RU2360677C1 - Therapy of prostatic tuberculosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to phthisiology and urology, and concerns therapy of prostatic tuberculosis that involves introduction of antituberculous remedies combined with daily instillations of autoblood 5 ml into urethra. Preliminary said autoblood is exposed to IR-laser radiation within 25 minutes at wavelength 0.86 mcm, radiation frequency 3000 Hz and power 10 mW. The therapeutic course takes 10 procedures.

EFFECT: due to specified irradiation mode, disclosed therapy provides effective immunomodulatory action of autoblood and therefore rapid normalisation of clinicolaboratory indices.

2 tbl, 1 ex

Description

The invention relates to medicine, namely to phthisiourology.

Tuberculosis of the genital organs of men is one of the most difficult to treat localization of tuberculosis, since the prostate gland is accessible to a limited number of antibiotics and chemotherapeutic drugs, the destructive cavity of the prostate remains throughout the patient's life, maintaining a high premorbid background. Tuberculosis of the prostate gland is manifested by constant pain in the perineum, often radiating to the scrotum and anus, impaired urination (rapid, cramped, weakened urine stream, a feeling of incomplete emptying of the bladder, discomfort during and after urination), and a deterioration in sexual life due to decreased libido , weakening erection, ejaculation disorders.

There is a method of treating tuberculosis of the external genitalia in men (SU 1282383 A1, Novosibirsk Research Institute of Tuberculosis) by conducting electrophoresis with 10% PASK solution on the scrotum organs during chemotherapy, which allows to increase the concentration of drugs in the tissues of the epididymis by 1.5 times and thereby increase the effectiveness of treatment. However, this method applies only to patients with tuberculosis of the external genitalia and is not indicated for tuberculosis of the presented gland and urethra.

Also known is a method of treating genitourinary tuberculosis (RU 2062453 C1, NPO Phthisiopulmonology, 06/20/96), in which at the peak of the concentration of chemotherapy drugs in the blood, an additional infrared laser with a wavelength of 0.82 microns at a power density of 0.12-0 is additionally exposed to the pathological focus , 8 mW / cm ² lasting 10-20 minutes, using 8-10 procedures per course. This method improves the effectiveness of treatment due to the deposition of chemotherapeutic agents in the area of the pathological focus, specifically the prostate gland.

Thus, the known methods are aimed at enhancing etiotropic therapy, which leads to rapid eradication of the pathogen, however, this does not at all mean the cessation of clinical symptoms, since only etiotropic therapy does not affect the mechanisms of pathogenesis; in particular, prolonged chronic inflammation is accompanied and supported by local immunodeficiency. Thus, along with etiotropic therapy, a pathogenetic treatment is indicated for a patient with tuberculosis of the prostate gland.

In order to increase the effectiveness of treatment by providing a pathogenetic effect that stimulates local immunity, a method of treating prostate tuberculosis with anti-TB drugs is carried out, characterized in that they additionally install 5 ml of activated autologous blood in the urethra, 10 procedures per course, while the activation of autologous blood is carried out by infrared laser radiation a wavelength of 0.86 microns at a frequency of 3000 Hz and a power of 10 mW for 25 minutes.

The method is as follows. Against the background of chemotherapy with anti-TB drugs, 80-100 ml of blood is drawn from the patient's cubital vein into a sterile plastic container with a heparin mixture. Immediately after the sampling, blood is irradiated with infrared laser light (wavelength 0.86 μm) at a radiation frequency of 3000 Hz and a power of 10 mW for 25 minutes.

Prepared activated autologous blood is injected into the urethra in the amount of 5 ml daily for 5-7 minutes, 10 procedures per course. Between the procedures, a plastic bag of blood is stored in the refrigerator; sampling of activated blood from the package is carried out through a special plug in compliance with all the rules of asepsis and antiseptics; immediately before administration, the syringe with autoblood is warmed in hands to room temperature.

Example. Patient P, 47 years old. Diagnosis: prostate tuberculosis, MBT +. Upon treatment, he complained of weakness, general malaise, constant dull aching pain in the perineum, weakening of the urine stream, pain during urination. In urine, prostate secretion and in the ejaculate, a significant number of leukocytes was detected, and the MBT was identified by the NDP method.

The patient was prescribed polychemotherapy with 4 drugs (isoniazid, rifampicin, streptomycin and pyrazinamide), and an additional course of urethral installations with activated autoblood was carried out. Literally on the 3rd day, stranguria and nocturia stopped, by the 5th day, painless urination 4-6 times a day was restored. By the 10th day, there was a significant decrease in the number of leukocytes in the sexual glands.

In order to confirm the immunomodulating action of activated autologous blood, the content of interleukin and gammainterferon in the blood serum was determined in patients before and after treatment; a significant increase in their content after the course of treatment was noted, the results are presented in table 1.

Table 1 The dynamics of interleukin and gamma interferon in blood serum Indicator Originally After treatment R Interferon-gamma (PCG / ml) 52.71 ± 10.42 76.24 ± 11.52 <0.001 Interleukin-10 (PCG / ml) 3.67 ± 1.14 7.93 ± 1.18 <0.001

The method was tested in 6 patients with prostate tuberculosis hospitalized in the urogenital clinic of the Federal State Institution Novosibirsk Research Institute of Tuberculosis of the Russian Medical Technologies and in the extrapulmonary department of the Amur Tuberculosis Dispensary. All had a rapid cessation of pain and faster reorganization of the secretion of the prostate gland, the results are presented in table 2.

table 2 The dynamics of clinical manifestations in patients with prostate tuberculosis treated only with anti-TB drugs (group 1) and with the use of activated autologous blood (group 2) Indicator 1 group n = 22 2 group n = 6 P Relief of pain (month) 2.4 ± 0.3 1.5 ± 0.2 <0.005 Relief of dysuria (months) 1.1 ± 0.15 0.4 ± 0.09 <0.005 Remediation of the secret (month) 3.7 ± 0.9 2.3 ± 0.6 <0.005

Thus, the proposed method for the treatment of prostate tuberculosis with anti-TB drugs, including additional instillations of 5 ml of activated autologous blood into the urethra daily, 10 procedures per course, has an immunomodulating effect. This method of pathogenetic exposure will significantly increase the effectiveness of treatment of patients with prostate tuberculosis and reduce its duration, as well as improve the quality of life of the patient, as it quickly eliminates the debilitating dysuria.

Claims (1)

A method for the treatment of prostate tuberculosis, including the introduction of anti-TB drugs, characterized in that they additionally carry out installations in the urethra of autologous blood in an amount of 5 ml, irradiated for 25 minutes with an infrared laser at a wavelength of 0.86 μm, a radiation frequency of 3000 Hz and a power of 10 mW , 10 treatments per course.