RU2197218C2 - Method for treating women with chronic inflammatory diseases of inner genital organs - Google Patents

Abstract

FIELD: medicine, gynecology. SUBSTANCE: one should affect with a UHF-therapy upon acupuncture points R12, BM 46, the course consists of 10 procedures. After the second procedure one should add general iodine-bromine baths, after the third procedure - hydrogen sulfide vaginal irrigations by alternating them every other day. The course has got per 8 balneoprocedures. EFFECT: higher efficiency of therapy. 1 ex, 1 tbl

Description

 The invention relates to medicine, namely to gynecology, and can be used in practical health care in the treatment of women suffering from inflammatory diseases of the internal genital organs complicated by infertility.

 Chronic inflammatory diseases of the uterus and its appendages are the most common gynecological pathology. The chronic course of the inflammatory process determines the weakening of the hypothalamic-pituitary-ovarian connections and disorders of the neuroendocrine regulation of the reproductive system. There are many ways to treat and rehabilitate women with chronic inflammatory diseases of the internal genitalia. However, in the treatment of a chronic inflammatory process, psychoemotional, autonomic and dishormonal shifts are rarely taken into account, and the goal is not to simultaneously correct the psychoemotional status, state of the autonomic nervous system, and neuroendocrine regulation of the reproductive system. The closest prototype is the method of EHF-therapy of chronic inflammatory diseases of the pelvic organs in women (Strugatsky V.M. // Questions of balneology and physiotherapy, 5, 1996, p. 43-45). The anti-inflammatory and absorbable, immunomodulating and immunocorrecting effects of the method are moderate.

 The objective of the invention is to increase the effectiveness of treatment by reducing the inflammatory process, the disappearance of pelvic pains, normalizing the neuroendocrine regulation of the reproductive system, increasing nonspecific resistance, normalizing cellular and humoral immunity, reducing treatment time.

The task is achieved by the fact that after a minimal adaptation every day (for a course of treatment of 10 procedures) an electromagnetic radiation of extremely high frequency, a wavelength of 5.6 mm from the apparatus "Yav-1", is applied to the organ-specific zones of the uterus (R 12 on the right and left) and its appendages (BM 46 on the right and left) on the anterior abdominal wall, and after the second EHF-therapy procedure, the vacation of iodine-bromine common baths is connected, alternating them every other day with hydrogen sulfide vaginal irrigation at a concentration of hydrogen sulfide of 150 mg / l, water temperature 39-40 ^o C , etc expectancy of 15 minutes on the course 8 baths and irrigations.

 The method is as follows.

 From the third day from the patient’s admission for treatment, she is prescribed daily sessions of EHF therapy, a wavelength of 5.6 mm, on the reflexogenic zones of the uterus (R 12 on the right and left) and its appendages (BM 46 on the right and left) for 10 minutes per point , changing the localization of exposure every other day, for 20 minutes per session, for a course of 10 procedures.

 The horn of the installation is applied to the area of the biologically active acupuncture point R 12 (da-he), located 2-2.5 cm above the pubic joint, retreating 1.5-2 cm from the midline of the abdomen to the right. The exposure time of 10 minutes Then the horn is transferred to a similar position on the left. The exposure time of 10 minutes The total procedure time is 20 minutes.

 The horn of the installation is applied to the area of the uterus appendage point, located 4-5 cm above the middle of the inguinal fold, approximately on the line separating hypo- and mesogastria and the corresponding extrameridian acupuncture point VM 46. The exposure time is 10 min. Then the horn is transferred to a similar position on the left. The exposure time of 10 minutes The total procedure time is 20 minutes.

After the second procedure of EHF-therapy, common iodine-bromine baths are attached, at a temperature of 36-37 ^o C, lasting 10-15 minutes, releasing them every other day, and after the third procedure of EHF-therapy, hydrogen sulfide vaginal irrigation according to Yagunov, with a concentration of hydrogen sulfide of 150 mg / l, is attached , a temperature of 39-40 ^o C, lasting 15 minutes, every other day, on a course of 8 baths and vaginal irrigation.

 Scheme vacation procedures are given in the table.

 Example. Patient M., 24 years old, was treated at the gynecological clinic of the SRC KiR ChZUSS Ministry of Health of the Russian Federation from September 7, 1999 to September 30, 1999. In 1993, she underwent resection of the right ovary for apoplexy. Since 1994 - registered for infertility. Examined at the Rostov Scientific Research Institute of Atomic Energy and Epidemiology: deviations in the secretion of gonadotropic and ovarian hormones were not detected. The menstrual cycle is ovulatory. The fallopian tubes are passable. Since 1998 - menstrual irregularities of the type of hyperpolymenorrhea, glandular endometrial hyperplasia, treatment and diagnostic curettage of the uterine cavity was performed twice. Since 1998, chronic metroendometritis, anovulatory menstrual cycle have been diagnosed. In 1999, cyclic hormone therapy was performed. With GHA, patency of the fallopian tubes was established.

 Upon admission to the SRCC clinic, complaints of infertility, an irregular menstrual cycle, and moderate pains in the lower abdomen.

During the examination in the clinic was diagnosed with Secondary infertility. Chronic bilateral salpingo-oophoritis in the stage of persistent remission (adhesive form). Screening before treatment:
Psychological tests
Wayne's psycho-vegetative questionnaire - 35 points (autonomic dysfunction syndrome).

 Dembo-Rubinstein test - 6 points (reduced self-esteem).

 SAN test - 152 points (subcompensated state).

 Sample Luria - 6 words (subcompensated state).

 Schulte-Gorbov's test - 47 seconds (slowed down rate of sensorimotor reactions).

Vegetative tests
Normotonic type of autonomic reactivity in an ortho-clinostatic sample.

Laboratory research methods
Blood test: Нb 126 g / l, er. 4.2 10 / l, CP 0.94, white blood cells 4.0 10 / l, ESR 6 mm / h, C / I neutrophils 52%, P / I neutrophils 3%, eosinophils 3%, monocytes 4%, lymphocytes 38 %

 Urinalysis: beats, weight 1.027, ep. - a small number, leukocytes 3-5 p / sp., mucus - a little, bacteria - neg.

 Immunogram: white blood cells 5.6 10 / L, lymphocytes 39% - 2184, monocytes 8%, T-lymphocytes 55% - 1201, B-lymphocytes 9% - 196, T-helpers 31% - 677, T-suppressors 24% - 524, PSA - neg. Immunoglobulins: G 11.2 g / l, A 1.48 g / l, M 1.04 g / l.

 Biochemical blood test: total protein 85.3 g / l, albumin 61.1%, globulins 38.9%, A / G ratio 1.57, alpha-1-globulins 6.0%, alpha-2-globulins 8, 0%, beta-globulins 8.8%, gamma-globulins 16.1%. Serum catalase 49.1 μkat / L, ceruloplasmin 0.346 g / L, total lipids 3.7 g / L, diene conjugates of blood plasma lipids 2.78, erythrocyte malondialdehyde 55.2 nmol / ml red blood mass, malondial lipid 14 9 nmol / mg lipid.

 According to the results of the initial examination, the patient revealed a subcompensated state of the psychoemotional sphere, decreased self-esteem and short-term memory, and slowed down rates of sensorimotor reactions. Integrative assessment of vegetative status indicates the presence of autonomic dysfunction syndrome. According to the blood picture, the patient has moderate leukocytosis and a shift towards lymphocytes, which indicates the presence of chronic inflammation and the tension of adaptive defense mechanisms (ratio of lymphocytes / segmented neutrophils = 0.730). According to the immunogram: against the background of low activity of humoral immunity, the number of T-lymphocytes is reduced. The results of a biochemical blood test indicate the tension of the antioxidant system of the blood.

 The patient was prescribed a course of treatment according to the proposed method: EHF-therapy for reflexogenic zones of the uterus and its appendages on the anterior abdominal wall, only 10 sessions, in combination with iodine-bromine shared baths every other day, alternating them with hydrogen sulfide gynecological irrigation, according to the scheme (table).

 After treatment, the patient noted a significant improvement in well-being, increased activity and mood, improved sleep. Objectively, indicators characterizing the psycho-emotional status improved. According to the tests of functional diagnostics, a full-fledged ovulatory menstrual cycle was diagnosed. The pain syndrome was completely stopped on the 4th day of treatment.

Final examination data (after treatment)
Psychological tests
Wayne's psycho-vegetative questionnaire - 24 points (autonomic dysfunction syndrome).

 Dembo-Rubinstein test - 12 points (adequate subjective self-esteem).

 SAN test - 201 points (compensated state).

 Luria's test - 8 words (compensated state of short-term memory).

 Schulte-Gorbov test - 45 seconds (normal rate of sensorimotor reactions).

Vegetative tests
Normotonic type of autonomic reactivity in an ortho-clinostatic sample.

Laboratory research methods
Blood test: Нb 130 g / l, er. 4.36 10 / l, CP 0.89, white blood cells 8.5 10 / l, ESR 5 mm / h, C / I neutrophils 46%, P / I neutrophils 2%, eosinophils 2%, monocytes 6%, lymphocytes 44 %

 Urinalysis: ud.weight 1.014, eppl.- a little, leukocytes 1-2 in s / sp., Mucus - a little, bacteria - neg.

 Immunogram: white blood cells 7.9 10 / l, lymphocytes 40% - 3160, monocytes 7%, T-lymphocytes 58% - 1832, B-lymphocytes 22% - 695, T-helpers 28% - 884, T-suppressors 30% - 948, PSA - neg. Immunoglobulins: G 13.6 g / l, A 2.0 g / l, M 0.92 g / l.

 Biochemical blood test: total protein 77.7 g / l, albumin 57.6%, globulins 42.4%, A / G coefficient 1.36, alpha-1-globulins 7.3%, alpha-2-globulins 9, 2%, beta globulins 9.8%, gamma globulins 16.1%. Serum catalase 30.2 μkat / L, ceruloplasmin 0.311 g / L, total lipids 3.75 g / L, diene conjugates of blood plasma lipids 1.56, erythrocyte malondialdehyde 51.3 nmol / ml erythritol. mass, malondialdehyde lipids 13.7 nmol / mg lipids. A distinct positive dynamics was noted in the immunogram: the absolute number of lymphocytes, the absolute number of T- and B-lymphocytes significantly increased, the ratio of T-helpers and T-suppressors normalized, and the functional activity of antibody production was restored. Significantly activated the antioxidant system of blood. The degree of tension of adaptive defense mechanisms (the ratio of lymphocytes / segmented neutrophils = 0.950) has changed.

 Thus, as a result of treatment of the patient by the proposed method, she normalized the neuroendocrine function of the reproductive system, increased ovarian activity, increased level of estrogen secretion. During treatment, an immunomodulatory and immunocorrective effect was achieved, and an anti-inflammatory effect was achieved. The patient was discharged with improvement.

 In total, the proposed method treated 25 patients with chronic inflammatory diseases of the internal genitalia - 1 group. The age of patients ranged from 23 to 35 years. The treatment according to the proposed method, the patients tolerated well. The patients underwent a correction of their psychoemotional status, autonomic reactivity; during the wedge-orthostatic test, the normotonic variant was noted in 80%, asymptotonic in 16%, and hyperdiastolic in 4%. A pronounced anti-inflammatory effect was achieved, the bimanual study was painless in 92% of patients, the disappearance and softening of adhesions was noted in 84%. Immunomodulating and immunocorrecting action was manifested in the normalization of the level of cellular and humoral immunity in 88% of patients. As a result of treatment, a reliable normalization of the neuroendocrine regulation of the reproductive system occurred: in 7 (28%) patients, a full ovulatory cycle was noted, in 12 (48%) the ovulatory cycle, with luteal phase insufficiency, against the anovulatory phase before treatment, in 6 (24%), Anovulatory menstrual cycle. The average treatment efficacy was 84%. With a significant improvement, 4 (16%) patients were discharged, with an improvement of 17 (68%), with a slight improvement of 4 (16%).

 Patients of the 2 groups who received treatment according to the prototype by EHF-therapy for organ-specific zones of the uterus and its appendages (30 patients with chronic VZOT) also noted an improvement in their general condition. A decrease in the severity of pain was recorded in 78.9% of patients. According to the vaginal examination, the disappearance and softening of adhesions was noted in 42% of the subjects. The normalization of the psychoemotional state, autonomic regulation was objectively recorded, the number of patients with asymptaticotonic variant of autonomic reactivity decreased from 41.1 to 33.3%, the normotonic type was revealed after treatment in 66.7%. Positive dynamics of immunological parameters was noted: the level of T-helpers increased by 12%, T-suppressors decreased by 3%.

 However, the degree of harmonization of the neuroendocrine regulation of the reproductive system and anti-inflammatory, immunostimulatory and immunocorrective effects in the 2nd group was significantly lower than in the 1st, and the prototype treatment efficiency did not exceed 70% (with an improvement of 68%, with a slight improvement of 32%) sick).

 Thus, when carrying out treatment according to the proposed method, there is an increase in the effectiveness of treatment by reducing the inflammatory process, the disappearance of pelvic pain, normalizing the neuroendocrine regulation of the reproductive system, increasing non-specific resistance, normalizing cellular and humoral immunity, and shortening the treatment time.

Claims (1)

 A method of treating women with chronic inflammatory diseases of the internal genital organs, including exposure to electromagnetic radiation of extremely high frequency, a wavelength of 5.6 mm, characterized in that the exposure to EHF therapy is carried out after minimal adaptation, daily, for a course of 10 procedures, on organ-specific zones of the uterus : biologically active acupuncture points R 12 on the right and left and its appendages: acupuncture points BM 46 on the right and left on the anterior abdominal wall, connecting the general iodine-bromine baths after the second procedure, and After the third procedure, hydrogen sulfide vaginal irrigation at a concentration of hydrogen sulfide of 150 mg / l, alternating between them, every other day, for a course of 8 balneological procedures.

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