The combined application of transvaginal collagenase electrophoresis and pulsed magnetic therapy to improve the quality of life of patients with chronic salpingo-oophoritis

Tamara Mikhailovna Medoeva, М. З. Дугиева, Vadim V. Portnov
In: Fizioterapevt (Physiotherapist) · 2021 · pp. 14–19 · doi:10.33920/med-14-2106-02 · W3195139925
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In 77 patients with chronic salpingo-oophoritis, combined transvaginal collagenase electrophoresis and pulsed magnetic therapy improved quality of life by 89.3%, outperforming monotherapies which yielded improvements of 75.7% and 73.1%.

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This study evaluated the efficacy of combining transvaginal collagenase electrophoresis with pulsed magnetic therapy for treating chronic salpingo-oophoritis in 77 women aged 18 to 42. The researchers compared this combined pharmacophysiotherapy approach against monotherapies to assess impacts on quality of life and functional shifts such as analgesic and anti-inflammatory effects. The trial aimed to determine if the synergistic application of these modalities provided superior outcomes compared to individual treatments for non-specific etiology conditions. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Chronic salpingo-oophoritis (CSO) is one of the most common diseases among the entire gynecological pathology, the frequency of which reaches 65-68%. Despite the progress made in the treatment of CSO, there is a serious problem due to the steady growth and complications leading to infertility, ectopic pregnancy and the development of chronic pelvic pain syndrome, which significantly reduces the quality of life of patients. In this regard, the development of promising pharmaco-physiotherapeutic methods with pronounced analgesic, anti-inflammatory, immunomodulatory and bacteriological effects to increase the therapeutic effectiveness and improve the quality of life of patients with salpingo-oophoritis is an important task of modern gynecology and physiotherapy. Objective: To study in a comparative aspect the effect of the combined use of transvaginal electrophoresis of the collagenase complex and pulsed magnetic therapy and their mono-effects on the quality of life of patients with chronic salpingo-oophoritis. Materials and research methods. The study included 77 patients aged 18 to 42 years (median age was 26,7±2,8 years) with a diagnosis of chronic salpingo-oophoritis of non-specific etiology. More than half of the patients (59,7%) were women under 25 years of age. All patients were divided into three groups that were comparable according to the main clinical and anamnestic data, somatic and obstetric-gynecological status: group 1 — the main group — included 28 patients who received a course of combined application of transvaginal electrophoresis of the collagenase complex and pulsed magnetic therapy; group 2 — comparison group 1 — included 25 patients who received acourse of transvaginal electrophoresis of the collagenase complex; group 3 — comparison group 2 — included 24 patients who received a course of pulsed magnetic therapy. The quality of life was assessed by the indicators of the Quality of Life Index (QOL), which takes into account the three most important and informative aspects of patients’ lives: physical condition and its dynamics, mental (psychological) health and daily functioning. The results of the study. Based on the obtained results, it was proved that the most pronounced results were achieved in patients of the main group who received a course of transvaginal electrophoresis of the collagenase complex in combination with pulsed magnetic therapy, where the quality of life improved by 89,3% according to the QOL index, compared to the monotherapy with transvaginal electrophoresis and pulsed magnetic therapy — 75,7% and 73,1%, respectively.
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Хронический сальпингоофорит (ХСО) среди всей гинекологической патологии занимает лидирующее положение, частота встречаемости которого достигает 65–68% [2, 4, 8, 15]. Несмотря на достигнутый прогресс в лечении ХСО, существует серьезная проблема в связи с неуклонным ростом и осложнениями, приводящими к проблемам в репродуктивном здоровье, в том числе бесплодию, внематочной беременности и развитию синдрома хронической тазовой боли, что значительно снижает качество жизни больных [16–18]. В разные годы в гинекологии достаточно широко применялись различные методы физиотерапии [1, 5, 9–12, 14], однако электрофорез комплекса коллагеназ не использовался, хотя для этого имеются все предпосылки [7, 13] и доказана высокая эффективность электро- и ультрафонофореза Ферменкола при лечении рубцов кожи [6]. В связи с этим представляется перспективным применение фармакофизиотерапевтической методики трансвагинального электрофореза комплекса коллагеназ и импульсной магнитотерапии, которые, по данным ряда исследований, в качестве монометодов индуцируют в организме широкий спектр положительных функциональных сдвигов, вызывая формирование анальгетического, противовоспалительного, иммуномодулирующего, регенерационного, трофостимулирующего и бактериологического эффектов, что, на наш взгляд, может способствовать улучшению качества жизни пациенток с хроническим сальпингоофоритом. Цель исследования: в сравнительном аспекте изучить влияние комбинированного применения трансвагинального электрофореза комплекса коллагеназ и импульсной магнитотерапии и их моновоздействий на качество жизни пациенток с хроническим сальпингоофоритом. Под нашим наблюдением в амбулаторных условиях находились 77 пациенток в возрасте от 18 до 42 лет (медиана возраста составила 26,7 ± 2,8 лет) с установленным диагнозом «хронический сальпингоофорит неспецифической этиологии». Более половины пациенток (59,7%) были женщины моложе 25 лет, все пациентки проходили обследование, соответствующее клиническому протоколу при данной нозологии (рекомендован Экспертным советом РГП на ПВХ «Республиканский центр развития здравоохранения» Министерства здравоохранения и социального развития, протокол от 20.11.2015 №16).

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