I-Vulva-vaginal atrophy (VVA) yenye yeziphumo eziqhelekileyo zokunqongophala kwe-estrogen, ngakumbi emva kokuyeka ukuya exesheni.Izifundo ezininzi ziye zavavanya iziphumo ze-hyaluronic acid (HA) kwiimpawu zomzimba kunye nezesondo ezinxulumene ne-VVA kwaye zifumene iziphumo ezithembisayo.Nangona kunjalo, uninzi lwezi zifundo zijolise kuvavanyo oluzimeleyo lwempendulo yeempawu kwimixube yezihloko.Nangona kunjalo, i-HA yi-endogenous molekyuli, kwaye kusengqiqweni ukuba isebenza ngcono ukuba itofwe kwi-epithelium engaphezulu.I-Desirial® yi-asidi yokuqala ye-hyaluronic edityanisiweyo elawulwa ngenaliti ye-mucosal ye-vaginal.Injongo yolu phononongo yayikukuphanda impembelelo yeenaliti ezininzi ze-intravaginal intramucosal ze-hyaluronic acid edibeneyo edibeneyo (DESIRIAL®, i-Laboratoires VIVACY) kwiziphumo ezininzi eziphambili zeklinikhi kunye nezigulane ezixelwe ngesigulane.
Iqela lophononongo lokulinga lwamaziko amabini.Iziphumo ezikhethiweyo zibandakanya utshintsho kwi-vaginal mucosal thickness, i-collagen formation biomarkers, i-flora ye-vaginal, i-pH yangasese, isalathisi sempilo ye-vaginal, iimpawu ze-vulvovaginal atrophy kunye nomsebenzi wesondo kwiiveki ze-8 emva kwe-injection ye-Desirial®.Uluvo olupheleleyo lwesigulane sokuphucula (PGI-I) isikali sasisetyenziselwa ukuvavanya ukwaneliseka kwesigulane.
Bebonke ngabathathi-nxaxheba abayi-20 bagaywa ukusuka ku-19/06/2017 ukuya ku-05/07/2018.Ekupheleni kophononongo, kwakungekho mahluko kubukhulu obuphakathi be-vaginal mucosa okanye iprocollagen I, III, okanye i-Ki67 fluorescence.Nangona kunjalo, i-COL1A1 kunye ne-COL3A1 i-gene expression inyuke kakhulu ngokwezibalo (p = 0.0002 kunye ne-p = 0.0010, ngokulandelanayo).I-dyspareunia exeliweyo, ukoma kwelungu lobufazi, ukurhawuzelelwa kwelungu lobufazi, kunye nokuxhuzula kwilungu lobufazi nazo ziye zancitshiswa kakhulu, kwaye yonke imilinganiselo yesalathiso sokusebenza ngokwesondo kwabasetyhini iphuculwe kakhulu.Ngokusekelwe kwi-PGI-I, izigulane ze-19 (95%) zichaze amanqanaba ahlukeneyo okuphucula, apho i-4 (20%) yaziva ingcono kancinci;Isi-7 (35%) sasingcono, kwaye isi-8 (40%) sasingcono.
I-Multi-point intravaginal injection ye-Desirial® (i-HA edibeneyo edibeneyo) yayinxulumene kakhulu nokubonakaliswa kwe-CoL1A1 kunye ne-CoL3A1, ebonisa ukuba ukubunjwa kwe-collagen kwakhuthazwa.Ukongezelela, iimpawu ze-VVA zancitshiswa kakhulu, kwaye ukwaneliseka kwesigulane kunye namanqaku okusebenza ngokwesondo kwaphuculwa kakhulu.Nangona kunjalo, ubukhulu obupheleleyo be-mucosa ye-vaginal abuzange butshintshe kakhulu.
I-Vulva-vaginal atrophy (VVA) yenye yemiphumo eqhelekileyo yokusilela kwe-estrogen, ngakumbi emva kokuyeka ukuya esikhathini [1,2,3,4].Iisyndromes ezininzi zeklinikhi zinxulunyaniswa ne-VVA, kubandakanywa ukomisa, ukucaphuka, ukurhawuzelelwa, i-dyspareunia, kunye nosulelo oluphindaphindiweyo lomgudu womchamo, olunokuba nefuthe elibi kakhulu kumgangatho wobomi babasetyhini [5].Noko ke, ukuqalisa kwezi mpawu kusenokungacacanga yaye ngokuthe ngcembe, yaye kuqalise ukubonakala emva kokuba ezinye iimpawu zokuyeka ukuya exesheni zithothile.Ngokweengxelo, ukuya kuthi ga kwi-55%, i-41%, kunye ne-15% yabasetyhini be-postmenopausal bahlupheka ngenxa yokoma kwe-vaginal, i-dyspareunia, kunye nokusuleleka ngokuphindaphindiweyo kwe-urinary tract, ngokulandelanayo [6,7,8,9].Nangona kunjalo, abanye abantu bakholelwa ukuba ukuxhaphaka kwezi ngxaki kuphezulu, kodwa uninzi lwabasetyhini alufuni uncedo lwezonyango ngenxa yeempawu [6].
Umxholo oyintloko wolawulo lwe-VVA lunyango lweempawu, kubandakanywa utshintsho lwendlela yokuphila, i-non-hormonal (njenge-lubricant ye-vaginal okanye i-moisturizers kunye nonyango lwe-laser) kunye neenkqubo zonyango lwe-hormone.Izithambisi ze-vaginal zisetyenziselwa ukukhulula ukoma kwe-vaginal ngexesha lokwabelana ngesondo, ngoko abanako ukubonelela ngesisombululo esisebenzayo kwisigxina kunye nobunzima beempawu ze-VVA.Ngokuchasene noko, kuxelwa ukuba i-vaginal moisturizer luhlobo lwemveliso "ye-bioadhesive" enokukhuthaza ukugcinwa kwamanzi, kwaye ukusetyenziswa rhoqo kunokuphucula ukucaphuka kwe-vaginal kunye ne-dyspareunia [10].Nangona kunjalo, oku akunanto yakwenza nokuphuculwa kwe-vaginal epithelial maturity index [11].Kwiminyaka yakutshanje, kukho amabango amaninzi okusebenzisa i-radiofrequency kunye ne-laser ukunyanga iimpawu ze-vaginal menopausal [12,13,14,15].Nangona kunjalo, i-FDA ikhuphe izilumkiso kwizigulana, igxininisa ukuba ukusetyenziswa kweenkqubo ezinjalo kunokukhokelela kwiziganeko ezimbi kakhulu, kwaye ayikamisela ukhuseleko kunye nokusebenza kwezixhobo ezisekelwe kumandla kunyango lwezi zifo [16].Ubungqina obuvela kwi-meta-analysis yezifundo ezininzi ezingahleliwe zixhasa ukuphumelela kwe-topical and systemic hormone therapy ekunciphiseni iimpawu ezinxulumene ne-VVA [17,18,19].Nangona kunjalo, inani elilinganiselweyo lezifundo liye lavavanya iziphumo ezizinzileyo zonyango olunjalo emva kweenyanga ze-6 zonyango.Ukongeza, ukuchasana kwabo kunye nokhetho lobuqu yimiba ethintela ukusetyenziswa okubanzi kunye nexesha elide kolu khetho lonyango.Ngoko ke, kusekho imfuneko yesisombululo esikhuselekileyo nesisebenzayo sokulawula iimpawu ezinxulumene ne-VVA.
Iasidi ye-Hyaluroniki (HA) yimolekyuli ephambili ye-matrix engaphandle, ekhoyo kwizicubu ezahlukeneyo kubandakanya i-mucosa ye-vaginal.I-polysaccharide evela kwintsapho ye-glycosaminoglycan, edlala indima ebalulekileyo ekugcineni ukulingana kwamanzi kunye nokulawula ukuvuvukala, ukuphendula komzimba, ukubunjwa kwe-scar kunye ne-angiogenesis [20, 21].Amalungiselelo e-HA ye-Synthetic anikezelwa ngendlela yeegels ze-topical kwaye anesimo "sezixhobo zonyango".Izifundo ezininzi ziye zavavanya impembelelo ye-HA kwiimpawu zomzimba nezesondo ezinxulumene ne-VVA kwaye zifumene iziphumo ezithembisayo [22,23,24,25].Nangona kunjalo, uninzi lwezi zifundo zijolise kuvavanyo oluzimeleyo lwempendulo yeempawu kwimixube yezihloko.Nangona kunjalo, i-HA yi-endogenous molekyuli, kwaye kusengqiqweni ukuba isebenza ngcono ukuba itofwe kwi-epithelium engaphezulu.I-Desirial® yi-asidi yokuqala ye-hyaluronic edityanisiweyo elawulwa ngenaliti ye-mucosal ye-vaginal.
Injongo yolu phononongo oluza kuba lumbindi-ziko lokulinga kuphonononga impembelelo yenaliti ye-intravaginal intravaginal intramucosal edityanisiweyo ethile ye-hyaluronic acid (DESIRIAL®, i-Laboratoires VIVACY) kwiziphumo eziphambili zeengxelo ezininzi zeklinikhi kunye nesigulane, kunye nokuvavanya. ukuba nokwenzeka kovavanyo Ukwabelana ngesondo kwezi ziphumo.Iziphumo ezibanzi ezikhethiweyo kolu phononongo zibandakanya utshintsho kwi-vaginal mucosal thickness, biomarkers of tissue regeneration, flora ye-vaginal, i-pH ye-vaginal kunye nesalathisi sempilo ye-vaginal kwiiveki ze-8 emva kwesitofu se-Desirial®.Silinganise iziphumo ezichazwe zizigulane ezininzi, kubandakanywa utshintsho kumsebenzi wesondo kunye nezinga lokunika ingxelo yeempawu ezinxulumene ne-VVA ngexesha elifanayo.Ekupheleni kophononongo, impembelelo yesigulane yokuphucula (PGI-I) isikali yayisetyenziselwa ukuvavanya ukwaneliseka kwesigulane.
Uphononongo lwabemi lwalubandakanya abasetyhini abasemva kokuya exesheni (iminyaka emi-2 ukuya kweli-10 ubudala emva kokuyeka ukuya exesheni) abathunyelwe kwiklinikhi yokuyeka ukuya exesheni abaneempawu zokungakhululeki kwelungu lobufazi kunye/okanye i-dyspareunia yesibini ukomisa kwelungu lobufazi.Abasetyhini kufuneka babe ≥ iminyaka eyi-18 kunye
Emva kokuba iisampuli zesiseko kunye nemilinganiselo zigqityiwe, i-HA (i-Desirial®) edibeneyo ifakwe enye yeengcali eziqeqeshiwe ze-2 ngokweprotocol eqhelekileyo.I-Desirial® [i-NaHa (i-sodium hyaluronate) i-IPN-Like 19 mg / g + mannitol (i-antioxidant)] ijeli ye-HA ene-injection yemvelaphi engeyiyo yezilwanyana, ukusetyenziswa okukodwa kunye nokupakishwa kwiSirinji efakwe ngaphambili (2 × 1 ml. ).Isixhobo sonyango seKlasi III (CE 0499), esetyenziselwa i-injection ye-intramucosal kubasetyhini, esetyenziselwa i-biostimulation kunye nokubuyisela amanzi kwindawo ye-mucosal yendawo yesini (Laboratoires Vivacy, 252 rue Douglas Engelbart-Archamps Technopole, 74160 Archamps, France).Malunga neenaliti ezili-10, nganye i-70-100 µl (0.5-1 ml iyonke), yenziwa kwimigca ethe tyaba eyi-3-4 kwindawo engunxantathu yodonga lwangasemva lobufazi, isiseko sayo esikwinqanaba le-vaginal yangasemva. udonga, kunye ne-apex kwi-2 cm ngaphezulu (umzobo 1).
Uvandlakanyo lokuphela kwesifundo lucwangciselwe iiveki ezisi-8 emva kobhaliso.Iiparamitha zovavanyo lwabasetyhini ziyafana nezo zikwisiseko.Ukongezelela, izigulane nazo ziyafuneka ukuba zizalise i-Ovall Improving Impression Impression (PGI-I) iScale Satisfaction Scale [30].
Ngenxa yokunqongophala kwedatha yangaphambili kunye nohlobo olulingwayo lophando, akunakwenzeka ukubala ubungakanani besampulu esesikweni yangaphambili.Ngoko ke, ubungakanani besampulu efanelekileyo yezigulane ze-20 zikhethwe ngokusekelwe kwizakhono zeeyunithi ezimbini ezithatha inxaxheba kwaye zanele ukufumana uqikelelo olufanelekileyo lweziphumo ezicetywayo.Uhlalutyo lwamanani lwenziwa kusetyenziswa isoftware ye-SAS (9.4; SAS Inc., Cary NC), kwaye inqanaba lokubaluleka libekwe kwi-5%.Uvavanyo lwenqanaba olusayiniweyo lukaWilcoxon lwasetyenziselwa izinto eziguquguqukayo eziqhubekayo kwaye uvavanyo lweMcNemar lusetyenziselwe ukuguquguquka ngokweendidi ukuvavanya utshintsho kwiiveki ezisi-8.
Uphando luvunywe yi-Comité d'ethique du CHU Carémeau de Nimes (ID-RCB: 2016-A00124-47, ikhowudi yeprotocol: LOCAL/2016/PM-001).Bonke abathathi-nxaxheba kuphando basayine ifomu yemvume ebhaliweyo esebenzayo.Kutyelelo lwezifundo ezi-2 kunye nee-biopsies ezi-2, izigulane zinokufumana imbuyekezo ukuya kuthi ga kwi-200 Euros.
Itotali yabathathi-nxaxheba be-20 bagaywa ukusuka kwi-19/06/2017 ukuya kwi-05/07/2018 (izigulane ezi-8 ezivela kwi-CHRU kunye ne-12 yezigulane ezivela kwi-KMC).Akukho sivumelwano esaphula imilinganiselo yokubandakanywa/yokungabandakanywa kuqala.Zonke iinkqubo zokutofa zazikhuselekile kwaye zilungile kwaye zagqitywa kwimizuzu engama-20.Iimpawu zedemografi kunye nesiseko sabathathi-nxaxheba bophando ziboniswe kwiThebhile 1. Kwisiseko, i-12 kwi-20 yabasetyhini (60%) isebenzise unyango lweempawu zabo (i-6 hormonal kunye ne-6 non-hormonal), ngelixa ngeveki 8 kuphela izigulane ze-2. (10%) basaphathwa ngolu hlobo (p = 0.002).
Iziphumo zeziphumo zengxelo yeklinikhi kunye neyesigulane ziboniswe kwiThebhile 2 kunye neTheyibhile 3. Esinye isigulane salile i-W8 ye-vaginal biopsy;esinye isigulane sala i-W8 ye-vaginal biopsy.Ke ngoko, abathathi-nxaxheba be-19/20 banokufumana idatha epheleleyo ye-histological kunye ne-genetic analysis.Xa kuthelekiswa ne-D0, akukho ntlukwano kubukhulu obupheleleyo be-vaginal mucosa ngeveki 8. Nangona kunjalo, ubukhulu be-basal layer ye-basal yanda ukusuka kwi-70.28 ukuya kwi-83.25 microns, kodwa oku kwanda kwakungabalulekanga ngokwezibalo (p = 0.8596).Kwakungekho nantlukwano yezibalo kwi-fluorescence yeprocollagen I, III okanye i-Ki67 ngaphambi nangemva kokunyanga.Nangona kunjalo, i-COL1A1 kunye ne-COL3A1 i-gene expression inyuke kakhulu ngokwezibalo (p = 0.0002 kunye ne-p = 0.0010, ngokulandelelanayo).Kwakungekho tshintsho olubalulekileyo lwezibalo, kodwa luncede ukuphucula umgangatho wezityalo ze-vaginal emva kwesitofu se-Desirial® (n = 11, p = 0.1250).Ngokufanayo, kufuphi nesiza se-injection (n = 17) kunye ne-fornix ye-vaginal (n = 19), ixabiso le-pH ye-vaginal nayo yayithande ukunciphisa, kodwa lo mahluko wawungabalulekanga ngokwezibalo (p = p = 0.0574 kunye ne-0.0955) (Itheyibhile 2) .
Bonke abathathi-nxaxheba bophando banokufikelela kwiziphumo ezixelwe ngesigulana.Ngokutsho kwe-PGI-I, umthathi-nxaxheba omnye (i-5%) akazange achaze utshintsho emva kwe-injection, ngelixa izigulane ze-19 ezisele (95%) zichaze amanqanaba ahlukeneyo okuphucula, apho i-4 (20%) yaziva ingcono kancinci;Isi-7 (35%) singcono, isi-8 (40%) singcono.I-dyspareunia exeliweyo, ukoma kwelungu lobufazi, ukurhawuzelelwa kwelungu lobufazi, ukurhawuzelelwa kwilungu lobufazi, kunye namanqaku ewonke e-FSFI kunye nomnqweno wabo, ukuthambisa, ukwaneliseka, kunye nemilinganiselo yeentlungu nazo ziye zancitshiswa kakhulu (Itheyibhile 3).
I-hypothesis exhasa olu pho nonongo kukuba ii-injection ezininzi ze-Desirial® kudonga lwangasemva lwe-vagina ziya kutyebisa i-mucosa ye-vaginal, i-pH ye-vaginal ephantsi, iphucule i-flora yangasese, ibangele ukubunjwa kwe-collagen kunye nokuphucula iimpawu ze-VA.Siye sakwazi ukubonisa ukuba zonke izigulana zichaze ukuphucuka okubalulekileyo, kubandakanya i-dyspareunia, ukomisa kwelungu lobufazi, ukuqhawuka kwelungu lobufazi, kunye nokurhawuzelelwa kwamalungu angasese.I-VHI neFSFI nazo ziphuculwe kakhulu, kwaye nenani labasetyhini abafuna unyango olulolunye ukulawula iimpawu zabo nalo liye lehla kakhulu.Ngokunxulumeneyo, kuyenzeka ukuqokelela ulwazi malunga nazo zonke iziphumo ezigqitywe ekuqaleni kwaye ukwazi ukubonelela ngongenelelo kubo bonke abathathi-nxaxheba bophando.Ukongezelela, i-75% yabathathi-nxaxheba bophando bachaze ukuba iimpawu zabo ziphuculwe okanye zingcono kakhulu ekupheleni kophononongo.
Nangona kunjalo, ngaphandle kokunyuka okuncinci kwi-avareji yobunzima be-basal layer, asikwazanga ukubonisa impembelelo ebalulekileyo kubunzima obupheleleyo be-mucosa ye-vaginal.Nangona uphononongo lwethu alukwazanga ukuvavanya ukuphumelela kwe-Desirial® ekuphuculeni ubukhulu be-mucosal ye-vaginal, sikholelwa ukuba iziphumo zifanelekile kuba ukubonakaliswa kwe-CoL1A1 kunye ne-CoL3A1 abamakishi baye banda kakhulu kwi-W8 xa kuthelekiswa ne-D0.Kuthetha ukuvuselela i-collagen.Nangona kunjalo, kukho imiba ethile ekufuneka iqwalaselwe ngaphambi kokuqwalasela ukusetyenziswa kwayo kuphando lwexesha elizayo.Okokuqala, ngaba ixesha lokulandelelana kweeveki ezisi-8 lifutshane kakhulu ukubonisa ukuphuculwa kobunzima be-mucosal epheleleyo?Ukuba ixesha lokulandelelana lide, utshintsho oluchongiweyo kwisiseko sesiseko lunokuthi luphunyezwe kwezinye iindawo.Okwesibini, ngaba ubukhulu be-histological boqweqwe lwe-mucosal lubonisa ukuvuselelwa kwezicubu?Uvavanyo lwe-histological of the vaginal mucosal thickness ayifuni ngqalelo i-basal layer, ebandakanya izicubu ezihlaziyiweyo ngokudibanisa nezicubu ezidibeneyo.
Siyaqonda ukuba inani elincinci labathathi-nxaxheba kunye nokungabikho kobukhulu besampulu esemthethweni yimiqathango yophando lwethu;nangona kunjalo, zombini ziimpawu eziqhelekileyo zophononongo olulingwayo.Kungenxa yesi sizathu ukuba siphephe ukwandisa iziphumo zethu kumabango okusebenza kwezonyango okanye ukungasebenzi.Nangona kunjalo, enye yeenzuzo eziphambili zomsebenzi wethu kukuba ivumela ukuba sivelise idatha yeziphumo ezininzi, eziya kusinceda ukubala ubungakanani besampulu esesikweni yophando lwexesha elizayo.Ukongeza, umqhubi wenqwelomoya uyasivumela ukuba sivavanye isicwangciso-qhinga sethu sokufuna abantu, izinga le-churn, ukuba nokwenzeka kokuqokelela isampulu kunye nohlalutyo lweziphumo, oluya kubonelela ngolwazi kuwo nawuphi na umsebenzi onxulumeneyo.Okokugqibela, uthotho lweziphumo esizivavanyileyo, kubandakanywa iziphumo zeklinikhi ezinenjongo, ii-biomarkers, kunye neziphumo ezixelwe ngesigulana ezivavanywe kusetyenziswa amanyathelo aqinisekisiweyo, awona mandla aphambili ophando lwethu.
I-Desirial® yi-asidi yokuqala ye-hyaluronic edityanisiweyo elawulwa ngenaliti ye-mucosal ye-vaginal.Ukuze kuhanjiswe imveliso ngale ndlela, imveliso kufuneka ibe ne-fluidity eyaneleyo ukuze itofwe ngokulula kwisihlunu esidityanisiweyo esikhethekileyo ngelixa igcina i-hygroscopicity yayo.Oku kufezekiswa ngokulungiselela ubungakanani beamolekyuli ze-gel kunye nenqanaba le-gel cross-linking ukuqinisekisa ukugxininiswa kwe-gel ephezulu ngelixa ugcina i-viscosity ephantsi kunye ne-elasticity.
Uninzi lwezifundo ziye zavavanya imiphumo enenzuzo ye-HA, ininzi yazo i-RCT engekho ngaphantsi, ithelekisa i-HA kunye nezinye iindlela zonyango (ikakhulukazi i-hormone) [22,23,24,25].I-HA kwezi zifundo yayilawulwa ekuhlaleni.I-HA yi-endogenous molekyuli ebonakaliswe ngamandla ayo abaluleke kakhulu ukulungisa nokuthutha amanzi.Ngokukhula, inani le-asidi ye-hyaluronic engapheliyo kwi-mucosa ye-vaginal iyancipha ngokukhawuleza, kwaye ubukhulu bayo kunye ne-vascularization nayo iyancipha, ngaloo ndlela inciphisa i-plasma exudation kunye ne-lubrication.Kule sifundo, siye sabonisa ukuba i-injection ye-Desirial® ihambelana nokuphuculwa okuphawulekayo kuzo zonke iimpawu ezinxulumene ne-VVA.Ezi ziphumo zihambelana nophando lwangaphambili olwenziwe nguBerni et al.Njengenxalenye yemvume yolawulo ye-Desirial® (ingcaciso eyongezelelweyo engachazwanga) (Ifayile eyongezelelweyo 1).Nangona kucingelwa kuphela, kunengqiqo ukuba olu phuculo luyisibini kumathuba okubuyisela ukudluliselwa kweplasma kwi-epithelial surface ye-vaginal.
Ijeli ye-HA edibeneyo kunye nayo ibonakaliswe ukwandisa ukuhlanganiswa kohlobo lwe-collagen kunye ne-elastin, ngaloo ndlela ikwandisa ubukhulu bezicubu ezijikelezileyo [31, 32].Kwisifundo sethu, asizange sibonise ukuba i-fluorescence yeprocollagen I kunye ne-III ihluke kakhulu emva kokunyanga.Nangona kunjalo, i-COL1A1 kunye ne-COL3A1 imbonakalo yofuzo yonyuke kakhulu ngokwezibalo.Ngoko ke, i-Desirial® ingaba nefuthe elikhuthazayo ekubunjweni kwe-collagen kwi-vagina, kodwa izifundo ezinkulu kunye nokulandelela ixesha elide zifunekayo ukuqinisekisa okanye ukuchasa le nto.
Olu phononongo lubonelela ngesiseko sedatha kunye nobungakanani besiphumo esinokubakho kwiziphumo ezininzi, eziya kunceda izibalo zesampulu zexesha elizayo.Ukongeza, uphononongo lubonakalise ukuba nokwenzeka kokuqokelela iziphumo ezahlukeneyo.Nangona kunjalo, ikwaqaqambisa imiba emininzi ekufuneka iqwalaselwe ngononophelo xa kucwangciswa uphando lwexesha elizayo kulo mmandla.Nangona i-Desirial® ibonakala iphucula kakhulu iimpawu ze-VVA kunye nomsebenzi wesondo, indlela yokusebenza kwayo ayicacanga.Njengoko kunokubonwa kwintetho ebalulekileyo ye-CoL1A1 kunye ne-CoL3A1, kubonakala kukho ubungqina bokuqala bokuthi ivuselela ukubunjwa kwe-collagen.Nangona kunjalo, iprocollagen 1, iprocollagen 3 kunye ne-Ki67 ayizange iphumelele imiphumo efanayo.Ke ngoko, iimarker ezongezelelweyo ze-histological kunye nebhayoloji kufuneka zijongwe kuphando lwexesha elizayo.
I-Multi-point intravaginal injection ye-Desirial® (i-HA edibeneyo edibeneyo) yayinxulunyaniswa kakhulu nokubonakaliswa kwe-CoL1A1 kunye ne-CoL3A1, ebonisa ukuba ivuselela ukubunjwa kwe-collagen, inciphisa kakhulu iimpawu ze-VVA, kwaye isebenzisa ezinye iindlela zonyango.Ukongeza, ngokusekelwe kumanqaku e-PGI-I kunye ne-FSFI, ukwaneliseka kwesigulane kunye nomsebenzi wesondo kuphuculwe kakhulu.Nangona kunjalo, ubukhulu obupheleleyo be-mucosa ye-vaginal abuzange butshintshe kakhulu.
Idatha esetyenzisiweyo kunye / okanye ihlalutywe ngexesha lokufunda ngoku inokufumaneka kumbhali ohambelanayo ngesicelo esifanelekileyo.
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Ixesha lokuposa: Oct-26-2021