RU2299742C1 - Method for treating anovulatory sterility cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves introduced Tanacan 40 mg three times a day 3 months long course. Magne B6 is concurrently introduced at a dose of 2 pills twice a day during 40 days. Endonasal Dalargin electrophoresis is additionally applied daily for 15-20 min. The total treatment course is 12 procedures long.

EFFECT: accelerated menstrual and reproductive function recovery.

Description

The invention relates to medicine, namely to endocrine gynecology, and can be used to treat primary and secondary infertility, the cause of which is anovulation.

Known methods of treating anovulatory infertility are: stimulation of ovulation with hormones (the use of synthetic progestins to obtain a rebound effect, the use of clostilbegit or other similar drugs, the administration of gonadotropins or gonadoliberin analogues), the suppression of excessive secretion of prolactin by ergot drugs, the stimulation of ovulation by surgical methods, in particular with laparoscopy (V.N.Serov et al. 1995, V.P. Smetnik, L.G. Timilovich, 1997, T.Ya. Pshenichnikova et al., 1991).

The disadvantages of these methods are their lack of effectiveness, "non-physiological", because there is no correction of metabolic, autonomic, endocrine disorders, concomitant anovulation, frequent complications (ovarian hyperstimulation syndrome, hirsutism, autonomic disorders, drug damage to the liver), the risk of damage to the abdominal organs and infections during endoscopic interventions, as well as the high cost and complexity of implementation.

The closest analogue of the proposed method is the use of bitemporal inductothermy in combination with infusions of sodium thiosulfate and injections of cerebrolysin (copyright certificate No. 1296126 of November 15, 1986).

Disadvantages: the method is invasive and complex, not effective enough.

The invention is aimed at solving the problem - the simplification of the method with high efficiency.

Effect: non-invasive restoration of menstrual and reproductive functions.

These tasks are achieved by using the drug “Tanakan” 40 mg 3 times a day with meals for 3 months while taking the multivitamin drug Magne B6 2 tablets 2 times a day for 40 days and conducting endonasal dalargin electrophoresis for 15-20 minutes daily, No. 10-12.

It is known that ovulation disorders in various endocrine diseases, including polycystic ovary syndrome, are caused by disorders of the hypothalamic-pituitary system. Tanakan is an extract of Ginkgo biloba, the effect of which is due to the effect on the metabolic processes in cells, the rheological properties of blood and microcirculation. The drug improves cerebral blood circulation and the supply of oxygen and glucose to the brain, normalizes metabolic processes, and has an antihypoxic effect on tissues. In addition, tanakan affects the release, reuptake and catabolism of neurotransmitters (norepinephrine, dopamine, acetylcholine) and their ability to bind to membrane receptors and thereby normalizes hypothalamic-pituitary disorders. Tanakan has not been used to treat anovulatous infertility. The use of vitamins is justified by their active participation in metabolic processes as coenzymes, their inherent adaptogenic and immunocorrective effects. The composition of the drug Magne-B6 includes magnesium, which is a vital element that is found in all body tissues and is necessary for the normal functioning of cells, is involved in most metabolic reactions. In particular, he is involved in the regulation of transmission of nerve impulses. Pyridoxine (vitamin B6) is involved in many metabolic processes, in the regulation of the metabolism of the nervous system, improves the absorption of magnesium from the digestive tract and its penetration into cells. Dalargin, which is a synthetic analogue of enkephalins, is characterized by antistress, immunomodulatory, cyto- and angioprotective, disaggregation effects and, in fact, is an adaptogen, because increases the functional reserves of adaptation mechanisms. The drug has high electrophoretic mobility. Given the anatomical and physiological connections between the nasal mucosa and the hypothalamus, in cases of menstrual and reproductive function disorders of central genesis, it is advisable to administer it in the form of endonasal electrophoresis, since this allows overcoming the blood-brain barrier for dalargin.

The method is as follows: the patient is prescribed 40 mg of tanakan 3 times a day with meals for three months while taking Magne-B6 2 tablets 2 times a day for 40 days. At the same time, 10-12 sessions of endonasal electrophoresis of dalargin are performed, daily, for 15-20 minutes, a session.

Examples of specific performance.

Example 1. Patient V., 24 years old, complained of rare (after 31-109 days) menstruation, weight gain, lack of pregnancy for two years of regular sexual life without co-contraception, headaches. Monthly irregular with menarche (from 12 years after 28-270 days), body weight has increased over the past 6 months. 5 kg. Sexual life since 18 years, there was no pregnancy. Among the diseases noted rubella, chickenpox, mumps, frequent tonsillitis, pyelonephritis from 16 years. Heredity: father has hypertension. Objective status: height 164 cm, weight 93 kg, BMI - 34.5. White striae on the mammary glands, buttocks and hips. Excessive hairiness on the legs and anterior abdominal wall. The thyroid gland is not enlarged. The mammary glands are soft, there is no discharge from the nipples. HELL 130/90 mm Hg, notes an increase to 140/100. Genital status: external genitalia are formed correctly, the cervix is clean, the symptom of the “pupil” is negative (day 26 of the cycle); the uterus is not enlarged, mobile, painless, the appendages are not clearly defined. Consulted by a therapist - DS: Symptomatic arterial hypertension of the 1st century, possibly dishormonal. ECG - sinus arrhythmia, heart rate of 65-130 per minute. The fundus - optic nerve discs are pale pink, arteries of normal caliber, moderate venous congestion. Ultrasound of the small pelvis: uterus 46 × 42.1 × 44.5 mm with even clear contours, homogeneous echostructure. M-echo - 4.6 mm. Right ovary: 49.4 × 20.7 × 33 mm, round shape, high echogenicity; follicles more than 10, in the form of beads along the periphery of the ovary, V = 17.2 cm ³ . Left ovary: 46.4 × 24.4 × 31.3 mm, similar structure, V = 18 cm ³ . In both ovaries there is no dominant follicle. Hormone testing: FSH - 9.0 mIU / ml, LH - 14.2 mIU / ml, prolactin 146.4 mIU / ml, testosterone - 0.63 ng / ml, C-peptide - 820.9 pm / l. Lipid spectrum - IV type of dyslipidemia. Fasting glucose - 4.1 mmol / L, after two hours - 5.2 mmol / L. In July 2004, surgical laparoscopy, wedge-shaped resection of the right ovary, electropuncture of the ovaries, chromosalpingoscopy.

Diagnosis: Menstrual dysfunction by the type of opsomenorrhea. Infertility I, anovulatory genesis. Polycystic ovary syndrome. Metabolic syndrome, obesity II tbsp. Arterial hypertension I Art.

The treatment was carried out: 40 mg tanakana 3 times a day with meals for three months with the simultaneous administration of Magne-B6 2 tablets 2 times a day for 40 days. Endonasal electrophoresis of dalargin, daily for 15 minutes No. 12. The rhythm of menstruation was optimized (after 29-38-40 days), pregnancy began. Pregnancy proceeded with the occurrence of threats, childbirth occurred on time. A boy was born 4314 g, 54 cm, according to Apgar 8-9 points.

Example 2. Patient T., 26 years old, complained of irregular periods after 27-112 days, periodic headaches, periodic stitching pains in the heart, weakness, fatigue, irritability.

Monthly from 15 years, irregular, for 5-7 days, moderate, painless. Sexual life from 16 years old, there were no pregnancies. Contraception: condoms, Diana - 35 for six months. After the cancellation of hormonal contraception, it aggravates the menstrual dysfunction - an increase in menstrual delays. Past diseases: frequent SARS, chickenpox, mumps, benign tumor of the left breast at birth, acute sinusitis at 16 years. Objective status: normostenic constitution, height - 164 cm, body weight - 55 kg, BMI - 20.4, OT / OB - 0.73. The thyroid gland is not enlarged, the mammary glands are soft, there is no discharge from the nipples. HELL 110/70 mm Hg From the internal organs pathology is not detected. Gynecological status: the cervix is clean, the symptom of the “pupil” is negative (21 days of the cycle); the uterus is not enlarged, mobile, painless, appendages are not clearly defined. Ultrasound of the small pelvis: uterus with dimensions of 50 × 33 × 38 mm of normal echostructure, M-echo - 4 mm, ovary: right 25 × 37 × 24 mm, V = 14.8 cm ³ , left 52 × 38 × 30 mm, V = 24.3 cm ³ ; both with echo-negative inclusions up to 10, with a diameter of 2-10 mm, located mainly on the periphery of the ovary, high echogenic stroma, strom / follicle ratio 50/50. According to the tests of functional diagnostics, anovulation was detected. The fundus is the plethora of arteries and veins. A hormonal study revealed slight hyperprolactinemia (prolactin 776 mIU / ml), FSH, LH, testosterone within normal limits. Fasting glucose - 4.0 mmol / L, after two hours - 3.8 mmol / L. The C-peptide is normal (463.4 pm). Indicators of the lipid spectrum of the blood without features. Diagnosis: Menstrual dysfunction by the type of opsomenorrhea of dysregulatory genesis. Anovulation. Polycystic ovary syndrome. Secondary hyperprolactinemia. The treatment was carried out: 40 mg tanakana 3 times a day with meals for three months with the simultaneous administration of Magne-B6 2 tablets 2 times a day for 40 days, dalargin edonasal electrophoresis daily for 20 minutes No. 10. The patient was examined after 6 months, the cessation of headaches, the optimization of the menstrual rhythm (3-6 days after 25-40 days) were noted. It is protected from pregnancy. A hormonal study showed normalization of prolactin levels (prolactin - 309.52 mIU / ml).

The positive effect of the proposed method in the form of increasing the effectiveness of treatment is that in women with neuroendocrine disorders and the anovulation caused by them, the function of the hypothalamic-pituitary system is optimized, the degree of metabolic disorders is reduced, cyclic processes in the ovaries are activated due to improved trophism of the brain structures due to tanakan and endonasal electrophoresis of dalargin, as well as the neurotropic action of pyridoxine, which is part of Magne-B6. The value of the proposed method lies in the fact that it does not cause complications and adverse reactions. The method is simple, affordable, easily reproducible, does not require large economic costs, is well tolerated by patients.

Claims (1)

A method for the treatment of anovulatory infertility with the help of medications and physiotherapy, characterized in that Tanakan 40 mg 3 times a day is prescribed as medications, a course of 3 months with the simultaneous administration of Magne B6 2 tablets 2 times a day for 40 days, and as a physiotherapeutic method, endonasal dalargin electrophoresis is used for 15-20 minutes daily, a course of 10-12 procedures.