RU2353344C1 - Treatment method for patients suffering from chronic pyelonephritis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, urology, physiotherapy and to be used in the patients suffering from chronic pyelonephritis accompanied with chronic prostatitis and chronic cystitis. The method involves taking the mineral water of the Slavjanovsky source dosed 3 - 5 ml per kg of body weight, combined with carbonic mineral baths 35-37°C for 15 minutes 3 times a day, № 8-10, mud "panties" at 40-42°C within 30 minutes to 1.5 hours, prostate massage № 8-10, additionally 50-60 minutes later followed with electropulse therapy combined with exposure to laser magnetic rays. Electropulse therapy involves low-frequency, low-voltage pulse current with a spherical unipolar electrode. Exposure is contact, labile, clockwise and located at skin projection of ascending, transverse and descending large intestine at frequency 30.2 Hz within 8-10 minutes. The course of treatment is 10-12 procedures.

EFFECT: method improves life quality of the patients both in latent phase of inflammatory process, and in mild and moderate active chronic process.

2 ex, 2 tbl

Description

The invention relates to the field of regenerative medicine, in particular urology, physiotherapy, and can find application in chronic pyelonephritis with concomitant pathology: chronic cystitis and chronic prostatitis.

Chronic pyelonephritis is the most urgent problem of modern nephro-urology. In recent years, the incidence of chronic pyelonephritis has increased markedly, which is associated not only with improved diagnostics, but also with increased virulence of microbes, increased their resistance to antibiotics and other antimicrobial agents. The number of patients with chronic pyelonephritis with an unfavorable, often relapsing course, complicated by its forms increased in combination with arterial hypertension and chronic renal failure. The worsening of the condition of this category of patients is facilitated by the addition of diseases such as chronic cystitis and chronic prostatitis. At the same time, the inflammatory process develops as a secondary process (the infection can penetrate the renal pelvis and kidney through the intermuscular crevices of the ureter or be introduced by vesicoureteral and pyelovenous refluxes).

In the treatment of patients with chronic pyelonephritis, drug treatment with various antibacterial drugs is used (biseptol 480, gentamicin, nitroxaline, phytolysin, furagin, ciprolet, etc.); immunomodulators (echinacea, polyoxidonium preparations); adaptogens and biostimulants (tincture of ginseng, eleutherococcus); means that improve microcirculation, etc. (Medicines. / Under the editorship of Mashkovsky MD - Kharkov: Torsing, 1997, v. 1, 2).

It is known that, along with medical, physiotherapeutic, and surgical methods of treating patients with chronic pyelonephritis, sanatorium therapy plays an important role, aimed at restoring and normalizing the activity of the main functional systems, mobilizing protective and compensatory-adaptive mechanisms (Yu.S. Osipov, N.V. Efimenko, 2003).

There is also known a method of treating patients with chronic pyelonephritis with chronic prostatitis, in which a course of physiotherapy is prescribed: UHF therapy, Inductothermy, Erytherapy, Laser therapy (Physiotherapy. / Ed. Osadchuk MA et al. S .: Medical University, 1999, p. 210-213). The disadvantages of this method are the low effectiveness of the treatment, many contraindications, the occurrence of side effects, short-term remission.

There is also a method of treating patients with chronic pyelonephritis with chronic prostatitis by taking mineral water of the Slavyanovsk source of the Zheleznovodsk type in a dose of 3-5 ml per 1 kg of weight 3 times a day, mineral baths at a temperature of 37 ° C, 15 min, No. 8-10, prostate massage No. 8-10, ultrasonic intrarectal influences daily (Balneology and physiotherapy / Edited by Bogolyubov VM - M .: Medicine, 1985, v.2, s.268-270, s.274-280). The disadvantages of this method is the low effectiveness of the treatment, which consists in insufficient improvement of erectile function, increased libido.

The closest in technical essence to the proposed method is a method of treating patients with chronic pyelonephritis with chronic prostatitis, which consists in taking mineral water from the Slavyanovsky source at a dose of 3-5 ml per 1 kg of weight 3 times a day, carbon dioxide mineral baths at a temperature of 35-37 ° C for 10-15 minutes, mud "panties" with a temperature of 40-42 ° C for 10-12 minutes with mud rectal swabs with a temperature of 40-42 ° C for 30-90 minutes, every other day, prostate massage No. 8-10 for 1-2 min and ultrasound exposure ktalno, optionally 20-30 min after exposure to the ultrasonic micro enema administered with a 10% solution of "Prostanorm" 100-120 ml daily, 8-10 per treatment procedures (patent №2212220 on 20 September 2003 YG). The disadvantages of this method is the presence of contraindications to Prostanorm in patients with complicated forms of chronic pyelonephritis, especially in patients with a single kidney.

The technical result of the proposed method for the treatment of patients with chronic pyelonephritis with chronic prostatitis and chronic cystitis is to increase the effectiveness of treatment of complicated forms of pyelonephritis, increase the period of remission of the disease and the possibility of its use in patients with a single kidney.

The specified technical result is achieved by the fact that a patient with chronic pyelonephritis with chronic cystitis and chronic prostatitis undergoes a comprehensive spa treatment and an additional 50-60 minutes after the balneo-mud procedures are prescribed electropulse therapy in combination with magnetic laser irradiation, which is carried out by pulsed electric current of low frequency , low voltage using a spherical unipolar electrode contact, labile over the skin projection of the ascending, transverse colic, nis of the colon, clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a moderate painless vibration under the electrode is felt for 8-18 minutes (with an increase of 1 minute with each procedure), daily, for the course of treatment - 10-12 procedures.

Method description

The method is as follows. The patient is prescribed the intake of mineral water of the Slavyanovsk source of the Zheleznovodsk type in a dosage of 3-5 ml per kg of body weight, three times a day 30-40 minutes before eating; carbonic mineral baths are prescribed every other day, at a temperature of 35-37 ° C for 10-15 minutes; mud “panties” and rectal tampons with a temperature of 40-42 ° С (duration: “cowards” - 10-15 min, rectal tampons 30-90 min), which are prescribed on the same day and alternate with mineral baths; daily massage of the prostate No. 8-10 is prescribed for 1-2 minutes and after these procedures, after 50-60 minutes, they carry out electro-pulse therapy in combination with magnetic laser radiation from the hardware-software complex KAP-ELM-01 Andro-Gin, which consists when exposed to pulsed electric current of low frequency, low voltage using a spherical unipolar electrode, contact, labile over the skin projection of the ascending, transverse colon, descending sections of the colon clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a sensation of a moderately pronounced painless vibration under the electrode for 8-18 minutes (with an increase of 1 minute with each procedure), 10-12 daily procedures (the second electrode (passive) is located on the patient’s arm).

The method is illustrated by the above observations.

Example No. 1.

Patient L., 43 years old.

Diagnosis: Chronic pyelonephritis in remission. Chronic prostatitis in the phase of incomplete remission.

Before treatment, he complained of dull pain in the lower back, lower abdomen, rapid urination, aggravated by hypothermia. Sick for 10 years. The onset of the disease is associated with acute respiratory disease, exacerbations 1-2 times a year are associated with hypothermia. Repeatedly conducted treatment inpatient and outpatient. Upon admission to the clinic objectively: a positive symptom of striking, tenderness of the prostate during palpation, tuberosity of its surface and asymmetry of the lobules. According to a clinical blood test - an increase in ESR, in the general analysis of urine - leukocyturia, slight proteinuria. In the secretion of the prostate is an increased number of leukocytes, a small amount of lecithin grains in secret and a three-glass sample.

Conducted spa treatment: mud “underpants”, rectal tampons, intake of min. water inside and out (in the form of baths), prostate massage No. 8, after 50 minutes was exposed to pulsed electric current of low frequency, low voltage in combination with magnetic laser irradiation using a spherical single-pole electrode, contact, labile over the skin projection of the ascending, transversely oblique , descending sections of the colon clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until you feel a moderately pronounced, painless vibration under the electrode for 8-18 minutes (with an increase in duration and for 1 minute with each procedure), 12 daily procedures.

The treatment was well tolerated. After treatment, there was a significant decrease in leukocyturia, normalization of the urine reaction, stabilization of ESR, blood pressure, dysuric phenomena disappeared, pain decreased, the symptom of tacking from a sharply positive became negative on day 8-10 of treatment. The soreness of the prostate during palpation was significantly reduced, the parenchyma became more elastic, less tuberous. In prostate secretion, the number of leukocytes decreased from 15-18 to 8-10 in the field of view (s / s), the amount of the lecithin enzyme increased from insignificant to a large number, the crystallization phenomenon changed from 3 to 1 degree. In addition, the performance of the GDV diagrams (gas-discharge visualization) of the biofield improved.

Thus, after a course of spa treatment using electropulse therapy in combination with magnetic laser radiation from the hardware-software complex KAP-ELM-01 Andro-Gin, a positive clinical effect is noted, the activity of the inflammatory process decreased.

Example 2

Patient K., 32 years old.

Diagnosis: Chronic pyelonephritis of the only left kidney in the phase of incomplete remission. Chronic cystitis and chronic prostatitis in the phase of incomplete remission.

Sick for 7 years, associates the onset of the disease with hypothermia (operated 2 years ago). Notes pain in the lower back, suprapubic region, decreased potency. Examination revealed cystitis and prostatitis. Previously, he took uroantiseptics, enzymatic preparations, plant diuretics. The following treatment was carried out in the Zheleznovodsk clinic: mud “underpants”, rectal tampons, min. water inside and out (in the form of baths), massage of the prostate No. 8, after 60 minutes, was exposed to pulsed electric current of low frequency, low voltage in combination with magnetic laser irradiation using a spherical single-pole electrode, contact, labile over the skin projection of the ascending, transverse-oblique , descending sections of the colon clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until you feel a moderately pronounced, painless vibration under the electrode for 8-18 minutes (with an increase in duration and for 1 minute with each procedure), 10 daily procedures.

The treatment was well tolerated. After the treatment, pain in the suprapubic region, lower back decreased. Laboratory parameters of urine and prostate secretion improved (the number of leukocytes decreased from 20-25 to 8-10 in the field of view, lecithin grains increased from a small to a larger number).

According to this method, two groups of patients (Tables 1 and 2) with a total number of 100 people aged 20 to 55 years were monitored at the Zheleznovodsk Clinic branch of the FGI Pyatigorsky Research Institute of Roszdrav. All patients suffered from chronic pyelonephritis, including a single kidney, in combination with chronic cystitis and chronic prostatitis for 10 years, had frequent relapses of the disease with exacerbation of severe and moderate severity. The clinical picture of the disease was characterized by the presence of pain (100%), hypertension (86%), dysuric (97%) syndromes.

To determine the effectiveness of electric pulse therapy in combination with magnetic laser irradiation from the KAP-ELM-01 Andro-Gin hardware-software complex, the patients were divided into 2 groups (50 people each), one of which (control) received mineral water for indoor and outdoor use, mud “pants” and rectal tampons at a temperature of 40-42 ° C, ultrasonic intrarectal influences daily (1 LC), the other (main) additionally received electropulse therapy in combination with magnetic laser radiation, 1 2 daily procedures (2 LC). The distribution of patients according to clinical indicators in the main and control groups was representative.

In a comparative assessment of treatment results in the main and control groups, it was noted that at the end of the course of spa therapy there was a significant decrease in leukocyturia in 97.9% of patients (P <0.05), normalization of the urine reaction in 95.9% (P <0, 01), ESR stabilization in 97.7% (P <0.05), blood pressure in 75% (P <0.01). In 100% of patients, dysuric phenomena disappeared (P <0.01), pain syndrome decreased in 92% (P <0.05). An increase in the content of lecithin grains in the main group occurred in 68% of patients against 44% in the control (P <0.05). Soreness of the prostate during palpation was significantly reduced in 94% (P <0.05), the symptom of sticking from a sharply positive became negative already on the 8-10th day of treatment in 96% (P <0.01).

As for the syndromic analysis, the highest efficiency was observed in patients of group II who received physiotherapy along with balneotherapy, and amounted to 93.2% in comparison with patients in the control group, 72.6%.

The dynamics of the main clinical indicators under the influence of complex spa therapy in this category of patients, depending on the applied medical complex, is reflected in table 1.

Table 1.
The dynamics of the main clinical indicators in patients with chronic pyelonephritis with chronic cystitis and chronic prostatitis, depending on the treatment complex used Indicator Patient groups I LC (control) (n = 50) II LC (main) (n = 50) The number of patients with abs. (%) % improvement The number of patients with abs. (%) % improvement R Pain syndrome

72

92 <0.05 Muscle tension of the anterior abdominal wall

80

97.9 <0.05 Dysuria

62.5

one hundred <0.01 Positive Striking Syndrome

67.5

96 <0.01 Edema syndrome

68.6

92.9 <0.05 Hypertension syndrome

47.7

75 <0.01 Palpation tenderness

67.5

94 <0.01 Note: the numerator indicates the number of patients with a deviated indicator before treatment, in the denominator - after spa therapy.

Thus, the proposed method leads to a decrease in the activity of the inflammatory process in the kidneys and urinary tract and prostate gland (Tables 1 and 2), the restoration of impaired urodynamics of the urinary tract and an increase in the efficiency of renal blood flow. Therefore, combination therapy with resort and physiotherapeutic factors is 15-20% more effective than the known methods and is indicated for patients with primary often recurring pyelonephritis with chronic prostatitis and chronic cystitis both in the latent phase of the inflammatory process and in the detection of activity of the chronic process of mild and moderate.

Table 2.
Dynamics of the main functional indicators in patients with chronic pyelonephritis with chronic cystitis and chronic prostatitis, depending on the treatment complex used Indicator Patient groups I LC (control) (n = 50) II LC (main) (n = 50) The number of patients with abs. (%) % improvement The number of patients with abs. (%) % improvement R Urine reaction

40

95.9 <0.01 Change in specific gravity

82.5

one hundred <0.05 Oliguria

72.9

95.7 <0.05 Proteinuria

75

87.8 <0.05 Leukocyturia (pyuria)

75.7

97.9 <0.05 Micro and macro hematuria

44,4

88.4 <0.01 Blood urea

65

97.7 <0.01 Blood creatinine

73.3

90.5 <0.05 Minute diuresis

74,4

92.8 <0.05 Concentrator, Index

67.6

86 <0.05 Filtration

73.5

one hundred <0.01 Reabsorption

79,4

86.6 <0.05 Hemoglobin

64

93.1 <0.01 Leukocytosis

45

one hundred <0.01 Toxic white blood cell count

fifty

89.7 <0.01 ESR increase

70

97.7 <0.05 Total protein

63,2

87.5 <0.05 Protein fractions Globulin a ₂

44.8

90,4 <0.01 Note: the numerator indicates the number of patients with a deviated indicator before treatment, in the denominator - after spa therapy.

The proposed method contributes to a more rapid relief of inflammatory activity, lengthening the phase of remission and a quick return of the patient to professional activities, in connection with which the quality of life of the patient is significantly improved, and the economic costs of treating the disease are reduced.

Claims (1)

A method for the treatment of chronic pyelonephritis in patients with chronic prostatitis and chronic cystitis, including the intake of mineral water from the Slavyanovsky source at a dose of 3-5 ml per kg of body weight, 3 times a day, carbon dioxide mineral baths 35-37 ° C, 15 min, No. 8-10 , mud “panties” at 40-42 ° C from 30 minutes to 1.5 hours, prostate massage No. 8-10, characterized in that the patient is given a comprehensive spa treatment and, in addition, 50-60 minutes after the balneotherapy, mud procedures are prescribed electropulse therapy in combination with magnetic laser irradiation, which is carried out with a pulsed electric current of low frequency, low voltage, using a spherical unipolar electrode, contact, labile above the skin projection of the ascending, transverse colon, descending sections of the colon clockwise (in the direction of peristalsis), with a frequency of 30.2 Hz until a moderate , painless vibration under the electrode, for 8-10 minutes, with an increase of 1 minute with each procedure, daily, for a course of 10-12 procedures.