The way to prevent violations of ovarian-menstrual cycle and endocrine infertility in women of reproductive age with tick-borne cns

 

The invention relates to medicine, in particular to the gynecologist, and relates to a method of prevention of violations of ovarian-menstrual cycle and endocrine infertility in women with tick-borne CNS. To do this, women of reproductive age with tick-borne CNS against the standard etiopathogenetic and symptomatic therapy impose additional hemorheological tool containing decortin and ascorbic acid, with the following ratio: 1: 2.5 and 1 tablet 3 times a day for 12-14 days and the first phase of the menstrual cycle - folic acid at a daily dose of 300 mg, and the second phase --tocopherol acetate in a daily dose of 400 mg. Method ensures the prevention of endocrine disorders leading to infertility in women with CNS infection. 3 table.

The invention relates to medicine, specifically to gynecology, and relates to a method of prevention of violations of ovarian-menstrual cycle (CMC) and endocrine infertility in women with tick-borne CNS (CED).

In the analyzed scientific medical and patent literature not found ways to prevent violations of the CMC and the CMC predominantly (91%) by type of metrorrhagia. The CMC changes are transient in nature, and after 2-3 months in 63% of patients noted for its normalization. The main manifestations of the impact of CGT in 73,3% develop long-term period of observation (more than 1 year after infection). They presented the young women of reproductive age violations of the CMC type oligomenorrhea (97,3%) and infertility (66,7%), factors which are chronic anovulation and luteal phase deficiency (NLF) (table.1. Gynecological pathology associated with CED). The study of the hormonal status of these women showed a significant decrease in the levels of FSH, LH and progesterone on 22-24 days of the menstrual cycle (table.2. Indicators of hormonal status (Mm)), which indicates that involvement in the pathological process of the hypothalamic-pituitary region[1, 2, 3, 4].

Thus, prevention of violations of the CMC and endocrine infertility in women who underwent CED is the actual problem.

The problem solved by this invention is the prevention of violations of the CMC and endocrine infertility in women of reproductive age who underwent CED.

The problem is solved by a method of prevention of violations of the CMC and endocrinol is Oh and symptomatic therapy hemorheological means, containing decortin and ascorbic acid at the following ratio: 1:2.5 and 1 tablet 3 times a day for 12-14 days, and additionally in the first phase of the menstrual cycle - folic acid at a daily dose of 300 mg, and the second phase --tocopherol acetate in a daily dose of 400 mg.

New in the present invention is that with the aim of preventing the development of disorders CMC and endocrine infertility women against the standard etiopathogenetic and symptomatic therapy of acute period THD appoint hemorheological tool containing decortin and ascorbic acid, with mixing ratio 1:2,5, 1 tablet 3 times a day for 12-14 days, and additionally folic acid at a daily dose of 300 mg in the first phase of the menstrual cycle and-tocopherol acetate in a daily dose of 400 mg in the second phase of the menstrual cycle.

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 apparent to a person skilled in the art. Thus, this corresponds to the e and can be used in clinical practice. Thus, it meets the criteria of the invention "industrially applicable".

The method is as follows. The patient in the acute period of tick neuroinfections against the standard etiopathogenetic and symptomatic therapy is prescribed hemorheological tool containing decortin and ascorbic acid in the ratio 1:2,5, 1 tablet 3 times a day daily doses of 60 and 150 mg, respectively for 12-14 days, folic acid in a daily dose of 300 mg in the first phase of the menstrual cycle and-tocopherol acetate in a daily dose of 400 mg in the second phase of the menstrual cycle.

Indications for use of this method: 1. Acute forms of tick-borne encephalitis.

2. Acute forms of Ixodes tick-borne borreliosis.

3. Acute forms of mixed pathology (EC+IKB).

Example 1.

Patient A. C., 24 years.

Diagnosis: Mixed-infection - encephalitis, febrile form and Ixodes tick-borne borreliosis acute, manifest basaltina form of mild severity.

Upon receipt complained of headache in the frontal-temporal region, increased body temperature to 37.8oWith, General weakness, pain in muscles and joints, lack Appollo acute 2 days ago. First noted moderate headache, weakness, decreased appetite, in a few hours the temperature rose, there was a fever, joined, muscle-joint pain and nausea. Took Fervex, aspirin. In the absence of the effect of treatment, the increase of symptoms in order ambulance delivered to the infectious diseases clinic SSMU. When transporting the patient vomited.

From epidemiological history revealed that 10 days ago while working at their summer cottage in the region of the left scapula patient found the stuck tick. The mite was found on the body approximately 5-6 hours. Addressed to the center of seroprotection tick CNS, where it was carried out the removal of the tick and its survey found a high content of tick-borne encephalitis virus), the patient entered a specific tick immunoglobulin in the titer of 1/80-3 ml and bicillin - 5-1,5 million UNITS.

Objectively: General condition of moderate severity. The skin is a normal color, moist. Language is at the root of coated white-yellow tinge. The temperature of 37.8oC, pulse 98 beats per minute, blood pressure of 95/60 mm RT.article.

The vesicular breathing, wheezing no. Heart sounds are clear,tion.

Neurological status: in the Romberg - tremor of the eyelids and fingers. Coordinating sample performs confidently. Pupils D=S, the movement of the eyeballs in full, in extreme abduction - light nystagmoid twitching. Language declined slightly to the right. Palpation of the exit points of the branches of the trigeminal nerve painless. Trunk boars. The reflexes of the hands and feet live, DS. Pathological signs, meningeal signs. Diffuse hyperhidrosis. Sensitivity is not changed.

Consultation of the gynecologist. No complains. Menarche at 13 years of age, the cycle established by 0.5 years; monthly after 30 days, 4-5 days, moderate, painless. Sexual life is 19 years old, barrier contraception. Pregnancy - 1 (2000), ended honey. abortion in the period of 5-6 weeks without complications. Gynecological diseases denies. Currently planning a pregnancy.

A pelvic exam on the 8th day of the menstrual cycle: external genitals are developed correctly, adult female type, vagina nulliparous. In mirrors: the cervix is clean. The uterus is in the correct position, not enlarged, mobile. Region appendages painless. Beli bright, mucous. The degree of purity rc="https://img.russianpatents.com/chr/8226.gif">109l, ESR - 23 mm/h Segmented. the leukocyte - 65%, Palakkad. - 4%, eosinophils - 5%, lymphocytes - 16%, monocytes - 10%.

The ultrasonographic scanning of the internal organs: diffuse changes of a parenchyma of the liver.

Serological tests: Tick-borne encephalitis (ELISA) is found to have a high content of tick-borne encephalitis virus in plasma, Ig M to the tick-borne encephalitis virus titer of 1/100.

Ixodes tick-borne borreliosis - n-REEF with borreliosis antigen in the titer of 1/80.

Treatment: - mode stationary, causal: yodantipirin 1 tablet 3 times a day, doximycin 200 mg per day. Pathogenesis: detoxification - 5% glucose solution - 500 ml 0.9% sodium chloride (200 ml, reopoliglyukin - 200 ml of intravenous drip; desensitizing - trexel 1 tablet 3 times a day; tonic - vitamin B1 6% - 1 ml, vitamin B2 1% - 1 ml, intramuscularly. Drugs that improve blood circulation in the brain, - Cavinton 2 ml aminophylline 2,4% - 10 ml; drugs, improves metabolic processes in brain - nootropil 5 ml intravenous drip. Antifungal agents - hilak Forte 60 drops 3 times a day. Symptomatic: aspirin 1 tablet 3 times a day. Vagotonic - Novopassit 1 teaspoon 3 times a day. islote when the mixing ratio 1:2,5, in daily doses of 60 and 150 mg, respectively, with 2 days on 1 tablet 3 times daily after meals for 14 days, given the 1-St phase of the menstrual cycle, folic acid 300 mg per day 2 x day for 7 days, then 9 days (from the beginning of the 2nd phase)-tocopherol 400 mg per day for 14 days.

At 2-3 days from start of treatment there is a strong positive trend. Subjectively, the patient indicates the improvement of health, the emergence of appetite, loss nausea, aches in muscles and joints, itching to the middle of the 3 day headache by the end of 4 days. In the objective status on the 3rd day after admission to hospital: a satisfactory condition, the skin is a normal color, moderate humidity, language is at the root of coated white-yellow tinge, the body temperature is 36.8oC, the pulse was 78 beats per minute, blood pressure of 100/70 mm RT.article Heart sounds are clear, rhythmic, heart rate of 78 beats per minute, vesicular breathing, wheezing no. Abdomen palpation soft, painless. Neurological examination on 4th day in the Romberg - light tremor of the eyelids. Coordinating sample performs confidently. Pupils D=S, the movement of the eyeballs in full, no nystagmus. Language //img.russianpatents.com/chr/8805.gif">S. Pathological signs. Meningeal symptoms are not present. Distal hyperhidrosis. Sensitivity is not changed. On the 6th day in the Romberg - resistant, movement of the eyeballs in full, no nystagmus. The tongue in the midline. Pupils equal. Palpation of the exit points of the branches of the trigeminal nerve painless. The reflexes of the hands and feet live, DS. Pathological signs. Meningeal symptoms are not present. Distal hyperhidrosis. Sensitivity is not changed.

During the examination after treatment, the patient no complaints. In somatic, neurological and gynecological status changes are detected. Clinical tests within normal limits.

1 month later the woman called for inspection. No complains. Your period came on time. In somatic, neurological and gynecological status deviations. The results of serological studies: tick-borne encephalitis (ELISA) is a tick - borne encephalitis virus in the blood is not detected, Ig M are absent, Ig G in the titer of 1/320; Ixodes tick-borne borreliosis - n-REEF with borreliosis antigen in the titre of 1/10. The condition is estimated as stable.

6 months - re-inspection. No complains. The menstrual cycle is conducted as a clinical recovery. Long-term results of treatment is regarded as very good.

After 12 months in connection with the planning of pregnancy examined in tests of functional diagnostics (CFD), define the levels of FSH, LH and progesterone on 22-24 days of the menstrual cycle. Changes are detected. Pregnancy occurred 3 months after the examination.

The reliability of the method of prevention was confirmed clinically. Surveyed 43 women aged from 19 to 28 years, who were hospitalized due to acute forms of SOI easy and moderate, as well as in the periods of 6 and 12 months after therapy. The patient had no history of violations of the CMC and infertility (table.1).

The main group consisted of 20 women, along with the standard etiopathogenetic and symptomatic therapy received hemorheological tool containing decortin and ascorbic acid in the ratio 1: 2.5 in combination with folic acid in the first phase and-tocopherol acetate in the second phase of the menstrual cycle.

The control group consisted of 23 women whose treatment did not include this complex.

The survey included the study of history, gynecological osmotolerance at 22-24 days of the menstrual cycle (table.2) Identified in the acute period CED violations of CMC in both groups mainly represented by metrorrhagia and dysmenorrhea.

After 6 months, 52% of women in the control group noted normalization of the CMC, in the main group, this figure was 75%. Women who have not occurred restore the menstrual cycle, noted the occurrence of delays in 12-14 days and reducing the amount of menstrual bleeding.

In addition, 8 women in the control group and 1 - main for the first time noticed in their menstrual cycle, also characterized by its elongation on average 10-12 days.

After 12 months of follow-up in the main group 8 of 20 women surveyed in connection with the planning of pregnancy. Examination of these patients by CFD, the definition of the levels of FSH, LH and progesterone on 22-24 days of the menstrual cycle, only 2 of them revealed violations in the form of luteal insufficiency (NLF) and chronic anovulation. Whereas in the comparison group of disorders of the menstrual cycle was significantly more often (p<0,05) in 7 patients, 3 - NLF, 4 - chronic anovulation.

Thus, women who are in the history BOOKS, belong to the group of high risk for the occurrence of gynecological pathologists who by the terms oligo - and/or dysmenorrhea. In addition, in the remote period was significantly more frequently detected the formation of infertility, the main factors which are chronic anovulation or NLP (PL.3).

The use of hemorheological products containing decortin and ascorbic. the acid in the ratio 1: 2,5 (RF patent 2150282, priority from 06.11.1998) permitted for use as a biologically active food Supplement "Antoxid" (registration certificate MOH 001284.R. 643.01.2000), in combination with a cyclic folic acid and-tocopherol acetate in the acute period in the proposed doses in combination with traditional therapy helps to reduce the frequency of the above pathology (PL.3. Menstrual irregularities in women with tick-borne CNS at different times since the disease when using hemorheological products containing decortin and ascorbic acid). Achieved positive preventive effect is stable and remains within one year from the disease.

The obtained results confirm the necessity of using this method to prevent violations of the CMC and endocrine bespamyatstvo, composed of divertida and ascorbic acid at the ratio 1: 2,5, prevents the development of gynecological pathology associated with CED. This composite was used by us in combination with folic acid and-tocopherol acetate.

The folic acid coenzymes are involved in the biosynthesis of nucleic acids and therefore play a role in the processes of cell division tissues undergoing periodic update (blood cells, the epithelium of the gastrointestinal tract, follicular apparatus of the ovary, endometrium, and others). In addition, there are reports about the involvement of folic acid in the initiation of the growth of follicles and differentiation of the follicular epithelium.-Tocopherol acetate provides prosperity and normal functioning of the yellow body.

In terms of infectious exposure, violating regulating hormonal support by Central mechanisms (pituitary, hypothalamus), supplementation of folic acid and-tocopherol acetate in cyclic mode is justified due to the ability to maintain the normal operation of the target organs.

In addition profilakticheskogo period CED there is a strong positive trend, lowering body temperature, stabilization of the General condition, the symptoms of intoxication, on the 5th day of the normalization parameters neurological status, which differs significantly from the average duration of clinical manifestations with conventional therapy[5, 6, 7, 8, 9, 10].

In a study of women after the end of therapy and after 1, 6 and 12 months is typical, according to literature data[1, 2, 3, 4], changes in gynecological status is not detected, in addition to registered the absence of subjective and objective symptoms that characterize the consequences of CED, the duration of which according to different authors can reach 2-5 years[7, 8, 10, 11, 12, 13].

The immediate result of prevention on set objective, laboratory and additional methods of research assessed as very good in 93% satisfactory 7% of women.

Sources of information 1. Frost N. N., Tikhon O. A. menstrual cycle in women undergoing tick neuroinfections. // Materials of III Russian Forum "Mother and child". / Abstracts. Moscow, 2001. - S. 413-414.

2. Frost N. N. Gynecological disorders in women after suffering glue is erenli them. N. And. Pirogov. Tomsk, 2001. - S. 4-16.

3. Frost N. N. Gynecological pathology associated with tick-borne CNS infection. // Abstracts of papers of the participants of Russian Open contest for the best scientific work of students in 2001 under the heading "Medical science". Moscow, 2002. - S. 122-123.

4. Tikhon O. A., Frost N. N. To the question of gynecological pathology associated with tick-borne CNS infection. // Problems of infectious pathology in the regions of Siberia, Far East and Far North: the Second scientific conference. Abstracts (29-31 may 2002, Novosibirsk, Russia). - Novosibirsk: CARIS, 2002. - S. 156.

5. Lepekhin A. C., Lukashova L. C., Portnyagin E. C., Cosewic E. C. Clinical aspects associated infections - Ixodes tick-borne borreliosis and tick-borne encephalitis. // The materials of the round table in the framework of the VI Russian-Italian research conference. December 14-16, 2001, St. Petersburg. St. Petersburg, 2000. - S. 107.

6. Leonov, N. Tick-borne encephalitis in Primorsky Krai. Vladivostok: Dalnauka, 1997. - 189 C.

7. Shapoval A. N. Tick-borne encephalitis. L., 1961. - 318 S.

8. Jerusalem A. P. Tick-borne encephalitis. Novosibirsk, 2001. - 360 C.

9. Bondarenko, A. L., S. Abbasov Century, Tikhomolov E., and other Clinico-epidemiological and laboratory features of Parvanova, Century, Chastikov O. Y. Epidemiological analysis of the incidence of Ixodes tick-borne borreliosis in Kirovo-Chepetsk district of the Kirov region for 1996-1998, / / the Honey. Parasitology and couples. disease. - 2000. - 3. - S. 16-18.

11. Smirnov C. D. the state of the cerebral circulation in patients with tick-borne encephalitis: author. Diss.... Kida. honey Sciences. Novosibirsk, 2000. - 25 S.

12. Konnova T. C. Comparative clinico-epidemiological characteristics of tick-borne CNS in Tomsk. // Modern problems of fundamental and clinical medicine. / Sat. Articles of young scientists and students. Tomsk, 1999. - S. 65-66.

13. Shapoval A. N. On the causes of persistent fatigue in tick-borne encephalitis. // The viruses and viral infections of man. / Conference abstracts. M., 1981. - S. 164.1

Claims

The way to prevent the development of impaired ovarian-menstrual cycle and endocrine infertility in women with acute tick-borne CNS, which is to assign the background standard and symptomatic therapy hemorheological products containing decortin and ascorbic acid in the ratio 1:2,5, 1 tablet 3 times a day for 12-14 days, and additionally folic acid at a daily dose of 300 mg performancerating cycle.

 

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