RU2417798C1 - Method of treating purulent arthritis with application of electro-activated water solutions: anolyte and catholyte - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, and deals with treatment of purulent arthritis. For this purpose carried out is intro-joint introduction of not less than 10ml of anolyte 0.3% NaCl with neutral Ph 7.3-7.7 and AFP +700-1100 mV. Said anolyte is introduced also paraorticularly in volume not less than 3 ml. Additionally perorally introduced is catholyte 0.3% NaCL with Ph 8.2-9.5 and AFP minus 450-600 mV. Catholyte introduction is carried out 3 times per day before meal in volume not less than 100 ml per intake. Treatment course constitutes not fewer than nine days.

EFFECT: method increases treatment efficiency, including at the background of post-traumatic hemarthrosis, synovitis, in absence of toxic action on joint and on surrounding it tissues and without application of pharmaco- and physiotherapy.

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Description

The invention relates to medicine, namely to surgery, relates to means for treating inflammation in the joint cavity and surrounding tissues; can be used to increase the effectiveness of treatment of patients with purulent arthritis, synovitis, hemarthrosis.

A known method of treating purulent arthritis (V. Struchkov / Guide to purulent surgery. / V.I. Struchkov, V.K. Gostishchev, Yu.V. Struchkov. - M .: Medicine, 1984. - 507 S.), in which antiseptic solutions - etericide, furacilin, potassium permanganate, dioxidine, chlorhexedine bigluconate are injected into the joint cavity and cause a bactericidal effect by inhibiting the growth and lysing of pathogenic microorganisms (Kanshin N.N. Treatment of ulcers with flow-fractional washing with prolonged aspiration / N .N. Kanshin, M.M.Abakumov // Vestn. II. - 1974. - N11. - P.25-31), (Kuzin M.I. The use of proteolytic enzymes and etericide in purulent surgery / M.I. Kuzin // Vestn. Surgery. - 1979. - N3. - C .111-112), (Dioxidine - a new chemotherapeutic drug for the treatment of various forms of purulent infection / E.N. Padeiskaya [et al.] // 1 All-Union Conference on Wounds and Wound Infections: abstract. 1977. - P. 216-217).

Treatment of patients with purulent arthritis continues for a long time, requires significant economic costs and does not always end in recovery. The disadvantage of these drugs is their lack of anti-inflammatory, decongestant, reparative action, the inability to introduce them into the tissues surrounding the joint due to local toxic effect. Karasev N.E. System for washing purulent wounds and cavities / N.E. Karasev // Healthcare of Belarus. - 1980. - No. 10. - P.61-62.

According to Alekhine S.A., Dumchev V.A. (Alekhin S.A. Methodological recommendations for the use of electroactivated aqueous solutions for the prevention and treatment of the most common human diseases. Ministry of Health of Uzbekistan, Ministry of Health of Russia, Ministry of Health of Ukraine / S.A. Alekhin. - Tashkent, 1994; Dumchev V.A. Treatment of purulent wounds prolonged capillary washing with solutions of antiseptics / V.A.Dumchev, V.A. Karlov // 1 All-Union conference on wounds and wound infections: thesis report - M., 1977. - P.111-112), any effective the method of local treatment of purulent arthritis should have inflammation in the first (purulent otic) phase - antimicrobial, antiinflammatory, dezinteksikatsionnoe, sorption, anti-inflammatory, analgesic and necrolytic action. Modern methods of medical correction of metabolic disorders in inflamed tissues are not always effective, which increases the duration of edema and the transition of the process to the stage of productive inflammation - regeneration. Thus, in the presence of a huge arsenal of drugs, there is not one that has both antiseptic, anti-inflammatory, decongestant, detoxification, analgesic and reparative effects. In this regard, our attention was drawn to aqueous solutions activated by the electrochemical method, which have many of the above effects (D. Gitelman Methodical recommendations for the use of electroactivated aqueous solutions for the prevention and treatment of the most common human diseases / D.S. Gitelman, S.A. Alekhin. - Uzbekistan, 1997; Devyatov V.A. Application of water activated by the electrochemical method for the treatment of purulent and sluggish wounds and trophic ulcers / V.A.Devyatov, S.V. Petrov // Inventor and rationalization ator. - 1988. - No. 5. - P.45).

Electroactivated solutions are prepared using a diaphragm flow-through electrochemical reactor (STEL).

AED - neutral anolyte (pH 7.3, redox potential + 700-1100 mV), active components HClO, HClO2 ^. , ClO-, ClO2, HO2 ^. , H2O2, O2, O3, Cl ^. BUT ^. , ^O. . Anolyte ANK according to the parameters of acute toxicity when introduced into the stomach and applied to the skin belongs to the 4th class of low-hazard substances according to GOST 12.1.007-76 and has minimal toxicity in this class. When inhaled, anolyte ANK with an oxidant content of 0.02% and a total salinity of 0.25-0.35% does not irritate the respiratory system and mucous membranes of the eyes. When introduced into the anolyte, it does not have an immunotoxic effect and does not increase the level of chromosomal aberrations in bone marrow cells and, therefore, does not have cytogenetic activity. When heated to 400 ° C, the biocidal activity of the anolyte increases by 30-100% (Bahir V.M. Electrochemical activation. / Bahir V.M., Dumchev V.A. Treatment of purulent wounds by prolonged capillary washing with antiseptic solutions. / V.A. Dumchev, V.A. Karlov // 1 All-Union Conference on Wounds and Wound Infection: Abstracts - Moscow, 1977. - P.111-112). There is information about the mechanisms of action of catholyte: acceleration of regeneration processes due to stimulation of DNA synthesis; immunocorrective effect; increased detoxifying liver function; stabilization of cell membrane permeability; normalization of the energy potential of cells; increased energy supply to cells through stimulation and maximum conjugation of respiration and oxidative phosphorylation.

Based on materials published in collections of the Second and Third International Symposiums “Electrochemical Activation in Medicine, Agriculture, Industry”, 1997, monographs by Prilutsky V.I., Bakhir V.M. "Electrochemically activated water: abnormal properties, the mechanism of biological action", 1995. S.12-16, the following data on some properties and therapeutic effect of anolyte and catholyte can be given. Anolyte has an antibacterial, antiviral, antimycotic, antiallergic effect and can have a cytotoxic and antimetabolic effect without harming human tissue cells. The biocidal substances in the electrochemically activated anolyte are not toxic to somatic cells, since they are represented by oxidants similar to those produced by cells of higher organisms.

The catholyte has antioxidant, immunostimulating, detoxifying properties, normalizes metabolic processes (increased ATP synthesis, changes in enzyme activity), stimulates tissue regeneration (increases DNA synthesis and stimulates cell growth and division by increasing the mass transfer of ions and molecules through membranes), improves trophic processes and blood circulation in the tissues.

A good biostimulating effect of the use of catholyte and antibacterial anolyte was found in case of burns, abscesses, hemorrhoids, dermatomycosis, prostate adenoma, tonsillitis, bronchitis, chronic pyelonephritis, chronic hepatitis, deforming arthrosis (Alekhine S.A. Living water - A. myths and reality S.Alekhin, I.M.Baibekov, F.Yu. Garib // MIS-RT, Collection No. 6, 1998. - S.12-14).

The high efficiency of anolyte and catholyte is shown for many pathological processes inside and out. The introduction of anolyte intraarticular and paraarticular and its decongestant and anti-inflammatory effects with this method of administration are not known from the prior art.

The purpose of the invention is the development of a method that improves the treatment of purulent arthritis, post-traumatic hemarthrosis, synovitis by a complex treatment using electro-activated solutions of anolyte and catholyte. The method allows to obtain an anti-inflammatory effect, reduce edema, reduce the permeability of the capillary bed without the use of pharmacotherapy and physiotherapy, which leads to a reduction in the treatment time for patients with purulent arthritis.

To achieve a technical result in purulent arthritis, joint punctures are used or flow perfusion flushing systems are installed, connected to a perforated drainage tube immersed in the joint cavity. A standardized anolyte solution of 0.3% sodium chloride solution is introduced, which corresponds to an active chlorine concentration of 0.03% (Guidelines for the use of electrochemically activated sodium chloride solutions (anolyte, catholyte) produced in the ECA-30 device for disinfection, pre-sterilization cleaning and sterilization dated September 18, 1991 N 15-6 / 22) (neutral pH 7.3-7.7 ORP + 700-1100 mV) in an amount of at least 10, depending on the size of the joint. Joint punctures are used for post-traumatic hemarthrosis, synovitis.

At the same time, the anolyte solution (neutral pH 7.3-7.7 ORP + 700-1100 mV) is injected into the tissues surrounding the joint (paraarticular) for at least 9 days in a volume of at least 3 ml. This provides a quick antibacterial effect, reduces intoxication, vascular permeability and exudation. From the 1st day of treatment, catholyte of 0.3% sodium chloride solution (ORP minus 450-600 mV, pH 8.2-9.5) is administered orally (orally) 3 times a day before meals, at least 100 ml throughout the entire period diseases to the maximum reduction of inflammatory phenomena in the joints. Electroactivated solutions are obtained on the STEL installation.

Histological examination was performed on the tissues of the knee joint of 10 healthy white rats weighing 300 g, to which 0.2 ml of a standardized solution of anolyte (neutral pH 7.3-7.7 ORP + 700-1100 mV) was injected intraarticularly and paraarticularly injection (subgroup A), s The goal is to prove that the standardized anolyte solution has no toxic effects on the joint and paraarticular tissues.

The results of histological studies of the knee joints of 10 rats (subgroup A): the synovial membrane is not changed, in the tissues surrounding the joint there is no edema and vasculitis. In some preparations, minor accumulations of neutrophils are found, from exposure to an injection needle with the introduction of anolyte solution into the joint and paraarticularly. Visually, the joints of animals of normal color and configuration, rats move well and feed.

The toxic effects of a standardized anolyte solution on the joint and surrounding animal tissue were not detected.

In addition, studies were performed on 10 rats with a model of purulent panarthritis of the knee joint (subgroup B) obtained by injecting 0.1-0.2 ml of Staphylococcus aureus infectious medium (1 ml microbial units in 1 ml) and mechanical trauma to the joint and bone fracture under anesthesia of thiopental sodium 2%. After 3 days, the animals develop a picture of purulent arthritis.

The results of histological studies of the knee joints of 10 rats with a model of purulent panarthritis: (subgroup B): the synovial membrane is diffusely infiltrated by leukocytes, surrounding tissues with a picture of purulent inflammation with foci of necrosis. Pronounced edema and phlegmonous inflammation of the muscles, vasculitis. In addition to neutrophils, eosinophils, histiocytes, single mast cells, sequesters, i.e. there is a pathomorphological picture of diffuse purulent panarthritis with an abundance of polymorphic nuclear leukocytes. Visually, the knee joints of animals are strongly swollen and hyperemic, hot upon palpation, spherical configuration. All 10 rats are dynamic, hardly step on their hind limbs, and eat poorly.

Thus, it became possible to proceed to the next stage of the experiment - the treatment of purulent arthritis in animals.

Formed 2 groups of 60 rats with purulent arthritis:

Group 1 — 30 animals — treated in the usual way — intra-articular administration of 1% dioxidine solution for 7 days;

Group 2 - the main, in the amount of 30 animals treated with intraarticular and paraarticular injection of a standardized pH-neutral solution of anolyte and the introduction of catholyte 0.3% sodium chloride solution to rats by mouth with a free approach for 7 days, i.e. during this time, rats take catholyte instead of water without restriction. There was no refusal to take Catholite.

To determine the sequence of development and the nature of the tissue reaction, the animals were withdrawn from the experiment (3, 5, and 7 days after the start of treatment) by decapitation with the preliminary introduction of a lethal dose of thiopental sodium. For histological studies, a block of a portion of the joint wall with about articular tissues was excised, a visual study of the preparations was carried out immediately after taking the material, which was then fixed in 10% neutral formalin. Through the center, the graft was cut in half. The resulting fragments were poured into paraffin according to a standard histological procedure. Histotopographic sections 7-10 μm thick were made from the obtained blocks, which were stained with Ehrlich hematoxylin and eosin, picrofuchsin according to Van Gieson and enclosed in balm. The resulting histological preparations were examined under a light microscope. In the study of histological preparations, at least 6 visual fields were randomly selected for each location and observation period.

For an objective assessment of the effect of the drug substance on the inflammatory process, in addition to microscopic examination of histological preparations stained with standard techniques (hematoxylin-eosin, Van Gieson), morphometric measurements of the degree of swelling of the articular bag and paraarticular muscle tissue were carried out with subsequent statistical processing of the results. Image of micropreparations was obtained using the Leica Qwin Standard V2.6 image analysis system (Leica, Germany), consisting of a Leica DMR microscope equipped with a Leica DC 300F digital camera, an IBM Pentium IV computer with Leica Q 5. Software. Morphometric studies of the obtained images were carried out with using VideoTest image analysis programs (ISTA VideoTest, Russia) and ImageJ (National Institutes of Health, USA) open source software. Statistic indicators were obtained using the BioStat 2007 program.

Statistical indicators were used (arithmetic mean, standard deviation, mean error), the significance of differences in the mean values for the study groups was determined by the Student criterion (L.S. Kaminsky, 1964).

The criteria for evaluating the effectiveness of treatment were microscopic manifestations of the dynamics of the inflammatory process in the joints of 60 rats with purulent arthritis of 2 groups.

3 days after the start of treatment, improvement was noted during the inflammatory process in both groups studied: in 95% of cases in the 2nd group, a clear regression of pathological changes was noticeable with the beginning activity of regenerative processes. Zones of previous necrosis in the synovia are replaced by maturing granulation tissue. Focal polymorphic cell infiltrates with an admixture of neutrophilic leukocytes are found mainly in the soft tissues around the joint and in exudate on the surface of the synovial membrane. In synovia and paraarticular muscles, destructive changes acquired a small focal character. Typical was the activation of macrophages and fibroblasts. The vascular reaction was significantly reduced. The number of mast cells increased. In 63% of cases in the 1st group only the prevalence of exudative changes was reduced, more actively than in the 2nd group. In general, in the samples from the 1st group of animals, a more sluggish dynamics of inflammation reduction was observed compared with the 2nd group - the area of purulent inflammation was covered with a continuous layer of exudate and tissue decay products. Quite extensive foci of purulent exudation and tissue destruction, fibrin alternated with islands of forming granulation tissue, were detected in various areas of the articular bag, bacterial colonies were sometimes detected.

Further observations - 5 days confirm a more active development of the positive dynamics of repair processes in the joints of rats of the 2nd group, compared with the 1st.

After 7 days of treatment, the positive dynamics are even more pronounced in the 2nd group, compared with the 1st. The newly formed connective tissue in the 2nd group consists of gentle bundles of collagen fibers of various cellular elements (active fibroblasts, macrophages, lymphocytes, etc.), in contrast to the 1st group. The specificity of the organization processes indicates a small probability of the formation of coarse scar tissue during the relief of the inflammatory process in the 2nd group.

For morphometric measurement of the edema, the area of spaces between the spaced apart edematous fluid structures of the joint bag of the knee joints of rats and muscle fibers located paraarticularly was taken. Measurements were made for each group in 10 fields of view at a magnification of × 200.

Table 1 Change in the magnitude of edema in the joint bag and paraarticular tissues of the knee joint of animals of groups 1 and 2. Scope of observations Dioxidine 1% Anolyte + inward catholyte 3 days (n = 2316) 13,407.72 ± 355.5 16277.9 ± 386.7 5 days (n = 3892) 15582.42 ± 486.1 * 14415.43 ± 331.1 * 7 days (n = 4255) 14505.87 ± 267.6 * 12093.83 ± 445.6 * Significance of differences 3-7 day Thrace. 2,3833 Thrace. = 2.2913 Tkrit. = 1.9612 Tkrit. 1.9603 with a probability of statistical error p <0.05

When analyzing the magnitude of edema of the paraarticular tissues and muscles, it was found that 3 days after the start of treatment, the edema was the smallest in the soft tissues of the joints of rat arthritis treated with dioxidine (group 1), the group average value of the edema area of which was 13407.72 ± 355, 5 pixels, however, by the 5th day of observation in this group, edema increased (15582.42 ± 486.1). By the 7th day of observation, there was a decrease in edema to 14505.87 ± 267.6 (see Table 1).

A more active and positive dynamics of edema reduction can be observed in the joints of rats treated with anolyte intraarticular and paraarticular + inside 3% catholyte solution (group 2) for 3 days, where the average value of the edema area is 16277.9 ± 386.7 pixels (Trace. = 2.2913> Tcrit. = 1.9612 with a probability of statistical error p <0.05). Then the edema significantly decreased: on the 5th day of treatment to (14415.43 ± 331.1) and on the 7th day to (12093 ± 445.6). Table number 1.

The highest index of edema area by the 3rd day of treatment was detected in the 2nd group of rats, less significant - in the 1st.

But by 5 days of treatment, the picture changes dramatically: edema decreased the most in the 2nd main group, while in the 1st group the edema area indicator continued to increase.

Further, on the 7th day of treatment, edema decreased most in the 2nd main group, in the 1st group it decreased slightly.

Thus, rats treated with anolyte intraarticularly and paraarticularly + inside 0.3% solution of catholyte (group 2) recovered faster than rats treated with intraolute 1% solution of dioxidine (group 1). Despite a short-term increase in edema in the first 3 days of treatment in animals in the 2nd group, in the future, edema decreased significantly faster and in a shorter time compared to the 1st group.

Testing the proposed method of treatment by intraarticular and paraarticular injection into the knee, ankle, shoulder and elbow joints of a standardized solution of sodium chloride anolyte 0.3% (neutral pH 7.3-7.7 ORP + 700-1100 mV) with the simultaneous introduction of catholyte 0 , 3% sodium chloride solution (AFP minus 450-600 mV, pH 8.2-9.5) inside the clinic was carried out in patients with purulent arthritis.

The study involved 36 patients with the signing of an agreement on informed consent with purulent arthritis of the knee (14 people), ankle (4 people), shoulder (5 people) and elbow joints (3 people).

Patients were given explanations regarding their condition, including the expected effect of the use of electro-activated aqueous solutions. When included in the study, which was conducted only in a hospital, each patient gave informational consent.

Patients with purulent arthritis in the amount of 36 people were divided into 2 groups: patients of the 1st group received treatment in the traditional way - an injection of 1% dioxidine solution was administered intra-articularly daily by injection or using a constant washing system (10 to 100 ml / day ( 18 people) 9-12 days.

In the 2nd group of patients, a standardized anolyte of 0.3% sodium chloride solution (neutral pH 7.3-7.7 ORP + 700-1100 mV) in an amount of 10 to 100 ml / day was injected intraarticularly and paraarticularly daily by injection or using a constant washing system. 9-12 days, at the same time, catholyte of 0.3% sodium chloride solution (ORP minus 450-600 mV, pH 8.2-9.5) is administered orally (orally) 3 times a day before meals, 100-200 ml throughout the entire period diseases to the maximum reduction of inflammatory phenomena in the joints (18 people).

Additionally, in both groups, IM 50% analgin was used as an anesthetic during the first 2 days of treatment; antibiotics were not administered for the purity of the experiment.

Evaluation of the results was carried out according to clinical, laboratory and instrumental methods of research: body temperature; the magnitude of edema of the diseased joint compared with healthy; the number of neutrophils and fibroblasts during puncture biopsy of the joints; the value of C-reactive protein in the blood; Visual analogue scale (YOUR) score at rest.

table 2 Dynamics of the temperature reaction, ESR and C-reactive protein in patients with purulent arthritis in the study groups. bed day temperature reaction, t ESR, mm / h C-reactive protein, g / l column 1 column 2 column 1 column 2 column 1 column 2 one 38.5 ± 0.3 38.6 ± 0.1 54.8 ± 0.5 51.7 ± 0.5 * 0,053 ± 0,001 0.051 ± 0.002 2 37.9 ± 0.2 37.5 ± 0.3 53.2 ± 0.4 52.9 ± 0.6 0.052 ± 0.001 0.049 ± 0.003 3 37.8 ± 0.2 37.5 ± 0.1 51.9 ± 0.3 52.1 ± 0.4 0.050 ± 0.002 0.042 ± 0.003 * four 37.7 ± 0.1 37.4 ± 0.1 * 51.4 ± 0.2 51.2 ± 0.6 0.048 ± 0.001 0.038 ± 0.002 * 5 37.8 ± 0.2 37.3 ± 0.1 * 46.8 ± 0.1 44.3 ± 0.5 * 0.046 ± 0.003 0.035 ± 0.001 * 6 37.5 ± 0.1 37.0 ± 0.3 * 44.2 ± 0.3 42.1 ± 0.2 * 0.041 ± 0.004 0.032 ± 0.002 * 7 37.3 ± 0.1 36.7 ± 0.2 * 40.7 ± 0.5 36.7 ± 0.4 * 0.039 ± 0.001 0.027 ± 0.001 * 8 37.1 ± 0.1 36.8 ± 0.1 * 37.5 ± 0.2 31.2 ± 0.6 * 0.035 ± 0.002 0.024 ± 0.003 * 9 37.1 ± 0.1 36.8 ± 0.1 * 36.6 ± 0.4 28.6 ± 0.5 * 0.032 ± 0.001 0.021 ± 0.001 * 10 37.0 ± 0.2 36.5 ± 0.2 * 31.9 ± 0.2 23.8 ± 0.3 * 0.031 ± 0.003 0.017 ± 0.001 * eleven 36.5 ± 0.1 36.6 ± 0.2 27.6 ± 0.3 19.4 ± 0.4 * 0.029 ± 0.002 0.015 ± 0.002 * 12 36.7 ± 0.2 36.7 ± 0.1 25.5 ± 0.5 18.1 ± 0.4 * 0.028 ± 0.003 0.013 ± 0.001 * * - significant difference between study groups at p <0.05.

The body temperature in patients in the 2nd group is normalized on day 8, in the 1st group on day 11.

ESR in patients of the 2nd group during the treatment process is significantly faster and more pronounced decreases - 28.88% by the 12th day of treatment, compared with the 1st group.

The value of the concentration of C-reactive protein in patients of group 2 during the treatment process is significantly faster and more pronounced decreases by 53.58% by the 12th day of treatment, compared with the 1st group.

Table 3 Dynamics of cytological parameters in the joint bag in patients with purulent arthritis in the study groups. bed day The dynamics of the number of neutrophils The dynamics of the number of fibroblasts column 1 column 2 column 1 column 2 one 0.99 ± 0.01 0.99 ± 0.02 0,000 0,000 2 0.99 ± 0.01 0.96 ± 0.05 0,000 0.020 ± 0.01 * 3 0.97 ± 0.05 0.96 ± 0.05 0.008 ± 0.007 0.031 ± 0.012 * four 0.96 ± 0.01 0.91 ± 0.05 0.016 ± 0.010 0.044 ± 0.010 * 5 0.96 ± 0.05 0.81 ± 0.01 * 0.21 ± 0.004 0.048 ± 0.015 * 6 0.93 ± 0.01 0.78 ± 0.02 * 0.036 ± 0.012 0.074 ± 0.007 * 7 0.91 ± 0.05 0.74 ± 0.05 * 0.042 ± 0.005 0.93 ± 0.007 * 8 0.90 ± 0.05 0.68 ± 0.05 * 0.46 ± 0.009 0.104 ± 0.009 * 9 0.83 ± 0.01 0.63 ± 0.05 * 0.048 ± 0.011 0.121 ± 0.011 * 10 0.77 ± 0.01 0.57 ± 0.05 * 0.068 ± 0.019 0.135 ± 0.015 * eleven 0.71 ± 0.05 0.51 ± 0.05 * 0.083 ± 0.018 0.147 ± 0.015 * 12 0.65 ± 0.05 0.45 ± 0.05 * 0.088 ± 0.016 0.151 ± 0.012 * * - significant difference between the study groups at p <0.05.

The number of neutrophils in the joint bag of patients with purulent arthritis during treatment in the 2nd group decreases more significantly, by 30.77% by the 12th day of treatment than in the 1st.

The number of fibroblasts in the joint bag of patients with purulent arthritis during treatment in the 2nd group increases more significantly, by 71.97% by the 12th day of treatment than in the 1st.

Table 4 Dynamics of the circumference of inflamed joints and the thickness of the synovial membrane according to anthropometry and ultrasound bed day Anthropometry (cm) Synovial membrane (mm) column 1 column 2 column 1 column 2 one 37.47 ± 0.2 36.84 ± 0.1 * 4.73 ± 0.53 4.82 ± 0.46 2 37.46 ± 0.3 36.74 ± 0.2 * 4.71 ± 0.24 4.83 ± 0.52 3 36.53 ± 0.1 36.83 ± 0.2 4.73 ± 0.32 4.81 ± 0.34 four 35.76 ± 0.1 34.22 ± 0.1 * 4.72 ± 0.31 4.65 ± 0.32 5 35.89 ± 0.2 33.16 ± 0.1 * 4.75 ± 0.21 4.17 ± 0.37 * 6 34.81 ± 0.2 31.73 ± 0.2 * 4.69 ± 0.11 3.67 ± 0.29 * 7 33.62 ± 0.1 28.55 ± 0.2 * 4.11 ± 0.28 3.28 ± 0.41 * 8 32.11 ± 0.2 27.24 ± 0.1 * 3.84 ± 0.34 2.72 ± 0.36 * 9 32.75 ± 0.1 27.24 ± 0.2 * 3.42 ± 0.32 2.51 ± 0.48 * 10 31.93 ± 0.2 27.25 ± 0.3 * 3.04 ± 0.31 2.24 ± 0.35 * eleven 30.85 ± 0.1 27.23 ± 0.2 * 2.86 ± 0.27 1.83 ± 0.42 * 12 29.45 ± 0.2 27.24 ± 0.1 * 2.45 ± 0.31 1.57 ± 0.38 * * - significant difference between study groups at p <0.05

The average circumference of the contralateral healthy joints in patients with purulent arthritis in centimeters: in the 1st group: 29.04 ± 0.03; in the 2nd group: 27.24 ± 0.03.

The average value of the circumference of the inflamed joints in patients with purulent arthritis in the 2nd group decreased after the 3rd day of treatment more significantly than in the 1st group and reached the norm by the 8th day. Whereas in the 1st group only by the 12th day of treatment.

The thickness of the synovial membrane of the joints in patients of group 2 after the 3rd day of treatment significantly decreases faster and more by 35.92% by the 12th day of treatment, compared with the 1st group.

Clinical, laboratory, instrumental indicators of the course of inflammation in the joint in patients with purulent arthritis in groups 1 and 2 (Table 5).

Table 5 Comparative characteristics of treatment dynamics in study groups Indicators column 1 column 2 At the beginning of treatment After treatment At the beginning of treatment After treatment temperature reaction of the patient 38.5 ± 0.3 36.5 ± 0.3 normalization by day 11 of treatment 38.6 ± 0.2 36.8 ± 0.1 normalization by day 8 of treatment the average value of the circumference of the inflamed joints in cm (edema value) 37.47 ± 0.05 29.45 normalization by day 12 of treatment 36.84 ± 0.05 27.24 normalization to day 8 of treatment the average thickness of the synovial membrane of the joints in mm 4.73 ± 0.53 2.45 ± 0.31 4.82 ± 0.96 1.57 ± 0.38 * ESR mm / h 54.8 ± 0.5 25.5 ± 0.5 51.7 ± 0.5 * 18.1 ± 0.4 * the number of neutrophils in the joint bag and paraarticular tissues 0.99 ± 0.01 0.65 ± 0.05 0.99 ± 0.01 0.45 ± 0.05 * the number of fibroblasts in the joint bag and paraarticular tissues 0,000 0.088 ± 0.016 0,000 0.151 ± 0.012 * C-reactive protein g / l * - significant differences at p <0.01 0,053 ± 0,001 0.028 ± 0.001 0.051 ± 0.002 0.013 ± 0.003 * The intensity of pain (according to YOUR) at rest from 0 to 100 points. 75 ± 3.7 35 ± 2.4 68 ± 1.9 24 ± 2.9 * The average treatment time 12.2 ± 0.5 8.1 ± 0.5 * * - significant differences at p <0.05

These data indicate that the action of anolyte + catholyte on the purulent process in the joint is paraarticularly more effective than monotherapy with dioxidine.

The anolyte solution (0.3% NaCl) has a pronounced anti-inflammatory effect, which is expressed in a decrease in synovial edema in the membrane and paraarticular tissues. A possible mechanism of this phenomenon may be a decrease in the permeability of the vascular wall, tissue dehydration, and improvement of lymphatic drainage of tissues and venous outflow.

The solution of catholyte (0.3% NaCl), when taken orally, is a biostimulator that enhances reparative processes in the inflamed tissues of the joint, but at the same time does not form coarse scar tissue.

Thus, the proposed method of treatment contains new technical steps to obtain additional treatment effects: the use of anolyte intraarticular and paraarticular to eliminate the inflammatory reaction and catholyte inward to improve regeneration.

Claims (1)

A method of treating purulent arthritis using flow-perfusion or injection washing of the joint cavity, characterized in that for this anolyte 0.3% NaCl is used, characterized by a pH of 7.3-7.7 and an ORP of + 700-1100 mV, which is introduced into the cavity of the joint in a volume of at least 10 ml, and anolyte is additionally introduced into the tissues surrounding the joint in a volume of at least 3 ml, while catholyte 0.3% NaCl, characterized by a pH of 8.2-9.5 and an ORP of -450-600 mV, is orally administered , 3 times a day before meals, at least 100 ml per reception; the course of treatment is at least nine days.