Method of prevention and treatment of inflammatory and degenerative dystrophic locomotorium diseases

FIELD: medicine.

SUBSTANCE: within predetermined exposure area, blood supply is increased locally without applying pantohematogen-containing preparations. Then exposure area is applied at least once with pantohematogen-containing preparation applicable for massage. Manual or apparatus massage of exposure area follows using this preparation with further additional massage without using pantohematogen-containing agents.

EFFECT: extended range of products applied for prevention and treatment of inflammatory and degenerative dystrophic locomotorium diseases.

10 cl, 2 tbl, 5 dwg

 

The invention relates to medicine, namely to Wellness and therapeutic massage and physiotherapy and can be used in the prevention and treatment of inflammatory and degenerative diseases of the musculoskeletal system.

Known methods of treatment and prevention, using as the main active element pantogematogen, such as "Method of secondary prevention of ischemic heart disease, angina, I-III functional classes" EN 2128494 [1]. According to the way daily at 12-13 h ill spend a shared bath with 0.9 to 1.0%solution of pantogematogen in the amount of 500 ml per procedure, lasting 10-12 minutes in the first two procedures and 13-15 min in the following procedures, in the course of 10-12 treatments.

The disadvantage of this method is the low efficiency of the treatment.

Closest to the claimed method of treatment and prevention is the way (see Dubrovsky VI Massage for injuries and diseases of the musculoskeletal system. - Therapeutic massage, M.: Medicine, 1995, S. 109-141). A known method of prevention and treatment of inflammatory and degenerative-dystrophic diseases of musculoskeletal apparatus includes manual hardware or massage with the use of appliqués therapeutic agents (drugs).

The disadvantage of this method is the bottom of the th effectiveness of treatment and prevention. The low efficiency is due to the fact that the described techniques technical execution of the massage is not designed specifically for pantogematogena drugs and do not provide sufficient penetrating power to the active components of pantogematogen.

The technical result of the present invention is to increase the effectiveness of treatment and prevention.

The technical result is achieved by the fact that pre-determine the scope of the impact on pathogenic zones, produce the procedure a local increase of blood supply to the area of impact without the use of pantogematogena drugs, and then produce at least one application on the scope of the impact pantogematogena drug, made in the form, suitable for massage, produce hand-made hardware or massage the area of impact with the drug and then hold additional massage without the use of products containing pantogematogen.

To verify the effectiveness of the proposed method of treatment and prevention conducted a joint study GU NIIKI WITH the RAMS and JSC Sanatorium "Russia" resort Belokurikha, Altai Krai, an extract from the report of which is given below. In the extract below shows massage pantogematogena drugs in gel base (Pantanassa) P-1 and P-2, to the which differ in concentration of pantogematogen (preparation a-2 concentration is higher than in the product P-1).

The aim of this work was to evaluate therapeutic effectiveness of gel preparations pantogematogen on the clinical course of osteochondrosis in the introduction of drugs through massage.

The study design. The study was conducted double-blind method is randomized and placebo-controlled.

The research program approved by the medical Research Council and Ethics Committee NIIKI WITH the RAMS.

The study was conducted at the sanatorium "Russia" resort Belokurikha, Altai Krai.

The objectives of the study were: 1. Assessment of therapeutic effectiveness of gel preparations pantogematogen (GHG) in the treatment of patients with osteochondrosis of the spine with the introduction of drugs through massage; 2. Assessment of tolerance of complex therapy with gel drugs pantogematogen in patients with osteochondrosis with the introduction of drugs through massage.

Methods of research. In the main group of the study included 100 patients with intervertebral osteochondrosis, as shown in table 1.

Before treatment, all patients were informed about the purpose of the study and gave consent to participate signed the informed consent sheets). The group surveyed included men and women aged 35-65 years without severe comorbidities with osteo what narosa the cervical or lumbosacral spine, complicated reflex and/or compression-radicular syndrome, with disease duration of at least 5 years. Exclusion criteria were expressed radiculopathy, spinal and radicular-spinal syndromes, destructive, traumatic and primary inflammatory lesions of the spine. The diagnosis is verified by physical examination and x-ray. Laboratory studies were performed according to indications.

Treatment: Pantanassa performed with gels PG, which was applied at 3-5 ml on the affected area after warming massage and creeping soft massaging movements for 3-4 min until fully absorbed, then massage ended with a neutral ointment on fat basis. Rate Pantanassa - 1 times a day for 10 sessions per course. Placebo similarly used biologically neutral gel Alcogel (Geltech). Immediately prior to his appointment course to avoid a severe allergic reaction patients were asked to assess possible changes in their health in response to the smell of the drug; then with the same purpose smear of drug was applied to the skin of the inner surface of the forearm. In the absence of unpleasant sensations of smell, as well as redness, swelling, burning and other skin preparations were prescribed for use.

The survey was carried out before, middle and after the course of the treatment. The efficacy was assessed quantitatively by analyzing subjective data, results of physical examination and results of laboratory tests. To this end consider each symptom, depending on the severity was assigned a certain number of points and was filled individual Protocol of the research participant (Table 2). In addition to the severity of the symptoms, it was recorded the date of examination, testing, treatment, age and sex of the patient, as well as subjective tolerability (0 - good, 1 - medium, 2 - bad 3 - very bad) and (if performed) results of additional studies.

When assessing the severity of the disease took into account the severity of pain syndrome and reflex symptoms, neurodystrophic and autonomic disorders. Pain was assessed on a 5-point scale (0 - no pain; 1 - slight pain, endangered alone; 2 - moderate pain at rest, increasing when moving; 3 - constant pain with periodic amplification and selectoptions shade; 4 - sharp constant pain with forced body position of the patient). Reflex syndromes accounted for mythicism, neurovascular and neurodystrophic syndromes. Mythicise syndrome was assessed on a 3-point scale; when the assessment took into account muscle tone and the presence of pin the Aktur (0 - Muscle tone is not changed, the muscle is soft, finger easily immersed in its thickness; 1 - muscle moderate density, to dive into the seal requires moderate effort; 2 - muscle stony density, it is impossible to deform). Neurovascular syndrome was assessed by 2-point scale (absence-presence of vasomotor disorders associated with cooling or hot weather or sugase-pricking pain, trophic disorders of the skin). Neurodystrophic syndrome was assessed by 3-point scale (0 - absent, 1 - moderately painful to palpation foci osteomyelofibrosis in 1-2 anatomical areas, 2 - very painful lesions in 2 or more areas).

Compressive radicular syndromes (radiculopathy) were included in the study when they are of lesser severity. For their characteristics commonly used for sensitive, reflex and motor disorders 4-point scale (0 - absent, 1 - weak in the area of innervation of a single spine, 2 - moderate in zone 1-2 roots, 3 - strong in zone 1-2 or more roots). Characteristic compressive disorders included an assessment of muscle strength, symptoms of tension (Neri, Lasaga, Wasserman) and static disorders; with the defeat of the lumbosacral auxiliary criterion was the trial of Sober.

Each patient before treatment, in the middle of the URSA treatment and after treatment were calculated severity index (it) and the coefficient of clinical effectiveness (OE). It was calculated according to symptomatology as the sum of all points taken into account symptoms, and e is the quotient of the difference (when it arrives - it at the time of accounting for it upon receipt.

Statistical processing of data was performed by methods of variation statistics, the significance of differences was assessed using t-student criterion when the accepted confidence level of P<0.05.

The results of the study

Only in the group of examined patients treated with massage, comprised of 100 people. Between subgroups treated with drugs pantogematogen (GHG) and placebo, no significant differences in disease severity, age distribution, sex, body mass index.

In General, the tolerability of the drugs was very good. Bounce from GHG drugs was not.

The results are shown in figure 1-5. From them it follows that the use of all songs, including drug placebo, has a therapeutic effect. However, the PG-containing preparations, the effect is more pronounced and causes an earlier reduction of symptoms during treatment.

Figure 1 presents the dynamics of the severity index in patients of different groups, which describes the average change in the severity of patients under the action of pandateria (it - severity index). Data shown is for the treatment of PG-containing gel P-2. the other GHG-containing gels had similar effects.

It is evident from Fig. it is clear that the most rapid improvement of the patients occurs under the action of Pantanassa with gel preparations, and Pantanassa procedure in increasing blood circulation in pathologically active zones (Pantanassa-2) causes the most rapid therapeutic effect. Differences in the rate of therapeutic effect with the different methods of application pantogematogena gels especially pronounced in the first half of the course of treatment, and then somewhat toned down. The slow effect has therapy massage with drug placebo.

The coefficient of effectiveness of different treatments is shown in figure 2. Comparison of the effectiveness of treatment with the different methods of receiving the drugs in the middle of treatment confirms that the most rapid and high therapeutic effect is achieved when Pantanassa.

Considering the data of this study, it can be concluded that the effectiveness of the gel preparations increases with the introduction by Pantanassa.

Palindromic analysis of efficacy is presented in Fig.3-5. Figure 3 shows the effect of investigational uses of drugs against pain syndrome, which was assessed by visual analogue scale with a factor of 0.5. The analysis shows that the dynamics of pain syndrome under the action of Asnah methods of therapy in General similar to that for the severity index. Obviously, one of the main mechanisms of therapeutic action of the applied combination therapy is the relief of pain.

It is shown that the increased muscle tone in the affected area most quickly removed pentominium with drug pantogematogena gel P-2 (figure 4). Given the location of Pantanassa in reducing severity index after a full course of adjuvant therapy, it can be assumed that mythicise syndrome patients in our study to some extent secondary to pain syndrome.

With mythicism syndrome pathogenetically associated with the formation in the myofascial structures of the so-called trigger points, which often determine the brunt of the disease. Figure 5 shows how different ways of treatment in our study lead to a decrease in activity and the number of trigger zones. It is evident from Fig. it is obvious that therapy with the drug, placebo almost no effect on this process, while pantogematogena gel drugs induce the disappearance of trigger points, and do it more efficiently when Pantanassa.

Considering the pathogenesis of the formation and persistence of trigger zones, as well as the composition and basic mechanisms of action pantogematogena gel, most likely triggeraction action Pantanassa related what about with induced abolition of nociceptive activity, improvement of microcirculation and tissue trophism zones, reduction of local hypoxia.

Clinical effect of basic therapy with the drug, placebo, and significant therapeutic effects of velvet antlers therapy revealed by the analysis of the dynamics of the severity index and palindromes analysis suggests different mechanisms of sanogenesis with classic therapeutic massage, antiapplication and Pantanassa. It can be argued that Pantanassa has its own clinical content, because different mechanisms of therapeutic action of massage and pantotheria are nonadditive and induce vzaimozacitivalis synergistic therapeutic effect.

Conclusions

1. Gel preparations PG for outdoor use in the introduction by Pantanassa well tolerated and virtually no local or systemic side effects.

2. Gel preparations PG for outdoor use in the introduction by Pantanassa have reliable therapeutic efficacy in patients with osteochondrosis of the cervical and lumbosacral spine.

3. The introduction of gel preparations GHG by massage, greatly enhances the effectiveness of pandateria in patients with osteochondrosis of the spine and in turn the use of pandateria dramatically enhances the effectiveness of the massage.

4. Given the good Pere is usemost investigated gel drug GHG a sharp increase in the effectiveness of treatment, as well as a significant reduction in the duration of treatment, method of application of Pantanassa may be recommended for inclusion in the complex therapy of spinal osteochondrosis.

Thus, given the above report it can be stated that the claimed in the claims is a method of treatment provides the claimed technical effect.

For further improvement of the claimed method of treatment can be recommended for vertebral pathology of the impact area to determine palpation, visual and/or hardware method for localization of trigger points, myotonica, neurovascular and neurodystrophic manifestations, and localization of pain.

When articular pathology of the impact area can be defined palpation, visual and/or hardware method for localizing enthesopathy, synovitis and periarticular swelling.

The local increase of blood flow can be performed using manual massage by transferring heat and using local applications of substances with a physiological warming effect.

After application pantogematogena drugs and end manual hardware or massage the affected area to further enhance therapeutic effect can be produced thermal insulation of the patient's body is rock for 10-100 minutes.

It is also possible after the end of the manual or the hardware massage with pantogematogena drugs to produce additional massage using a carrier oil, and then to produce the insulation body of the patient for a period of 10-100 minutes, for example, wrapping the patient in blankets.

To further enhance therapeutic action may apply balneotherapy procedures.

Industrial application. The proposed method for the treatment of inflammatory and degenerative diseases of the musculoskeletal system has high efficiency and can be applied with success in medical practice.

The method of prevention and treatment of inflammatory and degenerative diseases of the musculoskeletal system

Table 1

Group of patients in the study of therapeutic action gel drugs pantogematogen in patients with osteochondrosis of the spine with the introduction of drugs by massage
The GROUP of PATIENTSThe SUBGROUP of PATIENTSThe NUMBER of PATIENTS
Control massageClassic massage with gel placebo10
ApplicationsCutaneous application of gel P-115
Cutaneous application of gel P-215
PantanassaMassage with gel P-115
Massage with gel P-215
Staging Pantanassa covering pathological zonesMassage with gel P-1 a preliminary determination pathologically active zones and procedure of the local increase of blood flow in the area of impact15
Same with gel P-215

Table 2

Individual Protocol participant research to assess therapeutic effect of Pantanassa in patients with osteochondrosis
Study date
NAME
Age35-65
FloorM/W
Clinical diagnosisOsteochondrosis of the lumbar spine, relapsing course, the stage of exacerbation, lumbodynia (or lumboischialgia)
The pain intensityYOUR×0,5
Mythicise syndrome3-point scale
Neurovascular disorders2-point the Kala
Neurodystrophic syndrome3-point scale
Radicular sensory impairment, reflex, motor4-point scale
Tolerability3-point scale
The results of additional studies

1. The method of prevention and treatment of inflammatory and degenerative diseases of the musculoskeletal system, which includes manual hardware or massage with the use of pantogematogena preparations, characterized in that pre-determine the scope of the impact, make the procedure a local increase of blood supply to the area of impact without the use of pantogematogena drugs, and then produce at least one application on the scope of the impact pantogematogena drug, made in the form, suitable for massage, produce hand-made hardware or massage the area of impact with the drug and then hold additional massage without the use of products containing pantogematogen.

2. The method according to claim 1, characterized in that when vertebral pathology in the area of impact determine palpation, visual and/or hardware method for localization of trigger points, myotonica, n is rosasophistic and neurodystrophic manifestations, and localization of pain.

3. The method according to claim 1, characterized in that when the articular pathology of the impact area to determine palpation, visual and/or hardware method for localizing enthesopathy, sinovoice and periarticular swelling.

4. The method according to claim 1, characterized in that the local increase in blood flow produced by manual massage.

5. The method according to claim 1, characterized in that the local increase in blood flow produced using local applications of substances with a physiological warming effect.

6. The method according to claim 1, characterized in that the local increase in blood flow produced by transfer of heat.

7. The method according to claim 1, characterized in that after application pantogematogena drugs and end manual hardware or massage the affected area to produce the insulation body of the patient for a period of 10-100 minutes

8. The method according to claim 1, characterized in that the additional massage is carried out with the use of a carrier oil.

9. The method according to claim 1, characterized in that after the completion of additional massage produce the insulation body of the patient for a period of 10-100 minutes

10. The method according to claim 1, characterized in that additionally used in balneotherapy treatments.



 

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2 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out balneotherapy, foing physiotherapy exercises and intaking iodomarine and/or L-tiroksin. In first half of the day, physiotherapy exercises are performed, general artificial radon baths being performed in the second half of the day. Manual massages of a collar zone are perform in days free from baths. From November till March phonophoresis of Traumel S ointment on a thyroid gland projection is also performed with an intensity of 0.05 W/cm2, continuous regimen, duration of influence of 3-5 minutes on the right and at the left, general time of influence of 6-10 minutes, in a day with a magnetotherapy on a projection of palatine tonsils, size of a magnetic induction being 6-9 mT, for 5-6 minutes from each party, general time of 10-12 minutes, in a course of 8-10 procedures. At treatment during the period from April till October, patients are additionally prescribed a group galotherapy in the second half of the day, in a course of 10-15 procedures, and phototherapy of red range at a wavelength of 660-675 nanometers, densities of power of radiation of 1 mW/cm2 and an infra-red range at a wavelength of 840-950 nanometers, densities of power of radiation of 2.7 mW/cm2 to biologically active points: VC-20, VC-22, E-36 symmetrically on the right and the left, Gi-4 symmetrically on the right and the left. Time of influence for one point is 1.5-2 minutes, general time of influence being 9-12 minutes, daily, in 10-12 procedures, with duration of treatment making up 21-24 days.

EFFECT: decrease of exacerbations of chronic centres infection frequency; normalising action on the immunologic status during the most adverse periods of a year and maintenance of a condition of euthyroidism within all year.

3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: organism undergoes complex action of craniosacral therapy techniques combined with psychotherapy in narrowed consciousness environment created by hypnosis. Each session of craniosacral therapy lasts for 10-30 minutes. The method allows achievement of high treatment efficiency, particularly: improved state of health and working capacity, especially for chronic fatigue, stresses, anxiety, neuroses, depression, fears, irritability, uncertainty, internal recovery after irritable bowel syndrome, chronic pains, heartbeat muscular tension, dry mouth, muscular twitching, lump in throat, gastritis, bronchial asthma, impotence and other disorders of psychogenic nature. Efficiency of the method is sustained by destruction of undesirable barriers evolving both during psychotherapy treatment and craniosacral therapy sessions.

EFFECT: improved treatment efficiency.

6 cl, 9 ex

FIELD: medicine.

SUBSTANCE: table has frame, desk with the opening, support of jack with the traverse provided with members for massage and gymnastics, which can be moved with respect to the opening in the desk. The table is additionally provided with electromagnetic therapy. Each therapy block is connected with the power source, programmer, timer, and commutating device.

EFFECT: improved design.

2 cl, 12 dwg, 2 ex

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