RU2491956C2 - Method of treating vaginal infections - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine and is intended for treatment of vaginal infections. Method includes complex therapy with application of immunocorrector. As immunocorrector solution of medicine Betaleukin, introduced intravaginally during 40-90 minutes daily at least during 5 days, is applied.

EFFECT: method is highly efficient in complex therapy of vaginal infections.

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Description

The invention relates to medicine, namely to the field of gynecology, more specifically to methods of treating vaginal infections.

Currently, one of the most common obstetric and gynecological diseases in women is vaginal infections (bacterial vaginosis, vaginal candidiasis, trichomoniasis, chlamydia, nonspecific vaginitis, genital herpes). (Bayramova G.R. Bacterial vaginosis // Gynecology, - 2001. - No. 3. - P.52-54; Volodin N.N., Korshunov V.M., Bacterial vaginosis // In the world of medicines. - 2000. - No. 2. - P.23-26; Nemchenko O.I., Plieva Z.A., Uvarova E.V. Urogenital chlamydia in girls (literature review) // Gynecology. - 2004. - T-06. - No. 1. - S.31-35; Simbirtsev A.S. Medications based on proteins of the interleukin-1 family // Handbook of immunotherapy. - 2002. - Dialog Publishing House - St. Petersburg. - S.152-166.) The course of vaginal infections, usually accompanied by a decrease in local immunity, which exacerbates with there is a recurrence of the disease (Aleshkin V.A., Makarov O.V., Shaykov K.A. et al. The state of local immunity in inflammatory diseases of the female genital organs and the effect of the immunomodulator kipferon on it // Immunopathology and wedge. immunology. - 2000. - T. 5. - S.41-44). The treatment of vaginosis is complicated by the fact that in about half of women, the diseases are chronic, occurring in the absence of clinical manifestations of the disease with positive laboratory data.

Modern treatment regimens for bacterial vaginosis in most cases include antibacterial drugs (levomycin, synthomycin, gramicidin, etc.) and agents that normalize the physiological environment of the vagina, for example, sea buckthorn oil, furatsilin (Afanasyev S.S., Zulkarneev R.Sh., Kalinin, Yu.T. et al. Sanitation of the genital tract of pregnant women by immunobiological preparations // IV Russian National Congress "Man and Medicine": Abstracts - Moscow, 1997. - P.245; Tikhomirov A.L. Oleinik Ch.G. Bacterial vaginosis: some aspects of etiology, pathogenesis, clinics , diagnostics and treatment // Gynecology. - 2004. - T.6. - No. 2. - S.18-23; MD Mashkovsky. Medicines. M: Medicine, 1985, t.2 p.3, 47, 250-299, 306). At the same time, the effectiveness of the recommended treatment regimens rarely exceeds 80%, and the relapse rate reaches 56% of cases.

The closest in technical essence to the claimed invention is a complex therapy of urogenital latent current chlamydia, including the use of an immunocorrector - the drug "Kipferon" in the form of intravaginal suppositories on the background of antibiotic therapy (Aleshkin V.A., Lobachev N.V., Afanasyev S.S. and Chronic and recurrent diseases of the nasopharynx of chlamydial etiology in children // Problems of infectious diseases (immunology, biochemistry, biotechnology, immunobiological preparations and their use). - M. - 2000. - Part 2. P.2113-211 6).

However, this method is not effective enough and cannot be widely used to treat vaginal infections, as Kipferon has both local and systemic effects on the body and can cause unwanted side effects.

The problem solved by the authors was to develop a method for more effective treatment of vaginal infections.

The technical result was achieved due to the fact that patients with vaginal infections on the background of complex therapy of vaginal infections for at least 5 days every day for 40-90 minutes, a swab soaked in a solution of Betaleikin's drug is placed in the vagina.

Betalekin is usually dissolved in physiological saline and used at a dose of 5 ng / kg of patient body weight. The use of the drug in smaller doses is possible with an unexpressed nature of the disease or in combination with an increased procedure time. Large doses of Betaleikin are used only, as a rule, in severe forms of the disease and are usually not used for economic reasons.

The preparation Betaleikin developed by the authors (RU 2128706; P No. 000222 / 01-2001, January 25, 2001) contains interleukin-1β, human albumin, and polyvinylpyrrolidone. The course of treatment using Betaleikin, as a rule, consists of intravenous drip infusions at a dose of about 5 ng / kg body weight (Dolgushina A.I. Abstract of Cand. Diss., Chelyabinsk, 2003). The drug is used, as a rule, for the treatment of immune diseases and diseases of the gastrointestinal tract. For vaginal infections, betaleukin has not previously been used.

The experiments showed that this method significantly increases the effectiveness of the treatment of vaginal infections and reduces the percentage of relapses of the disease.

The method is as follows: a betaleukin ampoule is diluted in 1 ml of physiological saline, the required dose is taken and dissolved in 10 ml of physiological saline, which is then impregnated with a vaginal swab, which is then inserted into the vagina.

The effectiveness of the method is illustrated by the following clinical examples.

Example 1. Patient D., born in 1964 appealed to the GPTD with complaints of menstrual irregularities, pain in the lower abdomen, pus discharge from the genital tract. Since 1999, she was observed in a antenatal clinic for chronic adnexitis and bacterial vaginosis. Periodic pus discharge from the genital tract is disturbed for 5 years, in connection with which the patient was prescribed trichopolum, vaginal douching, antihistamines. Gynecological history: menstruation from 15 years old, irregular, painful. Pregnancy - 3, childbirth - 1, miscarriages - 2 for periods of 8-9 weeks. Gynecological status: external genitalia are developed normally. In the mirrors: the vaginal mucosa is hyperiminated, the cervix is eroded, the discharge is pus-like. In a bimanual study: the body of the uterus is painless on palpation, sedentary, rejected posteriorly. The appendages are swollen, sensitive to palpation in commissures. The vaults are free. Smears taken, sowing.

Preliminary diagnosis: Chronic adnexitis. A burdened obstetric history, menstrual irregularities, miscarriage, adhesions of the pelvis, cervical erosion. Bacterial vaginosis.

Cytology: white blood cells 50-60 in the field of view. Bacterial purity is 3-4. Conclusion: Bacterial vaginosis. In the crop: E. Coli. The following therapy was prescribed to the patient: Ampicillin by candlelight per.vagina, vitamins of the group. V / m, vaginal instillation with a decoction of chamomile, antihistamines per.os. Betaleikin's course at a dose of 200 ng / g once a day for 1 hour, intravaginally, in tampons, 5 days course.

In the control study after 2 weeks, complaints of discharge from the genital tract and pain in the lower abdomen disappeared. Gynecological status. In the mirrors: Discharge moderate, normal. The mucous membrane of the vagina and cervix is pink. The beginning of epithelialization of erosion.

Per. vagina: No dynamics.

When re-examined after a month and a half, there are no complaints of discharge and pain in the lower abdomen. In the mirrors: The selection is scarce. The cervix visually - without pathological changes. Smears taken.

Per. vagina: No dynamics. Cytology: Light background, a moderate amount of lactobacilli. No tumor cells.

Example 2. Patient V., 37 years old, complained of infertility for 2 years, pain in the lower abdomen, periodic discharge of a cheesy character throughout the year. Infertility 2 years. It was observed in a antenatal clinic for chronic adnexitis and vaginal candidiasis. Discharges of a cheesy character, itching of the vagina, are periodically disturbed during the year (exacerbations after menstruation), in connection with which the patient was treated in a antenatal clinic at the place of residence. Received pimafucin, levorin topically - without a lasting effect. To clarify the diagnosis sent to the GPA. Gynecological history: monthly from 13 years old, regular for 4 days after 30 days, moderate painless. There were no pregnancies. Gynecological status: external genitalia are developed normally. In the mirrors: discharge of a curdled character, the mucous membrane of the vagina and cervix uteri - are hyperiminated. In a bimanual study: the body of the uterus is normal in size, painless on palpation, mobile. Appendages in spikes, vaults free. Smears taken.

Preliminary diagnosis: Chronic adnexitis, Infertility I, Vaginal candidiasis.

Cytology: White blood cells covered the entire field of view. Bacterial purity - 4, Candida albicans mycelium. The patient was prescribed the following therapy: vaginal douching with 0.5% soda solution - 1 time per day, vaginal suppositories - “Pimafucin” - 1 suppository intravaginally 2 times a day for 10 days, Betaleikin's dose of 270 ng / g 1 time per day for 1.5 hours, intravaginally, in tampons, 5 days course.

During the follow-up examination 2 weeks after the course of treatment, complaints of discharge disappeared. Gynecological status: moderate discharge, the mucous membrane of the vagina and cervix is pink, with no visible changes. In bimanual research - without dynamics. Cytology: Single white blood cells. Bacterial purity is 2-3. Atypical cells were not detected.

When re-examined 1.5 months after therapy. Gynecological status: Discharge moderate, the mucous membrane of the vagina and cervix is pink, with no visible changes. In bimanual research - without dynamics. Cytology: single white blood cells. Bacterial purity 2-3. Atypical cells were not detected.

Example 3 Patient D., 25 years old, is undergoing treatment in GPTD with a diagnosis of Infiltrative tuberculosis of the upper lobe of the right lung.

I went to the gynecologist with complaints of itching of the vulva, discharge. Gynecological history: monthly from 14 years old, regular for 4-5 days after 28 days, moderate, painful on the first day. There were no pregnancies. Gynecological status: external genitalia are developed normally. In the mirrors: discharge of a mucopurulent nature, the mucous membrane of the vagina and cervix uteri - hyperimiens. Cervical erosion. In a bimanual study: the body of the uterus is normal in size, painless on palpation, mobile.

Appendages are sensitive to palpation, vaults are free. Smears taken, material for PCR studies.

Preliminary diagnosis: Bacterial vaginosis.

Upon receipt of answers from the laboratory - cytology: There are many white blood cells, Bacterial purity - 4, Candida albicans mycelium. PCR - Chlamydia DNA detected.

Diagnosis: Chlamydia, Vaginal candidiasis.

The patient was prescribed the following therapy: Summamed - 250 mg 2 times a day for 5 days, vaginal douching with 0.5% soda solution - 1 time per day, vaginal suppositories - “Pimafucin” - 1 suppository and vaginally 2 times a day with a course of 10 days, Betaleikin's course at a dose of 270 ng / g 1 time per day for 40 minutes, itravaginally, in tampons, 7 days course.

During the follow-up examination 2 weeks after the course of treatment, complaints of discharge disappeared. Gynecological status: Discharge moderate, the mucous membrane of the vagina and cervix is pink, with no visible changes. In bimanual research - without dynamics. Cytology: Single white blood cells. Bacterial purity is 2-3. Atypical cells were not detected.

Control studies by immunofluorescence method after menstruation - smears taken. In smears - chlamydial bodies were not found.

When re-examined 1.5 months after therapy. Gynecological status: Discharge moderate, the mucous membrane of the vagina and cervix is pink, with no visible changes. In bimanual research - without dynamics. Cytology: Single leukocytes, Bacterial purity 2-3. Atypical cells were not detected.

In the subsequent 2 multiple studies by immunofluorescence method, chlamydia was not detected.

Thus, clinical examples show the high efficiency of topical application of betaleukin solution in the complex treatment of vaginal infections, which helps to increase the effectiveness of treatment in patients who have previously received treatment for these diseases.

Claims (1)

A method for the treatment of vaginal infections, including complex therapy using an immunocorrector, characterized in that a Betaleukin solution is used as an immunocorrector, which is administered intravaginally for 40-90 minutes daily for at least 5 days.