A method of treating coronary heart disease, strokes voltage i-ii functional classes

IPC classes for russian patent A method of treating coronary heart disease, strokes voltage i-ii functional classes (RU 2177299):

A61N7 - Ultrasound therapy (lithotripsy A61B0017220000, A61B0017225000; massage using supersonic vibration A61H0023000000)

A61K35/08 - Mineral waters

A61H33/02 - Bathing devices for use with gas-containing liquid, or liquid in which gas is led or generated, e.g. carbon dioxide baths

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(57) Abstract:

The invention relates to medicine, cardiology. In the period of adaptation to conduct ultrasonic inhalations omagnichennogo aerosol hydrocarbonate sodium-calcium arsenic mineral water. The flow rate of aerosol 5 l/min Magnetic induction 65 MT. Duration: 3 minutes Hydrosulphuric baths go with 5 days of treatment. When I functional class at a concentration of 50-100-150 mg/l of hydrogen sulfide. When II functional class at a concentration of 50 mg/l of hydrogen sulfide. The method increases the remission period. 7 table.

The invention relates to medicine, namely cardiology, and can be used in medical practice and medical practice in the treatment of ischemic heart disease.

There is a method of treatment of ischemic heart disease by the total hydrogen sulfide baths, supplied at a concentration of hydrogen sulfide 25-50-100-150 mg/l N 12 of treatment (Shikhova N. M., Shikhov M, M, farm Laborer A. I. Sulfide balneotherapy coronary heart disease. In proceedings of the "Physical factors in the treatment and prevention of cardiovascular diseases". - Sochi. - 1978. - S. 5-7). However, this method is less efficient and requires pozmoznosti body, physical performance, improve processes lipoproteina metabolism, reduction of terms of treatment, the elongation of remission.

The problem is solved by holding in the period of adaptation ultrasonic inhalations omagnichennogo aerosol hydrocarbonate sodium-calcium arsenic mineral water at a flow rate of aerosol 5 l/min, with a duration of 3 minutes, the first 5 treatments every day, then every other day, a course of 10 treatments, and hydrogen sulfide baths released from the 7th day of treatment when I functional class with concentration 50-100-150 g/l of hydrogen sulfide, the first one or two a day and then 2 days in a row, day break, and when II functional class at a concentration of 50 mg/l of hydrogen sulfide through the first three day later or two days in a row with a day break in the course of 8 baths (see table 7).

The advantage of the combined method is that it corrects the adaptation of the body systems IHD patients by successive stages of exposure to ultrasonic inhalations omagnichennogo aerosol hydrocarbonate sodium-calcium arsenic water used in this way for the first time, and total sulphurous baths at the Lassa strokes voltage CHD.

For the first time in the recommended range of physical therapy in patients with CHD to achieve high therapeutic and health-economic effects using the method of transpulmonary introduction of mineral water in the body in the form of ultrasound (vysokodisperstnogo) aerosol. It is known that the dispersion of the fluid increases the pharmacokinetics, pharmacodynamics, bioavailability of aerosol absorption rate and, of course, the impact is higher than in General and drinking the mineral water, however ultrasound does not change its curative properties.

The use of this mineral water for transpulmonary introduction due to its chemical composition, physico-chemical properties of water, pathogenetic features of the disease ischemic heart disease.

Properties of trace elements such as arsenic, fluorine, boron, iodine, iron, sodium, calcium, etc. that are included with this mineral water, cause positive effects on various basic pathogenetic links to IHD. Given that among the starting mechanisms of ischemic heart disease are the reduction processes of adaptation, physical health and psihoemotsyonalnoe stability, disturbance processes cardiovasculara this method, with significant corrective action on the cardiovascular system, contractility of the heart muscle, increasing its resistance to oxygen starvation, while improving the adaptive capacity of the organism, pathogenetically substantiated.

It should be noted that correcting the above-mentioned effects enhance and potentiate the effect of total hydrogen sulfide baths with IBS, which provides a reduction of up to 8 instead of the existing 12.

In addition, the use of omagnichennogo aerosol mineral water provides early favorable effect due to specific physico-chemical processes occurring during the magnetic treatment of water and increase its biological activity.

The impact of low intensity factors, including mineral waters in small doses, at high efficiency in combination with other physical factors harmless, has no complications, economical from the standpoint of material costs.

The method is performed using vysokodispersnyh manichanh aerosols hydrocarbonate sodium-calcium placebomarijuana mineral water produced and introduced into the respiratory tract with IP is on the register of medical devices 1996) and the annular magnetic nozzles To-44-24-9.3 mm with a magnetic induction of 65 MT kit MN-1-001 for laser and biophysical devices (registration N 94/271-123 state register of medical devices 1996). Procedure release in a separate room with permanent ventilation (not less than 4 exchanges) according to standard rules for ultrasonic inhalers. Structural advantages inhaler TUR USI 50 (range drops of 0.5 to 8 microns, the efficiency of mist 2.5 ml/min, the possibility to regulate the flow of air from 0 to 20 liters per minute) give the opportunity to properly dispense the amount entered in the respiratory tract of therapeutic substances. To obtain vysokodispersnyh aerosols use hydrocarbonate sodium-calcium pliciloricus mineral water with arsenic content to 4.33 mg/l, boron of 40.3 mg/l, silicon 37,1 mg/l cations sodium 189,1, magnesium 42,4, calcium 448,5, iron (ferrous) 8,4, anions fluoride 1,6, chloride 66,0, bicarbonate 2091,1.

Circular magnetic K-44-24-9.3 mm is placed on the tube to which is attached a tube of staff / patient. The magnetization that occurs when the aerosol passing through the tube crosses the magnetic field of the annular magnet.

Set the following parameters procedure:
1. The composition of mineral water corresponds bottle manufactured for internal use;
2. The feed rate of the spray 5 l/min;
3. The consumption of mineral is Nino and the next 5 in a day.

During the procedure, the rhythm, the frequency and depth of breathing in normal and must comply with the conditions in the measurement of basal metabolic rate. Rapid and irregular breathing can cause hyperventilation and unwanted orthostatic reactions or trigger cardiac arrhythmia. Inhalation vysokodispersnyh aerosols of mineral water can be observed phenomena of irritation of respiratory tract, so after inhalation of mineral water immediately need to make a 3-minute inhalation olive or stone fruit oil.

Hydrogen sulfide baths appointed with a 7-day stay in the clinic when the water temperature 36^oC, duration 6-8-10-12-15 minutes, one or two baths a day, the next 6 - two days in a row with a day break with a differentiated assignment concentration of hydrogen sulfide baths depending on the severity of the disease: when I functional class 50-100-150 mg/l, at II - 50 mg/l

Preparatory five-day course of ultrasonic inhalations omagnichennogo aerosol hydrocarbonate sodium-calcium arsenic water create preconditions for the development of adaptation of the organism.

Example 1. Patient D. , 56 years old, live in, Tambov. Nahon₀. Hypertension 1 tbsp., slowly progressive course. Obesity II Art.

Upon receipt complained of aching pain in the region of the heart that occurs on the background of great emotional stress, radiating to the left arm, intractable validol, periodic headache, palpitations, shortness of breath when climbing on the 4th floor and above, increased irritability, fatigue.

The objective of the study at the time of admission: a proper physique, high power (body weight 78,4 kg with height 165 cm). Borders of the heart extended to the left by 1 cm, heart sounds, rhythmic, muted, accent II tone of the aorta, the heart rate of 74 beats per minute, rhythmic, satisfactory qualities. AD = 155/90 mm RT.article (S), and 150/80 mm RT.article (D). In the lungs - vesicular breathing. The abdomen is soft, painless, the liver is not enlarged. Symptom of Pasternack negative on both sides. Emotionally labile. In the Romberg sustainable, coordinating sample performs correctly.

These additional studies:
General an. blood: Hb - 118 g/l, er. - 3,8310¹²/l L - 4,710⁹/l, ESR - 12 mm/h, p is 2%, with 47% e - 1%, m - 6%, l - 44%. Response adaptation = 0,9 (Garkavi L. H.) reaction of increased activation.

E is tropia of the myocardium of the left ventricle.

VEM - tolerance to physical load is moderately low, the achieved power of 100 watts, the recorded ECG signs of CHD, normostenichesky type of reaction of the cardiovascular system to physical activity.

Biochemical blood test: the patient is marked minor violations lipoproteina metabolism - the total lipids of 5.03 g/l, triglycerides - 1,72 mmol/l, total cholesterol - 5,64 mmol/l, cholesterol-alpha-lipoproteins of 1.27 mmol/l, the index of atherogenic - 2,83, beta-lipoproteins - 5.20 g/l, diene conjugates of lipid - 3,11%, malonic dialdehyde red - 68,3 nmol/ml er. mass, malonic dialdehyde lipids of 13.6 nmol/mg lipid, serum catalase - 25,9 µkat/l ceruloplasmin - 0,299 g/L.

From the second day of stay in hospital the patient received ultrasonic inhalations with arsenic mineral water "Chvizhepse daily N 5, then a day, N 5. From the seventh day connected mos baths at t 36^oduration 6-8-10-12-15 minutes, a concentration of 50 mg/l 2 a day, 100 mg/l 3 baths, 150 mg/l, 3 baths, 8 baths (two first - through day, the next two days in a row with the day break). In the medical complex also included diet aimed at reducing izbytochnyye in the clinic decreased the blood pressure to 130/80 mm RT.art., decreased headache, decreased neurotic complaints. For the eighth day stay stopped the pain in the heart, disappeared headache, normalized sleep.

As a result of treatment by the end of the third week the patient's condition improved significantly: no pain in the heart, stopped headache, normalized sleep, increased tolerance to physical activity.

At follow-up, the following data:
Complete blood count: Hb - 137 g/l, er. - 3,7510¹²/l L - THE 5.45 10⁹/l, ESR - 6 mm/h, p - 3%, with 51% e - 1%, m - 6%, l - 32%. The reaction adapt Garkavi - 0,7 (reaction peaceful activation).

ECG sinus rhythm, 64 beats./min, improving the trophic infarction of the anterior and lateral wall of the left ventricle.

VEM is the increased tolerance to physical activity, achieved power - 125 W, which is 25% more compared to the original data. FC I. At the height of the load and in the recovery period of ECG signs of disease have not been reported.

Biochemical blood test: General lipid - 5,23 g/l, triglycerides - 0.49 mmol/l, total cholesterol - to 4.87 mmol/l, cholesterol-alpha-lipoproteins - 1,71 mmol/l, the index of atherogenic - 2,30, beta-lip is malonic dialdehyde lipids - of 10.7 nmol/mg lipid, serum catalase - 28,0 µkat/l ceruloplasmin - 0,298 g/L.

Thus, the use of recommended methods showed a clear adaptogenic, sedative, anesthetic effects: withdrawal heart pain, headaches, irritability, sleep improvement. The observed increase in physical health, emotional stability, improved processes lipoproteina metabolism - decrease the most atherogenic fractions of lipid metabolism, indicators of lipid peroxidation, activation of the antioxidant defense system. The transition of adaptive reactions of increased activation in a more favorable reaction calm aktivacii the middle of the course of treatment, not changing by the end of the treatment, indicates the development of adaptirovannoi body to this period and to create preconditions for a successful day further treatment hydrogen sulfide baths. Discharged with significant improvement.

Example 2 Patient P., 50 years old, works as a production Manager PMS, lives in Sverdlovsk region, p. baranchinskii. Were treated in the clinic with 23.02.99, 18.03.99, with a diagnosis of CHD. Angina, FC II, H₀. Arterial and occurring against a background of physical and emotional stress, radiating to the left arm, below the shoulder blade, couperosis nitroglycerin, periodic headache, insomnia, fatigue, increased blood pressure.

The objective of the study at the time of admission: asthenic physique, the subcutaneous fat layer is moderately developed. Borders of the heart is within normal limits, pulse 78 beats./min, rhythmic, satisfactory qualities, heart sounds, rhythmic, muted, accent II tone of the aorta. AD = 160/100 mm RT. Art. (D= S). In the lungs vesicular breathing, wheezing no. The abdomen is soft, painless, the liver is not enlarged. Symptom of Pasternack negative on both sides. Emotionally labile, the contact comes willingly. In the Romberg sustainable, coordinating sample performs correctly.

Complete blood count: Hb - 130 g/l, er. - 3,3310¹²L - 6,7510⁹, ESR - 35 mm/h, p - 1% - 48% e - 3%, m 10%, l - 37%. The reaction adapt Garkavi - reaction increased activation.

ECG sinus bradycardia, 52 beats./min, myocardial hypertrophy of the left ventricle, diffuse-degenerative changes in the myocardium of the anterior-lateral wall of the left ventricle.

VEM - tolerance to physical activity moderately, Eusko.

Biochemical blood analysis: serum catalase and 23.1 µkat/l ceruloplasmin - 0,323 g/l, total lipids 5,94 g/l, triglycerides - 1.28 mmol/l, total cholesterol - 7.05 mmol/l, cholesterol-alpha-lipoproteins of 1.65 mmol/l, the index of atherogenic - 3,27, beta-lipoproteins - 8,10 g/l, diene conjugates of lipids to 2.29%, malonic dialdehyde red - 64,9 nmol/ml er. mass, malonic dialdehyde lipids at 16.9 nmol/mg of lipids (there has been a violation of lipid metabolism and the processes of lipid peroxidation).

From the second day of stay at the resort with the aim of enhancing the adaptive capacity of the organism, the patient received ultrasonic inhalations hydrocarbonate sodium-calcium arsenic water "Chvizhepse" daily 5, then through day 5. From the seventh day of stay in hospital was connected mos baths, on a course of 8 treatments (the first two in a day, the next 6 - two days in a row with the day break), a concentration of 50 mg/L. In the medical complex also included diet (table N-10), physiotherapy, massage the neck area, dosed walking. The adaptation period was calm.

By the fifth day of stay in hospital the patient's condition has improved: decreased complaints neurotic is headache, normalized sleep, became more active. All complaints disappeared by the 15th day: stopped the pain in the heart, disappeared headache, normalized sleep, increased tolerance to physical loads, normalized and stabilized HELL on figures 120/80 mm RT.art., improved trophic infarction (EKG), improved lipoproteina metabolism: normalized total cholesterol by 8.5% (7,05 before treatment and 6.35 - after), atherogenic index 59% (3.27 to before treatment, 1,33 - after), decreased levels of beta-lipoproteins by 9.5%, improved lipid peroxidation (diene conjugates and malonic dialdehyde decreased by 19% and 33%, respectively) when the increase antioxidant (catalase serum and ceruloplasmin increased by 35% and 15% respectively). The treatment ended with a significant improvement.

The second example also confirms the high efficiency of the proposed method of treatment: the development of adaptation to the middle of the course of treatment that has created the conditions for a favorable effect of changes kardeogemodyinamiki, physical health, lipid metabolism, lipid peroxidation and antioxidant protection to 20 days licentie the proposed method - patients with ischemic heart disease, angina, I-II functional classes, without arrhythmias, circulatory failure is not above the I century, with risk factors - hypertension, hypercholesterolemia, psychological stress, impaired reactions of adaptation. II group - 30 patients with coronary artery disease, angina, I-II functional classes, without arrhythmias, circulatory failure is not above the I century, with risk factors - hypertension, hypercholesterolemia, psychological stress, impaired reactions adaptation - received treatment total hydrogen sulfide baths (prototype).

The most frequent subjective manifestations of disease in both groups had pain in my heart constricting or whining character with irradiation to the left arm, below the shoulder blade arising from physical or emotional stress, palpitations, shortness of breath while climbing uphill or upstairs. In addition, almost all patients had expressed various degrees of sleep disturbance, irritability, fatigue, unexplained feelings of fear, anxiety.

In the analysis of subjective symptoms during treatment were observed improvement in all groups ntny analgesic effect: removal of heart pain, palpitations, headaches in the middle of the treatment; observed and a clear anxiolytic effect disappeared irritability, fatigue, sleep disturbance (table 1.) in group II, the positive effect was observed only at the end of treatment.

According to table 1 notes a sufficiently high efficiency of treatment in group I patients who took the treatment by the proposed method in comparison with prototype: there is a more significant reduction in complaints, prevails% significant improvements and enhancements, there are no cases of the patient's condition is unchanged.

One of the objectives of this work was to study adaptive responses CHD patients in the treatment process using a variety of medical facilities. Adaptationa reactions were studied by L. Garkavi H. (the ratio of lymphocytes to segmental neutrophils) and is estimated by the value of this index (table 2.).

According to table 2 there is also a clear unidirectionality of change % of reactions adaptation influenced by using the proposed method of treatment, and the prototype: a reduction in the number of patients with adverse adaptive reactions of increased activation and indifferent reactions of the training and Vendee expressed in group 1 patients (+25,4 +15,7%, respectively). In addition, a positive feature of the impact of the proposed method of treatment in comparison with the prototype is to achieve an adaptogenic effect by mid-treatment (+ 24,3%), continued almost to the end of treatment (25,4), while the effect of the prototype is achieved only by the end of treatment (+3,8 in the middle and +15,7 at the end).

Thus, the proposed method of treatment has a more pronounced and more rapid adaptogenic action.

Comparative performance assessment exercise samples of patients with coronary heart disease under the effect of the combined treatment showed a high efficiency in all groups surveyed, but more significant in group I: the amount of work done in this group is significantly higher than in group II patients, showing a significant increase in tolerance to physical stress (the amount of work done in group I increased by 9.3% from the original, and in group II - 1.7%). The frequency of cardiac contractions at the level of achievement of the maximum tolerated load remained practically unchanged in both groups, and diastolic blood pressure in group II. Dynamics of double work, systolic and diastolic pressures are most pronounced Tawana only hydrogen sulfide baths less favorable than for physical health (table 3.).

Under the influence of the treatment with the use of various medical complexes in patients with positive dynamics of lipid metabolism by lowering cholesterol, triglycerides, beta-lipoproteins and increase 1-cholesterol and therefore reduce the atherogenic index. While significant changes in these parameters observed in the group of patients who took 1st medical complex, which included hydrogen sulfide baths and ultrasonic inhalations hydrocarbonate sodium-calcium arsenic water. When using therapeutic complex prototype of the studied parameters in orientation had a similar dynamics of lipid metabolism, but it is in most cases statistically only had a high tendency to significance (table 4, 5)
From tables 4, 5 show that the most effective is the complex using hydrogen sulfide baths and ultrasonic inhalations hydrocarbonate sodium-calcium arsenic water.

Thus, in the course of the research it is established that the proposed complex treatment causes more favorable and soft adaptation shifts and distinct positive change is easen lipid oxidation and increasing antioxidant protection of blood. It is noted increase physical performance by 9.3%, improvement of the processes of adaptation in patients with the transition to the most favorable reactions "calm activation (Garkavi L. H.) by the end of treatment and does not change by the end of the treatment period.

The comparative evaluation of two medical complexes in the treatment of heart disease, according to clinical and physiological reactions, dynamics of physical health indicators lipoproteina metabolism, hemostasis and immune protection, marked by rather high efficiency of the proposed method of treatment, due to its differentiated choice of multifactorial prevention and treatment of this group (table 6.)
When evaluating the effectiveness should be taken into account and the timing of its occurrence. Generally, improvement in the subjective symptoms, reactions adaptation and emotional stability observed in 5-7 day hospital stay in patients of group I, to the end of treatment in group II. Improvement of objective data in group I notes to 15-20 day of treatment, in group II - to 24 days.

When the overall therapeutic efficacy of almost 95% in a shorter time (15-20 days) also have significant economic e is rozwojowy inhalation (5 ml).

Effect lasts 12-15 months after treatment in patients of group I with a decrease in the number of exacerbations in 5,16 time.

A method of treating coronary heart disease, strokes voltage I-II functional classes by the total hydrogen sulfide baths which are released when the water temperature 36^oWith duration 6-15 min, characterized in that the adaptation period is conducted ultrasonic inhalations omagnichennogo aerosol hydrocarbonate sodium-calcium arsenic mineral water at a flow rate of aerosol 5 l/min, when the magnetic induction 65 MT duration of 3 minutes, the first 5 treatments daily, then every other day, a course of 10 treatments, and hydrogen sulfide baths released from the 7th day of treatment when I functional class at a concentration of 50-100-150 mg/l of hydrogen sulfide, the first one or two a day, the next two days in a row with a day break and when II functional class at a concentration of 50 mg/l of hydrogen sulfide, the first three in a day, the next 2 days in a row with a day break in the course of 8 baths.