Efficiency of systemic enzyme therapy in the combination treatment of pelvic inflammatory diseases in women
Objective: To evaluate the effect of Wobenzym included in the combination therapy of pelvic inflammatory diseases (PIDs) on the time course of changes in some clinical and laboratory parameters and on the number of relapses. Materials and methods: The results of examination and treatment were retrospectively analyzed in 118 reproductive-aged women diagnosed with PID. All the patients were divided into 2 groups: 1) 46 patients received etiotropic antibiotic therapy and probiotics; 2) 72 patients used etiotropic antibiotic therapy, probiotics, and Wobenzym that has anti-inflammatory and immunomodulatory effects. The investigators evaluated the impact of therapy on pain syndrome subjectively on the basis of the patients’ complaints and objectively during bimanual palpation on days 3, 7, 10, and 14 after the start of therapy, the time course of changes in the parameters of vaginal smear and real-time polymerase chain reaction on 14 days, and the rate of disease recurrence and menstrual disorders within 12 months after etiotropic treatment. Results: On 14 days after the start of antibiotic therapy, dysbiosis was detected in 56.5% (26/46) of cases in the patients receiving antibiotic therapy and probiotics and in 19.4% (14/72) of cases in those who additionally took Wobenzym (RR 0.34, 95% CI 0.20–0.59; p=0.0001). Within 12 months after the end of etiotropic therapy, relapses were recorded in 56.5% (26/46) of the patients who received standard therapy and in 15.3% (11/72) of those who additionally used Wobenzym (RR 0.27; 95% CI 0.15–0.49; p<0.0001). The patients taking Wobenzym were statistically significantly less likely to have menstrual irregularities within 3 to 6 months after etiotropic therapy (RR 0.17, 95% CI 0.08-0.39; p<0.0001) within 7 to 9 months (RR 0.014, 95% CI 0.0009–0.23), and within 10 to 12 months inclusive (RR 0.01, 95% CI 0.0008–0.22; p=0.003). Women who planned pregnancy and received Wobenzym were statistically significantly more likely than those with standard therapy to have spontaneous conception within 6 months after the end of etiotropic therapy (RR 0.18, 95% CI 0.07–0.45; p=0.0003). Conclusion: The use of systemic enzyme therapy with Wobenzym in the combination treatment of patients with PID improves vaginal microbiocenosis and assists in reducing disease recurrences and in restoring the reproductive health of women.Kokhno N.I., Gorshkova O.V., Molodtsova L.Yu.
Keywords
systemic enzyme therapy
Wobenzym
pelvic inflammatory diseases
reproductive dysfunction
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Received 12.12.2022
Accepted 21.12.2022
About the Authors
Nelli I. Kokhno, PhD, Associate Professor, obstetrician-gynecologist of the highest qualification, Center of Reproduction and Genetics LLC, +7(495)461-08-52,drkohno@gmail.com, 105043, Russia, Moscow, Parkaya 3rd str., 12.
Oksana V. Gorshkova, PhD, Associate Professor, Department of Obstetrics and Gynecology, Institute for Advanced Training of Healthcare Specialists,
Ministry of Health of Khabarovsk Region, +7(4212)72-87-15, goskana@mail.ru, 680009, Russia, Khabarovsk, Krasnodarskaya str., 9.
Larisa Yu. Molodtsova, PhD, obstetrician-gynecologist of the highest qualification, IRC LLC, +7(4212)46-69-32, larisamolodcova2@mail.ru,
680000, Russia, Khabarovsk, Gogolya str., 39.
Authors’ contributions: Kokhno N.I. – statistical analysis of the findings, writing the text of the manuscript; Gorshkova O.V. – collection of the data to be analyzed, development of the design of the investigation; Molodtsova L.Yu. – development of the design of the investigation, review of publications on the topic of the article, analysis of the findings, writing the text of the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Patient Consent for Publication: The patients have signed an informed consent form to use impersonal data for the analysis and publication of results.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Kokhno N.I., Gorshkova O.V., Molodtsova L.Yu.
Efficiency of systemic enzyme therapy
in the combination treatment of pelvic inflammatory diseases in women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 12: 159-164 (in Russian)
https://dx.doi.org/10.18565/aig.2022.294
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