The method of treatment of latent forms of genital chlamydia

 

(57) Abstract:

The invention relates to medicine, and gynecology. Carry out reorganization of the cervix and vagina with a solution chloridizing in Dimexidum, then a solution of papain. Irradiated cervical canal and vagina helium-neon laser with wavelength of 0.63 Ám. Then introduced into the vagina swab soaked mash. The mash contains BHT, Dimexidum, metronidazol, macropen, levorin. The specified composition process the vulva and external opening of the urethra. After the second procedure is additionally affected by the puncture. The method activates the metabolism of the cells of the vagina, their ability to hormonal reception and purification. 3 table.

The invention relates to medicine, namely to gynecology, and can be used in the treatment of patients with latent chlamydia.

Recent years chlamydial infection is one of the leading causative agents of inflammation of the genital organs and related disorders of childbearing, menstrual function and General health of women (1,4,10).

The spread of chlamydia contributes, among others, and a large number of cases of latent (persistent, torpid, asymptomatic) reaches sabelashvili complications during sexual relations, and so on, the Lack of adequate reaction for chlamydia when latent chlamydia is mainly due to defective phagocytic reaction, i.e., weak immunity, which, as the carriage infection additionally oppressed until the breakdown of false balance in the system the host - microbe and development of serious complications, including septic (1,2,4,10). The insidiousness of "asymptomatic" chlamydia is also in frequent associations chlamydia with other pathogens, such as gonorrhea, Trichomonas, viruses, Mycoplasma, fungi Candida and other

Chlamydia live mainly in the cylindrical epithelium of the uterus, where distributed in superposed sections of the reproductive system and beyond. Regardless of the form of the disease the cervix is the reservoir and the main source of chlamydia in women, which creates significant difficulties in the application of therapeutic means of a General action. Difficulties noticeable increase in latency for chlamydia. Needs a big dose of antichlamydial means capable of bactericidal effects of habitat chlamydia, which is not always indifferent to General and reproductive health of women. Second means on the ASS="ptx2">

Closest to the proposed invention is a method of combined use of antichlamydial funds General steps from the group of fluoroquinolones on the background of intramuscular administration of a powerful immunomodulator type "Neovir" (2,5,8). However, this method does not exclude internal use of antibacterial drugs with most immunosuppressive effect and exacerbate symptoms of dysbiosis, and does not provide for the immediate reorganization of the cervix as a primary source and reservoir of infection.

The purpose of the invention is to improve the health of women with latent genital chlamydia by immediate rehabilitation of the cervix and restore optimal immune responses with the exception of the overall impact of antichlamydial drugs and the reduction of treatment time.

This goal is achieved by the combined use of medical laser rehabilitation of the cervix and vagina against laser puncture on the BAHT total and segmental effects.

The method is as follows: the vagina through the mirror Cuzco pour in 1% solution of chlorhexidine in the 30% Dimexidum in sufficient quantity for "bath" with poslednja content from branches of surgical tweezers or forceps and spoon Volkmann and remains in solution up to 5 minutes. After removal of the mortar and easy drying of the vagina through a clean mirror Cuzco vagina pour 0,2% - 0,5% solution of papain (prepared extempore), its concentration within the specified limits selected individually. Neck re-release from contents, bath with papain lasts from 2 to 5 minutes, then the solution is drained, and in the cervical canal introduce the light from a helium-neon laser (wavelength = 0.63). The channel is irradiated for 2 minutes at MRP (power flux density) of 1 mW/cm2. After removal of the cervical fiber is irradiated vagina, starting with the back arch in MRP 1 mW/cm2. The fiber in 1 minute is transferred clockwise in the right side, then in front, and left side arches. The total exposure time for a vagina is 4 minutes. After laser irradiation of the cervix and vagina to the cervix for 6-8 hours supplied loose cotton-gauze swab soaked in "chatterbox" composition: liniment dibunola 10% - 10,0; Dimexidum 100% - 30,0; metronidazole - 2,0; macropen - 2,0; levorin - 0,1; distilled water - up to 100.0. While the outer opening of the urethra and vulva sequentially treated with this solution. Of the procedures performed in a day, the course 7-8, tampons with "mash" is used not more than 5 times.

The vacation scheme procedures are presented in table 1.

According to the testimony of laser irradiation of the vagina, cervix and (or) laser puncture on BAT skin again after 1-3 months, it is better in the 1st half of the menstrual cycle. The parameters of the NLI (low-energy laser radiation) do not change.

Thus, the first stage of the proposed method of treatment of latent chlamydia is the rehabilitation of the cervix and vagina with a mixture of chlorhexidine and Dimexidum. The rationale for this is the wide range of bactericidal action of chlorhexidine in combination with its determinism effect and universal protectora - inflammatory properties of dimethyl sulfoxide (Dimexidum, DMSO) (6). In the process of developing the method was used with different concentrations of the constituents and given preference 1% solution of harjutsalo epithelium and provide a complete coagulation of the cervical mucus and the ability bloodless liberation of the channel from the content during the procedure. Subsequent processing of the cervical canal and vagina 0,2-0,5% solution of papain supplements bactericidal effect of the preceding stage of rehabilitation, including through enzymatic destruction of protein cellular structures, including intracellular organisms, in particular chlamydia (6). The chosen concentration of papain in the range of 0.2-0.5% solution depends on the individual characteristics of patients, the anatomical condition of the cervix; its epithelium, epithelium of the vagina, i.e. hormonal saturation, etc.

Regenerative processes in the epithelium of the vagina and cervix, including a full service to the hormones and the appropriate protective mechanisms to restore normal flora under the influence of the 1st stage of treatment are enhanced and supported due to the impact of low-energy laser radiation to the cervical canal and vagina. Under the influence of NLI happen, as you know (3 and others), physiological changes at the subcellular, cellular, organ and systemic levels. Free radicals in cells, increasing the rate of protein synthesis, including DNA, RNA, enzymes, hormones are activated redox processes, increases proliferative-secretory activity cleton, metronidazole, levorin) in combination with Dimexidum and BHT, extends and prolongs antibacterial and regenerative effect on the flora of the preceding procedures, preventing irritation of the epithelium and the development of dysbiosis. Activate the metabolism of the cells of the vagina and cervix, their ability to hormonal reception and "self-cleaning" leads to the restoration of ecological and normal bacterial flora on the level of the vagina and cervix. General immunomodulatory effect of local procedures enhanced by additional puncture on the BAT, contributing among other things to restore hormonal balance in the body. When choosing a BAT, we were guided by personal experience and recommendations (7,9) on reflexology and modern Zhen-cutiepie to ensure the ultimate effect of treatment is recovery of somatic and reproductive health of women with latent genital chlamydia.

A specific example of the method.

Patient S. , 25 years have complained about the absence of pregnancy, intermittent abdominal pain, leukorrhea, loss of appetite and mood, periodic headaches and dizziness etc. Ill 4 years, when peremennymi birth of a dead fetus, and when the 2 weeks were treated with antibiotics (penicillin, gentamicin) about endometritis. The cause of premature birth does not know, considered themselves healthy. During the year, used a prophylactic (condom), then again became pregnant, this pregnancy was again interrupted in 11-12 weeks, again treated with gentamicin. In the last 2 years occasionally used a prophylactic (condom), there was uncertainty about the possibility of donsimoni pregnancy. When examining bacterial flora of specific pathogens is not found, the partner is not examined. The patient used a vaginal suppository according to the prescription of doctor of female consultation. In the study of bacterial flora by light microscopy with staining by Romanovsky - Institute and gram, as well as by using DNA-sensing (polymerase chain reaction - PCR) and direct immunofluorescence, the patient identified chlamydia, Mycoplasma, fungi Candida, abundant bacterial flora with a predominance of anaerobes, whereas visual gynecological examination manifest signs of inflammation of the cervix and vagina were not expressed.

The patient was diagnosed with Chlamydia (latent form). Chronic endocervicitis, colpitis mixed etiology. Be offered by way started from the 6th day of the menstrual cycle. Recommended concurrent treatment partner and strict contraception for the entire period of treatment. The treatment was carried out through the day, according to the method (table. 1) and finished on the 18th day of the cycle. After 2 treatments the patient noted a feeling of comfort in the pelvis and energized. Gradually being improved, disappeared virtually all complaints, have a faint hope to the possibility of procreation, which was strengthened after the final survey after menstruation. It is, as before treatment included hemogram, renogram, immunological and, of course, the study of bacterial flora. Range of surveys, in particular, by PCR at the insistence of the patient was expanded by virus, Trichomonas, Gardnerella, and gonococcus. When this data for the presence of chlamydia and other pathogens were not detected. After 3 months inspection on all parameters was repeated with the same result, the husband is also recognized as healthy. After 4 months the woman came uterine pregnancy ended with the birth of a healthy baby weighing 3600,0 with the growth 55 see

For the period from 1994 proposed method treated 48 women of childbearing age with a latent form of PI, mycoplasmas (table. 2). These treatments were compared with the results of treatment of 9 women with the same pathology that received treatment according to the prototype, i.e., "Neovir" in combination with antichlamydial drugs (abaktal, tarivid) according to the recommendations (8, 2, 5). Negative reactions to "Neovir" we have not recorded, entered it in a 2% novocaine, but taking drugs, in particular abaktal caused discomfort on the part of the liver and gastrointestinal tract, which prompted recommend patients additional treatment and / or examination.

Data bacteriological examination of patients in both groups are presented in table 2. As you can see, all the patients were light microscopy and DNA diagnosis, the majority of antigens and the number of patients (15 in total)- culture diagnosis with culture for chlamydia, Trichomonas and mushrooms. It is the latter (suspected dysbacteriosis) was the basis for cultural diagnosis, as patients previously treated with high doses of antibiotics over the inflammation of appendages. Features light microscopy allowed us to identify chlamydia (elementary bodies) in 50% of patients. In addition, when light microscopy many women identified the mushrooms, geopak not detected chlamydia and other intracellular microbes (Miko - and Ureaplasma), i.e., the proposed method not only not inferior to the prototype, but also has clear advantages: achieved almost 100 % sanitization against fungi, Gardnerella and Trichomonas.

Data immunological examination are presented in table. 3. Average indicators of immune status before treatment had no significant differences in the groups, but differed from the data of healthy women (control group). We surveyed noted a higher content of monocytes, lymphocytes, and an obvious imbalance of both subpopulations of T-lymphocytes (T-helper and T - suppressor) and a low level of secretory immunoglobulin in group 1. It is the content of the latter can be judged on the excellence of local immunity of the skin and mucous membranes. After treatment, the observed changes in immune status are more pronounced under the influence of Neovia. These women significantly increased the level of T-lymphocytes and T - helper cells at a lower rate of T-suppressors. Significantly decreased and also the level of circulating immune complexes. In the main group normalization immunograms was less pronounced, but the tendency to restore immune status was clear when reliable increase in the level of T-helper cells and normal levels of immunoglobulins.Sources of information

1. Hakobyan C. A., Mackillican A. A. et al. Rapamycin in the treatment of uncomplicated urogenital chlamydia. Journal of dermatology - 1997, N 1. - S. 60-62.

2. Delectorskaya Centuries, Malinovskaya Centuries, The Summary A. N. The interferon induction neovir (Caledon) in the combined treatment of chronic inflammatory diseases of uterine appendages chlamydial etiology (clinical and electron microscopic study). Antibiotics and chemotherapy. - 1995. - 40, 5.

3. Illarionov C. E. fundamentals of laser therapy. - M., 1992. - 99 S.

4. Contact sexually transmitted infections. Ed. by I. I. Mavrova. - Kiev: Health - 1989. - 378 S.

6. Mashkovsky M. D. Medicines. - M., 1993.

7. Macheret E. L. , Samosyuk I. 3. Guide to reflexology - Kiev, 1982. - 290 C.

8. Parfenov centuries, Delektorskaya centuries, Genkin D. D. Neovir is a new high antichlamydial the drug. Abstracts of the second Russian national Congress "Man and medicine" - M., 1995, - S. 311.

9. Zhu Lien. Guide to modern Zhen-cutiepie. - M., 1959.- 270 C.

10. The shatkin A. A., Moors, I. I. Urogenital chlamydia. - Kiev, 1983. - 192 S.

The method of treatment of latent forms of genital chlamydia, including antibacterial, anti-inflammatory, together with immunomodulating therapy, characterized in that from the first day of treatment through day carry out reorganization of the cervix and vagina 1% chlorhexidine in 30% Dimexidum for 5 min, then 0.2% to 0.5% solution of papain from 2 to 5 min with subsequent removal of the contents of the cervix and cervical irradiation channel helium-neon laser with a wavelength of 0.63 and the power flux density of 1 mW/cm2within 2 min and vagina from the rear arch, pereti exposure for 1 min on each arch, rate to 8 treatments, with subsequent introduction into the vagina for 6-8 h loose cotton-gauze swab soaked in a "mash" of the following composition, g:

Liniment dibunola - 10% - 10,0

Dimexide - 100% - 30,0

Metronidazole - 2,0

Macropen - 2,0

Levorin - 0,1

Distilled water Up to 100 ml

and treatment of vulvar and external opening of the urethra specified composition is not more than 5 times, after the 2nd procedure is conducted additionally laser puncture on the BAHT total and segmental effects when the power flux density of 0.5-3 mW/cm2and exposure from 10 to 32 C at a point irradiating at 3 points per session, including symmetric rate to 7 treatments.

 

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