RU2382645C1 - Method of complex treatment of perinatal pointed condylomatosis in outpatient and polyclinic conditions - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: for complex treatment of perinatal pointed condylomatosis in outpatient and polyclinic conditions during 10 days peroral introduction of iodantipyrin in dose 200 mg 3 times a day is carried out. Three days after beginning of iodantipyrin introduction bipolar diathermia of perinatal condylomes is performed to healthy tissues, electrodes being applied step-by-step in zigzag order on condyloma circumference. After that in region of operation applied are bandages with solution, containing 200 mg of iodantipyrin and 20 mg of licopid in 200 ml of physiologic solution, or with celandine sap. Bandages are alternated every other day during 14 days.

EFFECT: reduction of disease recurrence, reduces terms of post-operation wound healing and temporary disability.

1 ex, 1 dwg

Description

The invention relates to medicine, in particular to dermatovenerology, coloproctology, and for the treatment of perianal condylomatosis.

Perianal condylomatosis is one of the common sexually transmitted diseases. The disease is often found in young people aged 18-35 years and causes physical, mental and social suffering to patients. In Russia in 2003, 29.7 thousand patients with genital condylomatosis were registered, which amounted to 20.1 cases per 100 thousand of the population (V. Kulakov - 2003).

The etiology of the disease is human papillomavirus (HPV). Genital warts are small outgrowths of flesh-colored that can appear on the genitals, perianal region, less often on the mucous membrane of the oral cavity. After infection, the virus persists in the epithelial cells of the skin and mucous membranes.

A major clinical problem is the high relapse rate, the disease resistance to existing methods of treatment of perianal condylomatosis.

There are various methods of treatment for genital warts: cryodestruction, electrocoagulation, laser coagulation, methods of conservative exposure. The course of the disease in the treatment by traditional methods is characterized by maintaining a high frequency of relapse, large amounts of tissue damage, a long period of temporary disability of patients (abstract on the rights of the manuscript UDC 616.351 / 352.-0065-022.7. Khidiyatov II, Yekaterinburg - 1992).

There is a method of treating genital warts, which consists in treating the affected area with a solution containing salicylic, lactic acid and polydocanol, a course of 3-4 days with a treatment frequency of 1-2 times a day (Yu.N. Kuznetsova - Features of the treatment of genital warts // Thesis of scientific works of the 1st Russian Congress of Dermatovenerologists. St. Petersburg, 2003 - St. Petersburg, - T.2. - S.159-160).

One of the significant disadvantages of this method is the high recurrence rate of the disease - 10-65% (abstract on the rights of the manuscript UDC 616.351 / 352.-0065-022.7. Khidiyatov II, Yekaterinburg - 1992).

The prototype of the invention is a method for the treatment of genital genital warts, which consists in the appointment of pharmacotherapy with iodantipyrine. After a diagnosis was established (complaints, medical history, genital status, cytological examination) with warts up to 0.1 cm, iodantipyrine was prescribed 100 mg 2 times a day for 25 days and subsequently 100 mg 1 time a day for 50 days. In the presence of genital warts from 0.1 to 0.5 cm in size, they were chemically destroyed, for example, by solkovagin, simultaneously with the administration of iodantipyrine (RF Patent for the invention No. 2221562, 2004). This method has disadvantages associated with the insufficient immunomodulating effect of iodantipirin with its isolated systemic use without taking into account the possibility of immunomodulating action of the drug when used locally. In addition, a rough, painful, red scar was formed in the area of the perianal sciatica after chemical destruction, which led to discomfort and additional treatment of scar tissue.

The objective of the invention is to develop a comprehensive treatment that increases the effectiveness of treatment of perianal genital warts in an outpatient setting.

The technical result is a decrease in the recurrence rate of the disease, a reduction in the healing time of postoperative wounds and temporary disability.

The proposed method is as follows:

1. 3 days before the use of bipolar diathermy, iodantipyrine is prescribed orally 200 mg 3 times a day for 10 days. Bipolar diathermy is used with the WD 2 device (electronic device WD2 // Instructions for use, NPO, Mikrotest, Saratov, 1998, Registration certificate MZMPR No. 95/64 of 03/14/95), which consists in local burning of perianal condylomas to healthy tissues by the application of electrodes in stages in a zigzag pattern around the circumference of the focus, to prevent the growth of rough keloid scars.

2. After bipolar diathermy, local treatment is performed in the area of the perianal condylomas treated with the WD2 apparatus by dressing with a solution containing 200 mg of iodantipyrine and 20 mg of lycopide in 200 ml of physiological saline, or celandine juice, which alternate every other day, for 14 days.

The main target of lycopid in the body are cells of the monocyte-macrophage system. Lycopid increases the activity of lysosomal enzymes, the formation of reactive oxygen species, the absorption and killing of microbes, leads to increased synthesis of interleukin-1 and the expression of HLA-DR antigens on monocytes, which leads to stimulation of the humoral and cellular immune response. By stimulating the activity of monocytes and macrophages, lycopid acts on three main components of the immune system: phagocytosis, cellular and humoral immunity. Lycopid improves microcirculation, which provides an increase in the concentration of neighboring drugs in the focus of infection. At the same time, lycopid increases the sensitivity of microorganisms to antibacterial drugs, reduces their toxic effect and activates the production of interferon (Andronova T.M., Pinegin B.V. - Likopid (GMDP) - a modern domestic highly effective immunomodulator - 2nd ed. - 2005) .

Celandine has a large number of biologically active substances. This plant is characterized by the presence of alkaloids, the presence of which in the grass is 0.27-2.25%, and in the roots - up to 4%. It is also necessary to note the presence of such substances as tannins, flavonoids, saponins; vitamins A, C; organic acids (1.4-4.32%) represented by: helidonic, citric, malic, ascorbic, succinic; chelidoniol is the highest aliphatic alcohol, the fruits of celandine are characterized by the presence of up to 40% fatty oil (http://www.tiensmed.ru/news/chistotel-wkti/).

The drawing shows the perianal localization of genital warts 1, their diathermy apparatus (WD 2), which consists in local cauterization of perianal warts to healthy tissues by applying electrodes 2 in stages in a zigzag pattern around the circumference of the outbreak.

Clinical example: Patient M., aged 43, turned to the clinic with complaints of discomfort in the anus, a burning sensation, and the appearance of multiple formations in the perianal zone. On examination, a diagnosis was made: perianal multiple candidomatosis. Treatment was prescribed according to the proposed scheme and the proposed method:

3 days before the use of bipolar diathermy, iodantipyrine was prescribed orally 200 mg 3 times a day for 10 days.

We performed bipolar diathermy with the WD 2 apparatus by local cauterization of perianal warts to healthy tissues. The electrodes were applied around the circumference, stepwise zigzag, delimiting the diseased tissue from healthy tissue, resulting in elastic tissue regeneration without rough keloid scars. An indicator of effective treatment is a soft, elastic scarless tissue after treatment due to minimal bleeding of the focus and its trauma when electrodes are applied.

Further, for topical treatment in the area of the perianal condylomas treated with the WD2 apparatus, application bandages were alternated every other day with a solution containing 200 mg of iodantipyrine and 20 mg of lycopide in 200 ml of saline or celandine juice for 14 days.

Further, the patient was observed on an outpatient basis daily. During the control examination of the perianal region, which was performed on an outpatient basis after 5-6 days, a decrease in hyperemia after treatment of the lesion with the WD2 apparatus was revealed. The formation of a mild soft scarless tissue, persistent atrophy of multiple condylomas in the perianal region was also revealed.

The study was based on clinical observations of 90 patients with genital perianal condylomas, who were on outpatient treatment at the Municipal Clinical Hospital No. 21 of the city of Ufa.

All patients were divided into the main and control groups. Both groups included both men and women aged 20 to 40 years.

The main group consisted of 65 patients who were treated with the proposed method, the control group consisted of 25 patients who were treated with the method taken as a prototype. The proposed method of treatment was applied in outpatient settings in 65 patients with multiple perianal condylomas. Complications in connection with the application of the method were not identified.

After applying the proposed method revealed high immunomodulating, antiviral, regenerating, anti-inflammatory properties, confirmed by a reduction in the time of temporary disability of patients, the data of immunological, virological studies.

After 2 days of treatment, high rates of granulation of surgical wounds were noted. Complete epithelialization of operational defects with the formation of soft elastic tissue occurred on the 10th day of treatment.

Studies show that the application of the proposed method leads to the stimulation of regeneration processes, immunomodulation under the synergistic effect of Likopid, iodantipyrine, celandine juice, which ultimately reduces the healing time of surgical wounds, the duration of temporary disability of patients by an average of 4 days (compared with the control group), as well as the frequency of relapse in the immediate period after treatment. In addition, the application of electrodes in a phased zigzag manner around the circumference of the focus with the separation of the affected tissue from the healthy leads to the formation of soft, elastic scarless tissue in the area of the intervention.

Claims (1)

A method for the treatment of genital warts, including the oral administration of iodantipirin and the destruction of genital warts, characterized in that iodantipirin is administered 200 mg 3 times a day for 10 days, and the destruction is carried out 3 days after the start of the drug by bipolar diathermy of perianal warts to healthy tissues, in this case, the electrodes are applied stepwise in a zigzag pattern around the circumference of the focus, after which, in the area of the perianal condylomas treated, dressings are applied with a solution containing 200 mg of iodantipyrine and 2 0 mg of lycopid in 200 ml of saline, or celandine juice, which alternate every other day, for 14 days.

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