Method of treating degree 1 discirculatory encephalopathy complicated by climacteric syndrome

FIELD: medicine.

SUBSTANCE: treating degree 1 discirculatory encephalopathy complicated by climacteric syndrome is enabled by a therapeutic course of systemic ozone therapy consisting of 5 intravenous drop infusions of ozonised 0.9 % sodium chloride at rate 8-10 ml/min. The procedures are daily in the ozone concentration in physiologic saline 400 mcg/l. A single ozone dose introduced in a vascular bed for one infusion is 160 mcg, a course dose is 800 mcg. Thereafter, the preparation Climadinone 30 drops or 1 tablet is prescribed depending on presentation daily 2 times a day for 3 months.

EFFECT: invention allows eliminating manifestations of estrogenic deficiency and neurological clinics that promotes pathology stabilisation and prevents progression of the diseases in the absence of by-effects.

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The invention relates to medicine, namely to gynecology, neurology and rehabilitation medicine, and can be used with ulterior comorbidity - dyscirculatory encephalopathy 1 degree (St) and menopausal syndrome, mild in women of perimenopausal age, allowing to obtain a therapeutic effect due to the simultaneous elimination of manifestations of oestrogen deficiency and neurological clinic.

Chronic cerebral vascular insufficiency, which include dyscirculatory encephalopathy (DE) is already one of the most frequent neurological diseases. The coincidence of the age at which most often implemented neurological disease, and menopausal syndrome (CS) lead to the combination of these nosological forms for women in perimenopause.

So far not solved the issue with this comorbidity effective and safe therapy, simultaneously influencing the state of neurological diseases and menopausal disorders.

There is a method of treatment of menopausal syndrome in women with dyscirculatory encephalopathy by hormone replacement therapy (HRT) (Emerenciana, Menopause, No. 1, 2003, p.21).

However, the known method is ineffective because the use of m is dokumentazioa treatment in the form of HRT for women with complicated KS dyscirculatory encephalopathy decides to a greater extent, the problem of climacteric while the reduction of the incidence of neurological symptoms are minor, while a high dose of Progestogens may exacerbate neurological symptoms, in addition, Progestogens, which are an integral part of combined HRT, have a negative impact, causing depression, irritability in women, which reduces the efficiency of the method.

The closest achieved technical result is a method of treatment of dyscirculatory encephalopathy using ozone (Smirnov A.A. "the Dynamics of clinical and physiological parameters in patients with dyscirculatory encephalopathy during intravenous ozone therapy". The Author Of thesis. Kida. the honey. of Sciences, Nizhny Novgorod, 1996. 24).

However, the known method has the following disadvantages in women of perimenopausal age: he does not have sufficient effectiveness in this age; does not eliminate estrogen deficiency, resulting in clinical symptoms due to estrogen deficiency, affects the quality of life of patients; has weak dopaminergic effect and thus does not address sufficiently neurological symptoms.

The authors have developed and proposed a method for the treatment of dyscirculatory encephalopathy 1 tbsp. complicated climacteric syndrome, allowing to obtain a therapeutic effect due to the simultaneous eliminated what I manifestations of oestrogen deficiency and neurological clinic, has no side effects and can be used repeatedly 2 times per year, which not only contributes to the stabilization of the disease and prevent the progression of diseases.

The technical result of the claimed invention is to improve the effectiveness of treatment dyscirculatory encephalopathy 1 tbsp. complicated climacteric syndrome, in the conditions of sanatorium or in outpatient medical care.

The technical result is achieved by conducting a course of systemic ozone therapy consisting of 5 intravenous drop infusions of ozonated 0.9% sodium chloride solution with a rate of 8-10 ml/min daily at a concentration of ozone in the physiological solution of 400 μg/l, with a single dose of ozone introduced into the bloodstream within one infusion, 160 mcg, course - 800 mcg, the duration of the procedure is 20-25 minutes, then use a drug "Klimadynon" 30 drops or 1 tablet depending on the release form every day, 2 times a day for 3 months.

The method is as follows.

The inventive method lies in the consistent application of systemic ozone therapy with the subsequent connection of the drug "Klimadynon".

Systemic ozone therapy has a multifactorial effect and has no side effects. The treatment system about what Nataraja consists of 5 intravenous drop infusions of ozonated 0.9% solution of sodium chloride, carried out daily. Ozonated physiological solution is injected into the cubital vein of the patient in the standard conditions of the treatment room with the speed of 8-10 ml/min, and the duration of the procedure is 20-25 minutes.

The saturated saline solution with ozone is carried out using an apparatus for ozone "Medozons-2". Intravenous drip 200 ml of ozonated physiological solution is carried out directly after the 15-minute barbotirovaniya sterile vial with saline ozone-oxygen mixture at a speed of gazobetona 1 l/min Calibration is performed so that the ozone concentration in the physiological solution was 400 µg/L. thus, a single dose of ozone introduced into the bloodstream within one infusion, 160 mcg, course - 800 mcg. The ozonized solution start through 1-5 min after its receipt. Immediate introduction of ozonized physiological solution due to the rapid decomposition of ozone in aqueous medium. Effects of systemic ozone therapy lasts at least 3 months. After 3 months with little effect course of systemic ozone therapy may be repeated on a background of reception of phytoestrogens.

After a course of systemic ozone therapy prescribed medication "Klimadynon". Daily dose of drugs is a "Klimadynon is 30 drops or 1 tablet, depending on the form 2 times a day for up to 6 months. By selecting the choice was made in favor of the drug "Klimadynon" selective estrogen-receptor modulator, which includes the extract component BNO 1055, selectively exerting estrogen-like effect on the Central nervous system, blood vessels, bone, and at the same time is safe against the most important target organ - the uterus. This advantage allows you to use the drug more widely in contrast to HRT, which have contraindications and side properties on target organs and require constant monitoring. Thus, the claimed method of treatment dyscirculatory encephalopathy 1 tbsp. complicated climacteric syndrome, allows to stabilize a chronic progressive form of cerebral vascular insufficiency etiology, which is traditionally denoted in the literature by the term encephalopathy, thereby to contribute to the prevention of acute cerebral vascular disease, which occurs with a high percentage of death and disability. Combination with systemic ozone therapy of phytoestrogen "Klimadynon, taking into account the unidirectional action, allows you to more quickly eliminate neurological symptoms and menopausal disorders and to reduce the period of use fitest the genes up to 3 months.

Clinical example 1: the Patient Kustova Natalya Petrovna, 48 years old, was on rehabilitation treatment in the sanatorium "Barnaul" complaining of hot flashes, repeated up to 10 times per day, insomnia (can't sleep, often waking up), fatigue, memory loss, irritability, diffuse headaches and pressing nature, aggravated by physical activity, emotional strain, heaviness in the head, periodic dizziness, confusion attention.

The diagnosis of encephalopathy I strlogname Genesis (cardiovascular, hypertensive, vertebral), slow progredient course for the syndrome of moderate cephalgia, vestibulopathy. Climacteric syndrome of mild severity. Comorbidities: hypertension stage I, polysegmental osteochondrosis.

According to the lipid was detected increased cholesterol, increased LDL, triglycerides, reduced HDL. According to the duplex scanning of the brachiocephalic arteries violation of the ICA in the distal, left PA in segment VI without violating local hemodynamics. Reduce speed parameters of blood flow in the right PA in the V4 segment. According to the test before treatment, the patient revealed relatively low short-term and visual memory,increased time to switch attention Schulte tables. According to the questionnaire mental and physical health SF-36 - impairment of quality of life, depression emotional-volitional sphere on multifactor questionnaire for the study of personality - RESINS. The results of the study of cognitive functions to ensure women corresponded predementia cognitive disorders.

Patients received a course of systemic ozone therapy, including 5 in/drip infusion of 200 ml of ozonated 0.9% sodium chloride solution. Ozonation was performed using the apparatus of Medozons-2" with the concentration of ozone in the gas phase 400 ág/l (single dose was 160 μg, course - 800 mcg), as well as drug Klimadynon", which was adopted on 1 tablet 2 times a day during the stay at the resort and then recommended to take up to 6 months.

After the treatment, the patient noted improvement in health, hot flashes were observed very rarely, ceased to bother headaches, dizziness, normalized sleep, improved mood, which was significantly confirmed by neuropsychological tests as well as ultrasound and laboratory methods. Showed a significant improvement of the shape memory test "Memory images", short-term memory test on the Memory on numbers", "Schulte Tables". Test RESINS significant decrease in the level of hypochondria, anxiety, what confirmed Alstom about reducing irritability, anxiety, fatigue, increased vitality. Also, the results of the questionnaire mental and physical health SF-36 revealed a significant improvement in the quality of life of the patient on the following parameters: "physical role", "General health", "vitality", "mental health", "social activity", "physical activity". In addition to this, there has been significant normalization of the lipid profile, and according to a duplex scan of the brachiocephalic arteries was significantly increased perfusion reserve cerebral blood pool of the left ICA.

Clinical example 2: the Patient strigini Nadezhda I., 52, was on rehabilitation treatment in the sanatorium "Barnaul" complaining of headaches, mainly in the frontal and temporal areas, whining character, aggravated by stress, physical exertion, dizziness when changing position of the body, insomnia (can't sleep, often waking up, sensitive, superficial sleep, in the morning feeling exhausted), lower mood, irritability, anxiety, memory loss, fatigue, weakness, hot flashes up to 8-10 times a day, increased sweating.

The diagnosis of encephalopathy I strlogname Genesis (vascular, ateroskleroticheskoe, vertebral), slow PR is gradiente for the syndrome of moderate cephalgia, vestibulopathy. Climacteric syndrome of mild severity. Accompanying diseases: osteochondrosis of the cervical and lumbar spine.

According to the lipid was detected increased cholesterol, increased LDL, decreased HDL. According to the duplex scanning brachiocephalic artery atherosclerosis GCA, asymmetry of blood flow in the PA segment VI (S>D), V4 segment (D>S), amiodarone GCA, mainly on hypotonic type, asymmetry of blood flow about JW (D>S). According to the test before treatment, the patient revealed relatively low short-term memory, increased time to switch attention Schulte tables. According to the questionnaire mental and physical health SF-36 - impairment of quality of life, symptoms, reflecting a tendency of constant anxiety, depression, the same effect as "illness" on multifactor questionnaire for the study of personality - RESINS. The results of the study of cognitive functions to ensure women corresponded predementia cognitive disorders.

Patients received a course of systemic ozone therapy, comprising 5/drip infusion of 200 ml of ozonated 0.9% sodium chloride solution. Ozonation was performed using the apparatus of Medozons-2" with the concentration of ozone in the gas phase 400 µg/l dose was 160 mg, course - 800 mcg), as well as drug Klimadynon", which was adopted on 30 drops 2 times a day for 21 days of stay at the resort.

After the treatment, the patient noted improvement in health, decreased headaches were less frequent and less intense, were independently without analgesics, dizziness not to be disturbed, normalized sleep was deep and extended), improved mood, left the anxiety and hot flushes, sweating, which was significantly confirmed by neuropsychological tests as well as ultrasound and laboratory methods. Showed a significant improvement of the shape memory test "Memory images", short-term memory test on the Memory on numbers", "Schulte Tables". Test RESINS significant decrease in the level of hypochondria, anxiety, depression, hysteria, indicating a decrease in internal tension, reducing anxiety, and increasing activity, cheerfulness, reducing irritability and less fatigue from psychological stress. Also, the results of the questionnaire mental and physical health SF-36 revealed a significant improvement in the quality of life of the patient on the following parameters: "physical pain", "General health", "vitality", "mental health, "with the social activity", "physical activity". In addition to this, there has been significant normalization of the lipid profile, and according to a duplex scan of the brachiocephalic arteries was significantly increased reactivity MK to hypercapnia from 29 to 53%, recovered vascular tone in the MCA.

Thus, the claimed method of treatment dyscirculatory encephalopathy 1 tbsp. complicated climacteric syndrome, allows to stabilize a chronic progressive form of cerebral vascular insufficiency etiology, which is traditionally denoted in the literature by the term encephalopathy, thereby to contribute to the prevention of acute cerebral vascular disease, which occurs with a high percentage of death and disability. Combination with systemic ozone therapy of phytoestrogen "Klimadynon, taking into account the unidirectional action of non-pharmacological methods, allows you to more quickly eliminate neurological symptoms and menopausal disorders and to reduce the period of use of phytoestrogens to 3 months, so as to 6 months in patients was observed minor symptoms due to (MMI-14.5 points).

The inventive method of treatment can be applied in outpatient, inpatient, sanatorium treatment conditions. Due to the lack of side effect is in the ozone and phytoestrogens treatment can be used up to 2 times during the year.

A method for the treatment of dyscirculatory encephalopathy 1-St degree, complicated climacteric syndrome, by ozone, characterized in that undergo systemic ozone therapy consisting of 5 intravenous drop infusions of ozonated of 0.9%sodium chloride solution with a rate of 8-10 ml/min daily at a concentration of ozone in the physiological solution of 400 μg/l, with a single dose of ozone introduced into the bloodstream within one infusion, 160 mcg, course - 800 mcg, and then use the drug "Klimadynon" 30 drops or 1 tablet depending on the dosage form daily 2 times a day for 3 months.