The treatment vesico-renal reflux

 

(57) Abstract:

The invention relates to medicine, therapy. Spend antibacterial therapy. Perform sinusoidal modulated currents. Frequency modulation 100 Hz, the depth of modulation 50-75%. Forked electrode mounted on the projection area of the lower and middle third of the ureter. A second electrode mounted on the lumbar-sacral region. After 2-3 weeks conducting a course of reflexology. Realize the impact of acupuncture on the second vozbujdayuschego method for 7-10 days, 3-4 times affected by warming wormwood cigar. The method improves the efficiency of the treatment.

The invention relates to medicine, namely to children's uronephrology and reflexology (RT), and can be used for the treatment of vesico-renal reflux (WRR) in children.

This pathology occurs very often and is 35-46% among the causes of obstruction in chronic secondary pyelonephritis in children. Poorly to conservative treatment, often leads to the development of nephrosclerosis. Surgical treatment does not always lead to a positive outcome after surgical treatment is always required long-medic is effective treatment methods.

There is a method of treatment VRR by antibiotic therapy to prevent episodes of urinary tract infection. When choosing a drug taken into account the degree of reflux, the age of the patient, the effectiveness of earlier therapy, the frequency of urinary infection, the degree of microbial activity of the inflammatory process. During clinical and laboratory remission is anti-relapse therapy urocoptidae within 3-5 years (A. C. Papayan, I. C. Anichkov, I., Tsvetkov. Actual problems of vesicoureteral reflux and reflux nephropathy in children // ROS. Vestn. Perinatology and Pediatrics. - 1996. -N 3-C 50-54. ). This method of treatment is aimed at eliminating the infectious agent, without affecting other parts of pathogenesis. Antibacterial therapy is necessary to conduct long-term rates, which often generates resistance of pathogens to drugs. In the disturbed conditions of urodynamics prolonged antibiotic therapy leads to accumulation of the drug, the manifestation of its side effects.

Closest to the present invention is a method of treatment WRR diadynamic currents (DDT), exposure is performed by rhythm sinkopa on the projection area of the bladder is 7. - S. 541 - 542. ).

However, this method has disadvantages: there are adverse effects associated with carrying a DDT. In particular, unpleasant sensation under the electrodes, so there is poor tolerance procedures, especially younger children, since the effect is constant pulse of current. Low treatment efficiency, especially at the reflux 2-3 degrees. There is no clear based techniques for DDT. In the available literature there is no specific data on the effectiveness of this method of treatment, most urologists use a delaying tactic in terms of surgical treatment for 6-12 months. In General, low effectiveness of conservative treatment VRR.

The aim of the invention is to increase the effectiveness of conservative treatment VRR.

This goal is achieved by what is antibiotic therapy according to the standard technique, then as subacute inflammatory process is the effect of pulsed current, in particular a variable sinusoidal modulated current (SMC). The impact is two electrodes, one forked a small area (8-10 cm2) is installed on the areas of the industry. The AC mode, the nature of the work 2, the frequency of modulation of 100 Hz, the depth of modulation 50-75%, duration parcel - pause 2-3 with, the procedure 8-10 minutes treatment 7-10 treatments. 2-3 weeks after completion of the course the ITC is in a course of reflexology. The effect of acupuncture is performed on the second vozbujdayuschego method at point 13 (Zhong-JI), 14 (Guan yuan), E28 (Shui-Tao), E (GUI-Lai), R12 (da-Hae), R13 (qi-Xue). The procedure takes 1-2-3 point, the combination of arbitrary points. If unilateral reflux, then prick point front-middle Meridian and the Meridian points of the kidneys and stomach on the interested party, if the process is bilateral, then take the point of the front-middle Meridian and symmetrical points on the meridians of the kidneys and stomach. During treatment it is recommended to warm up the point 14, 13 wormwood cigar. Course RT consists of 7-10 procedures.

Comparative analysis of the prototype shows that the proposed method differs from the known fact that the applied AC pulse current (SMC). Proposed mode of action of the ITC - stimulation technique ureter, without affecting the bladder. 2-3 weeks after the course CMT undergo RT on our proposed methodology for 7-10 days.This method can be used in the treatment of patients VRR as in stationary conditions (specialized hospitals) and outpatient settings (clinics, physiotherapy and foot reflexology offices).

Therefore, the method meets the criteria of "inventive step" and "industrial applicability".

The method is as follows.

The patient, in the period of exacerbation of the process and is taking antibiotics. Medications are selected taking into account the degree of reflux, the activity of the process, taking into account sown flora. Dose and diceless, appointed by rosatti in maintenance doses, 1 times a day for 3-6 months and the impact of ITC on the following methodology: first forked electrode of small area (8-10 cm2) is installed on the projection area of the lower and middle third of the ureter, the second electrode (50 to 100 cm2) lumbar-crestorbuy region. The AC mode, the nature of the work 2, the frequency of modulation of 100 Hz, the depth of modulation 50-75%, duration parcel - pause 2-3 s, the exposure time is 8-10 minutes treatment 7-10 treatments. 2-3 weeks after graduating from ITC is in a course of reflexology. The effect of acupuncture is performed on the second vozbujdayuschego method at point 13 (Zhong-JI), 14 (Guan yuan), E28 (Shui-Tao), E (GUI-Lai), R12 (da-Hae), R13 (qi-Xue). The procedure takes 1-2-3 points in arbitrary combination. Points 13, 14 it is recommended 3-4 times in the course of treatment to heat in combination with these acupuncture points or without him. When unilateral reflux prick point front-middle Meridian and the Meridian points of the kidneys and stomach on the party concerned. If the process is bilateral, then take the point of the front-middle Meridian and symmetrical points on the meridians of the kidneys and stomach. Course RT includes 7-10% of the deposits are held 2-3 times per year with an interval of 2-3 months, depending on the degree of reflux and frequency of exacerbation of the inflammatory process.

Example 1. Sick T-Arina, 2 years. Was hospitalized in the Nephrology Department with a diagnosis of a Congenital abnormality of the urinary excretory system. Unilateral active and passive reflux of 3 degrees. Chronic secondary obstructive pyelonephritis.

During the examination in urinalysis beats. weight 1015, leukocytes-7 - 8-6, erythrocytes - 0, oxalate salt.

Nechiporenko-leukocytes - 250, erythrocytes - no.

Voiding cystography - passive and active VR 3 degrees to the left.

The treatment and after completion of antibiotic therapy, the course ITC-7 procedures in AC mode, 2 originally, frequency 100 Hz, the depth of modulation of 50%, the duration of the p - p with 2-3 8 min, 2 weeks after the end of the physiotherapy course conducted RT 7 procedures.

A monitoring study was conducted voiding cystography pictures of the complete absence of reflux.

In a long-term period through the year in the clinical picture and the laboratory analysis of changes it is not revealed.

Example 2. Patient C-Tanya 1 year 6 months. Were on treatment in the hospital from Orani active and passive VR 3 degrees. Chronic secondary obstructive pyelonephritis.

Urinalysis - tank weight 1027, leukocytes 10-12, oxalates significant amount.

Nechiporenko-erythrocytes - 500, leukocytes 4750.

Voiding cystography - active and passive bilateral reflux 3 degrees.

Were treated with the aforementioned method. Held 2nd year CMT 10 procedures in AC mode, 2 a native of work, frequency 100 Hz, the depth of modulation of 75%, the duration of the p - p with 2-3 10 min and 3 course RT for 10 treatments. On the control picture, the absence of reflux on the right side. In the control urine on Nechiporenko erythrocytes 750, leukocytes 3250. In the General analysis of urine without pathology.

In this way were treated 20 patients.

With bilateral reflux 2 degrees to 8 children, grade 2-3 - 3 children.

With unilateral reflux 2 degree - 2 children, grade 2-3 - 7 children.

Effectiveness of treatment was at the reflux 2 degree - 70.1% of the liquidation reflux, 21% reduction in degree; at reflux 3 degrees of 62.5% and 25.7%, respectively. In the prototype, the effectiveness of conservative treatment was when the reflux of 2 degrees 62,9% and 18.5%, when the reflux of 3 degrees to 37.5% and 25%, respectively (M. D. Jawad-is it // Urology and Nephrology. -6-1998. -S. 16-18. ).

The proposed method of conservative treatment WRR simple to perform, does not require expensive equipment, therefore, can be used in inpatient and outpatient environment. Procedures CMT and RT is easily tolerated by children, do not have any side effects. When turning on the RT in complex treatment significantly increases the effectiveness of conservative treatment WRR 2-3 degrees.

The treatment vesico-renal reflux, including antibiotic therapy, then the impact of the pulse currents to the area of the lower urinary tract, characterized in that the impact is sinusoidal modulated currents in AC mode, 2 originally, frequency modulation 100 Hz, the depth of modulation 50-75%, duration parcel - pause 2-3 C for 8-10 min 1 times 7-10 times a day, with a forked electrode of small area 8-10 cm2set on the projection area of the lower and middle third of the ureter, the second electrode area of 50-100 cm2set on the lumbar-sacral region, after 2-3 weeks, after which undergo additional reflexology path, including the effects of acupuncture on the second who is for 7-10 days, the number of points for the procedure from 1 to 3 in an arbitrary combination and 3-4 times the warming wormwood cigar points 13, 14.

 

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