Method for treating hypertension

FIELD: medicine, therapy, cardiology.

SUBSTANCE: at hypertension I stage a patient should be prescribed several courses of transcranial electrostimulation at interval of 1-2 mo per 5-7 seanses , current power being 0.5-0.8 mA. At hypertension II and III stages one should prescribe transcranial eletrostimulation along medicinal therapy, and, also, several courses at interval of 2-3 mo and current power being 0.8-1.2 mA. The innovation enables to remove side effects, shorten the period of in-patient therapy and reduce the dosage of hypotensive preparation.

EFFECT: higher efficiency of therapy.

2 cl, 2 ex, 4 tbl

 

The present invention relates to medicine and can be used in therapy and cardiology, namely, in the treatment of hypertension.

One of the important medical and social problems at the present time become vascular lesions of the brain (stroke, vascular dementia and cardiovascular damage (myocardial infarction, heart failure, rhythm disturbances, and others), a significant role in the formation of which divert hypertension (GB). According to the who working group (1997) Russia in mortality from these causes is one of the first places in Europe. Epidemiological survey of a representative sample of the Russian population, standardised by age, revealed that the prevalence of GB in different regions of the Russian Federation in the last 20 years is among men 39.2 per cent, and among women 41,1% (Opicina, Eharmany. Arterial hypertension and cerebral stroke. Moscow - 2001; 5-6.) Identified annually to 500,000 new cases GB, with 30-40% of them do not know about their disease. (Reganam. Prevention of cardiovascular disease: opportunities for practical health care. Cardiovascular therapy and prevention 2002; 1:5-9.) Hypotensive effect have many physiotherapeutic influence, in particular interest representation is given in electrosleep, amplipulse therapy, darsonvalization, inductothermy, the electric field of ultrahigh frequency (UHF).

Electrosleep.

There is a method of influence on the Central nervous system, a pulsed current of low frequency and low power rectangular (pulse duration of 0.2-2.0 MS, frequency Hz). The mechanism of action is complex, includes direct and reflex effects. (V.M. Bogolyubov, TN. Ponomarenko. General physiotherapy - M - SPb., 1996; 480.) A direct impact on the nervous system leads to sleepy braking, the formation of conditioned reflex reactions that occur during the course of treatment due to similar conditions of procedures; the emergence of protective inhibition in the Central nervous system when exposed to weak, monotonous rhythmic stimuli.

Darsonvalization.

therapeutic method, the applicable factor is the discharge pulse rarely decaying high frequency alternating current of low power and high voltage (up to 20 kW). These currents can pass through the body without causing tissue irritation. D'arsonval currents affect the receptors embedded in the skin, and reflex is being transmitted to internal organs.

The sensitivity of cutaneous receptors is reduced, providing an analgesic effect and reducing itching. Dilate the arterioles of the capillaries, especially in the superficial tissues, improves blood circulation, metabolism, increases the tone of the veins, decreases venous stasis. Thermal effect is almost completely absent. (Innocene. Clinical physiotherapy. Kiev, 1996; 624.)

Disadvantages: increased drowsiness preventing driving, active work during the day, dry mouth and other

There is a method of stimulating protective (endorphin) mechanisms of the brain, we adopted for the prototype. To this end, the skin of the scalp affected by a weak electric signal in the form of rectangular current pulses (up to 4 mA) fixed frequency, and duration. This effect has been called Transcranial electrical stimulation (TES), and the method has received the name of TES-therapy. Installed normalizing the effect of TPP on hemodynamics and anti-stress action (a New method of non-medical treatment. Sat. articles editor V.P. Lebedev, St. Petersburg, 1993, 133 S.). The normal duration of the procedure recommended for therapeutic diseases is 30 minutes, 1-2 times per day, the number of procedures (course) 8-10, rated current up to 2 mA, refresher courses after 1-3 months (if necessary), treatment can be repeated many times during the year, but not recommended for more than 40-50 per year.

Transcranial electrical stimulation implementing tlaut by means of electrodes (occipital and frontal), connected to the apparatus. First, using adjustable headband fix occipital electrodes placed on the skin behind the ears on the mastoid processes (projections) of the skull. Under each electrode is placed a small strip abundantly moistened with warm tap water. Then the frontal electrodes fixed on the forehead of the patient also using the adjustable headband. Under both electrodes placed on the forehead one large strip, liberally soaked in warm tap water. The patient should be in a comfortable position, preferably lying on the back with a raised head end. The increase in current during the procedure should be done gradually under constant supervision of the patient's feelings. In most cases, sufficient is the value of current at which the electrodes appear tingling, weak vibration or sensation of flicker in his eyes. In the process of the session to ensure that these feelings were not, but were not overly intense. The first procedure is always adaptive. The first procedure to 20 minutes, the current is 0.5 mA, even if the patient it does not feel. Since the second procedure, the time increased to 30 minutes. The disadvantages of the prototype:

1. No differential approach to treatment of hypertension depending on the stage of the disease.

2. N is sufficiently justified treatment (current strength, the number of procedures, their duration, the interval between courses.).

3. Adverse (negative) effect on the force of the current.

Objectives of the invention are: to improve the effectiveness of treatment, elimination of side effects, reduction in the duration of inpatient treatment, reduce the dose of antihypertensive medication.

The technical essence of the invention is the implementation of treatment depending on the stage of hypertension: when the 1st stage of hypertension the patient alone - several courses transcranial electrical stimulation with an interval of 1-2 months 5-7 sessions, amperage of 0.5-0.8 mA, for the 2nd and 3rd stages of hypertension transcranial electrical stimulation is administered in combination with drug treatment, also several courses with an interval of 2-3 months and amperage of 0.8-1.2 mA.

The method is as follows. Prepare the patient for TPP-treatment is the same as in the prototype. Transcranial electrical stimulation is carried out by means of electrodes (occipital and frontal)connected to the apparatus. First, using adjustable headband fix occipital electrodes placed on the skin behind the ears on the mastoid processes (projections) of the skull. Under each electrode is placed a small strip abundantly moistened with warm tap water. Then the skull is the fixed electrodes on the forehead of the patient also using the adjustable headband. Under both electrodes placed on the forehead one large strip, liberally soaked in warm tap water.

The patient should be in a comfortable position, preferably lying on the back with a raised head end. The increase in current during the procedure should be done gradually under constant supervision of the patient's feelings. In most cases, sufficient is the value of current at which the electrodes appear tingling, weak vibration or sensation of flicker in his eyes. In the process of the session to ensure that these feelings were not, but were not overly intense. The first procedure is always adaptive. The first procedure to 20 minutes, the current is 0.5 mA, even if the patient it does not feel. Since the second procedure, the time increased to 30 minutes, the Current must not exceed 0.5 mA. Current selected individually, at the 1st stage of hypertension from 0.5 to 0.8 mA, with the 2nd and 3rd stages of hypertension 0.8 to 1.2 mA. Carefully study the clinical effect and the patient's condition after each procedure to a distinct but not unpleasant feelings. In case of occurrence of unpleasant sensations amperage should be reduced. During the procedure, as a rule, there is rapid adaptation to electric current and the patient no longer perceive. In this case, the PE the iodine procedures (starting with the second) recommend gradually add the amperage until the above sensations. The number of treatments on the course of treatment is for hypertension 1st stage 5-7 sessions, when the 2nd and 3rd stages of hypertension 8-10 sessions 1 time per day. The interval between courses TES therapy for hypertension 1st stage 1-2 months, with hypertension 2nd and 3rd stage 2-3 months. The optimum interval and the necessity of repeated courses is decided individually, and if in the period between courses there is an acute disease with pain (toothache, myositis etc) may unscheduled conducting a short course TES therapy to relieve acute pain syndrome (usually 2-5 procedures). After the procedure, a slight dizziness and slight redness at the place of attachment of the electrodes, which soon pass spontaneously. For normal completion of all biochemical processes caused by thermal power plants, after the procedure recommended rest for 15-20 min, relax in a comfortable position lying down or sitting. If during or after the procedure, the patient appeared drowsiness, you should not resist it. As a rule, the dream does not last longer than 40-60 minutes and did not violate the subsequent night's sleep. In case of occurrence during the course of TES therapy of symptoms of acute illness such as colds, you should get con is oltulu doctor. It should be remembered that after the second or third procedure can occasionally cause aggravation of symptoms. In this case, you should not stop therapy.

Testing was performed on 86 patients with GB 1, 2, 3 stages in age from 23 to 78 years. (38 men, 42 women.) The study included patients undergoing individually selected antihypertensive therapy for 6 months. We studied the effect of TPP on the clinical course of GB and a set of indicators of skin capillary blood flow.

In the examined patients GB revealed the heterogeneity of the microcirculation with a significant increase in the share of pathological types. Change ICR significantly varied depending on the stage GB: when stage 1: hyperemic - 55,6%, normocalcaemia is 22.2%, spastic is 22.2%. When stage 2: spastic - 41%, stagnant - 20,5%, normocalcaemia - 15,4%, stationsi - 12,8%, hyperemic and 10.3%. When stage 3: congestive - 41,7%, stationsi - 25%, spastic - 16,6%, hyperemic - 16,6%.

Table 1
Type ICRStage 1Stage 23rd stage
 The Exodus. display.After TPPThe Exodus. display.After TPPEx is D. display.After TPP
Normocalcaemia22,277,815,474,3 58,3
Hyperemic55,622,210,325,616,641,7
Spastic22,2-41-16,6-
Stationsi--12,8-25-
Congestive--20,5-41,7-

After 10 treatments TES therapy, established a significant redistribution of microcirculation, in the direction of increase in the weight of normocalcaemia type (PL. No. 1), so regardless of the stage GB exchange treatment using the method of TES therapy helps to normalize the microcirculatory changes and can be recommended as additional non-medical method for the treatment G.B.

Method TES therapy can be used as the sole therapeutic agent (GB 1 tbsp.) or in combination with drug therapy (GB 2-3 tbsp.) for the correction of microcirculatory parameters.

Example 1. Patient Knodels in-patient treatment in KKB in the cardiology Department with 13.02 02 28.02.02. Case history No. 4282, Diagnosis: hypertension 2 tbsp. risk 3. NC 1. Complaints at admission: raising HELL (to 220/100 mm Hg), pressing pain in region of heart, independent of physical activity, long >1 hour, arising HELL, headache, noise in the head, dizziness, pastos lower limbs in the evening, a feeling of shortness of breath, weakness, malaise, insomnia, irritability.

The patient is examined to exclude symptomatic hypertension. Blood pressure at entry: other 170/100, Leo. 180/110. Of drug therapy the patient received during 6 months: enalapril 10 mg/day, cardio magnel 75 mg/day, calcic 5 mg/day, from 10 non-drug sessions TES therapy, daily 1 time per day amperage of 0.8-1.2 mA with a duration of 30 minutes.

The treatment was conducted in a calm atmosphere, the position of the patient lying on his back. Transcranial electrical stimulation was carried out using electrodes (occipital and frontal)connected to the apparatus. First, using adjustable headband secured occipital electrodes placed on the skin behind the ears on the mastoid processes (projections) of the skull. Under each electrode was placed a small strip moistened with warm tap water. Then the frontal electrodes were fixed on the forehead of the patient also using the PE wireimage headband. Under both electrodes on the forehead, put one large strip, liberally soaked in warm tap water. The first procedure was an adaptation. The first procedure lasted 20 minutes, the current did not exceed 0.5 mA.

Since the second procedure was a set time of 30 minutes, the current strength of 0.8-1.2 mA. The current was adjusted individually to a distinct but not unpleasant feelings based on the clinical effect and the patient's condition after each procedure. In case of occurrence of unpleasant sensations amperage reduced.

During the procedure, have led to a rapid adaptation to the electric current and the patient continued to feel him. Starting with the 3rd procedure, the patient returned to normal sleep, irritability disappeared after 5 treatments stabilized BP - 130/80 mm RT. Art. (conducted daily monitoring of blood pressure), after 8 treatments reduced dose of enalapril to 5 mg/day, calcica 2.5 mg/day.

Table 2
Type ICR Stage 2
 The Exodus. display.After 1 TPPAfter 5 TESAfter 10 TPP
normocalcaemia  ++
Hyperemic the sky     
Spastic++  
Stationsi    
Congestive    

As seen from table 2, as in this patient on a background of TES therapy has changed the type of microcirculation, which was estimated using the method of the LDF.

28.02.02 - patient was discharged in satisfactory condition.

Example 2. Patient P. was hospitalized in KKB in the cardiology Department, with 11.05.02 on 25.05.02, case history No. 6412, Diagnosis: hypertension 1 tbsp. risk 2. NC. Complaints at admission: raising HELL (up to 150/90 mm Hg), discomfort in the heart, associated with a rise in arterial pressure, headache, pastos lower limbs in the evening, a feeling of shortness of breath, weakness, malaise, insomnia, irritability. The patient is examined to exclude symptomatic hypertension. Blood pressure at admission other 150/90 mm RT. senior, Leo. 140/80 mm Hg the Patient had not received medication, non-medication 7 sessions TES therapy, daily 1 times day amperage of 0.5-0.8 mA with a duration of 30 minutes. The treatment was conducted in a calm atmosphere, the patient lying on his back. Transcranial electrical stimulation was carried out using electrodes (occipital and frontal)connected to the apparatus. First, using adjustable headband secured occipital electrodes placed on the skin behind the ears on the mastoid processes (projections) of the skull. Under each electrode was placed a small strip moistened with warm tap water. Then the frontal electrodes were fixed on the forehead of the patient also using the adjustable headband. Under both electrodes on the forehead, put one large strip, liberally soaked in warm tap water. The first procedure was an adaptation. The first procedure lasted 20 minutes, the current does not exceed 0.5 mA.

Since the second procedure was a set time of 30 minutes, the current is 0.5 to 0.8 mA. The current was adjusted individually to a distinct but not unpleasant feelings based on the clinical effect and the patient's condition after each procedure. In case of occurrence of unpleasant sensations amperage reduced. During the procedure was quick adaptation to the electric current and the patient continued to feel him. Starting with the 3rd procedure, the patient returned to normal sleep, irritability disappeared after 5 treatments stabilized BP - 110/70 mm Hg, (conducted daily monitor the Finance AD).

As seen from table 3, as in this patient on a background of TES therapy has changed the type of microcirculation, which was estimated using the method of the LDF.

Table 3
Type ICR Stage 1
 The Exodus. display.After 1 TPPAfter 5 TESAfter 10 TPP
Normocalcaemia  ++
Hyperemic++  
Spastic    
Stationsi    
Congestive    

25.05.02 - patient was discharged in satisfactory condition.

Example 3. The patient was So in-patient treatment in KKB in the cardiology Department with 09.12 02 24.12.02 history No. 8764. Diagnosis: hypertension C senior risk 4. Coronary heart disease, angina 2 F.K. PKS (1998) NK 2. Complaints at admission: increased blood what about the pressure to 220/100 mm Hg), pressing pain in region of heart with irradiation in the region of the left scapula, a short time before, 10 minutes, depending on physical activity (lifting on the 3rd floor), intractable nitroglicerina, noise in the head, dizziness, swelling of the lower extremities in the evening, dyspnea (difficult breath), fatigue, malaise, insomnia, irritability.

Blood pressure at entry: other 190/110, Leo. 180/100. Of drug therapy the patient received during 6 months: enalapril 10 mg/day, cardio magnel 75 mg/day, egilok 50 mg/day, olicard 40, of non-pharmacological: 10 sessions TES therapy, daily 1 time per day amperage of 0.8-1.2 mA with a duration of 30 minutes. The treatment was conducted in a calm atmosphere, the position of the patient lying on his back. Transcranial electrical stimulation was carried out using electrodes (occipital and frontal)connected to the apparatus. First, using adjustable headband secured occipital electrodes placed on the skin behind the ears on the mastoid processes (projections) of the skull. Under each electrode was placed a small strip moistened with warm tap water. Then the frontal electrodes were fixed on the forehead of the patient also using the adjustable headband. Under both electrodes on the forehead, put one large strip, liberally soaked in warm tap water. Paraponera was adaptation. The first procedure lasted 20 minutes, the current did not exceed 0.5 mA.

Since the second procedure was a set time of 30 minutes, the current strength of 0.8-1.2 mA. The current was adjusted individually to a distinct but not unpleasant feelings based on the clinical effect and the patient's condition after each procedure. In case of occurrence of unpleasant sensations amperage reduced. During the procedure was quick adaptation to the electric current and the patient continued to feel him. Starting with the 4th procedure, the patient returned to normal sleep, irritability disappeared after 7 treatments stabilized BP - 130/80 mm Hg, (conducted daily monitoring of blood pressure), after 9 treatments reduced dose of enalapril to 5 mg /day, egilok 25 mg/day.

From table 4 it is seen, as in this patient on a background of TES therapy has changed the type of microcirculation, which was estimated using the method of the LDF.

Table 4
Type ICR 3rd stage
 The Exodus. display.After 1 TPPAfter 5 TESAfter 10 TPP
Normocalcaemia  ++
Hyperemic     
Spastic    
Stationsi    
Congestive++  

24.12.02. - the patient was discharged in good condition.

1. A method of treating hypertension, including transcranial electrostimulation, characterized in that during the 1st stage of hypertension the patient alone - several courses transcranial electrical stimulation with an interval of 1-2 months 5-7 sessions, amperage of 0.5-0.8 mA, for the 2nd and 3rd stages of hypertension transcranial electrical stimulation is administered in combination with drug treatment, also several courses with an interval of 2-3 months and amperage of 0.8-1.2 mA.

2. The method according to 1, characterized in that transcranial electrical stimulation is carried out at all stages of hypertensive disease once per day.

3. The method according to claims 1 and 2, characterized in that during the 2nd and 3rd stages of hypertension appoint 8-10 sessions of transcranial electrostimulation.



 

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EFFECT: higher efficiency of therapy.

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