Method of treatment for chronic trichomoniasis

FIELD: medicine, urology.

SUBSTANCE: susceptibility of pathogenic organism to antiprotozoan drugs is determined. At the preliminary stage sporobacterin, sulodexide, methadoxil, and vobenzyme are injected; the prostate is affected by ultrasound exposure. After that at the etiotropic treatment stage, the blood is taken and separated in plasma, erythrocyte suspension, and leukocyte suspension fractions by sequential centrifuging at 800 rpm and 1800 rpm speed and temperature +4°C. The plasma is eliminated and replaced by crystalloid solution. The erythrocyte suspension is injected intravenously to the patient. The leukocyte suspension, with 0.5 ml ATP added, is affected by semiconductor laser radiation exposure at λ=0.70 mcm, then 0.75 g of metronidazol in solution is added and, after incubation at +37°C, injected to the patient. Simultaneously nifuratel is administered perorally in 200 mg dose twice a day. The procedure is repeated during 8 days. At the rehabilitation therapy stage during 10 days trilact is administered by 2 doses twice a day, as well as polyvitamin mix "Alpha-Vit". The method provides directed metronidazol transport into infection focuses, activates autoblood cells metabolism and phagocytic, adhesive, and migration leukocyte activities, stimulates resorption of fibrotic degenerated chronic inflammation niduses in urino-genital tract, decreases manifestation of side effects.

EFFECT: increase in treatment effectiveness.

2 ex

 

A method of treating chronic trichomoniasis relates to the field of medicine, specifically to the urogenital protozoal diseases.

According to the results of epidemiological studies in the Russian Federation annually more than 2 million patients with sexually transmitted diseases, and leading place in the structure of the inflammatory diseases of the urogenital tract is occupied by urogenital trichomoniasis, which is a disease of the urogenital tract of man, caused the simplest single-celled parasite Trichomonas vaginalis. According to who it affects up to 10% of the world population. This invasion leads in the detection rate among sexually transmitted infections in individuals seeking specialized dermatological, obstetric-gynecological and urological assistance regarding infectious-inflammatory diseases of the urogenital tract. The incidence of urogenital trichomoniasis in Russia ranges from 261 to 343 per 100,000 population. Urogenital trichomoniasis often occurs as a mixed infection. On the background of protozoal agent can form complex associations of bacterial, viral, chlamydial and other nature. The very same urogenital Trichomonas is one of three species of trichomonads (together with the oral and intestinal), parasitise the common man. The complexity and ambiguity of the pathogenesis of Trichomonas invasion caused along with the state of cellular and humoral immunity, integration competitive relationship pathogens and symbionts, forming individual microbiocenosis urinary tract in patients with trichomoniasis. The ability vaginal Trichomonas to perform incomplete phagocytosis of various infectious agents, and to serve as a reservoir for many pathogenic bacteria and viruses explains how mnogochasovoj lesions in this disease and the problems associated with its treatment. Clinic trichomoniasis similar to clinic other inflammatory diseases of the urinary tract. In men it is urethritis, prostatitis, vesiculitis, orthoapedic, Cooper, and cystitis. In women as in men, it also mnogocelevoe disease occurring in the form of vaginitis, urethritis, cystitis, salpingitis, endocervicitis, we have to stop spreading, adnexitis, endometritis, proctitis. Trichomonas can be the cause of ulcers in vulvovaginal region, condileeza cancer and Paget's disease. Often due to Trichomonas invasion weakened erection, orgasm, premature ejaculation occurs, develops infertility. Disease duration can be up to 30 years. In the last 10-15 years among patients with trichomoniasis HC is the increased frequency of detection amastigote forms of vaginal Trichomonas - metabolically inactive individuals of a parasite, devoid of organelles movement (blepharoplasty, flagella and undulipodia membrane), which greatly complicates the diagnosis of infection and in the absence of appropriate causal treatment promotes the formation of trihomonadonositelstvo. Chronic treatment of trichomoniasis in the most difficult because of the circulation in the human population strains of Trichomonas resistant to most Antiprotozoal drugs. This is due primarily to the predominance of empirical regimens patients without regard to determining the sensitivity allocated Trichomonas patient to Antiprotozoal drugs, and inadequate drug concentration in infected tissues, side effects Antiprotozoal drugs and associative nature of the flow genitourinary infection. Given the growth of resistance to metronidazole Trichomonas, requires a search for new drugs with antitrichomonas activity.

In medicine known methods of treatment of patients with chronic trichomoniasis. For example, "a Method for the treatment of chronic recurrent trichomoniasis" p. RU # 2180567, 2001.05.03, AK 31/41, A61K 31/739, A61P 33/02, consisting in the installation of the diagnosis, the implementation of the preparatory phase by receiving pyrogenal, holding fiziterapevticheskogo the impact for example, inductothermy, from 1 to 15 day every day at the crotch in men and in the projection of the uterus in women. 8 through 11 days of treatment - reception of metrogel a single dose of 1.0 g every 8 h, i.e. the dose rate to 12, From 8 th to 17-th day along with metrogram additional daily topical treatment by introducing into the urethra of men and posterior vaginal vault women 3.0 g of cream Makmiror, i.e. dose rate of 30, the Method provides a more effective treatment of chronic trichomoniasis by creating opportunities to improve pay and course doses of medicines.

The disadvantages of the solution are: the practice of treatment of trichomoniasis showed that increasing doses of metrogel, "shock dose"does not lead to effective treatment, as it is increasing the sustainability of trichomonads to metrogel, frequent (8 hours) intravenous drip of metrogel, because the half-life of metrogel is 8-10 hours, low cure the sick - 83,9%, increased duration of treatment, a large percentage of of side effects of therapy, toxic liver damage, allergic reactions, intestinal dysbiosis, there is no pre-determination of the sensitivity of Trichomonas to Antiprotozoal drugs, so this method of treatment is not effective enough, because in the long term observations for after some disease and patients (3-6 months after treatment) there are relapses Trichomonas invasion.

The closest solution to the proposed method of treatment is a method of treating chronic trichomoniasis specified in paragraph (RU # 2154477 from 12.10.1998,, A61K 31/41, A61K 31/70, AM 1/38, which consists in making a diagnosis, the implementation of the preparatory period of 10 days by taking pyrogenal, physiotherapeutic effect from 1st to 15th day, for example inductothermy in the crotch in men and in the projection of the uterus in women, performing etiotropic therapy from 10 to 20 a day, including exposio the patient's blood, centrifugation its speed 700g divided into plasma and cell mass (fractional plasmapheresis), remove plasma and reinfusion autologous cell mass of the blood after incubation for 15' with a single therapeutic dose of metronidazole 0.5 g in 100 ml of physiological solution and 2.0 ml of ATP, the course of treatment is 6 treatments with an interval of 48 hours, held in 10, 12, 14, 16, 18, days of treatment, in addition, from 10 to 20 days daily injected into the urethra of men or the posterior vaginal vault women 2.5 g of cream Makmiror" and intramuscularly carry out the introduction of thrombolysis 2.0 ml daily from 10 to 24 days. The method allows to increase the effectiveness of treatment of chronic trichomoniasis by reducing daily and course doses Protistology funds.

The disadvantages of this method of treatment of chronic trichomoniasis are: the ri of the method is insufficiently activated adsorption and migration activity of blood leukocytes due to the application as they are activated only drugs ATF, the result has not been implemented for maximum effect directional transport of metronidazole in inflammation of the urinary tract using cells (phagocytes), lack of use of circulating blood (only 6-8% of the total), which does not provide the maximum therapeutic efficacy for sorption at the same time all highlighted by centrifugation cell mass of the blood, which is composed of leukocytes, erythrocytes and platelets, which does not ensure maximum absorption of metronidazole, as only leukocytic mass of blood capable to absorb causal drug and to provide directional transport it to the inflammation, the use of inductothermy insufficient for the activation of phagocytic, the adhesive activity of leukocyte and especially neutrophils, a daily dose of 0.5 g introduced into the body through cell mass in a day (48 hours interval) insufficient due to inactivation of the drug circulating in the blood and liver, do not take into account the sensitivity of Trichomonas to etiotropic drugs, there is provided the effect dissolution and resorption vibroseismic and scleratinian foci of inflammation in the urogenital tract (prostate gland), the lack of effectiveness of the treatment was 82%.

The technical result of the proposed decision who of is: increasing the effectiveness of treatment by increasing the directional transport of metronidazole in the foci of chronic inflammation in the urogenital tract, caused by trichomonads, by increasing the activation of metabolism autoclear blood, namely increasing phagocytic, adhesion, adsorption and migration of leukocytes and neutrophils, as well as by increasing the effect of softening and dissolution of the fibrous modified and scleratinian foci of chronic inflammation in the urogenital tract (prostate gland).

This result is achieved by the fact that in the treatment of chronic trichomoniasis, which consists in establishing the diagnosis, the implementation of the preparatory phase with the introduction of medical preparations, conducting etiotropic therapy, including exposio the patient's blood, centrifuging it to separate the plasma and cell mass, remove plasma, physiotherapeutic effect and intravenous injection of cell mass with metronidazole in physiological solution before treatment after isolation of the pathogen from lesions in the urinary tract to determine the sensitivity of the culture method to the most effective combination Antiprotozoal drugs, preparatory and causal stages of treatment the patient was given sporobacterin 2 ml 2 times a day, sulodexide 1 capsule 250 LE 1 time per day, metalaxyl 0.5 g per day, Wobenzym 5 tablets 3 times a day, to provide massage of the prostate gland No. 5 and the ultrasound is 5 a day on the soft tissue in the area of projection of the prostate, and in the period of etiotropic therapy after exposee blood in a patient share it, centrifuger in two consecutive modes at speeds of 800 and 1800 rpm for 10' at a temperature of +4°With, on the plasma, the suspension of erythrocytes and leukocytes, and after the removal of toxic plasma it replaced in equal amount of crystalloid solution and intravenous autoerythrocyte suspension to the patient, and in a suspension of cells after irradiation by laser radiation with λ=0,70 μm for 15' with a power density of 1-1,5 MW/cm2inject 0.5 ml of ATP, saturated solution of metronidazole at a dose of 0.75 g, having the last solution in thermostat for 30' at a temperature of +37,0°and parenterally administered to a patient with simultaneous oral administration of nitrates at a dose of 200 mg 2 times a day at equal intervals in 10-12 hours, repeating the treatment for 8 days, after etiotropic therapy, exercise rehabilitation therapy within 10 days by oral administration of trisakti 2 (10 ml) dose in the morning and evening and vitamins with minerals - alpha-Vit 1 tablet each 3 times a day with an interval between doses of 4-8 hours.

The essence of the invention is expressed in a set of key characteristics, sufficient to achieve provided by the invention a technical result.

Things the public signs in this solution, coinciding with the characteristics of the prototype are the following: diagnosis; the implementation of the preparatory phase with the introduction of therapeutic drugs; conduct etiotropic therapy, including exposio the patient's blood, centrifuging it to separate the plasma and cell mass, remove plasma, physiotherapeutic effect and intravenous injection of cell mass with metronidazole in physiological solution.

Salient features of the process of therapy of patients with chronic trichomoniasis are: A - before treatment after isolation of the pathogen from lesions in the urinary tract to determine the sensitivity of the culture method to the most effective combination Antiprotozoal drugs; B - in the preparatory and causal stages of treatment the patient was given sporobacterin 2 ml 2 times a day, sulodexide 1 capsule 250 LE 1 time per day, metalaxyl 0.5 g per day, Wobenzym 5 tablets 3 times a day, to provide massage of the prostate gland No. 5 and ultrasound No. 5 in a day on the soft tissue in the area of projection of the prostate; In the period of etiotropic therapy after exposee blood in a patient share it, centrifuger in two consecutive modes at speeds of 800 rpm and 1800 rpm for 10' at a temperature of +4°With, on the plasma, the suspension of erythrocytes and leukocytes, and after deletion the of toxic plasma it replaced in equal amount of crystalloid solution and intravenous autoerythrocyte suspension to the patient, and in a suspension of cells after irradiation by laser radiation with λ=0,70 μm for 15', with a power density of 1-1,5 MW/cm2inject 0.5 ml of ATP, saturated solution of metronidazole at a dose of 0.75 g, having the last solution in thermostat for 30' at a temperature of +37,0°and parenterally administered to a patient with simultaneous oral administration of nitrates at a dose of 200 mg 2 times a day at equal intervals in 10-12 hours, repeating the treatment for 8 days; D - after etiotropic therapy, exercise rehabilitation therapy within 10 days by oral administration of trisakti 2 (10 ml) dose in the morning and evening and vitamins with minerals - alpha-Vit 1 tablet each 3 times a day with an interval between doses of 4-8 hours.

A method for the treatment of chronic urogenital trichomoniasis is the following. After issuing preliminary diagnosis by clinical signs carry out laboratory and instrumental examination with the final diagnosis. For this purpose, cytological, immunofluorescence (DFA) and culture methods. The culture method is used to determine the sensitivity of the allocation of trichomonads to Antiprotozoal drugs and their combinations. As clinical materials from patients use the n centrifugal 1 portion of urine, swabs from the urethra, the prostate fluid, ejaculate. The survey was conducted before treatment and at 13-15 days from the beginning of treatment. Treatment of chronic urogenital trichomoniasis was conducted in 3 phases: preparatory, causal, and rehabilitation (rehabilitation). In the preparatory (10 days) and citropram stages of the patients were treated for prophylaxis of a dysbacteriosis of intestines medicine "Sporobacterin liquid" (bacteria strain Bacillus subtilis 534) 1 vial (2 ml) 2 times a day, sulodexide 1 capsule 250 LE 1 time per day to improve capillary circulation in the tissues, metalaxyl 0.5 g - 1 tablet per day for the prevention of Hepatology, a comprehensive therapeutic agent "Wobenzym" 5 tablets 3 times a day to ensure absorbing effect in the prostate, massage of the prostate gland No. 5 in a day and ultrasound No. 5 through the day on the soft tissue in the area of projection of the prostate. In the period of etiotropic therapy, patients also received and Antiprotozoal drugs taking into account the sensitivity to them Trichomonas. In this period of treatment in patients taking blood from a vein, then this portion sequentially centrifuged in two consecutive modes at speeds of 800 rpm and 1800 rpm for 10' at a temperature of +4°separating the plasma, the suspension of erythrocytes and leukocytes. Then the current of the ranks of the plasma is removed, replace her an equal amount of crystalloid solution and intravenous autoerythrocyte suspension to the patient. And a suspension of cells irradiated by laser radiation poluprovodnikov laser λ=0,70 μm for 15' with a power density of 1-15 MW/cm2and give it 0.5 ml of ATP, saturated solution of metronidazole 0.75 g, stand it within 30', and parenterally administered to the patient. At the same time also give the patient an oral medicinal drug nifuratel at a dose of 200 mg 2 times a day at equal intervals in 10-12 hours, because the half-life of the drug from the liver is 8-10 hours. Medical procedure is repeated for 8 days. Heading dose of metronidazole was 6 g, and nifuratel - 3,2, After etiotropic treatment rehabilitation therapy within 10 days in order to restore the intestinal microflora by oral administration of trisakti 2 doses (10 ml) in the morning and evening, as well as the purpose of vitamins and trace elements - alpha-Vit" 1 tablet each 3 times a day with an interval between doses of 4-8 hours.

To assess the clinical and bacteriological effectiveness of the proposed method of treatment of chronic urogenital trichomoniasis were investigated the results of treatment 2 groups of patients of the same age (20-55 years) and sex (men)living in the same climate is a mini-conditions (Leningrad region) and engaged in the same employment (military). The first (control) group of 40 persons were patients for which treatment was applied traditional infusion therapy metronidazole for 12 days (intravenous infusion), 2 times a day morning and evening in regular intervals after 10-12 hours, the daily dose was 1.0 g dose rate of the drug 12, the Second group is experienced in the number 20 was sick with the same form and severity of chronic urogenital trichomoniasis. Preliminary and rehabilitation stages carried out equally for both groups. In the period of etiotropic therapy of patients of the control group received intravenous metronidazole 2 times per day to 0.5 g per infusion. Treatment 12 day dose rate of metronidazole - 12, treatment Assessment was performed according to clinical and bacteriological effectiveness. As a criterion for assessing the clinical effectiveness of treatment of patients used the terms edema following main clinical symptoms characteristic of the disease: itching, burning, cramps, discomfort in the urethra, urethral discharge, frequent urination, lack of subjective sensations. Patients of the experimental group to which you've applied the proposed method of treatment, these symptoms were relieved as compared with patients in the control group in the earlier period. Differences b the credibility of the above symptoms in the second period of observation of patients (13-15 days from the beginning of treatment). Differences were also characteristic 3 and 4 period of examination of patients. After 3 months from the start of treatment in the control group itching in the urethra is preserved in 5% of patients, discomfort in the urethra - 25%, the adhesion of the urethral sponge - 5%, frequent urination - 12.5%, and the absence of subjective sensations in 75% of patients. At the same time, the examination subjects of the experimental group in this observation period revealed multiple symptoms: itching in the urethra, discomfort in the urethra only one patient is 5%.

To assess bacteriological efficiency as the main criterion served absence in soskolne materials of the anterior urethra, the prostate fluid and semen Trichomonas. For this purpose we have used the whole range of laboratory diagnostic methods (cytological, DFA, culture methods). Patients of the experimental group bacteriological efficacy was higher (p≤0.05) as compared with control patients (first) group in all periods of the survey. After 3 months from start of treatment of trichomoniasis was diagnosed by culture method in the ejaculate of 9 patients in the control group and, accordingly, a complete reorganization of the pathogen was observed only in 31 patients (77.5%of). In this group of patients in the fourth period of observation failed to detect Trichomonas secret of the prostate is the gland in 77.5% of violence. Compared with the control group in subjects of the experimental group was not observed complete renovation of the genitourinary tract in only one patient, and in the remaining 19 (95%) the cause has not been diagnosed by various methods, including in the ejaculate.

By comparing the performance of the developed method compared to the traditional therapy of chronic urogenital trichomoniasis (control group), we used the following criteria: daily dose of causal drug; dose rate assigned medication; duration of treatment; complete redevelopment of the urinary tract from Trichomonas; side effects of therapy (after treatment and 2 months after completion of treatment). Comparing the results obtained from groups of patients, it can be noted that the daily dose of metronidazole decreased by 25%, dose rate decreased 1.5 times the length of treatment from 12 days to 8 (66.7%); fully sanitized patients in the experimental group were observed in 95% of cases, while the control group is 77.5%. The frequency of side effects of therapy in patients of the experimental group was 30%, and in control - 51,3%.

Clinical example is given in the Appendix.

The use of the invention "Method of treatment of chronic trichomoniasis compared with the prototype allows to increase the effectiveness of treatment through enhancement the directional transport of metronidazole in foci of chronic inflammation in the urogenital tract (prostate gland), caused by trichomonads, due to increased absorption and migratory activity of cells autologous blood. Application reinfused autologous leukocyte cell mass of the blood after pre-activation of the laser radiation in therapeutic mode and then connecting with a solution of metronidazole on the background of oral administration of nitrates increases fast delivery etiotropic drugs in the foci of chronic inflammation in the urogenital tract caused by trichomonads. Optimal and exchange daily dose of metronidazole, as well as the optimal time of treatment. Increased softening effect and resorption vibroseismic and scleratinian foci of inflammation in the urogenital tract (prostate gland). The application of the proposed method allowed to reduce the frequency of side effects of therapy more than 1.5 times. The combined use of two Antiprotozoal drugs (metronidazole + nifuratel) against strains of Trichomonas sensitive to this combination in vitro, provides maximum sanitizing effect in vivo (95%). A method of treating chronic trichomoniasis has been applied in clinical practice. All treated with the use of 20 patients. Dynamic observation recover after 13-15 days from the beginning of therapy and after 2 month from the beginning of therapy showed a significant reduction in the number of side effects. Therefore, the proposed method can be recommended for use in clinical practice for the treatment of trichomoniasis.

APPLICATION

Example 1. Patient M., 33 years. Clinical diagnosis: chronic trichomoniasis, chronic prostatitis. He complained of poor mucous discharge from the urethra in the morning, the feeling of discomfort in the urethra, a feeling of heaviness in the perineum, erection and orgasm. Ill for three years. Ambulatory received three courses of treatment over Trichomonas urethritis (inside African-250, tinidazole, tiberal, installation Antiprotozoal funds) without effect. In the in-depth examination in the clinic in the ejaculate detected Trichomonas. Using the culture method has allowed to confirm the presence of the pathogen. When dvuhtonnoy the urine sample in the first portion contains small flakes and filaments. The second had a small flakes. An ultrasound of the prostate of the patient revealed a significant fibrotic changes of the body, the calcium, the increase in volume of the gland, its asymmetry, the increase in residual urine volume. When microscopy secret - moderate leukocytosis and reducing the number of lecithin granules. Conducted therapy with use of the developed drug plasmacytomas. The culture method chosen is effective is I the combination of Antiprotozoal drugs conducted accepting patients over 18 days of drugs: "Sporobacterin liquid 2 ml 2 times a day, sulodexide 1 capsule 250 LE 1 time per day, metalaxyl 0.5 g per day, "Wobenzym" 5 tablets 3 times a day. Also made massage of the prostate gland No. 5 in a day on the soft tissue in the area of projection of the prostate gland, then after exposee blood in a patient, the separation of the plasma, the suspension of erythrocytes and leukocytes by successive centrifugation at speeds of 800 rpm and 1800 rpm for 10' at a temperature of +4°With removal of toxic plasma and replacing it with equal quantity of crystalloid solution intravenous autoerythrocyte suspension to the patient, suspension auto leukocytes after exposure to laser radiation of a semiconductor laser λ=0,70 μm for 15' with the power density of 1-1 .5 MW/cm2inject 0.5 ml of ATP, saturated solution of metronidazole at a dose of 0.75 g, having the last solution in thermostat for 30' at a temperature of +37°and parenterally injected the patient with simultaneous oral administration of nitrates at a dose of 200 ml 2 times a day at equal intervals in 10-12 hours, repeating the treatment for 8 days, then within 10 days gave triact 2 doses (10 ml) in the morning and evening and vitamins with minerals - alpha-Vit by 1 tablet each 3 times a day with the interval between meals 4-8 hours. This treatment resulted in the reduction of patient complaints that were simultaneously accompanied by bacteriological 100% readjustment of the organism from Trichomonas, which was confirmed 3x laboratory control. After the course of antibiotic therapy and rehabilitation of the urinary tract of the patient from the pathogen was achieved stable remission (observation period 1 year).

Example 2. Patient D., 29 years. Clinical diagnosis: chronic trichomoniasis, total urethritis, prostatitis, vesiculitis. He complained of a burning sensation and itching in the urethra, frequent urination, pain in the perineum, smack in the testicles and suprapubic region, painful rash on the glans penis and minor light discharge from the urethra. Ill for two years. Were outpatients in several hospitals. Had been repeated bacteriological cultures of prostate secretion or 3rd portion of urine (after the massage gland). The results of bacteriological crops were negative. Ambulatory received two courses of empiric treatment over non-specific urethritis (inside trichopol, intramuscularly cycloferon) without effect. During examination of smears from the urethra, the prostate fluid, semen found Trichomonas, white blood cell count to 20 in the field of view. When two is takanos the urine sample in the first glass contains flakes and filaments, the second glass had cereal. The culture method determined the susceptibility of Trichomonas to the combination of metronidazole and nifuratel. Carried out the treatment on the new developed method. In the preparatory and causal periods of therapy conducted medication: sporobacterin, sulodexide, metalaxyl, Wobenzym, in appropriate doses, massage of the prostate and ultrasound on tissue in the area of projection of the prostate, plasmacytomas, physiotherapy exposure to laser radiation of a semiconductor laser λ=0,70 μm corresponding capacity, medication metronidazole with nifuratel. Implemented the rehabilitation stage of treatment with the medication of trisakti and vitamins from foods. After treatment, the pain had stopped, the mucous membrane in the area of erosion at the head of the penis has become a normal appearance, came epithelialization. Bacteriological studies sosabravo material from the urethra, the prostate secretion, centrifugate urine and semen on sexually transmitted infections after treatment, after 1, 3, 6, and 12 months were negative.

A method of treating chronic trichomoniasis, which consists in establishing the diagnosis, the implementation of the preparatory phase with the introduction of the drug, conducted by the attachment etiotropic therapy, including exposio the patient's blood, centrifuging it to separate the plasma and cell mass, remove plasma, physiotherapeutic effect and intravenous injection of cell mass with metronidazole in physiological solution, characterized in that before treatment after isolation of the pathogen from lesions in the urinary tract to determine the sensitivity of the culture method to the most effective combination Antiprotozoal drugs, preparatory and causal stages of treatment the patient was given a liquid sporobacterin 2 ml 2 times a day, sulodexide 1 capsule 250 LE 1 time per day, metalaxyl 0.5 g per day, Wobenzym 5 tablets 3 times a day perform massage of the prostate gland No. 5 and ultrasound No. 5 in a day on the soft tissue in the area of projection of the prostate gland, and in the period of etiotropic therapy after exposee blood in a patient share it, centrifuger sequentially in 2 consecutive modes at speeds of 800 rpm and 1800 rpm for 10', on the plasma, the suspension of erythrocytes and leukocytes at a temperature of +4°and after the removal of toxic plasma it replaced in equal amount of crystalloid solution and intravenous autoerythrocyte suspension to the patient, and a suspension of leukocytes after exposure laser radiation with λ=0,70 μm for 15' with a power density of 1-1,5mW/cm 2inject 0.5 ml of ATP, saturated solution of metronidazole at a dose of 0.75 g, having the last solution in thermostat for 30' at a temperature of +37,0°and parenterally administered to a patient with simultaneous oral administration of nitrates at a dose of 200 mg 2 times a day at equal intervals in 10-12 hours, repeating the treatment for 8 days, after etiotropic therapy, exercise rehabilitation therapy within 10 days by oral administration of trisakti 2 doses (10 ml) in the morning and evening and vitamins with minerals alpha Vit on 1 tablet each 3 times a day with an interval between receptions 4-8 p.m.



 

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FIELD: chemistry.

SUBSTANCE: invention relates to new compounds with the general formula (I) in the racemic, enantiomeric form or in any combination of these forms and in which: A represents -CH2-, -C(O)-, -C(O)-C(Ra)(Rb)-; X represents -CH-; Ra and Rb independently represent the hydrogen atom or a radical (C1-C6)alkyl; Rj represents the atom of hydrogen; a radical (C1-C8)alkyl, not necessarily substituted hydroxyl or by one or more identical or different radicals of halogens; (C2-C6)alkenyl; or a radical of the formula -(CH2)n-X1; R2 represents a radical (C1-C8)alkyl not necessarily substituted hydroxyl or by one or more identical or different radicals of halogens; (C2-C6)alkenyl; or a radical of the formula -(CH2)n-X1; each X1 independently represents (C1-C6)alkoxy, (C3-C7)cycloalkyl or heteroaryl, and radicals (C3-C7)cycloalkyl, aryl and heteroaryl are not necessarily replaced by one or more either identical or various assistants chosen from: -(CH2)n'-V1-Y1, halogen and; V1 represents -O-, -S- or a covalent bond; Y1 represents a radical (C1-C6)alkyl, not necessarily substituted hydroxyl or by one or more identical or different radicals of halogens; n represents an integer from 0 up to 6 and n ' - an integer from 0 up to 2 that if n is equal 0 then X1 does not represent a radical alkoxy); or R1 and R2 form together with the atom of nitrogen to which they are attached, heterobicycloalkyl or heterocycloalkyl, are not necessarily replaced by one or more either identical or various substitutes chosen from: hydroxy, (C1-C6)alkyl, not necessarily substituted by hydroxy, (C1-C6)alkoxycarbonyl, heterocycloalkyl and-C(O)NV1'Y1', in which V1' and Y1' independently represent the atom of hydrogen or (C1-C6)alkyl; or R1 and R2 together form a radical of the formula: R3 represents-Z3, -C(RZ3)(R'Z3)-Z3, -C(RZ3)(R'Z3)-(CH2)p-Z3 or -C(O)Z'3; RZ3 and R'Z3 independently represent atom of hydrogen or a radical (C1-C6)alkyl; Z3 represents Z3b, Z3c, Z3d or Z3e; Z3b represents (C1-C6)alkoxy, (C1-C6)alkythio, (C1-C6)alkylamino, or a radical di((C1-C6)alkyl) amino; Z3c represents aryl or a radical heteroaryl; Z3d represents C1-C6)alkoxycarbonyl, aminocarbonyl, (C1-C6)alkylaminocarbonyl, di((C1-C6)alkyl) aminocarbonyl, (C1-C6)alkyl-C(O)NH-, (C3-C7) cycloalkyl, heterocycloalkyl; and radicals (C3-C7) cycloalkyl and heterocycloalkyl are not necessarily replaced by one or more either identical or various substitutes chosen from: (C1-C6)alkoxy, (C1-C6)alkylcarbonyl, (C1-C6)alkoxycarbonyl and oxy, radicals aryl and heteroaryl are not necessarily replaced by one or more either identical or various substitutes chosen from: halogen, cyanogen, nitro, azide, oxy, (C1-C6)alkylcarbonyl-(C1-C6)alkenyl, (C1-C6)alkylaminocarbonyl-(C1-C6)alkenyl, -SO2-NR31R32, heterocycloalkyl, heteroaryl or -(CH2)P'-V3-Y3; R31 and R32 form together with atom of nitrogen to which they are attached, heterocycloalkyl, V3 represents -O-, -S-, -C(O)-, -C(O)-O-, -O-C(O)-, -SO2-, -SO2NH-, -NR'3-SO2-, -NR'3-, -NR'3-C(O)-, -C(O)-NR'3-, -NH-C(O)-NR'3- or covalent bonds; Y3 represents the atom of hydrogen; radical (C1-C6)alkyl, not necessarily replaced by one or more either identical or different radicals of halogens; radical aryl or a radical aryl-(C1-C6)alkyl; Z3e represents a radical of the formula

, Z'3 represents a radical aryl, not necessarily replaced by one or more oreither identical or various substitutes chosen from: halogen, nitro and -(CH2)P"-V'3-Y'3; V'3 represents -O-, -C(O)-, -C(O)-O, -C(O)-NR'3-,-NH-C(O)-NR'3- or covalent bonds; Y'3 represents the atom of hydrogen or a radical (C1-C6)alkyl, not necessarily replaced by one or more either identical or different radicals of halogens; R'3 represents the atom of hydrogen (C1-C6)alkyl or a radical (C1-C6)alkoxy; p represents an integer from 1 up to 4; p' and p" independently represent an integer from 0 up to 4; R4 represents a radical of the formula -(CH2)S-R'4; R'4 represents a radical guanidine; heterocycloalkyl containing, at least, one atom of nitrogen and not necessarily substituted (C1-C6)alkyl or aralkyl; heteroaryl containing, at least, one atom of nitrogen and not necessarily substituted (C1-C6)alkyl or a radical of the formula -NW4W'4; W4 represents an atom of hydrogen or (C1-C8) alkyl; W'4 represents a radical of the formula -(CH2)S-Z4; Z4 represents an atom of hydrogen (C1-C8) alkyl, (C3-C7)cycloalkyl, heteroaryl and aryl; s and s' independently represent an integer from 0 up to 6; and i) if R3 represents -C(O)-Z'3 and R4 represents a radical of the formula -(CH2)S-NW4W'4, and W4 and W'4 independently represent an atom of hydrogen or a radical C1-C6)alkyl, then -(CH2)s represents neither radical ethylene nor radical -(CH2)-CH((C1-C4)alkyl) and ii), if R3 represents -Z3c and Z3c represents phenyl or naphthyl, then phenyl and naphthyl are not substituted by cyanogen; also note that if R3 represents -Z3d, then Z3d, represents only one (C3-C7)cycloalkyl or heterocycloalkyl; or to their pharmaceutically acceptable salts. The invention also relates to the method of obtaining the compounds of the formula (I), to a pharmaceutical composition, and to the application of compounds of the formula (I) and (I ').

EFFECT: obtaining new biologically active compounds on their basis, possessing activity with respect to receptors MC4.

41 cl, 535 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to medicine, particularly, to pharmaceutical vaginal compositions for treatment or prevention of vaginal infections. Composition contains synergistic mixture of bioadhesive medicinal form of prolonged release which reduces value pH and includes peroxide in amount, sufficient to increase oxygen concentration without either vagina sterilisation or considerable destruction of normal required local vaginal flora. Invention also refers to method of treatment or prevention of vaginal infections, including vaginal introduction of pharmaceutical vaginal compositions in amount, sufficient to decrease pH and increase in oxygen concentration without either vagina sterilisations or considerable destruction of normal desirable local vaginal flora.

EFFECT: development of effective method of treatment and prevention of vaginal infections.

35 cl, 1 tbl, 1 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to chemical-pharmaceutical industry, namely production of means used in balneology for treatment and prevention of various diseases. Balneal product consists of natural components: bischofite 2.5-3.5 g, 5-% argentiferous disinfectant solution 41.5-42.5 ml, 1.0-2.0 ml, fir essence 1-2 ml and pre-milled air-dry powder of bolus alba 52-55 g. Offered product is fine-dispersed, homogeneous and elastic substratum with widen range of indications and purposeful differentiated influence on specific types of nosology with high medical effect. Simple production technique can be combined with possibility to pack "Glinofit" in plastic containers of various volumes. It is easy-to-use both in hospital, and at home in the form of applications.

EFFECT: development of effective balneal product.

5 tbl

FIELD: chemistry.

SUBSTANCE: invention pertains to non-peptide antagonists GnRH, with general formula 1 , where each of A1, A2 and A3 are independently chosen from A5 and A6; and A4 represents either a covalent bond, or A5; under the condition that, if A4 is a covalent bond, then one of A1-A3 represent A6, and the other two represent A5, and that, if A4 represents A5, then all of A1-A3 represent A5; A5 is chosen from C-R13 and N; A6 is chosen from N-R14, S and O; R1 is chosen from H, NHY1 and COY2, and R2 represents H; or and R1, and R2 represents methyl or together represent =O; each of R3, R4 and R5 independently represents H or low alkyl; each of R6, R7, R8, R9, R10, R11 and R12 are independently chosen from H, NH2, F, CI, Br, O-alkyl and CH2NMe2; R13 is chosen from H, F, CI, Br, NO2, NH2, OH, Me, Et, OMe and NMe2; R14 is chosen from H, methyl and ethyl; W is chosen from CH and N; X is chosen from CH2, O and NH; Y1 is chosen from CO-low alkyl, CO(CH2)bY3, CO(CH2)bCOY3 and CO(CH2)bNHCOY3; Y2 is chosen from OR15, NRI6R17 and NH(CH2)cCOY3; Y3 is chosen from alkyl, OR15 and NR16R17; R15 represents H; each of R16 and R17 is independently chosen from H, low alkyl and (CH2)aR18, or together represent -(CH2)2-Z-(CH2)2-; R18 is chosen from OH, pyridyl, pyrizinyl and oxadiazolyl; Z represents NH; a represents 0-4; and b and c represent 1-3. The invention also relates to use of formula 1 a compound as a therapeutic agent and pharmaceutical composition, with antagonistic effect to GnRH receptor. Description is also given of the method of obtaining compounds with the given formula.

EFFECT: obtaining new compounds, with useful biological properties.

27 cl, 70 ex

FIELD: medicine.

SUBSTANCE: described oil solution for injection to patient is characterised by the fact that it includes 25-200 mg/ml of the first component which is ethonogestrel ether and 50-400 mg/ml of the second component which the fatty acid ether with chain length within C6 to C12 and 7-alpha-methyl-19-nortestosterone, where progesterone ether and androgen ether are dissolved in ethylundecanoate. Besides, related introduction device is described.

EFFECT: high level of predisposition to treatment implying infrequent painless introduction without by-effects and local reactions.

2 cl, 2 tbl, 6 ex, 15 dwg

FIELD: chemistry; pharmaceutical compositions.

SUBSTANCE: imidazole derivatives have general formula (I) where each of R1 and R2 independently represents hydrogen, (C1-C6)alkyl or (C3-C8)cycloalkyl; n=0.1 or 2; each of R3, R4, R5 and R6 independently represents hydrogen or (C1-C6)alkyl, halogen, cyano, (C1-C6)alkoxy, trifluoromethyl, (C1-C6)alkylthio, (C1-C6)alkylsulphonyl or (C1-C6)alkoxycarbonyl; R3 and R6 together with their carrier phenyl ring can also form N-methylbenzotriazole and to its acidic-additive salts, solvates and stereoisomer forms. Also, the given invention relates to pharmaceutical compositions, inhibitory aromatiser and application of derived imidazole of formula (I) for producing of medication.

EFFECT: new compounds, with useful biological properties.

23 cl, 2 tbl, 33 ex

FIELD: medicine; gynaecology.

SUBSTANCE: vyferon-3 is introduced through rectum by 1 suppository 2 times a day during 10 days followed with laser vaporisation of pathologic focus. Besides, on 4th, 6th and 8th day of treatment rhoncoleukin in introduced in two points of uterine cervix submucosa in total dosage 0.25 mg.

EFFECT: decreased disease relapse and risk of malignant process developing within uterine cervix providing maintenance of reproductive function.

3 ex

FIELD: medicine; pharmacology.

SUBSTANCE: offered liquid concentrate based on reindeer antlers contains reindeer antlers powder extract and preserving agent, and additionally it contains water-soluble gel, as extract it contains alcohol-free water-soluble powder extract of he- and she-reindeer antlers, and as reserving agent it contains hydroperit and ascorbic acid. Offered treatment-cosmetic agent for external application includes liquid concentrate of he- and she-reindeer antlers.

EFFECT: increased efficiency of disease prevention and treatment.

5 cl, 13 ex

FIELD: medicine.

SUBSTANCE: invention relates to ophthalmology and can be used for treatment of frequently relapsing suppurative chronic dacryocystitis and suppurative complications thereof (abscess, phlegmon) in elderly people. Lacrimal sac is cut and washed, filled with photosensibilising gel (PhS gel) containing 0.1% of photosensibiliser of chlorine row, kept for 10-15 minutes. Then remaining gel is removed and inner surface of lacrimal sac is irradiated by laser radiation with wavelength corresponding to maximum absorption by PhS of light radiation, energy density being 80-100 joule/cm2 . After that, deep wound tamponade is performed. In 3 weeks, in remission stage, extirpation of lacrimal sac is carried out. Bed which formed after extirpation is filled with PhS gel containing 0,1% of PhS of chlorine row and kept for 10-15 minutes Then remaining gel is removed and bed is irradiated by laser radiation fields with wavelength corresponding to maximum absorption by PhS of light radiation, energy density being 80-100 joule/cm2 and with overlap of adjacent fields by 5-10% of the surface.

EFFECT: absence of relapses of dacryocystitis and suppurative inflammatory process during post-operative period when treating suppurative chronic dacryocystitis.

1 ex

FIELD: medicine.

SUBSTANCE: invention relates to ophthalmology and can be used for treatment of lacrimation with chronic dacryocystitis in remission period. Dacryocystorhinostomy according to Toti in modification of Dupui-Dutan-Burge is performed. Then through vertical cut in the wall of lacrimal sac photosensibilising (PhS) gel containing 0.1% of PhS of chlorine row is injected. In 10-15 minutes, irradiation of inner surface of lacrimal sac and along formed stoma is performed with laser radiation whose wavelength corresponds to maximum absorption of light radiation by photosensibiliser. Duration of application is 2-3 minutes at the power of 20-30 MW. Operation ends with stitching. Stitches are removed in 6-7 days.

EFFECT: absence of dacryocystitis relapses and inflammatory complications in postoperative period during chronic dacryocystitis treatment.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to protection of biological objects against damaging action of ionising radiation. Fibroblast cells are experimentally exposed to helium-neon laser radiation. Dose is 0.99 mJ/cm2. Laser power is 0.5 mW. Dot size is 4.4 cm.

EFFECT: method provides maximally effective protection and universality.

1 tbl, 4 dwg, 1 ex

FIELD: medicine, veterinary science.

SUBSTANCE: method provides melanoma injection with resonant photoabsorber as aqueous suspension of gold nanoparticles, consisting of a silicon nucleus in diameter of 100-150 nanometers, coated gold in thickness of 10-20 nanometers, particle concentration is 1010-1011 particles/ml. Further melanoma is irradiated within 1 minute with laser beam with wavelength 800-1150 nanometers at optical power density 1-3 W/cm2.

EFFECT: invention provides treatment of dogs' mouth tunica mucosa melanoma by means of laser destruction of tumour tissues; method is intended for veterinary science application.

1 tbl

FIELD: medicine.

SUBSTANCE: invention is intended for treatment of patients with scar-commissural processes of small pelvis against hormone-dependent gynaecologic diseases, or chronic inflammatory processes of small pelvis, or coetaneous covering after operative interventions. Laser therapy is carried out in autoresonant mode at varying frequency of laser device, regardless of frequency characteristics of human body, at wavelength 0.89 microns, capacity 10 W, by 3 - 5 minutes for each exposure field. In case of hormone-dependent gynaecologic diseases and chronic inflammatory processes of small pelvis projection zone of scar-commissural process is exposed. In case of postoperative scar-commissural process affected area is exposed.

EFFECT: method provides expressed improvement of hemodynamic within affected centre and reduction of scar-commissural processes.

2 ex

FIELD: medicine; addictology.

SUBSTANCE: individual rational psychotherapy is carried out. Temperance attitude is created. Corporeal acupuncture points are exposed with infra-red laser at wavelength 0.87-1.3 microns, laser power 0.4-0.7 W. Then large ozone autohemotherapy is carried out (LAHT). LAHT is accompanied with trans-object suggestion according to V. M. Bekhterev. Break in treatment of duration of 1-6 days is followed with repeated LAHT session and emotionally-stress psychotherapy. Thus patient is plunged into alternating consciousness, using breathing techniques through mouth as deep as possible. Further suggestion is accompanied with symmetric electropuncture of acupuncture points VG20 (baj-huej), VB8 (shuaj-gu) E8 (tou-vej) and in-tan point with electric impulses with frequency 10±2 Hz. Besides, photo- and sound exposure is performed. It is followed with pharmacotherapy course of length not less than 1 month.

EFFECT: increased efficiency of treatment due to complex psychophysiological intervention.

2 ex

FIELD: medicine.

SUBSTANCE: general diabetes-corrigent therapy and low-intensity laser radiation are performed. Surgical processing of purulent-necrotic centre, hydromechanical wound clearing, ozone-therapy are followed with magnetic-infrared-laser radiation initially of trophic ulcer area within 2 minutes, then - of left infraclavicular region and inguinal vascular beams within 2 mines per zone, of thymus gland projection area within 1 mines, of pancreas projection area with scanning within 2 minutes. Frequency is 50 Hz. Infra-red radiation power of light-emitting diodes is 60 mW. Procedures are performed every second day, totally 10 - 16 procedures.

EFFECT: decreased dosage of sugar-lowering medicinal agents; reduced terms of wound surface clearance from purulent-necrotic tissues; pain syndrome reduction; inflammatory processes reduction; activated regenerative process; reduction of operative intervention volume and restoration of limb support function.

7 dwg, 1 tbl, 2 ex

FIELD: medicine; psychiatry.

SUBSTANCE: tranquilizers, antidepressants, homeopathic agents of sedative and antidepressant action. Autogenic training, rational, hypnosuggestive family and sexual psychotherapy are applied. Surface multi-needle acupuncture, transdermal electric stimulation of nerves, pressure point and deep massage of cervicocollar area, back, lumbosacral and gluteal region, abdomen and anterior chest are applied. Acupuncture, thermal and infrared light puncture to auricular and corporeal median points of heart, lungs, pericardium, liver, pancreatic gland, small and large intestine, triple heater, gallbladder, anterior and posterior median meridians is performed considering modifications detected by pulse and acupuncture diagnostics. Corporeal points are magnet laser punctured. Colour and musical therapy are applied.

EFFECT: reduced therapy time and prolonged remission.

2 ex

FIELD: medicine; oncology.

SUBSTANCE: ray therapy combined with electron or slowing-down or gamma radiation is followed with exposure on organs and tissues included in radiolesion area by low intensity laser radiation using contact or contactless method. Simultaneously continuous low intensity radiation of two infrared lasers at wave length 970 nm 1264 nm is applied. Radiolesion focus skin is exposed in central plane. Output power is not more than 200 mWt and not less than 2 mWt. Total energy per one procedure is 3 -60 joules. End distance between two lasers is 1-3 cm depending on radiation area.

EFFECT: method enables to increase efficiency of organ radiolesion therapy of organs and tissues of deep localization without any supplement agents.

2 cl, 4 ex

FIELD: medicine.

SUBSTANCE: method implies cut out of U-shaped abdominal graft in area of hernial defect with base directed to patient's head. It is contact separated from aponeurosis together with hernial sac by means of high-intensity laser radiation (HILR) at wave length 970 nm and power 4-6 Wt. Bleeding vessels are distantly coagulated with the same HILR at power 6-8 Wt. Aponeurosis defect is sutured. Reticular prosthesis is layered between aponeurosis and peritoneum followed by fixation and closure of peritoneum and skin. Hernial defect and prosthesis fixation is performed by endoscopic suture using intracorporal endoscopic node. During surgery three trocars are introduced for women through posterior fornix of vagina, and for men - by abdominal raphe.

EFFECT: method enables to prevent relapses.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, rather to transfusiology, specifically to release of haemoglobin solutions purified of stromal components. Method implies that erythrocyte mass is isolated from blood, washed, hemolysed, centrifugated with following supernatant purification from all soluble impurities by anionites, thus supernatant is purified from soluble impurities by addition of anionites as flocculent of particle size 90-160 microns at mass ratio flocculent/haemoglobin = 1.0-4.0, thus pH is maintained at values 6.6-7.2. Invention provides scaled technological process of production of haemoglobin purified of stromal components.

EFFECT: development of effective method of production of haemoglobin purified of stromal components.

2 ex, 2 tbl

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