The method of functional physiological correction of the human condition and diagnosis in the process of correction

 

The invention relates to medicine, in particular for preventive medicine, therapy, physiology and valeology, and can be used in intelligent computer system as in the treatment individually and collectively disorders functional state. The method includes a visual representation of the patient's own cardiotocogram (kardiointervalogrammy) in real time. The patient synchronizes its respiratory movements with variations of their own heart rhythm: the higher the heart rate provides a breath, but at a lower heart rate exhale. In the process of correction estimating parameters of cardio-respiratory status of the patient and in accordance with these parameters decide the completion or interruption of the correction and the number of sessions. The method allows to recover cardiorespiratory synchronization of the patient in the range fast from 0.15 to 0.4 Hz or slow from 0.04 to 0.15 Hz waves heart rhythm depending on the individual patient. 1 C.p. f-crystals, 10 ill.

The invention relates to medicine, in particular for preventive medicine, caraceni individually, and collectively disorders functional state, for example, the cardiovascular system. The invention is also applicable in the diagnosis.

Known methods of correction (treatment) with the use of biofeedback (BFB).

Known "Method of treatment of vegetative-vascular dystonia" [1], the essence of which lies in the prolongation of remission and reduce the number of attacks by combining the use of pharmacological agents and the impact of biofeedback, in particular the introduction of the patient dilantin after a preliminary determination of the upper and lower limits of heart rate (HR). On the backdrop of dilantin continue measuring heart rate and, if there is a sharp deviation for one of the limits, the patient auditory training through biofeedback to establish heart rate within normal limits.

In fact, in the known method for obtaining a positive result is pharmacotherapy, and barefoot at the sharp HR outputs beyond the norm serves as an additional tool in the form of electric, sound or light alarm the patient.

The main disadvantage of this method is the complete lack of control over bioritmologicheskikh characteristics of cardiac rhythm and Dina is testowanie respiratory sinus or respiratory arrhythmia is unfavorable diagnostic sign. Accordingly, there is no guarantee of long-term effectiveness of treatment in a known manner. In addition, the use of dilantin when many associated diseases, not shown, which limits the scope.

Known "Method of functional correction of arterial blood pressure" [2], which is the closest to the technical nature of the offer. The method consists in training the cardiovascular system (CVS) using barefoot through a visual presentation to the patient of his cardiotocogram (synonyms - kardiointervalogrammy, pulsogram, speed tachogram;), derived from the electrocardiogram (ECG) of the first standard derivations, computer processed, appearing on the screen of the dual-trace oscilloscope with the sweep time of the beam 50, simultaneously, one of the sinusoid is the objective function (fit) from the generator with fixed periods of oscillation 7, 10, 13, 17, 34 and 47 C for 2-2,5 minutes with breaks for rest 2 min Hold at least 6 presentations per session, the number of which is from 2 to 12, one daily or intermittently between up to 5 days. There are 3 options for exercise, different combinations of requirements of sinusoids, sequence and time fakim inadequate situation with regard to the real cardiotocogram patient, there are certain periods of the sinusoids presented for tracking, not always related (or not appropriate) with real breathing vibrations are located in the ranges of fast waves from 0.15 to 0.4 Hz and slow waves from 0.04 to 0.15 Hz heart rhythm (SR), the absence of objective constraints on the amplitude of the sinusoid and average heart rate, which is the DC component of the sine wave that does not exclude the exit status of the patient beyond the individual physiological norm, leading, for example, to hyperventilation with possible negative consequences. The choice of parameters of the reference sinusoid is actually subjective, is not optimal for the different States of the patient and does not take into account the state of neurocirculatory link regulation of CF, which polyharmonically process that leads to the real possibility of missing fixed period groups of sine waves in the range of oscillations of the CF patient. It has been forced impact on the patient that some individuals counteracts the rapid involvement in the process of cardiotraining. In fact, there is no objective diagnostic evaluation of the patient's condition as is and diagnostics.

Thus, the known methods do not solve the problem of high therapeutic effect, safety, patient care, which limits the field of application under different physiological conditions (diseases) patients.

The objective of the invention is the expansion of the patient's adaptation to the procedure of training by avoiding imposing harmonic curves, simulating real cardiotocogram patient.

The invention consists in the optimal effects on the Central nervous system, the sympathetic and parasympathetic divisions of the autonomic nervous system on the individual for a specific patient, the pattern of functional normalization parameters of the cardiovascular system by biofeedback on heart rhythm method of visual presentation in real-time graphic information in the form of own cardiotocogram patient as a target function for synchronization of the dynamics of respiratory movements with variations of SR and recovery cardiorespiratory synchronization with subsequent automatic analysis of CRF for the rapid diagnosis of the patient.

Brief description of Dali documentary charts, where appropriate symbols: Fig. 1 is a block diagram of a system for training (to simplify circuits are not shown included in the set of computer system unit, keyboard, printer), with 1 patient, 2, 3 sensors transducer cardiomegaly, 4 - block check kardiosignalas, 5 - unit forming a feedback signal, 6 - analytical block (blocks 5 and 6 are part of the computer), 7 - monitor.

In Fig.2 - real schedule normal source CWG the state of relaxed wakefulness 8.

In Fig.3 - source CWG 9 patient N. with the absence of periodicity.

In Fig.4 - final 10 AWG patient N., synchronization in the range of slow waves.

In Fig.5 - source CWG 11 patient L., rigid rhythm.

In Fig. 6 - final 12 AWG patient, synchronization in the range of slow waves.

In Fig. 7 - lack of cardiorespiratory synchronization, AWG 13 the patient railroad in the initial state with pneumogram 14.

In Fig.8 - final AWG 15 (recovery of cardiorespiratory synchronization in the range of fast waves) in the patient with J. pneumogram 16.

In Fig. 9 - lack of cardiorespiratory synchronization, AWG 17 patient C. in the initial state with pneumogram is the R waves) in a patient With. with pneumogram 20.

The principle of the method consists in the following. Sessions cardiotraining (biocontrol) is carried out in a moderately lit, soundproof, well-ventilated room with a comfortable temperature. Patient 1 (the nasal passages should be free, clothes not to hamper normal breathing and circulation) seated in a comfortable chair at a distance of 1.5-2 meters from the screen (Fig.1). On the domestic processed mixture Nikiforova the surface of the forearms impose fixed with an elastic band not tightening hand sensors 2 and 3, with which the electrocardiogram entered in block 4 registration kardiosignalas. Measure blood pressure (BP), for example, by using a blood pressure monitor UA 702. In this case, the patient 1 explain the essence of the training, showing on the monitor screen in real time his own CWG associated with the state of the cardiovascular system of the body.

In Fig.2 presents a particular case of the normal curve 8 AWG with a pronounced rhythm in the area of slow waves. Subjective and objective indicators this patient did not need correction. The initial and final CWG registered in the state of relaxed wakefulness with secretarytimothy, offer gently breathe so that with increasing pozarnej pulse (rising curve up) was done breath, and at lower pozarnej pulse rate (lower curve) - exhale. The patient's attention is drawn to the dependence of the fluctuations of the KRG from the frequency and amplitude of breathing. It also stresses the need for relaxation during the session cardiotraining, the patient is given a 4-5 min for habituation to the environment.

In essence, the respiratory movements are synchronized with the heart rate variability (HRV), which excluded the primary influence baroreceptor incentives on the cardiovascular system that occur when the unorganized rhythm of breathing. This allows you to identify your own rhythms, modulations of heart rate, strengthen their manifestation due to respiratory movements of the corresponding HRV due to impulse activity with peripheral chemo - and baroretseptorov and repeated repetitions allows you to secure new rhythmically coordinated (through neurohumoral regulation) rhythms of breath and heart (the relationship between the respiratory and cardiovascular systems). When forming arbitrarily modulated respiratory arrhythmia in ranges pricescope, and parasympathetic regulation of heart rate, thereby expanding the range of adaptability of the system of regulation SK, respectively, is manifested in the constant increase period of cardiorespiratory synchronization and management capabilities WED indirectly through the process of respiration in the spectrum of waves with smaller periods. The confirmation of such features are, for example, real curves final AWG 10 in Fig.4, and the final AWG 16 in Fig.8.

In fact, the patient 1 performs arbitrary control of respiratory rhythm, and the presence of ongoing respiratory waves is favorable diagnostic sign. Being on the first 2-3 sessions, the doctor that owns the method of cardiotraining, provides psychological preparation of the patient, verbal correction phases of inhalation and exhalation in accordance with the rise and decline pozarnej frequency of cardiac rhythm (KRG curve). After each sample of the training measure AD and enter its value in the computer memory, and 1 patient resting 2-3 minutes with your eyes closed. The number of samples in the session can be from 6 to 8, each of which has a duration of 120-150 seconds. Before and after each session with the eyes closed in a relaxed state region is Geneve or every other day, from 1 to 12 or more, depending on the objectives of the study, the initial diagnosis of the patient's condition and its dynamics on the results of the training on the basis of objective data, computer analysis, presented in the form of graphs, tables, text conclusions on the screen of the monitor 7 or printed on the printer, self-reports of the patient and doctor.

For rapid assessment of the current condition of the patients in the proposed method uses the parameters determined before, during (after each sample) and after session: HELL, it automatically measures the average for the sample curves and determined the average dynamic and pulse pressure, respiratory rate, automatically built cardiotocogram and calculates its rhythmic structure (spectral power), indicating the status of the autonomic (simpato-vagusnye) balance and are scatterogram heart rhythm (SR), indicating the presence of some types of arrhythmias, histograms of the distribution of RR-intervals, with a number of design parameters and indexes (minute and a stroke volume of blood circulation, cardiac index, peripheral resistance, energy, heart, cardio-respiratory coefficient, coefficient of endurance, variational scale, indexarray system.

After a session of cardiotraining fairly quickly analyze spatial (19 ECG) electroencephalogram, and focuses on the intensity and spatial distribution of its basic rhythms.

The presence in the way of detailed analysis of directly measured and calculated indices of cardiovascular system substantiates the ability to use it not only for biofeedback procedures, but also for the continuous supervision of trained patient during the operations of the method for dispensing the load and making an informed decision about the completion or interruption of the session. A large amount of above leads to a high degree of accuracy diagnostics of patients in the training process that provides enhanced and reliable effectiveness of treatment.

Thus, the desired cycle of operations of the method carried out with patients in a therapeutic purposes, restores normal bioecological the structure of the heart rate, the alpha rhythm of the EEG normalizes the heart rate, blood pressure and other indicators of cardiovascular system with significant improvements in patients ' well-being. tavernost high efficiency correction status of the patients presented with specific examples of implementation of the method.

Example 1. Patient N. on I. N., 16 at the end of March 2000 had suffered a severe psychological shock and asked to help cope with their condition. Objectively on 14.04.2000 - HELL 140/90 mm RT.art., HR - 101 beats/min, respiratory rate - 17 cycle/min, no quasi-periodic component in the CWG 9 Fig.3. Complaints about any deviations in the state of his health did not Express. In fact, the procedure of the method was for this patient preventive, aimed at relieving tension caused by Psychotrauma.

The patient explained that she had to breathe, when the heart rate increases (the curve goes up and exhale when the deviation of the curve down. The first signs of rhythm in CWG appeared in the 5-th sample of the first session. However, the second and third sessions began with a lack of pronounced fluctuations in the frequency of heart rate associated with respiratory movements. Rhythmic elements in CWG appeared only in the 3rd - 4th samples of these sessions. Achieving the desired result has an effect on the patient as positive reinforcement, satisfaction with the successful samples formed a certain emotional state, and the results began to improve with each subsequent trial. To secure dostignutoi waves, respiratory rate of 5.5 cycle/min, BP 125/80 mm RT.art., Heart rate 80 beats/min, 10 AWG in Fig.4. Normalization of the physiological status of the patient is confirmed by the results of psychological testing.

Example 2. Patient L in S. K., 46 years old, suffering from hypertension since 1984, the maximum registered HELL 200/140 mm RT.art., he complained of headaches, dizziness, palpitations, ringing in the ears. History: acute myocardial infarction (from 1990). Objective: AD - 180/120 mm RT.art., rigid rhythm (original CWG 11 in Fig.5) with a heart rate of 109 beats/min muffled heart sounds, accent 2 tone of the aorta, no noise. Recommended a series of biofeedback. The patient had to catch minor fluctuations in heart rate in the background of rigid rhythm. For the formation of sinus rhythm, the patient was placed in the most comfortable position and following the instructions, breathing calmly, stretching phase and exhalation. After 4 sessions the amplitude of heart rate increased slightly, which gave the patient an opportunity to synchronize the breath with the recovery phase variation, and the expiratory - phase reduction curves. After 8 sessions CRF patient has acquired a quasi-periodic nature that has allowed them to recover cardiorespiratory synchronization. For fixing Aracinovo scope KRG from 0.05 to 0.15 C. The patient noted significant improvement in General condition: the disappearance of headaches, tinnitus, palpitations. Objective: the reduction of blood pressure to 145/105 mm RT.art., the decrease in heart rate from 109 to 85 beats/min, 12 AWG in Fig.6.

Example 3. The patient W-VA L. C., 50 years, from 1978 suffers from atopic form of bronchial asthma of moderate severity, had complained of insomnia. During examination: heart rate 91 beats/min, BP 130/85 mm RT.art., respiratory rate 14 cycle/min, a sample of the breath of 14 seconds, AWG 13 in Fig.7. The chest is barrel-shaped, auscultative - over the entire surface of the lung tissue were heard hard breathing with extended breath. Recommended a series of biofeedback. For 91 samples - 12 sessions, the patient was trained to breathe in the rhythm of heart rate fluctuations. It has been a constant decrease in the breathing rate to 9.7 cycle/min - restoration of cardiorespiratory synchronization in the range of fast waves, the amplitude increase its own harmonics of the heart rate detected by spectral analysis in the 1st and 91st samples from 0.002 to 0,044 with, respectively, the heart rate of 65 beats/min, BP 130/85 mm RT.art., sample our breath and 39 seconds AWG 15 in Fig.8. According to electroencephalography (topographic mapping) decreased functional asset is, the changing auscultatory picture in the lungs (inhalation phase is shorter expiratory phase) reduced the number of inhalations in 3.5 times. The patient noted a decrease in headaches, normalized sleep. Positive dynamics with a relatively short cycle of training (12 sessions) contributed to the independent exercise at home - the patient sat in a chair, took a relaxed position, closed his eyes and mentally reproduced a situation of real samples. In most cases it was possible to prevent the development of asthma.

Example 4. The patient-IR B. C., 43, has complained of palpitations that occur after physical or emotional stress, dizziness, headache, weakness, fatigue. Objective: heart rate 70 beats/min, BP 140/80 mm RT.art., respiratory rate of 9.1 cycle/min heart sounds clear, no noise. Auscultation over the lungs vesicular breathing. In 1998, the hospital delivered clinical diagnosis: neurocirculatory dystonia of mixed type, easy for.

With the patient performed a series of biofeedback training. Initial background AWG 17 in Fig.9 was chaotic. By the middle of the cycle, consisting of 117 samples in 15 sessions, after recovery cardiorespiratory synchronization AWG 19 fennah waves) with a long expiratory phase.

The patient noted improvement in General condition: disappeared headaches, dizziness, increased efficiency and mood, which is confirmed by the results of psychological testing.

A technical advantage of the proposed method over similar known and the most advanced technical solutions in this field of medicine, in particular, the method of the prototype [2], is that it can significantly improve the effectiveness of treatment due to the high degree of reliability of the diagnostic status of the patient at all moments of cardiotraining by automatically measuring the average for the sample HR, average dynamic and pulse pressure, respiratory rate, build cardiotocogram and computing the spectral power, indicating the status simpato-vagusnye balance, build scatterogram heart rhythm, histograms of the distribution of RR-intervals, and so on (more than 20 measured and calculated indicators) that indicate the degree of tension of regulatory mechanisms of the cardiovascular system.

These technical advantages are achieved by the fact that the patient during the sample biofeedback as ZF instead of abstract sinusoi the standing patient when training outside their own physiological norm, on the other, causes an additional interest in the process and results of the training and achieved fitness and a positive result using the techniques of breathing (respiratory rate) at home to normalize their status. The effect of emotional recovery, driven by the positive results and ease of training that contributed to the normalization of cardiovascular interaction was observed in all patients, respectively, were given recommendations to conduct sessions of self-regulation at home.

In fact, the normalization of the oscillatory nature of the cardiac rhythm is performed by the use of biofeedback linking respiratory movements (inhale and exhale) with increasing and decreasing pozarnej pulse frequency, i.e. carry out the synchronization of breathing with HRV.

Moreover, an advantage of the proposed method is the possibility of preliminary diagnostics of the cardiovascular system of the patient, and assessment of its condition at any time biofeedback, thus ensuring that the optimal number of procedures training for different types of functional disorders in the cardiovascular system.

Using the information that p is a logical correction of the human condition and diagnosis without further invention can be implemented in any medical institutions, what characterizes the object of the invention as widely applicable.

In accordance with the application materials was a significant number of corrections state of patients with various diseases, which confirmed the above capabilities of the proposed method.

Sources of information 1. USSR author's certificate 1209224, IPC a 61 K 31/00, publication 08.10.1985.

2. USSR author's certificate 1745200, IPC And 61 In 5/00, publication 08.03.1992.

Claims

1. The method of functional physiological correction of the human condition, including a visual representation of the patient's own cardiotocogram (kardiointervalogrammy) in real time, wherein the patient synchronizes its respiratory movements with variations of their own heart rhythm: the higher the heart rate provides a breath, but at a lower heart rate exhale.

2. The method according to p. 1, characterized in that in the process of correction estimating parameters of cardio-respiratory status of the patient and in accordance with these parameters decide the completion or interruption of the correction and the number

 

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