Method for treating essential arterial hypertension

FIELD: medicine, cardiology, physiotherapy.

SUBSTANCE: it is necessary to carry out a multiple-seance transcutaneous impact with low-intensity infrared laser radiation with the help of laser therapeutic equipment paravertebrally at frequency being 100 Hz. Paravertebral areas should be irradiated at C3-C7 level. An emitter should be constantly replaced transcutaneously so, that the duration of irradiation of 1 point should not exceed 2 sec. The duration of irradiation seance should be established individually by taking into account the area of irradiation so, that exposure dosage should correspond to 0.2 mJ/sq. cm/area. The innovation removes side effects such as the appearance of "acute waves" at EEG, standardizes the dosages of laser radiation, decreases the duration of temporary inability to work and increases the quality of rehabilitation in such patients.

EFFECT: higher efficiency of therapy.

1 ex

 

The invention relates to medicine, namely to cardiology and physical therapy to treatment esenciales arterial hypertension (hypertension) laser radiation.

A prototype of the invention taken treatment of hypertension by repeated session transcutaneous effects of low-intensity infra-red (λ=0.89 microns) laser using a semiconductor laser installation "Pattern" on the relative cardiac dullness within 5-10 minutes [Tsholetsegile, Avebury, Masapan "application of the semiconductor laser Pattern for the treatment of hypertension in the outpatient setting". /"Physical medicine". - 1992. - Vol.2. - №3-4. - P.46-48].

As noted by the authors, to the end of the course of laser therapy in patients systolic blood pressure dropped from 159,9±4.5 to 150,4±4.0 mm Hg; diastolic blood pressure decreased from 96,7±2,0 up to 91.6±1.9 mm Hg, which was not statistically significant [Tsholetsegile, Avebury, Masapan "application of the semiconductor laser Pattern for the treatment of hypertension in the outpatient setting". /"Physical medicine". - 1992. - Vol.2. - №3-4. P.47]. In addition, the target blood pressure in patients with hypertension, according to clinical studies, less than 140/90 mm Hg [guidelines for the diagnosis and l is the treatment of hypertension. /"Arterial hypertension". - V.10. No. 2. - P.65-92]. Thus, the disadvantage of this method is unreliable and insufficient reduction of blood pressure, because by the end of the treatment target blood pressure was not reached. Furthermore, the method of the prototype is not regulated by the frequency of the pulses, thus, does not provide for the calculation of the dose of laser radiation received by the patient during the session and for the course.

There is also known a method of treating vascular disorders in pathological menopause in women by repeated session transcutaneous effects of low-intensity infra-red (λ=0.89 microns) laser radiation with a laser installation Pattern (with a pulse power of 2-3 watts) on peripheral sympathetic education (left and right superior cervical and stellate nodes of the sympathetic trunk and vertebral nerves) in a certain sequence, with a frequency of 300-1500 Hz within 1-5 minutes. During one session irradiate two points, and in the first session - the projection of the upper cervical sympathetic ganglion (left and right), the second projection of the starry host (left and right), the third projection of the spinal nerve (left and right), then the cycle is repeated 4 more times, frequency, and duration of exposure determine individually the level of blood pressure of the patient. The irradiated point subsequently is conducted on the leading edge of the Sterno sternocleidomastoid muscle (at the level of the mandibular angle and Sterno-clavicle joint) and on line, connecting the upper edge of the mastoid process and the spinous process of C2, at the junction of its outer and middle thirds [Liikennemelua, a Method of treating vascular disorders in the climacteric syndrome in women. Patent No. 2022553 from 15.11. 94]. As follows from the example of the practical implementation of the method and outcomes specified by the author, the method can reduce blood pressure in persons with blood pressure 150/90 mm Hg or higher, for example, from 160/100 mm Hg to 140/90 mm Hg, i.e. more efficient than the method prototype. However, the target blood pressure of less than 140/90 mm Hg in the treatment by this method is also not achieved, i.e. it is not efficient enough to ensure esenciales arterial hypertension.

It was established that laser exposure exceeding the exposure dose of 0.3 MJ/cm2when the irradiation of the brain stem can lead to the development of adverse physiological effects in the form of increased epileptiform activity and pathological medlennovolnovoj rhythm that is a complication of laser therapy and limits the application of this method in patients with convulsive seizures in history and Ostrovnoy activity in the EEG [Auspolen. "Optimization of modes of infrared laser therapy in patients with autonomic-the vascular dystonia on the basis of neurophysiological criteria: abstract of thesis... candlenut. - Obninsk, 2003. - P.17-18].

Therefore, the disadvantage of the method proposed Lioresalo is the presence of a risk of side effects in the appearance of epileptiform activity, as the method does not exclude the penetration of the laser radiation on the brain stem at the irradiation point of the projection of the spinal nerve and involves the use of exposure dose 4,67-175,32 MJ/cm2. Its application leads to an overestimation of the energy of the irradiation parameters, both single and total (per session, per course). The way the prototype also does not differentiate between the treatment considering the area of exposure and exposure rate, which reduces the effectiveness of the treatment esenciales arterial hypertension. Furthermore, the method is not standardized by the exposure dose.

The technical result is to increase the effectiveness of treatment esenciales hypertension laser radiation by taking into account individual medical and biological parameters of the patient, a more precise definition of the length of exposure for each patient.

The technical result is achieved by including multiple transcutaneous effects of pulsed low-intensity infrared laser radiation with a laser therapeutic installation method for the treatment of es the social arterial hypertension involves the irradiation of the paravertebral regions at the level of C3-C7 (right and left) with a frequency of 100 Hz, in the course of which the emitter constantly move without interruption from the skin, in the downward direction, so that the exposure time of each point within the zone does not exceed 2 seconds, the duration of the session is determined individually, taking into account the area of irradiation, so that the exposure dose was 0.2 MJ/cm2one area. The duration of exposure (t) calculated by the formula:

where t is the exposure time, s;

0,1×10-3- exposure dose, j/cm2;

S - area irradiation, cm2;

P - average pulsed radiation power, W;

100 - pulse repetition rate, Hz;

τ - pulse duration, S.

As can be seen from the formula for calculation of the exposure time is taken into account, the average pulse power of the beam and the pulse duration, which are specified in the technical passport of the laser apparatus. Thus, the treatment may be carried out using laser devices with different power and pulse duration that provides the versatility of the proposed method.

As shown by experiments on animals [CAD, Mailan, Egharevba, Wahooo "Effects of low intensity infrared laser radiation on models of biological systems. Ivanovo: Yugma, 2002. P.87-101], "sharp is any" on EEG seizures, focal changes in brain tissue appear when the exposure dose of 0.3 MJ/cm2and more (region).

Therefore, the proposed method comprising determining the time of exposure by the exposure dose of 0.2 MJ/cm2(i.e. less than 0.3 MJ/cm2) eliminates the risk of the emergence of epileptiform activity on the background of treatment.

Fixed exposure dose allows to take into account the area of exposure - specific individual medical-biological indicator and calculate the session and the exposure time of each zone for a specific patient, i.e. to individualize treatment esenciales arterial hypertension. Check exposure dose allows to take into account the radial load on the body of patients.

Introduction paravertebral zone exposure from C3 to C7 allows to irradiate the peripheral sympathetic ganglia, and vertebral arteries, i.e. provides a comprehensive effect on the autonomic nervous system and the rheological properties of blood, which increases the effectiveness of treatment esenciales arterial hypertension.

The introduction of continuous movement of the feed into the exposure zone so that the exposure time of one point does not exceed 2 seconds, provides for prevention of overdose of laser radiation, da is of the vessels and nerve trunks laser radiation, prevention of focal fibrosis in the sympathetic ganglia after treatment, increases the effectiveness of the treatment laser radiation esenciales arterial hypertension.

It is known that the pulse frequency of 100 Hz is the resonance of the nervous system, since it coincides with the frequency of pulsation of neurons, and high dose laser irradiation with a frequency of 100 Hz have on the nervous tissue is minimal, compared with other frequencies, the damaging effect. Therefore, the introduction of the exposure right and left paravertebral areas with a frequency of 100 Hz at the level of C3-C7 prevent leakage of the laser radiation to the brain, provides for the development of reflex component of the response to treatment contributes to the correction of vegetative regulation of vascular tone, which increases the effectiveness of treatment esenciales arterial hypertension.

An example of the practical implementation of the method.

1. Patient K., 49 years. Diagnosis: Esentially arterial hypertension (Hypertension), 2 tbsp. HI. The patient was bothered by headaches, dizziness accompanied by nausea, low performance, feeling palpitations, aching pain in the heart, not associated with physical activity and activity-dependent nitroglycerin, sleep disturbance. Antihypertensive therapy consisted of Enap 20 mg 2 times a day, indepa the ID 2.5 mg in the morning. Blood pressure medication 160/100 mm Hg According to the spectral analysis of HRV before treatment were reduced: total spectral power (1497,15 MS2/Hz) and each of its three components (oscillations of high 541,07 MS2/Hz, low 340,08 MS2/Hz and very low frequencies 614,82 MS2/Hz). In the structure of the spectrum was dominated by oscillations of very low frequency, they accounted for 42%. Thus, the patient due to impaired adaptive capabilities of the organism occurred relative hyporeactivity the sympathetic nervous system in combination with the relative vagotonic, and prevailed humoral-metabolic regulation of the reactivity of the organism.

In accordance with the proposed method, the patient is assigned a daily session transcutaneous influence of low-intensity infrared laser radiation with a laser therapeutic settings "Mustang 026" paravertebral region C3-C7 area of 7 cm2with a pulse frequency of 100 Hz, with a constant emitter movement within the area without separation from the skin, so that the exposure time of each point does not exceed 2 seconds. The course of treatment - 10 sessions.

The duration of exposure (t) calculated by the formula:

where t is the time region is ing, C;

0,1×10-3- exposure dose, j/cm2;

S=7 cm2the area of irradiation;

P=8 W, the average peak power of the radiation;

100 - pulse repetition rate, Hz;

τ - pulse duration, S.

After putting in the formula of the individual square of the exposure and the characteristics of the laser system, we obtain that t=40 sec. Therefore, the total duration of the session 80 seconds (instead of 1-5 minutes, as in the method of the prototype).

After completion of the treatment: the woman disappeared headaches, dizziness, aching pain in the heart, palpitations, normalized sleep, improved mood, increased efficiency. On EEG "sharp waves" are not fixed. The total power spectrum after treatment increased to 1978,97 MS2/Hz (i.e. normalized); the contribution of very low-frequency component is reduced to 20%, which corresponds to the normalization of the reactivity of the organism, which objectively confirms the regression of clinical symptoms. Blood pressure decreased to 135/80 mm Hg (i.e. reaches the target level of blood pressure).

According to the prototype, in patients after treatment, in addition to lowering blood pressure systolic - to 150,4±4.0 mm Hg and diastolic - up to 91.6±1.9 mm Hg, decreased the number of patients complaining of headache pain is, dizziness, noise in the head, pain in the heart; not changed the frequency of complaints of patients on sleep disturbance, palpitations, interruptions in heart work, poor health. Dynamics of rheoencephalography in patients with regression of cerebral symptoms were characterized by unreliable changes in arterial inflow, the velocity of blood flow in large, medium and small cerebral arteries, venous outflow from the cranial cavity. Significantly improved with 22,94±1.06 to 20,10±1,01 (norm 15,04±2,02) the ratio of the velocity of blood arteries and duration of the cardiac cycle, indirectly characterizing the state of autonomic regulation of heart rhythm. [Tsholetsegile, Avebury, Masapan "application of the semiconductor laser Pattern for the treatment of hypertension in the outpatient setting". /"Physical medicine". - 1992. - Vol.2. - №3-4. - P.48].

Therefore, the proposed method has higher clinical effect, providing a stronger hypotensive effect and normalizes the function of the autonomic nervous system.

In the group of patients (95 people)treated with laser therapy on the proposed method, blood pressure decreased up to 132.6±4,2/83±2.6 mm Hg In 72,16% of cases, in addition to achieve the target pressure, the improvement of health, the disappearance of the complaints noted normal is within cerebral blood flow (according to rheoencephalography reduced the severity of vascular vasomotor reactions, normal vascular tone, increases blood flow velocity in medium and small cerebral arteries, improves the tone of the veins and venous outflow), the reduction or disappearance of irritation hypothalamic structures" (electroencephalogram), improve the functioning of the autonomic nervous system (the increase of the power spectrum was 32% compared to the initial value, the structure of the spectrum is normalized). "Sharp waves in the EEG after treatment by the proposed method is not registered.

Thus, the proposed method, including transcutaneous exposure to laser radiation with a frequency of 100 Hz on the paravertebral region to the right and to the left at the level of C3-C7, in which the emitter constantly move without interruption from the skin, so that the exposure time of one point does not exceed 2 seconds, the duration of the session is determined individually, taking into account the area of irradiation, so that the exposure dose was 0.2 MJ/cm2for each region, increases the effectiveness of therapy esenciales hypertension due to the normalization of vascular tone, contributing to the correction of cerebral blood flow, reduction of vegetative dysfunction, and absence of side-effects in the form of appearance after treatment "sharp waves on EEG.

The advantage is the EU ETS invention in relation to the prototype is to standardize the dose of laser radiation (session and course), the possibility of use for treatment laser devices with different technical characteristics.

The use of the invention is to reduce the duration of temporary disability, improve the quality of rehabilitation.

The method of treatment esenciales hypertension, including multiple session transcutaneous effects of pulsed low-intensity infrared laser radiation with a laser therapeutic units, characterized in that the irradiated paravertebral region at the level of C3-C7 (right and left) with a frequency of 100 Hz, and the emitter constantly move without interruption from the skin so that the exposure time of one point does not exceed 2, the duration of the session is determined individually, taking into account the area of exposure so that the exposure dose was 0.2 MJ/cm2one area.



 

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