A method of treating inflammatory diseases of female genital organs
(57) Abstract:The invention relates to obstetrics and gynecology and is intended for the treatment of inflammatory diseases of female genital organs. Carry out electrophoresis of the uterus mud extract background drug, symptomatic therapy. At the same time and additionally affected through the vagina alternating magnetic field, gradually increasing the frequency of the travelling pulse from 1 to 10 Hz, rate of 8-15 procedures. As mud extract using 3% aqueous solution of dried mud extract "Isobel". The method allows to increase the effectiveness of treatment of inflammatory diseases of female genital organs. The invention relates to medicine, namely to gynecology, and relates to methods of treatment of inflammatory diseases of female genital organs.Known methods of treatment of inflammatory diseases of the genital organs (WSPA) women, which is to assign medicines in combination with peloidoterapija: electrophoresis and micro "dry brine" in acute and chronic salpingitis [1,2] , the alternating magnetic field of low frequency, decimeter waves, pulsed electric field [3,4], phonophoresis with Lydney balneotherapy .However, despite the good therapeutic efficacy of these treatments of WSPA women remains high frequency of complications, re-sharpening, menstrual irregularities and generative functions.It is known that prolonged relapsing course of the inflammatory process leads to excessive growth of connective tissue, circulatory disorders, degenerative processes, and immune disorders [1,7]. According to C. N. Serov et al. , Y. C. Tsvelev et al. , USPO women present with pronounced symptoms of dysbiosis and Allergy, hyperstimulation and subsequent immunosuppression and reduced anti-infective organism protection. The above necessitates a wider use of non-pharmacological methods of treatment with the use of other modern medical technologies.The closest in technical essence and the achieved positive effect to the present invention is a method for the treatment of acute inflammatory diseases of female genital organs  by carrying out vaginal baths with 0,5-0,8% aqueous solution of the drug "dry brine" and sacral and abdominal electrophoresis with 1.5-1% aqueous solution of "dry is a course of 10 treatments .However, this method of treatment has several disadvantages. In this methodology is used balneophysiotherapy at 5-7-th day from the beginning of treatment. Literature data [3,10,6] and clinical observations indicate the need for an earlier application of peloidoterapiya, i.e. directly after removing the marked severity of inflammation and the symptoms of intoxication. In addition, to enhance foretical penetration of therapeutic drugs requires the concomitant use of preformed physical factors.The problem solved by the invention is to increase the effectiveness of treatment by reducing the number of complications caused by inflammatory diseases of female genital organs and normalization of immunoreactivity.A new technical result is reached by applying a new method of treatment of inflammatory diseases of female genital organs, consisting in carrying out electrophoresis of mud extract of the uterus against medical symptomatic therapy, and at the same time and additionally affected through the vagina alternating magnetic field, gradually increasing the frequency of the travelling pulse from 1 to 10 Hz, curse the l".In the analyzed literature not found in this population characteristics. Thus, this method meets the criteria of the invention of "novelty."This set of distinctive features is not explicitly derived for the expert from the prior art. Thus, it meets the criteria of the invention "inventive step".This method has been clinically tested and can be used in clinical practice. Thus, it meets the criteria of the invention "industrially applicable".The method is as follows. The patient with WSPA (chronic, acute or subacute inflammation of the uterus) prescribed drugs (antibacterial, anti-inflammatory, antisense and other) and provide magnetoelectrics 3% aqueous mud extract "Isobel". The patient located in the gynecological chair, introduced into the vagina and placed in a condom zhelobkovye magnetoinductive apparatus "Intermag" cateora filled with a syringe 3% aqueous solution of "Isobel". The catheter is connected to the active electrode apparatus for electrophoresis ("Thread-1"), Passy is eccii of the uterus. The frequency of the magnetic field changes from session to session with 1-2 Hz to 10 Hz. The mode - pulse, the duration of the procedure is 15 minutes Number of sessions - 8-15.Justification mode
In the proposed method of treatment used several therapeutic factors: preformed physical (alternating magnetic field and galvanization) and mud extract "Isobel".Galvanization (direct current) provides humoral and neuro-reflex influence. It causes dilation of blood vessels, improves trophic tissues. Activation of the reticulo-endothelial system leads to fixation in the tissues of a whole range of drugs present in the blood. When electroplating under the electrodes decreases the concentration of acetylcholine due to an increase in cholinesterase, resulting in analgesic effect. In addition, in the tissues creates an active background that enhances the pharmacological effect of an administered drug [11,12,13].The alternating magnetic field has a set of factors determining its therapeutic effect: information action - the capacity of the field to force the body of the information contained, as a rule, in its frequency parameters; power - Mekhanichesky; separator is to separate the formed elements of blood and other charged particles; sanitizing - the ability to reduce colonization of tissues by pathogenic flora [11,14,15].The highest number of biotropic parameters has running pulsed magnetic field (TPMF), for radiation in which this technique uses a device, for example, "Intermag" (, Saratov). Expressed biological activity TPMF identified with the frequency modulations of 10 Hz, which corresponds to the frequency of normal biorhythm of the Central nervous system. For the formation of the activation reaction, which is accompanied by strengthening of the functions of the endocrine system and the normalization of immunoreactivity, as well as to avoid adaptation effects, it is necessary to gradually increase the frequency from 1 Hz to 10 Hz during the course of treatment.In the proposed method uses the vaginal-abdominal-sacral technique, which allows, on the one hand, to strengthen foretical penetration of therapeutic drugs and to bring the impact directly to the uterus, taking into account the anatomical and physiological characteristics of regional blood and lymphatic vessels, and on the other hand, to hold simultaneously reorganization bottom from the communities mud extract "Isobel" created in IPC SB, Russian Academy of Sciences, Tomsk (patent 1793578, St-175350). The use of "Isobel resolved centre surveillance in 1999, the number ROSS RU AV. Clinical application of mud extract "Isobel" is presented in the methodological letter of the RF Ministry of health, approved in 1995 by the Chairman of the section of rehabilitation and physiotherapy of the scientific Council of the Ministry of health academician C. M. Bogoliubov. How to apply extracts of mud and brine in physiotherapy presents the methodical recommendations of the Ministry of health of the USSR, approved December 29, 1988, the chief of the Main Directorate of preventive care Century. I. Kalinin. "Isobel" concentrate of water-soluble biologically active substances from the saline treatment silt sulphide mud with a unique natural complex of mineral salts (NaSO4, Mg2SO4, NaHCO3Ca2SO4), trace elements (cu, Mn, Ag, Co, P, Zn, V), organic matter (humic acids, amino acids, compounds highly polar lipids).According to A. I. Vinerovskogo  the mechanism of its therapeutic action is due to the antioxidant, membranostabiliziruyuschim, reparative properties of the drug. Experimental model of inflammation of the uterus proven anticapitalist normalizes the level of redox reactions promotes repair of the nervous system, prevents the death of the generative elements of the ovaries  .The duration of the treatment approach depends on the shape and type of clinical course of WSPA women and determined based on the data analysis of clinical material surveillance of patients with different degrees of severity of the inflammatory process. Thus, when the primary acute inflammation of the uterine appendages us is assigned a course consisting of 8 sessions, when chronic, especially in the presence of adhesions varying degrees of severity - from 15 sessions, subacute, and acute erased during - of 10-12 sessions.A number of biotropic factors TPMF that determines its therapeutic effect, the absence of significant thermal effect can be attributed to this preformed physical factor to motivirovannom, i.e. gentle. This has served as a prerequisite to the appointment of running pulsed AC magnetic field of low frequency in the acute phase of the inflammatory process simultaneously with medication (causal, pathogenetic treatment. In the future, if the clinical trial marked a high therapeutic effect when it technical testing of the developed method. During the course of treatment less than 8 procedures in cases of acute primary inflammation of the uterus - therapeutic effect is not expressed; in subacute and acute erased during less than 10-12 sessions, chronic inflammation is less than 15 sessions. This is due to the severity of pathomorphologic changes in the pelvis in women with long-term chronic inflammatory process. therapeutic efficacy of various modes are determined by the totality of anamnestic, clinical, laboratory and additional methods of examination. And we relied on the experience and recommendations of leading physiotherapists and, in particular, adhered to the principles of "reasonable sufficiency" and "small doses"  .Example 1.Patient T. C. , 26 years. Diagnosis: Exacerbation of chronic salpingitis. Adhesions pelvic II senior Retrodelica of the uterus. Endocervicitis. Colpitis.From the anamnesis: considers herself a patient within 7 days. Onset connects with severe hypothermia. Marriage is not. Sex life is not regular, partners are not permanent. Contraception is not.When handling complaints about low-grade fever (37,2-37,5o), weakness, pains in the lower abdomen is active: General condition is satisfactory. The skin and the regular color, clean. Tongue moist. The temperature was 37.4o, pulse 84 beats./min, a/D 110/70 mm RT. Art. Abdominal palpation painful in the lower sections of the symptoms of peritoneal irritation are not defined.At vaginal examination: the uterus is not enlarged, retrocaval. Movement of the uterus at the cervix painful. Appendages on both sides increased, sedentary, painful on palpation. In mirrors: the vaginal mucosa and cervical hypermonogenic, swollen. Detachable cervical canal, the vagina is rich, pussy. Complete blood count: HB - 118 g/l; er - 3,26 1012/l; L - 9,2109/l; ESR - 18 mm/h WBC: segmented - 69%, stab - 4%, eosinophils - 5%, lymphocytes - 16%, monocytes 6%.Biochemical blood test:
total protein - 62,7 g/l, seromukoidy - 0,280 u; CRP +.The immune system: T-lymphocytes - 24% b-lymphocytes - 11%,
T-helpers (teof. Res. ) - 15%; T-suppressors (teof. feelings.) - 27%; immunoglobulins: A - 1.1 g/l; M - 1.4 g/l; G - 12,6 g/l; CEC (3% PEG) - 240 srvc. unitSmear on the degree of purity of vaginal secret: L - entirely in the field of view; mixed flora, richly - cocco-bacillary.Bacteriological examination of cervical mucus: Entero Bahteriae, the feeling is m home;
- oral antibiotics: klacid 1 cap 2 times a day 5 days cifran h times a day for 5 days metronidazole 0,h times a day for 7 days;
- desensibilisation drugs, analgesics, vitamins;
- magnetoelectrics 3% aqueous mud extract "Isobel" with 3 day vaginal-abdominal-sacral technique; frequency alternating magnetic field was increased from 1 Hz to 10 Hz from session to session; current electrophoresis 10-15 mA, duration of treatment 15 min, the course of 15 sessions.In the treatment process marked analgesic effect with the 4th procedure, reducing the size of the uterus, increase their mobility with 7-8-th. Inflammatory manifestations of the lower section of the genital tract disappeared after 10 sessions. Balneophysical noted at the 7th session - adequate, local, early, mild, not requiring a change in the course of treatment.When examining women after treatment in General and genital status changes are detected. Had no complaints. Clinical and biochemical analyses within normal limits. The ultrasonographic scanning pathology of the pelvic organs is not revealed.Immune status: L 5,0109/l; lymphocytes 34%; the L. unitSmear vaginal smear: L 6-8 in the field of view, small wand (Doderlein).After treatment, the woman recommended contraception - femoden. After 2 months - due for inspection. Pathology in General and genital status is not detected. Recommendations are given. Long-term results of treatment is regarded as very good. In the immune status of the marked increase in the content of T-lymphocytes (56%) and increased subpopulations immunoregulatory cells with helper activity (49%).Example 2.Patient O. N., 19.Diagnosis: Acute bilateral salpingitis. Endocervicitis. Colpitis.From the anamnesis: got sick on the 5th day after the hospital abortion when the pregnancy is 8-9 weeks. Marriage is not, the pregnancy is unwanted. Complaints of sharp pain in the lower abdomen with a large area irradiation, General malaise, weakness, fever up to 38o, abundant purulent hemorrhagic discharge from the genital tract, dysuric disorders.Objectively: General condition closer to satisfactory, the skin is pale pink, wet tongue. The temperature of 37.6o, pulse 92 beats./min, a/D 110/70 mm RT. Art. Abdominal palpation years: the uterus is in the correct position, not increased, the movement for the cervix sharply painful. The epididymis is enlarged, the projection of their sharply painful. In mirrors: the phenomena of endocervicitis, vaginal mucosa is hyperemic, edematous. Discharge from the cervical canal, the vagina is rich, pussy.Complete blood count: HB 108 g/l, er 3,021012/l L 10,6109/l, ESR 25 mm/h Segmented. the leukocyte - 69%, Palakkad. - 6%, eosinophils - 5%, lymphocytes 10%, monocytes - 10%.Biochemical blood test: whole protein to 61.8 g/l, seromukoidy 0,320%, CRP ++. The immune system: T-lymphocytes - 30%, b-lymphocytes - 14%, T-helpers - 24%, T-suppressors - 20%. Immunoglobulins: A - 1,06 g/l, M - 1,62 g/l, G - 12,6 g/l CEC (3% PEG)=200 srvc. unitSmear on the degree of purity of vaginal secret: L - entirely, abundant flora, mixed, gardnerelly. Bacteriological examination of cervical mucus: Staphylococcus epiderm., E colli - sensitive to gentamicin, Cefazolin, oxacillin.Treatment: the stationary mode. Antibacterial therapy: Cefazolin 3 g/and/m, metrogylum 100,0/drip 3, klacid 1 drop 2 times a day, indomethacin 50 MGH times a day. Vitamins, desensibiliziruyuschee therapy. Magnetoelectrics 3% aqueous mud extract "Isobel" vaginal-Abd is awn session 15 min, in the course of 8 treatments.In the course of treatment showed a significant analgesic (on the 3-4th session) and antiexudative (4-5-th session) effects. By the end of treatment in the examination revealed no pathological changes: the uterus and appendages were of normal size and consistency, palpation painless. Symptoms endocervicitis and colpitis no. The peripheral blood counts, biochemical analysis within normal limits. The ultrasonographic scanning pathology of the pelvic organs is not revealed. After 2 weeks, the immune status: L - 6,2109/l, lymphocytes - 33%, T-lymphocytes - 44%, lymphocytes - 18%, T-helpers - 42%, T-suppressors - 14%. Immunoglobulins: A - 1.22 g/l, M - 1,02 g/l, G and 10.8 g/lWithin 2 months after treatment, the woman took novinet. Upon examination after 2 months revealed no pathology, with an estimated fortune as a permanent cure, the treatment effect is very good.A method for treating inflammatory diseases of the genital organs of women underwent clinical testing in the medical-sanitary unit of the Central Bank of the Russian Federation on the Tomsk region (634041, Tomsk, Komsomolsky Ave, 68). After 3 to 4 sessions of treatment of patients with inflammatory diseases of the uterus had distinct anesthetic and antiexudative effects. PR is th size and consistency, increased their mobility, palpation was painless. It should be noted and significant sanitizing effect of the lower section of the genital tract, manifested by the disappearance of the inflammatory reaction of the mucosa and pathogenic flora, the recovery of the resident flora of the vagina. In 100% of cases there was recovery of endocervicitis. A direct result of treatment by the totality of the objective, laboratory and additional methods of research assessed as clinical recovery in 92% of women and a significant improvement in 8% of cases. The immune response to peloidoterapiya observed after 2-3 weeks and showed normalization of the cellular link (on the level of T-lymphocytes and their subpopulations, the ratio of lymphocytes with helper and suppressor activity) and humoral (decrease Ig M, G, and CEC) immunity.The indication for treatment by the proposed method were:
1. Acute inflammation of the uterine appendages.2. Subacute inflammation of the uterine appendages.3. Exacerbation of chronic inflammation of the uterus (infectious-toxic and scar-adhesive variants).4. Endometritis, metroendometrity.5. Infertility, tubal-peritoneally fruitit).7. Condition after surgery on the uterus (ectopic pregnancy, apoplexia ovaries, hydrosalpinx, tubal-peritoneal infertility).Thus, the application of the proposed method for the treatment of inflammatory diseases of female genital organs allows for a more differentiated approach to the treatment of patients with different clinical course of inflammation, depending on the severity of the pathologic process. The proposed method of treatment improves therapeutic efficacy of immediate and remote results, prevents complications caused by acute inflammation (transition into a chronic and formation of the syndrome pelvic pain, infertility, ectopic pregnancy, and others).REFERENCES
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FIELD: medical engineering.
SUBSTANCE: device has container for keeping product to be applied, dosing unit for distributing the product, power supply element placed near the dosing unit. The dosing unit is designed as rotating element and is apiece of felt. Container walls are flexible. The dosing unit is manufactured from electric conducting material and connected to the power supply element.
EFFECT: enhanced effectiveness in carrying out viscous product iontophoresis.
8 cl, 7 dwg