RU2434657C1 - Method of treating chronic prostatitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to urology, and deals with treatment of chronic prostatitis. For this purpose introduced is afala in dose 1 tablet 4 times per day sublingually during two months. Additionally combined physiotherapy is carried out, which alternates procedures of transrectal laser therapy with wavelength 0.82 nm and power 10 mW every second day with procedures of transrectal electric stimulation. Duration of each procedure constitutes 10 minutes, course includes 7-8 procedures of each type of impact.

EFFECT: method makes it possible in fast and stable way to stop inflammation and pain, improve microcirculation of blood and lymph in prostate gland tissue, recover functional activity of prostate.

1 ex, 1 tbl

Description

The invention relates to medicine, namely to urology.

Chronic inflammation of the prostate gland has a different etiology and complex pathogenesis. Chronic prostatitis is one of the most common urological diseases, the treatment efficiency of which is low; as a rule, patients develop chronic pelvic pain syndrome. Abroad, patients with chronic prostatitis are recommended to prescribe fluoroquinolones for 4-6 weeks, alpha-blockers, non-steroidal anti-inflammatory drugs. In especially difficult cases resort to surgical aids [1, 2].

A known Method for the treatment of chronic prostatitis (RU (11) 2063162 (13) C1; authors Pechersky A.V., Mikhaylichenko V.V., Tiktinsky O.L. and Aleksandrov V.P .; status: according to data on May 29, 2007 - terminated). The purpose of this invention is to increase therapeutic efficacy due to the selective accumulation of the drug in the prostate gland and the prevention of complications by reducing its dose. SUMMARY OF THE INVENTION An antibiotic is injected subcutaneously into the area of the projection of the external opening of the inguinal canal after preliminary administration of lidase. However, the lymphotropic administration of antibacterial drugs, indeed increasing their concentration in the tissue of the prostate gland, in no way affects the mechanism of the pathogenesis of chronic prostatitis, does not improve its microcirculation, and does not restore drainage function.

A known method of treating patients with chronic prostatitis with laser reflexology [3]. This method uses a helium-neon laser with a wavelength of 632.8 nm. The exposure is made to corporate biologically active points by a light beam with a diameter of 0.4 cm, a power output of 20 mW and a power flux density of 60 mW / cm2, exposure time - 1 min. Auricular biologically active points are exposed to a laser beam with a diameter of 0.2 cm with a power output of 10 mW and a power density of 10 mW / cm2, irradiation time of 30 s. The course of treatment consists of 8-12 procedures with a total duration of one session of 10-15 minutes.

Also known is a Method for the treatment of chronic prostatitis (RU (11) 2180553 (13) C2; authors - Bogolyubov SV; Dmitriev B.V; status: according to data as of May 29, 2007 - has ceased action) by exposure to biologically active points with an infrared laser radiation, and the parameters of laser radiation and points were determined by the form of chronic prostatitis. The authors used a pulsed infrared laser based on gallium arsenide with a wavelength of 0.89 nm, a power of 10 mW, and a frequency of 1-10000 Hz.

There is a method of complex treatment of chronic prostatitis, including the introduction of afala [4], the closest analogue of the claimed invention.

However, although the authors noted a more rapid dynamics in the clinical and laboratory examination data compared with patients in the comparison group who received only traditional methods of treatment, these methods are not pathogenetically substantiated and do not allow to influence the main links in the pathogenesis of chronic prostatitis. In addition, reflexology is the prerogative of a specialist of the appropriate profile who does not have deep knowledge in urology and skills in rectal examination of the patient, which is necessary for a correct assessment of the state of the prostate gland.

With inflammation of the prostate gland, one of the pathogenetic factors is the excess release of prostate-specific antigen (PSA) into the gland parenchyma; it is this pathogenetic mechanism of chronic prostatitis that causes pain and inflammation in the parenchyma of the prostate gland.

PSA is a natural enzyme whose main purpose is to liquefy ejaculate. During inflammation, the permeability of the vascular wall increases, which determines the release of PSA into the gland tissue. Being chemically active, PSA causes (or exacerbates) irritation and inflammation of the prostate, which, in turn, further enhances the influx of PSA into the parenchyma. A vicious circle is forming. To break it, the patient is prescribed an afala - the only drug available today that contains microdoses of antibodies to the prostatic antigen, which block its aggressiveness in the prostate tissue and stop inflammation.

However, the cessation of the inflammatory process is not enough for reorganization, since with the prostate gland atony develops and a violation of microcirculation in it.

In the proposed method for the treatment of chronic prostatitis, an afala is prescribed, 1 tablet 4 times a day and additionally combined multifactor exposure to low-intensity laser radiation with a wavelength of 0.82 nm at a power of 10 MW transrectally, alternating it every other day with transrectal electrical stimulation for each procedure lasting 10 minutes, 7-8 procedures of each impact on the course, which allows you to stop inflammation and pain, improve microcirculation of blood and lymph in the prostate gland, increase its tone. As a result, a pronounced anti-inflammatory effect quickly and steadily sets in and prostate function is restored.

The method is as follows. The patient is prescribed afala 1 tablet four times a day under the tongue for 2 months. At the same time, combined physiotherapy is performed, alternating with local transrectal laser therapy (wavelength 0.82 nm, power 10 MW) every other day with transrectal electrical stimulation. The duration of each procedure is 10 minutes, in total for a course of 7-8 procedures of laser therapy and electrical stimulation.

Example.

Patient D., 39 years old. He complained of pain in the perineum, frequent painful urination, weakening potency. During rectal examination, the tone of the gland is reduced, the groove is smoothed, palpation is painful. A large number of leukocytes was found in the secretion of the prostate; the number of lecithin grains was sharply reduced. Microcirculation indices determined by laser Doppler flowmetry (LDF) were 47% lower than normal.

The patient was prescribed afala 1 tablet under the tongue 4 times a day for two months; simultaneously conducted a course of laser therapy and electrical stimulation, alternating transrectal procedures every other day, a total of 14 procedures.

After 2 months, the patient showed no complaints, during a rectal examination, the prostate was of normal size, elastic, the groove was pronounced, palpation was painless. 5-7 leukocytes, a large number of lecithin grains were found in prostate secretion under light microscopy. LDF microcirculation returned to normal.

The proposed method was tested in the urogenital clinic of the Federal State Institution of the Novosibirsk Research Institute of Tuberculosis in 14 patients. Efficiency was evaluated by the following criteria:

1. pain - intensity in points from 0 to 10,

2. the number of leukocytes in the secretion of the prostate, as a sign of inflammation,

3. the number of lecithin grains in the secretion of the prostate as a sign of its functional activity (in scoring from 0 to 5),

4. the integral indicator of microcirculation, determined by laser doppler flowmetry at the projection point of the prostate in the middle of the perineum.

Initially, the average pain efficacy was 7.1 ± 2.4; the number of leukocytes in prostate secretion by light microscopy of the native smear was 81.3 ± 7.9 on average. The saturation of the smear with lecithin grains was reduced to 0.9 ± 0.2 points. Microcirculation was also insufficient, and on average its integral indicator was 9.7 ± 0.3 cu

2 weeks after the completion of physiotherapy, on the background of taking afala, a pronounced positive dynamics was noted in all indicators, which improved even more by the end of treatment (2 months). A follow-up examination, which was conducted in 12 men after 6 months, confirmed the persistence of the results.

The effectiveness of treatment is clearly presented in the table.

Table The dynamics of clinical and laboratory parameters in patients with chronic prostatitis who received treatment by the present method Indicator Originally In 2 weeks 2 months later In 6 months Pain (points) 7.1 ± 2.4 4.2 ± 1.7 1.2 ± 0.2 0.8 ± 0.2 White blood cells 81.3 ± 7.9 19.3 ± 4.4 7.4 ± 2.1 6.8 ± 1.9 Lecithin grains 0.9 ± 0.2 3.6 ± 0.3 4.6 ± 0.1 4,5 ± 0,2 The integral indicator of microcirculation 9.7 ± 0.3 12.6 ± 0.6 14.7 ± 0.3 14.7 ± 0.3

Thus, the proposed method, quickly and effectively acting on the main links in the pathogenesis of chronic prostatitis, allows to achieve good and lasting results; can be used on an outpatient basis.

Literature

1. Naber K.G., Bergman B., Bishop M.C. et al. Guidelines on Urinary and male genital tract infections. - 2001. - P.53-55.

2. Nickel J. Recommendations for the evaluation of patients with prostatitis // World J Urol. - 2003 .-- Vol.21 (2). - P.75-81.

3. Vozianov A. F., Pasechnikov S. P., Kovtunyak O. N. Laser reflexology of patients with chronic prostatitis // Medical business, 1991. No. 2, p. 45-48.

4. Kulchavenya E.V. The effectiveness of afala in the complex treatment of patients with chronic prostatitis. Medical Estate, 2007, No. 5, p.20-23.

Claims (1)

A method of treating chronic prostatitis by a complex treatment, including the introduction of afala, characterized in that afala is administered 1 tablet 4 times a day sublingually for two months and additionally carry out combined physiotherapy, alternating transrectal laser therapy at a wavelength of 0.82 nm and a power of 10 MW every other day with transrectal electrical stimulation procedures, the duration of each procedure is 10 minutes, with 7-8 procedures of each exposure per course being carried out.