RU2297823C1 - Method for treating patients with hormonally dependent diseases - Google Patents

Abstract

FIELD: medicine, gynecology.

SUBSTANCE: the present innovation deals with treating patients with hormonally dependent gynecological diseases occurring at the background of hyperestrogenemia: genital endometriosis, and/or uterine myoma, and/or diffuse proliferative mastopathies. The method deals with radon procedures as baths, gynecological irrigations, microenemas along with the intake of mineral water thrice daily about 30-60 min before meals, at the dosage of 3.5 mg/kg body weight, and laserotherapy in autoresonance mode, at radiation wave length being 0.89 mcm, 10 W power, at alternating frequency of laser irradiation. Additionally, patients should follow light mode at no artificial irradiation during the period since 9-10 p.m. up to 6-7 a.m. Laserotherapy in case of genital endometriosis or uterine myoma should be fulfilled onto uterine projection area at 15 min exposure, and in case of mastopathies - at choosing 10-16 fields of impact sectorally by not affecting the area of a teat and aureoles, per about 10-15 sec/field. The innovation improves therapeutic result due to marked decrease of estrogens level and normalization of gonadotropins ratio.

EFFECT: higher efficiency of therapy.

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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. Perfiliev, 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 treatment of patients with genital endometriosis and vulvar kraurosis", 1995; A.B. Ovsienko, EE Urvacheva "The influence of radon waters on the hormonal balance in genital endometriosis" - Mate Rals of the YII International Forum April 21-28, 2002 - Tunisia, Hammamet. - Moscow, 2002), radon waters in combination with laser therapy locally on the projection zones of the uterus and ovaries and mammary glands (A.B. Ovsienko "Non-drug therapy of genital endometriosis" - Materials of the International scientific-practical conference "University. Health. Intellect. - 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. When used in the treatment complex, the internal intake of mineral water normalizes the lipid profile (levels of cholesterol, high and low density lipoproteins, atherogenic coefficient).

The closest in technical essence to the proposed one is the treatment method, which consists in the use of radon procedures and laser therapy on the uterine projection area in combination with internal intake of mineral water (A.B.Ovsienko "Natural and preformed physical factors in the treatment of menopausal syndrome, genital endometriosis and kraurosis vulva in peri- and postmenopausal women. "- Abstract of a dissertation for the degree of Doctor of Medical Sciences. - Pyatigorsk, 2004).

However, the applied treatment methods only partially affect the central links of the pathogenesis of the development of hormone-dependent diseases, and this effect is mainly based on the use of radon water in the treatment complex. Thus, being essentially a pathogenetic method for the treatment of hormone-dependent gynecological diseases, the complex use of radon, laser therapy and internal intake of mineral water does not affect all the links in the pathogenesis of these processes. The ratio of gonadotropins when using all these factors to a certain extent is normalized indirectly, on the basis of feedback from sex steroid hormones. At the same time, the dependence of the secretion of gonadotropins on the functional activity of the hypothalamic structures of the brain is known. Currently, it is believed that the circhoral secretion of RH LH triggers the hypothalamic-pituitary-ovarian system, but this circhoral rhythm is modulated by pulses from extrahypothalamic structures (Knobil E., 1980; Smetnik V.P., Tumilovich L.G., 1999). One of the modulators of the functioning of hypothalamic structures is the pineal gland - an analyzer and a neuroendocrine link in the environmental illumination conditions that transport this information to the gonads (Serov V.N., Prilepskaya V.N., Pshenichnikova T.Ya. et al., 1995). A number of authors revealed an increase in the level of melatonin (hormone of the pineal gland) in the evening and during the night and a decrease in its level in the morning and especially at noon. In experiments with epiphysectomy, the presence of antagonistic correlations between the pineal gland and the ovaries was shown. According to a number of works, the inhibitory effect of melatonin on gonads is carried out through the pituitary gland. So, Damian (1980) showed that epiphysectomy in rats led to a significant increase in the production of gonadotropic hormones, and in the works of V. Isachenkov et al. (1981) showed that melatonin reduces the effects of LH and LH / FSH-RH. According to Milku, insufficient secretion of melatonin leads to increased FSH production and, therefore, persistence of follicles, polycystic ovaries, general hyperestrogenia (Serov V.N., Prilepskaya V.N., Pshenichnikova T.Ya. et al., 1995). The decrease in the functional activity of the pineal gland leads to excessive stimulation of estrogen production.

In connection with the foregoing, we proposed a method for treating patients with hormone-dependent diseases using natural and preformed physical factors and lifestyle changes in accordance with the natural daily biological rhythms of a person (observing the light regime of illumination).

The technical result of the proposed method of treatment is a more pronounced and lasting decrease in estrogen levels, normalization of the ratio of gonadotropins.

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 observing the light regime of illumination in accordance with natural biological rhythms person. 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 are used, 10 procedures per course; not earlier than 2 hours after receiving radon procedures or in alternation with radon procedures, laser therapy is prescribed in an autoresonant mode with a changing frequency of the laser apparatus every other day (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 location 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-sulfate sodium-calcium water of warm narzans of sources N4, N7 and N24 is used, 3.4 mg per 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 H4, 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.

Compliance with the light regime of illumination in accordance with the natural biological rhythms of man is to restore the biologically programmed natural light regime of illumination. In the period from 21-22 hours and until the next morning (6-7 hours), patients do not use artificial lighting and are in a state of sleep or simply without artificial lighting.

The technical result is achieved by the fact that patients observe a biologically programmed light regime with no artificial lighting in the period from 21-22 hours to 6-7 in the morning, against the background of course therapy, including radon procedures in the form of baths, gynecological irrigation, microclyster; laser therapy on the projection zone of the uterus with genital endometriosis and uterine myoma and on the mammary glands with diffuse proliferative mastopathies in autoresonance mode with a changing frequency of the laser apparatus, regardless of the frequency characteristics of the human body, with a radiation wavelength of 0.89 microns, power - 10 W, at genital endometriosis and uterine myoma - to the uterine projection zone with an exposure of 15 minutes, with mastopathy - with a choice of exposure fields from 10 to 16 for 10-15 seconds per field of exposure, and the laser It s not exerted on the nipple and areola area, in combination with an internal reception mineral water for 30-60 minutes before meals, depending on the state of the gastro-intestinal tract 3 times a day for 3.5 mg / kg body weight.

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 for 15 minutes, 10 treatments per course, 2-3 days, 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 with a radiation wavelength of 0.89 μm, the frequency mode is autoresonant, with a power of 10 W, 10-15 seconds per field of exposure, which are selected depending on the hormone-dependent disease: for genital endometriosis and uterine fibroids - the projection area of the uterine body, for mastopathy - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure, while the emitter is set ivaetsya on another field exposure with the touch to the field at genital endometriosis and uterine myoma - Exposure is for 15 minutes on a projection area of the uterus, mastopathy emitter when the movement is clockwise and radiarno on the nipple and areola area of laser exposure is not provided; internal intake of mineral water is carried out daily, 30-60 minutes before a meal, depending on the state of the hepatobiliary system, in an amount of 3.5 mg / kg of weight 3 times a day; in the period from 21-22 hours and until the next morning (6-7 hours), patients do not use artificial lighting and are in a state of sleep or simply without artificial lighting.

The method is illustrated by the following examples.

Example 1. Patient Nerobeeva OV Diagnosis: diffuse mastopathy, genital endometriosis. Complaints of pain in the lower abdomen, in the mammary glands, arising regardless of the menstrual cycle, pain during menstruation, blood clotting before menstruation. In a bimanual study, an increase in the body of the uterus up to 7 weeks, heterogeneity of consistency, surface roughness, pain on palpation. On examination and palpation of the mammary glands - painful diffuse foci of seals in the upper quadrants of both mammary glands. No discharge from the nipples. During the examination: clinical blood and urine tests - without pathology, ECG - without features. In the study of blood hormones, the concentration of estradiol was increased (287.6 pg / ml) compared with the level of healthy women by 148.8%, the level of progesterone was reduced (3.7 nmol / l). According to the lipid profile, cholesterol was within normal limits (6.1 mM / L), high density lipoproteins (HDL) was 2.41 mM / L, and low density lipoproteins (LDL) was 2.25 mM / L. The atherogenic coefficient (KA) was slightly increased (up to 3.56). Ultrasound 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.

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 influence - on the projection area of the uterine body and sectorally throughout the volume of the mammary gland, 10 fields of exposure. Internal intake of mineral water was carried out daily, 30-60 minutes before a meal, depending on the state of the hepatobiliary system, in an amount of 3.5 mg / kg of weight 3 times a day. The light mode corresponding to the biologically programmed rhythms of the human body was not observed by the patient.

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 (192.4 pg / ml), while remaining 66.4% higher in comparison with healthy women. The progesterone content increased (8.3 nmol / L). 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. KA dropped to 2.9. 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. The patient was discharged from the clinic with an improvement in general condition (reduction of pain, reduction of headaches, irritability, weakness, fatigue), gynecological status, 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 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. The level of hyperestrogenia after the received treatment complex has steadily decreased, in comparison with the initial indicator - by 36.3%.

Example 2. Patient Shiryaeva ON Diagnosis: diffuse mastopathy, genital endometriosis. Complaints of pains in the lower abdomen that occur before and during menstruation, often not related to the cycle, hemorrhage before menstruation, pain in the mammary glands that occur periodically, regardless of the menstrual cycle. In a bimanual study - an increase in the uterus up to 6-7 weeks., The body of the uterus is heterogeneous, with a rough surface, painful on palpation, inactive, in many adhesions. Upon examination and palpation of the mammary glands - multiple foci of seals with fuzzy contours, up to 2-3 cm in diameter, in the upper and upper inner quadrants of both mammary glands. During the examination: clinical blood and urine tests - without pathology, ECG - without features. In the study of blood hormones, an increased level of estradiol (264.7 pg / ml) was determined compared with that in healthy women - by 129% and a decrease in progesterone level (4.1 nmol / l). According to the lipid profile, there was slightly increased cholesterol - 7.7 mmol / L, and KA - up to 3.6; HDL was 1.23 mM / L and LDL was 3.28 mM / L. An ultrasound examination of the genitals determined multiple echopositive polymorphic inclusions, with irregular contours throughout the myometrium.

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, the exposure time was 15 minutes, the temperature was 36 ° C, the concentration of radon water was 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 projection area of the uterine body and 12 fields of exposure in the mammary gland. Internal intake of mineral water was carried out daily, 30-60 minutes before a meal, depending on the state of the hepatobiliary system, in an amount of 3.5 mg / kg of weight 3 times a day. In accordance with the natural biological rhythms of daily lighting, the patient observed the daylight hours with the exception of artificial lighting after 21-22 hours.

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 (158.3 pg / ml), while remaining 36.9% higher in comparison with healthy women, the progesterone concentration increased (11.7 nmol / L). According to the lipid profile, cholesterol decreased - 6.36 mM / L, HDL decreased slightly - to 0.97 mm / L, and LDL - increased to 3.43 mm / L. KA dropped to 2.9. 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. The patient was discharged with improvement in general condition (reduction of pain, reduction of headaches, irritability, weakness, fatigue), gynecological status, after 1 year she was re-examined in the clinic. The clinical condition, examination and palpation data, ultrasound examination of the genitals, hormonal and immunological studies, lipid profiles 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. The level of hyperestrogenia after the received treatment complex has steadily decreased, in comparison with the initial indicator - by 40.2%.

According to this method, 95 patients with hormone-dependent gynecological diseases were treated in the gynecological department of the Pyatigorsk clinic, of which 33 women (34.7%) with genital endometriosis, 31 (32.6%) with uterine fibroids and 31 (32.6%) - with diffuse proliferative dishormonal breast diseases that developed against the background of hormone-dependent diseases of the genitals. The control group consisted of 97 patients: 36 women (37.1%) with genital endometriosis, 30 (30.9%) with uterine myomas, and 31 (32%) 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 of 15 minutes, 40 or 180 nCi / l, for a course of 10-12 procedures. Not earlier than 2 hours after receiving radon procedures or in the alternation mode with radon procedures, laser therapy was prescribed the next day in autoresonance mode: for genital endometriosis and uterine fibroids - for gynecological zones (projection of the uterine body) without capturing the ovarian projection area, for diffuse mastopathies - sectorally depending on the volume of the mammary gland, from 10 to 16 fields of exposure. Patients in the control group also received carbonic chloride-hydrocarbonate-sulfate sodium-calcium water of warm narzans of sources N4, N7 and N24, 3.4 mg per kg of body weight 3 times a day, 40 minutes before meals. The biologically programmed light regimen was not observed by the control group patients.

Both groups were identical clinically. All patients with genital endometriosis and more than half of patients with uterine fibroids and mastopathy complained of pains in the lower abdomen that appear in the premenstrual or menstrual periods, spotting spotting before menstruation, with fibroids there were heavy spotting during menstruation, a long 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.

Patients of both groups underwent a study of blood hormones in the second phase of the menstrual cycle (FSH, LH, prolactin, estradiol and progesterone), lipid analysis, ultrasound scanning of the genitals, mammary glands, and colposocytological data were evaluated before and during 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 119.2%, with uterine fibroids - by 71.9%, with mastopathy - by 106.4%. Progesterone was reduced more evenly in all nosologies.

Violations of the content of HDL and LDL or their ratios were observed in almost all patients in all nosological observation groups. CA was increased in 62.3% of patients with genital endometriosis of the main group, 59.2% of the control group, 71.6% of women with uterine fibroids of the main group and 79.4% of the control, 67.4% of patients with diffuse proliferative dishormonal diseases mammary gland of the main group and 65.6% of the 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.

After complex treatment, in both groups of the observed patients, 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 lesion foci during bimanual, palpation and ultrasound examinations in all the observed patients.

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 of the indicator in healthy women (115.6 ± 9.5 pg / ml) by an average of 39.7%, with uterine myoma - by 41.5% with mastopathy - by 38.6%. In patients of the control group, the concentration of estradiol exceeded the average level in healthy women (115.6 ± 9.5 pg / ml) by an average of 59.5%, with uterine fibroids - by 42.2%, with mastopathy - by 49, 4% (see drawing).

According to lipidograms, after receiving treatment, cholesterol decreased in all patients in both the main and control groups. The content of HDL and LDL and the atherogenic coefficient tended to normalize in patients of both groups, a significant difference in the changes in the indicators in patients of both groups after treatment was not found.

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. In studies of blood hormones in the long term, patients of the main group showed a more pronounced decrease in estradiol levels compared with this indicator in healthy women. There was no significant difference in the levels of lipid profile in patients in both groups. In patients in both observation groups, stabilization of positive changes in hormonal status was maintained, however, taking into account data obtained immediately after course therapy, positive changes were more pronounced in patients of the main group than in patients of the control group.

Thus, the treatment method, including the correction of the light mode in accordance with biologically programmed rhythms, according to the effect on the hormonal status and the lack of difficulty in reproduction, is advantageous in comparison with the complex method of treatment without correction of the biologically programmed light mode and can be used at the stage of spa treatment sick.

Claims (1)

A method of treating patients suffering from hormone-dependent gynecological diseases developing against the background of hyperestrogenemia, genital endometriosis, and / or uterine fibroids, and / or diffuse proliferative mastopathies, including radon procedures in the form of baths, gynecological irrigation, microclyster, in combination with internal water intake 3 times a day before meals, depending on the state of the gastrointestinal tract, and laser therapy in autoresonance mode, with a radiation wavelength of 0.89 microns, a power of 10 W, with varying the frequency of laser irradiation, characterized in that patients additionally observe the light regime with no artificial irradiation from 21-22 hours to 6-7 hours in the morning, mineral water is taken 30-60 minutes before meals, at a dose of 3.5 mg / kg of weight, and laser therapy for genital endometriosis or uterine fibroids is carried out on the uterine projection zone with an exposure of 15 minutes, and for mastopathy - with the selection of 10-16 fields of exposure sectorally, without affecting the area of the nipple and halo, 10-15 s on each field.

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