RU2821747C1 - Method of treating endometriosis degree ii - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to gynaecology and physiotherapy, and concerns methods of restoring energy balance of pelvic organs. When treating patients with endometriosis of II degree at the stage of subsiding aggravation, hormone therapy, sanatorium-and-spa treatment, physiotherapeutic procedures are prescribed. Above patients undergo photophoresis of succinic acid from the preparation "Alesorb enterosorbent gel" in the upper one-third of the sternum, above the pubis and in the inguinal triangles on both sides. Wavelength of the laser radiation is 0.89 mcm. Exposure frequency is 1,000 Hz. Exposure technique is contact and labile. Procedure is carried out in one day in four fields for 6 minutes per each field. Total time of procedure is 24 minutes. Next day, magnetophoresis of 1.5% sodium iodide is performed. Inductors are placed in a projection of the lower thoracic and lumbosacral spine. Alternating magnetic field with frequency of 20 Hz and induction of 20 mT is used. Procedures are carried out for 20 minutes. Magnetophoresis and photophoresis procedures are alternated day by day. Therapeutic course of each factor makes 10–12 procedures, depending on the patient's condition. During 6–7 months these patients suffered a normal pregnancy that ended in childbirth.

EFFECT: method provides higher fertility and higher probability of pregnancy.

1 cl, 2 ex

Description

The invention relates to medicine, in particular to gynecology and physiotherapy, and concerns methods for restoring the energy balance of the pelvic organs in patients with endometriosis. The effect is carried out by photophoresis of succinic acid. Areas of influence: in the upper third of the sternum, above the pubis and in the inguinal triangles on both sides. Impact parameters: laser radiation wavelength 0.89 microns, frequency 1000 Hz. The procedures are carried out in a contact and labile manner. Apply one day successively to four fields, 6 minutes per field. The total procedure time is 24 minutes. The next day, magnetophoresis is performed with a 1.5% sodium iodide solution. Inductors are installed in the projection of the lower thoracic and lumbosacral spine. Characteristics of an alternating magnetic field: frequency 20 Hz, induction 20 mT, procedure time - 20 minutes. Magnetophoresis procedures are alternated daily with photophoresis. The course of treatment for each factor is 10-12 procedures, depending on the patient’s condition.

A method of treating endometriosis is known from the prior art, including exposure to low-frequency pulsed currents (diadynamic, sinusoidal modulated, fluctuating, interference, rectangular currents - electrotranquillization), transcutaneous electrical neurostimulation, for small doses of drugs, the treatment method is used on the 5-7th day of the menstrual cycle, the aftereffect period during treatment with pulsed currents is at least 2-4 months [Bestaeva A.E. Balneophysiotherapy of endometriosis at the Pyatigorsk resort // Scientific search, No. 2.2 2015. P. 15-16].

Also known from the prior art is a method of treating endometriosis, in which iodine-bromine waters are used as an active agent, with a concentration of iodine of at least 10 mg/dm ³ and bromine of at least 25 mg/dm ³ , in the form of baths and vaginal irrigations in indifferent thermal conditions (33-36°C) [Bestaeva A.E. Balneophysiotherapy of endometriosis at the Pyatigorsk resort // Scientific search, No. 2.2 2015. P. 15-16]. The aftereffect period of such baths is up to 4 months.

Also known from the prior art is a method for treating endometriosis, which uses low-frequency magnetic and electromagnetic fields with different characteristics - magnetotherapy (constant, alternating, pulsating, pulsed, traveling magnetic field), pulsed electromagnetic field. They use both local (on the pelvic area) and general magnetic therapy, which give a general sedative effect [Bestaeva A.E. Balneophysiotherapy of endometriosis at the Pyatigorsk resort // Scientific search, No. 2.2 2015. P. 15-16].

The disadvantages of the above treatment methods are their low effectiveness and lack of influence on the body’s energy balance.

A method for treating endometriosis is also known from technology [Akhkubekova N.K., Tereshin A.T., Bestaeva A.E. Correction of psycho-emotional and vegetative-vascular disorders in patients with endometrioid disease under the influence of complex radon, laser and pharmacotherapy. // Physiotherapy, balneology and rehabilitation. 2019; 18(3): 161-165. DOI: https://doi.org/10.17816/1681-3456-2019-18-3-161-165], where the 1st, main group (MG; 50 people) received radon, laser and pharmacotherapy with melaxen. The patients received RT at the Upper Radon Hospital in Pyatigorsk in the form of general baths, gynecological irrigations, microenemas with a radon concentration of 40 nCi/l, a temperature of 36°C, an exposure of 15 minutes, and 10 procedures per course. Laser therapy was prescribed to the lower abdomen in an autoresonance mode with a variable frequency programmed into the structure of the used laser device “AZOR 2K” from 10 to 1500 Hz (regardless of the frequency characteristics of the human body); radiation wavelength 0.89 microns; power 10 W; exposure 4.5 min; in one day; course of treatment - 10 procedures. If the days of taking therapeutic factors coincided, RT was carried out no earlier than 2-3 hours after the end of radon procedures. Melaxen was prescribed 3 mg (1 tablet), 1 time per day, 30-40 minutes before bedtime, during the entire period of the patient’s stay in the clinic (21 days).

The disadvantage of the method is its focus only on eliminating existing functional disorders of the vegetological supply of the body and the syndrome of psycho-emotional stress, which is a secondary manifestation of the complex changes occurring in the body of patients with endometriosis, and the lack of influence on the energy balance of the body.

Also known from the prior art is a method of treating genital endometriosis using laser acupuncture, which includes exposure to organ-specific points of the vagina with a helium-neon laser with a frequency of 1-100 Hz, a power density of 10-15 mW/cm ² , and a duration of 15-20 seconds. At the same time, laser aculuncture of corporal and auricular acupuncture points of general action is carried out in parallel for a course of 6-8 sessions, carried out with an interval of one day. [RU No. 98121306, 09/10/2000].

The disadvantage of this method of treatment is the lack of effect on the energy balance of the body.

The closest analogue of the claimed invention is a method for the treatment of genital endometriosis [RF Patent No. 2073534, 20.02.1997], including iodine-bromine balneotherapy in the form of vaginal irrigations and general baths, characterized in that vaginal magnetophoresis is performed with a 12.5% solution of 17-hydroxyprogesterone capronate in 30% dimexide with a magnetic induction of 20-35 mT, pulsating current with a frequency of 50 Hz in continuous mode for 1-2 procedures and intermittent for subsequent ones lasting 10-20 minutes every other day with balneotherapy for a course of 8-10 procedures each.

The disadvantage of this method of treatment is the lack of effect on the energy balance of the body.

Thus, there is a need for a method for treating endometriosis without the above disadvantages.

The technical result of the claimed invention is to restore the energy balance of the pelvic organs, increase fertility and increase the likelihood of pregnancy.

The technical result is achieved due to the fact that the method of restoring the energy balance of the pelvic organs includes hormone therapy, followed by sanatorium treatment and physiotherapeutic procedures that can be carried out for patients with stage II endometriosis, in the stage of subsiding exacerbation, characterized in that patients undergo succinic acid photophoresis , in the areas of the upper third of the sternum, above the pubis and in the inguinal triangles on both sides, wavelength of laser radiation 0.89 microns, frequency 1000 Hz, contact and labile exposure methods, the procedure is carried out on one day sequentially in four fields, 6 minutes per field , the total time of the procedure is 24 minutes, the next day, magnetophoresis is carried out with a 1.5% sodium iodide solution, installing the first inductor in the projection of the lower thoracic and the second inductor in the lumbosacral spine, using an alternating magnetic field, frequency 20 Hz, induction 20 mTl, the procedure time is 20 minutes, magnetophoresis procedures are alternated daily with photophoresis, the course of treatment for each factor is 10-12 procedures, depending on the patient’s condition.

The method is carried out as follows. Photophoresis of succinic acid, contained, for example, in Alesorb Enterosorbent Gel, can be carried out using any device; we used the Mustang 2000 laser therapy device. At the same time, “Alesorb enterosorbent gel” containing succinic acid is applied to the skin in the following fields.

The first field of influence is located in the upper third of the sternum in the projection of the thymus, which is one of the central organs of the immune system, which has integral connections with its other components - hematopoietic and neuroendocrine. It is known that dysregulation of the neuroendocrine system, which is the main regulator of energy balance, plays an important role in endometriosis.

The second field is located above the pubis - this is the projection of the ovaries and uterus, in which hypoxia develops as a result of the disease. It is known that during hypoxia, the mitochondrial respiratory chain cannot accept hydrogen from any substrate other than succinic acid. As a result of the synergy of laser radiation and succinic acid, peripheral blood flow improves and pain decreases, the supply of oxygen improves, without which the formation of bioenergy is impossible. The influence on the third and fourth fields is carried out in the area of the inguinal triangles on both sides, where the lymph nodes are located, into which part of the lymph flows from the pelvic organs. This enhances lymphatic drainage and the outflow of pathological metabolites. It is known that succinic acid affects not only lymphopoiesis, but also phosphorus-calcium metabolism, as well as muscle tone, reducing bleeding during metrorrhagia, which is typical for patients with endometriosis. Excessive blood loss increases anaerobic glycolysis, which also worsens energy balance.

Impact parameters: wavelength of laser radiation - 0.89 microns, which corresponds to the infrared spectrum of radiation, which penetrates into the depth of tissue by 4-5 cm, with a frequency of 1000 Hz. A contact and labile method of exposure is used, the speed of movement of the emitter is 0.5-1.5 cm/s. Each procedure is carried out on one day in succession with four fields of 6 minutes for each field on one day, the total procedure time is 24 minutes.

Magnetophoresis procedures can be carried out using any magnetic therapy device, but we chose the Polyus-2 device.

The next day, magnetophoresis is carried out with a 1.5% sodium iodide solution as follows. Two gauze wipes are moistened with this solution, on which magnetic inductors are placed in contact. In this case, to normalize the functioning of the neuroendocrine system, the first inducer is placed in the projection of the lower thoracic spine, where the adrenal glands are located. In order to detoxify the woman’s body, the second inductor is placed in the lumbosacral spine, where the celiac lymph nodes are located, collecting lymph from the pelvic organs. Here we influence the trunk of the sympathetic division of the autonomic nervous system, which innervates the uterus and ovaries.

Among magnetic fields, the most interesting is the alternating magnetic field, which, according to scientific data, has the greatest analgesic effect. For magnetophoresis, the continuous mode that we used in the proposed method will be more effective, since in the intermittent mode there is a pause during which the drug will not be administered. It is known from the literature that the biotropic parameters of magnetic fields include a frequency of 20 Hz and an induction of 20 mT, which we used in this method. The duration of exposure is 20 minutes. At the same time, magnetophoresis procedures alternate days with photophoresis, and the course of treatment is 10-12 procedures for each factor, depending on the patient’s condition.

It is known that magnetophoresis can be used in the early stages - from the first days of the development of an active inflammatory process, as well as with a pronounced exudative component. It is important that the magnetic field does not destroy drugs and penetrates more deeply than other physical factors. At the same time, iodine preparations reduce estrogenic activity, against the background of which endometriosis occurs. The procedure creates an increased concentration of iodine in the endometrium, which reduces the expression of nuclear steroid intracellular receptors for sex steroids, regulates cyclic changes in hyperplastic pathology, which can be attributed to the non-hormonal correction of disorders of the reproductive system.

Clinical examples

Example 1. Patient “K”, 40 years old. She was observed with a diagnosis of genital endometriosis, stage II, in the stage of subsiding exacerbation (N80.0 Endometriosis of the uterus, adenomyosis). Complaints of algodismenorrhea, as well as almost constant pain in the pelvic area. The pain subsided somewhat after taking analgesics, metrorrhagia occurred periodically, and dyspareunia often occurred. Ill for 5 years. Concomitant diseases: chronic tonsillitis, subcompensation; stage I hypertension, subcompensation. Patient “K” had no history of pregnancy. The diagnosis was confirmed by clinical and ultrasound examination. The examination, among other things, revealed that the concentration of erythrocyte ATP, which reflects the energy balance, was reduced to 0.51 mmol/l before treatment.

The patient was treated according to the proposed method. At the same time, the treatment was carried out in a physiotherapy room. The patient was lying on the couch, her eyes were protected from laser radiation with special glasses. “Alesorb enterosorbent gel” containing succinic acid was applied to the skin. The first field of influence was located in the upper third of the sternum, the second field in the area above the pubis, and the third and fourth fields in the region of the inguinal triangle on both sides. The emitter of the laser device was placed in contact and moved labilely in the areas of the applied gel, at a speed of 0.5-1.5 cm/s, for 6 minutes in each field. The total procedure time was 24 minutes. The laser radiation parameters corresponded to: wavelength 0.89 µm, at a frequency of 1000 Hz. The course of treatment is 10 procedures, taking into account the presence of concomitant diseases.

The next day, the magnetophoresis procedure was performed. To do this, two gauze napkins were soaked in a 1.5% sodium iodide solution and placed in the projection of the lower thoracic and lumbosacral spine, where the first and second magnetic inductors were then placed in contact. In this case, an alternating magnetic field was used, with a frequency of 20 Hz and an induction of 20 mT. The procedure was carried out on both fields for 20 minutes. Magnetophoresis procedures were alternated daily with photophoresis procedures. The course of treatment for each factor was 10 procedures, due to the presence of concomitant diseases.

After treatment, the clinical condition of patient “K” improved, including the concentration of erythrocyte ATP after treatment increased to 0.62 mmol/l.

Example 2. Patient “S”, 32 years old. Diagnosis of genital endometriosis, stage II, in the stage of subsiding exacerbation (N80.0 Endometriosis of the uterus, adenomyosis). Complaints of pain in the pelvic area during menstruation, which decreased after taking analgesics, metrorrhagia periodically occurred without the development of anemia, and dyspareunia also sometimes occurred. Ill for 3 years. The patient had no pregnancies. History of frequent colds. The diagnosis was confirmed by clinical and functional studies, including the concentration of erythrocyte ATP before treatment was reduced to 0.54 mmol/l.

The patient was treated according to the proposed method. The patient was in the physiotherapy department, in compliance with safety requirements when working with laser radiation. To carry out the photophoresis procedure, “Alesorb enterosorbent gel” was applied to the skin in the upper third of the sternum, where the first field was located, as well as in the area of the second field above the pubis. Then the same gel was applied to the third and fourth fields in the area of the inguinal triangle on both sides. The emitter of the laser device was placed in contact and moved labilely in the areas of the applied gel, at a speed of 0.5-1.5 cm/s, for 6 minutes in each field. The total procedure time was 24 minutes. The laser radiation parameters corresponded to a wavelength of 0.89 µm at a frequency of 1000 Hz.

The next day, magnetophoresis was carried out with a 1.5% sodium iodide solution in the indicated areas, as in the previous example. Magnetophoresis procedures were alternated daily with photophoresis, the course of treatment with each factor was 12 procedures. After treatment, the clinical condition of patient “C” improved, including the concentration of erythrocyte ATP after treatment increased to 0.65 mmol/l.

After the course of treatment, both women noted an increase in the energy balance in the pelvic organs, and within 6-7 months pregnancy occurred, which proceeded normally and ended in childbirth.

The technical result of the claimed invention is to restore the energy balance of the pelvic organs, increase fertility and increase the possibility of pregnancy.

Claims (1)

A method of treating stage 2 endometriosis, characterized in that patients undergo succinic acid photophoresis in the areas of the upper third of the sternum, above the pubis and in the inguinal triangles on both sides, with a laser radiation wavelength of 0.89 microns, a frequency of 1000 Hz, contact and labile exposure methods, the procedure is carried out on one day sequentially with four fields of 6 minutes per field, the total procedure time is 24 minutes, the next day magnetophoresis is carried out with a 1.5% sodium iodide solution, installing the first inductor in the projection of the lower thoracic and the second inductor in the lumbosacral parts of the spine, an alternating magnetic field with a frequency of 20 Hz, an induction of 20 mT is used, the procedure time is 20 minutes, magnetophoresis procedures are alternated daily with photophoresis, the course of treatment for each factor is 10-12 procedures.