RU2417801C1 - Method of treating patients with vulvar kraurosis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to gynecology, physiotherapy. Method includes impact by pulse electric current. Impact is carried out on perineal, on pubic and anal areas. Pubic and anal areas are influenced sequentially, placing common electrode on perineal. Influence is carried out by electric current with power 7-14 mA, pulse frequency inside train - 4-6 kHz, with train duration -0.2 msec. Form of circumflex pulse train is trapezoidal, frequency of bundle switching -0.4-0.6 Hz, current power - from 0.8 to 1.2 Wt. Influence is carried out for 15-20 minutes.

EFFECT: method improves trophic processes of tissues in area of vulva due to restoration of parasympathetic innervation in said area.

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Description

The invention relates to medicine, namely to gynecology, and for the treatment of women suffering from vulvar kraurosis.

A known method of treating patients with kraurosis of the vulva, including the use of radon water. Radon water is used in combination with EHF-therapy for the vulva. At the same time, radon baths are prescribed with a temperature of 36-37 ° C, lasting 10-15 minutes, every other day, gynecological irrigation and microclysters are prescribed on the days of bathing, the same temperature and exposure; on days free from balneotherapy, or with an interval of 2 hours from receiving balneotherapy. Locally, EHF-therapy is carried out on the vulva (kraurotic triangle) with an exposure of 20 minutes, for a course of 8-10 procedures (RF patent No. 2163822, class A61N 5/02. Publish. March 10, 2001).

However, in the known method, EHF-therapy is only energizing for tissues prone to kraurosis, but does not contribute to the electrophysiological restoration of the conductivity of damaged structures of the parasympathetic nervous system. In addition, only a complex effect on the vulva tissue is proposed, not supporting the function of local parasympathetic nerve fibers, and the use of radon water can cause an imbalance of micro- and ultramicroelements in the vulva tissues, which will negatively affect trophic tissue.

There is also a method of treating patients with kraurosis of the vulva, including the use of local laser therapy for the vulva. Laser therapy is carried out in the autoresonant mode of the device with a frequency varying from 10 to 1500 Hz at a wavelength of 0.89 μm, a pulsed mode with a power of 10 W, a duration of 4-5 minutes, 30 s for each field of exposure, with sequential sounding of each zone of exposure , for a course of 8-10 procedures (RF patent No. 2146957, class A61N 5/067. Publ. March 27, 2000).

The disadvantages of this method include the fact that the tissues have an individual sensitivity to laser radiation. Therefore, an individual selection of radiation characteristics for each patient is required, which can adversely affect the plastic metabolism in tissues (enumeration of different radiation ranges instead of one specific one). A change in the frequency of exposure to a considerable extent can cause instability of tissue enzymes, as well as enhance local degenerative processes due to excessive stimulation of tissues against the background of insufficient trophism.

Closest to the proposed in its technical essence is a method of treating patients suffering from vulvar kraurosis, including phonophoresis. Sounding is carried out on the vulva, perineum, inguinal and pubic ultrasound with an intensity of 0.2-0.4 W / cm ² for 45 minutes during the first procedure and with an exposure of 7-8 minutes during subsequent procedures, every other day, on course 8 -10 treatments. And on days free from phonophoresis, prescribe radon baths, microclysters and gynecological irrigation (patent No. 2082468, class A61N 7/00, А61Н 33/04, А61Н 35/00. Publ. June 27, 1997).

But in this method, dosages of ultrasound intensity (0.2-0.4 W / cm ² ) are hyperthermal and destructively affect biological substrates, adversely affect the endocrine system. In addition, phonophoresis of hydrocortisone ointment does not provide a proper effect on the etiology of kraurosis, since hydrocortisone accumulates and is partially metabolized in the skin without affecting the parasympathetic nerve endings, the dysfunction of which provokes degenerative diseases of the vulva.

The problem to which the claimed invention is directed is to restore the disturbed parasympathetic innervation of the vulva and adjacent tissues, which helps to improve their trophism and significantly attenuate degenerative processes.

The technical result is to improve metabolic trophic processes.

The problem is solved in that in the method of treating patients with vulvar kraurosis, including the physiotherapeutic effect on the perineum and pubic area with a course of 8-10 procedures every other day, the effect of pulsed electric current is chosen as the physiotherapeutic effect. In this case, additionally affect the anal area. Moreover, the pubic and anal regions are sequentially respectively affected by a pulsed electric current when a common electrode is placed on the perineum with the following parameters: current strength is from 7 to 14 mA, the pulse frequency inside the packet is 4-6 kHz, the duration of the packet is 0.2 ms, shape the envelope of the pulse train is trapezoidal, the switching frequency of the packets is 0.4-0.6 Hz, the current power is from 0.8 to 1.2 W, the exposure time is 15-20 minutes.

The impact of pulsed electric current affects all areas and links of the pathological process, starting with impaired parasympathetic innervation, which restores the balance of the ratio of acetylcholine / cholinesterase. The restoration of tissue trophism involves an impact on the etiology of the disease, and not on its manifestations, as a result of which the effectiveness of therapy is increased. In the claimed method, an overdose of energy exposure is excluded, since the tissues do not accumulate this effect.

The inventors found that exposure to pulsed electric current with the proposed parameters increases the effectiveness of treatment of patients with kraurosis of the vulva by restoring the disturbed parasympathetic innervation of the vulva and adjacent tissues.

The method is implemented as follows.

The pubic and anal areas are affected by a pulsed electric current in series, respectively, with a common electrode placed on the perineum with the following parameters: current strength is from 7 to 14 mA, the pulse frequency inside the packet is 4-6 kHz, the duration of the packet is 0.2 ms, the shape of the envelope the pulse packets are trapezoidal, the switching frequency of the packets is 0.4-0.6 Hz, the voltage of the packet is from 50 to 60 V, the current power is from 0.8 to 1.2 W, the exposure time is 15-20 minutes. The patient is placed on a couch on his back. The electrodes equipped with a pre-soaked tissue pad are fixed in the appropriate areas: the first is at the level of the lower edge of the pubic joint; the second - in the anal area; and the third (common) - directly in the perineum. Dynamics of electric current: a pulsed electric current is sequentially supplied to the electrode: first to the first, located at the level of the lower edge of the pubic joint, then to the second, located in the anal region. In this case, a packet of pulses is sequentially supplied to each electrode. The patient is under the influence of a current of 15-20 minutes, after which the procedure ends: the electrodes are de-energized and removed.

Example

Patient B., 55 years old, is under observation at the antenatal clinic for kraurosis of the vulva for the past 5 years. History: vulvectomy for vulvar kraurosis in combination with leukoplakia. 2 years after vulvectomy, itching and burning again appeared in the perineum. The diagnosis of relapse of kraurosis is confirmed by histological examination of the vulva biopsy during repeated biopsy. At a visual examination, atrophicity of the clitoris, the labia minora and labia minora, swelling of the affected areas, minor abrasions, bruising, dry organs and tissues of the vulva, and narrowing of the vaginal opening were noted. In vaginal examination: the cervix, uterine body and appendages without features. Hyperemia of the vaginal mucosa, no discharge. Vulvoscopy revealed atrophy and thinning of the vulva tissue: labia minora, clitoris; swelling of the submucosal and subcutaneous tissues, sclerotic changes in the entrance to the vagina, a crack in the region of the posterior commissure, bruising. Malignant transformation of tissues and leukoplakia with extended vulvoscopy (using 3% acetic acid, Lugol's solution and a “color” breakdown with methylene blue) was not detected. Studies were performed: clinical blood and urine tests - without pathology, ECG - without features. Blood sugar, prothrombin index, blood coagulation time are normal. Helminthic invasion in the study of feces was not detected. Wasserman reaction, blood test for HIV-negative. Cytological smear of the vulva - without atypia, from the cervix and cervical canal - without pathology. Gonococci and Trichomonas were not detected in smears on the purity of the vaginal flora, there is a moderate coccal flora and single lactobacilli in the field of view. As a physiotherapeutic treatment, we chose the effect of a pulsed electric current on the pubic, anal areas and perineum according to the proposed method with a course of 8-10 procedures every other day.

After the physiotherapeutic treatment, itching and burning in the vulva, a feeling of tightening of the perineum, swelling of the affected tissues disappeared. The general state of health has improved. The conclusion of vulvoscopy testified to a rather effective effect in the restoration of the skin-mucous membranes of the vulva. Within 6 months of observing discomfort in the external genitalia, the patient did not notice.

Claims (1)

A method of treating patients with vulvar kraurosis, including a physiotherapeutic effect on the perineum and pubic area with a course of 8-10 procedures every other day, characterized in that the pulse effect is selected as a physiotherapeutic effect, with an additional effect on the anal region, and on the pubic and anal regions sequentially, respectively, they act with a pulsed electric current when a common electrode is placed on the crotch with the following parameters: current strength - from 7 to 14 A, the pulse frequency inside the packet is 4-6 kHz, the packet duration is 0.2 ms, the shape of the envelope of the pulse train is trapezoidal, the switching frequency of the packets is 0.4-0.6 Hz, the current power is from 0.8 to 1, 2 W, exposure - 15-20 minutes.