RU2241466C1 - Method for treating male climacteric syndrome - Google Patents

Abstract

FIELD: medicine, andrology.

SUBSTANCE: one should pre-evaluate the degree of copulative function disorder by the scale of its quantitative evaluation by Loran and Segal, 1998. At deviation of points' sum against average statistic norm in 51-65-aged men it is necessary to conduct intravenous infusions of an ozonized physiological solution. At deviation of points' sum for 1-4, one should intravenously inject 200 ml 0.9%-ozonized solution at ozone concentration being 1.5-2.5 mg/l, thrice weekly, at total quantity of 3-4. At deviation for 5-8, one should intravenously inject 200 ml 0.9%-ozonized solution at ozone concentration being 2.5-3.0 mg/l, thrice weekly, 6-7, totally. At deviation for 9-12, one should intravenously inject 200 ml 0.9%-ozonized solution at ozone concentration being 3.5-4.5 mg/l, thrice weekly, 9-10, totally. At deviation for 13-14, one should intravenously inject 200 ml 0.9%-ozonized solution at ozone concentration being 5.0-5.5 mg/l, thrice weekly, 10-12, totally. At deviation against average statistic norm by neurohumoral constituent for 2 and higher one should introduce andriol 120 mg/d, once daily. At deviation against average statistic norm by erectile constituent for 2 and higher it is necessary to additionally perform vibromassage of erogenous reflexogenic areas at frequency of 150-250 Hz at pressure of 150-300 KPa per 1-1.5 min for each area. The method provides correction of erectile dysfunction appeared due to age-induced involution alterations.

EFFECT: higher efficiency of therapy.

2 cl, 2 ex, 1 tbl

Description

The invention relates to medicine and can be used in urology and sexopathology for the treatment of erectile dysfunction against a background of pronounced climacteric disorders.

The use of electrophoresis of various vasoactive drugs for the treatment of menopausal disorders in men is known. Karpukhin N.V. “Electrophoresis by sinusoidal modulated currents of vasoactive drugs in the treatment of impotence patients”, “Questions of balneology, physiotherapy and physiotherapy,” No. 3, 1994, p.24).

Known treatment of erectile dysfunction with yohimbine and arginine for the treatment of erectile dysfunction (application 2000100301/14, published 06.07.1998.), Adopted by us as a prototype. However, despite the widespread use in clinical practice, this method of treating erectile dysfunction is ineffective.

In order to increase the effectiveness of treatment of menopausal syndrome in men, an integral component of which is erectile dysfunction, we have proposed a method for ozone therapy of this pathology. We have used ozone therapy in the treatment of erectile dysfunction in the elderly and senile in view of the fact that the latter is an integral component of menopause. Attempted treatment with yohimbine, Sustanon, andriol, intracavernous injections of PRE1 drugs, traditional physiotherapy were unsuccessful, which became understandable after a comprehensive and comprehensive study of patients, which established that erectile insufficiency in the study group arose not only due to endocrine disorders due to menopause syndrome, and developed in a complex of psychosomatic disorders of the whole organism.

The problem is solved by first evaluating the degree of impairment of copulative function according to the MKF scale, and when the degree of deviation of copulative function from the average age norm from 1 to 4, intravenous infusions of 200 ml of 0.9% ozonized physiological solution with an initial concentration of ozone of 1.5-2 5 mg / l, 3 times a week, the total number of infusions 3-4;

with a degree of deviation of copulative function from 4 to 8 iv, 200 ml of 0.9% ozonized saline solution with an initial concentration of ozone of 2.5-3.0 mg / l, 3 times a week, a total of 6-7 infusions;

with a degree of deviation of copulative function from 8 to 12, 200 ml of 0.9% ozonized saline solution with an initial concentration of ozone of 3.5-4.5 mg / l, 3 times a week, a total of 9-10 infusions;

with a degree of deviation of copulative function from 12 to 14, 200 ml of 0.9% ozonized saline solution with an initial concentration of ozone of 5.0-5.5 mg / l, 3 times a week, a total of 10-12 infusions;

moreover, with a degree of deviation in block I (neurohumoral component) from 2 and higher, andriol 120 mg / day is additionally administered throughout the course, once a day throughout the entire course of ozone therapy, and with a degree of deviation in block 3 (erection component) from 2 and above additionally carry out vibration massage of erogenous reflexogenic zones with a frequency of 150-250 Hz and a pressure of 150-300 KPa for 1-1.5 min per zone.

The method is as follows.

Ozonation of physiological saline was carried out using an automatic ozone therapy unit with ozone destructor UOTA-60-01 “MEDOZON”, which allows smoothly regulating the concentration of ozone in the ozone-oxygen mixture at the outlet from 0 to 60 mg / l and measuring the ozone concentration in ozonized saline. The unit is powered by compressed oxygen with an overpressure at the inlet of the unit from 45 to 400 kPa. The installation consists of an ozonizer, an input reducer, a valve for smooth adjustment of the oxygen flow rate, a measuring unit, a catalytic decomposition unit for ozone, and a microprocessor control unit. Oxygen through the inlet fitting enters the gearbox, where its pressure decreases from the inlet to the working level (35-45 kPa). Then, through a fine adjustment valve and a flow rate meter, oxygen enters the inlet valve controlled by the microprocessor. When the “START” button is pressed, the microprocessor opens the inlet valve and the oxygen stream enters the ozonizer and then into the photometric unit for continuous measurement of the ozone concentration in the oxygen stream. After the measuring unit, the ozone-oxygen mixture through the fitting "OZONE" enters into external devices. Residual ozone, through the “RESET” fitting, enters the moisture trap and then into the catalytic decomposition unit of residual ozone. Management of the installation and measurement of parameters in it is performed by a microprocessor unit. The measurement results are displayed on the liquid crystal screen: the concentration of ozone in the gas and liquid in digital form, in mg / l; gas mixture flow rate - graphically, in the form of a column, the height of which is proportional to the flow velocity.

Male copulative function was investigated using the scale of quantitative assessment of male copulative function (MKF scale) [O. B. Laurent, A. S. Segal, 1998]. The authors emphasize that one of the most important features of the examination of patients with a sexological profile is the scarcity of pathological changes detected, and sometimes in their complete absence. The expert’s conclusion is based on the analysis of the patient’s complaints, information obtained from a conversation with him and his sexual partner.

The ICF scale was proposed in 1998 by O.B. Laurent and A.S. Segal and is generally accepted for a total assessment of male copulative function among urologists and sexopathologists in the Russian Federation. The ICF rating methodology was approved and adopted by the European Association of Urology and the Russian Society of Urology. In most of the modern scientific research in andrology and urology, the ICF scale is used as a comprehensive assessment. The MKF scale is designed to identify, summarize and monitor violations of male copulative function and to monitor the effectiveness of corrective measures. The scale includes a number of indicators (questions), indicated by Roman numerals from I to XIII. For each question from the 6 proposed answer options, the patient selects one that matches his situation. Each answer has a score in points from 0 to 5, that is, from the extreme degree of violation to the extreme severity of the analyzed indicator. The answer option with a score of 5 points for each indicator from I to XII reflects the sexual reactions inherent in the period of youthful hypersexuality, as well as people with a strong type of sexual constitution. The maximum score for all indicators will be 60 (12 × 5). A score of 4 points reflects sexual manifestations corresponding to the average norm for men aged 20 to 35 years (maximum average points - 48), 3 points - from 36 to 50 years (maximum amount - 36), 2 points - from 51 to 65 years old (maximum amount - 24), 1 point - over 65 years old (maximum amount - 12). The answer, rated 0 points, indicates the extreme degree of violation of the analyzed indicator. The MKF scale is designed in such a way that it allows not only to identify a sexual disorder, but also to carry out its structural analysis, that is, to detect the defeat of the individual components of the copulative cycle. So, indicators I, II and III characterize mainly the neurohumoral component of the copulative cycle, IV and V - the psychic component, II, III and VI - the erection component, VII, VIII and IX - the ejaculatory component, and X, XI and XII - the functioning of the copulative system generally. Indicator XIII reflects the subject's opinion of his sexual potency in general. An ICF-filled patient questionnaire is reviewed by a physician. First of all, the sum of points from I to XII is calculated, which reflects the general state of the copulative function for a given period of time. Then, the calculated amount is compared with the sum of points corresponding to the average norm for the age of the patient. The result obtained by subtraction will be proportional to the degree of deviation of the copulative function from the average age norm. Similarly, the analysis of indicator XIII is carried out, reflecting the opinion of the subject about his sexual potency in general. Since the answer to this question is more subjective than the sum of the scores from I to XII indicator, comparing them may reveal the patient’s tendency to exaggerate or downplay the severity and significance of sexual dysfunction. At the next stage, a structural analysis is performed, that is, the presence and degree of involvement of individual components in sexual dysfunction is determined. The total score scored by the patient for each block of three indicators (I, II, III - neurohumoral component; II, III, VI - erection component; VII, VIII, IX - ejaculatory component; X, XI, XII - functioning of the copulative system as a whole ), is compared with the sum of points corresponding to the average norm for the age of patients: maximum - 15 (maximum score is multiplied by the number of indicators - 5 × 3), from 20 to 35 years old - 12 (4 × 3), from 36 to 50 years old - 9 (3 × 3), from 51 years to 65 years - 6 (2 × 3), over 65 years old - 3 (1 × 3), from 0 to 3 points - an extreme degree of violation. Similarly, an assessment of the mental component is presented, represented by a block of two indicators - IV and V (maximum score - 10).

The age parameters of patients treated with the proposed methods were 51-65 years. After assessing the deviations of the indicators of male copulative function from the average indicators of this age group, with a degree of deviation from 1 to 4, intravenous infusions of 200 ml of 0.9% ozonized physiological solution with an initial concentration of ozone of 1.5-2.5 mg / l, 3 times are carried out per week, total infusion 3-4;

with a degree of deviation from 4 to 8 iv, 200 ml of 0.9% ozonized saline with an initial concentration of ozone of 2.5-3.0 mg / l, 3 times a week, a total of 6-7 infusions are administered;

with a degree of deviation from 8 to 12, 200 ml of 0.9% ozonized saline with an initial ozone concentration of 3.5-4.5 mg / l, 3 times a week, a total of 9-10 infusions;

when the deviation is from 12 to 14, 200 ml of 0.9% ozonized saline with an initial concentration of ozone of 5.0-5.5 mg / l, 3 times a week, a total of 10-12 infusions are administered; and, as clinical studies have shown, with significant deviations from the norm in the neurohumoral component (from 2 and above), and in the erection component (from 2 and above), ozone monotherapy is ineffective, and therefore, in the first case, andriol 120 mg / day, once a day throughout the entire course of ozone therapy, and in the second, vibromassage of erogenous reflexogenic zones is carried out with a frequency of 150-250 Hz and a pressure of 150-300 KPa for 1-1.5 min per zone (see table).

As can be seen from the table, the dynamics of indicators of male copulative function shows the greatest positive shifts in ICF when using ozone therapy. The overall assessment of ICF indicators in the third group of patients was significantly higher than in the first two groups of patients (P <0.05). In addition, there is a significant improvement in the erection component of MKF in patients of the third group (P <0.05), which may be associated with stimulation of the production of nitric monoxide (NO) under the influence of ozone therapy. The indicators of the mental, ejaculatory components and the total ICF score are significantly higher in patients of the third group.

Clinical examples of the method

Example 1

Patient T., 58 years old. He complained of erectile dysfunction for about 8 months, poor sleep, fatigue. An erection occurs rarely, incomplete. He was treated by a sexologist with the use of LD therapy, drug therapy. In a rheophallographic study, the rheographic index was 0.9, and the dicrotic index was 35%. When assessing copulative function according to the MKF scale, a deviation degree of 5 was revealed, with a degree of deviation in the erection component 2. Treatment: iv / drop, at a rate of 400 drops / min, every other day, 200 ml of 0.9% ozonized saline solution was administered with initial ozone concentration of 2.7 mg / l; simultaneously with ozone therapy, vibromassage of erogenous reflexogenic zones was performed with a frequency of 150-250 Hz and a pressure of 150-300 KPa for 1-1.5 min per zone.

After carrying out 4 ozone therapy procedures, the patient began to note the preservation of an erection during rest, between infusions. After the 6th procedure, the patient noted the appearance of persistent erections, both spontaneous and adequate (under conditions of specific penile stimulation). He began a sex life, successfully conducted coitus. Rheophallographic research indicators showed: the rheographic index was 1.6, the dicrotic index was 60%. The assessment on the ICF scale has become consistent with age norms.

Example 2

Patient K., 64 years old, suffers from a violation of erectile function of 1.7 years, against the background of which notes irritability, fatigue, sleep disturbance. An erection occurs rarely, a weakened duration of 1-1.5 minutes. He was treated by a urologist (LD therapy, drug therapy) without a positive effect. The reographic index was 0.9, the dicrotic index was 35%. When evaluating the copulative function, a deviation degree of 9 with a degree of deviation in the neurohumoral component 3 was revealed. The following treatment was carried out: iv drip, at a rate of 180 drops / min, every other day, 200 ml of 0.9% ozonized saline solution with an initial concentration of ozone was administered 4.0 mg / l, for a total of 10 injections, from the second day of ozone therapy, andriol 120 mg / day was administered once a day throughout the entire course of ozone therapy. After 4 ozone therapy procedures, the patient began to note the persistence of an erection between infusions. After the 8th procedure, the patient noted the appearance of adequate and spontaneous erections. Held 4 sexual contacts successfully. An erection was sufficient for the introduction of the penis and sexual intercourse for 3-4 minutes. Sleep improved, bouts of irritability stopped. The rheophallographic research indicators were as follows: the rheographic index was 1.6, the dicrotic index was 60%. The assessment on the ICF scale has become consistent with age norms.

The claimed method was used in 18 patients, after the course of ozone therapy 14 were able to have sexual intercourse, the psychological status was normalized, 4 patients refused to continue treatment for financial reasons.

Thus, the dynamics of the clinical symptoms and mental status of patients with menopausal syndrome within 12 months of observation indicate the advantage of new technologies for the complex treatment of patients using ozone therapy over traditional methods of treatment.

Claims (3)

1. A method of treating menopausal syndrome in men, characterized in that they preliminarily assess the degree of impairment of copulative function on a scale of quantitative assessment of it by O.B. Loran and A. S. Segal, 1998, and when the sum of the points deviates from the average norm for men 51 -65 years for 1-4 carry out intravenous infusions of 200 ml of 0.9% ozonized physiological solution with an ozone concentration of 1.5-2.5 mg / l, 3 times a week, the total amount of infusion 3-4; when the score is deviated by 5-8 iv, 200 ml of 0.9% ozonized saline solution with an ozone concentration of 2.5-3.0 mg / l is administered 3 times a week, for a total of 6-7 infusions; when the score is deviated by 9-12 iv, 200 ml of 0.9% ozonized saline solution with an ozone concentration of 3.5-4.5 mg / l is administered 3 times a week, for a total of 9-10 infusions; when the score is deviated by 13-14 iv, 200 ml of 0.9% ozonized saline solution with an ozone concentration of 5.0-5.5 mg / l is administered 3 times a week, for a total of 10-12 infusions. 2. The method according to claim 1, characterized in that when deviating the sum of the scores for the neurohumoral component by 2 or more, additionally, andriol 120 mg / day is administered throughout the entire course of ozone therapy once a day. 3. The method according to claim 1, characterized in that when deviating the sum of the scores for the erection component by 2 or more, vibromassage of erogenous reflexogenic zones is additionally carried out with a frequency of 150-250 Hz and a pressure of 150-300 kPa for 1-1.5 min per every zone.