the end of treatment became painless in 89.3% of cases in group 1 and 78.9% in the second.

 According to the vaginal examination, at the end of treatment for infiltrative adhesions, the complete disappearance of puffiness and pastiness was detected in both groups, and the disappearance and softening of adhesions were recorded in 79% of women in the 1st group and in 42% of the second group.

 In the course of the study, approximately equal positive dynamics of adaptive blood reactions in both groups was revealed. So, the number of “calm activation” reactions in group 1 increased by 10%, and in 2 - by 12.8%, reactions of “increased activation" in group 1 - by 9%, and in 2 - by 8%.

 Thus, in both groups there was a decrease in tension in the system of adaptive reactions due to an increase in the number of "calm activation" reactions and a decrease in "increased activation" reactions.

 According to the wedge-orthostatic test (CPC), more significant dynamics was achieved in the first group. So, the number of patients with the asymptotic-to-CPC variant decreased from 36.4% to 18.2% in group 1, and in the second group - from 41.1% to 33.3%. And the number of patients with normotonic type reached 81.6% in the 1st group and 66.7% - in the second.

 An improvement in central hemodynamics was noted in group 1: vascular tone decreased from 16.7 + 0.92% to 15.7 + 0.80% after treatment (and in the second group it increased from 15.8 + 1.9% to 17.3 + 0.93%), interhemispheric asymmetry significantly disappears (the coefficient decreases from 34.6 + 5.42% to 17.8 + 3.72%, p <0.001). In the second group, the difference in the blood supply to the hemispheres practically does not change: before treatment 41 + 3.5%, after - 40.5 + 4.0%.

 Positive dynamics of immunological parameters in both groups was noted. The increased level of leukocytes and lymphocytes decreased, T-lymphocytes increased. but a more pronounced positive dynamics of cellular immunity was achieved in group 1. The average level of T-helpers increased from 27.8% to 30.75 (and in the second group, it remained unchanged: 43.6% and 43.7%). Moreover, the number of patients with a normal level of T-helpers increased in the first group by 20%, and in the second - by 12%. The increased level of T-suppressors decreased in the first group from 29% to 25%, and in the second - from 21% to 18%.

 Based on the analysis of the data obtained, the treatment efficiency in the 1st group was 1.9 points, and in the second - 1.6 points (Table 2)

Claims (1)

 A method of treating chronic salpingo-oophoritis by exposure to EHF therapy from the Yav-1 apparatus, characterized in that after the adaptation period, EHF therapy is carried out with a wavelength of 5.6 mm daily on paired reflexogenic points of the uterus R-12 on the right and left and ovaries of the BM 46 on the right and on the left, 10 min for each point, changing the localization of exposure every other day, and from the second EHF procedure, iodide-bromine balneotherapy in the form of vaginal irrigation and general baths is connected every other day, for a course of 8 balneotherapy and 10 physiotherapy procedures.

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