A method of treating pain in patients with chronic somatic diseases

 

(57) Abstract:

The invention relates to medicine, in particular therapy, and can be used in medical institutions for the treatment of pain in patients with chronic somatic diseases. Orally administered trifluperazine at a dose of 2.5 mg 1 time per day every day for months. Then spend psychoeducational therapy with biofeedback duration 15-20 minutes 3-5 times a week, just 8-10 lessons. The method allows to reduce the dose of the neuroleptic, while reducing side effects of the drug and increase the effectiveness of the treatment.

The invention relates to medicine, in particular therapy, and can be used in medical institutions for the treatment of pain in patients with chronic somatic diseases.

Aggravation of most chronic somatic diseases accompanied by the development of pain. This is often expressed pain syndrome, poorly amenable to correction, which has a negative effect on psychosocial adaptation, impairs quality of life, leads to the formation of hypochondriacal disorders and reduce tradespace the e only, narcotic analgesics (Mashkovsky, M. D., 1972), non-steroidal anti-inflammatory drugs (Mashkovsky, M. D., 1972), and antidepressants (Mosolov S. N., 1995). However, the development of drug dependence from the first, irritating effect on the gastrointestinal tract, second and selectivity of the third substantially complicate therapy of pain.

In addition, for the treatment of pain syndrome use of transcutaneous electrical nerve endings (Bogolyubov C. M., 1982), acupuncture (luvsan,, 1990) and hypnotherapy (Rozhnov C. E., 1985; Myshlyaev S. Yu, 1999). But to ensure these methods require special costly equipment and specially trained personnel.

There is also known a method for the treatment of pain in patients with somatic diseases with devices providing biofeedback. The basis of the method is patient education techniques, allowing to influence its state in the right direction, with minimal changes to one or another physiological indicator of the activity of the body. For treatment use of an electronic device that provides patients such information in real-time. As us normalize autonomic manifestations, increases the threshold of pain perception (Aloe L., McGradya A., Collins C., Gerard G., 1994) and psychological tolerance to pain (Shterman I. P., Evans, S., arena, D., 1993).

The disadvantage of this method is low efficiency at high concern for their health, fixity of attention on pain.

The closest in technical essence to the proposed method of treatment of pain syndrome is the use of intramuscular injection of a solution Trifluoperazin of 0.2% and 1 ml (St. George L. N., Zavgorodny E. P., Brotankova O. N., Lysonic E. M., 1995). The disadvantages of this method include the appearance of infiltrates from the injection and observed during the treatment of neurotic disorders requiring the use of offsets, which by themselves can cause side effects.

The technical result of the proposed method is the cessation or significant reduction of pain in patients with chronic somatic diseases in the absence of side reactions.

This technical result is achieved by oral administration of the drug Trifluoperazin at a dose of 2.5 mg once a day every day for months with simultaneous psycore Psychorelaxation with biofeedback allows not only affect the spastic component of pain, but to a certain extent, reduce the level of anxiety in some patients, which is accompanied by increased sensitivity to pain. And the simultaneous adoption of the drug Trifluoperazin at a dose of 2.5 mg the vast majority of patients with chronic somatic diseases also contributes to reducing anxiety, moreover, prevents fixation of the attention of the patient on the unpleasant sensations in the body, thereby reducing pain. Oral administration of the drug Trifluoperazin at a dose of 2.5 mg helps to avoid side effects, and simultaneous psychorelaxation allows you to do this dose is sufficient, despite the fact that oral introduction this dose creates almost two times lower concentration of the drug in comparison with the method of the equivalent (roughly the same dose of the drug, however, introduced parenteral).

Thus, the combined use of psychoreactive with biofeedback and drug Trifluoperazin potentiates their effects and eliminates side reactions, increasing therapeutic effect.

Description of the method. Patients in the treatment of pain syndrome every day during the month take Trifluoperazin at a dose of 2.5 mg once a day, while the rate of psicodelicas the-IP (patent No. 2033082), providing continuous information about the changes in the emotional state of a patient to measure the electrical resistance of the skin: increased emotional tension is accompanied by a decrease in the electrical resistance of the skin, which leads to increased tone of the sound device and increasing the frequency of flashing of the visual indicator; and relaxation - an increase in electrical resistance of the skin (respectively lower tone sound and decrease the frequency of flashing visual indicator). To achieve psychological relaxation patients use different techniques: focus on breathing, verbal formulas relaxation (“I am calm... I am completely calm...”), representing relaxing visualizations (overgrown pond, beach, birch grove). The duration of each class is 15-20 minutes Frequency group exercise 3-5 times a week. The total treatment course of 8-10 sessions.

In addition to the sessions with the doctor carried out using the apparatus of biofeedback IE, patients recommended for daily independent relaxation training: regular performance self-training provides increased effeci Tregubov A. K., 40 years with a diagnosis of Osteochondrosis of the lumbar spine with pain.

Admission: shooting pains in the lumbar region radiating to the right leg, low physical activity concerns the amplification of pain, irritability, tension, sleep disturbance. Started a course of treatment. Sick for months took Trifluoperazin 2.5 mg per day, while psychorelaxation using the biofeedback device-IP. In each session, after connecting the device biofeedback IE, the patient was taking a relaxed pose, the first two lessons lying on the couch, then sitting in a chair (feet on the floor, legs not crossed, hands on the armrests or on the hips, the fingers are not linked, the eyelids are relaxed, eyes closed) and regulator setup installed low frequency sound and light flickering. After this he said to himself verbal formulas relaxation “I am calm... I completely calm... I completely relaxed..., to be comfortable..., no extraneous thoughts don't bother me... I'm fine”. Classes are held 4 times a week, on the first lesson arose a state of relaxation. On the third day marked improvement in General condition, decrease irritability and naprej, sleep is normalized, total physical activity increased. During the observation marked decrease in Visual analogue scale pain from 45 to 0 mm

Example 2. Patient B. N. Zelenin, 29 years old, was admitted to the gynecological Department with the diagnosis: Exacerbation of chronic adnexitis, pain syndrome. Admission: abdominal pain, headaches, sleep disturbances, decreased mood. Conducted monthly treatment: Trifluoperazin 2.5 mg/day, while psychorelaxation using the biofeedback device-IP. Classes were held in a sitting position in a chair in a relaxed position (feet on the floor, legs not crossed, hands on the armrests or on the hips, the fingers are not linked, the eyelids are relaxed, eyes closed). At the beginning of each session, the patient was hooked up to the biofeedback device-IP and regulator setup installed low frequency sound and light flickering. After that she was concentrating on breathing and imagined visual images (forest glade, lit by the rays of the sun). Classes are held 3 times per week, the overall rate was 10 lessons. By the end of the course the pain in the lower abdomen, normalized sleep, improved mood. The marked decline in Visual analogues of onionskin somatic diseases, the hospital received the Russian scientific center for restorative medicine and balneology.

A method of treating pain syndrome can reduce the intensity of pain already 2-3 days of therapy. By the end of the month of treatment, patients recorded a greater reduction in performance on a Visual analog pain scale (45,1±3.7 to 15.4±2.4 mm) than with traditional treatment (from 46.3±3,1 to 38.8±2.9 mm). Only the use of biofeedback has also been less effective (44,6±3.4 to treatment and 27.2±2.7 mm after). Thus, based on the results of the research showed a higher efficiency of the proposed method of treatment of pain in patients with chronic somatic diseases.

Adverse reactions are not registered, contraindications for use of this method no.

Moreover, our proposed method is more simple and convenient way of introducing a medicine for both patients and medical staff.

High therapeutic efficacy, safety, ease of use, efficiency of the proposed method of treatment of pain, the possibility of use by General practitioners without special training,curently in the treatment of pain syndrome in patients with somatic diseases.

The method of treatment of pain, including the introduction of trifluoperazine, wherein the drug is administered orally at a dose of 2.5 mg 1 time per day every day for months and spend psychoeducational therapy with biofeedback duration 15-20 minutes 3-5 times a week, just 8-10 lessons.

 

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