A method for the treatment of vertebrogenic cerebral spinal vascular disorders

 

The invention relates to medicine and is intended for complex treatment of patients with cerebral vascular disorders. Against the background of a Spa treatment effect pulse currents of low frequency on the cervical sympathetic nodes and plexus. Spend vector traction of the cervical spine. Assign carbonate mineral baths T=35With a duration of 12 minutes over the course of 10 baths. First, spend 6 carbon mineral baths, considenng carbon dioxide to 1.3 g/l after 4 baths with natural concentration of carbon dioxide of 0.8-1.0 g/L. the Method improves the efficiency of treatment of patients with vertebral spinal vascular disorders. 3 tab., 30 Il.

The invention relates to medicine, intended to be a comprehensive treatment of patients with spinal vascular disorders, physical /including resort/ medical factors: vertical (in the chair) vector (optimized) traction of the cervical spine by the method of I. I. Velikanova. I., Ignatieva (patent No. 1805945 from 25.03.1991, in the resort of Kislovodsk with the use of natural carbonated mineral baths (Alikhanova, S. M. Bychenkov “About restorative treatment of patients with combined spinal vascular disease in low - and middle mountain resort of Kislovodsk” (Actual problems of rehabilitation medicine, balneology and physiotherapy, M. 2001. - S. 45), which shows the feasibility and efficacy of treatment referred to pathology with the approbation of the medical complex, consisting of internal reception sulfate Seltzer, diet, walks along the routes of the path, carbonated mineral baths (with a natural concentration of carbon dioxide), pulsed currents effects on the cervical sympathetic nodes and plexus and traction of the cervical spine by the method of I. I. Velikanova, I., Ignatieva (1991).

The work was shown the effectiveness of applied medical complex for both clinical and paraclinical parameters (according to rheoencephalography, multimodal evoked potentials of the brain and the heart rate variability).

The disadvantage of this work is that to increase the efficiency of treatment of patients was not taken into account earlier studies about the leading, the main role of carbon dioxide in carbonated mineral bath and increasing the concentration to within the 2 different concentrations under different physiological response systems on it are analogues of the proposed method: I. I. the Giants. Effect of a single Narzan baths with different concentrations of carbon dioxide on brain electrical activity in patients with early clinical manifestations of cerebral atherosclerosis (in kN.: Topical issues of balneology and physiotherapy. Pyatigorsk. 1966. - N-300-303); and I. I. Giants, N. And.Voronov. Effect of a single course and Narzan baths with different concentration of carbon dioxide in some hemodynamic parameters of patients with early stages of atherosclerosis of cerebral vessels (according to theacceleration). (Balneology, pharmacy and pharmacology. Pyatigorsk. 1967. - S. 277-279).

In the work of I. I. Velikanova (1966) have shown that a single UPS, consisency to 1.35 g/l CO2improves bioelectrical activity of the brain and its reactivity in patients with more than a bath with natural carbon dioxide content (0.8 to 1.0 g/l). From the work of I. I. Velikanova and N. And.Voronova (1967), hemodynamic parameters (systolic, diastolic, lateral pressure, and others) WMV as with natural carbon dioxide content, and consisency CO2the eye, the knowledge, the nature of the coming changes depending on the time of the study after the bath, and from a baseline hemodynamic parameters. Under the influence of the course UPS with natural content of CO2(11 baths) noted the alignment of the arterial pressure (AP), and under the influence of considenng CO2- the tendency to raise HELL with 132.8±12.53 to 136.8±13.7 mm RT. Art.

S. P. Melnychuk (External breathing in patients with cardiovascular diseases in the health-resort treatment in Kislovodsk: author. Diss. Prof. the honey.of Sciences, 1965. - S. 33) on the basis of their research concludes that UPS with artificially elevated (up to 1.3 g/l) carbon dioxide content have the same type with the usual UPS (Seltzer), but a much more pronounced effect on the indices of external respiration, the concentration of carbon dioxide in WMV “is very important and a major factor determining the degree of favorable (unloading) the effect of the bath on the function of external respiration, and hence the circulation”.

A. A. Lozinski (1949), Remlinger (1958) believe that fully carbonated mineral baths can be only when the concentration of carbon dioxide is not lower than 1.0 g/l (CIT. by C. P. Melnychuk. 1965. - S. 33).

However, in the above prototype and analogues in the aspect of the present invention has the following significant drawbacks.

2) Studied the effects of single UPS with a natural concentration of CO2and considenng only on the indices of the bioelectrical activity of the brain, a single course and baths on some hemodynamic parameters and does not aim their comparative influence on the clinical condition of the patients (health objective status).

3) Studied the effect of a single normal and considenng CO2the function of external respiration without regard to the dynamics of the clinical condition and were not studied the impact on the patient of course considenng CO2bath.

4) did Not set itself the task of studying afferent stream-side vegetative innervation (sympathetic and parasympathetic) on sinus node and, therefore, the regulation of cardiac rhythm with extrapolation of these changes on the regulation of physiological systems.

5) did Not set itself the task of studying a more severe group of patients with combined spinal vascular disorders, as well as research on the conduction of impulses to the somatosensory pathways of the spinal cord (at the level of the cervical thickening) and brain stem and their changes under the influence of UPS with different concentrations of CO2.

Proceeding and dinocrates course and their application: 1 UPS with a natural concentration of CO2No. 10 and 2nd - UPS considenng CO2No. 6 followed by a reception 4 baths with natural concentration of CO2on the following parameters:

a) level of HELL;

b) the clinical condition of the patients (subjective and objective);

C) the dynamics of the afferent flows autonomic pathways to the sinus node (according to the study of heart rate variability with the inclusion performing);

g) conductivity somatic afferent impulses at the level of the cervical thickening and auditory pathways at the level of the brain stem when submitting somatosensory and auditory stimuli:

d) the dynamics of cerebral and spinal blood circulation, indicators of inflow and outflow of blood through the intra - and extracerebral blood vessels (carotid and vertebrate).

To solve this problem we use the following apparatus and method.

1. Apparatus “Neuron-Spectrum-4” firm “Neurosoft” (, Ivanovo), which studied event-related potentials of the brain (somatosensory and auditory), as well as indices of autonomic regulation of heart rate (HRV).

2. Eographically console WG-02 (BC lions), which examined the state (tone, elasticity) of extra - and intracranial vessels of the brain in 2 leads: posleduushie treatment: diet, walks the path, the internal use of mineral water (sulphate or dolomite Seltzer), diadynamic or sinusoidal modulated currents on the cervical sympathetic nodes and plexus and vector traction in the chair by the method of I. I. Velikanova, I., Ignatieva (patent No. 1805945 from 25.03.1991,) the main Difference (experienced) and the comparison group consisted of patients of the main group received 6 donsimoni and 4 normal UPS, and patients in the comparison group received all 10 baths with normal (natural) concentration of CO2Considine carbon dioxide UPS was carried out using the saturator: saturator tank was supplied UPS t+38Since, then from a container with carbon dioxide through tube with holes at the bottom of the saturator was passed carbon dioxide until then, until the pressure in the saturator not reached 2.5 atmospheres. Then supply CO2stopped, and Considine UPS carbon dioxide under this pressure was held for 30 minutes. During this time t of the water in the saturator has fallen in the tub the water was done with t+35C, concentration of CO21.3 g/L.

Before and 1.5 hours after UPS with the natural concentration of carbon dioxide viability heart rhythm (HRV) using tilt-test, recorded REG in frontolateral and occipitomastoid leads: patients were interviewed about their health. A day later a similar study was conducted on donsimoni to the limit of solubility of CO2(1.3 g/l) UPS. The parameters of both types of baths were the same: t+35With a duration of 12 minutes

Depending on therapeutic complex of all patients were divided into main (experienced) and the comparison group (control). Clinical characteristics of patients in groups are presented in table 1. As can be seen from the tables, both groups of patients had no significant clinical differences, i.e., were comparable.

Studies of cerebrospinal neurodynamics, hemodynamic and autonomic supply of the heart rate control was performed before and after the course of treatment, and before and after 1.5 hours of rest after administration of a single carbonate mineral baths with different degree of saturation with carbon dioxide.

The analysis of indicators of autonomic supply of the regulation of heart rhythm under the influence of a single carbonate mineral baths (UPS) with a natural abundance of CO2and donsimoni to limit the concentration of CO2revealed, Sterno criteria nonparametric statistics p=0.0001 by Dixon-Modo and p=0,0004 on the rank criterion Wilcoxon).

Under the influence of donsimoni carbonate mineral baths (DUMB) heart rate decreased from 67.9±1,67 to 65.3±1,51 (reliably accurate method Fisher's p=0,041: criteria Dixon-Muda and Wilcoxon - p<0,05).2). 1.5 hours after taking UPS with a natural concentration of CO2the power spectrum has slightly increased and amounted 1278±168,1 MS2(significantly on the exact method of Fischer p=0,024 and significant criterion of Wilcoxon-p=0.008). After a single DUNG total capacity increased to a greater extent - with 918,2±to 145.7 to 1428,1±239,8 MS2(approaching a reliable value for the Student t-p=0,075; significantly Fisher - p=0,0076 and criteria nonparametric statistics). The dynamics of the balance of the divisions of the autonomic nervous system (LF/HF) was as follows: under the influence of “normal” UPS the predominance of the parasympathetic in the initial state increased with 2,22±0,346 to 1.82±0,323, approaching significant shifts in the exact method of Fisher (p=0,088) and significant criterion of Wilcoxon (p=0,059). After taking DUMB dynamics of LF/HF was less pronounced - criterion LF/HF decreased from 2,37±0,442 to 2 is pectra humoral-metabolic and cerebral ergotropic effects in the initial state was high - 56,09+3,27 (at the rate of 17.5-39,8). Under the influence of normal UPS it slightly (not statistically significant p>0,05) decreased to 53,61±3,45. Under the influence of DUNG this figure was virtually unchanged.

During an orthostatic test in the initial state, the parasympathetic reactivity (30/15 ratio) was reduced to 1.09±0,01 (at the rate of 1.2 and 1.35). Under the influence of a single UPS with a natural concentration of CO2this criterion slightly (and unreliable) increased with 1.09±0,01 to 1.11±0,01 (p>0,05): at that time, after taking DUMB, he was significantly increased from 1,08±0,009 to 1,15±0,02 (Student's t - p=0.0005, Fisher - p=0.023, highly reliably criteria nonparametric statistics). Sympathetic autonomic software /according to the indicator LF%/ during an orthostatic test, low in initial state - RUB 24.55±2,67 (standard >38,3) was increased after taking the “normal” UPS to 28.5±3,64% (reliably at significant criterion of Wilcoxon p=0,0044). After taking DUMB this figure has increased substantially with 25,38±3.1 to 31,58±3,33 (approaching conditional norm: reliably criteria nonparametric statistics).

Thus, the impact DUNG has a more pronounced positive effect on the autonomic regulation of heart rhythm, vegetatively nervous system. The amphoteric character (bidirectionality) actions carbonate mineral baths increases with donsimoni Narzan to the limit of solubility of carbon dioxide. Labilization (“shaking”) rigid vegetative regulation of heart activity /characteristic for patients with combined spinal vascular pathology/ under the action of UPS leads to more adaptive responses on the part of the heart (with the extension of their range) on the action of disturbing stimuli” - UPS, AutoProbe. DUMB in this plan have a more pronounced positive effect compared to the Narzan baths standard concentrations of CO2.

Dynamics of cerebral blood flow under the influence of a single donsimoni CO2the bath according to rheoencephalography (REG) reflected in the table.2.

As can be seen from table data pulse volume vessels basin of the internal carotid artery (abstraction F-M) increased 1.5 hours after taking DUMB on 8,72% 0,872±0,055 to 0,948±advanced 0.729 right (reliably at significant criterion of Wilcoxon p=0,0176) and 5,79% 0,777±0,069 to 0,822+0,067 left (p=0,0123). Also increased the blood vessels and the vertebrobasilar basin (UBB) - /discharge O-M/ - 11.2% - 0,626+0,037 to 0,696+0,sky was not changed (index/T REG), but the venous outflow of blood from the skull cavity (according to diastolic index REG - DUI) was significantly improved, mainly on the right (with 89,032,81 to 86,91±to 2.29; p=0.003).

The asymmetry factor of the pulse of the blood vessels of the basin of the internal carotid artery decreased unreliable, and the vertebrobasilar basin alignment asymmetry was accurate size 45,56±12,21 to 24,70±3,93% (p=0,0095 Fisher). Alignment asymmetry of blood vessels according to L. B. Ivanov and B. L. Makarova (Lectures on clinical rheography. M, 2000, - 320 C.) is an important indicator of improvement of brain blood circulation.

Due to the more pronounced increase in pulse blood flow through the vessels of the vertebrobasilar system vertebral-carotid index (V/C) was significantly (p=0.007) increased with 0,715±0,033 to 0,762±0,043.

Under the influence of a single UPS with a natural concentration of CO2dynamics of cerebral circulation was less favorable as compared to that when receiving considenng CO2baths (see tab.2). So-RI in the pool of the internal carotid artery decreased right from 1.00±0.09 to 0,887±0,051 (Fisher p=0,0901) and left - 0,865±of 0.066 to 0,835±0,05 approached the authoritative Velicina changed. The tone of the arteries of medium and large caliber in the pool of the internal carotid artery (F-M and O-M lead) was slightly increased (significantly on the milestone Wilcoxon criterion). Venous outflow of blood or it was difficult in the F-M diversion or had a different orientation in O-M lead. The asymmetry factor in the F-M diversion was increased from 18.00±3,74 to 21,51±3,81 (p=0,0878 on the milestone Wilcoxon criterion), and the vertebrobasilar basin (O-M lead) decreased with 32,73±15,12 to 27.18 per±6,90 (Fisher p=0,0472). The ratio V/C slightly decreased with 0,721±0,039 to 0,716±0,03 (landmark criterion of Wilcoxon p=0,078).

Thus, the comparison of actions on cerebral blood flow single bath with natural content of CO2and donsimoni CO2revealed a more favorable impact donsimoni CO2bath is a greater increase in pulse blood flow to the brain, especially in the vessels of the vertebrobasilar system with reduction of the asymmetry of the flow of blood through the sides of the pool, the improvement of the venous outflow of blood, reducing the initial high tone of the arteries of medium and large caliber.

The results of a course of treatment of the entire array of patients is shown in table. 3. All patients were discharged with positive dynamics.

As is use compared with the control group (II) (48,6% and 11.4%, respectively). The results of treatment of highly reliable criterion2=13,22 (p<0,001).EXAMPLE 1

B-Neu-cki, 39 years old, engineer, medical history, No. 1605, was treated with 24.12.2001 on 14.01.2002 with a diagnosis of chronic cerebral circulation insufficiency, mainly in the vertebrobasilar system. Ismos in the vertebrobasilar system (from 1996), neck radiculomyelopathy; osteochondrosis CVI-ThIIII Art. syndrome Kimmerle, protrusion of disks4-7craniocervical, brachialgia vertebrogenic; the upper periastron, arterial hypertension.

Was admitted with complaints of headaches, dizziness, including systemic, worse when turning the head, unstable walking, hearing loss, tinnitus, pain in craniocervical transition, cervical spine, the muscles of the shoulder girdle and the right shoulder joint, reduction of forces in the muscles and numbness of the fingers, fatigue, confusion, attention, memory loss on current events.

Within 10 years of concern vertebrogenic pain in the cervical-thoracic spine with the gradual accession and the build-up of the above symptoms. In 1996, amid Psarou vasoactive treatment and metabolic drugs with a positive effect; the state regarded as a stroke with minimal residual symptoms. In subsequent episodes of cerebral circulation is not marked. In 2001, the worsening vertebral symptoms.

When admitted to the neurology ward Kislovodsk clinic: heart rate is 72 per minute, satisfactory properties, HELL 140/95 mm RT.art., temporal HELL right 80, left 70 mm RT.article.

Motion in the cervical spine is limited: turn to the right - to 60left - 80back - to 20. When turning the head causes pain, discomfort in the SHOP. Pain paravertebral points along the spine. Eyes wide, reaction to light is weak, the weak convergence from both sides: reducing corneal reflexes; asymmetry grin, deviation of the tongue and uvula to the right reveals Houben-chin reflex, carpal reflex Rossolimo (s). The reflexes on the hands - teleradiology s>d, with biceps and triceps - reduced (d=s). Knee reflexes with hyperkinetic component (d=s), Achilles - satisfactory (d=s). In the Romberg unstable, when performing planosol sample - pomahivaya, more to the left. The violation of the sensitivity of the upper limbs Semenych stop (d), Bogolepov. Pathological stop signs.

ECG - signs of hypertrophy of the left ventricle, violations of repolarization processes peredneperegorodochnoj area.

R-grams of the cervical spine - stiffening of the occipito-axial ligament: the straightening of the cervical lordosis, limitation of flexion and extension. Seal the switching plates WithII-VIII; schmorl's hernia CVI-VII. Conclusion: osteochondrosis of the CVI-ThIIII Art. syndrome Kimmerle.

MRI of the cervical-thoracic spine - eccentric protrusion With5-6and concentric protrusion drives4-5and C6-7. segmental deforming dural bag, partially stenocereus the lumen of the spinal canal, compremise anterior subarachnoid space. The contours of the spinal cord at this level of strain. Reduced height drives4-7. polarisavenue lower closing plate C7inside the vertebral body type formed schmorl's nodule. Signs of spondylarthrosis.

REG - pulse volume is moderately reduced in all pools on the background of increase of arterial tone in the arteries of small caliber and the microvasculature with the asymmetry of the pulse cravenplan the Noah regulation (1166), the excessive influence of the parasympathetic component (HF-57,9%) when shortages of full-time influence of the sympathetic component (LF-19,2%). When AutoProbe observed reduced activation of the sympathetic division of the autonomic nervous system: (a coefficient. 30/15.E.).

Spinal evoked potentials - impaired somatosensory holding neck Stalowa level.

Patients received balneotherapy (carbonate mineral baths No. 10, including 6 considenng carbon dioxide to limit the concentration of CO2and 4 with a standard concentration of CO2), physiotherapy (diadynamic currents on the projection of the vertebral artery No. 6) and “sparing” the traction of the cervical spine (AIZ) when the OPT 15forward with a thrust of 1.5-2.0 kg No. 10, massage of neck and collar zone No. 8.

As a result of therapy disappeared dizziness and unsteadiness when walking, normalized hemodynamic performance. improved concentration. Degenerate vertebrogenic pain symptoms in the cervical-thoracic spine (SHOP), the muscles of the shoulder girdle), disappeared numbness of the fingers, decreased frequency and intensity of craniocervical. However, there is moderate pain in the right shoulder, “crunch” when turning goth. Pupils normal size and shape, the expression alive. Remains light weak convergence. Reflexes of oral automatism no. Tendon reflexes satisfactory, with no clear difference between the parties. Movement in the SHOP in full, paravertebral points sensitive, symptoms of tension of the cervical roots there. In the Romberg sustainable, palanisamy sample performs clearly, with little intention on the left. Sensitivity is not compromised. Muscle tone is not changed, pathological stop signs. Issued with significant improvement.

According to REG noted a moderate increase in pulse blood filling both carotid and vertebrobasilar system (15.2%); the trend toward normalization of vascular tone, reducing the asymmetry between the parties VBS (to 5.7%).

According to the VRS after the course of treatment was increased, the average heart rate of 5 beats per minutes a Slight increase in the total power spectrum of autonomic regulation.

More pronounced changes occurred in the structure of the spectrum of vegetative regulation - the contribution of the very slow waves (VLF), reflecting humoral-metabolic and cerebral ergotron effects, decreased slightly (2.3%), however, the contribution slow the I /source excessively high/ decreased by 18.5%. The balance of the divisions of the ANS has changed from parasympathicotonia to atonia; slightly increased sympathetic activation when performing orthostatic test.

According to the somatosensory evoked potentials of the brain marked improvement holding neck Stalowa level.

In Fig.1-18 summarizes the research findings.

EXAMPLE 2

B-s G-s, 53 years of age, doctor, medical history, No. 144. was treated with 27.07 on 18.08.2002, with a diagnosis of chronic cerebrovascular insufficiency, mainly in the vertebrobasilar system, the initial manifestations of cervical radiculomyelopathy: extravasal comissiona-irritative effect on vertebral artery, cervical osteochondrosis; craniocervical vertebrogenic; arterial hypertension, including regional cerebral.

Admitted with complaints of dizziness, including when the head turns, hearing loss, severe tinnitus, the head, pain in craniocervical transition, cervical spine, numbness of the fingers, especially in the daytime, irritability, fatigue, confusion, attention, memory loss on current events.

Within 2 years disturb vertebrogenic pain in the cervical spine with a gradual prisoedinenie is nemenee fingers began to worry in the daytime. A history of episodes of raising HELL.

When admitted to the neurology ward Kislovodsk clinic: heart rate is 74 per minute, satisfactory properties, HELL 140/90 mm RT.article.

Motion in the cervical spine is limited. When turning the head causes pain, discomfort in the SHOP. Pain paravertebral points in the cervical-thoracic spine. Pupils normal size and shape, reaction to light is weak, the weak convergence on both sides; tremor of the eyelids. Detected reflex Marinesco-Radovici (s>d), carpal reflex Rossolimo (s). The reflexes on the hands is reduced (d=s). Knee reflexes with hyperkinetic component (d=s), Achilles - satisfactory (d=s). In the Romberg position is unstable, palanisamy test performs satisfactorily. Muscle tone is not changed. Pathological stop signs.

ECG - signs of hypertrophy of the left ventricle, violations of intraventricular conduction.

REG - moderate decrease in pulse blood, mainly in the vertebrobasilar basin on the background of arteriovenous dystonia with signs of difficulty of venous outflow, increase arterial tone in the arteries of small caliber and the microvasculature.

HRV - source reduction total reduction regulation (VLF-62,5%) while reducing the reflex effects (HF-21,5%: LF-16%). When AutoProbe observed reduced activation of the sympathetic division of the autonomic nervous system: (a coefficient. 30/15-1,11.E.).

Patients received balneotherapy (carbonate mineral baths No. 10, including 1 considera carbon dioxide to limit the concentration of CO2and 9 with a standard concentration of CO2), physiotherapy (diadynamic currents on the projection of the vertebral artery No. 6) and “gentle” traction SHOP at WHOLESALE 0forward with a thrust of 1.5 kg No. 10, massage of neck and collar zone No. 8.

As a result of therapy decreased the frequency, intensity, dizziness and noise, improved sleep quality, reduced vertebrogenic pain and disappeared numbness of the fingers, especially in the daytime.

After the course of treatment according to REG a slight increase in pulse blood filling in the vertebrobasilar system (5.4%); reduction of dystonia, the tendency to normalization of vascular tone.

In the study of HRV conducted on a “one-off” admission procedures, mineral baths with different concentrations of carbon dioxide obtained from the following data.

1. Once the procedure UPS with a standard concentration of CO2: you were born in the average heart rate by 15 beats per minute;

the d is very slow waves (VLF-humoral-metabolic and cerebral ergotron influence) 11.8%;

the contribution of slow waves (LF - sympathetic effect) practically did not change (1.7%);

the contribution of fast waves (HF - parasympathetic effects) increased by 10.1%;

- balance departments ANS remained at the level of itonia:

on AutoProbe parasympathetic reactivity did not change significantly (30/15 ratio remained low); sympathetic activation remained at the same level.

2. Once the procedure WMV, donsimoni CO2:

- there has been a decrease in the average heart rate of 26 beats per minute;

- background recording increased TR 5.7 times;

- in the structure of the spectrum the contribution of the very slow waves (VLF - humoral-metabolic and cerebral ergotron influence) practically did not change (increased by 0.7%);

the contribution of slow waves (LF - sympathetic effect) significantly decreased (by 22.1%);

the contribution of fast waves (HF - parasympathetic dominance) significantly increased 21.4%.

- sympathicotonia turned parasympathicotonia;

on AutoProbe increased parasympathetic reactivity (30/15 ratio has entered into a conditional norm); increased and became adequate sympathetic activation.

The above shifts registered immediately after DUMB and most appeared after 1.5 hours of rest after DUMB.

So, on this note the consultative apparatus of the organism (in terms of effects on the sinus node and the autonomic regulation of the heart) a single procedure DUMB compared to UPS with a standard concentration of CO2that is primarily manifested in a more significant increase in the total power spectrum of autonomic regulation of the heart, increased parasympathetic and decreased sympathetic influences and improve parasympathetic reactivity and autonomic operation.

At discharge: the pulse rate of 72 per minute, satisfactory properties, HELL 140/90 mm RT.article Pupils normal size and shape, the expression satisfactory. Remains light weak convergence. Hyperalgesia of the outer zones of Zelder. Detected unstable reflex Marinesco-Radovici (s>d). Carpal reflex Rossolimo (s). The reflexes on the hands is moderately reduced (d=s). Knee reflexes are increased (d=s), Achilles - satisfactory (d=s). Movement in the SHOP in full, paravertebral points sensitive, symptoms of tension of the cervical roots there. In the Romberg - resistant, palanisamy test performs satisfactorily. Muscle tone is not changed. Pathological stop signs. Issued with improvement.

In Fig.19-22 shows the data of the research results.

EXAMPLE 3

The patient is In s, 51, administrator, medical history, No. 253, was treated with 05.03 on 27.03.2002, with a diagnosis of chronic cerebrovascular not enough is lita (1954).

Was admitted with complaints of headaches, discomfort in the cervical spine and the muscles of the shoulder girdle, weakness of the muscles of the left hand, irritability, insomnia, decrease of memory.

History - as a child, suffered acute polio in the last 6 years of pain, discomfort in the SHOP, the shoulder girdle, severe weakness in the muscles of the hands, headache. Repeatedly conducted outpatient treatment (metabolic drugs, physiotherapy, massage) with weak positive effect up to 2-3 months.

When admitted to the neurology ward Kislovodsk clinic: heart rate is 74 per minute, satisfactory properties, HELL 120/80 mm RT.article.

Motion in the cervical spine is limited. Pain paravertebral points of the cervical spine. The reflexes on the hands of right - satisfactory, left - reduced, knee reflexes - d>s. In the Romberg sustainable, coordinating sample performs satisfactorily.

The patient received a course of treatment, including hardware physiotherapy mild traction to SHOP at WHOLESALE and 10 carbonated mineral baths (6 DOOM and 4 UPS with a standard concentration of CO2).

According to HRV after a course of treatment occurred ischemia average heart rate on the 14 is like normal;

- in the structure of the spectrum significantly decreased the contribution of the very slow waves (VLF - humoral-metabolic and cerebral ergotron influence) 35.9%;

the contribution of slow waves (LF - sympathetic effect) increased by 22%;

the contribution of fast waves (HF - parasympathetic influence increased by 13.9%;

the balance of the divisions of the ANS has changed from sympathicotonia to atonia;

on AutoProbe increased parasympathetic reactivity (30/15 ratio was included in the “corridor” conditional norms); increased sympathetic activation.

The state of the cerebral circulation according to REG the patient In the society. 51, (ist. b-FDI No. 253) and its dynamics under the effects of a single UPS with a natural concentration of CO2and WMV, considenng CO2; and in the course of application DUNG reflected in Fig.27-30.

Welcome WMV with a natural concentration of CO2(Fig.27) contributed to reductions pulse blood vessels in the carotid and vertebrobasilar basin. Thus, RI in lead F-M decreased from 1.2 to 1.0 (d) and from 1.1 to 0.75 (s); in lead O-M RI decreased from 1.0 to 0.87 (d) and from 0.6 to 0.53 (s) increased and the asymmetry factor.

The same direction of changes in the indicators REG, albeit to a lesser extent, was observed when receiving the 1st DUNG (Fig.28>at the end of treatment (Fig.30) significantly increased pulse blood pressure in the carotid pool (from 1.25 to 1.75 d and from 1.1 to 1.4 s) and to a lesser extent in the vertebrobasilar system (from 0.64 to 0.72 d and from 0.95 to 0,86 s). The asymmetry factor in the vertebrobasilar system decreased from 48.5 to 19.5, i.e., normalized. This is an important indicator of improvement of brain blood circulation (L. B. Smith. A. C. Makarov. Lectures on clinical rheography, M., 2000. - 320 S.).

It is known that UPS have amphoteric effect on the autonomic nervous system - the bowl is predominant activation of the parasympathetic. However, depending on many factors: the initial balance of vegetative regulation, the ratio of the Central and peripheral actions of CO2on the vasomotor center and the vessels, the action UPS can be worn as parasimpaticheskih and simpaticotonici character. So, M. E. Marshak (Physiological significance of the carbon dioxide. Publishing house of Medicine. M., 1969. - 144 S.) showed that the direct effect of CO2on the vasomotor center and the reflex action of CO2this centre via chemoreceptors sinocarotid and aortic reflex zones has a vasoconstrictor effect, and the predominance of local action times the reception WMV prevailed simpaticotonici effect and in exchange - parasimpaticescoe effect on the brain vessels.

The patient is In s was discharged with improvement by objective and subjective symptoms.

EXAMPLE 4

B-s P-howl. 36 years. military, history, No. 727, was treated with 17.06 on 10.07.2001, with the diagnosis: consequences of repeated craniocervical injuries, posttraumatische encephalopathy, osteochondrosis of the cervical and lumbar spine, cervical malaisamy with paresis myotome5-7, tetraparesis, more pronounced in the right limbs.

Was admitted with complaints of headache, dizziness, including when turning head, pain, and craniocervical transition, cervical and lumbar spine, weakness and numbness in the hands, irritability, fatigue, confusion, attention, memory loss on current events.

In 2000 he moved again craniocervical injury, without specialized treatment. During the year arose and overgrow the above symptoms. In 2001, conducted in-patient treatment at the hospital of the Ministry of interior (vasoactive and metabolic drugs).

Patients received balneotherapy (carbonate mineral baths No. 10), physiotherapy (diadynamic currents on the projection of the vertebral artery No. 6) is th zone No. 8.

As a result of therapy decreased the frequency, intensity, dizziness and noise, improved sleep quality, lined background mood, degenerate vertebrogenic pain and paresthesias in the right hand and leg. Issued with improvement from subjective of objective symptoms.

In the study of HRV conducted at the beginning and at the end of a course of treatment, the following data: after completing the course of therapy occurred ischemia average heart rate of 5 beats per min;

- on the background recording the total power spectrum of autonomic regulation (TR) increased in 2 times:

- in the structure of the spectrum the contribution of the very slow waves (VLF - humoral-metabolic and cerebral ergotron influence) practically did not change (increased 0.42%);

the contribution of slow waves (LF - sympathetic effect) practically did not change (increased by 0.15 per cent);

the contribution of fast waves (HF - parasympathetic dominance) practically did not change (increased by 0.15 per cent);

- balance departments ANS remained at the level of parasympathicotonia;

on AutoProbe increased parasympathetic reactivity (30/15 ratio was included in the “corridor” conditional norms); increased sympathetic activation.

Thus, in the above examples can be traced amperemeter) at the end of treatment along with the increase in the total power spectrum has been transferred to eatonii (by increasing segmental parasympathetic and reduce cerebral ergotropic effects on sinus node), when the original parasympathicotonia (1st example) at the end of the course including 6 DUMB along with the increase in the total power spectrum was also observed transition to eatonii (by reducing segmental parasympathetic and increase segmental sympathetic and cerebral ergotropic effects on sinus node); in addition, the course considenng UPS has a greater modulatory effect on the ANS than the rate UPS with a standard concentration of CO2(4th example).

EXAMPLE 5

B-I P-BA C. I., 47 years old,

East. b-FDI No. 745, were treated at the clinic with 03.07.02, 26.07.02,

Diagnosis: HNMC in VBS with pnmc; cervico-thoracic osteochondrosis; spondylogenic radiculomyelopathy C3-5; neuralgia nadgortannika nerve left, occipital neuralgia nerve left; dysfunction of the hypothalamus.

Received a standard course of treatment of 10 UPS with a natural concentration of CO2.

Discharged with improvement in the subjective state.

At the beginning and at the end of treatment the study was conducted ASWP (acoustic stem inside of the potentials). The results are shown in table.5-8, Fig.23.

At the beginning of treatment.

Sample 1. Auditory EP. Short-latency

1K: Cz-M1

2K: Cz-M2

EXAMPLE 6

B-I P-BA C. I., 47 years old.

(ASIT) Acoustic stem evoked potentials in the end l of the studies are presented in table.9-12.

EXAMPLE 7

B-I G-VA F. M., 61.

East. b-FDI No. 546, were treated at the clinic with 15.05.02, 07.06.02,

Diagnosis: HNMC in VBS; radiculomyelopathy at cervical level; vertebrocardialgias syndrome; CHD angina of FC I.

Received treatment from 6 DUMB and 4 standard HB.

Discharged with significant improvement.

At the beginning and at the end of treatment the study was conducted ASIT; presented in tab.13-16 and Fig.25.

At the beginning of treatment.

Sample 1. Auditory EP. Short-latency

1K: Cz-M1

2K: Cz-M2

EXAMPLE 8

Patient: Mr. VA F. M., 53.

Date: 1.06.2002.

Department: neurology.

Diagnosis: HNMC in VBS; radiculomyelopathy at the cervical level.

At the end of treatment (after a course of 6 DUMB and 4 standard WMV), the results are shown in table.17-20, Fig.26

Sample 1. Auditory EP. Short-latency

1K: Cz-M1

2K: Cz-M2

Claims

A method for the treatment of vertebral spinal vascular disorders by assigning the background of a Spa treatment, a pulsed current of low frequency impact on the cervical sympathetic nodes and plexus, vector traction of the cervical spine, carbonated mineral baths T 35With a duration of 12 min, in the course of 10 baths, characterized in that nazyvanej concentration of carbon dioxide of 0.8-1.0 g/L.

 

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