THE EXPERIENCE OF USING THERAPY OF INFLAMMATORY DISEASES OF THE WOMEN’S PELVIC ORGANS IN REPRODUCTIVE AGE

DOI: https://doi.org/10.29296/25877305-2022-08-13
Issue: 
8
Year: 
2022

V. Krutova(1, 2), MD; Professor E. Bolotova(1), MD; A. Dudnikova(2), Candidate of Medical Sciences; N. Prosolupova(2)
1-Kuban State Medical University, Ministry of Health of Russia, Krasnodar
2-Clinic of Kuban State Medical University, Ministry of Health of Russia, Krasnodar

Pelvic inflammatory disease (PID) are a serious risk factor for reproductive health disorders, representing not only a medical, but also an important socio-economic problem requiring an integrated approach to therapy. The purpose of the study: to evaluate the effectiveness of the use of the drug bovgialuronidase azoximer in the complex therapy of inflammatory diseases of the pelvic organs in women of reproductive age. Material and methods. A comprehensive prospective clinical trial «Double-blind placebo-controlled multicenter randomized comparative study of the efficacy and safety of drugs, vaginal and rectal suppositories bovgialuronidase azoximer (NPO Petrovax Pharm LLC, Russia) in the complex therapy of patients with exacerbations of chronic inflammatory diseases of the pelvic organs» was conducted on the basis of the Clinic of FSBEI at KubSMU in 2017, which included 112 patients (average age 30.1±6.2 years). The patients were divided into 2 groups: group 1 – 58 women received the drug bovgialuronidase azoximer at a dose of 3000 IU according to the scheme: 1 suppository rectally 1 time in 3 days 10 injections, then 1 suppository 1 time in 5 days 5 injections (total course – 15 suppositories); patients in the control group (n=54) received placebo suppositories, which were administered according to a similar scheme. Dynamic observation of the patients was carried out over the next three years. Results. In the patients of the main group, on the background of the treatment on day 5–7, subjective improvement was statistically significantly more frequent (50% vs 16.7%, respectively, χ2=12.52, p=0.04). On the 10th–12th day, statistically significantly more often in the main group, positive dynamics of laboratory data (96.6% vs 68.5%, respectively, χ2=15.5, p=0.04), normalization of vaginal biocenosis (96.6% vs 66.7%, respectively, χ2=17.2, p=0.025) and subjective sensations (100% vs 87%, respectively, χ2=7,906, p=0.04). With dynamic follow-up, the patients of the control group compared with the main group had a statistically significantly higher frequency of relapse of exacerbation of PID (31.5% vs 5.2%, χ2=13.2, p=0.01) during the first 6 months of follow-up and during the first year of follow-up (40.7% vs 8.6%, χ2=15.8, p=0.025), the onset of pregnancy is statistically significantly lower (25.9% vs 55.2%, χ2=9.5, p= 0.04). Conclusion. The data revealed by us indicate that in women with PID who received, along with standard methods of treatment, the drug bovgialuronidase azoximer, there was a faster (3–5 days compared to the control group) disappearance of the main clinical symptoms, the number of pregnancies that occurred.
Keywords: 
gynecology
inflammatory diseases of the pelvic organs in women
bovgialuronidase azoximer

References: 
  1. Kuznetsov R.E., Skripchenko D.V. A modern overview on the diagnosis and treatment of pelvic inflammatory diseases. Consilium Medicum. 2019; 21 (6): 63–7 (in Russ.). DOI: 10.26442/20751753.2019.6.190565
  2. Vospalitel’nye bolezni zhenskikh tazovykh organov. Klinicheskie rekomendatsii. M.: 2021 (in Russ.).
  3. Krutova V.A., Chulkova A.M., Vanyan D.L. et al. Neoadjuvant diagnosis and management of chronic endometritis. Kuban Scientific Medical Bulletin. 2018; 25 (1): 23–9 (in Russ.). DOI: 10.25207/1608-6228-2018-25-1-23-29
  4. Bebneva T.N., Damirov K.F. Pelvic inflammatory disease. Gynecology. 2019; 21 (5): 39–44 (in Russ.). DOI: 10.26442/20795696.2019.5.190743
  5. Wang Y., Zhang Y., Zhang Q. et al. Characterization of pelvic and cervical microbiotas from patients with pelvic inflammatory disease. J Med Microbiol. 2018; 67 (10): 1519–26. DOI: 10.1099/jmm.0.000821
  6. Kovalenko Y.A., Krutova V.A., Naumova N.V. et al. The effectiveness of in vitro fertilization and embryo transfer in women suffering from non-specific chronic endometritis. Kuban Scientific Medical Bulletin. 2017; 24 (6): 59–64 (in Russ.). DOI: 10.25207/1608-6228-2017-24-6-59-64
  7. Kalinkina O.B., Tezikov Y.V., Lipatov I.S. et al. Non-invasive treatment of adhesions in women with tubal infertility and inflammatory pelvic disease. Modern problems of science and education. 2016; 6: 265 (in Russ.).
  8. Vinnikova S.V., Tsechoyeva L.Sh. Characteristics of the vaginal microbiota in women with non-developing pregnancy. Global Reproduction. 2021; S1: 51–6 (in Russ.).
  9. Lebedeva E.A., Rishchuk S.V., Dushenkova T.A. et al. Altered microbiota in the female reproductive tract as a risk factor for failure of assisted reproductive technologies. Russian Journal of Infection and Immunity. 2021; 11 (2): 365–70 (in Russ.). DOI: 10.15789/2220-7619-CIT-1551
  10. Krutova V.А., Tulendinova A.I., Aslanyan I.E. et al. To the question of current problems of chronic inflammatory processes during adolescence. Reproduktivnoe zdorov’e detey i podrostkov = Pediatric and Adolescent Reproductive Health. 2019; 15 (4): 61–6 (in Russ.). DOI: 10.24411/1816-2134-2019-14007
  11. Kulakov V.I., Manukhina I.B., Savel’eva G.M. Ginekologiya: natsional’noe rukovodstvo. 2011; 512 s. (in Russ.).
  12. Fomina O.V., Bolotina E.S. Opyt primeneniya test-sistemy «FEMOFLOR-16» dlya otsenki vaginal’noi mikrobioty. IKh Vseross. nauchno-prakt. konf. s mezhdunar. uchast. «Molekulyarnaya diagnostika 2017». Sb. tr. 2017; 379–80 (in Russ.).
  13. Tapilskaya N.I., Savicheva A.M., Shalepo K.V. et al. Experience in the treatment of chronic endometritis. Gynecology. 2020; 22 (4): 68–70 (in Russ.). DOI: 10.26442/20795696.2020.4.200312
  14. Serebrennikova K.G., Arutyunyan N.A., Alekhin A.I. Diagnosis and clinical criteria for chronic endometritis. Gynecology. 2018; 20 (6): 53–9 (in Russ.). DOI: 10.26442/20795696.2018.6.180070
  15. Abramova S., Bolshakova U., Bolshakov A. et al. Chronic salpingo-ооforitis: the present vision of etiopathogenetic specific features. Bulletin of Science and Practice. 2018; 4 (10): 56–61 (in Russ.).
  16. Repin I.A., Selikhova M.S., Soltys P.A. et al. Antibiotikoterapiya pri VZOMT. Forcipe. 2019 (2): 164 (in Russ.).
  17. Khryanin A.A., Knorring G.Yu. Modern understanding of bacterial vaginosis. Gynecology. 2021; 23 (1): 37–42 (in Russ.). DOI: 10.26442/20795696.2021.1.200680
  18. Erichev V.P., Petrov S.Yu., Makarova A.S. Clinical evaluation of the efficacy of azoxime boviolaluronidase in the prevention of excessive scarring after surgical treatment of glaucoma. National Journal glaucoma. 2018; 17 (1): 86–100 (in Russ.). DOI: 10.25700/NJG.2018.01.09