Method for treating patients with alcoholic polyneuropathy

FIELD: medicine, neurology, psychiatry.

SUBSTANCE: one should affect with amplipulsephoresis of "Berlition" preparation in rectified mode. One should apply types III and V of operations at modulation frequency being 130-150 Hz, modulation depth of 50-75%, impact duration for every type of operation lasts for 5-7 min. During the 1st d electrode-cathode should be located in inferior cervical - superior thoracic department of vertebral column, and electrode-anode - at anterior and posterior surfaces of forearms. During the 2nd d - in inferior thoracic - superior lumbar department of vertebral column and at anterior-lateral and posterior surfaces of shins, correspondingly. The present method improves clinico-electrophysiological and biochemical parameters.

EFFECT: higher efficiency of therapy.

5 ex, 8 tbl

 

The invention relates to medicine, in particular, neurology and physiotherapy, and can be used in the treatment of patients with alcoholic polyneuropathy (NPA).

Currently, for the treatment of patients with APS, the use of vitamins of group In (B1In6B12), folic acid, analgesics, cardiovascular drugs, anti-depressants, antioxidants, cerebral gangliosides [1]. Use for the treatment of patients with PLE b vitamins and vascular drugs is not effective, because after the treatment (18-20 day) saved complaints of patients on a feeling of tightness, numbness, tingling, violation of coordination of movements, mainly in the lower extremities; the clinical picture of the disease remains polyneuropathies type of sensory, motor and autonomic-trophic disorders [2]. When using additional electrophysiological examination, first and foremost, ENMG, in patients after treatment remain signs of mixed polyneuropathy (axona and myelinopathy), characterized by a decrease in the amplitude of neural potential and decrease the velocity of propagation of excitation (SRV) on sensory and motor fibers [3], largely preserves trophic disorders.

For the treatment of the sick the NPA is also widely used intravenous drugs a-lipoic acid (Thioctacid), which is also not efficient enough, because after the course of treatment remain vegetative trophic disturbances [4].

On the closest in technical essence as a prototype of the selected method of treatment of the APS, which is to assign a sinusoidal modulated currents (SMC) on local and reflex-segmental techniques [5].

Not enough high efficiency SMT is manifested in the preservation of the typical complaints of patients and maintaining polyneuropathies type of sensory, motor and autonomic-trophic disorders, characterized by the use of additional clinical and electrophysiological and biochemical methods.

The objective of the invention is to increase the efficiency of treatment of patients with APS by improving basic clinico-electrophysiological and biochemical parameters.

The problem is solved in that in the treatment of patients with APS affected by amplipulse drug “Berlition” in an extended mode, and the effects exercise III and V come work with frequency modulations 130-150 Hz and a depth of modulation 50-75%, the duration of exposure of each kind of works for 5-7 minutes, and in the first day of active electrode - cathode placed in niinisalo-Wernigerode spine, the second day in nignog odnom-verkhnepashino spine, the anode is placed on the front and back surfaces of the forearms on the first day and on anterolateral and posterior surfaces of the tibia on the second day, and the course of treatment is 8-10 procedures.

The method is as follows.

On the first day of the active electrode, the cathode, an area of 200 cm2moistened with 12 ml of the drug “Berlition”feature in niinisalo-Wernigerode spine (the projection of the cervical enlargement of the spinal cord), the second electrode, the anode - forked, with an area of 100 cm2everyone have a turn on the rear and front arms. On the second day of the active electrode, the cathode, an area of 200 cm2moistened with 12 ml of the drug “Berlition”feature in nijaguna-verkhnepashino spine (the projection of the lumbar enlargement of the spinal cord), the anode - forked, with an area of 100 cm2everyone have a turn on the rear and front-side areas of the lower legs. Treatment of patients is carried out by the “Amplipulse-5”. Amplipulse is held in an extended mode, III and V on the type of work, frequency of modulations 130-150 Hz, the depth of modulation 50-75%. The duration of exposure of each kind of works for 5-7 minutes. The treatment is 8-10 procedures.

Distinguishing the essential features of the proposed method are:

1) impact ampli what lhorizon drug “Berlition”, representing ethylendiamine salt of a-lipoic acid, affecting energy metabolism and the processes of binding and inactivation of free radicals, and thereby to prevent the destruction of cellular membranes;

2) additional effect: (a) (III originally works - shock "parcel-carrier frequency (LOI), which is a parcel of the modulated oscillation is selected in the range of 130-150 Hz frequency, changing assumptions unmodulated oscillations with a frequency of 5000 Hz, to provide a weak irritating effect with moderate excitation pulses to relieve significant pain syndrome; b) V the type of work that represents the current "intermittent frequency-pause" (PPP), which is formed by a combination of alternating parcels current with different modulation frequencies in the range of 130-150 Hz and pauses between them, to achieve soft neuromyotonia actions, improve the structure of tissues; the use of III and V of the genera works in an extended mode allows you to enter with their use of medicinal substance;

3) the place of administration of the medicinal product in niinisalo-Wernigerode spine (the projection of the cervical enlargement of the spinal cord) and in nijaguna-verkhnepashino spine (the projection of the lumbar enlargement of the spinal cord).

Taken together, the awn distinctive essential features is new and allows to increase the efficiency of treatment by improving the main clinical and electrophysiological parameters.

Example 1. Patient C., 52 years old, and a/b No. 18449, was on the examination and treatment in the clinic of nervous diseases with state medical Academy 26.11.01 on 28.12.01. The diagnosis of alcoholic polyneuropathy of upper and lower limbs. A course of treatment with b vitamins, folic acid, trental; conducted amplipulsephorese drug “Berlition” (parameters amplipulse presented in table 1). The results of treatment of patient V., 52 L., presented in table 2. The treatment results in decreased complaints of the patient according to the visual analogue scales (VAS); additional electrophysiological methods has not changed.

Example 2. Patient M, 51,,/b, No. 842, was on the examination and treatment in the clinic of nervous diseases with state medical Academy 20.01.03 on 22.02.03. The diagnosis of alcoholic polyneuropathy of upper and lower limbs. Conducted a comprehensive treatment using vitamins, folic acid, trental. Were amplipulse drug “Berlition” (table 1). The results of treatment are presented in table 3. As a result of treatment was observed more pronounced positive dynamics in terms of reduced patient complaints according to YOUR; decreased pain threshold and sensitivity vibration according to altimetry, pallesthesicly and vibrate the tests, increased conduction velocity and amplitude of neural potential according to ENMG.

Example 3. Patient F., 57 HP, and/b 7482; was on the examination and treatment in the clinic of nervous diseases with state medical Academy 04.03.03 on 7.04.03. The diagnosis of Alcoholic polyneuropathy of upper and lower limbs. Treatment: b vitamins, vitamin C, folic acid, trental. Amplipulse drug “Berlition” (table 1). The results of treatment are presented in table 4. As a result of treatment significantly decreased complaints of patients according to YOUR; significantly decreased pain thresholds and sensitivity vibration; more than 2-fold increase in the amplitude of the neural action potential; to norms increased conduction velocity.

Example by way of a prototype.

Patient K., 49 HP, and a/b No. 15219; was on the examination and treatment in the clinic of nervous diseases state medical Academy with 04.10.01 on 09.11.01. The diagnosis of alcoholic polyneuropathy of upper and lower limbs. Treatment: b vitamins, vitamin C, folic acid, trental. As a physical therapy patient received CMT local and reflex-segmental method. The CMT mode: AC, childbirth papers III and IV; frequency modulation 100-70 Hz; depth modulations 75%; duration of parcels 2-3 seconds. Duration of exposure for 3-5 minutes every kind of work. The results of the chickens is and treatment are presented in table 5.

According to its own data in the group of patients (50 people), treated according to the method of the prototype, the improvement was achieved in 28 (56%), manifested in the reduction of complaints of patients according to YOUR 20%decrease in pain threshold and sensitivity vibration at 14%, the improvement ENMG indicators in the form of increasing the amplitude of the neural potential of 13% Vietnam 16%. In 18 patients (36%) main study figures have remained almost unchanged. 4 patients (8%) there was a slight deterioration, mainly according to ENMG, in the form of reducing the amplitude of the neural capacity, reducing NRW.

The example with the equivalent.

Patient S., 42, and/b No. 4804; was on the examination and treatment in the clinic of nervous diseases with state medical Academy 01.03.02 on 08.04.02. The diagnosis of alcoholic polyneuropathy of upper and lower limbs. Treatment: b vitamins, vitamin C, folic acid, trental, aminophylline. The results of treatment are presented in table 6. As a result of treatment of patient complaints decreased slightly, the threshold of pain and vibration sensitivity according to altimetry and pallesthesicly virtually unchanged, the amplitude of the neural action potential and after treatment did not exceed background noise, Vietnam has increased slightly.

The proposed method is tested on 30 bol is different APN. The characteristics of the clinical picture of the disease, all patients were divided into 3 groups:

group 1 - 12 patients (10%) - mainly with autonomic-sensory manifestations of polyneuropathy;

group 2 - 5 patients (17%) - primarily with musculoskeletal manifestations of polyneuropathy;

group 3 - 13 patients (43%)with autonomic sensory and motor symptoms of PN are expressed equally. The results of treatment in this group of patients are presented in tables 7 and 8.

When examining antioxidant defense in patients with alcoholic polyneuropathy (table 8) before treatment revealed a decrease in the power substrate-level AOC: almost all patients reduced regenerative potential ascorbate link (Inf/Aboutf) in comparison with healthy persons more than 3 times due to the reduced content of the recovered components (f). At the same time decreased the activity of the reactions of aerobic glycolysis with the increase in the blood content of lactic acid and excess lactate characterizing the shift in the balance of lactatepyruvate in the direction of lactate. As it turned out, the tension in the protective compensatory mechanisms and reactions of energy metabolism were examined in the experimental group is more pronounced, which confirms what I lower (p< 0.05) in this group of indicators reduction potential (TDK) thiol AOC and increase the degree of peroxidation of protein-lipid complexes. On a more profound disturbance in the reactions of energy metabolism group of patients for clinical trials and indicates a significant increase in the examined values of the ratio of lactate/pyruvate.

The results of blood tests in patients with alcoholic polyneuropathy after complex treatment using the drug "Berlition " indicates the ability of this drug to increase the antioxidant capacity of the body, causing an increase in TDS (p<0,05), Infascorbate system (p<0,05).

In addition, patients receiving "Berlition"there has been a stimulation of aerobic glycolysis with a decrease in blood levels of lactate and the ratio of lactate/pyruvate (p<0,05). In the blood of patients in the control group, not receiving "Berlition", post-treatment changes of the investigated biochemical parameters towards the normalization is not mentioned. In addition, there was an increase in the lactate content and the ratio of lactate/pyruvate, indicating that the decrease in the rate of aerobic glycolysis and, as a consequence, inhibition of the reactions of the Krebs cycle.

Thus, as can be seen from the above data, the positive dynamics in the treatment achieved by the claimed method 10 b is selected in group I and 11 patients of group III - a total of 21 patients (70%), manifested in the reduction of complaints and improvement in overall health: according to YOUR 45%, reduced sensitivity to pain by 21%, the vibration sensitivity of 16%; the improvement ENMG indicators in the form of increasing the amplitude of the neural capacity by 20% and Vietnam by 23%, the improvement of the main indicators of non-specific protection and energy metabolism. 7 patients (23%), mainly patients of group II and III, the basic electrophysiological and biochemical parameters remained virtually unchanged. In 2 patients (7%) from group II was observed deterioration, mainly in ENMG (a decrease in the amplitude and Vietnam) and biochemical indicators. Therefore, treatment of the claimed method is more effective in patients predominantly with autonomic-sensory manifestations of polyneuropathy than in patients with motor or mixed polyneuropathy.

As a result, as can be seen from the above data, the inventive method of treatment of patients with APS is much more efficient compared to the prototype, since it results in greater reduction of complaints of patients according to YOUR (45 and 20%, respectively), the improvement of the clinical picture of the disease in the form of reduced neurological symptoms of polyneuropathy, evidenced by the improvement in additional electrophysiological methods in the form of more Zn is a significant reduction in pain threshold (21 and 14%, respectively), vibration sensitivity (16 and 14%, respectively), increasing the amplitude of the neural capacity (20 and 13%, respectively), the increase in Vietnam (23% and 16%, respectively), decreased activity of reactions of free-radical oxidation and reduction in the deficit substrates of low molecular weight fractions of the antioxidant system.

Table 1
Parameters amplipulse used to treat patients
 modebirth worksfrequency modulationthe depth of modulationthe exposure timethe treatment
B-th Century, 52, and/b No. 18449straightIII (MON); IV (FC)50-100 Hz50-75%3-5 minutes5-7 procedures
B th M, 51,, and a/b No. 842straightIII (MON); IV (FC)130-150 Hz75-100%3-5 minutes7-9 procedures
B-th F., 57 HP, and a/b No. 7483straightIII (MON); V (PPP)130-150Hz50-75%5-7 minutes8-10 procedures

Table 2/td>
The results of treatment of patient V., 52 L. in example 1.
 YOUR (in points)altimetry (ved.)palleschisommese (dB)vibroaction (dB)ENMG
amplitude (mA)Conduction velocity(m/s)
before the treatment91,352600 (not defined)1.6539,8
after the treatment81,3240301,6839,5

Table 3
The results of the treatment of the patient M, 51, example 2.
 YOUR (in points)altimetry (ved.)palleschisommese (dB)vibroaction (dB)ENMG
amplitude (mA)Conduction velocity(m/s)
before the treatment81,25270251,6638,4
after the treatment51,20250 20to 2.5744,3

Table 4
Results patient treatment F., 57 L. example 3.
 YOUR (in points)altimetry (ved.)palleschisommese (dB)vibroaction (dB)ENMG
amplitude (mA)Conduction velocity(m/s)
before the treatment82,217001,6536,4
after the treatment42,0140153,8450,8

Table 6
Results of treatment of patients by way of analog (vitamins, medications).
 YOUR (in points)altimetry (in units)palleschisommese (dB)vibroaction (dB)ENMG
amplitude (mA)Conduction velocity (m/s)
before treatment/td> 92,8035Background noise28,4
after the treatment82,8030background noise30,8

Table 7
Results of treatment of patients by the claimed method according to major additional methods.
 I groupGroup IIGroup III
before the treatmentafter the treatmentbefore the treatmentafter the treatmentbefore the treatmentAfter the treatment
YOUR (in points)8-95-68-97-88-95-6
altimetry (in units)2,6-2,81,8-2,01,8-2,01,6-1,82,4-2,61,8-2,0
palleschisommese (dB)180-200140-160>200180-200180-200140-160
vibroaction (d the) 25-3015-2030-3525-3025-3020-25
ENMGamplitude (mA)1,67-3,062,9-4,31,60-2,183,4-5,31,8-2,13of 4.3 to 5.8
Conduction velocity (m/s)29,4-30,648,4 is 55.227,8-29,230,4-39,230,8 by 34.240,8-52,3

Table 8
Indicators of nonspecific protection and energy metabolism in patients with alcoholic polyneuropathy (Me and boundaries fluctuations)
indicatorsGroupindicators of healthy personscontrolmain
before the treatmentafter the treatmentbefore the treatmentafter the treatment
Low-molecular AOthiol AOCHS mm/l1,43

1,25-1,6
1,56

1,28-1,76
1,56

1,36-1,68
1,28

the 1.04 to 1.76
1,36

1,04-1,6
SS mm/l0,44

0,32-0,5
0,32

of 0.28 to 0.44
0,3

0,36-0,48
0,48

0,36-0,52
0,4

0,28-0,68
TDK3,1

2,6-3,6
4,72

3,64-5,5
4,23

3,0-4,67
2,8

2,17-4,89
3,4*

1,88-5,71
ascorbate AOCEfmg/l24,0

20,0-26,0
18,5

11,5-32,0
17,0

11,5-26,0
12,0

7,5-27,0
17,0

7,0-34,0
Aboutfmg/l16,4

14,0-17,0
14,25

9,5-29,0
was 12.75

of 10.0 to 19.5
10,5

6,5-25,0
12,5

5,0-29,0
Infmg/l9,8

8,0-13,0
2,5

2.0 to 6.5
4,25

1,5-6,5
1,5

0,5-5,5
2,5

0,5-6,0
Inf/Aboutf0,6

of 0.53 and 0.68
0,2

0,1-0,36
0,32

0,15-0,36
0,14

of 0.05 to 0.44
0,18

0,03-0,4
peroxidase proteinsHS mm/l9,4

of 8.5 to 10.6
8,61

7,22-9,4
7,44

6,64-7,82
6,98

of 5.83-12,22
6,9

5,72-9,14
SS mm/l3,0

2,8-3,8
2,2

1,43-3,06
1,77

1,64-2,27
2,77

2,02-3,53
2,35

1,68-3,39
TDK3,2

2.7-3.6V
3,69

3,07-5,76
4,14

3,11-4,77
2,65

1,67-4,07
3,03

2,05-5,17
Glucose mmol/l4,8

3,6-6,1
or 4.31

3,61-5,32
4,84

3,67 and 5.36
4,93

3,96-5,62
4,94

4,29-of 7.55
Lactate mmol/l1,2

0,66-1,8
3,55

a 2.0 to 7.2
2,8

1,9-3,85
4,5

2,95-7,4
2,8*

1,5-4,05
Pyruvate mm/l0,09

0,07-0,11
0,23

0,14-0,5
0,17

0,12-0,22
0,27

0,17-0,5
0,2

of 0.14 to 0.28
The lactate/pyruvate10,7

9,0-12,0
14,58

14,29-16,67
16,67

15,29-of 18.75
17,39

13,6-24,19
12,5*

9,38-22,86
.- a statistically significant change (p<0,05) compared to the control group;
* - statistically significant changes (p<0,05) compared to the in the same group before treatment.
HS - sulfhydryl group, SS - disulfide group, TDK - thiol disulfide ratio;
Ethe - aggregate form, Aboutfis the oxidized form Inf- reduced form

Literature used

1. Astapenko A.V. Clinical and experimental substantiation of the use of certain vasoactive drugs and gipobaricheskoi oxygenation in alcoholic polyneuropathy // Diss...KMN - Minsk. - 1991

2. Neretin WE Yakushin, M.A. New approaches to the treatment of alcoholic polyneuropathy // Materials of conference - Ufa. - 1996, - P.28-30.

3. Yarosh A.A., 'ilhas TI Alcoholic polyneuropathy // Kiev: Health - 1986. - P.4-5.

4. The finger WAS About the outcomes of alcoholic polyneuropathy // Gopros addiction. - 1990. No. 1. - P.30-33.

5. Avakian GN. and other Electroneuromyographic stage alcoholic polyneuropathy and use of anticholinesterase preparatov // Ukr. Neuropathology and psychiatry. Saw. - M - 1990 - No. 3. - P.44-49.

6. Sklar I.A., Vorobyov O. Thioctacid in treatment of alcoholic polyneuropathy. // Ukr. Treatment of nervous diseases. - M - 2001 - vol. 2. No. 2. - P.39-41.

7. Siman A.G., Sykova L.A., Kiryanov CENTURIES Physiotherapy diseases of the peripheral nervous system // St. Petersburg. - 2001 - C.262-278.

Method of treatment of alcoholic polyneuropathy, including the effects of sinusoidal modulated currents, III is a native of work, the treatment course of 8-10 treatments, characterized in that Thu is affected by amplipulse drug "Berlition" rectified in mode III and V come work with modulation frequency 130-150 Hz and a modulation depth of 50-75%, the exposure time for each kind of works for 5-7 minutes, with the first day of the electrode-the cathode is placed in niinisalo-Wernigerode spine, the second day in nijaguna-verkhnepashino spine, and the anode is placed in the first day on the front and back surfaces of the forearms, and the second day on the anterolateral and posterior surfaces of the tibia.



 

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The invention relates to medicine, namely to surgery, and can be used in patients with traumatic injuries and diseases of the stomach

FIELD: medicine, cardiology.

SUBSTANCE: the suggested method should be performed at the background of medicinal therapy with preparations out of statins group, tevetene, polyoxidonium and conducting seances of plasmapheresis by removing 800 ml plasma twice weekly with N 5 due to additional intramuscular injection of immunophan 0.005%-1.0 with N 10 and fluimucyl 300 mg intravenously daily with N 5-10, total course of therapy lasts for 2 mo. The method provides modulation of leukocytic functional activity, moreover, due to altered cytokine profile and, thus, through disintegration of protein-lipid complexes participating in the development of atherosclerotic platelets.

EFFECT: higher efficiency of therapy.

3 ex

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