The method of complex treatment of patients with chronic adnexitis, infectious-toxic option, nonspecific etiology

 

(57) Abstract:

The invention relates to medicine, and gynecology. Conduct conventional drug therapy. Introducing antibiotics into the submucosal vagina in 1/4 of the daily dose. Enter the vagina tampon with SMS-1. Rectum impose a candle with trypsin or chemotrypsin. Spend the sinusoidal modulated currents. Carry out treatment prodigiozana. Spend immunocorrective therapy tactivin. Restore vaginal microflora introduction of Lactobacterin or Narine. After discharge from the hospital appointed adaptogens, spend the vitamin. The method improves the efficiency of the treatment. 2 C.p. f-crystals, 6 PL.

In the treatment of chronic nonspecific inflammatory diseases of uterine appendages currently proposed many methods of treatment. It should be noted that in recent years there has been a tendency to polipragmazie, consequently, included in the complex therapy of new drugs (7, 13, 16). Antibacterial, desensibilizing, immunocorrective, symptomatic, vitamin therapy. According to the testimony of detoxification(4, 5, 7, 8, 9, 22).

It is now known, Chinese, because through the lymphatic system is resorption of the decay products of cells, proteins, macromolecular substances, bacteria and their toxins from inflammation(1, 2, 14, 17). Abnormalities in the lymphatic system, the inadequacy of its functions affect the development and outcome of the disease. Correction of violations, as well as the optimization of its inadequate functions is essential therapy. The saturation of the lymphatic system drugs, you can intervene in the transport, metabolic, immune, barrier and other functions of the lymphatic system(1, 2, 3, 11, 12).

Keith L. G. at all. (1989) described the relationship of the lymphatic system of the cervix with the overlying departments lymphatics.

It is known that patients with chronic inflammation macrophages are not able to remove the alien to the body of molecules and cells from the circulation, accumulating their intracellular, not by "digesting" them and "not present" molecules of antigen to lymphocytes, thereby not start a specific immune response. Inactive macrophages are not able to cause the death of the captured microbes, the last inside the macrophage can not only persist, but even to reproduce. On the germs that are intracellular, antibiotics are not gassnova" of the pathogen in the body (18).

Under the influence of microbes or their products (LPS) is the transformation of cells in a fully activated with the maximum mobilized cytopathogenic potential (17, 20). Moreover, macrophages stimulated by LPS E. Coli, produce more endorphin than the intact cells. Produced while interleukin-1 leads to an increase in corticosterone after a maximum of 2 hours, and ACTH in 30-60 minutes In the study of the mechanisms of regulation of the synthesis of interleukin-1, PGE-2 dependence of these processes on the functional state of macrophages (6).

Classical exogenous pyrogens, such as pyrogens and prodigiozan are and classical immuno - stimulants system of mononuclear phagocytes. Synthesized H. C. Ermolieva and G. E. Braude prodigiozan activates the system pituitary-adrenal axis, enhances the activity of the reticuloendothelial system, phagocytosis, increases resistance to viral infection by stimulation of endogenous interferon (15). These substances that increase the body temperature, are lipopolysaccharide complexes derived from bacteria. Under the influence of prodigiozana activated macrophages: increase in size, povidone activated macrophage, such as PGE, interferons, collagenase and other neutral proteases, lysosomal hydrolases. When adequate stimulation of these protivovirusnye factors dramatically inhibit fibrosis (19). Macrophages, inkubirovanie in the presence of LPS, become pronounced cytotoxicity against syngeneic or allogeneic tumor cells, but not cells with normal growth parameters (10).

As a prototype, we suggest a method for the treatment of chronic adnexitis infectious-toxic options described Century. P. Smetnik et al. (1995). The method consists in the introduction of antibiotics, detoxification, desensitizing, physical therapy and symptomatic therapy.

We offer a comprehensive method for the treatment of nonspecific chronic inflammatory diseases of the uterus, infectious-toxic variant of nonspecific etiology.

The technical result of the proposed method - increasing the effectiveness of treatment, relapse prevention.

The proposed method consists in the following:

1) Within 5-7 days carry out the introduction of antibiotics into the submucosal lateral fornix, and then introduced into the vagina tampon with SMS-1 in the amount of 2 g, and p is a private currents.

2) then spend the rehabilitation of chronic foci of infection of the nose and throat.

3) then assign prodigiozan with the selection of individual therapeutic dose and with increasing body temperature to 37.8oC begin the introduction of antibiotics (kanamycin, ampicillin, gentamicin) in submucosal lateral fornix in 1/4 of the daily dose in the rectum impose candles with trypsin or chemotrypsin and after 10-15 minutes of physical exercise sinusoidal modulated currents, within 5 days of conducting immunocorrective therapy T-activin sensitivity to it blood lymphocytes, then restore the microflora of the vagina Lactobacterin or Narine.

4) After discharge from the hospital within 6 months appoint adaptogens (eleuterokok, tincture of Rhaponticum or Golden root), are cyclic vitamin therapy, restoration of the menstrual cycle according to testimony.

In the presence of anaerobic infection within 3 days of conducting blood electrophoresis with metrogram.

Under our supervision, within 5 years there were two groups of patients with chronic nonspecific inflammatory diseases of the uterus, infectious-toxic anatomy method the second 50 - man on the proposed method of treatment.

The results of the treatment were assessed according to three categories: the cure (disappearance of General and local symptoms of inflammation, biochemical signs of active inflammation, normalization of parameters of immunological reactivity and level of hormones, and normalization of reproductive function), improvement (improvement of health, the cessation of pain and discharge, reducing infiltrative changes in the uterus), no effect (stabilization or increase of clinical signs of inflammation).

Long-term results of treatment were considered in three categories: the recurrence rate, duration of remission for 5 years of follow-up, restore reproductive function.

In patients with chronic salpingitis infectious-toxic option in the first group immediately after treatment partial response was observed in 66.67% of cases, there was no effect of therapy at 33,33% of patients. All patients had disease recurrence within 3-6 months. Indicators of immune (PL. 1) and endocrine status (table. 2), circadian rhythm thymosin-alpha (PL. 3) in these patients has not recovered.

In the second group after providinng the L. 4), the indices of immunity (table. 5) and the circadian rhythm of thymosin-alpha (PL. 6) one year after treatment.

Used abbreviations

Tables 1, 5.

P - early E-rosette cells (E-ROCK) - helpers-inducers.

R/M - helpers/inductors morula ("socket", surrounded by more than 10 sheep erythrocytes.

In the restored E-ROCK - suppressor/killer.

/M - suppressor/killer cells of the morula.

P:With - attitude helpers/inductors to the suppressor/killer.

With stable E-ROCK.

T - total E-ROCK (the total number of differentiated T lymphocytes).

T/M - total E-ROCK of the morula.

It is a comprehensive E-ROCK (undifferentiated T-lymphocytes).

K/M - a comprehensive E-ROCK of the morula.

CFT is a function of the thymus, reflecting the processes of differentiation of T-lymphocytes.

M - the index of inhibition of migration.

EI - index migration.

PEF is an indicator of effector functions.

Tables 2, 4.

ACTH - adrenocorticotropic hormone.

FSH - follicle stimulating hormone.

LH - luteotropic hormone.

LH/FSH ratio of the number luteotropin the on to amount of estriol.

PSG progesterone.

E - estriol.

Example 1. Patient W., 18 l, N history 7240, was on treatment and examination III in the Department of gynecologic hospital # 2, Novosibirsk with a diagnosis of exacerbation of chronic bilateral oophoritis, infectious-toxic option, nonspecific etiology, cystic degeneration of the left ovary. From the anamnesis it is known that a child suffers frequent colds, sore throats, often takes antibiotics. Monthly from the age of 14, irregular, within 30 - 45 days, abundant painful. Inflammation of the uterine appendages suffer from the age of 16. Twice was treated in hospital, but after suffering flu or a sore throat again, the pain in the lower abdomen, pain, increased body temperature. Takes antibiotics alone.

At clinical examination in the General analysis of blood was revealed leukocytosis with a left shift formula, lymphopenia, monocytopenia, accelerated erythrocyte sedimentation rate (Hb 128, leukocytes-11,4109/l, stab neutrophils - 8%, segmented - 65%, lymphocytes - 21%, monocytes - 5%, ESR - 24 mm/hour).

Urinalysis without pathological changes.

Positive C-reactive protein 3 UNITS. Smear who was b identified immunodeficiency, which was reflected in the increase in the number of active lymphocytes helpers/inductors with vsokoaffinnah communication, lower index helpers/inductors to the suppressor/killer cells and a decrease in the overall number of T-lymphocytes, the indicator function of the thymus and effector functions of T-lymphocytes (P - 22%, P/M - 11%, P:At - 0,72, T - 35%, 30%, CFT - 0,61, PEF - 0,74).

The greatest sensitivity of lymphocytes to taktivin the succinate dehydrogenase revealed in the morning time of the day.

Bimanual study determined the uterus is not enlarged, limited in mobility, the appendages on both sides thick, enlarged, painful on the left is determined cystolithotripsy ovary in spinach.

The patient spent treatment: penicillin 500 thousand UNITS 4 hours intramuscularly for 5 days, blood electrophoresis with metrogram within 3 days, within 5 days in submucosal lateral vaginal fornix was administered 0.5 g of kanamycin, has introduced a tampon with SMS-1 in the vagina in the amount of 2 grams (16 h), rectum has introduced a candle with trypsin and after 10-15 minutes spent physiotherapy sinusoidal modulated currents.

In the hospital the patient was examined by the otolaryngologist, was diagnosed with curvature of Perugia pharyngoscope: gargling with 1% solution of vinegar, lubrication Lugol solution, cheek levorin 500 thousand IU every 6 hours, decaminada caramel, UFO throat.

Significant improvement was noted on 3 days of treatment: normalized body temperature, decreased abdominal pain.

On the fifth day - improved blood: white blood cell count was 6,8109/l, stab neutrophils - 4%, segmented - 69%, lymphocytes - 20%, monocytes 7%, and ESR - 20 mm/hour, C-reactive protein - 1 ED.

12 days after the start of treatment complaints were absent, the blood counts have returned to normal, gynecological study determined the uterus is normal in size, limited in mobility, the appendages in spinach sensitive to palpation, immunological parameters, hormonal status is not normalized. After discharge from the hospital the woman was held submucous resection of nasal septum, then tonsilectomy.

Then the woman again was hospitalized and was appointed prodigiozan, therapeutic dose of 1.25 ml amid a rise in body temperature to 38oC was injected into the submucosal lateral fornix gentamicin, then candles with trypsin and after 10 to 15 min was performed physical sinusoidal, modelirovie Narine.

During therapy the woman noted a significant improvement. After treatment bimanual study adhesions in the appendages was not expressed, the left ovary remained cystic changed.

After discharge within 6 months. the woman took Siberian ginseng, cyclic vitamin therapy. In the study of hormones in the blood was found increased levels of prolactin and decreased estriol, and therefore was assigned parlodel within 6 months.

After 6 months. after treatment of menstrual function was restored, recovered immune status. During the observation time of the recurrence was not.

Example 2. Patient S. , 21, N history 1518, was treated in the third division. gynecological hospital No. 2 diagnosis: exacerbation of chronic bilateral salpingitis, infectious-toxic variant of nonspecific etiology. From the anamnesis it is known that a child suffers frequent sore throats. Inflammation of the uterine appendages suffer for 5 years. Was treated in the hospital many times, but after treatment, the effect was short-lived. Menstruation at the age of 13, was established immediately after 28 days on 4 days, painless, moderate. After hypothermia appeared lower abdominal pain, increased is not improved. For admission in the General analysis of blood leukocytosis with a left shift formula, lymph-monocytopenia, accelerated erythrocyte sedimentation rate (leukocytosis 14,3109/l; stab neutrophils - 12%; segmented - 74%; lymphocytes - 10%; monocytes - 3%; ESR - 34 mm/h). Urinalysis without pathological changes; C-reactive protein - 3 UNITS; PAP test - III senior purity. Bimanual study determined the uterus is not enlarged, the appendages on both sides were thick, clearly not even royalty due to the sharp pain. Was the treatment: penicillin intramuscularly, kanamycin into the submucosal lateral fornix of the vagina, the vagina has introduced a tampon with SUMS-1, rectum candle with chemotrypsin and after 10-15 minutes spent physiotherapy sinusoidal modulated currents, along with this, the patient received suprastin, vitamin E, ascorbic acid. As a result of treatment the patient's condition improved, the symptoms of intoxication, abdominal pain disappeared. The patient was examined by an ENT doctor, was diagnosed with chronic tonsillitis, asthma. The patient was performed tonsillectomy, then treated with prodigiozana, intraorganic electrophoresis with metrogram, lymphotropic ampicillin, immunities vagina Lactobacterin, cyclic vitamin therapy, Siberian ginseng. A year later the woman recovered indicators of immune and hormonal status, relapse during the observation time was not.

The proposed method treated 50 women aged from 18 to 30 years with inflammatory diseases of the uterus, nonspecific etiology and 30 - way prototype, the effect on the proposed method was 100%, and the method prototype partial effect was observed 66,67%, no effect 33,33%, disease recurrence was 3-6 months., and 33,33% of patients was made on surgical treatment.

References

1. Borodin, Y. I. , Grigoriev C. N., Letyagin A. Y. and other Functional morphology of the immune system. - Novosibirsk: Nauka. - 1987. - 236 S.

2. Borodin, Y. I. About the functional interaction sorbing substances with lymphatic structures. /Problems sorption detoxification of the internal environment of the body. - Novosibirsk. - 1995. - N-3-7.

3. Buyanov C. M. Lymphogenous detoxification. - M - 1990. - S. 163.

4. Vorontsov A. A. Ways of increasing the effectiveness of the treatment of women with inflammatory diseases of internal genital organs/Method. recommendations. MINISTRY OF HEALTH OF THE USSR. - Ternopil. - 1978. - 21 S.

5. Gerasimo the complex treatment of ultrasound and levamisole//Akush. and gynecol. - 1982. - #4. - S. 31-34.

6. Hromycin N. Yu, Crimean L. G., bear this in mind A. F., Kurakin O. Century and other immunoregulatory Mechanisms of the system of macrophages. //The pathogenesis of chronic inflammation. - Novosibirsk. - 1991. - S. 80-82.

7. Dubasari H. M. Of pathogenetic therapy of chronic oophoritis//Akush. and gynecol. - 1989. - N 2. - S. 24-26.

8. Dubasari H. M. Some problems of diagnosis and treatment of chronic oophoritis.//Akush. and gynecol. - 1989. - N 7. - S. 71-74.

9. Zhukova O. S. the Use of stimulants immunogenesis in the treatment of chronic inflammation of the female genital organs in the acute stage//Akush. and gynecol. - 1982. - N 11. - S. 47-50.

10. Lazarev A. N., Alekhin E. K. immune Stimulants. - M.: Medicine. - 1985. - 256 S.

11. Levin Y. M. Clinical lymphology. - M.: Medicine. - 1985.

12. Levin Y. M. foundations of medical lymphology. - M.: Medicine. - 1986. - 283 C.

13. Nazarov Century, Inflammatory diseases of the uterus and its appendages (some aspects of pathogenesis, diagnosis, treatment and clinical supervision). Dis. Prof. the honey. Sciences. - Penza. - 1988.

14. Gain M. G., N. Lysenkov.K. Boscovich Century. And. human Anatomy. - L. - 1974.

15. Silvestrov B. N., Vanina N. F. Some parsepacket Century M Physical factors in obstetrics and gynecology. - M.: Medicine. - 1981. - 178 C.

17. Fedko E. C. Materials to the question of lymphatic drainage genital sphere in normal hemodynamic conditions and venous stasis: a Pilot study.//Diss. Kida.the honey.Sciences. - Novosibirsk. - 1974.

18. Freidlin, I. C. System of mononuclear phagocytes. - M.: Medicine. - 1984. - 272 S.

19. Schwartz J. W. , Mayansky A. N. Research perspectives of postinflammatory fibrosis./In The Book: The pathogenesis of chronic inflammation. - Novosibirsk. - 1991. - S. 124-128.

20. Shurygina A. C., Dergachev T. I., Dergachev C. S., Trufakin C. A., elected VP Method of immunotherapy. A. C.-N. 1780752. - 1992.

21. Adams D. , Hamilton, T. Molecular transductional mechanisms by wich IFN-gamma and other signals regulate macrophage development.//Immunol.Rev. - 1987. - vol.97. - P. 5-27.

22. Keith L. G., Creinin M., Method M. W., Hidvegi D. La cervicite: antecendant de l infection pelvienne une mise au point.//Fertil. Contracept. Sexual. - 1989. - vol.17. - N-6. - P. 931-940.

23. Tison E., Marpeau L., Pigne A., Fessier F., Barrat J. Traitement des salpingites aigues non chlamydiennes. Etude de l efficacite et de la tolerance d' un antibiotique en monotherapie//J. Gynecol. Obstetr. Biol. Reprod. - 1988. - Vol.17. - #4. - S. 513-519.

1. The method of complex treatment of patients with chronic adnexitis, infectious-toxic option, nonspecific etiology, including the introduction antibiot is or ampicillin in the submucosal layer side of the vagina in 1/4 of the daily dose, then introduced into the vagina tampon with SMS-1 in the amount of 2 g, a candle with trypsin or chemotrypsin in the rectum and after 10 to 15 min conducting physical sinusoidal modulated currents, after edema exacerbation spend reorganization of chronic foci of infection of the nose and throat, and then carry out the treatment prodigiozana with the selection of individual therapeutic doses, with an increase of body temperature to 37.8oC enter within 7 days of gentamicin or kanamycin in submucosal lateral fornix in 1/4 of the daily dose, a candle with trypsin or chemotrypsin injected into the rectum and hold physical sinusoidal modulated currents, within 5 days of conducting immunocorrective therapy tactivin sensitivity to it blood lymphocytes, then restore the microflora of the vagina by the introduction of Lactobacterin or Narine, after discharge from the hospital within 6 months appoint adaptogens, cyclic vitamin therapy.

2. The method according to p. 1, characterized in that within 3 days of conducting blood by electrophoresis metrogram.

3. The method according to p. 1, characterized in that carry out the restoration of the menstrual cycle.

 

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