ABSTRACT
The use of physical factors according to the principles of syndromic-pathogenic approach with the patients suffering from chronic endometritis ensures the restoration of physical and mental health. OBJECTIVE: To evaluate and scientifically substantiate therapeutic effects of staged rehabilitation treatment of the patients with chronic endometritis and reproductive disorders including therapeutic physical factors. MATERIAL AND METHODS: There have been observed 103 patients of childbearing age with chronic endometritis and reproductive disorders. They were divided into two groups by simple randomization. In the control group (n=49), the treatment was based on clinical guidelines and included antibacterial pharmacotherapy and magnetic laser therapy in combination with intravaginal magnetic laser electrical stimulation. In the main group (n=54), this treatment was carried out at the I and II stages, however, at the II stage, a pulsed low-frequency electrostatic field was additionally included in the treatment program; clay therapy was included at the III stage. Clinical monitoring, cytokine status, and regional circulation were used to assess the effectiveness of the treatment. RESULTS: After a staged rehabilitation treatment, the reduction of clinical manifestations was observed in the main group in 89.2% (p<0.01) of cases, while in the control group - in only 76.5% (p<0.01). The patients of the main group had a decrease in the level of pro-inflammatory cytokines on average by 44.0% (p<0.01), whereas the level of anti-inflammatory cytokines increased on average by 29.6% (p<0.01). In the control group the dynamics of cytokine activity indicators was lower by 18-20% (p<0.05). The use of physical factors provided a significant improvement in regional hemodynamics, and in all the cases there was a significant significance in relation to similar indicators in the control group. The effectiveness of personalized programs of rehabilitation treatment of the patients suffering from chronic endometritis and reproductive disorders was 78.4%, and standardized programs - 59.5%. CONCLUSION: Staged rehabilitation treatment of chronic endometritis and infertility with the use of physical factors at each stage ensures the leveling of pain and inflammatory syndromes, improvement of immune status, pelvic hemodynamics, which, in general, provides an increase in the effectiveness of rehabilitation treatment of this category of patients by 18.9% (p<0.05).
