Method for repairing antireflux function lower esophageal sphincter

FIELD: medicine.

SUBSTANCE: method involves stimulating lower esophageal sphincter zone with rectangular electric pulses of 6 ms duration, 6-8 mA large current amplitude and pulse succession rate of 50 Hz on the background of traditional therapy comprising antisecretory preparations and antacids. The pulses are joined in packets of 16 pulses each, the packets succession and polarity alternation period is equal to 3 s. Intracavitary electrophoresis with prokinetic preparations is applied to lower esophageal sphincter zone with treatment session duration equal to not longer than 30 min given every other day. The total treatment course is 5-7 sessions long.

EFFECT: reduced risk of traumatic complications.

2 dwg

 

The invention relates to medicine, namely to surgery, gastroenterology and physiotherapy, and can be used to restore antireflux function of the lower esophageal sphincter at gastroesophageal reflux disease, varicose veins of the esophagus and stomach 1 and 2 degrees, conditions after various surgical procedures on the esophagus and the stomach, accompanied by the failure of the cardia.

Known 3 methods of recovery antireflux function of the lower esophageal sphincter: 1) medical[1, 2, 3], 2) physiotherapy [7], and 3) operational [2]. However, the application of H-2 blockers, blockers of the proton pump and prokinetics with medication is a long, not always effective and temporary, precautionary. The high cost of medications often do not allow adequate symptomatic therapy that affects the course of the disease. Intolerance to medications, allergic reactions and side, the negative impact of drugs in some cases make it impossible to conduct drug therapy. Physiotherapeutic methods are, as a rule, through all layers of the anterior abdominal wall and do not have adequate therapeutic effect. Surgical methods are used for screening is the ij - only in cases of severe complicated gastroesophageal-reflux and expressed pathological changes in the esophagus. For their application, there are contraindications (patient refusal, severe comorbidities and so on). In addition, in some patients after surgery the symptoms recur and complications associated with the reflux of stomach contents into the esophagus, which greatly complicates the treatment of this group of patients.

Closest to the proposed method is a method trancedevotee and transgastric electrical stimulation [4] using the Autonomous electrostimulator probe (patent No. 1223922 dated September 27, 1993 [5]). The method is used for the treatment of reflux esophagitis and reflux gastritis and is based on the use of the pacemaker, representing gastroduodenal probe with olive size 20×10 mm, consisting of two hemispheres electrodes placed inside the square-wave generator, modulated pulses and power supply. The inclusion of the pacemaker automatically on contact with the conductive environment of the digestive tract. The best course of treatment consists of 6-10 twenty-minute sessions trancedevotee (at the level of the cardiac sphincter) or 8-12 thirty minute sessions transgastric (pyloric Department) e is extrastimulation.

However, this method has poor efficiency, as it is based solely on electrical stimulation. In addition, the application of monopolar electrical impulses, muscle structure of the esophagus are electrostimulation every 3 C. taking into account the physiology of smooth muscle contraction, it hinders adequate relaxation of smooth muscles of the esophagus in its refractory period, which ultimately reduces the effectiveness of incentives. Another disadvantage of offline monopolar stimulation is inevitable defects from electrochemical corrosion on the surface of the electrodes of the stimulator that threatens the application of mechanical and electrochemical damage the lining of the esophagus during the procedure.

The objective of the invention is to increase the efficiency of the method by expanding the scope of its application, get a stable therapeutic effect, reduce complications and reducing the potential for injury.

The set task is solved in a new way recovery antireflux function of the lower esophageal sphincter, which consists in cardiac electrical stimulation of the esophagus, and on the background of traditional pharmacotherapy, including antisecretory drugs and antacids, conduct the stimulation region nizhnegibridnogo sphincter pulses of rectangular shape, duration 6 MS, the amplitude of the current 6-8 mA, with a pulse frequency of 50 Hz, formed in packs of 16 pulses, the repetition period of the packets and interleaving their polarity every 3 s and at the same time spend intracavitary electrophoresis of prokinetics in the area of the lower esophageal sphincter, session length not more than 30 minutes, running every other day in the amount of 5-7 sessions per course of treatment.

In the analyzed scientific medical and patent literature no data found distinctive characteristics and they explicitly do not follow to a person skilled in the art. This method is passed clinical trials at the research Institute of gastroenterology of the Siberian state medical University. Thus, this solution meets the criteria of the invention of "novelty", "inventive step" and "capable of industrial application".

The method is as follows: the procedure is performed in the morning on an empty stomach. The mucous membrane of the pharynx irrigated with 2% solution of dikaina. According to the standard methodology in the esophageal probe with olives, perform the installation of the probe with the electrostimulator, the patient arbitrarily swallows the last. At the first introduction of the probe pacemaker is placed under fluoroscopic control at the level of the lower esophageal sphincter, the patient then re is Imam probe teeth (incisors) and the probe marker make a mark at the level of the outer surface of the incisors. In subsequent procedures, individually for each patient, the probe is inserted up to the mark, which must be at the level of the incisors.

The patient assumes a sitting position. To the outer end of the probe device is connected to a drip solutions with a bottle containing 60 ml of 0.9% solution of sodium chloride and 2 ml of metoclopramide. The supply of the medicinal mixture in a probe for irrigation of olive-electrostimulator is carried out at a rate of 40 drops per minute. The session of electrical stimulation and intracavitary electrophoresis is carried out for 30 min by means of, for example, mounted on the probe biological pacemaker of the internal organs (patent No. 2089239 from 10.09.1997, [6]), depicted in figure 1 and figure 2, where 1, 5 - electrode, 2 - generator 3 - insulating sleeve, 4 - power supply, 6 - socket, 7 - holes in the catheter, 8 - catheter 9 is a label on the catheter. The pacemaker generates electrical impulses of rectangular shape, duration 6 MS, the amplitude of the current 6-8 mA, with a pulse frequency of 50 Hz, formed in packs of 16 pulses, the repetition period of the packets and interleaving their polarity every 3 seconds every 10 minutes is monitored condition of the patient, through survey, examination, General examination, determination of pulse rate, blood pressure, breathing rate. The procedure is rowdata once in 2 days. The treatment consists of 5-7 sessions. The method can be carried out in inpatient and outpatient settings.

Example 1. Patient P., 51 years (and a/b No. 3327) enrolled in the Institute of Gastroenterology SSMU. The diagnosis of Gastroesophageal reflux disease. Reflux esophagitis first degree. Failure of the cardia.

Upon receipt complained of burps after each use, heartburn up to 3-4 times a week, bitter taste in the mouth, pain in the epigastrium after eating. Exacerbation of the disease occurred in minor errors in diet.

During examination: according to fibrohistiocytoma from 8.04.04 - Esophageal freely pass, the mucosa in the distal slightly hyperemic, no defects. Cardia at 38 cm from the incisors, disclosed, when peristalsis is not fully closed. A slight prolapse of the gastric mucosa into the lumen of the esophagus. In the stomach a moderate amount of clear mucus, the angle is not deformed, in the distal mucosa is hyperemic. The pylorus is preserved rounded, closed, freely pass, the bulb 12 duodenal ulcer the usual form (KDP), mucous her hyperemic with small superficial erosions, distal duodenum 12 is not changed. Conclusion: the Failure of the cardia. Reflux esophagitis I tbsp. Distal superficial gastritis. Erosive Bullit.

Endoscopic ultrasonogram the FFL of the esophagus No. 159 from 10.04.04, The endoscope GIF-1T140 freely held in the esophagus. Scanned the walls of the esophagus and paraesophageal space using ultrasonic probe with a scanning frequency of 20 MHz. The wall of the esophagus throughout evenly deviationa. In the distal slight thickening of the mucosa, no defects. Muscle sphincter achalasia is saved. Paraesophageal lymph nodes are not enlarged. Conclusion: Echoprint esophagitis 1 tbsp.

Intragastric 24-hour pH-metry from 9.04.04: hyperacidity, increased production of hydrochloric acid in the face of basal secretion. Hyperacidity, increased production of hydrochloric acid on the background of a submaximal stimulation with histamine. A normal reaction of the mucous membrane of the esophagus in the background basal secretion and stimulation. Recorded episodes of intense acid gastroesophageal reflux (the number of reflux episodes with a pH of less than 4 - 39,5, the total time pH below 4 to 5.8%).

When conducting oesophageal manometry from 10.04.04 revealed a high intragastric pressure (30 mm Hg), low pressure compression of the lower esophageal sphincter (5,6 (N14,3-34,5) mm Hg), violation of the valve and sphincter function of the cardia, the weakening of the amplitude of peristalsis of the lower third of the esophagus.

According to x-ray of the esophagus, stomach and DNA signs of hernia esophageal resp is rste aperture is not detected, in the Trendelenburg position is marked cast contrasting masses from the stomach into the esophagus, the evacuation of the stomach is timely evacuation by WPC with some delay (up to 55 seconds), marked bulbourethral refluxes.

When primary entering the patient and the diagnosis assigned and carried out the conventional treatment of gastroesophageal reflux disease, complicated esophagitis 1 tbsp.

Along with the relevant regime and diet for 6 weeks inside assigned to H2-blocker "Ranitidine" 150 mg 2 times a day morning and evening with a required interval of 12 hours, in combination with antacid "Maalox" 15 ml 1 hour after meals 3 times a day and just before bedtime.

The patients taking background of H2-receptor blockers histamine and antacid made little positive effect: stoped heartburn, decreased bitterness in the mouth, but continued to bother belching and epigastric pain. According to fibrohistiocytoma preserved signs of reflux esophagitis first degree. When re-oesophageal manometry revealed a high intragastric pressure (28 mm Hg), low pressure of the lower esophageal sphincter (6,8 (N14,3-34,5) mm Hg), violation of the valve and sphincter function of the cardia, the weakening of the amplitude of peristalsis of the lower third of the esophagus.

When the control ASCS is adowanie 3 months after drug therapy achieved positive dynamics was not observed. In conclusion, endoscopic ultrasonography of the esophagus from 14.07.04 have echoprint esophagitis I Art. According to fibrohistiocytoma esophagus freely pass, the mucosa in the distal significantly hyperemic, no defects. Cardia ziaee, when motility is linked not completely. In the gastric mucosa in the distal hyperemic. The pylorus is preserved shorted freely pass, the bulb of the duodenum is sufficient, mucous slightly hyperemic with a single, small superficial erosions, distal duodenum is not changed.

Conclusion: the Failure of the cardia. Reflux esophagitis I tbsp. Distal superficial gastritis. Erosive Bullit.

Intragastric 24-hour pH-metry from 15.07.04: hyperacidity, increased production of hydrochloric acid in the face of basal secretion. Hyperacidity, increased production of hydrochloric acid on the background of a submaximal stimulation with histamine. A normal reaction of the mucous membrane of the esophagus in the background basal secretion and stimulation. Recorded episodes of intense acidic gastroesophageal reflux, the number of reflux episodes with a pH of less than 4 - 23.5cm, total time pH below 4 is 4.8%.

Given the small positive effect of the course of conservative treatment, the patient on the background ranitidine 150 mg 1 tablet 2 times a day, Maalox 1 p is ketiku 3 times a day 1 hour after meals and at bedtime were treated according to the proposed method. In the morning, under radiological control, mounted on the probe pacemaker was set at the level of the lower esophageal sphincter. The patient was perirenal probe teeth and put a mark on the probe outer surface of the incisors. To the outer end of the probe connect the device to a drip solutions with a bottle containing 60 ml of 0.9% solution of sodium chloride and 2 ml of metoclopramide. The supply of the medicinal mixture in a probe for irrigation should be carried out with a speed of 40 drops per minute. The session of electrical stimulation and intracavitary electrophoresis, for example, prokinetic metoclopramide was carried out for 30 minutes Procedure was done in a day in amounts of 10 sessions. Common drug therapy for treatment was not conducted. At the end of treatment Oliva electrostimulator were examined to determine the polarization of the electrodes and possible traces of electrochemical corrosion.

After 5 sessions of electrical stimulation, the patient noted improvement in General condition, decrease the frequency and intensity of attacks, heartburn, eructation of air, pain behind the breastbone. Traces of polarization and electrochemical corrosion on the electrodes of the stimulator is not revealed. The control study was conducted after 1 and 6 months.

After 1 month was observed following the positive Dean is Mika: almost ceased to disturb bitter taste in the mouth, belching and chest pain. According to the esophageal manometry from 10.09.04 noted the pressure increase peace in the region of the lower esophageal sphincter to 15.5 mm Hg, restoring the amplitude of esophageal peristalsis by 30%. According to endoscopy and endoscopic ultrasonography from 11.09.04 signs of esophagitis was absent. Intragastric pH-metry showed a decrease in the number of gastroesophageal reflux for 24 hours at 28%, prolonged gastroesophageal reflux 32%, reflux with a pH of less than 4 at 23%,

After 6 months during the control study: epigastric pain didn't bother, belching and heartburn cropped. According to the esophageal manometry from 13.12.04 observed pressure increase peace in the region of the lower esophageal sphincter to 18.7 mm Hg Intragastric pH-metry from 13.12.04 revealed an additional reduction of gastroesophageal reflux for 24 hours at 18%, long gastroesophageal reflux 22%, reflux with a pH of less than 4 to 14%.

Example 2. Patient W., 64 years old (and a/b No. 3299) enrolled in the Institute of Gastroenterology SSMU. The diagnosis of Gastroesophageal reflux disease. Reflux esophagitis II degree. The distal superficial gastritis. Bullit.

Upon receipt complained of frequent belching, constant heartburn, epigastric pain and burning sensation behind the breastbone in progl is tiwani food especially hot. During examination: according to fibrohistiocytoma from 02.05.04: the esophagus is freely pass, the mucosa in the distal hyperemic, multiple superficial erosions up to 3-4 mm Cardia gaping, not closed. In light stomach mucus, mucous in the distal hyperemic. The pylorus is preserved shorted freely pass, the bulb of the duodenum is of the usual form, hyperemic mucosa, distal duodenum is not changed. Conclusion: the Failure of the cardia, gastroesophageal reflux disease. Erosive esophagitis. The distal superficial gastritis. Bullit.

In conclusion, endoscopic ultrasonography of the esophagus No. 108 of 02.05.04: Endoscope GIF-1T140 freely held in the esophagus. Scanned the walls of the esophagus and paraesophageal space using ultrasonic probe with a scanning frequency of 20 MHz. The wall of the esophagus throughout evenly deviationa. In the distal the oesophageal mucosa is edematous, thickened, within the mucosa multiple hyperechoic education up to 3 mm - erosion. Data for fibrotic changes submucosal membrane, muscle layers no. Paraesophageal lymph nodes are not enlarged. Conclusion: Echoprint esophagitis II Art.

Intragastric 24-hour pH-metry from 03.05.04: hyperacidity, increasing products with what Laney acid on the background of the basal secretion. Hyperacidity, increased production of hydrochloric acid on the background of a submaximal stimulation with histamine. A normal reaction of the mucous membrane of the esophagus in the background basal secretion and stimulation. Recorded episodes of intense acid gastroesophageal reflux (the number of reflux episodes with a pH of less than 4 - 49,5, the total time pH below 4 is 6.4%).

When conducting oesophageal manometry from 05.05.04 identified low pressure in the lower esophageal sphincter (7,6 (N14,3-34,5) mm Hg), violation of the valve and sphincter function of the cardia, the weakening of the amplitude of peristalsis of the lower third of the esophagus.

According to x-ray of the esophagus, stomach and duodenum - signs of hernia hiatal not identified in the Trendelenburg position the reflux of contrast from the stomach into the esophagus, the evacuation of the stomach timely, bulbourethral refluxes.

From the anamnesis it is known that long-term within 6 months of outpatient on the advice of a gastroenterologist took reglan. The intake of this drug began to notice expressed headaches, fatigue. This was interpreted as a negative side effect of cerucal. From the reception coordinates patient refused due to its high cost.

The treatment was carried out according to the following scheme: along with the relevant: diet, regulation of lifestyle, appointed inside an the acido (Maalox) 1 dose 1 hour after meals 3 times a day and just before bedtime. At 8 weeks inside was appointed blocker of H2-histamine receptors famotidine 40 mg 2 times a day (morning, evening). Along with this, the patient is administered a course of recovery antireflux function of the lower esophageal sphincter, consisting of 7 sessions of electrical stimulation and intracavitary electrophoresis of prokinetic with the aforementioned method. After 3 weeks, after the disappearance of symptoms, treatment is continued only with famotidine 40 mg once a day, at night. This prokinetic treatment was not used.

After 2 months, after carried out under the above scheme of treatment, according to fibrohistiocytoma from 04.07.04: the esophagus is freely pass, the mucosa in the distal slightly hyperemic, no erosions. Cardia interlocks. In light stomach mucus, the mucous is not changed. The pylorus is preserved shorted freely pass, the bulb of the duodenum is of the usual form, mucous and distal duodenum is not changed. Conclusion: Catarrhal esophagitis. In conclusion, endoscopic ultrasonography of the esophagus No. 108 of 05.07.04 the Endoscope GIF-1T140 freely held in the esophagus. Scanned the walls of the esophagus and paraesophageal space using ultrasonic probe with a scanning frequency of 20 MHz. The wall of the esophagus throughout evenly deviationa. In the distal mucosa moderately thickened the. Data for fibrotic changes submucosal membrane, muscle layers no. Paraesophageal lymph nodes are not enlarged. Conclusion: Echoprint esophagitis Art. I

Intragastric 24-hour pH-metry from 07.07.04: hyperacidity, increased production of hydrochloric acid in the face of basal secretion. Hyperacidity, increased production of hydrochloric acid on the background of a submaximal stimulation with histamine. A normal reaction of the mucous membrane of the esophagus in the background basal secretion and stimulation. Recorded episodes of intense acid gastroesophageal reflux (the number of reflux episodes with a pH less than 4 for 29.3, total time pH below 4%to 3.8%).

When conducting oesophageal manometry 08.06.04: rest pressure in the lower esophageal sphincter 17,6 (N14,3-34,5) mm Hg, the length of the zone of high pressure 2.2 cm, the increase of the amplitude of esophageal peristalsis by 24%.

After 2 months the patient underwent a second course of treatment according to the proposed method. Recurrence of symptoms is not marked.

During examination after 3 months, no complaints. According to fibrohistiocytoma from 21.12.04: the esophagus is freely pass, the mucosa without pathology. Cardia interlocks. In light stomach mucus, the mucous is not changed. The pylorus is preserved shorted freely pass, the bulb of the duodenum is of the usual form, mucous and distal duodenum n is changed. Conclusion: Organic pathology no.

When conducting oesophageal manometry from 22.12.04: rest pressure in the lower esophageal sphincter 19,2 (N14,3-34,5) mm Hg, the length of the zone of high pressure 2.4 cm, the increase of the amplitude of esophageal peristalsis by 12%.

The proposed method of treatment used in 19 people: in 8 patients with reflux esophagitis I Art. and in 11 patients with reflux esophagitis Art. II (classification Savary-Miller).

Of these 4 patients, electrical stimulation of the lower esophageal sphincter simultaneous electrophoresis of prokinetics was used as monotherapy Gioachino condition and low levels of rest pressure in the lower esophageal sphincter (below 13 mm Hg). In 5 patients in the combined treatment used H2-receptor blockers of histamine and antacids.

In 5 patients at the initial stage of conducted electrical stimulation of the lower esophageal sphincter and intracavitary electrophoresis of prokinetics as monotherapy Gioachino condition and low levels of rest pressure in the lower esophageal sphincter (below 13 mm Hg). Symptoms cropped by 18±2 days. The pressure in the lower esophageal sphincter after 1 year of electrical stimulation and intracavitary electrophoresis increased by 8±2.3 mm Hg, the number of gastroesophageal the data reflux decreased by 23%.

10 patients, electrical stimulation and intracavitary electrophoresis of prokinetics was used in the complex treatment in combination with antacids (Maalox, aluminium phosphate gel and other analogues) 1 dose 1 hour after eating (usually 3 times a day) and just before bedtime when Gioachino condition and low levels of rest pressure in the lower esophageal sphincter (below 13 mm Hg). The treatment was carried out on an outpatient basis. Symptoms cropped by 13±3 days. The pressure in the lower esophageal sphincter after 1 year of treatment increased by 9±2.6 mm Hg, the number of gastroesophageal reflux decreased by 34%. When hyperacid state in a complex of treatment used H2-receptor blockers of histamine and antacids.

The improvement observed after 5-7 procedures, after 30 days there has been significant improvement in the clinical picture, even in patients with the II degree of reflux esophagitis. The method allows to achieve long-term remission and prevents progression of the disease.

Thus, the proposed method of treatment is simple, affordable, physiological, absolutely harmless, practically has no contraindications, may be used as monotherapy and in combination with other treatments. The treatment proposed method can be performed outpatient conditions is the third and requires significant material costs.

The combination of electrical stimulation and intracavitary electrophoresis of prokinetics in the area of the lower esophageal sphincter significantly increases the efficiency of the method. As shown by the analysis of the results, positive myostimulating effect of electrical stimulation of smooth muscle fibers secured using a specific drug (prokinetic), introduced in the muscle layer by regional high-frequency electrophoresis. Optimal parameters for the above-mentioned electrophoresis, the results of this study are: electrical rectangular pulses, with duration of 6 MS, the amplitude of the current 6-8 mA, with a pulse frequency of 50 Hz, formed in packs of 16 pulses, the repetition period of the packets and interleaving their polarity every 3 seconds

The application of alternating polarity on the electrodes allows to solve several problems. First, given the physiology of contraction of smooth muscles of the esophagus, significantly different in timing from the other sections of the gastro-intestinal tract, alternating polarity allows to increase the refractory phase reduction, which promotes a more efficient recovery of energy resources of the muscle fibers. Secondly, alternating the polarity of them is osnago current prevents the formation on the electrode surface lesions electrochemical corrosion, that eliminates the possibility of electrochemical burn the lining of the esophagus and significantly reduces traumatic during the procedure.

The best modes of applying the method are: the application of the method in the morning on an empty stomach, in the sitting position, which ensures uniform distribution of the injected solution prokinetic on all the walls of the esophagus in the area of stimulation. The duration of the session of electrical stimulation with simultaneous conducting of intracavitary electrophoresis should not exceed 30 minutes, a time sufficient to optimally achieve a positive effect, on the one hand, and relatively short for the patient. A small number of sessions per course of treatment (5-7) running through the day due to the high efficiency of the method.

References

1. Ivashkin V.T., Trukhmanov A.S. diseases of the esophagus. Pathological physiology, clinic, treatment. - M.: publishing house "Triada-X, 2000.

2. Kubyshkin VA, Karnak BS Gastroesophageal reflux disease. - M.: publishing house "Demand", 1999. - 208 S.

3. Mayev I.V., Vyuchnova Y.S., Lebedev Mrs x, Dicheva DT, Antonenko O.M., Merenkov IM Gastroesophageal reflux disease. Educational-methodical manual. - M.: NERC MOH, 2000. - 52 S.

4. Martusevich A.G., V.I. Tikhonov Autonomous electrical stimulation in the treatment of reflux-e is fagito and gastritis. - Proceedings of the 3rd international Congress on Palliative medicine and rehabilitation in health care" volume 1, 2, p 23. - Antalya, Turkey, April 22-28, 2000

5. Baker VV, Dambai GC Martusevich A.G. and other Patent USSR No. 1223922 dated April 15, 1986, Bulletin of inventions No. 14, p.16. - M., 1986.

6. DIRIN V.N., Martusevich A.G. Patent RF №2089239 dated September 10, 1997, Bulletin of inventions No. 25 (II o'clock), p. 179. - M.: VNIIPO, 1997.

7. Zabel-Langhennig A., Schiefke I, Neumann S. et al. Endoscopic gastroplication (EndoCinch) as alternative option in treatment of GERD: an 18-month follow-up [abstract]. Gastroenterology 2004; 126: A-330.

Method of recovering antireflux function of the lower esophageal sphincter, which consists in cardiac electrical stimulation of the esophagus, characterized in that on the background of traditional pharmacotherapy, including antisecretory drugs and antacids, conduct stimulation of the lower esophageal sphincter electrical rectangular pulses with duration of 6 MS, the amplitude of the current 6-8 mA, with a pulse frequency of 50 Hz, formed in packs of 16 pulses, the repetition period of the packets and interleaving their polarity every 3 s and at the same time spend intracavitary electrophoresis of prokinetics in the area of the lower esophageal sphincter, the total duration of the session not more than 30 minutes, running every other day, number 5-7 sessions per course of treatment.



 

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SUBSTANCE: electrical stimulator can be used for restoration motor-evacuator function of gastrointestinal tract and for iontophoresis of microelements. Gastrointestinal electrical stimulator with endogenous iontophoresis of microelements has electrodes with coatings made in form of two electrically insulated parts of airtight capsule. Electric power source and pulse former are disposed inside the capsule. Pulse former is connected with electrodes. Coating applied onto electrodes has microelements in form of layers of materials having different electrode potentials.

EFFECT: improved efficiency of operation.

3 cl, 1 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves administering magnesium sulfate solution and sodium thiosulfate solution by means of electrophoresis. Positive poles for introducing magnesium sulfate solution are arranged in lumbar zone in kidney projection area. Negative pole for introducing sodium thiosulfate is arranged in urinary bladder area. Electric current of 10-15 mA is applied. A procedure is 15-20 min long. The total treatment course is 10-15 procedures long.

EFFECT: enhanced effectiveness in reducing crystalluria and leukocyturia manifestations.

4 tbl

FIELD: medicine.

SUBSTANCE: method involves sequentially administering Adler silt mud enriched in hydrogen sulfide applied to appendages region according to suprapubic sacral method with current intensity of 0.05-0.1 mA/cm2 for 20 min after 2 days long adaptation period. The treatment is alternated with general hydrogen sulfide baths in sinusoid hydrogen sulfide concentration mode like 50-100-150-100-50 mg/l during 6-15 min. The treatment course is 8 balneological procedures and physiotherapy procedures long.

EFFECT: enhanced effectiveness in achieving marked anti-inflammatory and anesthetic action; improved B-cell response and ovarian function.

5 tbl

FIELD: medicine.

SUBSTANCE: device has current generator and at least a pair of electrodes applicable to patient body, one of them holding carrier containing active substance. The generator produces unidirectional current with succession frequency of 100-3000 Hz. Periodical signal amplitude modulator is available with succession frequency of 0.1-5 Hz for modulating the unidirectional current produced by the generator feeding the electrodes. Modulator output signal has amplitude varying from zero to maximum value. Current shape is produced as positive sinusoid, half-sinusoid, triangular, saw-shaped or rectangular pattern. Modulating signal takes shape of oscillations selected from a group containing triangular, rectified sinusoid, half-sinusoid shape or their combination. The modulating signal has frequency of 0.1-5 Hz. Maximum current value available between the electrodes is 100 mA. Method involves applying two electrodes to tissue under treatment, transdermal means and supplying unidirectional current amplitude-modulated with modulating signal.

EFFECT: enhanced effectiveness of treatment.

11 cl, 14 dwg

FIELD: medicine, physiotherapy.

SUBSTANCE: pharmaceutical compositions are administered into colon and eliminated though explorer introduced in rectum in dose of 1.5-2 l and in total volume of 30 liters. Simultaneously electrophoresis of intestinal walls is carried out with feeding solution by using electrodes, wherein current of 40-80 muA is used. Electrodes are placed in explorer and in frontal abdominal wall.

EFFECT: effective method for treatment of colon inflammation and functional diseases, sorter treatment duration.

1 ex, 1 dwg

Medical applicator // 2269368

FIELD: medical engineering.

SUBSTANCE: device has metal casing having permanent magnet inside. Electrode is outside of the casing and connected to electric current source. The second electrode, manufactured from non-magnetic material having cavity, is inside of the casing. Permanent magnetic is mounted in the cavity. Substance like mineral solution or plant oil is placed between the electrodes. Dielectric bushing is mounted in the casing for insulating electrodes and substance from the casing. Electric current supply source is mounted with one of its contacts on the first electrode and with its second electrode having ironwork fault. One of applicator embodiments has spring placed between electric current supply source and casing. Another version has electrode mounted outside of the casing. It is manufactured from nonferrous metal having silver coating.

EFFECT: wide range of functional applications.

3 cl, 1 dwg

FIELD: medicine.

SUBSTANCE: apparatus can be used for transdermal introduction of ion preparations by means of iontophoresis. Apparatus has electrode for iontophoresis (active electrode) and grounding electrode (non-active electrode) both connected with power supply. Electrodes are made of membranes. First membrane disposed on front side of electrode holds electrolytic solution. First ion-exchange membrane disposed on first membrane is selective to ions having charge being opposite in polarity to charges of ions of preparation. Second membrane is disposed onto first ion-exchange membrane and is intended for holding ion preparation. Second ion-exchange membrane is selective to like ions as ions from ion preparations. There is at least one ion-exchange membrane, which is selective to ions with opposite of ion preparation; the membrane is located at grounding electrode. Apparatus allows introducing ion preparation without stoppage for long periods of time with high transfer trial to provide less skin irritation.

EFFECT: improved convenience.

27 cl, 9 dwg, 2 tbl

FIELD: medicine.

SUBSTANCE: method involves introducing 0.06% sodium hypochlorite solution from intravaginally arranged cathode during 10-15 min every session in 5-7 days long course.

EFFECT: reduced risk of abdominal pregnancy relapses; retained reproductive function.

1 tbl

FIELD: medicine; electrokinetic mass transfer.

SUBSTANCE: device can be used for transfer mass inside tissue, for example, mass transfer of medicinal aid into area of treatment. Device has case with power supply, first active electrode and tactile grounding electrode. Applicator has layer for sustain medicinal aid, intended for overlapping first electrode of the device from the top. Medicinal aid can be applied by user onto aid sustaining layer to present inside the layer or to present in dismounting capsules inside the layer together with hydraulic gel. According to the other variant of manufacture, applicator is made autonomous and it has power source, first electrode which overlaps the aid sustaining layer from the top, and grounding electrode disposed at the side being opposite to layer. Patient presses the layer against the area of treatment for closing electric circuit and introduces the medicinal aid kinetically into area of treatment. Solitary dose or doses can be delivered to the area of treatment.

EFFECT: improved efficiency of operation.

21 cl, 31 dwg

FIELD: medicine.

SUBSTANCE: method involves administering electrophoresis with 1-2% silver nitrate solution to injured articulation region. The number of procedures reaches 10-20. The first one is 15 min long and the following ones are 20 min long.

EFFECT: enhanced anti-inflammatory effectiveness caused by inhibiting tumor necrosis factor.

FIELD: medical engineering.

SUBSTANCE: device has container for keeping product to be applied, dosing unit for distributing the product, power supply element placed near the dosing unit. The dosing unit is designed as rotating element and is apiece of felt. Container walls are flexible. The dosing unit is manufactured from electric conducting material and connected to the power supply element.

EFFECT: enhanced effectiveness in carrying out viscous product iontophoresis.

8 cl, 7 dwg

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