RU2564792C1 - Method of treating chronic endometritis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: what is applied is small pelvis organs are exposed by means of the KAP-ELM-01 Andro-Gin apparatus. The treatment is two-staged. The first stage involves a physiotherapeutic provocation pre-exposure consisting of 3-5 procedures. That is combined with intracavitary electric stimulation in operation mode "3" with positive polarity, amplitude from 5% to 100% at a frequency of 50 Hz with an excitation period of 2 sec and a pause of 1 sec; neurostimulation is conducted with using a surface sensor at a frequency of 30 Hz; magnetic and laser therapies represent external and internal in-phase exposures; colour and rhythm therapy is a continuous exposure to blue and red lights with the switch position set to "3" to select power options; a switch setting period is 3 seconds at a modulation frequency of 20 Hz. The procedure length is from 15 to 20 minutes either daily or every second day. A pharmaceutical treatment is prescribed individually in accordance with reference data. The second stage represents 15-20 procedures of a primary physiotherapeutic exposure. That is combined with intracavitary electric stimulation in operation mode "4" with positive polarity, amplitude from 5% to 100% at a frequency of 80 Hz with an excitation period of 3 sec and a pause of 5 sec; neurostimulation is conducted at a frequency of 10 Hz; magnetic and laser therapies represent external and internal in-phase exposures; colour and rhythm therapy is a continuous exposure to green and orange lights with the switch position set to "3" to select power options; a switch setting period is 3 seconds at a modulation frequency of 20 Hz. Each procedure lasts for 15 to 20 minutes either daily or every second day.

EFFECT: method provides the high efficacy of the pharmaceutical stage of treatment following the short physiotherapeutic provocation pre-exposure, ensures the higher efficacy of the primary physiotherapeutic treatment by the integrated nature of the exposure to pre-formed physical factors, and reduces side effects accompanying physiotherapy.

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Description

The invention relates to medicine, namely to gynecology.

For the treatment of chronic endometritis, antibacterial drugs are used in combination with metabolic therapy, disaggregation therapy and immunomodulators as causes of miscarriage. As a rehabilitation treatment, a physiotherapeutic effect is applied in the form of: a “running” magnetic field (apparatus “AMUS-01 Intramag-Zh”) [Shagerbieva EA, Abstract. diss. ... cand. honey. sciences. Moscow, 2008. 25 pp.], Interference therapy (apparatus "AIT-01"), electric pulse therapy (apparatus KAP ELM-01 "Andro-Gin") [Shishkanova O.Ya., Abstract. diss. ... cand. honey. sciences. Moscow, 2008. 25 pp.], Low-frequency ultrasound with polyadenylurenedyl acid (half-dan) [Spirina Yu.V., Abstract. diss. ... cand. honey. sciences. Tomsk, 2009. 24 pp.], Medical ozone (apparatus AOT-N 01-Arz-01/1) [Dudareva Yu.A., Abstract. diss. ... cand. honey. sciences. Barnaul, 2007. 25 pp.], SCENAR-therapy, plasmapheresis and ultraviolet blood [Petrov Yu.A., Abstract. diss. ... Dr. honey. sciences. Moscow, 2012. 47 pp.], TLC therapy (Ultraton TNCh-10-1 apparatus), low-frequency pulsed electrostatic field (Infita apparatus) [Evseeva MM, Abstract. diss. ... Dr. honey. sciences. Moscow, 2008.52 p.].

They also use Longidaza preparations (NPO Petrovax Pharm) [Dubnitskaya L.V., Nazarenko T.A. “Chronic endometritis: diagnostic and treatment options” Consilium Medicum. 2007; 9: 6: 45-52], lycopid and polyoxidonium [Mikhnina EA, Abstract. diss. ... Dr. honey. sciences. St. Petersburg, 2009. 40 p.].

However, all these methods have a number of significant drawbacks. Chronic endometritis is an inflammatory process in the endometrium, which has a sluggish course and often its main manifestation will be reproductive failures. According to literature [Korsak B.C. et al. Study of the endometrium in patients with tubal-peritoneal infertility at the stage of preparation for IVF. Reproduction problems. 2005. No2. P. 39-42] in 100% of patients with CE there is no pathogenic and conditionally pathogenic flora at all. This is consistent with the data of other authors [Dubnitskaya L.V., Nazarenko T.A. Chronic endometritis: diagnostic and treatment options. Consilium Medicum. 2007; 9: 6: 45-52], which showed that during the initial examination of patients with CE in almost 70% of cases, the use of traditional routine research methods does not allow to identify the etiological factor of chronic inflammation. Therefore, the appointment of antibiotic therapy against such an initial background is not always justified.

There are methods of preliminary pharmaceutical provocation to achieve the best effect of the use of antibacterial drugs. As provocative methods, the use of pyrogenal and gonovaccine is known [Petrov Yu.A., Author. diss. ... Dr. honey. sciences. Moscow, 2012. 47 p.].

At the same time, in modern practice, they try to use preformed physical factors so that they have the least harmful effect on the body, but at the same time achieve the greatest therapeutic effect. It is known that when using one physical factor, its effect should be large enough for a specific effect and minimal for the occurrence of side effects.

The closest in technical essence is the use of electric pulse therapy using the apparatus KAP-ELM-01 "Andro-Gin" 10 procedures lasting 20 minutes daily.

The disadvantage of this method is: unidirectional exposure, an increase in the number of side effects with an increase in the strength and power of the exposure with one preformed factor to achieve a positive result, the absence of a primary provocative effect to activate a sluggish inflammatory process.

To overcome these factors, a method is proposed for treating chronic endometritis using the two-stage method using the complex physiotherapeutic effect of the Andro-Gin device KAP-ELM-01.

The technical result of the invention is: high efficiency of the medication stage of treatment after a short provocative physiotherapeutic effect (there is no additional use for the purpose of provoking medications whose effects on the patient’s body during the preparation for pregnancy have not been evaluated), the reduction of side effects during physiotherapy, which consists in the minimum effective the impact of a complex of preformed physical factors, which generally increases the effectiveness of treatment and possibility of pregnancy in the next menstrual cycle after treatment, which is not possible with other methods, when it is necessary to take a break after using drugs before pregnancy.

The technical result is achieved by the fact that in the treatment of chronic endometritis with the influence of electrical pulses on the pelvic organs using the apparatus KAP-ELM-01 Andro-Gin, the treatment is carried out in 2 stages, the first of which uses a preliminary provocative physiotherapeutic effect before the medical stage of treatment , including 3-5 procedures, consisting in the application of simultaneously the modes of electrical stimulation - “intracavitary”, in operating mode - “3”, polarity “positive”, amplitude from 5% to 100%, frequencies 50 Hz, the excitation - 2 sec, pause - 1 sec; neurostimulation - skin sensor, frequency 30 Hz; magnetotherapy and laser therapy - external and internal effects, in phase; colorite therapy - continuous exposure to blue and red, with the following parameters: power - switch position - position “3”, switching time - 3 seconds, modulation frequency 20 Hz; the duration of the procedure is 15-20 minutes when applied daily or every other day, while in the second stage, carried out after drug treatment, determined individually, depending on the initial data, the main physiotherapeutic effect is applied, including 15-20 procedures using the device, which consists in simultaneously under the influence of electrostimulation modes - “intracavitary”, in the operating mode - “4”, polarity “positive”, amplitude from 5% to 100%, frequency 80 Hz, excitation - 3 sec, pause - 5 sec; neurostimulation - frequency 10 Hz, magnetotherapy and laser therapy - external and internal effects, in phase; colorite therapy - continuous exposure to green and orange, with the following parameters: power - switch position - position “3”, switching - 3 sec, modulation frequency 20 Hz; the duration of each procedure is 15-20 minutes when applied daily or every other day.

The proposed method is implemented as follows. A provocation of exacerbation by a complex physiotherapeutic effect is preliminarily carried out (3-5 procedures). Electrostimulation modes are used simultaneously (“intracavitary” (sensor into the posterior vaginal fornix), mode - 3, polarity “positive”, amplitude from 5%, frequency 50 Hz, excitation - 2 sec, pause - 1 sec), neurostimulation (skin sensor for buttock area, projection of the output of the sciatic nerve, frequency 30 Hz, the amplitude of the current in a pulse of 0-100 mA per load of 2000 Ohms, the alternation of pulses and pauses of 1-10 seconds with an intensity of 1 second), the in-phase effect of magnetotherapy (cutaneous sensor on both inguinal regions, 40 mT magnetic induction) and laser therapy (external exposure - inguinal areas on both sides and internal exposure - the posterior vaginal fornix, total power of semiconductor laser and LED radiation 7 mW) and color therapy (continuous exposure of blue and red to the visual analyzer, power - 3, switching - 3 sec, frequency (modulations) ) 20 Hz). The duration of the procedure is 15 minutes. Procedures are performed daily. The aggravation reaction is the appearance after the procedures of pain in the lower abdomen and / or an increase in body temperature to subfebrile values or more.

Next, a course of etiotropic therapy is prescribed depending on the results of bacterioscopy and polymerase chain reaction (PCR) diagnostics, vasoactive drugs (actovegin, angiovit), antiplatelet agents (chimes) and metabolic therapy (tocopherol, methionine), α- drugs were prescribed to correct interferon status interferon.

At stage 2, the course of complex physiotherapeutic effects includes 15 procedures. At the same time, electrostimulation modes are used (“intracavitary” (sensor into the posterior vaginal fornix), mode - 4, polarity “positive”, amplitude from 5%, frequency 80 Hz, excitation - 3 sec, pause - 5 sec), neurostimulation (skin sensor for buttock area, projection of the output of the sciatic nerve, frequency 10 Hz, the amplitude of the current in the pulse 0-100 mA per load of 2000 Ohms, the alternation of pulses and pauses 1-10 seconds with an intensity of 1 second), the in-phase effect of magnetotherapy (cutaneous sensor on both inguinal regions, 40 mT magnetic induction) and laser therapy (external exposure - inguinal areas on both sides and internal exposure - the posterior vaginal fornix, the total power of semiconductor laser and LED radiation 7 mW and color therapy (continuous exposure of green and orange to the visual analyzer, power - 3, switching - 3 sec, frequency (modulation) 20 Hz). The duration of the procedure is 20 minutes.The procedures are carried out daily or every other day.

Electrical stimulation reduces muscle fibers to the full depth, which improves the microcirculation of blood in the uterus and causes a quick analgesic effect.

Laser therapy improves microcirculation, accelerates regeneration, activates metabolic processes, stimulates a more rapid change of the edema phase by the proliferation phase in the focus of inflammation, and provides analgesia.

Magnetotherapy has anti-inflammatory, hypocoagulation, analgesic and sedative effects.

Neurostimulation improves microcirculation, has anti-inflammatory and analgesic effects, improves microcirculation.

Colorite therapy, depending on the color used, can have psychostimulating and antidepressant or muscle relaxant, sleeping pills and sedatives.

Case Studies

1. Patient S., 31 years old. It is observed by the doctor about the usual miscarriage. In the anamnesis: childbirth - 1 (urgent, without complications), non-developing pregnancy - 2 (at 9-10 weeks and 5-6 weeks).

Specific infection is excluded. There is no evidence for genetic pathology, thrombophilia. According to the results of a histological examination of the endometrium, the diagnosis was made: Chronic endometritis. A burdened obstetric and gynecological history.

According to ultrasound, signs of chronic endometritis were found. Dopplerometry of the uterine arteries showed hemodynamic disturbances in the uterus.

The patient was treated in 2 stages. A preliminary provocative course of physiotherapy with the KAP-ELM-01 Andro-Gin apparatus in the amount of 3 procedures, after which the patient developed minor pulling pains in the lower abdomen. Further drug treatment: broad-spectrum antibiotics, immunomodulators, metabolic therapy and antiplatelet agents. The second course of physiotherapy with the KAP-ELM-01 Andro-Gin apparatus was 15 procedures. No complaints.

According to the data of ultrasound and Doppler studies after treatment, signs of chronic endometritis are not determined.

Pregnancy has come through one menstrual cycle, prolonged. According to the results of screening 2 trimesters - without pathology.

2. Patient B., 26 years old. She complained of the absence of pregnancy for 4 years of regular sexual activity without contraception. History: at the age of 18 years, medical abortion with a gestational age of 8-9 weeks, without complications.

Surveyed. Pathogenic and conditionally pathogenic flora is absent. The fallopian tubes are passable. Examination of the partner pathology did not reveal. According to the results of a histological examination of the endometrium, the diagnosis is Infertility 2. Chronic endometritis. A burdened obstetric and gynecological history.

According to ultrasound, signs of chronic endometritis were found. Dopplerometry of the uterine arteries showed hemodynamic disturbances in the uterus.

The patient was treated in 2 stages. A preliminary provocative course of physiotherapy with the KAP-ELM-01 Andro-Gin apparatus in the amount of 5 procedures. The patient tolerated them well, no complaints. Further drug treatment: NSAID course, immunomodulators, metabolic therapy and disaggregants. The second course of physiotherapy with the KAP-ELM-01 Andro-Gin apparatus was 15 procedures. No complaints.

According to an ultrasound scan after treatment, signs of chronic endometritis are not detected. Hemodynamics in the uterus - without pathology.

Pregnancy occurred in the next after the treatment menstrual cycle, prolonged. According to the results of screening of the 1st trimester - without pathology.

This method has been used since 2011 in the antenatal clinic KOGBUZ "Northern City Clinical Hospital", the antenatal clinic "Kirov Maternity Hospital No. 1", in the clinic and at the Department of Obstetrics and Gynecology, IPO Kirov State Medical Academy. During this period, more than 80 patients were cured.

The positive effect of a comprehensive physiotherapeutic effect is the minimal impact of preformed physical factors with a significant positive result of treatment, the possibility of pregnancy in the next menstrual cycle after treatment. All this is the advantage and advantage of the proposed technical solution compared to the prototype.

Claims (1)

A method for the treatment of chronic endometritis with the effect of electrical pulses on the pelvic organs using the KAP-ELM-01 Andro-Gin apparatus, characterized in that the treatment is carried out in 2 stages, the first of which uses a preliminary provocative physiotherapeutic effect before the medical treatment stage, including 3-5 procedures consisting in the application of simultaneously the modes of electrical stimulation - “intracavitary”, in the operating mode - “3”, polarity “positive”, amplitude from 5% to 100%, frequency 50 Hz, excitation - 2 seconds, pause - 1 sec neurostimulation - skin sensor, frequency 30 Hz; magnetotherapy and laser therapy - external and internal effects, in phase; colorite therapy - continuous exposure to blue and red, with the following parameters: power - switch position - position “3”, switching time - 3 sec, modulation frequency 20 Hz; the duration of the procedure is 15-20 minutes when applied daily or every other day, while in the second stage, carried out after drug treatment, determined individually, depending on the initial data, the main physiotherapeutic effect is applied, including 15-20 procedures using the device, which consists in simultaneously under the influence of electrostimulation modes - “intracavitary”, in the operating mode - “4”, polarity “positive”, amplitude from 5% to 100%, frequency 80 Hz, excitation - 3 sec, pause - 5 sec; neurostimulation - frequency 10 Hz; magnetotherapy and laser therapy - external and internal effects, in phase; colorite therapy - continuous exposure to green and orange, with the following parameters: power - switch position - position “3”, switching - 3 sec, modulation frequency 20 Hz; the duration of each procedure is 15-20 minutes when applied daily or every other day.