Method for treating patients possessing endocrine syndrome for menstrual function disorders

FIELD: medicine.

SUBSTANCE: method involves administering to patients mineral water drinking from Slavianovsky source of Zheleznovodsk type at a dose of 3-5 ml per 1 kg of body mass 3 times a day 30-60 min before taking meals depending on gastric juice acidity. Carbonic acid gas baths and gynecological irrigation treatments are administered every other day at 36-38°C high temperature, exposure time of 10-15 min in 8-12 procedures long course. Physical activity is applied daily as individual dosed terraincour walks.

EFFECT: enhanced effectiveness in repairing menstrual and ovulation functions.

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The invention relates to medicine, namely to the gynecologist, and for the treatment of women suffering from neuroendocrine syndrome related and there is no pregnancy, and can be used in the health clinics.

One of the most pressing problems in modern gynecology refers postpartum neuroendocrine syndrome (PRES) due to the increased its frequency in the last decade.

Polietiologic the nature of the disease, its rapid development, often resistant to medical therapy determine the difficulty of treating this group of patients. Therefore, the questions seek new methods of treatment of PNES remain one of the urgent problems in gynecology. In this regard, of particular interest is the use of the Spa treatments.

Known methods of treating disorders of menstrual function in postpartum neuroendocrine syndrome with the use of diet, exercise, drug clomiphene (clostilbegyt) 50 mg 1 time per day 5 through day 10 of the menstrual cycle in 2-3 months (Smetnik VP, Tumilovich L.G., 2001). Given that clomiphene stimulates the runic gonadotropin, has a strong anti-estrogenic effect, it is prescribed to stimulate ovarian function. The presence of a reducing diet, moderate exercise. This sposobleny has a positive effect on the menstrual function.

However, if after the weight loss and the elimination of metabolic disorders is not restored ovulatory cycle, the authors shows surgical treatment. In addition, prolonged use of these drugs causes a number of complications: ovarian hyperstimulation (lower abdominal pain, flatulence), menorrhagia, cystic ovaries, nausea, diarrhea, flushing, dizziness, visual disturbances, dermatitis and multiple pregnancy. However, hormone therapy is widely used in clinical practice, because there are no effective tools for the treatment of this pathology milder impact, moreover, that the effect of the hormone is not proof enough.

The technical result of the proposed method of treatment of women suffering from menstrual function when PNAS, is the improvement of menstrual function, weight loss, increased libido, and, as a consequence, the improvement of reproductive function.

This technical result is achieved by the fact that despite the internal intake of the mineral water of patients to designate mineral baths, gynecological irrigation with mineral water and physical activity in the form of a path.

Apply mineral baths and gynecological mineral irrigation using hydrocarbonate-sulphate-sodium-is alleway mineral water Slavyanovskaya source temperature of 36-38° With the exposure time of each treatment 15 minutes, at the rate of 8-12 treatments. Throughout the course of sanatorium-resort treatment is internal reception of the same mineral water 3 times a day for 40-60 minutes before eating 3-5 ml per 1 kg of body weight, gently-toning, with the transition to a training regime, diet (nutrition fractional, low calorie), and path.

The method is performed as follows. The treatment is 18-24 days. Patients designate mineral baths and gynecological irrigation with mineral water Slavyanovskaya source Zheleznovodsk type temperature 36-38°S, the exposure time of each procedure is 10-15 minutes, at the rate of 8-12. Procedures patients receive mode: 2-3 days reception - 1 day break or every other day. Throughout the course of sanatorium-resort treatment is internal reception of the same mineral water 3 times a day for 30-60 min before meals, depending on the acidity of gastric juice, 3-5 ml per 1 kg of body weight. The food was varied, low-calorie. Applied physical activity in the form of a path to a pleasant feeling of fatigue (individually).

The method is illustrated by the following examples:

Example 1. Patient Volovik IV the Diagnosis of Neuroendocrine syndrome. Ectopia of the cervix. Oligomenorrhea. Infertility II. Complaints of pain in the first day of menstruation, irregular IU is stroili delays for 2-3 months, the progressive increase of body weight after honey. the abortion. Objective data: the patient high power fat deposits mainly in the neck, arms, abdomen, thighs. The skin of the abdomen and thighs multiple striae. Gynecological status: cervix cylindrical shape, on the front and rear lip - ectopia ≈ 1 cm in diameter. The uterus and appendages without features. Studies: clinical blood and urine tests - without a pathology. ECG - sinus tachycardia (100 in 1 min). Signs of hypertrophy of the muscles of the left ventricle. Lipid metabolism blood (total lipids, triglycerides, β-lipoproteins, phospholipids) - all parameters increased. The sugar content in the blood is increased, liver function tests, prothrombin index is normal. Cytological smear of the vulva without atypia, with the cervix and cervical canal - without a pathology. Smears on the purity of the vaginal flora - gonorrhea is not detected, there is a rod flora in large quantities, leukocytes - 6-8 in the field of view. Research on specific infections (chlamydia, mycoplasmosis, ureaplasmosis, Gardnerella) - negative.

Treatment. The complex treatment consisted of assigning fractional, low-calorie diet, exercise (path), mineral baths (37°C, 15 min), gynecological irrigation mineral water (37°C, 15 min). All procedures were performed in one day through the day, in the course of 12 treatments.

After receiving the specified complex treatment decreased body weight. Menstrual function is normalized. Weight before treatment 114 kg, after - 104 kg

Clinical blood and urine tests within normal limits, the degree of purity of the vaginal flora - I. Lipid metabolism blood: the content of total lipids and triglycerides decreased, and β-lipoproteins increased. The patient was discharged with improvement in General condition, gynecological status.

Summary. Thus, the patient received in the clinic treatment mineral baths and gynecological irrigation, bore the procedure well, negative side effects were not. The effect was observed within 4-5 months, menstrual function was regular all these months. Then gradually, the weight was increased and the cycle has again become irregular.

Example 2. Patient Varekova P. Diagnosis: Postpartum neuroendocrine syndrome. Chronic bilateral salpingo-oophoritis in remission. Polycystic ovaries. Oligomenorrhea. Infertility II. Complaints of pain in the first day of menstruation, irregular menstruation with delays on 2-2,5 months, progressive increase of body weight after childbirth.

Data of objective examination: the patient high power fat deposits mainly in the abdomen and hips. The skin of the abdomen multiple striae. Studies clinical blood and urine tests - without pathology. ECG is a local violation of intraventricular conduction. The sugar content in the blood is normal, prothrombin index is increased. Cytological smear of the vulva without atypia. Smears on the purity of the vaginal flora - gonorrhea is not detected, there is coccal flora in large quantities, leukocytosis - 25-35 in the field of view. Research on specific infections (chlamydia, mycoplasmosis, ureaplasmosis, Gardnerella) - negative.

Treatment. The complex treatment consisted of assigning fractional, low-calorie diet, exercise (path), baths gynecological irrigation mineral water temperature 36-38°S, the exposure time of each treatment 15 minutes, at the rate of 10 treatments. All procedures were performed in one day, 2-3 bottoms in a row, a break of 1 day, or every other day.

After receiving the specified complex treatment decreased body weight. Weight before treatment - 85 kg, was 78.

Clinical blood and urine tests within normal limits, the degree of purity of the vaginal flora. the Patient was discharged from the clinic with the improvement of the General condition, decrease in body weight gynecological status, improvement of menstrual function. After 1 month, the patient became pregnant.

Summary. Thus, the patient received in the clinic treatment of mineral waters, bore the procedure well, negative side effects were not. As a result of treatment is observed pregnancy testified to normalize the function of the ovary.

Example 3. Patient Parkanova GN. Diagnosis: Postpartum neuroendocrine syndrome. Chronic bilateral salpingo-oophoritis in remission. Polycystic ovaries. Oligomenorrhea. Dysmenorrhoea. Complaints of pain before menstruation, irregular menstruation delays for 7-10 days, the progressive increase of body weight after childbirth.

Data of objective examination: the patient high power fat deposits mainly in the abdomen and hips. The skin of the abdomen, breast - multiple striae. Studies: clinical blood and urine tests - without a pathology. ECG violation of repolarization in the back wall of the left ventricle. The sugar content in the blood is normal, prothrombin index is normal. Cytological smear of the vulva without atypia. Smears on the purity of the vaginal flora - gonorrhea is not detected, there is coccal flora in large quantities, leukocytosis 8-15 in the field of view. Research on specific infections (chlamydia, mycoplasmosis, ureaplasmosis, Gardnerella) - negative.

Treatment. The complex treatment consisted of destination 8 baths and gynecological irrigation mineral water temperature 36-38°S, the exposure time of each treatment 15 minutes, the background fraction, low-calorie diet, physical load (path). All procedures is conducted in one day, 2-3 days in a row, a break of 1 day, or every other day.

After receiving the specified complex treatment decreased body weight. Weight before treatment - 69 kg, became after treatment 61 with the growth of 152 see

Clinical tests after treatment of blood and urine within limits, the degree of purity of the vaginal flora. the Patient was discharged from the clinic with the improvement of the General condition, decrease in body weight gynecological status, improvement of menstrual function. After 1 year, the patient was called for re-examination and treatment in the clinic. She notes that within 8-9 months after balneotherapy cycle was regular, then returned to the source.

Summary. Thus, the patient received in the clinic treatment of mineral waters, bore the procedure well, negative side effects were not. As a result of treatment were observed normalization of ovarian function.

In this way in Zheleznovodsk clinic Pyatigorsk Institute of balneology was treated 25 patients suffering from menstrual function, developed on the background of postpartum neuroendocrine syndrome. The residence time of the study group patients in the clinic was 23.3 days. The control group consisted of 12 people who received a course of clomiphene scheme within 2 months. Both groups in clinical terms were identical. All patients had presented with complaints is to menstrual dysfunction and the absence of pregnancy. All women were higher physique. The amount of subcutaneous fat was increased everywhere, but especially in the area of the upper parts of the trunk, neck, anterior abdominal wall. Basically bimanual pathological changes are not registered. In some patients, we determined the sensitivity and slight tenderness to palpation of the uterus.

Patients in both groups the study was conducted on tests of functional diagnostics and ultrasound scan of the genitals. According to the U.S. structure of the endometrium and ovary was not changed in 8 out of 37 patients. In 12% of cases atresia of follicles, 64% had polycystic changes in the ovaries, and 20% - hypoplasia of the uterus.

After comprehensive treatment using mineral procedures in the form of baths, gynecological irrigation were observed normalization of menstrual function and ovarian function (the appearance of biphasic basal body temperature), the decrease in body weight.

After the complex treatment of patients of the main group there was a marked reduction of body mass index with 34,45±, and 0.40 kg/m²to 31,13±0.20 kg/m². In 10 out of 25 people recovered two-phase menstrual cycle (biphasic basal body temperature) (table).

Patients of the main group were reported positive changes as a General SOS is sustainability, and the picture of ULTRASONIC research: reducing the size of cystic structures in the ovaries. In the control group, this index increased 1.6 times. In addition, the adverse effect of clomiphene on the General condition of women was significant. Long-term use of the drug also argues in favor of a softer impact balneotherapy treatments.

Thus, taking into account the influence of balneotherapy on the broken original function of the ovaries have given the category of patients with absence of pathological changes due to the ongoing impact applied complex treatment, including mineral baths, gynecological irrigation is pathogenetically justified treatment method at the stage of sanatorium-resort treatment.

The method of treatment of menstrual function in patients with neuroendocrine syndrome, including fractional diet low-calorie diet, physical activity in the form of a path, characterized in that patients prescribed intake of mineral water Slavyanovskaya source at a dose of 3-5 ml per 1 kg of body weight 3 times a day, baths and gynecological irrigation carbonated mineral water temperature 36-38°With, exposure of 10-15 minutes, at the rate of 8-12 treatments.