RU2113852C1 - Method to treat chronic candidous vulvovaginitis - Google Patents

Abstract

FIELD: medicine, gynecology. SUBSTANCE: it is necessary to conduct a syringing with 3-% protargol solution with subsequent introduction of finely divided tablet of nistatin preparation by spraying it onto vaginal walls, in the evening it is recommended to conduct a syringing with 5-% sodium hydrocarbonate solution. EFFECT: higher efficiency to conduct a local treatment of candidous vulvovaginitis at the background of stimulation of nonspecific body resistance in female youngsters.

Description

 The invention relates to medicine, namely to gynecology, and can be used to treat chronic vulvovaginitis in girls and adolescent girls (girls).

 In recent years, researchers have increased interest in the problem of genital candidiasis, which is explained by the increased number of patients with candidiasis, as well as insufficiently studied pathogenesis of the disease and the lack of highly effective therapeutic agents [1].

 The increase in the incidence of genital candidiasis is explained on the one hand by the significant prevalence of patients with immunodeficiency, and on the other hand, by the lack of sufficiently effective drugs that meet modern requirements [2].

 Therapy of genital candidiasis is long, ineffective, relapses are frequent, which is mainly due to the limited selection of specific therapeutic agents [3].

 A known method of treating candida vulvovaginitis with a single application of 150 mg of diflucan can lead to side effects such as skin itching, nausea, swelling of the eyelids and lips [4].

 In patients with fungal infections, severe immune deficiency was detected [5]. It is also known that immunity disorders favor candidal calpites [6].

 Physiotherapeutic methods of candidiasis vulvovagenitis are not widely used [7].

 The treatment methods used to increase the reserve capacity of the body with gonovaccine, perogenal [8] by the generally accepted method are unacceptable for the treatment of candidal vulvagenitis in girls.

 Despite a number of drugs, both local and general effects, treatment often does not reach the goal. There are analogues of the treatment of candidiasis with the use of antifungal antibiotics (levorin, clotrimazole, amphotericin B).

As a prototype used the method [10], which consists in the combined effects of local drugs with laser radiation. However, the prototype has the following disadvantages:
1) the impossibility of treatment with this method of virgins due to the need to introduce a curved tube into the vagina for irradiation with a laser beam;
2) the specified method does not provide for an impact on the immunological reactivity of the body.

 It is known that immune disorders play a role in the pathogenesis of chronic infections. In addition, some antibacterial drugs used as an etiotropic treatment have a depressing effect on the immune system.

 The invention solves the problem of complex effects along with local treatment on the body's immune system by ultraviolet irradiation of autologous blood.

 The problem is solved in that the local treatment of chronic vulvovaginitis is as follows. In the morning, douching with a 3% solution of protargol followed by the introduction of a crushed tablet of nystatin into the vagina (by spraying on the walls of the vagina) and a 5% solution of sodium bicarbonate, followed by the introduction of borax with glycerin (in the evening), and from the 4th day of treatment, ultraviolet is prescribed blood irradiation (AUFOK) 3-5 procedures every other day, and blood sampling is carried out at the rate of 2 ml per 1 kg of body weight.

The essential features that provide a persistent clinical effect include
1) a combination of local treatment with effects on the immunological reactivity of the body;
2) a deeper introduction of drugs into the vagina of girls and spraying on the walls and arches, deeper penetration of the drug into the folds of the vaginal mucosa.

 The method is as follows.

 A soft urological catheter is inserted into the vagina, moving deep into the vaginal arches, and thoroughly washed with a 3% solution of protargol, after which a crushed tablet of nystatin is blown through a special device. This procedure is carried out every morning for 3 to 5 days. In the evening, during this time, douching is carried out with a 5% sodium bicarbonate solution, followed by the introduction of a solution of sodium tetraborate in glycerol.

 From the 4th for treatment, AUFOK begins, while blood sampling is carried out 2 ml per 1 kg of patient body weight, and the total time of blood irradiation is 15 minutes. Irradiation is carried out by the apparatus MD 73 m "Isolde".

 Example 1. Patient K., 15 years old. She complained of constant discharge from the genital tract, periodic itching and burning in the external genital area.

 From the anamnesis: suffers from chronic candidiasis of vulvovaginitis for 1.5 years. During bacteriological examination during the last exacerbation of the process, Candida albicans 10 fungi were isolated. Mycelium filaments were smeared.

 The patient received repeated treatment with a temporary effect according to generally accepted methods.

 The patient was examined at the State Pediatric Medical Center. On examination of the external genitalia: external genitalia with a slightly bluish tinge. Hymen int. Free secretions are liquid milk whites.

 Vaginal data: the vaginal mucosa is pink, folding is moderate. In the vaginal arches and in the folds - abundant discharge (liquid milk leucorrhoea), which impede the visualization of the cervix.

Ultrasound data:
The uterus is 51 • 43 • 41 mm, the contours are even, the myometrium is homogeneous, the M-echo is 7 mm (endometrium). Right ovary: 37 • 24 • 18 mm, slightly hydrophilic, homogeneous structure. Left ovary: 36 • 25 • 17 mm, uniform.

 According to bacteriological and bacteriological examination, the diagnosis of candidal vulvovaginitis has been confirmed.

 The treatment was carried out according to the claimed method. Control examinations were carried out after 14 days, after 1 month, after 3 months, Candida albicans was not detected. At control examinations of complaints the patient did not show.

 The proposed method treated 25 patients with chronic candidal vulvovaginitis. All patients noted the onset of persistent clinical effect, the disappearance of complaints.

Used Books
1. Taibi D., Patella A., Carta G., Carosu R. // Clin. Europ. - 1984. - Vlo. 23. N 3. - P. 355 - 365 /
2. Fedotov V.P., Gladyshev V.V., Soloviev V.P., Kozlenko V.V. Modern methods of specific therapy for urogenital candidiasis in women. Obstetrics and gynecology. - 1987. N 11, p. 9 - 11.

 3. Trakhovsky M.L., Mikhailenko E.T. Pharmacotherapy in obstetrics and gynecology. - Kiev. 1985.

 4. Ankirskaya A. S., Zaydieva Y.Z., Latynova I.Kh., Fursova S.A. The experience of using one dose of diflukin for the treatment of candidal vulvovaginitis // P. 28 - 30.

 5. Katsitadze A. G. Associated fungal-viral infections of the skin and mucous membranes, pathogenesis and treatment methods / Thesis ... Ph.D. - M., 1991, - S. 5 - 36.

 6. Martynchuk N.V. Clinic, diagnosis and treatment of candidal kalpitis in patients with uterine myoma / Dis ... Ph.D. - L., 1991. - p. 110.

 7. Pavlova G.V. New methods of treating patients with candidal vulvaginitis. Abstract ... dis ... candidate of medical sciences - L., 1988.

 8. Aylamazyan E.K. /// Obstetrics and gynecology. 1991, N 4. - p. 62 - 66.

9. Chaika V.K., Mogilevkina I.A., Zolotukhin N.S. Quantum hemotherapy in obstetrics and gynecology. - Donetsk, 1993. - N 57 - 65 /
10. Patent of Russia N 2001644, Kornova VV, Tsvetaeva T.Yu., Salnikova Z. V., Movchan S.I. A method for the treatment of urogenital candidiasis. M. cl. A 61 N 5/06, c. N 492471 B / 14. prior. from 02.21.91., publ. 10/30/93. Bull. N 39 - 40.

Claims (1)

 A method of treating chronic candida vulvovaginitis, including douching the vagina with solutions of antifungal agents, characterized in that for 3 to 5 days in the morning douching is carried out with a 3% solution of protargol followed by the introduction of a crushed tablet of nystatin by spraying on the wall of the vagina and its vaults, and in the evening, douching 5% solution of sodium bicarbonate, followed by the introduction of a solution of sodium tetraborate in glycerol, while in addition from the fourth day of local treatment prescribed ultraviolet blood blood irradiation (AUFOK) 3-5 procedures every other day, moreover, blood sampling, irradiation and return are performed at the rate of 2 ml per 1 kg of the patient’s body weight, and the total irradiation time is 15 minutes.