A method of treating chronic sensorineural hearing loss

 

The invention relates to medicine, otorhinolaryngology. Daily within 10 days of conducting acupuncture in corporal and auricular biologically active points (BAP). Are pharmacopuncture introduction to auricular and preauricular BAHT 0.1 - 0.2 ml LEU-enkefalina of dalargin daily for 10 days. Bechamel administer orally in a daily dose of 0.25 g at eight o'clock in the morning every day. The method improves the efficiency of the treatment. 5 C.p. f-crystals, 5 tab., 4 Il.

The invention relates to medicine, namely to otolaryngology, and can be used for the treatment of patients with chronic sensorineural hearing loss, contributes to lowering the threshold of hearing intensity reduction and disappearance of ear noise.

Known RF patent 2094038, publ.27.10.97.: "A method for treating sensorineural hearing loss", in which the method of treatment, comprising the three ten-day courses of pharmacopuncture in 3 - 5 biologically active points (BAP) with sequential application of the following medicines: 1st course - enhancing drug metabolism in brain tissue (0.1 ml Cerebrolysin); 2nd - rate drug that dilates blood vessels of the brain (Cavinton 0.1 ml);the method is he does not reduce the intensity of ear noise, involves the use of three courses of pharmacopuncture. All prescription drugs have the common disadvantage: low efficiency and safety of treatment of chronic sensorineural hearing loss.

It is known for the treatment of acute and sudden sensorineural hearing loss and deafness (RF patent 2119335, publ.27.09.98 g), containing as active substance a dihydrochloride monohydrate 3(2-morpholinoethyl)-1,2,4-triazino [5,6-b] Indiana (trican).

However, when using the specified tools in the treatment process, there are no data about the effectiveness of its chronic sensorineural hearing loss.

There is a method of treatment of patients with sensorineural hearing loss in acute and chronic periods, which is the impact on the BAHT electrical impulses and following pharmacological preparations: lydasum, diluted with 2% solution of novocaine on 0,1-0,2 ml, Cavinton 0.1-0.2 ml, lei - enkephalin dalargin 0.1-0.2 ml (RF patent 2106854, publ.20.03.98 g). This treatment is adopted as a prototype, as the most similar combination of essential features and the achieved result.

However, the prototype has several disadvantages: 1) electropuncture physiological method of treatment, which includes the mechanisms of autoregulation (the release of endorphins, acting on the Central nervous system); 2) application lidz diluted solution of novocaine, often accompanied by allergic and autoimmune reactions; 3) the duration of treatment exceeds ten sessions; 4) there are no data concerning the influence of the presented method for the treatment of the immunological component of the pathogenesis of chronic sensorineural hearing loss; 5) there are no data on the cost-effectiveness of this treatment method.

The invention solves the problem of creating a highly effective, safe and low-cost method of treating patients with chronic sensorineural hearing loss by eliminating neuroimmune shifts associated with impaired blood supply to the inner ear, resulting in a dysfunction of the hair cells.

The technical result of the claimed method of treatment is expressed in the reduction of ear noise, threshold of hearing, increase the effectiveness, efficiency, and safety of treatment with reduced economic cost pharmacoenhancer.

The essence of the invention lies in the fact that the use of combined use of acupuncture in classical is evalin the dalargin, by injecting it subcutaneously insulin syringe with a thin needle placed symmetrically preauricular and auricular acupressure points on 0,1 - 0,2 ml daily for ten days and using from 4 to 6 points on one session, and assign actoprotector bemythyl orally in a daily dose of 0.25 g at eight o'clock in the morning every day for ten days, at the outpatient stage.

The invention is illustrated by specific examples, tables, and audiograms (Fig.1-4).

The method is as follows. Used steel and silver needle size 1-5 cm (production Kazan medical instruments plant). Reflexology is at its most effective combination of classical corporal acupuncture with auricular acupuncture and subsequent pharmacopuncture courses for 10 -11 sessions for one course of treatment, if necessary, with a repetition rate of one month. Reflexology is performed in an office, in an outpatient setting, lying, necessarily in a relaxed state. Before the medical procedure is carried out inspection and display of acupuncture points. Search for acupuncture points is "traditional" ways (pulpotomy using proportional OTS BAT common actions as a rule, using symmetrical to the following points: Hye-su (GI 4), qu Chi (GI-11) zu San Li (E 36), show-San-Li (GI-10), San-Yin-Jiao (RP-6), Wai Guan (TR-5), Ney-Guan (MS-6). Point the General steps used in each procedure. With the second procedure RTI is in point of General jurisdiction, segmental, local and auricular considering the etiopathogenesis of the disease. Use the following segmental and local points: Yes-Jui (T-14), Yes-Zhu (V-11), Shen-Chu (V-12), FEI-Shu (V-13), Feng-fu (T-16), Bai-Hui (T-20), Yan Bai (VB-14), Phu Bai (VB-10), Jiang Ching (VB-2), Feng Chi (VB-20); parotid point: and-Feng (TR-17), er-men (TR-23), tin-Chun (IG-19), ting-Hui (VB-2), the point of the inner ear (AR-9). For relief of ear noise, use the following BAT NII-tan (N), Bai-Hui (T-20), Shen-tin (T-24), Chi-Jie (R-5). In one procedure combined depending on the etiopathogenesis of the impact of inhibitory or excitatory method BAHT corporal and auricular.

A prerequisite is a clear explanation to the patient of the expected sensations provided in the introduction needle. Selection BAHT is always individual. To enhance and prolong therapeutic effect of acupuncture in patients with chronic sensorineural hearing loss after a session of acupuncture is pharmacopuncture drug dalargin.

the military preauricular and auricular points (and fan of TR-17, er-men-TR-23, ting Gong IG -19, ting-Hui VB-2, AT the inner ear AR-9), point of introduction of the drug dalargin dose of 0.1-0.2 ml alternate every other day. Use 4-6 points in one session. Actoprotector - bemythyl is entered in a daily dose of 0.25 g at eight o'clock in the morning once a day for ten days.

The use of vasoactive drugs (Cavinton, nicotinic acid), drugs with metabolic course of action (ATP, kokarboksilaza) is missing, which contributes to increase the value of the coefficient of efficiency of the developed mode of treatment taking into account the economic costs of up to 17% (vs. 7.7% when conducting IRT), preserving the frequency of repeat calls by 50%, increase the percentage of cured patients to 97%.

Way passed clinical trials in Road hospital S. - K., J.-D. 78 patients (70 men, women, 8 men) aged from 25 to 62 years.

Distribution of patients according to the etiological factor is presented in table 1.

In 60 patients hearing loss was accompanied by a subjective ear noise of I - II stages of severity. After treatment ear noise decreased in 12 patients and 46 patients had disappeared completely.

The distribution of patients according to the degree of lowering of the hearing is presented in table 2.

Comparing the effectiveness of treatment of patients on the parameters of these methods are presented in tables 3 (tonal threshold audiometry),4 (REG), 5 (immunological research).

Based on the results presented in table 3, the tone audiograms of patients with chronic sensorineural hearing loss who were treated by the method of combined use of acupuncture and pharmacopuncture, there has been a lowering of thresholds of hearing from 10-15 30-45 dB. Complete recovery was noted in 10 patients in the chronic phase of disease, the results of a ten-day treatment.

All patients noted a decrease in speech intelligibility, the disappearance of subjective ear noise and improvement in General condition.

When using standard mode of therapy lowering of thresholds of hearing occurs mainly from 15-20 20-25 dB, which reflects the low efficiency of the standard treatment regimens for chronic sensorineural hearing loss.

As can be seen from table 4, according to REG celebrated the elimination of a spasm of cerebral vessels, improving venous outflow and increase in pulse to the e application of IRT and pharmacopuncture resulted in a significant improvement of the parameters of immunological profile: the increase in CD3+, CD4+, CD8+, CD16+, CD25+, CD95+, IgA with decreasing CD4+/CD8+, CD72+, IgM, IgG, CEC, TNF-IL-1.

Based on the results of treatment are presented in table 3, the tone audiograms of patients with chronic sensorineural hearing loss who were treated by the method of combined use of acupuncture, pharmacopuncture drug "Dalargin and oral intake of the drug "Bemythyl" marked lowering of thresholds of hearing from 15-20 to 25-45 dB, remitting and disappearance of subjective ear noise, improving speech intelligibility and improvement in General condition. In the treatment of chronic sensorineural hearing loss 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 sensorineural hearing loss has a low efficiency percentage.

The analysis of the results shows that the method of combined use of acupuncture, pharmacopuncture drug "Daralyn and oral administration of the drug "Bemythyl" contributes to a more complete recovery of auditory function, has a lasting therapeutic effect.

Example 1 Patient I. , 1940, R., was in outpatient treatment in the outpatient Department of Road hospital S. - the second noise low degree of tonality of the 1st degree. Upon examination of ENT-organs revealed no pathology. The tone audiogram - chronic sensorineural hearing loss II degree right the first level to the left. General analysis of blood, urine normal.

Data immunological research before treatment:
CD3+ -0,8109/l; CD4 (+) of-0.7109/l; CD8+ -0,22109/l; CD4+/8+ -3,02; CD16+9%; CD25+ -8,8109/l; CD72+ -0,52109/l; CD95+ to-9.2109/l; Ig A-1.8 g/l; Ig G and 15.3 g/l; Ig M-1.7 g/l; CEC-4,32 Rel. unit; TNF--125 PG/ml; IL-1 39 PG/ml

Data REG before treatment:
eographically index of 0.82 Ohms; the lag time rowany -0,170 with indicator peripheral resistance 72,15%; the index of the venous outflow 35,20%; coefficient of skewness 22,90%.

Within ten days there were sessions of acupuncture with drug "Dalargin" 0.1 - 0.2 ml in each BATH. The drug Bemythyl" was used orally in a daily dose of 0.25 to 8 hours for 10 days.

As a result of treatment showed a steady improvement that is displayed on the audiogram 1, 2, where the solid line corresponds to the air conductivity, and dashed lines the bone.

109/l; CD8+ -0,5109/l; CD4+/8+ -1,48; CD16+ -13%; CD25+ 30.5 per109/l; CD72+ -0,4109/l; CD95+ -13,5109/l; Ig A-1,90 g/l; Ig G-10,35 g/l; Ig M-1,15 g/l; CEC 1,50-Rel.ed.; TNF --105 PG/ml; IL-1 32 PG/ml

Data REG after treatment:
eographically index - 0,150 Ohms; the lag time rowany -0,160 with indicator peripheral resistance 63,10%; the index of the venous outflow 25,10%; coefficient of skewness 20.75 per cent.

Example 2
Patient S. , 1944 R., was in outpatient treatment in the outpatient Department of Road hospital S. - K., J.-D. 18.12.2000, 29.12.2000, diagnosed with bilateral chronic sensorineural hearing loss (more than 2 years), ear noise low degree of tonality of the II degree. Upon examination of ENT-organs revealed no pathology. The tone audiogram - bilateral chronic sensorineural hearing loss first degree, the reduction of speech intelligibility. General analysis of blood, urine - within normal limits.

Data immunological research before treatment :
CD3+ -0,8109/l; CD4 (+) of-0.7109/l; CD8+ -0,3109/l; CD4+/8+ -3,21; CD16+9%; CD25+ 8.9bn- 130 PG/ml; IL-1-41 PG/ml

Data REG before treatment :
eographically index is 0.80 Ohms; the lag time revani - 0,175 with indicator peripheral resistance sampled at 74.25%; the index of the venous outflow 37,40%; coefficient of skewness 25,95%.

Within ten days there were sessions of acupuncture with drug "Dalargin" 0.1-0.2 ml in each BATH, and oral intake of the drug "Bemythyl" in a daily dose of 0.25 to 8 hours as a result of treatment showed a steady improvement that is presented on the audiogram 3, 4.

Data immunological studies after treatment :
CD3+ -1,32109/l; CD4+ of 0,95109/l; CD8+-0,50109/l; CD4+/8+ -1,51; CD16+ -14%109/l; CD25+ -29,4109/l; CD72+ -0,45109/l; CD95+ -14,2109/l; Ig And-1,95 g/l; Ig G is 9.15 g/l; Ig M 1.25 g/l; CEC - 1.50 Rel.ed.; TNF--103 PG/ml; IL -1 29 PG/ml

after treatment:
eographically index - 0,145 Ohms; the lag time revani - 0,155 with indicator peripheral resistance 65,18%; the index of the venous outflow to 25.15%; adjusted the efforts of his disappearance; pharmacopuncture prolongs the effect of RTIs and leads to lower thresholds of hearing to 10-40 dB by removing neuroimmunol component of the mechanism of progression of chronic sensorineural hearing loss, which contributes to a tight control of the achieved high level of adaptation in the body of the patient and to prevent the rise of hearing loss and thus improves the quality of life of the patient.

When using the method in patients with chronic sensorineural hearing loss says:
normalization of indicators tonal threshold audiometry (tonal threshold audiometer MAICO-41);
improvement of the parameters of the whispered and spoken language;
the decline and disappearance of subjective ear noise;
normalization of indicators of immunological parameters: CD4+, CD8+, CD4+ /CD8+, CD25+, CD95+, CEC, IgM, G, A;
the decrease in the activity of Pro-inflammatory cytokines TNF -IL-1;
stabilization of parameters of cerebral hemodynamics according to rheoencephalography.

This makes it possible to reduce the volume of the standard mode of pharmacotherapy to reduce the duration of treatment, to reduce the incidence of repeated calls about this disease. The technical result is achieved sciscoe sensorineural hearing loss first used actoprotector bemythyl. It is established that the bemythyl - derived 2 ethylthiophenethylamine the hydrobromide is neuroimmunomodulation with vasoprotective activity. The obtained facts was a prerequisite to the development of a method of combined treatment of chronic sensorineural hearing loss involving the combined use of the auriculo-corporeal complex of acupuncture in combination with pharmacopuncture drug dalargin and oral administration of the drug bemythyl on the outpatient phase of treatment.


Claims

1. A method of treating chronic sensorineural hearing loss, including the combined use of acupuncture and pharmacotherapy Ecoprotection, characterized in that as acupuncture uses acupuncture and pharmacopuncture, as a drug for pharmacopuncture use lei-enkephalin dalargin, and as ectoprocta apply bemythyl.

2. The method of treatment under item 1, characterized in that reflexology spend classical corporal acupuncture combined with auricular acupuncture daily for ten days.

3. The method of treatment under item 1, characterized in that the sessions pharmakeia preauricular and auricular acupressure points.

4. The method of treatment according to PP.1 and 3, characterized in that during the session of pharmacopuncture the dalargin use from 4 to 6 points in one session.

5. The method of treatment according to PP.1, 3 and 4, characterized in that the lei-enkephalin dalargin injected subcutaneously in the specified BAHT daily for 10 days.

6. The method according to p. 1, characterized in that the bemythyl administer orally in a daily dose of 0.25 g at eight o'clock in the morning, every day, for 10 days.

 

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