RU2301655C1 - Method for treating the disorders of menstrual cycle in women - Google Patents

Abstract

FIELD: medicine, gynecology.

SUBSTANCE: the present innovation deals with treating the disorders of menstrual cycle in women in case of amenorrhea and oligoamenorrhea of central and inflammatory genesis. It is necessary to affect symmetrical acupuncture epiphyseal points Mp31, alternately right and left ones due to alternate switching red color -λ 700 nm and green color -λ 546.1 nm. The exposure of impact onto a point with one color is 60 sec. Total duration of impact for points corresponds to 12 min. Then during 5 min one should affect eyes with chromatorhythmostimulation of blue color - λ 435.8 nm with flashes of 10 sec duration and interval between flashes of 60 sec. Additionally, one should introduce an immunomodulator tamerite and an adaptogen melaxen. The innovation enables to increase the terms of remission and exclude side effects of hormonal therapy.

EFFECT: higher efficiency of therapy.

1 cl, 2 ex

Description

The invention relates to medicine, namely to physiotherapy and gynecology, in particular to the problem of menstrual irregularities, and is intended for the treatment of secondary amenorrhea - oligoamenorrhea of central and inflammatory origin.

Violations of the menstrual function in women of reproductive age are a serious problem in the medical and social sphere, which is associated with an unfavorable demographic situation in the Russian Federation. Treatment of patients with secondary amenorrhea should be comprehensive, stage-wise, etiological, individual and pathogenetically substantiated. The main emphasis in the treatment of patients of this group falls on the etiotropic treatment, which causes a significant drug load on the female body and does not give a pronounced clinical effect.

In this regard, it is relevant to search for new therapeutic methods, for example, using physiotherapeutic factors, one of which is color therapy. Over the past few years, the therapeutic effect of color has been convincingly proven. Color is widely introduced into medicine in many countries of the world and, if only the main colors were used at the first stages: red, yellow, blue, then recently turquoise, purple, pale red, pure green and others are used (Alternative treatment methods in obstetrics and gynecology / Edited by Prof. A.G. Kolomitseva. - Kiev, 1996. - 264 p.).

On the basis of the three-component theory of color vision, a unified color classification system was built, according to which the International Tri-color Measurement System was introduced in 1931 by the ICE, slightly adjusted in 1964. It uses three main monochromatic colors, denoted by international agreement as R (red, λ = 700 nm), G (green, λ = 546.1 nm), B (blue, λ = 435.8 nm). The color of any radiation can be obtained by mixing the primary colors taken in a certain proportion. The most promising method of treatment was the use of the action of visible light of various wavelengths on the active areas, zones and points of the skin of the human body. Color therapy helps prevent the development of diseases and speeds up the healing process for existing diseases. Depending on the chosen strategy and tactics of treatment, exposure to visible light of different spectral composition can be carried out on the organs of vision, various areas, zones or points of the skin, while having a local or systemic effect on the patient's body. The optimal therapeutic effect is realized with an appropriate choice of the site of exposure and color (wavelength).

Known methods for treating patients with secondary amenorrhea and oligomenorrhea of central genesis using hormone replacement therapy (William W. Beck. Jr., Obstetrics and gynecology, publication GOETAR. M .: Medicine, 1997, p. 380-382, translated from English under Edited by Savelyeva G.M., Sichenava L.G.). However, some patients suffering from endocrine diseases, allergic reactions, diseases of the digestive system, blood, etc., cannot use the whole range of therapeutic measures, which reduces the effectiveness of treatment and lengthens its time.

Several schemes of complex treatment of NMCs are described, carried out in stages (Treatment of menstrual dysfunction in women / Medicine and Health, www.agat.aorta.ru.25-07-2005). According to the description, estrogens are prescribed at 10,000 units on the 1st, 3rd, 5th, 7th days of the cycle; on the 9th, 11th, 13th days, 10,000 units of estrogen and 10 mg of progesterone in oil (in one syringe); on the 15-21st days of the cycle - progesterone 10 mg / m. In the absence of menstruation after 10 days, the treatment is repeated. At the same time, vitamin E is used (30% solution in capsules - 0.2 mg) - 1 capsule every other day, folic acid - 0.02 g 2-3 times, glutamic acid - 0.25 g 2-3 times a day , ascorbic acid - 1.0 g / day and hardware physiotherapy (vaginal diathermy, gynecological massage). In case of insufficiency of the luteal phase in order to compensate for the deficiency of progestogens, prescribe: progesterone - 1.0 ml of 1% solution in oil from the 18th to the 25th day of the cycle or 3.0 ml of 1% solution in 21, 22nd, 23rd day of the cycle; 17-OPK - 1.0 ml of 12.5% v / m on the 18th day of the cycle; pregnin - 30 mg / day under the tongue daily for 6-7 days from the 18th to the 24th, 25th day of the cycle. Choriogonin is prescribed at 1,500 units IM from the 14th day for 3 days, then from the 18th to the 25th day - at 500 units every other day; clomiphene - 4 tablets. per day from the 19th to the 25th day or 1 v / m ampoule on the 21st, 23rd, 25th days; rigevidone, non-ovlon - 1 tablet per day from the 15th to the 25th day of the cycle. Vitamin E is prescribed at 50-60 mg / day, ascorbic acid - at 0.5 g daily. Non-drug treatment - electrophoresis with 2% zinc sulfate solution in the second phase of the cycle; various types of reflexology.

However, this method has a number of significant drawbacks, one of which is the long duration of treatment that does not lead to the achievement of a sufficient and stable clinical effect, as well as relapse of the disease. The use of a large number of various drugs often leads to drug dependence on some of them, the occurrence of side effects and various complications, including impaired fertility.

A known method of treating menstrual dysfunction in patients with neuroendocrine syndrome (RF patent No. 2248196, 2005), including fractional diet low-calorie diet, physical activity in the form of terrencur, characterized in that patients are prescribed intake of mineral water from a Slavyanovsky source at a dose of 3-5 ml per 1 kg of weight 3 times a day, baths and gynecological irrigation with carbon dioxide mineral water with a temperature of 36-38 ° C, an exposure of 10-15 minutes, for a course - 8-12 procedures. However, this method does not provide a stable remission and, as the authors themselves note, a positive effect was observed only for 4-5 months, and then gradually the weight increased and the cycle became irregular again.

Methods of treating menstrual dysfunction with postpartum neuroendocrine syndrome using diet, exercise, and clomiphene (clostilbegit) 50 mg once a day from 5 to 10 days of the menstrual cycle for 2-3 months are described (Smetnik V.P., Tumilovich L.G., 2001; RF patent No. 2101024, 1998). However, if the ovulatory cycle is not restored after weight loss and the elimination of metabolic disorders, the authors consider surgical treatment indicated. In addition, the long-term use of these drugs causes a number of complications: ovarian hyperstimulation (lower abdominal pain, flatulence), menorrhagia, cystic ovarian enlargement, nausea, diarrhea, flushing, dizziness, visual impairment, dermatosis and multiple pregnancy.

By the prototype of the invention, we have chosen a method for treating menstrual dysfunction (AS USSR No. 1587733, 1988) by exposure to a helium-neon laser, which is carried out on the nasal mucosa at a power density of 100 mW / cm ² for 2 min 5 days.

The disadvantage of this known technical solution is the relatively low efficiency and brevity of remission.

The task of the invention is the steady normalization of the menstrual cycle in women suffering from amenorrhea and oligomenorrhea of central and inflammatory origin.

The problem is solved by a method involving alternating monochromatic color effects on the symmetric acupuncture points of the pineal need Mn31 in red (λ = 700 nm) and green (λ = 546.1 nm) for 60 seconds per point with a change in color stimulus directed to the point, with a common exposure duration of 12 minutes, then binocular controlled color stimulation stimulates the organ of vision (eyes) with blue (λ = 435.8 nm) color flashes lasting 10 seconds and the interval between flashes 60 seconds for 5 minutes, additionally She is prescribed drug therapy with the inclusion of immunomodulators and adaptogens. As an immunomodulator, tamerite is used, 100 mg IM every other day, 5 injections, and as an adaptogen, melaxen is used orally for 1/2 tab. for three weeks.

The technical result obtained by using the present invention is to reduce side effects and increase the therapeutic effect, as well as reduce the time and increase the effectiveness of treatment; increasing the level of social and labor adaptation and the quality of life of patients; individualization of treatment. The use of this treatment technique improves fertility, has a biostimulating, anti-allergic effect.

Due to the fact that in the known patent and scientific and technical sources there is no information on the use of the above essential features for the treatment of NMC in women, it can be concluded that the claimed method meets the criteria of the invention inventive step.

Moreover, the proposed invention is based on a fundamentally new conceptual provision on the pathogenetic mechanisms of NMC. Color puncture - cholestic therapy. It is aimed at restoring energy balance, eliminating the causes of the disease, activating the immune system, and restoring the body's defenses. It is known that a number of women suffering from disorders of the menstrual cycle of central genesis have a concomitant astheno-depressive syndrome, for the treatment of which a wide range of neurotropic drugs is used.

So, for example, in the case of prolonged use of antipsychotics, an increase in the level of prolactin in the blood plasma is recorded in mental patients and healthy people (Arushanyan E.B., Borovkova G.K. Pharmacology and Toxicology, 1988, No. 6, pp. 104-111), which may indicate some effect of these drugs on the hypothalamic-pituitary system.

Light perceived by the eye has two important functions: one is the process of perceiving visual information (optics 25%), the second is a biological function (the energy part of the visual field is 75%) (“Sunlight and Health” // Dr. Zane and R. Kaym). The mechanism of action of color therapy is associated with structural and functional changes in the components of the circulating blood according to the type of trigger mechanism: the functional activity of leukocytes and macrophages increases, the deformability and viscosity of red blood cells are normalized, the aggregation ability of platelets is reduced, which leads to an improvement in the rheological properties of blood, microcirculation, gas exchange in tissues, transport blood function.

A study of the nature of changes in the concentration of sex hormones in serum indicates the anti-stress effect of color-pulse therapy on the endocrine system of women. An improvement in hemodynamics in the vascular basin of the small pelvis plays a significant role in the achieved clinical effect, which creates favorable conditions for normalizing the menstrual cycle.

Polarized monochromatic light through the limbic system and hypothalamus increases the number of neurotransmitters: adrenaline and norepinephrine, initiates the production of neurotransmitters in suphypothalamic structures, thereby has an antidepressant effect (Damirov M.M. Adenomyosis: Clinic, diagnostics and treatment. - Moscow - Tver. 2002 - Moscow - Tver 249 p. 8; Zavalko A.F. Clinical and immunological evaluation of vascular disorders in patients with genital endometriosis: Abstract of thesis of Candidate of Medical Sciences. - Samara, 1996. - 16 p.). Lateral exposure to light with different wavelengths on the field of view, and separately for the right and left eye — lateral color stimulation — is effectively used to correct various emotional states (Chuprikov A.P. et al. Lateral color stimulation is a new way to correct affective disorders in patients alcoholism // Clinical aspects of the modern age, prob. functional asymmetry of the brain / Tez, dokl.Semin. - Minsk, 1989. - P.66).

Comparative studies of the effectiveness of the stimulating effects of coherent (laser) and incoherent red light both in vivo and in vitro, showed their qualitative identity (Karu T.Y. et al. Phototherapy of patients with peptic ulcer of the stomach and duodenum based on stimulation of cells with low-intensity red light / / Issues of balneology - 1984. - No. 1. - S.36-39). Green has a moderate anti-inflammatory and anti-allergic effect. Providing a tonic effect, relieves headache and stabilizes pressure. Blue is one of the most healing colors, because beneficial effect on most systems of the human body. Its main function is a painkiller (www.med2000.ru).

Due to the fact that menstrual dysfunction is accompanied by disorders of the regulation of autonomic functions, a decrease in general resistance, autoimmune and maladaptive disorders, in addition to physiotherapeutic methods, it is advisable to prescribe drug therapy with the inclusion of immunomodulators and adaptogens, while it is advisable to use new pharmacological developments (new generation drugs), with improved properties and fewer side effects. In our studies, we used tamerite as an immunomodulator, which affects secondary immune deficiency, 100 mg IM every other day, 5 injections, and as an adaptogen, melaxen, which has an antioxidant effect, orally for 1/2 tab. for three weeks. Based on modern concepts of inflammation, the leading role is assigned to one of the universal damaging mechanisms - the triggering of lipid peroxidation (LP) and, accordingly, the depletion of the antioxidant system, one of the key enzymes of which is ceruloplasmin. Our studies showed that a significant decrease in the level of ceruloplasmin in the blood of the examined women occurred during the complex exposure to physical and pharmacological factors.

It is possible to consider pathogenetically substantiated the use of not only one physical factor at the same time, but a complex of physiotherapy methods of self-potentiating (synergistic) action, which will allow to achieve the greatest therapeutic effect with the least load on the body. Combined physiotherapeutic effects expand the possibilities of individualizing rehabilitation treatment by varying the components of the therapeutic complex, selecting the optimal components, localization and exposure parameters (V.A. Golubchikov et al. Pathogenetic substantiation of the combined use of physical factors in the complex treatment of patients with chronic prostatitis // Hardware-software complex KAP-ELM-01 “Andro-Gin” in urological practice. - Moscow., 2002. - S.12-28). Obviously, from the standpoint of practical expediency and convenience of performing procedures with the combined use of various physical factors, compact devices representing a single block of sources of the corresponding healing energies deserve attention. This leads to a reduction in both the duration of treatment and the economic losses associated with the temporary disability of patients.

Currently, a number of foreign and domestic companies produce specialized color therapy devices, for example, the company YANINVEST CJSC (Russia) produces the hardware-software complex KAP-ELM-01 Andro-Gin. The principle of operation of the device is based on the simultaneous complex effect of a local magnetic field, electrical stimulation of the pelvic organs with the introduction of a contact vaginal electrode, neurostimulation of pathogenic zones, low-intensity laser and LED radiation, as well as color-pulse therapy. Colorite therapy involves exposure to light of various wavelengths on the human body through a visual analyzer with the involvement of the structures of the reticular formation of the brain. Colors used for color therapy: red, yellow, green, blue, orange. Modulation by the frequency of emission of LEDs: 2-32 Hz. The use of special glasses for color therapy allows you to act through the visual analyzers on the thalamo-hypothalamic centers and thereby optimize the results of treatment. Thus, there is a regulatory effect on the central nervous system and the psycho-emotional state of patients is corrected.

The use of special glasses for color therapy is also possible for exposure to reflexogenic zones irradiated with a specific color. The effect is carried out on paired symmetric acupuncture points (AT) of the Mp31 epiphysis alternately, since previous clinical studies have shown that unilateral therapeutic effect in patients undergoing vegetative dysfunction enhances the hemispheric asymmetry of cerebral blood flow, visualized on rheoencephalograms, which worsens the clinical course.

Under the influence of color stimuli on AT, a kind of resonance occurs in the tissues, which allows you to effectively act pathogenetically also on all parts of the inflammatory process. Our studies have shown that with a complex effect on visual analyzers and acupuncture points with the inclusion of color therapy, the level of sex hormones significantly increases by an average of 12%.

Based on the data of clinical and laboratory studies, women with a menstrual dysfunction of a central or inflammatory genesis are selected. Treatment is carried out under the control of tests of functional diagnostics, determination of the excretion of hormones in urine and their content in blood plasma. The procedure of color-puncture treatment of patients is carried out at room temperature on an outpatient basis or in a hospital.

The industrial applicability of the proposed method is confirmed by the following clinical examples.

Example 1

Sick P-ko, 26 years old. Case history No. 121. Married, has a child of 6 years, works at a sewing enterprise in the cutting and finishing shops for 5 years. The working environment is characterized by a complex of negative factors of a physico-chemical nature. Clinical and laboratory signs of menstrual irregularities were found during a routine examination. After honey. the abortion suffered inflammation of the appendages and began to notice a progressive increase in body weight, painful and irregular menstruation with delays of 1.5-2 months. The diagnosis was made: neuroendocrine syndrome, oligomenorrhea. Infertility II. An ultrasound examination of the uterus and ovaries revealed no organic changes. Blood and urine were examined in the gynecological department of the Novoshakhtinsk city hospital by radioimmunological and enzyme immunoassay methods without pathology. Blood lipid metabolism (total lipids, triglycerides, - lipoproteins, phospholipids) - all parameters are increased. Blood sugar is slightly increased, liver tests, prothrombin index is normal. Research on specific infections (chlamydia, mycoplasmosis, ureaplasmosis, gardnerelosis) is negative. Was prescribed treatment by the claimed method.

The method is as follows. They use the multifunctional complex KAP-ELM-01 Andro-Gin, approved by the Ministry of Health of the Russian Federation (Moscow), in particular, special glasses for color therapy, which are connected by cable to a light exposure generator. Before conducting color therapy, the patient must empty the bladder, treat the affected areas with any non-alcohol-containing lotions. The patient lays down on the couch with her stomach down, and the acupuncture points of the pineal gland Mn31 are located symmetrically in the lumbar region. At a distance of 1 cm from the exposure zone (a completely non-contact method that does not require special treatment of the device), the right and left points of Mp31 are alternately affected by alternately switching on red (λ = 700 nm) and green (λ = 546.1 nm) light stimuli (with by exposure to one point in one color for 60 seconds) by applying one of the glasses of glasses for color therapy (the other glass is covered with a dense material), to which red and green light pulses are supplied from the generator. The total duration of exposure to the points is 12 minutes.

Then, after reflexology, the patient in a sitting position in a soft chair puts on the eyes of special glasses of the multifunctional complex KAP-ELM-01 Andro-Gin. Conduct a sedative photo-exposure on the visual analyzer to reduce the neurosis-like state (blue, λ = 435.8 nm, exposure for one exposure for 10 seconds, the interval between stimuli 60 seconds, for 5 min). General course of physiotherapy 15-18 procedures. At the same time, from the first day of treatment, 100 mg IM tamerite is prescribed as an immunomodulator every other day, 5 injections and an adaptogen - melaxen (orally, 1/2 tablet per night) for three weeks.

After the specified complex of treatment, body weight decreased. Menstrual function returned to normal. Weight before treatment 90 kg, after - 72 ct. Clinical blood and urine tests are within normal limits, and the purity of the vaginal flora is I. Blood lipid metabolism: total lipids and triglycerides decreased and lipoproteins increased. The patient was discharged from the clinic with an improvement in general condition, gynecological status. According to clinical and laboratory parameters, the woman returned to the normal menstrual cycle, no adverse side effects were observed. Follow-up observations for 18 months after the course of treatment of relapse of the disease were not found. Thus, after treatment by the claimed method, a stable remission was achieved.

Example 2

Patient A-ova, 30 years old, case history No. 195, married, has a child of 9 years old, works at a sewing enterprise in the cutting and finishing shops for 8 years. The working environment is characterized by a complex of negative factors of a physico-chemical nature. After 4 years of work, she began to notice dysrhythmia of the menstrual cycle, lengthening of the menstrual period. In the future, these phenomena progressed, the diagnosis was made: dysfunctional uterine bleeding.

Somatically, a woman is healthy, menarche from 12 years without features. She periodically suffered respiratory diseases, recent years accompanied by herpetic manifestations on the mucous membranes of the lips. Examined in the gynecological department of the city hospital in Novoshakhtinsk by radioimmunological and enzyme immunoassay methods. Monotonous estrogenia was found with an increase in estradiol, a decrease in progesterone. Functional diagnostic tests indicated anovulatory cycle, luteal phase insufficiency. An ultrasound examination of the uterus and ovaries revealed no organic changes.

A history of 1 artificial abortion 6 years ago, which, according to the woman, went without complications. I did not suffer from genital infections.

The woman was treated with gestagen drugs (17-OPK, vitamins), but the positive effect was short-lived. 3 months after the end of the course, the previous picture of the disease began to be noted. The woman did not want to change her place of work, although she was warned about the possible consequences of contact with a chemically aggressive environment with intense illumination of workplaces and elevated temperatures.

In 2005, a woman was recommended to undergo rehabilitation therapy according to the claimed methodology on the basis of the gynecological department of the city hospital. A pathogenetically determined course of treatment was prescribed according to the claimed method, consisting of a complex of biostimulating agents, which allows normalizing the neuroendocrine correlations between the pineal gland and the pituitary gland, controlling the rhythm of secretion of sex hormones, as well as increasing the nonspecific resistance of the body and the secretory activity of the endocrine glands.

In parallel with physiological effects, taking into account the asthenization of a woman, as indicated by the periodic manifestation of herpetic infection on the mucous membranes of the lips, the woman received a course of injections of tamerite (100 mg IM every other day, 5 injections) and the adaptogen melaxen, which has an antioxidant effect (orally 1/2 tablets at night) for three weeks.

The change in the functional state during the course of rehabilitation therapy was monitored by measuring skin resistance at the acupuncture points of the pineal gland and analyzing the antioxidant activity of saliva (a marker of stressogenicity). At the end of the course, the woman was examined using radioimmune and other research methods.

The tests showed an increase in the overall resistance of a woman’s body (cortisol, malondialdehyde, antioxidant enzymes), normalization of ovarian function, levels of gonadotropins and ovarian hormones, functional diagnostics tests). Ultrasound studies did not detect morphometric changes in the uterus and ovaries. An analysis of the microbial landscape of the vagina of the IPP pathogens was not found, the microflora was represented by fungi and opportunistic microorganisms. Thus, according to clinical and laboratory parameters, the woman returned to the normal menstrual cycle.

Follow-up observations within 12 months after the course of relapses were not found. Thus, after treatment by the claimed method, a stable remission was achieved. The woman wished to keep her former place of work. In this regard, she was recommended a systematic (every six months) laboratory examination, once a year preventive courses of rehabilitation therapy (if indicated), general strengthening measures.

On our material, observation over a period of 1 year to 3 years for 200 patients with NMCs of central and inflammatory genesis showed significantly high efficiency of the proposed treatment method (98.4%). The complex physiotherapeutic effect was well tolerated by all patients. In 31 patients suffering from infertility, pregnancy occurred. Geographic studies of the vascular basin of the pelvic basin showed that a single placebo procedure does not affect the nature of regional hemoregulation, whereas already after the first treatment procedures according to the claimed method, a significant increase in blood flow intensity was recorded: the rheographic index significantly increased to 0.040 ± 0.005 Ohm (p <0 , 05).

The proposed method for the complex treatment of NMCs of central and inflammatory genesis, compared with the known methods, is more effective and has longer remission periods (12-18 months), is simple to execute, can be performed by a nurse (the doctor notes the localization of points), less traumatic compared to needles, not invasive. In addition, the method is easily tolerated by patients, which makes it possible to expand the indications for its use. Thus, the claimed method of treatment of NMC in women successfully uses the possibilities of modern color therapy.

The method allows to reduce the side effects of hormone therapy, such as gastrointestinal upsets, dryness of the vaginal mucosa, decreased libido, hot flashes, spotting from the genital tract, headache, emotional lability, etc. The claimed method provides a reduction in the overall drug load by eliminating about 7-8 medications and, thus, reducing side effects and providing the possibility of treatment of NMC in patients with endocrine disorders and manifestations of allergies to honey Instruments. The method has been tested on a large volume of clinical material and can be widely used in both inpatient and outpatient care. Due to the fact that at present the incidence of NMC among young women has become more frequent, treatment on an outpatient basis without interruption from production is of great importance for widespread use.

Claims (2)

1. A method of treating menstrual irregularities in women suffering from amenorrhea and oligoamenorrhea of central and inflammatory genesis, characterized in that they act on the symmetric acupuncture points of the pineal gland Mp 31, alternately on the right and left points by alternately turning on red - λ 700 nm and green - λ 546.1 nm, with exposure to the point in one color for 60 s, with a total duration of exposure to the points for 12 minutes, after which they influence the eyes for 5 minutes with color-stimulation of the blue color and - λ 435,8 nm flashes of a duration of 10 seconds and an interval between the flashes 60 and further introduced immunomodulator Tamerit and adaptogene melaxen. 2. The method according to claim 1, characterized in that tamerite is administered intramuscularly every other day, 5 injections, and melaxen - orally, 1/2 tablet for 3 weeks.