The method of treatment of osteoarthritis of the large joints

 

(57) Abstract:

The invention relates to medicine, arthrology. Influence of laser radiation on biologically active points located in the area of large joints. The wavelength of not more than 1.06 Ám, the thickness is not more than 0.6 kW. A single pulse on each point. Then at the same point injected drug solutions. The method provides lasting remission.

The invention relates to medicine, namely to traumatology and orthopedics, and can be used for the treatment of patients with osteoarthritis of large joints.

The problem of choosing a method of treatment of osteoarthritis conservative methods remains unresolved up to the present time. Usually the success of the treatment is noticeable depending on the duration of remission of the disease, the degree of functional activity of the joint is in remission and periods of incapacity and/or disability, as well as how the patient is free in remission from drug loads.

There is a method of treatment of osteoarthritis of the large joints (A. N. Smirnov. Articular syndromes: differential diagnosis and principles of pathogenetic therapy. M: "KAPPA", 1999 - -28 C.) is injected into the cavity susstones anti-inflammatory therapy.

However, against the background of various lengths improve the clinical condition of the patient (from 1 month. to, in rare cases, two years), in the joint continues pathological changes, as may occur after treatment, the remission is always accompanied by drug therapy, for example, nonsteroidal anti-inflammatory drugs, which are also known to cause General and local complications.

There is a method of treatment of osteoarthritis of the large joints (M. A. Berlizov. Degenerative and post-traumatic joint diseases in outpatient practice. Act. speech. M, - 1993. - S. 21) by intra-articular injection of various drugs: rumalon, arteparon, hydrocortisone, etc., and laser therapy and acupuncture.

However, the known method can cause purulent arthritis, in the process of its application is trauma paraartikulyarnye tissues, subsequently causing various chronic tentative, with the formation of persistent contractures. The method does not provide drug-free remission after treatment, and the remission continues depending on the stage of the disease relatively short period of time: from NESCO the surveillance of patients with osteoarthritis of large joints (C. Y. Bora. A comprehensive and conservative approach to the treatment of arthrosis deformans in the day hospital. Samara. 1997 abstract. Kida.Diss.). by "receptormediated blockades", essentially paraartikulyarnye introduction to the area of the tendons that attach directly to the area of the joint (the area of the condyles, namyslow, patella), procaine, oxygen, platifillina, vikasola, sometimes intraarticular injection of steroid hormones, etc. In the method of complex treatment techniques used physical therapy, laser therapy, low-energy red laser topically to the area of joint exposure to 30 minutes and other types of physical impact.

However, the known method does not solved the problem of prevention of purulent arthritis, synovitis, trauma paraartikulyarnye tissues. Duration of remission heterogeneous, the introduction of a large number of drugs in almost tendon fraught with the development of tentati with the formation of contractures. The drug load is extremely high and not always justified.

The closest analogue is a method of treatment of patients with osteoarthritis of large joints (I. P. Petkovski reflexology Techniques in complex treatment of patients with arthritis is affected by focused laser radiation by exposure places the needle red laser light in the red spectrum with a wavelength of 632.8 nm (HeNe laser) for 8-12 C. In addition, the author has used laser irradiation with wavelengths in the range from 325 to 632.8 nm. Thus the flux density of the radiation power was not more than 2 mW/cm2the exposure time is not more than 3 min, the course of treatment is 10 to 20 sessions.

However, the method does not allow to achieve prolonged and repeated remission, used low-intensity laser radiation has a low depth of penetration is not always appropriate location depth BAHT. Thus, the use of laser therapy has most likely non-specific effects, but does not impact directly on the BAT.

The objective of the invention is to provide a highly effective method of treatment of osteoarthritis of large joints, allowing persistent repeated drug-free remission, improvement of cartilage, increasing the functionality of the joint.

The invention consists in that in the method of treatment of osteoarthritis of the large joints, including the impact on biologically active points of the focused laser radiation influence on biologically active introspections points located in the area of large joints, wysokopre is a pulse at each point, and then at the same point injected solutions of vitamins, drugs with local anesthetic and chondroprotective effect. With the defeat of the shoulder joint use point - 10GI, 14GI, 15GI, 6GI,; elbow - 11GI, 5GI, with the defeat of the hip - 36V, 31E, 31VB, 34E; knee - 10RP, 9RP, 36E, 34E. In the presence of synovitis in biologically active introspections point additionally injected during the first 3-5 sessions a solution desensitizing drugs, and in the presence of contractures - enzyme preparations.

The use of the invention allows to obtain the following technical result.

The method is highly effective. It allows almost 100% of cases to prevent the development of septic complications, trauma paraartikulyarnye tissues, worsening of degenerative-dystrophic processes in the joint and surrounding tissue. Provides long lasting, repeat when repeat courses of treatment, drug-free remission. During preoperative preparation method allows to improve the results of surgical treatment. The method reduces disability and improves quality of life of patients, especially in case of late about the 3 stage process, the method provides stable, repeatable remission of up to 10 years and over.

The method has practically no contraindications. Contraindication can only be individual intolerance of drugs used for the introduction of biologically active introspections point.

The authors first established the following.

System zones acupuncture is part of the apparatus of biological regulation of the body and is tasked with maintaining optimal energy level in accordance with the changing internal and external conditions, i.e., BAST are areas of energy exchange. Under the influence of irradiation of high-level neodymium laser change their conductivity. We have developed and theoretically justified the new scheme of treatment of OA with the use of basic drugs with regard to the nature and localization of the pathological process. Comparative study of different methods of conservative treatment of OA, based on the injection of various drugs, including the introduction of similar products not biologically active specific point, showed a significant potentiation of the action of drugs, enter in BEAST and acceleration of clinical effect during the preliminary irradiation points of the laser. On the with a total capacity per session points - 2-2,5 kW, showed a significant potentiation of drug action entered in BEAST and accelerate the timing of any clinical effect: on average 3-5 days after the start of treatment is the relief of synovitis and pain, increase range of motion in the joint, and so on, the Positive effect of the laser with the above parameters is provided by the light penetration depth, allowing you to lead BEAST in the excited state and to improve the response points for drugs. Irradiation of BEAST activates the oxidative system providing an antioxidant effect in the area of the affected segment, which in turn leads to the shortening phase of inflammation, and therefore speeds up the process of cupping process as a whole.

The method is as follows.

The biologically active introspections points located in the area of large joints are affected by radiation with a wavelength of not less than 1.06 Ám with a capacity of not more than 0.6 kW contact single pulse at each point, and then at the same point injected solutions of vitamins and drugs with local anesthetic and chondroprotective effect. This piennolo replacement - 36V, 31E, 31VB, 34E; knee - 10RP, 9RP, 36E, 34E; and in the presence of synovitis in biologically active introspections point additionally injected during the first 3-5 sessions a solution desensitizing drugs, and in the presence of contractures - enzyme preparations.

For this purpose, we first determine the location of the bioactive introspections points (BEAST) on anatomical landmarks. For example, the location of the point 10RP is located on the inner side of the thigh, at a distance of 2 tuna from the upper edge of the patella; 9RP - at the intersection of the horizontal straight line through the tuberosity of the tibia and the vertical through the middle of the inner muscles of the tibia; 36E - in the gap between the little tibial bone, the width of the finger from the tuberosity of the tibia; 34E - 2 CUN above the outer corner of the patella, in the depression between the tendons of the straight muscle of the thigh and outer heads of the quadriceps muscle. Use domestic neodymium laser machine "Good light" or import permitted for use in the Russian Federation "SHARLAN" Nd: YAG LASER SYSTEM (model 3040, 3060 or 3100) or other devices with the specified parameters. Perform the tuning apparatus for pulsed exposure regime, apoena to the surface of the segment, first sequentially irradiated previously found biologically active points of high-energy neodymium laser with power density at each point is 0.5 kW, followed by injection in the same BEAST. The puncture points are produced at an angle of 90oto the skin surface, the depth of insertion of the needle is about 1 CUN. Determine the nature of the flow of the process: the presence or absence of signs of synovitis. In the presence of phenomena of synovitis use an antihistamine, a local anesthetic (novocaine or its analogues), vitamin b 12, protective agents. In BEAST corresponding localization exacerbation of the pathological process in one or two of the three major joints irradiated with neodymium laser, enter the above mixture of drugs in average therapeutic doses, spaced equally on all active points. The procedures are performed daily. Possible 1-2 day break in the middle of the course. Throughout the course of 10-12 treatments. 3-4 days after relief of symptoms of synovitis an antihistamine of the part of the medical cocktail output and continue the introduction of the mixture consisting of hondroprotektor, novocaine and vitamin B12. If effusion in the joint there, but Idasa. In the absence of the above violations (synovitis and contractures) therapeutic mixture consists of three basic products. Conducted a comprehensive conservative treatment with physical therapy, bracing drug therapy. The proposed method eliminates the use of steroid hormones. The criterion for remission is the normalization of indices and biochemical studies of blood levels of alkaline phosphatase and seromucoid and clinical results of the treatment: the function of the affected limb, no pain, allowing the patient to dispense oral medication.

The method applied in 34 patients with osteoarthritis of large joints (knee, hip, elbow, shoulder) in the city hospital, Art. Russa and 15 clinical hospital, Moscow.

Of them in age from 24 to 78 years were 23 women and 11 men. As a result, the method has provided a positive clinical result, based on the fact that for 3-4 days was docked pain syndrome, the phenomenon of synovitis, for 5-6 day significantly increased range of motion at 1-2 tbsp. process to physiological amounts, and in the case of 3-4 tbsp. - up to the original (prediciting) level. Ultrasound and roentgenologic is the result of the treatment.

Clinical examples.

Example 1. Patient M, 51, was on the treatment of osteoarthritis of the left knee 1-2 tbsp., synovitis. Patients received a course of laser therapy and injection therapy in BEAST: I0RP, 9RP, 36E, 34E N 14. For this purpose, we first determined the location of the bioactive introspections points (BEAST) on anatomical landmarks. The location of the point 10RP is located on the inner side of the thigh, at a distance of 2 tuna from the upper edge of the patella; 9RP - at the intersection of the horizontal straight line through the tuberosity of the tibia and the vertical through the middle of the inner muscles of the tibia; 36E - in the gap between the little tibial bone, the width of the finger from the tuberosity of the tibia; 34E - 2 CUN above the outer corner of the patella, in the depression between the tendons of the straight muscle of the thigh and outer heads of the quadriceps muscle. First carry out the irradiation point of the high-energy neodymium laser with power density at each point is 0.5 kW, followed by injection in the same BEAST. The puncture points are produced at an angle of 90oto the skin surface, the depth of insertion of the needle is about 1 CUN. Have introduced the following medications: supranational acid and aloe course of 14 injections. After 3 introduction synovitis and pain almost cropped, treatment was continued with the aim of improving the condition of the connective tissue, cartilage. Upon completion of the course of treatment during the inspection palpation of the knee joint painless range of motion in the joint in full, the patient walks without a stick, notes that the greater the load on the joint performance restored.

The patient is examined after 6 months, no complaints, works in the specialty.

Example 2. Patient A. 64 years was in outpatient treatment for acute exacerbation of chronic right-sided coxarthrosis 3-4 tbsp. history of injury is a fall on the street. The patient walks with a limp. Movement in the joint, especially the abduction is the abduction and rotation, limited and painful. By using the search apparatus EPA determined BEAST: 36V - in the center of the gluteal folds. 31E - the intersection of a horizontal line drawn through the pubic bone and the vertical drawn through the upper iliac spine. 31VB - place touch 3 finger extended along the body of the patient's arm rear edges of the muscles of his broad fascia of the thigh. 34E - at a distance of 3 cm above the upper outer corner of the patella, in a hollow between two dry okain 2.0 ml, rumalon 2.0 ml, vitamin B12 400 scale in points with their pre-irradiation with high-energy neodymium laser with a wavelength of 1.06 Ám and the radiation power at a single point of 0.5 mW. The patient received concomitant therapy: aq Aloe and nicotinic acid parenteral, FT, exercise therapy. The patient's condition has improved: 4-5 introduction cropped pain syndrome, by the end of the treatment range of motion increased, improved gait, quality of life. Inspection a year later - almost no pain, the patient is active, works in the specialty - guide.

The method of treatment of osteoarthritis of the large joints, including the impact on biologically active points of the focused laser radiation, characterized in that the impact on biologically active points located in the area of large joints, high-energy laser radiation with a wavelength of not less than 1.06 Ám with a capacity of not more than 0.6 kW, contact single pulse for each biologically active point, and then at the same point injected solutions of vitamins, drugs with local anesthetic and chondroprotective effect.

 

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