RU2223726C2 - Method for performing medicamentous treatment of female lutein phase insufficiency cases - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering rhythmic heat treatment of nasolabial area of a woman from Thermopulser apparatus daily. A treatment is 15 min long during the first two sessions and 30 min the last eight sessions. EFFECT: improved gonadotropic hypophysis function; repaired adequate ovary response; improved central and peripheral hemodynamics. 1 tbl

Description

 The invention relates to medicine, namely to gynecology, and can be used as an independent non-drug method for treating women with menstrual dysfunction.

 Disorders of ovarian function in the structure of the incidence of women of young reproductive age continue to occupy a leading place and account for up to 40% of the pathology [1]. Being the cause of infertility and miscarriage in 80% of patients. Luteal phase insufficiency (NLF) accounts for a significant proportion of other ovarian dysfunction and is the most poorly treatable form of pathology.

 There is a method of restoring ovarian function using magnetotherapy [2], which consists in exposure to constant or alternating low-frequency magnetic fields, which causes a selective effect on blood coagulation, microcirculation and vascular permeability, exerting anti-inflammatory decongestant, analgesic and stimulating the regeneration of a number of tissues action.

The disadvantages of the method are:
1) low efficiency
2) numerous contraindications (tendency to bleeding, hypocoagulation of blood, malignant neoplasms),
3) the possibility of exacerbation of existing chronic inflammatory diseases of the pelvic organs.

 The closest in technical solution is a way to restore ovarian function using endonasal galvanization [3].

The method has the following disadvantages:
1) is used as an integral part of complex treatment,
2) has contraindications (acute inflammatory processes that often accompany menstrual irregularities, hemostatic disorders, hematuria, skin diseases, individual intolerance to galvanic current),
3) the method has undesirable side effects:
headache, sleep disturbance, irritability,
4) lack of data on the accuracy and effectiveness of the method.

 These disadvantages are supposed to be eliminated in the claimed method. Currently available methods of treating NMF do not meet all the requirements of high efficiency, safety, and the absence of side effects.

 The technical result of the proposed method is non-pharmacological treatment of NLF insufficiency in women suffering from menstrual dysfunction, by applying a rhythmic thermal impulse effect on the nasolabial region for 15 minutes for the first two sessions, all subsequent ones are brought up to 30 minutes, the number of procedures is 10. The effect is carried out daily, s 5th to 14th days of the menstrual cycle. The effectiveness of the treatment is 87.2%.

 The rhythmic thermal effect is used from the Thermopulsator apparatus (copyright certificate 308757), developed by V.A. Lichtenstein. The method of thermal pulsation was proposed in 1972 by V.A. Lichtenstein. With this effect, the temperature of special heaters (thermodes) fixed on the surface of the nasolabial triangle changes alternately. In one phase corresponding to expiration, the temperature of the thermodes corresponds to the temperature of the skin, and the patient does not have a thermal sensation. In the next phase - the inspiratory phase - the thermode acquires a higher temperature, and the patient has a sensation of pulsating heat. The pulsation frequency is set in the rhythm of the respiratory movements, the intensity of the thermal effect is selected individually. Procedures are carried out daily in the morning. The duration of the first two sessions is 15 minutes, the subsequent 30 minutes.

 The device is intended for the treatment of neuroses of various etiologies, hypoxic-ischemic encephalopathies, sleep disorders, to improve performance, to normalize autonomic reactivity. The therapeutic effect is based on a mechanism for improving central and peripheral hemodynamics, a sedative-hypnotic effect.

 The novelty of the proposed method lies in the fact that for the first time "Thermopulsator" is used in gynecological practice as an independent method for the treatment of NLF in girls and women of the early reproductive period. The therapeutic effect, as our studies first showed, is based on the effect of improving the pituitary gonadotropic function in the form of increasing serum concentrations of LH and FSH, improving ovarian function, in the form of increasing levels of estradiol in the first phase of the menstrual cycle and progesterone in the second phase, to the figures characteristic for the full phase of secretion, improving the protein-secretory function of the endometrium - there is an increase in the level of AMHF of menstrual blood. In addition, an adequate ovarian response to gonadotropic effects is restored.

Distinctive features of the method are:
1) is used to treat NLF in girls and women of early reproductive age as an independent method,
2) the course of treatment - 10 procedures, the duration of the first 2 for 15 minutes, then for 30 minutes. Patient's position - lying on his back.

 The effect of using the method was evaluated by restoring the usefulness of the luteal phase of the menstrual cycle (serum progesterone and the content of menstrual blood DMHF), restoring the regular rhythm of menstruation and pregnancy.

 In this way, 47 women with NLF were treated, of which restoration of ovarian function occurred in 87.2%.

The advantages of the method:
1) can be used as an independent method of treatment,
2) high efficiency (87.2%),
3) simplicity and accessibility.

 The essence of the method is illustrated by the following examples.

1. Patient T., 18 years old. Received examination and treatment with a diagnosis of: Violation of the menstrual function of the type of luteal phase insufficiency. The examination revealed that according to the tests of functional diagnostics: the basal temperature has a two-phase character, with a rise in temperature to 37.0-37.2 ^o With a duration of 8 days, the concentration of FSH in the blood serum is 3.45 mIU / ml, LH is 3 , 05 mIU / ml, estradiol - 21.06 ng / ml, progesterone - 16.5 ng / ml, AMHF concentration in menstrual blood - 16 μg / ml, endometrial Zug - endometrium of the initial phase of secretion. The diagnosis was made on the basis of a shortening of the phase of hyperthermia of less than 12 days, a decrease in the concentration of AMHF and progesterone, on the nature of secretory transformations of the endometrium.

After treatment according to the claimed method, the patient in the next cycle after treatment restored the luteal phase adequacy: the rise in basal temperature in the range of 37.1-37.3 ^o C for 12 days. The FSH level was 5.82 mIU / ml, LH 6.02 mIU / ml, estradiol 32.5 ng / ml, progesterone 20.2 ng / ml, AMHF content in menstrual blood 64 μg / ml, TSUG endometrium - menstrual secretory endometrium. According to all the data, the patient restored the normal ovulatory cycle. By the end of 6 months of observation, the adequacy of phase II was maintained by basal temperature and AMHF of menstrual blood. 7 months after the end of treatment, T. became pregnant, which ended in timely delivery with the birth of a living healthy child. Pregnancy was complicated by early toxicosis of pregnancy in the form of mild vomiting of pregnant women, the birth act was complicated by a pathological preliminary period.

2. Patient N., 22 years old. Received treatment with a diagnosis of menstrual dysfunction as a type of luteal phase failure. The duration of the hyperthermia phase is 5 days, with basal temperature fluctuations of 36.9 ^o -37.2 ^o C. During the examination: FSH - 4.25 mIU / ml, LH - 3.87 mIU / ml, estradiol - 28.7 ng / ml, progesterone - 13.8 ng / ml, AMHF content in the menstrual blood - 8 μg / ml, endometrial ZAG - corresponds to the initial phase of secretion.

After treatment according to the claimed method in the next cycle, according to all the data, the patient restored the normal ovulatory cycle: the duration of the hyperthermia phase is 12 days, with basal temperature fluctuations of 37.0-37.3 ^o C; serum FSH content - 7.08 mIU / ml, LH - 6.93 mIU / ml, estradiol - 38.2 ng / ml, progesterone - 19.8 ng / ml, AMHF content in menstrual blood - 32 μg / ml , ZAG endometrium - consistent with the menstrual secretory endometrium.

 The adequacy of phase II was maintained according to basal temperature, AMHF of menstrual blood, and data from morphological studies of the endometrium during the 1st year of observation.

3. Patient I., 20 years old. Diagnosis at admission: menstrual dysfunction of the type of NLF. During the examination: the duration of the hyperthermia phase is 2 days, with basal temperature fluctuations of 36.9-37.0 ^o C; serum FSH content - 5.24 mIU / ml, LH - 6.12 mIU / ml, estradiol - 20.23 ng / ml, progesterone - 9.28 ng / ml, AMHF content in menstrual blood - 4 μg / ml , CUT endometrium - corresponds to the initial phase of secretion.

After the treatment according to the claimed method, in the next cycle after treatment, the basal temperature rose more than 37.0 ^o C for 12 days, the content of FSH in the blood serum was 6.02 mIU / ml, LH - 6.48 mIU / ml, estradiol - 28.89 ng / ml, progesterone - 19.36 ng / ml, the content of AMHF in the menstrual blood - 32 μg / ml, ZAG of the endometrium - corresponded to the late phase of secretion.

 By the end of the first half of the year after treatment, the patient again showed luteal phase insufficiency according to the tests of functional diagnostics: the phase of hyperthermia lasted no more than 10 days, AMHF of menstrual blood was 16 μg / ml. Similar indicators remained at the end of the 1st year of observation.

 Comparative data on treatment with the prototype method are shown in the table.

 List of used literature.

 1. Guide to endocrine gynecology / Ed. E.M. Vikhlyaeva. - M.: Medical News Agency, 1997. - 768 p., Ill.

 2. Handbook of physiotherapy / V. G. Yasnogorodsky, T. V. Karachevtseva, N. I. Strelkova et al. / Ed. V.G. Yasnogorodsky. - M .: Medicine, 1992, 512 p., Ill.

 3. Strugatsky V. M. Physical factors in obstetrics and gynecology. - M .: Medicine, 1981, 208 p., Ill.

Claims (1)

A method of non-drug treatment of luteal phase insufficiency in women with menstrual dysfunction, characterized in that instead of conventional therapy, they use rhythmic thermal effects on the woman's nasolabial region from the Thermopulsator apparatus for 15 minutes for the first two sessions, followed by eight for 30 minutes daily.

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