RU2281748C2 - Method for correcting hormonal and immune disorders in patients with hormonodependent diseases - Google Patents

Abstract

FIELD: medicine, gynecology.

SUBSTANCE: patients should be suggested to take radon procedures as baths, gynecolopgical irrigations, microenemas, laserotherapy in autoresonance mode at altering frequency of laser apparatus independently against frequency characteristics of human body, at wave length of 0.89 mcm, power of 10 W onto area of uterine projection in case of genital endometriosis and uterine myoma at exposure of 15 min and onto mammary glands in case of diffuse proliferative mastopathies. Impact fields should be chosen by sectors ranged 10-16 per 10-15 sec for each impact field. Local therapy should be conducted about 2.5-3 h after taking radon procedures successively, not earlier. The first stage - baths with malavit at 1:5 dilution at exposure of 15 min. The second stage - after removing the solution out of vagina it is necessary to introduce malavit gel at a tampon for 4-6 h. The whole therapy should be carried out together with internal intake of mineral water 30-60 min before meals thrice daily per 3.5 mg/kg body weight. The innovation enables to achieve prolonged remission, normalize hormonal level in blood and duration of the second phase of the cycle and decrease cholesterol level in blood.

EFFECT: higher efficiency of correction.

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Description

The invention relates to medicine, namely to gynecology, and for the treatment of women suffering from hormone-dependent gynecological diseases.

Known methods for treating women suffering from hormone-dependent diseases (genital endometriosis, uterine fibroids, diffuse mastopathy) using radon water in the form of baths, gynecological irrigation, microclyster (I.F. Perfilieva, E.Sh. Chumburidze, N.V. Cheltsova 1985 ; L. P. Lugovaya, V. A. Guryev, B. G. Ermoshenko, M. M. Evseeva, A. B. Ovsienko: "Differentiated methods of spa therapy of patients with genital endometriosis and vulvar kraurosis", 1995; A. B. Ovsienko, E.E. Urvacheva: “Changes in immunogenesis during radon therapy in patients with genital endometriosis Balneology and physiotherapy of Siberia in the concept of development of health care and medical science of the Russian Federation. - Materials of a scientific conference. - Tomsk, 2002; A.B.Ovsienko, E.E. Urvacheva: "The effect of radon water on hormonal balance in genital endometriosis" - Materials YII International Forum April 21-28, 2002 - Tunisia, Hammamet. - Moscow, 2002), radon waters in combination with EHF-therapy (E.E. Urvacheva, A.B.Ovsienko: “The use of EHF-therapy in spa rehabilitation patients with genital endometriosis and vulvar kraurosis ", 2000) and radon waters in plex with laser locally on the projection area uterine and ovarian and mammary gland (AB Ovsienko: “Non-drug therapy of genital endometriosis” - Materials of the International scientific-practical conference “University. Health. Intelligence". - Kislovodsk, 2003).

These methods of treatment have a positive effect on hormonal and immune status (a decrease in the initially elevated estrogen level and an increase in the decreased progesterone concentration, immunomodulating or immunostimulating effect in some cases). The structure of the tissues of the body and neck of the uterus, mammary gland improves: the size of the foci of tumor-like processes decreases. However, when assessing the immediate results of the complex of radon and laser therapy, an increase in cholesterol and atherogenic coefficient in 65% of patients is noteworthy, and in the analysis of long-term treatment results, it should be noted that the concentration of progesterone in 78% of patients remains quite high at low estradiol values. The set of exposure factors, in addition to the positive aspects, leads to pronounced vascular spasm, including in target organs, which indirectly can contribute to the “blocking" of receptors for sex steroid hormones and in the long term causes the resumption of pathological manifestations to one extent or another. Thus, being essentially a pathogenetic method for the treatment of hormone-dependent gynecological diseases, the complex of radon and laser therapy does not affect all the links in the pathogenesis of these processes.

The essence of the invention lies in the fact that patients are prescribed radon procedures in the form of baths, gynecological irrigation, microclyster, laser therapy on the projection area of the uterus and (or) on the mammary glands in combination with the internal intake of mineral water and local treatment consisting in the use of baths with malavit and tampons with malavit gel. Radon baths, gynecological irrigation, microclysters with a radon concentration of 1.5 or 6.5 kBq / l are used, with an exposure of each radon procedure of 15 minutes per course - 10 procedures; not earlier than 2 hours after receiving radon procedures or in the alternation mode with radon procedures, laser therapy is prescribed every other day in autoresonance mode with a changing frequency of the laser apparatus (regardless of the frequency characteristics of the human body). The radiation wavelength is 0.89 microns, the frequency mode is autoresonant, the power is 10 W, 10-15 seconds per field of exposure. Fields of exposure are selected depending on the nature of the hormone-dependent gynecological disease and the area of the pathological process. In case of genital endometriosis and uterine myoma (without gross structural changes in the nodes and in the absence of a pronounced predominance of the fibrous component according to ultrasound data), the area of exposure to laser radiation is gynecological zones (projection of the uterine body) without capturing the ovarian projection area. With diffuse mastopathy, the laser therapeutic effect is sectoral depending on the volume of the mammary gland, from 10 to 16 fields of exposure. The emitter is installed above the next field with a touch to the field, the emitter moves as it is exposed clockwise and radially. Laser effects are not exerted on the nipple and areola area.

For internal intake of mineral water, carbonic chloride-bicarbonate-sulphate sodium-calcium waters of warm narzans of sources N4, N7 and N24 are used, 3.4 mg per 1 kg of body weight 3 times a day, 40 minutes before meals. These waters are characterized by high gas saturation, hypotonic salt concentration (5.2 g / l), therapeutically active concentration of iron - more than 10 mg / l (source K4, N24) and silicon (source N24), and an increased content of heavy metals (source N4, N7, N24), manganese, potassium and thorium X (source N7). The content of the latter makes it possible to attribute source N7 (Pyatigorsk) to weakly radioactive waters with a high content of thorium X.

For local procedures, malavit is used in the form of a solution and gel: a 1: 5 dilution of malavit for baths, standard malavit gel for vaginal swabs. The choice of drug substance (malavit) is associated with its features. Malavit normalizes the vaginal biocenosis, contributes to an increase in the number of Doderlein sticks, and is an informationally active drug. Along with a powerful antiseptic antibacterial, pronounced antiviral, antifungal actions, it has the ability to regulate the restoration of information of body cells through the skin, mucous membranes, biologically active substances and nerve endings. Malavit improves the conductivity of nerve impulses in the central and peripheral nervous system. These effects of the drug contribute to the restoration of the normal structure of the cells of the tissues of the target organs.

The method is as follows.

Patients are prescribed radon baths, gynecological irrigation, microclysters with a radon concentration of 1.5 or 6.5 kBq / l, with an exposure of each radon procedure of 15 minutes, 10 procedures per course. The patient's procedures are received in the regimen: 2-3 days admission - 1 day break. Not earlier than 2 hours after receiving radon procedures or in alternation with radon procedures, laser therapy is prescribed every other day. The radiation wavelength is 0.89 μm, the frequency mode is autoresonant, the power is 10 W, 10-15 seconds per field of exposure. Fields of exposure are selected depending on the hormone-dependent disease: in case of genital endometriosis and uterine myomas, the projection area of the uterine body, in case of mastopathy - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure. The emitter is installed over the next exposure field with a touch to the field, with genital endometriosis and uterine myoma, the effect is exerted for 15 minutes on the uterine projection zone, with mastopathy the emitter moves clockwise and radially. Laser effects are not exerted on the nipple and areola area. Local treatment in the form of baths with malavit and tampons with malavit gel is carried out no earlier than 2.5-3 hours after taking radon procedures and is carried out sequentially. The first stage - baths with malavite in a dilution of 1: 5 with an exposure of 15 minutes, the second stage - after removing the solution from the vagina, the malavit gel on the swab is inserted for 4-6 hours. Internal intake of mineral water is carried out daily, 30-60 minutes before meals, depending on the state of the hepatobiliary system, in the amount of 3.5 mg / kg of weight 3 times a day.

The method is illustrated by the following examples.

Example 1. Patient Ponomarenko L.N. Diagnosis: Diffuse mastopathy, genital endometriosis. Complaints of pain during menstruation, pain in the mammary glands that occur before and during menstruation, often unrelated to the cycle, blood clotting before menstruation. In a bimanual study, an increase in the uterus is determined up to 4-5 weeks., The body of the uterus is heterogeneous, with a somewhat rough surface, painful on palpation; seals and heterogeneous rough formations on the sacral uterine ligaments. On examination and palpation of the mammary glands - multiple painful diffuse foci of seals in the upper quadrants of both mammary glands, more on the right. There was no discharge from the nipples. Research conducted: clinical tests of blood and urine - without pathology. ECG - without features. In the study of blood hormones, increased estradiol values (318.3 pg / ml) and a decrease in progesterone levels (4.6 nmol / l) were determined. Immunological studies revealed violations of cellular immunity (an excess of B-lymphocytes and a decrease in T-helpers), violations of phagocytic activity and a decrease in immunoglobulins. According to the lipid profile, cholesterol was increased to 6.9 mM / L, HDL was 1.97 mM / L and LDL was 2.63 mM / L. The atherogenic coefficient was also increased. An ultrasound examination of the genitals determined multiple echopositive polymorphic inclusions with irregular contours in the myometrium of different parts of the uterus; endometrial thickness 11 mm (examination - in the second phase of the cycle). Ultrasound of the mammary glands recorded multiple diffusely located sections of echopositive inclusions in the upper outer, upper inner quadrants. A colpocytological study showed a prolonged increase in KPI (up to day 18 of the cycle), a shift to the right in the maturation index (IS) with a predominance of surface cells up to day 17 of the cycle.

Treatment. The treatment complex consisted of prescribing general radon baths, gynecological radon irrigation and microclysters from radon water (200.0) using the drop method at a temperature of 36 ° C, the exposure time was 15 minutes, with a concentration of radon water of 180 nCi / l (6.5 kBq / l) . All procedures were performed on the same day, 2-3 days in a row, 1 day off, 10 courses per course.

After taking the indicated complex of treatment, the pains in the lower abdomen and in the mammary glands decreased, with palpation - pain, the size of the foci of endometriosis and diffuse seals in the mammary glands, the degree of prevalence of pathological formations. Clinical analyzes of blood and urine remained within normal limits; the degree of purity of the vaginal flora was II. ECG - without features. The level of estradiol decreased (276.4 pg / ml), and progesterone increased (6.9 nmol / L). In immunological studies, the level of B-lymphocytes, T-helpers, indicators of phagocytic activity and immunoglobulins increased. According to the lipid profile, cholesterol increased to 7.2 mM / L, HDL decreased slightly to 1.88 mM / L, and LDL increased to 2.89 mM / L. The atherogenic coefficient remained elevated. An ultrasound examination of the genitals determined an improvement in the structure of the myometrium (in general, a decrease in the number of echopositive polymorphic inclusions, more even contours in the inclusions, a decrease in the size of the initially enlarged uterine body). With ultrasound of the mammary glands, the areas of echopositive inclusions in the upper outer, upper inner quadrants decreased in size. A colpocytological study maintained an increase in KPI until the 11th day of the cycle, a shift to the left in the maturation index (IS) with an increase in the number of intermediate cells up to the 12th day of the cycle.

The patient was discharged with improvement in general condition, gynecological status, condition of the mammary glands; after 1 year re-examined in the clinic. The clinical condition, examination and palpation data, ultrasound examination of the genitals and mammary glands deteriorated somewhat compared with the state after course therapy, but the foci of the pathological changes in the tissue cells did not reach their previous sizes. The patient notes a slight increase in pain in the lower abdomen and in the mammary glands over the past 3 months. In studies of blood hormones, the concentration of estradiol was 291.4 pg / ml, and progesterone - 5.6 nmol / L. Significant changes in the immunological background compared with the state after course therapy were not detected.

Summary. Thus, the patient took a course of treatment with radon waters in the clinic, tolerated the procedure well, there were no adverse side effects. Remission was observed for 9 months.

Example 2. Patient Sizhazheva F.K. Diagnosis: Diffuse mastopathy, genital endometriosis. Complaints of pain in the lower abdomen, in the mammary glands that occur before and during menstruation, often - not related to the cycle, pain during menstruation, hemorrhage before menstruation. In a bimanual study - an increase in the uterus up to 5-6 weeks., The body of the uterus is heterogeneous, with a rough surface, painful on palpation. On examination and palpation of the mammary glands - painful diffuse foci of seals in the upper quadrants of both mammary glands, more on the right. There was no discharge from the nipples. During the examination: clinical blood and urine tests - without pathology, ECG - without features. In the study of blood hormones, increased estradiol values (294.6 pg / ml) and a decrease in progesterone levels (3.9 nmol / l) were determined. Immunological studies revealed violations of cellular immunity (excess levels of B-lymphocytes), minor violations of phagocytic activity and the content of immunoglobulins. According to the lipid profile, cholesterol was within the normal range of 5.6 mM / L, HDL was 1.91 mM / L and LDL was 3.13 mM / L. The atherogenic coefficient was slightly increased. An ultrasound examination of the genitals determined multiple echopositive polymorphic inclusions with irregular contours throughout the myometrium. With ultrasound of the mammary glands - multiple diffusely located sections of echopositive inclusions in the upper outer, upper inner quadrants. A colpocytological study showed a prolonged increase in CRPD (up to 17 days of the cycle), a shift to the right of IP with a predominance of surface cells up to 17 days of the cycle.

Treatment. The treatment complex consisted of the appointment of gynecological radon irrigation, general radon baths and microclysters from radon water (200.0) using the drip method, the exposure time was 15 minutes, and the temperature was 36 ° C. Radon waters of a concentration of 180 nCi / L (6.5 kBq / L) were used. All procedures were performed on the same day, 2-3 days in a row, 1 day off, 10 courses per course. 2 hours after receiving radon procedures or in alternation with radon procedures, laser therapy was prescribed every other day. The radiation wavelength is 0.89 μm, the frequency mode is autoresonant, the power is 10 W, 10-15 seconds per field of exposure. Fields of exposure are selected depending on the hormone-dependent disease: in case of genital endometriosis and uterine myomas, the projection area of the uterine body, in case of mastopathy - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure. The emitter is installed over the next exposure field with a touch to the field, with genital endometriosis and uterine myoma, the effect is exerted for 15 minutes on the uterine projection zone, with mastopathy the emitter moves clockwise and radially. Laser effects are not exerted on the nipple and areola area. Not earlier than 2.5-3 hours after taking radon procedures, local treatment was sequentially performed in the form of baths with malavit and tampons with malavit gel. Internal intake of mineral water was carried out daily, 30-60 minutes before meals, depending on the state of the hepatobiliary system, in quantity 3.5 mg / kg of weight 3 times a day.

After taking the indicated complex of treatment, the pains in the lower abdomen and in the mammary glands decreased, with palpation - pain, the size of the foci of endometriosis and diffuse seals in the mammary glands, the degree of prevalence of pathological formations.

Clinical analyzes of blood and urine remained within normal limits; the degree of purity of the vaginal flora was I-II. ECG - without features. The level of estradiol decreased (223.1 pg / ml), and progesterone increased (8.3 nmol / l). In immunological studies, the level of B-lymphocytes decreased slightly, T-helper cells remained within normal limits, initially elevated levels of phagocytic activity and immunoglobulins decreased, and lower ones increased. According to the lipid profile, cholesterol remained within the normal range of 5.27 mM / L, HDL decreased slightly to 1.29 mM / L, and LDL increased to 3.19 mM / L. The atherogenic coefficient decreased. An ultrasound examination of the genitals determined an improvement in the structure of the myometrium (in general, a decrease in the number of echopositive polymorphic inclusions, more even contours of the inclusions, a decrease in the size of the initially enlarged uterine body). With ultrasound of the mammary glands, the areas of echopositive inclusions in the upper outer, upper inner quadrants decreased in size. A colpocytological study showed an increase in KPI to 10 days of the cycle, a shift to the left in the maturation index (IS) with an increase in the number of intermediate cells.

The patient was discharged from the clinic with an improvement in general condition, gynecological status, and condition of the mammary glands. After 1 year, the patient was re-examined in the clinic. The clinical condition, examination and palpation data, ultrasound examination of the genitals and mammary glands, hormonal and immunological studies, lipid profiles and colpocytology remained almost unchanged compared with the state after course therapy.

Summary. Thus, the patient took a course of treatment with radon waters in the clinic, tolerated the procedure well, there were no adverse side effects. Remission was observed within 12 months.

Example 3. Patient Sitko IB Diagnosis: Genital endometriosis. Complaints of pain in the lower abdomen that occur before and during menstruation, often unrelated to the cycle, blood clotting before menstruation. In a bimanual study - an increase in the uterus up to 5-6 weeks., The body of the uterus is heterogeneous, with a rough surface, painful on palpation, inactive, in many adhesions. During the examination: clinical blood and urine tests - without pathology, ECG - without features. In the study of blood hormones, increased estradiol values (328.2 pg / ml) and a decrease in progesterone levels (4.4 nmol / l) were determined. Immunological studies revealed violations of cellular immunity (excess levels of B-lymphocytes and T-helpers), violations of phagocytic activity and a reduced content of immunoglobulins. According to the lipid profile, cholesterol was slightly elevated - 7.2 mM / L, HDL was 1.23 mm / L and LDL - 3.28 mm / L. The atherogenic coefficient was slightly increased. An ultrasound examination of the genitals determined multiple echopositive polymorphic inclusions with irregular contours throughout the myometrium. A colpocytological study showed a prolonged increase in KPI (up to day 19 of the cycle), a shift to the right in the maturation index (IS) with a predominance of surface cells up to day 18 of the cycle.

Treatment. The treatment complex consisted of prescribing gynecological radon irrigation, general radon baths and microclysters from radon water (200.0) using the drip method, exposure for 15 minutes, temperature 36 ° C, radon water concentration 180 nCi / l (6.5 kBq / l). All procedures were performed on the same day, 2-3 days in a row, 1 day off, 10 courses per course. 2 hours after receiving radon procedures or in alternation with radon procedures, laser therapy was prescribed the next day. The radiation wavelength is 0.89 μm, the frequency mode is autoresonant, the power is 10 W, 10-15 seconds per field of exposure. Fields of exposure are selected depending on the hormone-dependent disease: in case of genital endometriosis and uterine myomas, the projection area of the uterine body, in case of mastopathy - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure. The emitter is installed over the next exposure field with a touch to the field, with genital endometriosis and uterine myoma, the effect is exerted for 15 minutes on the uterine projection zone, with mastopathy the emitter moves clockwise and radially. Laser effects are not exerted on the nipple and areola area. Not earlier than 2.5-3 hours after taking radon procedures, local treatment was sequentially performed in the form of baths with malavit and tampons with malavit gel. Internal intake of mineral water was carried out daily, 30-60 minutes before a meal, depending on the state of the hepatobiliary system, in the amount of 3.5 mg / kg of weight 3 times a day.

After taking the indicated complex of treatment, pains in the lower abdomen decreased, with a bimanual study, pain, the size of the foci of endometriosis, and the degree of prevalence of pathological formations decreased.

Clinical analyzes of blood and urine remained within normal limits; the degree of purity of the vaginal flora was I-II. ECG - without features. The level of estradiol decreased (198.7 pg / ml), and progesterone increased (11.7 nmol / L). In immunological studies, the level of B-lymphocytes decreased slightly, T-helper cells remained within normal limits, initially elevated levels of phagocytic activity and immunoglobulins decreased, and lower ones increased. According to the lipid profile, cholesterol decreased to 6.36 mM / L, HDL decreased slightly to 0.97 mM / L, and LDL increased to 3.43 mM / L. The atherogenic coefficient decreased. An ultrasound examination of the genitals determined an improvement in the structure of the myometrium (in general, a decrease in the number of echopositive polymorphic inclusions, more even contours in the inclusions, a decrease in the size of the initially enlarged uterine body). With ultrasound of the mammary glands, the areas of echopositive inclusions in the upper outer, upper inner quadrants decreased in size. A colpocytological study maintained an increase in KPI up to day 10 of the cycle, a shift to the left in the maturation index (IS) with an increase in the number of intermediate cells.

The patient was discharged with an improvement in general condition, gynecological status, after 1 year she was re-examined in the clinic. The clinical condition, data of examination and palpation, ultrasound examination of the genitals, hormonal and immunological studies, lipidograms and colpocytology remained almost unchanged compared with the state after course therapy.

Summary. Thus, the patient took a course of treatment with radon waters in the clinic, tolerated the procedure well, there were no adverse side effects. Remission was observed within 12 months.

Example 4. Patient Yandarova N.A. Diagnosis: uterine fibroids. Complaints of a feeling of heaviness in the lower abdomen, heavy menstruation, sometimes - blood clotting before menstruation. In a bimanual study - an increase in the uterus up to 5-6 weeks., The body of the uterus is of heterogeneous consistency, with large foci of consolidations, an uneven deformed surface, inactive, in many adhesions. During the examination: clinical blood and urine tests - without pathology, ECG - without features. In the study of blood hormones, the concentration of estradiol did not exceed the standards (144.7 pg / ml); progesterone levels were reduced (2.8 nmol / L). Immunological studies revealed violations of cellular immunity (somewhat lower content of B-lymphocytes and an excess of T-helpers), disturbances in phagocytic activity and low immunoglobulins. According to the lipid profile, cholesterol was increased 7.93 mM / L, HDL was 2.23 mM / L and LDL was 2.33 mM / L. The atherogenic coefficient was increased. An ultrasound examination of the genitals determined the heterogeneity of the myometrium structure, the formation along the posterior wall of the uterus (closer to the bottom of the uterus), which gives an acoustic path, some deformation of the contours of the uterus, and the thickness of the endometrium in the second phase of the cycle is 12 mm. A colpocytological study showed a prolonged increase in KPI (up to 21 days of the cycle), a sharp shift to the right in the maturation index (IS) with a significant predominance of surface cells up to 18-19 days of the cycle.

Treatment. The treatment complex consisted of the appointment of gynecological radon irrigation, general radon baths and microclysters from radon water (200.0) by the drip method, exposure for 15 minutes, temperature 36 ° C, radon water concentration of 180 nCi / l (6.5 kBq / l). All procedures were performed on the same day, 2-3 days in a row, 1 day off, 10 courses per course. 2 hours after receiving radon procedures or in alternation with radon procedures, laser therapy was prescribed a day later. The radiation wavelength is 0.89 μm, the frequency mode is autoresonant, the power is 10 W, 10-15 seconds per field of exposure. Fields of exposure are selected depending on the hormone-dependent disease: in case of genital endometriosis and uterine myomas, the projection area of the uterine body, in case of mastopathy - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure. The emitter is installed over the next exposure field with a touch to the field, with genital endometriosis and uterine myoma, the effect is exerted for 15 minutes on the uterine projection zone, with mastopathy the emitter moves clockwise and radially. Laser effects are not exerted on the nipple and areola area. Not earlier than 2.5-3 hours after taking radon procedures, local treatment was sequentially performed in the form of baths with malavit and tampons with malavit gel. Internal intake of mineral water was carried out daily, 30-60 minutes before a meal, depending on the state of the hepatobiliary system, in the amount of 3.5 mg / kg of weight 3 times a day.

After taking this complex of treatment, the feeling of heaviness in the lower abdomen decreased, with a bimanual examination, the uterine body acquired greater mobility, the size of the formations giving the acoustic path decreased, the structure of the myometrium became more uniform. Clinical analyzes of blood and urine remained within normal limits; the degree of purity of the vaginal flora was I-II. ECG - without features. The level of estradiol decreased (91.2 pg / ml), and progesterone increased (14.9 nmol / L). In immunological studies, the level of B-lymphocytes increased slightly, T-helper cells, on the contrary, remained within normal limits, initially elevated levels of phagocytic activity and immunoglobulins decreased, and lower ones increased. According to the lipid profile, cholesterol decreased to 5.79 mM / L, HDL decreased slightly to 1.32 mM / L, and LDL increased to 3.85 mM / L. The atherogenic coefficient decreased. An ultrasound examination of the genitals determined an improvement in the structure of the myometrium (overall, the heterogeneity of the myometrium, the size of the echo-negative formation, and the size of the initially enlarged uterine body decreased). A colpocytological study showed a decrease in KPI after 12 days of the cycle, a shift to the left in the maturation index (IS) with an increase in the number of intermediate cells from 13 days of the cycle.

The patient was discharged with an improvement in general and gynecological status; re-examined in the clinic after 1 year. The clinical condition, data of examination and palpation, ultrasound examination of the genitals, hormonal and immunological studies, lipidograms and colpocytology remained almost unchanged compared with the state after course therapy.

Summary. Thus, the patient took a course of treatment with radon waters in the clinic, tolerated the procedure well, there were no adverse side effects. Remission was observed within 12 months.

According to this method, 102 patients with hormone-dependent gynecological diseases were treated in the gynecological department of the Pyatigorsk clinic, of which 37 women (36.28%) with genital endometriosis, 31 (30.39%) with uterine fibroids and 34 (33.33% ) - with diffuse proliferative dishormonal breast diseases that developed against the background of hormone-dependent diseases of the genitals. The control group consisted of 92 patients: 32 women (34.78%) with genital endometriosis, 31 (33.7%) with uterine fibroids and 29 people (31.52%) with diffuse proliferative dishormonal breast diseases. Patients in the control group received radon procedures in the form of baths, gynecological irrigation and microclysters with a temperature of 36 ° C, with an exposure of each procedure for 15 minutes, 40 or 180 nCi / l, for a course of 10-12 procedures. Both groups were identical clinically. All patients with genital endometriosis and more than half of patients with uterine fibroids complained of pain in the lower abdomen that appears in the premenstrual or menstrual periods, smearing spotting before menstruation. Patients with uterine fibroids observed abundant spotting during menstruation, a prolonged period of bleeding. With mastopathy, women noted periodically arising pulling and bursting pains in the mammary glands, associated and not related to the cycle. In all patients, foci of diffuse seals in the mammary glands, painful on palpation, were determined.

The study of blood hormones in the second phase of the menstrual cycle (FSH, LH, prolactin, estradiol and progesterone) was carried out for patients of both groups, in some patients (50%) immunological blood tests were performed, as well as for all women - lipid profile studies, ultrasound scanning of genitals, milk glands, evaluated data colposcitological studies before and after treatment.

In the study of blood hormones in women in both groups, increased estradiol values and a decrease in progesterone levels were determined. It should be noted that in patients with genital endometriosis, the concentration of estradiol exceeded the average level in healthy women (115.6 + 9.5 pg / ml) by an average of 115.7%, with uterine fibroids - by 74.3%, with mastopathy - by 101.7%. Progesterone was reduced more evenly in all nosologies. Immunological studies were carried out in some patients: 29 women (42.03%) with genital endometriosis, 24 (38.71%) with uterine myomas, and 28 (44.44%) with diffuse proliferative dishormonal breast diseases. Violations of cellular immunity, phagocytic activity and immunoglobulin levels were noted in 23 patients (79.31%) with genital endometriosis of the total number examined, 16 (66.67%) with uterine fibroids and 21 (75%) with diffuse proliferative dishormonal diseases the mammary gland. According to lipidograms, cholesterol was initially increased in 31 patients (83.79%) with genital endometriosis in the main group and 25 (78.13%) in the control group, 22 women 70.97%) with uterine fibroids in the main group and 24 (77.42 %) - control, 27 patients (79.41%) with diffuse proliferative dishormonal breast diseases of the main group and 18 (62.07%) - control. Violations of the content of HDL and LDL were observed in almost all patients in all nosological observation groups. The atherogenic coefficient was increased in 34 patients (91.89%) with genital endometriosis of the main group, 28 (87.5%) in the control group, 28 women (90.32%) with uterine fibroids of the main group, and 26 (83.87%) - control, 23 patients (67.65%) with diffuse proliferative dishormonal breast diseases of the main group and 23 (79.31%) - control.

Ultrasound examination of the genitals with genital endometriosis revealed multiple echopositive polymorphic inclusions, heterogeneous, with irregular contours, in the myometrium of different parts of the uterine body. With uterine fibroids, thickenings of the walls of the uterus, nodular inclusions giving acoustic shadows, deforming the external and internal contours of the uterine body were generally determined. Ultrasound of the mammary glands in patients with diffuse proliferative dishormonal diseases of the mammary gland registered multiple diffusely located areas of echopositive inclusions, mostly in the upper outer, upper inner, and less often the lower outer quadrants.

Colpositological studies were carried out before admission to the spa treatment in some patients: 62.32% of patients with genital endometriosis, 61.29% with uterine myomas and 61.91% with diffuse proliferative dishormonal breast diseases. There was a long-term increase in KPI (up to 18-19 days of the cycle), a shift to the right in the maturation index (IS) in all patients examined according to these parameters: 21 (56.76%) and 22 women (68.75%) with genital endometriosis and the control groups, respectively, with uterine myoma - 24 (77.42%) and 21 (67.74%) people, with diffuse proliferative dishormonal breast diseases - 27 (79.41%) and 22 (75.86%) patients respectively.

After complex treatment using radon procedures, laser therapy, internal intake of mineral water and local treatment (baths with malavit and tampons with malavit gel), a significant improvement was noted: a decrease in pain in the lower abdomen and in the mammary glands, a decrease in the size of the lesions with bimanual, palpation and ultrasound in all observed patients. In patients of the control group, after radonotherapy as a monofactor treatment, the indicators of clinical status and data of bimanual, palpation and ultrasound studies were slightly worse. In this group, pain in one degree or another was more often preserved, with bimanual, palpation and ultrasound examinations, the sizes of endometriotic foci and foci of densification in the mammary glands decreased, but to a lesser extent than in patients of the main group, and myomatous nodes generally responded rather weakly .

In the study of blood hormones in women in the main group after treatment, there was a more pronounced decrease in estradiol levels and an increase in progesterone than in patients of the control group. So, in patients of the main group after treatment with genital endometriosis, the concentration of estradiol exceeded the average value in healthy women (115.6 ± 9.5 pg / ml) by an average of 54.7%, with uterine fibroids - by 41.8% with mastopathy - by 37.2%. In patients of the control group, the concentration of estradiol exceeded the level of average values in healthy women (115.6 + 9.5 pg / ml) by an average of 91.2%, with uterine fibroids - by 64.1%, with mastopathy - by 63, 7% (see drawing).

In immunological studies after treatment, indicators of cellular immunity, phagocytic activity and levels of immunoglobulins in all patients in the main observation group tended to normalize (that is, when the values of the indicators were exceeded, the tendency to decrease in their values was determined, and if the values were initially reduced, to increase the levels of indicators) . Patients in the control group showed a unidirectional tendency to increase levels of indicators (immunostimulating effect of the applied treatment factor), which in cases with initially reduced indicators is undoubtedly a positive aspect of the influence of the treatment factor, and at initially increased values of the indicators it can contribute to aggravation of disorders.

According to lipidograms, after receiving treatment, cholesterol decreased in all patients in the main group and remained elevated in the control group. The content of HDL and LDL and the atherogenic coefficient tended to normalize only in patients of the main group, and in the control group these indicators either remained unchanged, or the atherogenic coefficient increased slightly.

According to a colpocytological study, during treatment, normalization of the duration of the second phase of the cycle was observed in all patients (increased KPI to 10-13 days of the cycle, some shift to the left in the IS after 11-14 days of the cycle). More noticeable positive changes in colposcitological studies were recorded in patients of the main group.

When using complex therapy in all cases of observation, a prolonged remission was observed (up to 11-12 months). Long-term studies showed the absence of a pronounced tendency to worsen indicators according to clinical status, bimanual, palpation and ultrasound studies, hormonal, immunological studies, lipid profile and colpocytology in patients of the main group. In patients of the control group, despite prolonged clinical improvement (7–9 months), after 7–9 months. there was a slight increase in estradiol concentration, a decrease in progesterone levels, some destabilization of immunological parameters, lengthening of the first phase of the cycle according to colpositological studies, worsening clinical status, bimanual, palpation and ultrasound data.

Thus, a comprehensive treatment method in many respects is advantageous in comparison with monofactor radon therapy.

Claims (1)

A method of treating patients suffering from hormone-dependent gynecological diseases, characterized in that the patients undergo radon procedures in the form of baths, gynecological irrigation, microclyster, auto-resonant laser therapy with a changing frequency of the laser apparatus, regardless of the frequency characteristics of the human body with a wavelength of 0.89 μm, with a power of 10 W per projection zone of the uterus with genital endometriosis and uterine myoma with an exposure of 15 min and to the mammary glands with diffuse proliferative mastopathies with a choice of leu sectorally exposure from 10 to 16 with 10-15 per exposure field; local treatment, not earlier than 2.5-3 hours after radon procedures sequentially: the first stage - conduct baths with malavit at a dilution of 1: 5 with an exposure of 15 minutes, the second stage - after removing the solution from the vagina, the malavit gel is injected on a swab for 4-6 h, all treatment is carried out in combination with the internal intake of mineral water 30-60 minutes before meals, 3 times a day, 3.5 mg / kg of body weight.