Method of coronary disease treatment

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly cardiology. Starting from the 2^nd day of adaptation period patient undergoes extremely high frequency therapy with 4.9 mm wavelength. Starting from the fifth day of treatment radon balneotherapy with radon concentration of 40-60-80 nCi/l is added. First balneological procedure duration is 6 minutes, second procedure is 8 minutes, third one is 10 minutes, and fourth one is 12 minutes, the other procedures of 15 minutes each are performed over a day for the course of 10 physiological procedures and 8 balneological procedures. Bath procedures 1-4 are performed with radon concentration of 40 nCi/l, procedures 5-6 - 60 nCi/l, procedures 7-8 - 80 nCi/l.

EFFECT: enhanced adaptive capabilities of organism, physical efficiency, improved indicator values of lipid exchange, peroxide lipid oxidation, antioxidant and coagulation systems, stabilisation of course, and reduction of coronary disease complication risk.

11 tbl, 2 ex, 1 dwg

The invention relates to medicine, namely cardiology, and can be used in the treatment of coronary heart disease, strokes voltage I-II functional class.

There is a method of treatment of ischemic heart disease by assigning General iodobromide baths from the fourth day of stay of the patient in the clinic with strokes voltage FC I-II in combination with EHF-therapy on biologically active points, which are released from the second day of the patient stay in the resort, in a day, the course of 10 physiotherapy (Mponela, Wpotkan. - "EHF-puncture and odabrana balneotherapy in the treatment of patients with coronary heart disease". - Proceedings of the international Congress "Health-2006". - M., 2006 - P.124).

However, this method is not very effective in the multifactorial prevention and treatment of heart disease.

The technical result of the invention is to increase the adaptive capacity of the organism, physical health, improvement of lipid metabolism, lipid peroxidation, antioxidant and coagulation systems, improving therapeutic efficacy, stabilization of the flow and reducing the risk of complications of ischemic heart disease.

The technical result is achieved by the fact that 2-day period of adaptation to the patient to carry out procedures of EHF-therapy with a wavelength of 4.9 mm, connecting with the fifth the nya treatment radon balneotherapy with radon concentration 40-60-80 NCI/l duration of the first balneological treatment - 6 min, the second 8 minutes, the third 10 min, IV - 12 min, all the remaining procedures in 15 min a day on the course 10 physio - and 8 hydrotherapy, and 1-4 procedures baths release at concentrations of radon 40 NCI/l, 5-6 baths - 60 NCI/l, 7-8 baths - 80 NCI/L.

The method is as follows.

EHF-therapy let the patient lying on the stomach or back. The emitter EHF establish contact to the area of the skin in the following biologically active points (BAP) (table 1 and drawing):

The first procedure EHF performed in the CW mode, the other pulse. The exposure duration for a single zone of biologically active points (BAP) - 8 minutes per session is irradiated with 3 point BAHT, the total treatment time is 24 minutes. In a course of 10 treatments a day in the days without bathing (table 2).

The method of EHF-therapy is performed with the use of EHF-therapy trekhchastichnogo microprocessor EHF-7,1/5,6/4,9-ND.

Radon therapy is prescribed 5-day stay of the patient in the clinic when the water temperature is 36°through the day, lasting from 6 to 15 minutes, at the rate of 8 baths.

The medical complex, including the procedures of EHF-therapy and radon baths, presented in table 2.

The use of EHF-therapy as an adaptive-training therapy is an effective rehabilitation tool in complex treatment of chronic diseases. EHF-therapy is a therapeutic method of electromagnetic radiation of millimeter range (1-10 mm) extremely high frequency (30-300 GHz), low intensity (less than 10 mW/cm²). Data electromagnetic waves have low penetration in biological tissue up to 1 mm and is almost completely absorbed by the superficial layers of the skin and do not have heat. This method is mainly used in EHF-puncture for influence on biologically active points (BAP). EHF-radiation absorbed skin the receptors has a stimulating effect on the autonomic, endocrine and immune system, causes the system activation of opioid receptors (enkephalins), restores the field structure and energy reserves in the body systems. The response of the organism appears as a type of dermal-visceral reflexes, and General reactions, aimed at increasing adaptive, protective reactions.

Sochi has good hydro base for the treatment of chronic diseases. Balneotherapy resort, supplemented by information therapy - EHF-puncture, allows you to extend the range of positive clinical effects and increase the quality of treatment of patients with chronic diseases.

Radon baths have therapeutic effects due to dissolved inert gas radon (Rn), the decay of which is accompanied by α-radiation, and its daughter products (emanations)emitting γ-radiation. Radioactive radiation causes ionization of the molecules of proteins and water dermis and the formation of toxic metabolites of oxygen and hydroperoxide. The products of radiolysis of proteins, like the protein products of photodegradation, come in contact with sensitized T-lymphocytes-lymphocytes and stimulate the secretion of cytokines. As a result, increases SinTe the tissue GIS tiltai (macrophages) and polymorphic cell granulocyte neutral proteases, biologically active substances and immunoglobulins. The induction of immune processes in the skin also potentiate the products of lipid peroxidation, which can activate the differentiation of T - and b-lymphocytes with the production of immunoglobulins. In addition to increasing the reactivity of the organism α-stimulates the differentiation of cells of the basal and spinous layers of the epidermis, the synthesis of glycosaminoglycans in the connective tissue, which leads to scar formation with structurally arranged fibers of granulation tissue. A small part of the radon accumulates in the basal cells of the segmental and sub-segmental bronchi. Increasing the affinity of αand β-adrenergic receptors of the released mediators and biologically active substances, radon causes phase changes in local blood flow in them. Short-term (within 1-3 min) spasm is followed by a prolonged expansion of arterioles and some decrease in venular outflow, which causes flushing of the skin. Alpha radiation from radon significantly reduces the conductivity demyelinizing nerve agents, which leads to the reduction of pain sensitivity of the skin, decrease sympathetic tone and increase parasympathetic divisions of the autonomic nervous system. In addition, radon increases the shock and minute volume of the heart, causes shortening of systole and is linnie diastole at a constant heart rate. Breathing becomes rare and profound increases minute volume. Activating the function of the cortical substance of adrenal glands, α-radiation radon stimulates the production of corticosteroids and insulinproducing the function of the pancreas, glycolysis and lipolysis, which leads to reduction of body weight, to some reduction in basal metabolic rate and decrease in blood free lipids and β-low density lipoprotein. In addition, the radon reduces the activity of the thyroid gland and ovary, urinary excretion of catecholamines by the adrenal glands. Therapeutic effects: reparative-regenerative, secretory, catabolic, necrotic, immuno-stimulant, vasodilator.

Example 1: the Patient M, 48 years old. Was treated in the cardiology clinic with 12.04.2005, 02.05.2005, with a diagnosis of CHD. Angina, functional class I, atherosclerosis of the aorta, chronic heart failure functional class I (NYHA), hypertension article II, 1 tbsp. Osteochondrosis of the lumbar spine. Lumbodynia.

Upon receipt complained of intermittent pressing pain in region of heart arising from the execution of a significant physical exertion, radiating to the left arm, intractable nitroglycerin and validol; slight shortness of breath and palpitations when lifting Bo is its 4 floors of stairs, increased irritability, pain in the lumbar spine with numb legs on the outer surface.

Coronary heart disease, hypertension installed for the first time 5 years ago when the survey periodically to take drugs antihypertensives.

The objective of the study at the time of admission: a proper physique, high power, weight 96 kg with height 159 cm (body mass index - 29). Borders of the heart is within normal limits, the pulse 86 beats/min, rhythmic, satisfactory qualities. Heart sounds rhythmic, loud. HELL 170/90 mm Hg (D=S). In the lungs vesicular breathing, wheezing no. The abdomen is soft, painless, the liver is not enlarged. Symptom tapping negative on both sides. In the Romberg sustainable, coordinating sample performs correctly. Palpation of the paravertebral points in the lumbar spine was marked tenderness.

These additional studies:

Complete blood count: Hb - to 126.8 g/l, er. - 4,3×10¹²/l L - 4,6×10⁹l, ESR - 11 mm/h, p - 2% - 49%e - 4%, m - 8%, l - 37%. Response adaptation - the calm reaction activation (Phharmacy). Blood sugar - 4.3 m/mol.

ECG sinus rhythm, 76 beats/min, normal position of the electrical axis of the heart, the initial signs of hypertrophy of the left ventricle.

VEM - tolerance Fizicheskaya reduced, achieved capacity - 83 watts (should TFN - 147 watts). The sample is negative (achievement submaximal heart rate (HR). Hypertensive reactions of the cardiovascular system to physical activity.

Biochemical analysis of blood: total cholesterol - 4.3 mmol/l (normal 3,9-6,37 mmol/l)HDL cholesterol - 1.2 mmol/l (normal range of 1.01 to 1.9 mmol/l), atherogenic index of 2.5 (normal 2,6-2,9), LDL - ceiling of 5.60 g/l (normal 2,94-5,42 g/l), diene conjugates of lipids 4,33% (rate of 1.06-2.06 to unit), malonic dialdehyde erythrocytes by 34.2 nmol/ml er. mass (rate of 35.6-to 43.4 mmol/ml er. mass), malonic dialdehyde lipid - of 14.3 nmol/mg of lipids(norm 8,05-8,65 nmol/mg lipid), catalase serum - 17.9 ákat/l (normal range of 10.6-23.0 µkat/l)ceruloplasmin - of 0.332 g/l (normal 0,300-0,380 g/l), fibrinogen - 2,89 g/l (normal range 2,0-4,0 g/l), kaolinovo time - 50 sec (normal 50-70 sec), the tolerance of the plasma to the heparin - 14 minutes (normal 10-16 min), fibrinolytic activity of plasma - 240 minutes (normal 183-263 min).

The adaptation period was calm. From the second day of stay in hospital the patient was prescribed a course of treatment by the proposed method - the procedure of EHF-therapy, a day, a course of 10 treatments. On the fifth day - radon baths with radon concentration 40-60-80 HKM/l at a water temperature of 36°S, the duration of the first balneological treatment to 6 minutes, the second 8 minutes, the third 10 min, IV - 12 min, all the remaining procedures in 15 minutes, every other day, at the rate of 8 VA is n (table 2). By mid-stay patient in the clinic angina occurring, pain in the lumbar spine decreased. By the end of treatment of coronary pain was not decreased shortness of breath, increased physical activity, remained controlled blood pressure, disappeared cardialgia, irritability and weight declined by 1.5 kg

When conducting follow-up examination following data were obtained:

Complete blood count: Hb - 141,7 g/l, er. - 4,5×l0¹²/l, L. - 6,05×10⁹/l, ESR - 6 mm/h, p/I - 4%, with/I - 51%e - 3%, m - 9%, l - 33%. Response adaptation - the calm reaction activation (Phharmacy). Blood sugar - 4.7 m/mol,

ECG sinus rhythm, 74 beats/min, normal position of the electrical axis of the heart, the initial signs of left ventricular hypertrophy. Unchanged.

VEM is the increased tolerance to physical activity, achieved power - 100 watts (147 watts), which is 17% more compared to the original data, the sample is positive (offset segment S-T V4-V5 2 mm), hypertensive reactions of the cardiovascular system to load.

Biochemical analysis of blood: total cholesterol - 4.3 mmol/l, HDL cholesterol - 1.2 mmol/l, the atherogenic index of 2.5, LDL - 5.6 g/l, diene conjugates of lipids 4,33%, malonic dialdehyde erythrocytes by 34.2 nmol/ml er. mass, malonic dialdehyde lipid - of 14.3 nm, the al/mg lipid, catalase serum - 17.9 µkat/l ceruloplasmin - of 0.332 g/l, fibrinogen - 2,89 g/l, kaolinovo time - 50 sec, the tolerance of the plasma to the heparin - 14 minutes, fibrinolytic activity of plasma - 240 minutes.

Thus, the proposed method has allowed to improve physical performance by 17%; contributed to the demise of stenokardicheskie pain, shortness of breath, irritability, mild pain in the lumbar spine; positive dynamics of ECG; stabilization reactions adaptation. It was noted influence on plasma lipid profile: reduction of atherogenic lipid fractions - no change of total cholesterol to LDL cholesterol by 12%, atherogenic index 54.5%; increased atherogenic potential of the plasma is increased HDL cholesterol was 4.0%. Dynamics of indicators of lipid peroxidation: the primary products of the degradation of lipid - diene conjugates of lipids decreased by 8.0%, the content of secondary products of degradation - malondialdehyde erythrocytes and malondialdehyde lipid decreased by 4% and 31.1%, respectively, against the background of decreasing the activity of antioxidant enzymes - catalase by 3.6 times, however, when the level of ceruloplasmin by 16.6%. From coagulation activity of the blood parameters were changed in the direction gipokoagulyatsii: reduction of fibrinogen by 35%, kaolinovogo time by 44% privyshenii activity of the fibrinolytic activity in plasma by 14%. Discharged with improvement.

Example 2: the Patient, The, 44, was treated in the cardiology clinic with 02.06.2005, 22.06.2005, with a diagnosis of CHD. Angina, II functional class of chronic heart failure functional class I (NYHA). Essential hypertension stage II, grade 1, the risk is very high. Obesity class II). Osteochondrosis of the cervical, thoracic spine.

Upon receipt complained of intermittent pressing pain in the retrosternal area for 5 years, occurring against a background of moderate physical and emotional stress, radiating to the left arm, accompanied by a feeling of lack of air, with the effect of nitroglycerin with validol, shortness of breath when climbing to the 4th floor. Arterial hypertension for 10 years, occasional reception of hypotensive drugs without control of blood pressure. Frequent headaches, chest pain at rest lasting for several hours, are avoided by the use of nonsteroidal anti-inflammatory drugs.

The objective of the study at the time of admission: a proper physique, high power, weight 90 kg with height 160 see the Border of the heart is extended to the left by 1 cm, heart sounds, rhythmic, muted, systolic murmur in the projection of the apex of the heart, accent II tone of the aorta, the pulse 83 beats per minute, Ritmi the tion, satisfactory quality. HELL 150/90 mm Hg (D=S). In the lungs - vesicular breathing, wheezing is not heard. The abdomen is soft, painless, the liver is not enlarged. Symptom tapping negative on both sides. Emotionally labile. In the Romberg sustainable, coordinating sample performs correctly.

These additional studies:

Complete blood count: Hb - 133,9 g/l, er. - 4,4×10¹²/l, L. - 4,95×10⁹/l, ESR - 3 mm/h, p/I - 2%, with/I - 54%e - 2%, m - 9%, l - 33%. Response adaptation - enhanced activation (Garkavi LH).

ECG sinus rhythm, 62 beats/min, normal position of the electrical axis of the heart, incomplete blockade of the right leg PGIs, myocardial hypertrophy of the left atrium and the left ventricle.

VEM - tolerance to physical load average, achieved power - 100 watts (should - 152 W), the sample result is negative, but with features (rare arrythmia at the height of the load, severe shortness of breath and dizziness), hypertensive reactions of the cardiovascular system to physical activity.

Biochemical analysis of blood: total cholesterol - 5,44 mmol/l (normal 3,9-6,37 mmol/l)HDL cholesterol - 1.44 mmol/l (normal range of 1.01 to 1.9 mmol/l), atherogenic index was 3.3 (normal 2,6-2,9), LDL - 5.8 g/l (normal 2,94-5,42 g/l), diene conjugates of lipids is 2.55% (rate of 1.06-2.06 to unit), malonic dialdehyde erythrocytes to 39.4 mmol/ml er. m is ssy (rate of 35.6-to 43.4 mmol/ml er. mass), malonic dialdehyde lipid - of 16.6 nmol/mg of lipids (norm 8,05-8,65 nmol/mg lipid), catalase serum - 35.9 ákat/l (normal range of 10.6-23.0 µkat/l)ceruloplasmin - 0,290 g/l (normal 0,300-0,380 g/l), fibrinogen - 3,22 g/l (normal range 2,0-4,0 g/l), kaolinovo time - 60 s (normal 50-70 C), the tolerance of the plasma to the heparin - 12 min (norm 10-16 min), fibrinolytic activity of plasma - 210 minutes (normal 183-263 min). The results of the study show that the activation of processes of lipid peroxidation, the tension of the antioxidant defense system and the tendency to gipokoagulyatsii.

The adaptation period was held from episodes of headaches, meteorology. From the second day of stay in hospital the patient was prescribed a course of treatment by the proposed method - the procedure of EHF-therapy in a day, a course of 10 treatments. 5-day stay - radon baths with a radon concentration of 40-60 NCI/l at a water temperature of 36°S, the duration of the first balneological treatment to 6 minutes, the second 8 minutes, the third 10 min, IV - 12 min, all the remaining procedures in 15 minutes, every day, in the course of 10 baths. On the seventh day stay patient in the clinic angina did not arise, normalized blood pressure numbers 120/80 mm rst By the end of treatment of coronary pain was not, shortness of breath have decreased, remained controlled blood pressure, disappeared headache and giorgia, Metatronic reactions were not.

At follow-up, the following data:

Complete blood count: Hb - 114,2 g/l, er. - 3,9×10¹²/L., L. - 6,85×10⁹/l, ESR - 5 mm/h, p/I - 2%, with/I - 53%e - 5%, m - 13%, l - 27%. The response of the adaptive response of increased activation (Phharmacy).

ECG sinus rhythm, 67 BPM, improve trophism of the myocardium of the left ventricle. VEM is the increased tolerance to physical activity, achieved capacity - 112 W (152 W) is high, which is 12% more compared to the original data. The sample result is questionable (slowly upward shift of the interval S-T up to 1 mm, hypertensive reactions of the cardiovascular system to the load).

Biochemical analysis of blood: total cholesterol - 4.4 mmol/l, HDL cholesterol - 1.55 mmol/l, the index of atherogenic - 2,4, LDL - 4.8 g/l, diene conjugates of lipids -2,44%, malonic dialdehyde red - 30.2 nmol/ml er. mass, malonic dialdehyde lipid - 7.4 nmol/mg lipid, serum catalase - 20.2 µkat/l ceruloplasmin - 0,302 g/l, fibrinogen is 2.44 g/l, kaolinovo time - 40, the tolerance of the plasma to the heparin - 7 min, fibrinolytic activity of plasma - 180 minutes

Thus, the proposed method has allowed to improve physical performance by 12%, contributed to the regression stenokardicheskie pain, shortness of breath, normalization of blood pressure and pokazatel the th electrocardiography, stabilization reactions adaptation, relief of headaches and false angina, reduce Metatronic reactions. Noted effects on lipid metabolism: atherogenic range of plasma decreased no change, total cholesterol and 37.5% of the atherogenic index, with the increasing content antiatherogenic properties of blood by 21% HDL cholesterol by 17%. Dynamics of indicators of lipid peroxidation showed a decrease in the primary products of the degradation of lipid - diene conjugates of lipids by 11%, secondary products of degradation - malondialdehyde erythrocytes and malondialdehyde lipid decreased by 23%, while increasing the activity of antioxidant enzymes - catalase 43% and ceruloplasmin 8%. Remained a tendency clotting activity of blood to gipokoagulyatsii. Discharged with significant improvement.

The study included 60 patients with diagnosed coronary heart disease, angina, I-II functional classes without arrhythmia, chronic heart failure not more than II FC (NYHA), with risk factors - hypertension, dyslipidemia, psycho-emotional stress, impaired reactions of adaptation, which in the two groups on demographic variables (age, number of men and women) source to comprehensive treatment is not different is the n.

Group I - 28 patients received treatment by the proposed method - EHF-therapy in combination with radon baths.

Group II (prototype) - 32 patients received treatment iodobromide baths in combination with EHF-therapy.

The analysis of the dynamics of clinical manifestations of coronary artery disease showed positive changes after treatment, however, the higher efficiency the impact on the clinical course of strokes voltage and symptoms of chronic heart failure was observed in patients in group I of the study (table 3). The severity of antianginal effect in group I was higher by 24.1%, and manifestations of chronic heart failure by 3.2% to 5.6 below compared with those in group II. A significant decrease in complaints neurasthenic nature in the form of a normalization of sleep, irritability, fatigue, headaches, tension and feelings of palpitations were noted in all groups of patients, however, the biggest setback neurasthenic complaints were in group I, which is associated with potentiation of therapeutic effects of EHF-therapy and radon baths.

According to table 3, it was noted the prevalence of percent improvement in clinical symptoms in group I patients who took the treatment by the proposed method in comparison with the dynamics of clinical parameters in patients of group II.

Analyzing dynamic changes of adaptive reactions (Phharmacy) to end of treatment in the I and II groups, patients noted a decrease in the number of reactions increased activation by 17.9%, and 14.3%, respectively. In group I the redistribution of adaptive reactions of adaptation was towards a peaceful activation, whereas in group II there was an increase only reactions peaceful activation towards the indifferent reactions to training (table 4). In this regard, the application of the proposed medical complex indicates adequate strength irritant physical factors and "soft" achieving positive adaptogenic effect in the treatment process without sharp fluctuations, which had positive effect on the health of patients.

The clinical condition of patients is consistent with the data electrocardiography. When assessing the processes of repolarization on the ECG was a decrease ischemic (interval ST) and non-specific changes (the T wave) in the I g is the SCP by 9.7% and 12.9%, respectively, whereas in group II was lower percentage of recourse ischemic performance and increase nonspecific changes the terminal portion of QRs complex by 7.8%.

When evaluating interval Q-T corrected (Q-Tc) tended to lengthen this interval, 1.5% of patients in group I and statistically insignificant dynamics in group II, but the value of the Q-Tc did not reach its significant prognostic value (more 0,440 with^1/2). These changes in the terminal part of the QRs complex may reflect the influence of the autonomic system and electrolyte disturbances when exposed to the myocardium physical factors (table 5).

Table 5
The dynamics of the interval Q-T corrected (Q-Tc) in the treatment process
Group	Treatment periods	Q-Tc	Δ%	p
I			+1,5	<0,05
II			0	>0,05

Data exercise tests showed the dynamics of reduction of hypertensive type reactions cardio-SOS the vascular system to the load after the treatment by the proposed method - 28,9%, which is 1.8% more compared with the treatment of the prototype (table 6).

When the quantitative assessment of exercise performance tests noted marked a positive change after treatment in group I: men gain power threshold load was 16.9% (p<0.05), and in women significant increase by 7.9% (p<0,05). In group II men significant changes tolerance to physical activity was not observed.

A similar trend was determined by the level of maximum oxygen consumption (IPC). rarest physical performance adequate to the increase in BMD and shows the greatest increase in the level of training is the combined application of physical factors (table 7).

When a threshold load was observed trend of decreasing performance dual works in both groups of women.

Table 7
Dynamics of indicators of physical health in patients with coronary artery disease
Group	Floor	Power (W)	Double product (srvc. unit)	IPC (ml/min)
Statocaster	Data	And%	Data	And%	Data	And%
I	husband n=15	M±m		+16,9		+7,6		+24.6
p	<0,05	>0,05	>0,05
wives n=17	M±m		+7,9		of-1.5		+5.0
p	<0,01	>0,05	<0,05
II	husband n=13	M±m		+15,3		+1.9		+11.5
p	>0,05	>0,05	>0,05
wives n=15	M±m		-3,2		a-2.5		-0.9
p	<0,01	>0,05	>0,05
Note: the numerator is the value before the treatment; the denominator is the value of the parameters after treatment; Δ% dynamics of changes in indicators, p - significance of differences in parameters before and after treatment.

Thus, after analyzing the data, we can say that high performance radon balneotherapy and EHF-therapy Proc. of the dominant factors in improving the functional reserves of the myocardium in patients with ischemic heart disease, reducing inadequate hemodynamic responses to exercise.

Detection and correction of hyperlipidemia are the main tasks for the prevention and treatment of CHD. Original to the complex treatment of patients in all groups were identified lipid metabolism in the form of hypercholesterolemia, hypertriglyceridemia, hyperlipoproteinemias under reduced cholesterol high density lipoprotein (table 8). High atherogenic range of lipid metabolism was extremely unfavorable factor in the development and progression of atherosclerosis in this group of patients.

Under the influence of the treatment of patients in all groups reported an improvement in lipid profile plasma. A significant reduction of atherogenic lipids was observed in group I: total cholesterol (TC) decreased by 11% (p<0.05), and the atherogenic index by 10.0% (p<0,05) (table 8). In this group marked the most favorable trend to lower cholesterol low-density lipoprotein (LDL) and increased atherogenic cholesterol high density lipoprotein (HDL cholesterol) by 23% (p<0,05). Positive changes atherogenic profile, in our view, due to the influence of EHF-therapy. In group II there was a significant increase of the level of antiatherogenic potential of plasma LDL cholesterol by 5.3%.

Thus, l is peakorruse effect due to the action of the physical factors, but significantly associated with the use of EHF-therapy and General radon baths.

Table 8
Dynamics of lipid metabolism in patients with coronary heart disease under the influence of complex treatment
Group	Stat. index	Total cholesterol mmol/l	HDL cholesterol mmol/l	The atherogenic index, %	LDL cholesterol g/l
I	M±m
P	<0,05	<0,05	<0,05	>0,05
II	M±m
P	>0,05	<0,05	>0,05	>0,05
Healthy	M±m	5,20±0,21	1,46±0,08	2,75±0,13	4,16±0,22
Note the tion: in the numerator indicators before treatment, in the denominator - after treatment.

Pathological changes of lipid metabolism in atherosclerosis and coronary heart disease are manifested by the increase in the content of lipoperoxides in plasma due to the activation of free radical peroxide oxidation with the formation of active primary and secondary oxidation products - malondialdehyde, diene conjugates, providing irreversible damage to cell structures that enhance platelet aggregation and provoking the processes of progression and complications of atherosclerosis. All observed patients in the evaluation system of lipid peroxidation (LPO) in the resultant diene conjugates (DC) and malondialdehyde (MDA) increased performance compared with the healthy group. The high content of DK-initial phase processes the FLOOR pointed to reduced resistance of lipoproteins to oxidation and their willingness to oxidize. At the same time, the system antioxidantes protection in ischemic heart disease depressed and exhausted, which is regarded as one of the reasons for the intensification of the FLOOR. Enzymatic antioxidants in plasma catalase and ceruloplasmin are involved in protecting LDL cholesterol from atherogenic oxidative modification.

The antioxidant defense system was evaluated in patients according to the activity of catalase and ceruloplasmin. Recognize the significant increased level of catalase in all groups was associated with the intensification of LPO with increased production of hydrogen peroxide, and the level of ceruloplasmin was reduced as a result of irreversible interaction with the hydroperoxides and the accumulation of oxidized free radicals with the depletion of this enzyme.

The use of medical facilities contributed to the positive change of GENDER indicators and AOD. The most pronounced changes were observed in patients of group I: lipid peroxidation and antioxidant protection reduction of LPO products amounted to DKK 15.4% (p<0,001), erythrocyte MDA 14,6 (p<0.01), and MDA lipid 34,3% (p<0,01) with increasing content of ceruloplasmin 27.0% (p<0,05) (table). This positive biochemical effects could be due to the inhibiting effect of EHF-therapy on the FLOOR system. Impact on the level of catalase was not recorded.

In group II patients under the influence of treatment odabrani balneotherapy and EHF-therapy reliable shifts in the studied indicators GENDER and AOD was observed (table).

Table 9
Indicators of lipid peroxidation and antioxidant protection in patients with coronary artery disease under the influence of complex treatment
Group	Stat. index	Indicators of lipid peroxidation	Indices of antioxidant system
Diene conjugates	HMM mmol/ml er. weight	MDA n/mol/mg LPS.	Catalase µkat/l	Torulopsis min g/l
I	M±m
-15,4%	-14,6%	-34,3	+1,0%	+27%
2,1	2,5	the 4.7	0,03	2,34
II	M±m
-13,6%	-4,6%	-10%	+6%	+4,4%
1,95	0,57	1,84	0,55	0,99
Healthy	M±m	1,56±0,14	39,5±0,92	8,35±0,08	16,8±1,59	0,340±0,009
Note: numerator data before treatment, in the denominator - after treatment.

Thus, the analysis of lipid metabolism revealed corrective action complex, including EHF-therapy and radon balneotherapy. The use of this medical complex promotes balanced systems peroxidation and antioxidant protection. Obviously, the effect of EHF-therapy potentiated radon baths, contribute to the retention processes of atherogenesis and the equilibrium of the oxidation of lipids. Inclusion in the medical complex iodine-bromine baths is not sufficient for the correction of lipid metabolism.

Biochemical changes clotting and fibrinolytic properties of blood cause the formation of thrombosis and determine their significance as a risk factor of coronary heart disease and the need for correction.

We observed CHD patients in the initial state noted the increase in the content of fibrinogen, decreased tolerance to heparin plasma, a significant reduction in fibrinolytic activity of plasma.

Treatment of patients with CHD for the proposed method (group I) contributed to the improvement of the blood coagulation system: reduction of fibrinogen by 26% (p<0.05), and increased tolerance to heparin plasma by 6% (p<0.01), and a significant increase in fibrinolytic activity is human plasma by 16% (p< 0,01) - anticoagulation of blood potential (table 10).

In group II patients changes of coagulation and anticoagulation properties of blood also significantly expressed that determines therapeutic value of the mineral water.

Table 10
The performance of the coagulation system in patients with ischemic heart disease
Group	Stat. index	Fibrinogen g/l	Kalinovo time sec	Tolerance to heparin plasma, minutes	Fibrinolytic activity, min
I	M±m
p	<0,05	<0,05	<0,01	<0,05
II	M±m
p	<0,05	>0,05	>0,05	>0,05
Healthy	2,0-4,0	50-70	10-16	183-263

When the quantitative assessment of treatment results the highest efficiency was observed in group I -4,02±0.13 points, with a high percentage (18,6) "significant improvement" and "improvement" (71,1%) at low values of "minor improvements". The use of a second medical complex (odabrana balneotherapy and EHF-therapy) showed less pronounced efficiency with a high percentage of "improvements" and "minor improvements" (table).

Thus, the high therapeutic efficiency the efficiency have been reported with the use of EHF-therapy and radon balneotherapy.

In the analysis of remote results of a Spa treatment in 10 patients with coronary artery disease treated with developed medical complex, including EHF-therapy and radon baths, note the following: remission (stable flow) coronary heart disease was observed during 7,6±0,41 months, the number of strokes voltage per week decreased by 54% (p<0,05) (from 1.96±a 0.27 to 0.75±0,19 times/week); maintaining a stable level of blood pressure in patients (absence of hypertensive crises, the most resistant to weather factors) were observed during 6,0±0,72 months. The number of days of temporary disability the basic disease decreased by 2.7 times.

A comprehensive analysis of issues relating to secondary prevention and treatment of coronary artery disease using radon balneotherapy and EHF-therapy, showed that integrates the influence of physical factors capable of correction prognostically significant risk factors and thereby to stabilize for atherosclerosis and coronary heart disease, reduce the risk of complications.

Spa treatment with a multi-factorial influence, to a certain extent, can be an alternative to pharmacological treatment and secondary prevention of coronary heart disease.

A method of treating ischemic bolezn the heart by balneo - and EHF-therapy, characterized in that 2-day period of adaptation to the patient to carry out procedures of EHF-therapy with a wavelength of 4.9 mm, connecting with the fifth day of treatment radon balneotherapy with radon concentration 40-60-80 NCI/l, the length of the first balneological treatment 6 min, the second 8 minutes, the third 10 min, the fourth 12 min, all the remaining procedures for 15 minutes, every day in the course of 10 physiotherapy and 8 balneological treatment, and 1-4 procedures baths release at concentrations of radon 40 NCI/l, 5-6 baths - 60 NCI/l, 7-8 baths - 80 NCI/HP