Method of treatment of sensorineural hearing loss in acute and chronic periods

 

(57) Abstract:

The invention relates to medicine, namely to otolaryngology, and can be used for the treatment of patients with sensorineural hearing loss in acute and chronic periods. The essence of the method is exposed to biologically active unequally and new acupuncture points by introducing them in pharmacological preparations, the choice of which depends on etiologii and pathogenesis of the disease, with subsequent exposure to a rectangular pulse of current of negative polarity, frequency, 5 - 8 Hz rated current 8 to 12 μa. 2 Il. 5 table.

The invention relates to medicine, namely to reflexotherapy in the treatment of sensorineural hearing loss in acute and chronic periods and contributes to lowering the threshold of hearing, to improve the intelligibility of speech, reduced intensity, and more-the disappearance of ear noise.

There is a method of treatment of patients with sensorineural hearing loss methods reflexotherapy ("Reflexotherapy in treatment neironalnuu hearing loss". Methodological recom. The USSR Ministry of health, FR. Central research Institute of reflexotherapy, MMI M, 1989) includes the introduction of diverse quite active drugs by common methods of treatment toohot the th similar, the authors recommend the consistent application of a course of drug therapy with the use of a large number of different medicines, which together do not always have a positive effect. Reflexology on the background of such a powerful drug exposure becomes an extension component, contributing to the strengthening of the achieved results.

There is a method of treatment requires a long stay patient in the hospital.

The most similar essential features of the claimed invention is a method of treating patients with hearing loss and ear noise (M. A. Sakhalinsky and D. I. Bartkevichene. Auth. St. N950383, class A 61 H 39/00, 1982), taken for the prototype, including the impact on the acupuncture points around the ear with the introduction of solutions of biological stimulants, in which pre-add hyaluronidase, affecting daily for 2-3 point, repeat the treatment after 3-6 months.

The prototype of the invention has the following essential characteristics: 1) a biologically active points (BAP) are microdose drugs, contributing to the achievement of a higher therapeutic effect ol the type used solutions of biological stimulants adding lidz and 0.5% solution of novocaine. In the claimed invention medicinal substance is selected depending on the etiology of the disease. In the treatment of sensorineural hearing loss (PCT) influenza and intoxicates etiology is applied lydasum, divorced 2% solution of novocaine.

3) In the prototype used acupuncture points, located near the ear or directly on it. In the claimed invention was used unequally and "new" points located paraquinone.

The disadvantage of the prototype is that to get the desired result, treatment is simple introduction of a solution of a biological pacemaker, which is added lydasum and 0.5% solution of novocaine in BAT without follow-through electric current cannot simultaneously affect multiple stages of pathogenesis. In addition, in the prototype the introduction of the medicinal substance in the acupuncture points is not much different from the simple point subcutaneous injection and, consequently, cannot be used nst in the acute and chronic periods.

The invention is aimed at solving the problem of establishing a treatment neurosensory hearing loss in acute and chronic the definition effect.

This task contributes to lowering the threshold of hearing in acute PCT from 15-20 to 35-45 dB, and sometimes (10,7%) and full recovery, chronic HCT-lower hearing thresholds of 15 to 25-30 dB, and increases clarity, improves the General condition, in the presence of ear noise is reducing its intensity or complete disappearance. Electropuncture in conjunction with the introduction to acupuncture points pharmacological drugs provoke or prolong acts of the action of electric current. The use of currents of negative polarity contributes to the restoration of the regeneration mechanism bioelectric impulses. The use of weak pulsed currents, approaching in magnitude to the currents generated by the body, helps to achieve a therapeutic effect due to the normalization homeostatic mechanisms of the body.

To achieve this, the technical result of the claimed method of treatment of sensorineural hearing loss in acute and chronic periods contains the following significant similar signs: 1) in unequally and new BATH, located preauricular, entered microdose pharmacological drugs, insulin syringes, 2) in the Declaration is, divorced 2% solution of novocaine. In the prototype used the solutions of biological stimulants adding lidz and 0.5% solution of novocaine.

Unlike the prototype of the claimed invention in BAT are microdose medicinal substances, which are selected according to the etiology and pathogenesis of the disease. When vascular etiologies used drugs, improves cerebral circulation (Cavinton), infectious and toxic etiologies used drugs, containing hyaluronidase, in particular lydasum, divorced 2% solution of novocaine, under the PCT, which has arisen on a background of stress, unclear etiology and outcome of traumatic lesions of the applied synthetic LEU-enkephalin dalargin.

Introduction of medicinal substances in the prototype in the BATH produced in the form of simple exact subcutaneous injection. In the invention the pharmacopuncture methods produce irritation, using toning in cases with acute PCT and dispersion in chronic PCT, with the subsequent impact on the point of a rectangular pulse voltage of negative polarity with a frequency of electrical signals 5-8 Hz, amperage 8-12 µa apparatus adimy to achieve a stable positive therapeutic effect.

IN relation to the prototype of the claimed invention has the following distinctive features:

1. For pharmacopuncture in combination with electropuncture use unequally (RS 11 Shang-LUN, RS 13-min RS 25 I-Hsu) and the new point (RP 13 ting-Hsu, SPM 14 ting-Lin, SPM 15 ting-Tsung, SPM 16 tin-Ming, RP 18 HOU-ting Gong, SPM 21 HOU-Tsung), located preauricular that allows you to carry out medical procedures at any time of the day and in a sitting position. One procedure used 8-10 points located symmetrically.

2. Microdose medicinal substances enters into BAT under the two methods irritant effect. However, in cases with acute PCT used method of toning (BU)-"add energy", which includes a quick introduction of the drug, while rotating the syringe 3-7-9 times, followed by a closing point with a dry cotton ball or soft massage points. In cases with chronic PCT used method variance (CoE)-"take power" in which the needle slowly enter and quickly retrieve it. The shot put with a full deep breath. Drug is injected slowly, while rotating the syringe up to 6 times.

3. After the introduction of pharmacological agents on these points affect the rectangular pulse is I electroacupuncture ANALEC-5. The pharmacopuncture spend a day within 10 days of electro - daily for 20 days. The course of treatment is 20 days.

Between the features and the technical result is the following causal relationship:

1. The use of pharmacopuncture contributes to the achievement of improved therapeutic effect with small doses of drugs than the introduction of pharmacological agents in the usual way. I.e., put into BAT medicinal substance in smaller doses exert their therapeutic properties stronger and more long term.

Drug administration is performed on the basis of the rules of traditional Oriental medicine using methods irritant effect in order to restore the lost equilibrium: toning in the acute period of the disease and the dispersion in the chronic period.

2. On the BAHT, which previously entered medicinal substances, served rectangular pulse current of negative polarity with a frequency of electrical signals 5-8 Hz, amperage 8-12 µa for 3-5 minutes

Weak impact on the BAHT electric current cause changes of physiological parameters of the whole organism, in cha the General circulation, microcirculation of blood and lymph, cellular and tissue metabolism, changing the concentration of ions in the intercellular space, improves neurotransmitter metabolism, which leads to the generation of nerve impulses in the fibers and education in their membranes free radicals.

For the implementation of pharmacopuncture used insulin syringes with fine needles, as injections of drugs into the acupuncture points are more painful than usual injections. Pharmacopuncture is done through the day, the electro - daily. The treatment course consists of 10 sessions pharmacopuncture and 20 sessions of electroacupuncture.

Electropuncture is a device for electro ANALEC-5. The choice of a rectangular pulse current has a negative polarity due to the fact that electric stimulation current of negative polarity contributes to the activation of antinociceptive system, resulting allocated endogenous oligopeptides morphine-like nature that promote the regeneration of nerve tissue.

According to the authors the information set of essential features that characterize the essence of the claimed invention, is not known from the prior art that allows SDE is not necessary for the expert explicitly known level of medicine, since it cannot be detected by the above characteristics on the resulting therapeutic effect of the combination of the combined use of pharmaco - and electroacupuncture using a rectangular pulse voltage of negative polarity with a frequency of electrical signals 5-8 Hz, amperage 8-12 MCA, contributes to the achievement of improved therapeutic effect with small doses injected drugs into biologically active points than the introduction of pharmacological agents in the usual way, and finding patients at the day hospital, which allows to conclude that the criterion of "inventive step".

The set of essential features that characterize the invention, in principle, can be used repeatedly in medicine with the technical result consists in a more complete recovery of the function of the auditory analyzer, which allows to make a conclusion about conformity of the invention, the criterion of "industrial applicability".

This method was carried out as follows.

At admission the patient to the hospital the diagnosis was established on the basis of complaints, anamnesis, physical examination data of ENT organs what geometria, conducted by the audiometer MA-31.

The degree of hearing loss was determined based on the classification given to a Professor Grappa N. With. (Manual of otorhinolaryngology. M.: Medicine, 1994).

Treatment consisted of 20 days while being sick at the day hospital. The pharmacopuncture produced through day-10 procedures. Electro - daily - 20 procedures. The pharmacopuncture produced insulin syringes, using 8-10 BAHT, which are symmetrical. Each BAT was injected with 0.1-0.2 ml of drug substances with the addition of a 2% solution of novocaine. Selection of pharmacological preparations were carried out depending on the etiology and pathogenese disease. So in infectious and toxic etiologies PCT used enzyme preparations containing hyaluronidase, in particular hyaluronidase (1,2-2,4%), divorced 2% solution of novocaine. In the vascular etiology of the disease was used drugs, improves cerebral blood flow (reverse), with the PCT, which has arisen on a background of stress, unclear etiology and outcome of traumatic injury, used the opiate receptor ligand is a synthetic LEU-enkephalin dalargin.

For pharmacopuncture used unican the spine with the frequency of the electrical signals 5-8 Hz, amperage 8-12 µa apparatus for electro ANALEC-5.

In cases with acute pathology used a method of toning (BU), chronic CNT-dispersion (CE). Method of toning includes a quick introduction of needle and slow extraction, while rotating the syringe 3-7-9 time, followed by slow extraction of the needle, followed by a closing point with a dry cotton ball or a light massage points.

The method of dispersion needle slowly enter and quickly retrieve it. With the introduction of needles produce a slow rotation it up to 6 times.

This method of treatment was applied at 130 patients with sensorineural hearing loss, of which 89 people with acute pathology and 41 people with chronic diseases.

On the etiological factor, the patients were distributed as follows (see tab. 1).

In 91 patient's hearing loss was accompanied by a subjective ear noise 1-2 stages of severity. After treatment ear noise decreased from 40 patients and in 51 patients disappeared altogether.

The degree of decrease in hearing distribution of patients was as follows (see tab. 2).

Treatment of patients was done according to the above method. Audiological research is about the degree of lowering of the hearing are listed in the table. 3.

Patients of the control group was 60 people in the acute and chronic periods of sensorineural hearing loss. Of these 30 people were treated by the method of acupuncture with treatment of HCT and 30 people were treated by the method of injection of solutions of biological stimulants adding lidz and 0.5% solution of novocaine in acupuncture points.

Based on the results presented in table. 4, the tone audiograms of patients with acute sensorineural hearing loss who were treated by the method of combined use of pharmacological and electroacupuncture, there has been a lowering of thresholds of hearing from 15-20 to 25-3O-35-40 dB. Complete recovery was noted in 14 patients in the acute period of the disease within one week from the date of hearing loss.

All patients reported improvement of speech intelligibility and improvement in General condition.

In the treatment of other ways of lowering the threshold of hearing occurs mainly in the acute period of the disease from 15-20 25-30 dB, the application of these methods of treatment in the chronic period, the PCT has a low rate of efficiency.

The analysis of the results shows that the method is the combined use of pharmaco - and electropuncture seanie it is possible both in the acute, and chronic periods of sensorineural hearing loss.

Example 1. Patient H., 28, was at the day hospital ENT Department of the GENUS, Vladikavkaz, 20.11.1995, 09.12.1995, with a diagnosis of right-sided acute neurosensory hearing loss. Bilateral tubolit.

4 days before admission to hospital the patient after stress decreased hearing, appeared constant noise in the ear low tone, I degree. The noise was amplified by the evening. Data of objective inspection without features. When endoscopie ENT organs revealed no pathology.

Data hearing passports are given in table. 5.

The tone audiogram is a hearing loss II senior on the right. Bilateral tubolit. Data over threshold audiometry FUNG, SiSi-test-positive. General blood tests, urine in the normal range. Biochemical analysis of blood - in norm. On radiographs of the cervical spine revealed no pathology.

Within 20 days the patient were treated pharmacopuncture with the introduction of dalargin on 0,1-0,2 ml each BAT, then hit on the same point of the rectangular pulse current with a frequency of electrical signals 5-8 Hz, amperage 8-12 µa apparatus for electro ANALEC-5.

In addition it held catheterization auditory tubes with the introduction of lidz with Hidrocortizonum intratumor, and blowing off and pneumomassage (treatment Subotica).

He was discharged after 20 days with full clinical recovery. Tonal audiogram before (Fig.1) after treatment (Fig.2) are attached.

Method of treatment of sensorineural hearing loss in acute and chronic periods by influence on biologically active points of pharmacological preparations and electric current, characterized in that unequally and "new" biologically active points methods irritant effect in the form of toning (BU) in the acute period of the disease and the dispersion (CE) in the chronic period of insulin syringes injected with infectious and toxic etiologies hyaluronidase, divorced 2% solution of novocaine on 0,1 - 0,2 ml, with vascular etiology Cavinton 0.1 - 0.2 ml, with sensorineural hearing loss of unknown etiology, resulting from traumatic injuries and stress - lei - enkephalin dalargin - 0.1 - 0.2 ml, and then act on the same point of the rectangular pulse of current of negative polarity, amperage 8 - 12 mA, a frequency of the electrical signals 5 to 8 Hz in t is via daily for 10 days electro - daily for 20 days.

 

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where R1represents hydrogen, lower alkyl, lower alkenyl, lower quinil, aryl lower alkyl, cycloalkyl lower alkyl, lower alkoxy lower alkyl, hydroxy lower alkyl, amino lower alkyl, mono - or di-lower alkyl, amino lower alkyl, formyl, lower alkylsulphonyl, amino lower alkylsulphonyl, lower alkoxycarbonyl, mono - or di-aryl-substituted lower alkyl, arylcarbamoyl lower alkyl, aryloxy lower alkyl, or lower alkylene

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where R3represents hydrogen, lower alkyl or aryl lower alkyl, and R4represents lower alkyl or aryl lower alkyl; or alternatively the groupas a whole represents the

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R5is hydrogen, lower alkyl, aryl or aryl lower alkyl; and

Z predepression

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mixtures of their isomers or their individual isomers and their salts, mainly their physiologically tolerated acid additive salts, in particular with pharmacological action
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