Method of treating patients with osteoarthrosis with cardiovascular disorders accompanying metabolic syndrome

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely therapy, and is applicable for correction of cardiovascular disorders accompanying metabolic syndrome in the patients suffering osteoarthrosis. It involves the supravenous blood exposure at wave length 405 nm, light guide tip power 1.5 mWt, length of a procedure 5 minutes. It is followed by contact joints exposure at wave length 630 nm, pulse power 10 Wt, frequency 80 Hz. Knee joints are exposed for 2 minutes from 4 sides and with using a lability technique by beam scanning along an joint space for 2 minutes. Hip joints are exposed through a projection of inguinal ligament, greater trochanter, ischial tuberosity for 2 minutes and with using a lability technique by beam scanning along the joint space for 4 minutes. The therapeutic course includes 10 daily sessions.

EFFECT: method allows providing prolonged remission and lowered drug load ensured by eliminating inflammatory activity, lipid spectrum, coagulation hemostasis and carbohydrate metabolism disorders.

19 tbl

 

The invention relates to medicine, namely to therapy, and can be widely applied for the correction of cardiovascular disorders metabolic syndrome in patients with osteoarthritis (OA).

Joint disease is widely distributed throughout the world. Up to 55% in the structure of articular pathology accounts for osteoarthritis (Nasonova V.A., 2000). The interest in the problem of osteoarthritis is primarily due to its wide prevalence and associated significant financial costs to both the individual patient and society as a whole (Benevolensky LI, 2001; Simon, L.S., 1999). Osteoarthritis leads to deterioration of the physical condition of the patient, and chronic progressive course and disability cause psychological problems, and lead to reduced social activity (Vaasana, Omolola, Vnimaniya, 2000).

Diseases of the musculoskeletal system with articular syndrome objectively and significantly affect the quality of life for all age groups of society, draws attention to the fact that 2/3 of patients seek medical help with articular syndrome (osteoarthritis suffer from 12.8 per cent). (Nasonova V.A. Diagnosis and treatment of elderly patients suffering from manifest osteoarthritis. Russian medical journal. - 2001. - V.9, No. 3-4. - S-159; Fife RS Osteparthritis - epidemiology, pathology and pathogenesis/R.S.Ffe//Primer on the rtheumatic Diseases. Atlanta; Georgia, 1997. - P.216-217.)

Many years osteoarthritis was seen as an isolated disease of the joints, associated with degeneration of cartilage in the natural aging of the human body. Now suppose that the basis of the progression of osteoarthritis is a lot difficult interacting causes and mechanisms that are only partially related to age-related changes. In recent years, evidence of influence on the development of osteoarthritis genetic predisposition, biochemical and metabolic changes, local inflammation, etc. (Nasonova V.A. Rheumatic diseases in Russia in the beginning of the XXI century. Scientific-practical rheumatology. - 2003. No. 1. - P.6-10. Nasonova V.A. Systemic enzyme therapy: a practical guide for physicians. SPb. 2001. - 31 p.114).

In most cases, patients with osteoarthritis are characterized by the presence of overweight, hypertension, systemic inflammation, i.e. the classical risk factors of cardiovascular diseases associated with endothelial dysfunction and potentiating its development.

The main components of metabolic and cardiovascular disorders are impaired tolerance to glucose, abdominal-visceral obesity, hypertension, hyperuricemia, impaired hemostasis, atherogene the dyslipidemia (increased blood concentrations of triglycerides (TG) and reduced cholesterol high-density lipoprotein (LDL HDL)). From the point of view of the life prediction is important is that the combination of the above violations significantly accelerates the progression of atherosclerosis, i.e. increases cardiovascular risk in this group of patients (Cardiology. National leadership. Edited Belenkov YU.N., Organova RG Moscow "GEOTAR-Media 2007; 1232 S.).

It is known that in patients with osteoarthritis hypertension is more common than in the population (the Khitrov N.A., 2005). There are various points of view on the prevalence of arterial hypertension in patients with osteoarthritis. In combination these diseases occur in 45-58% of the population (the Khitrov N.A., 2005; Alekseeva LI, 2008; R. Caporali 2005).

One of the most dangerous complications of atherosclerosis is atherothrombosis in the development of which we can distinguish the following pathogenetic links:

- violation of the lipid-protein spectrum whey "atherogenic shift";

- deviation of rheological properties of blood as a result of different changes in the hemostatic system;

- damage to the vascular wall.

Violation lipid profile (decreased concentration "antiatherogenic" cholesterol high density lipoprotein - helpit) in inflammatory and infectious diseases of the joints correlates with the activity of the inflammatory process (increased erythrocyte sedimentation rate, and serum concentrations of CRP) [Stunayake R.D., 2006; D. White, 2006].

In recent years, an increasing attention is paid to the treatment of osteoarthritis using low-intensity laser radiation. The main tasks of laser therapy in the treatment of patients with osteoarthritis is to provide an anesthetic effect; to improve the nutrition of the tissues of the affected joint; strengthen regional blood flow and microcirculation, to help stimulate the regeneration of cartilage tissue (Kozlov V.I., Bolin VA, 2001; Brekhov H., 2007; Moskvin S.V., 2006; Makelines V.I., 1999; Lubenko OO, 1999).

Treatment in osteoarthritis remains a serious problem, despite the fact that the list of drugs used in the last time has been considerably augmented. Constantly search for new drugs that could not only reduce pain, but also to slow the progression of joint destruction, thereby delaying the onset of disability (Kovalenko V.N., Bortkevich OP, 2005; Benevolensky LI, 2005). That is why it is so important to all treatments and primarily effective modern medicines in combination with non-pharmacological methods of treatment.

Known methods of using a combination of laser therapy in patients with osteoarthritis for the correction of cardiovascular disorders and metabolic syndrome:

- the influence of low-intensity laser irradiation is of indicators of glycosaminoglycans in patients with osteoarthritis (Starodubtseva IA The influence of laser radiation on the performance of glycosaminoglycans in patients with osteoarthritis abstract. Voronezh., 2008;

- stage combined laser therapy in different clinical variants of coronary heart disease (GV Babushkin et al. Cartelised AV - M.: Publishing house LLP "Firm "Technique". - 2000 - prototype).

However, these methods of laser irradiation differ in a number of significant drawbacks. In the known methods:

- not achieved the elimination constant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and protracted course of osteoarthritis;

- observed side effects in the form of the phenomenon of "secondary aggravation"that require correction or termination of treatment;

- limit therapeutic possibilities of laser therapy in patients with osteoarthritis;

- do not carry out the correction of adverse diseases.

The elimination of the aforementioned disadvantages of the known technical solutions and an objective of the claimed invention.

The task of the invention is to develop a method of treatment of patients with osteoarthritis and cardiovascular disorders in the metabolic syndrome.

The technical result is: elimination of inflammatory activity, lipid spectrum, coagulation hemostasis, uglevodnogo the exchange, achieving harmonization of blood rheology, metabolic, energy, immune processes, endothelial dysfunction, anti-inflammatory effect, that is, contributes to the development of complex therapeutic effects on the entire body of the patient with such comorbidity as cardiovascular disorders in the metabolic syndrome and osteoarthritis.

The method is as follows.

The effects of laser therapy is carried out in a combined mode. First exercise venous blood irradiation with a wavelength of 405 nm, the power at the end of the light guide 1.5 mW, the total duration of the procedure 5 min (for exposure may be used, for example, ALT matrix-ILIB", radiant cylinder KL-ILIB-405). Venous impact of exercise on the projection of the cubital vein.

Then immediately perform a contact exposure of joints: with a wavelength of 630 nm, a pulse power of 10 W, a frequency of 80 Hz (for exposure may be used, for example, ALT matrix, laser head CLO-3). Moreover, the duration of impact on the joints is:

knee joints: General procedure duration - 10 min: 2 min with 4 sides and labile technique, the scanning beam along the joint space 2 min;

hip joints: the total procedure duration - 10 min: irradiation through C is well projection of papatowai ligaments, greater trochanter ischial tuberosity for 2 min and labile technique, the scanning beam along the joint space 4 minutes

In the course of 10 daily sessions. The procedure of laser treatment at the same time of day (±1 hour). These requirements are due to the fact that underlying mechanisms of therapeutic action of laser therapy are the phase and rhythmic response of homeostasis, in particular, characterizing the correction dysmetabolism, adaptogenic vascular reactions and others. So important modes of laser therapy to ensure adequate therapeutic effect is treatment procedures at the same time of day (±1 hour), taking into account the biological memory of the body on the adaptogenic effect.

A noticeable improvement in the efficiency of complex treatment of osteoarthritis is achieved by the combination of the contact exposure of the joints and venous irradiation of blood and correction of disorders of lipid profile, coagulation homeostasis, carbohydrate metabolism.

It is advisable when exposed to use of the laser emitting head CL-ILIB-405 for ALT matrix-ILIB", since it allows to implement the most effective and promising technology laser irradiation of blood - ILIB-405: NEELY with a wavelength of 405 nm is absorbed most effectively of all blood components, i.e. impacts is of equally carried out on all blood components; the use of laser radiation head CL-ILIB-405 to the unit matrix-ILIB allows you to replace three heads: CL-ILIB (wavelength 0.63 μm, the capacity of 1.5-2.0 mW), CL-ILIB-M (wavelength 0.63 μm, the capacity of 15-20 mW) and MS-ILIB-365 (wavelength 0,365 μm, the power of 1.0 mW).

Clinical and experimental studies have confirmed the feasibility of making all of the combined laser exposure, because it allows to implement the most effective and promising technology for the treatment of patients with osteoarthritis and cardiovascular disorders and metabolic syndrome. This technology correction inflammatory activity, lipid spectrum, coagulation homeostasis, carbohydrate metabolism, causing the harmonization of blood rheology, metabolic, energy, immune processes, endothelial dysfunction, anti-inflammatory, anti-edema effects, i.e. contributes to the development of complex therapeutic effects on the entire body of the patient.

The procedure according to the claimed method is performed in equipped office laser therapy. Before each subsequent session of laser therapy, the physician should ask the patient's individual response of the organism to NEELY, which develops during the previous day. This is necessary to prevent unwanted reactions su is bedstvie overdose NEELY (power settings, time of exposure and the total number of sessions).

For sessions NEELY patient conveniently laid on the couch. At this time the patient should not be distracted by any noise, noises or conversations. Sessions are conducted at the same time of day (±1 hour).

The effect of LLLT begin with venous laser irradiation of blood: the wavelength of 405 nm (using, for example, the radiant cylinder KL-ILIB-405), the power at the end of the light guide 1.5 mW, the total treatment takes 5 minutes To this end, the emitter fix the cuff-holder over the projection of the cubital vein and include the source of the NILE in the specified mode. At the end of the session, the unit automatically turns off. The patient should remain lying down on the couch for another 5-10 minutes

Venous laser irradiation of blood is as follows:

1. The patient is in the supine position.

2. On the wrist (in the area of the cubital vein of the patient secure the radiant cylinder KL-ILIB-405 with cuffs.

3. Set on the apparatus required treatment time is 5 minutes.

4. On a laser apparatus (for example, ALT matrix-ILIB") click "start".

5. After the time of the procedure, the device automatically turns off and you hear a beep.

6. Remove the radiant head. The procedure is completed.

Then immediately perform Comte is the things impact on joints:

1. The patient is in the supine position.

2. Install radiant head (for example, CLO), the contact projection of the joint space with 4 sides of each knee for 2 minutes. Then scan the beam along the joint space 2 min, through the area of the projection of papatowai ligament greater trochanter ischial tuberosity (hip joints) for 2 min and the scanning beam along the joint space 4 minutes

3. Set on the apparatus required procedure: procedure duration - 10 minutes

4. On the unit press the start button.

5. After the time of the procedure, the machine automatically shuts off and sounds a tone. The procedure is completed.

The total duration of each course NEELY is 10 combined treatments.

For the implementation of LLLT may be used: for venous access device laser irradiation of blood ALT "matrix-ILIB", radiant cylinder KL-ILIB-405; for contact exposure (cutaneous access) - ALT matrix, laser head CLO-3. Devices certified by the health Ministry.

According to the claimed method treated 56 patients with osteoarthrosis of the 2nd degree of severity of lesions of the knee and hip joints in combination with metabolic and cardiovascular disorders, found that decreased activity indicators, osteoarthr is for, improved lipid profile ("atherogenic shift"), the main parameters of coagulation homeostasis, carbohydrate metabolism, and functional performance. Deterioration of the clinical condition was not detected in any case.

Was conducted correlation analysis between the studied parameters and estimated cardiovascular risk in patients with osteoarthritis were studied. To assess the effect of laser irradiation of blood on the dynamics of the clinical, biochemical and functional parameters in patients with osteoarthritis with metabolic syndrome and without it. Conducted analysis of remote results of treatment and evaluated the possibility of reducing the dose used drugs.

The resulting effects are confirmed by the following data. Just was 86 persons:

group 1 - 22 patients with osteoarthrosis of the 2nd degree with lesions of the knee and hip joints in combination with metabolic and cardiovascular disorders who received traditional therapy in combination with contact exposure of joints and venous blood irradiation.

group 2 - 14 patients with osteoarthritis treated with conventional therapy in combination with the venous blood irradiation.

group 3 - 13 patients with osteoarthritis treated with conventional therapy in combination with NEELY contact on knee and hip sust is you.

group 4 (control) - 19 patients who received only conventional therapy.

group 5 - 20 people, healthy volunteers without somatic diseases, not consisting in the dispensary, in their history for the last 3 months has not been registered acute pathology.

A comprehensive clinical examination of patients with osteoarthrosis was held on 1-3, 10-13 day hospital stay and long-term results after 6 months of treatment.

Table 1
Clinical characteristics of patients in the studied groups (n-68)
Group1234
Age (years)52-5854-6250-6248-64
Women16151615
Men2211
The duration of OA (years)5-105-105-105-10

/tr>
Table 2
The main clinical manifestations of osteoarthritis
The main clinical manifestations of osteoarthritisNumber of patients n=68
Abs.%
Pain in the joints "mechanical" nature and "start-up"68100
Crepitus with active motion in the joints68100
Stiffness5479
The limited mobility of the affected joint3856
Swelling of the joints46
Deformation of joints (valgus or varus)1217
Tenderness to palpation68100

An assessment of the overall severity of joint pain was assessed on YOUR in mm (Iagnosing, Usamarovskiy, Heathrow, 1992):

0 - no pain;

1 - slight pain may be intermittent or constant, but do not interfere with sleep;

2 - moderate pain that delivers the concern that violate sleep, at least once per night;

3 - strong, almost constant pain, often violate the dream.

Analyzed the duration and severity of morning stiffness as a measure of the overall activity of inflammation in the joint:

0 - absence of constraint,

1 - stiffness up to 10 minutes

2 - stiffness 10-20 minutes

3 - duration constraint 20-30 minutes.

Crepitus:

0 - no crepitate,

1 - felt sick when performing active movements in the joints,

2 - felt sick, and the doctor felt by palpation when performing active movements in the joints,

3 - felt sick and felt by the physician when performing passive movements in joints.

Defigure - increasing the size of the joint as a result of inflammation. Total numeric expression of defiguration was estimated visually according to the following grades: 0 - no defiguration, 1 - questionable or poorly expressed defigure,2 - explicit defigure, 3 - strong defigure.

Evaluation of defiguration was conducted for the knee joints. Limitation of motion was assessed on a 4-point scale: 0 - none; 1 - slight or moderate limitation of movement in the joints, 2 - marked limitation of movement in the joints, 3 - marked limitation of active and passive movements in joints.

Assessment of severity of joint pain on palpation in points:

0 - no pain, 1 - feeling sick minor pain to palpation, 2 - feeling moderate pain, 3 - sharp pain on palpation, the patient is removed from the doctor.

Disease severity and functional status of the joints was evaluated using index Lekena. Each feature included in this index is evaluated, and the severity of the condition is based on the amount of points.

Index Lequeesne:

Morning stiffness: (no - 1, less than 15 min - 2, more than 15 min to 3).

Joint pain increase after a night: (no - 1, the motion - 2, without movement - 3).

Pain worsens when walking (no - 1, in the beginning of the movement - 2, after a - 3).

Pain worsens when sitting for more than 2 hours: (no - 1, up - 2).

Pain worsens when standing for 30 minutes or more (no - 1 Yes - 2).

The maximum traveled distance: more than 1 km without limit - 1; 1 km, but with difficulty - 2; about 1 is m (15 min) - 3; 500-900 m (8-15 min) - 4; 300-5 00 m -5; 100-300 m - 6; with one stick or crutch - 7; with two sticks or crutches - 8.

Can You go up one flight of stairs up? (easy-to - 1, labor 2, 3).

Can You take one flight of stairs down? (easy-to - 1, labor 2, 3).

Can You sit in the squat? (easy-to - 1, labor 2, 3).

Can You go on rough roads? (easy - 14, with labor - 2, 3). The assessment of severity of OA (in points) 1-4 points - lightweight severity 5-7 points - average severity 8-10 points - severe severity.

During follow-up for evaluation of therapeutic action of a doctor and a patient assessed outcomes at 3 borders: Improving the disappearance or significant reduction in pain, morning stiffness, crepitate in combination with increased movements and disappearance of the symptoms of frozen shoulder joint; Without effect - saving clinical signs or mild improvement; Deterioration - saving signs of inflammation of a joint. Persistent deformity and limitation of range of motion in the joint.

To assess the intensity of pain at rest, with movement and palpation, as well as morning stiffness in patients with OA using a visual analog scale (VAS - Hexicon). This is a straight horizontal line with a length of 100 mm, the horse is stationary points which indicate the opposite values of the estimated parameter. The patient notes a vertical line on the scale of severity, for example, pain, then the pain YOUR are expressed in mm (distance from the beginning of the scale to the intersection with a vertical line).

In the group of patients receiving conventional therapy in combination with contact exposure of joints and venous blood irradiation in the control group, were included 68 patients with osteoarthrosis of the hip and knee joints of the 2nd degree in combination with metabolic and cardiovascular disorders (table 1, table 2).

In the monitoring of patients in the dynamics of treatment it was noted that in the group of patients receiving combination therapy (group 1), pain scores significantly decreased after 11-13 days 1, 77 points (p<0,05) (table 3). Of the 22 patients observed in this group, this time the pain has been preserved only in 1 patient (4.5 per cent), among the received traditional therapy and venous blood irradiation (group 2) - 2 patients (14.2 percent), which was significantly less than in the other two groups: among patients receiving conventional therapy (group 4), pain was preserved in 10 patients (52.6 per cent).

Table 3
Change the severity of pain in the two groups in the scores under the influence of time, the ranks of therapies in the dynamics of treatment (M±m)
The group of patientsThe nature of the pain (points)Dynamics in points from the original P
1-3 day11-13 day6 months
group 13,27±0,721,77±0,08**0,76±0,22**1,772,152,3
group 23,16±0,441,75±0,32**1,22±0,18**1,311,521,9
group 32,82±0,791,5±1,02*1,41±0,32**1,221,31,39
group 43,02±0,822,4±0,892,5±0,22**0,490,550,2
Notes: * the validity time is of ice parameters in the dynamics of therapy in the two groups (p< 0,05); ** - significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001); R is the dierence between the indices before treatment and after 13 days, 6 months of therapy in the two groups.

The investigation of changes in the severity of pain when the load groups under the influence of various treatment regimens in mm for YOUR showed (table 4, 5)that has the lowest rates in YOUR under the influence of treatment was noted in group 1. So on 11-13 day of YOUR treatment decreased by 18.7 mm compared with baseline and after 6 months of 37.5 mm, respectively. All changes are accurate p<0.05.

In group 2, treated with traditional therapy in combination with venous laser therapy, also observed a significant decrease in performance in YOUR treatment dynamics, but these changes were less significant.

In group 3, treated with LLLT and traditional media, the indicators also improved p<0.05. However, after 6 months YOUR began to increase and the difference in the rate from YOUR source decreased to 4.3 mm and has become unreliable p>0.05.

The worst dynamics pain on YOUR mm was in group 4, who received only conventional therapy. On 11-13 day in this group experienced reduced pain, which decreased by 8.4 mm But after 6 months the rate of pain began to increase, and the difference from the initial digits of the part of the La only 2.4 p> 0.05.

Table 4
Change the severity of pain during movement in the two groups in mm for YOUR under the influence of various types of treatment (M±m)
The group of patientsThe nature of the pain (mm)Dynamics in points from the original P
1-3 day11-13 day6 months
group 173,8±0,5656,5±0,36**37,8±0,32**18,725,637,5
group 269,5±0,4860,6±0,12**53,36±0,28**9,614,116,8
group 371,8±0,3959,2±0,86*67,9±0,4215,417,24,3
group 4 77,9±0,4673,5±0,72for 77.2±0,388,411,72,4
Notes: * the significance of differences of the parameters in the dynamics of therapy in the two groups (p<0,05); ** - significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001); R is the dierence between the indices before treatment and after 13 days, 6 months of therapy in the two groups.

Table 5
Pain to palpation on YOUR in mm in patients with OA in the two groups (M±m)
Pain to palpation on YOUR (in mm)Patients OA (68)
group 1 (n=22)group 2 (n=14)group 3 (n=13)group 4 n=19
Before the treatment61,2±2,461,3±1,859,5±1,9660,4±2,16
11-13 day35,7±1,7*41,7±1,24 52,6±1,557,3+1,6
After 6 months19,9±1,8*37,6±1,438,6±1,658,5±1,4
Note: * - p<0,001

The 13 th day of this indicator decreased by 25.5 mm (42%) (p<0.001) in the 1st group. Analysis of pain intensity in the groups after 6 months demonstrated a clear advantage of using combination therapy (traditional therapy in combination with contact exposure of joints and the venous blood irradiation).

A study of indicators of morning stiffness (table 6, 7) showed that the duration of morning stiffness was significantly decreased in the dynamics of treatment patients of groups 1 and 2, the stiffness in the 3rd group also changed significantly, but the values were lower compared with patients first and second groups (p<0.05). The worst results were in the 4th group compared with other groups.

Upon admission to hospital and before treatment intensity (points) and duration (minutes) morning stiffness in all groups amounted to 3.35-3,14 points or 37.5-27,4 minutes. After 11 to 13 days after the start of treatment stiffness most significantly decreased in the first group who received integrated treatment. In points of pain decreased from 2.25 to 1.72 is minutes from 27,5 to 16.7, respectively.

A significant decline occurred in the second group, receiving venous blood irradiation in combination with conventional therapy - dynamics 0.84 points and 8.7 minutes. In the third group there was a decline of 0.43 points and 7.3 minutes. The least dynamic of decline observed in the fourth group receiving only standard anti-inflammatory therapy. The reduction amounted to 0.32 points and 4.2 minutes, respectively. The positive dynamics of this indicator in the minutes was statistically significant at p<0.05 for all groups except for the group treated only with conventional therapy.

Table 6
The change in morning stiffness in the two groups in the scores under the influence of various types of treatment (M±m)
The group of patientsThe severity of morning stiffnessDynamics
indicators
Pi
1-3 day11-13 day6 months
group 13,35±0,621,72±0,76**1,74±0,84** 1,3
group 23,25±0,521,81±0,72*1,71±0,77*0,84
group 33,27±0,682,13±0,58*2,11±0,69*0,43
group 43,14±0,572,25±0,623,18±0,850,32
Notes: * the significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,05); ** - significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001); R is the dierence between the indices before treatment and after 13 days, 6 months of therapy in the two groups.

Table 7
The change in morning stiffness in the two groups in the minutes under the influence of various types of treatment (M±m)
The group of patientsThe severity of morning stiffnessthe dynamics
indicators
Pi
1-3 day11-13 day6 months
group 137,5±2,116,7±1,3**16,6±1,44**18,5
group 227,4±2,320,7±1,120,6±2,18,7
group 332,6±1,925,6±1,6*25,4±1,8*7,3
group 432,8±2,727,5±1,7*27,7±1,9*4,2
Notes: * the significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,05); ** - significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001); Pi is the difference in index before treatment and after 13 days, 6 months of therapy in the two groups.

In the dynamics of treatment in patients of all groups were observed (table 8) reducing the severity of crepitate - first FCU is PE by 0.36 points, in the second 0.21 points, in the third and fourth by 0.23 and 0.12 points respectively.

The best speaker was in patients treated with combination therapy, and in patients who received conventional therapy in combination with the venous blood irradiation, in third place on the results of treatment were patients of the third group. The worst results were observed in patients who received only the TT.

Table 8
Change the severity of crepitate in the two groups in the scores under the influence of various types of treatment (M±m)
The group of patientsThe severity of crepitate (points)Dynamics
indicators
Pi
1-3 day11-13 day6 months
group 12,60±0,982,1±0,2**1,6±0,2**0,36
group 22,72±0,72,39±0,822,23±0,790,21
group 3 2,58±0,212,31±0,912,12±0,910,23
group 4of 2.51±0,382,38±0,422,36±0,440,12
Notes: * the significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,05); ** - significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001).

Research index Lekena (Jack Jean Pierre) in groups under the influence of treatment (table 10): index decreased by 11-13 day by 3.2 points and 4.2 after 6 months of treatment in group 1, the second group by 0.96 and 1,68, respectively, in the third group of 1.24 and 1.16 to 6 months, in the fourth on 11-13 day at 0,2 and 6 months by 0.3 points. As can be seen from this survey, the most significant reliable results were obtained at 11-13 days of treatment in groups 1 and 3 through 6 months of treatment in groups 1 and 2 received combination therapy.

Table 10
The dynamics of the functional index Lekena in groups under the influence of various types of treatment the (M±m)
The group of patientsThe nature of the pain (mm)Dynamics in points from the source Pi
1-3 day11-13 day6 months
group 112,1±0,52of 7.69±0,34**at 6.84±0,32**3,24,2
group 211,8±0,48of 9.89±0,12**8,32±0,28**0,961,68
group 312,2±0,3910,22±0,86*9,38±0,421,241,16
group 411,3±0,4510,32±0,72a 10.74±0,320,2-0,3
Notes: * the significance of differences of the indices before treatment and after 13 days, 6 months of therapy in the two groups (p<0,05); ** - significance of differences is pokazateli before treatment and after 13 days, 6 months of therapy in the two groups (p<0,001).

When comparing pain scores on a scale Lequesne (tabl) in patients of group 1, treated against the background of traditional therapy contact exposure of joints and venous blood irradiation, noted that the examined core group was more pronounced change indicators such as "pain during the night's rest" in 13 patients (59%); duration of morning stiffness" in 11 patients (50%) and significant improvements in pain when walking" in 16 patients (72,7%). While this improvement was significant (p<0,05).

Tabl
Comparative evaluation of the efficacy of treatment of patients with OA in the Lequesne scale (in %)
The Lequesne scalePatients OA (n=68)
Positive effects, %
group 1group 2group 3group 4
Pain or discomfort during the night5936,823,321,1
The duration of morning stiffness or pain after rising5027,212,811,2
Duration of standing in for 30 minutes increases the pain26,818the 15.6the 13.4
Pain when walking72,77,67,115,3
Pain or discomfort in sitting for two hours32,326,126,519,6
The maximum distance of movement24,410,89,26,8

Tabl
Dynamics of laboratory parameters in patients at admission
IndicatorsPatients, n=68 Healthy n=20
group 1group 2group 3group 4
The leukocyte number. 1 l12,1±0,9*11,2±0,9*12,5±0,71*11,8±1,1*6,7±1,1*
ESR, mm/h18,3±2,0*18,6±2,0*16,5±1,0*17,8±1,0*9,0±1,0*
SLO7,6±0,8*7,8±0,8*7,4±1,2*7,3±0,5**2,6±2,2*
Seromukoidy282±2,38281±2,29280±2,34282±2,36257,6±2,46
Sialic acid715±4,6715,4±4,79716,2±4,54714,7±to 4.52645±4,05
Total protein g/l72,8±3,474,5 the 2,8 74,4±3,274,6±2,966,2±3,1
Fibrinogen g/l5,58±1,35,56±0,925,56±1,25,58±0,924,46±1,2
Platelets386±1,2405±0,68387±1,6404±0,58286±1,2
Prothrombin index120±0,2118±0,4118±0,2121±0,268±1,6
Glucose7,18±1,137,18±1,127,19±1,127,18±1,13*6,03±0,95**
Note:
*reliability of differences from normal values (p<0,05)
** reliability of differences from normal values (p<0,01)

Table 13
Dynamics of clinical parameters in patients after treatment for 11-13 days
IndicatorsPatients, n=68Healthy n=20
group 1group 2group 3group 4
The leukocyte number. 1 l6,8±1,1*7,1±1,1*7,3±1,1*7,4±1,1*6,3±1,1*
ESR, mm/h9,3±2,0*9,6±2,0*9,5±1,0*9,8±1,0*9,0±1,0*
SLO2,2±0,8*2,3±0,8*2,4±1,2*2,4±0,5**2,5±2,2*
Seromukoidy262±2,38271±2,29270±2,34272±2,36257,6±2,46
Sialic acid625±4,6665,4±4,79 676,2±4,54711,7±to 4.52645±4,05
Total protein g/l62,8±3,464,5±2,864,4±3,274,2±2,966,2±3,1
Fibrinogen g/lto 4.52±1,34,86±0,925,16±1,25,28±0,924,46±1,2
Platelets256±1,2285±1,2321±0,6324±0,4254±0,6
Prothrombin index68±1,688±1,498±1,2102±1,468±0,8
Glucose4,4a 4.95,1of 5.44,3
Note: *reliability of differences from normal values (p<0,05)

Table 14
The range of lipid metabolism at admission
IndicatorsPatients n=68Healthy n=20
group 1group 2group 3group 4
Total cholesterol, mmol/l7,16±0,247,17±0,24of 6.96±0,237,21±0,235,32±0,27**
TG, mmol/l4,03±0,093,75±0,083,84±0,08was 4.02±0,082,86±0,08
LDL cholesterol, mmol/l5,13±0,225,16±0,214,86±0,23to 4.92±0,223,71±0,21*
HDL cholesterol, mmol/l1,03±0,031,03±0,0021,04±0,0021,03±0,0031,11±0,03**
Haemoglobin rate of 6.96±0,316,48±0,31of 6.68±0,326,57±0,324,79±0,3**
*the significance of differences before and after treatment (p<0.05)and ** significance of differences before and after treatment (p<0,01)

The average for the group (table-15) was determined moderate violations in the form of hypercholesterolemia, hypertriglyceridemia, and reduced HDL. In addition to reducing the concentration of total cholesterol was observed a statistically significant decrease of LDL cholesterol (17.1%) with a simultaneous increase of the HDL cholesterol level (6.9 per cent). During treatment there was a trend of decrease in TG.

Tabl
The range of lipid metabolism after treatment at 11-13 days
IndicatorsPatients n=68Healthy n=20
group 1group 2group 3group 4
Total cholesterol, mmol/lof 5.34±0,24lower than the 5.37±0,24are 5.36±0,23 lower than the 5.37±0,235,31±0,26**
TG, mmol/l2,83±0,082,85±0,083,02±0,083,05±0,072,84±0,08
LDL cholesterol, mmol/l3,66±0,213,71±0,213,76±0,224,05±0,213,71±0,21*
HDL cholesterol, mmol/l1,12±0,031,08±0,0021,08±0,0021,05±0,0031,11±0,03**
Haemoglobin rate4,56±0,31to 4.98±0,32of 5.34±0,32lower than the 5.37±0,324,79±0,3**
*the significance of differences before and after treatment (p<0.05)and **significance of differences before and after treatment (p<0,01)

Table 16
Echocardiographic indicators of the functional status of the left ventricle of patients before treatment
Indicatorsgroup 1group 2group 3group 4Healthy
The CRA LV, cm5,22±0,545,23±0,535,24±0,565,22±0,574,74±0,64
DAC LV, cm3,70±0,343,71±0,223,72±0,253,80±0,233,14±0,16
FU LV, %25,26±of 4.4426,26±4,4326,16±4,5426,24±4,4734,90±3,67
The LV EDV, ml123,1±being 9.61122,5±9,5122,8±9,59123,4±9,7109,5±9,23
CSR LV, ml59,78±6,660,14±6,5459,71±6,7259,74±6,6241,71±are 5.36
UO LV, ml61,87±7,161,77±7,1261,82±7,1061,79±7,1368,51±6,97
MO LV, l/min4,72±0,92to 4.73±0,904,71±0,974,72±0,934,63±0,83
LVEF, %50,3±7,151±7,0950,31±7,150,3±7,163,9±6,32
IM LV,. ml/m241,9±4,2441,91±4,2341,93±4,2341,9±4.26 deaths47,2±3,36
SI LV, min/m23,18±0,43,19±0,413,18±0,43,19±0,43,15±0,31
ADJ. LV d./0,82±0,090,82±0,070,84±0,070,83±0,091,12±0,15
KDR - end-diastolic size, DAC - end-systolic dimension, FU LV - fraction shortening of the left ventricle, LV EDV - end-diastolic volume, CSR LV end-systolic volume, PP LV stroke volume of the left ventricle, MO LV - minute volume of blood the left ventricle, LV EF - ejection fraction of the left ventricle, IM LV stroke index, SI LV cardiac index. ADJ. LV is the velocity of the left ventricle.

From table 16 it is evident that in patients with dilatation of the left ventricle, which is manifested by increased end-diastolic and systolic volumes. This is accompanied by a decrease in stroke volume in patients in the studied groups. The consequence of this reduction in emissions with a concomitant increase in end-diastolic volume is the drop ejection fraction in patients with OA and reduction of shock index in comparison with healthy. The emission reduction did not significantly affect the minute volume of blood circulation due to a compensatory increase in heart rate: measures cardiac output is approximately equal in all groups. Also almost equal were indicators of cardiac index. The increase in end-diastolic volume in the examined patients with inadequate increase in end-systolic volume leads to a decrease in the fraction shortening of the left who ludacka and speed of the left ventricle (table 17).

Table 17
ECHO-cardiographic the indicators of the functional status of the left ventricle in patients after treatment (11-13 days)
Indicatorsgroup 1group 2group 3group 4Healthy
The CRA LV, cm4,69±0,684,71±0,614,70±0,624,71±0,624,71±0,61
DAC LV, cm3,13±0,193,13±0,153,14±0,163,14±0,153,13±0,18
FU LV, %33,89±3,5332,96±3,5631.90 beef±3,6231,86±3,5434,87±3,64
The LV EDV, ml109,5±9,2111,5±9,25of 114.3±9,2to 114.4±which 9.22to 109.6±9,2
The COP is LV, ml41,7±5,2641,72±5,2641,72±are 5.3641,72±5,3841,69±5,32
UO LV, ml66,651±of 5.8964,75±6,7664,61±6,8765,34±6,8768,51±6,97
MO LV, l/minand 4.68±0,78and 4.68±0,82and 4.68±0,834,69±0,684,63±0,81
LVEF, %61,7±6,2860,9±6,360,7±of 6.3159,9±6,363,9±6,3
IM LV, ml/m246,8±3,2445,8±3,2245,2±3,2344,8±3,2247,6±3,32
C
LV, min/m2
3,16±0,283,16±0,33,16±0,313,17±0,323,15±0,32
ADJ. LV d./1,54±0,12 1,62±0,161,64±0,21,75±0,161,12±0,14
KDR - end-diastolic size, DAC - end-systolic dimension, FU LV - fraction shortening of the left ventricle, LV EDV - end-diastolic volume, CSR LV end-systolic volume, PP LV stroke volume of the left ventricle, MO LV - minute volume of blood the left ventricle, LV EF - ejection fraction of the left ventricle, IM LV stroke index, SI LV cardiac index. ADJ. LV is the velocity of the left ventricle.

According to the Smad in patients with OA was observed the increase in blood pressure both during wakefulness and during sleep (table, 19). In the study groups there was a higher level of the middle of the GARDEN (p<0.05) in the daytime. Daily values of mean DBP between groups did not differ. Diastolic blood pressure in groups is not decreased at night, but no significant differences were found.

Thus, patients in the studied groups had stable type hypertensive syndrome (YVES GARDEN in the daytime and nighttime >50%), insufficient reduction of blood pressure at night ("non-dipper").

Tabl
Indicators of Smad in groups of patients with postplan and
Indicatorsgroup 1group 2group 3group 4Healthy
Daily indicators GARDEN222,1±24,2218,3±21,7224,0±21,2218,8±23,2120,1±0,6
Daily indicators dad84,6±1,886,2±1,484,6±2,184,6±2,272,6±1,6
Day Average GARDEN, mm Hgof 148.4±1,4152,2±1,1148, 8 persons±1,5to 150.2±1,1120,2±0,9
Day Average DBP, mm Hg83,2±1,278,2±1,281,2±1,481,2±1,273,8±1,2
Day YVES GARDEN, %55,8±3,255,8±3,255,8±3,255,8±3,21,4±1,1
Day IVE DBP, %35,3±3,836,2±3,135,6±3,635,4±3,95,2±1,6
At night the Average GARDEN, mm Hg136±1,2126,2±1,1to 112.2±1,4106,4±1,4to 108.3±1,3
At night the Average DBP, mm Hg74,4±1,178,6±1,4is 78.4±0,976,4±1,868,4±1,2
Night WILLOWS GARDEN, %56,8±5,658,4±5,459,2±4,260,0±4,22,4±1,1
Night IVE DBP, %43,6±5,445,2±4,244,6±5,144,6±4,611,9±3,1
YVES - time index.

Daily averages GARDEN(224,0±21,2%-218,3±21,7%) and dad(65,8±13,0%-64,6±12,4%) in patients studied statistically significantly higher than in healthy subjects. Average daily and srednesrocnye on the simple GROUNDS were also significantly (p< 0,01) higher among patients with OA, as well as srednesrocnye indicators dad was also significantly higher (p<0,01) in patients with OA.

Table 19
Indicators of Smad in groups of patients after treatment (11-13 days)
Indicatorsgroup 1group 2group 3group 4Healthy
Daily indicators GARDEN122,2±0,4126,0±0,2of 124.1±0,4126,1±0,6120,1±0,2
Daily indicators dad68,8±2,672,6±1,472,2±0,671,6±1,868,6±1,6
Day Average GARDEN, mm Hgof 124.6±1,4128,2±1,2to 132.8±1,2138,2±1,4to 120.4±1,4
Day Average DBP, mm Hg74,2±1,174,8±18 an 80.2±1,278,2±1,272,8±1,4
Day YVES GARDEN, %24,2±2,225,3±2,224,8±2,625,4±2,31,4±1,2
Day IVE DBP, %15,1±1,316,2±1,416,±2,616,8±2,95,1±1,2
At night the Average GARDEN, mm Hg109,2±1,2of 111.2±0,6110,2±1,6110,6±1,6109,2±0,9
At night the Average DBP, mm Hg68,4±1,1870,6±1,471,4±1,272,4±1,269,2±1,6
Night WILLOWS GARDEN, %2,6±1,42,4±1,62,8±1,12,4±1,62,4±1,1
Night IVE DBP, %11,9±3,111,9±3,111,9±3,1 11,9±3,111,9±3,1

Significantly decreased daily averages GARDEN under the action of the treatment, i.e. in 1 group. Average daily and srednesrocnye indicators GARDEN was also significantly (p<0,01) lower in group 1, and srednesrocnye indicators DBP compared with other groups.

Thus, the claimed method has the following advantages:

1. Treatment of the claimed group of patients using the combined low-intensity laser radiation (the combination of the contact exposure of the joints and venous irradiation of blood) can achieve long-term remission, i.e. has a prolonged action.

2. The use of combined laser therapy significantly reduces, and in some cases, and the abolition of the drug load, thus avoiding the side effects associated with their reception.

3. In the process of combined laser therapy is not detected phenomena "syndrome" or habituation, the proposed technique has a full safety and simplicity of the technology.

4. The proposed method combined combination of the contact exposure of the joints and venous irradiation of blood improves the efficiency of treatment of patients with osteoarthritis by correction of cardiovascular disorders and meta is oricheskogo syndrome.

Method of treatment of patients with osteoarthritis and cardiovascular disorders in the metabolic syndrome, including the implementation of the effects of low-intensity laser radiation (NEELY), characterized in that carry venous blood irradiation with a wavelength of 405 nm, the power at the end of the light guide 1.5 mW, for a total duration of procedure 5 min, then carry out a contact exposure of joints: with a wavelength of 630 nm, a pulse power of 10 W, a frequency of 80 Hz, and knee joints exposed for 2 min with 4 sides and with labile technique by scanning the beam along the joint space 2 min, hips: affected by the area of the projection of papatowai ligament, greater trochanter, ischial tuberosity for 2 min and using labile technique by scanning the beam along the joint space 4 min, the rate impact NEELY includes 10 daily sessions.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention refers to physiotherapeutic apparatuses and is applicable for vitality recovery after damaging exercises and mental overload, and for treating various diseases by laser reflex therapy. A presented apparatus comprises a handle body which integrates a laser diode coupled with a control unit with emission brought outside through an outlet on a pointed handle tip. A side surface of the handle comprises a general electrode also connected with the control unit. The control unit is connected to a power supply unit. In the presented apparatus, the power supply unit and the control unit are integrated in the handle, on an internal side surface of the outlet, there is an acupuncture point detector represented by a thin metal core of the diameter no more than 1 mm one end of which is bent so that it gets into a laser beam, and another one is connected to the control unit.

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FIELD: medicine.

SUBSTANCE: claimed invention relates to ophthalmology, namely to ophthalmic oncology and is intended for organ-preserving treatment of intraocular tumours. Transpupillary PDT is performed. After 3-20 days treansscleral PDT is carried out. After tumour devitalisation, total vitrectomy and endoresection of tumour is performed. Vitreous cavity is filled with substitute of vitreous body and laser coagulation of retina is carried out.

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FIELD: agriculture.

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FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to cardiology and laser therapy, and may be used in treating the patients with ischemic heart disease (IHD) or patients with IHD combined with diabetes. A method involves standard therapeutic treatment of the disease. Before the beginning of treatment, blood glucose and total blood cholesterol are evaluated. If blood glucose in the patients with IHD is less than 4.75 mmol/l and total blood cholesterol in the patients with IHD combined with diabetes is less than 5.5 mmol/l, laser therapy is additionally prescribed.

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1 tbl

FIELD: medicine.

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3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment and can be used for treatment of tuberculosis, open wounds, ETN diseases and in gynecology. Multiwave laser system contains laser emitter with radiation wavelength 1.06 mcm, with pump system, power source, control system, converter of radiation into visible and ultraviolet region of spectrum on linear crystals, system of isolation of spectrum sections and fiber-optic system of laser radiation transport. Laser emitter is made in form of solid-state driving oscillator with longitudinal pump by semiconductor diode 21, which contains active element 25, made with possibility to generate radiation with σ-polarisation, and passive Q-switching.

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4 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly gastoenterology, reflexotherapy, physiotherapy. It involves a conventional drug-induced therapy of chronic pancreatitis. It is added with the antidepressant azaphen 75 mg daily in clinically apparent affective disorders, 50 mg daily in subclinically apparent affective disorders for 30 days. Magnetic laser puncture is performed with considering a vegetative balance state. One biologically active point is exposed to modulated wave length 1.3 mcm, frequency 2.4 Hz, magnetic induction 50 mT for 10-30 seconds. Sympathicotonia requires sequential sedation of the point GI 4 and toning of the points. E 25, E 36, MC 6. Vagotonia requires toning of the point GI 4 and sedation of the points E 25, E 36, MC 6. It is accompanied with transcutaneous magnetic laser exposure at wave length 0.89 mcm with using a magnetic tip 150 mT. A solar plexus area, a projection of pancreas, a projection of gall bladder are covered for 2 minutes. In manifested pain syndrome, the exposure starts at the frequency of 820 Hz to be decreased to 80 Hz. In weak pain syndrome, the frequency of 360 Hz is gradually decreased to 80 Hz. In the absence of pain syndrome, the exposure is applied at the frequency of 80 Hz.

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2 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely ophthalmology. A method involves introducing a photosensitiser (PS) in a patient's body that is followed by retinal exposure to laser light. Chlorine photosensitiser 0.4-0.5 mg/kg is intravenously injected for 10 minutes. Immediately after the PS introduction, ischemic areas and retinal neovascularisation areas are exposed to transpupillary laser light. That is ensured by laser light at wave length matched to maximum PS adsorption of optical emission. Power density makes 50-75 J/cm2.

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FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely ophthalmology. A method involves the intravenous drop-by-drop introduction of chlorine photosensitiser (PS) 0.4-0.5 mg/kg for 10 minutes. Immediately after the PS introduction, filtration points are exposed to transpupillary laser light on the basis of fluorescent angiography values. That is ensured by laser light at wave length matched to maximum PS adsorption of optical emission. Power density of the exposure is 20-25 J/cm2.

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FIELD: medicine.

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14 dwg

FIELD: medicine.

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3 cl, 5 dwg

FIELD: medicine.

SUBSTANCE: method involves making incision in conjunctiva and Tenon's capsule of 3-4 mm in size in choroid hemangioma projection to sclera 3-4 mm far from limb. Tunnel is built between sclera and Tenon's capsule to extrasclerally introduce flexible polymer magnetolaser implant through the tunnel to the place, the choroid hemangioma is localized, after performing transscleral diaphanoscopic adjustment of choroid hemangioma localization and size, under visual control using guidance beam. The implant has permanent ring-shaped magnet in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 2-3 mTesla units intensity. It is arranged with its north pole turned towards the choroid hemangioma so that extrascleral implant laser radiator disposition. The other end of the implant is sutured to sclera 5-6 mm far from the limb with two interrupted sutures through prefabricated openings. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. 0.1-1% khlorin solution is injected in intravenous bolus dose of 0.8-1.1 mg/kg as photosensitizer and visual control of choroid hemangioma cells fluorescence and fluorescent diagnosis methods are applied. After saturating choroid hemangioma with the photosensitizer to maximum level, transscleral choroid hemangioma laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm with total radiation dose being equal to 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the intraocular neoplasm, repeated laser irradiation of the choroid hemangioma is carried out with radiation dose of 30-60 J/cm2.

EFFECT: enhanced effectiveness of treatment.

4 cl

FIELD: medicine.

SUBSTANCE: method involves creating tunnel between sclera and Tenon's capsule in intraocular neoplasm projection. Intraocular neoplasm localization and size is adjusted by applying transscleral diaphanoscopic examination method. 0.1-0.3 ml of photosensitizing gel based on viscoelastic of hyaluronic acid, selected from group containing chealon, viscoate or hyatulon, is transsclerally introduced into intraocular neoplasm structure using special purpose needle in dosed manner. The photosensitizing gel contains khlorin, selected from group containing photolon, radachlorine or photoditazine in the amount of 0.1-1% by mass. Flexible polymer magnetolaser implant is extrasclerally introduced into the built tunnel in intraocular neoplasm projection zone under visual control using guidance beam. The implant has permanent ring-shaped magnet axially magnetized and producing permanent magnetic field of 3-4 mTesla units intensity, in the center of which a short focus scattering lens of laser radiator is fixed. The lens is connected to light guide in soft flexible envelope. The implant is arranged with its north pole turned towards the intraocular neoplasm so that implant laser radiator lens is extrasclerally arranged in intraocular neoplasm projection zone. The implant light guide is sutured to sclera 5-6 mm far from the limb with single interrupted suture. The implant is covered with conjunctiva and relaxation sutures are placed over it. Light guide outlet is attached to temple using any known method. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transscleral intraocular neoplasm laser radiation treatment is carried out via laser light guide and implant lens using divergent laser radiation at wavelength of 661-666 nm. The treatment course being over, the flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, neodymium-iron-boron or samarium-iron-nitrogen. 0.1-1% khlorin solution as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is additionally intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg and repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2 15-20 min later during 30-90 s.

EFFECT: complete destruction of neoplasm; excluded its further growth.

4 cl

FIELD: medicine.

SUBSTANCE: method involves applying transscleral diaphanoscopic examination method for adjusting intraocular neoplasm localization and size. Rectangular scleral pocket is built 2/3 times as large as sclera thickness which base is turned from the limb. Several electrodes manufactured from a metal of platinum group are introduced into intraocular neoplasm structure via the built scleral pocket. Next to it, intraocular neoplasm electrochemical destruction is carried out in changing electrodes polarity with current intensity of 100 mA during 1-10 min, and the electrodes are removed. Superficial scleral flap is returned to its place and fixed with interrupted sutures. 0.1-2% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, transpupillary laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2. the operation is ended with placing sutures on conjunctiva. Platinum, iridium or rhodium are used as the metals of platinum group. The number of electrodes is equal to 4-8. 0.1-1% khlorin solution, selected from group containing photolon, radachlorine or photoditazine, is additionally repeatedly intravenously introduced in 2-3 days at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells is carried out by applying fluorescence and fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, repeated laser irradiation of the intraocular neoplasm is carried out with radiation dose of 30-45 J/cm2.

EFFECT: complete destruction of neoplasm; excluded tumor recurrence; reduced risk of tumor cells dissemination.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: the present innovation deals with treating vascular cutaneous neoplasms, such as nevus flammeus and gemangiomas. Light-thermal impact at energy ranged 39-47 J/sq. cm should be performed in two stages, and between them, 2-3 wk after the onset of vascular resistance at the first stage one should perform beta-therapy daily for 2-3 d at single dosage being 20 g. Then, 3 wk later it is necessary to conduct the second stage of light-thermal impact by starting at energy value being 42 J/sq. cm, not less. The method enables to shorten therapy terms due to applying combined method to affect vascular cutaneous neoplasms.

EFFECT: higher therapeutic and cosmetic effect.

1 ex

FIELD: medicine.

SUBSTANCE: method involves intravitreously introducing two electrodes into intraocular neoplasm after carrying out vitrectomy and retinotomy to expose the intraocular neoplasm. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with current intensity of 100 mA during 1-10 min or 10 mA during 10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2.The transformed retina and tumor destruction products are intravitreally removed. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. Another embodiment of the invention involves adjusting position and size of the intraocular neoplasm in trans-scleral diaphanoscopic way. Rectangular scleral pocket is built above the intraocular neoplasm to 2/3 of sclera thickness with its base turned away from limb. Several electrodes are introduced into intraocular neoplasm structure via the built bed. The electrodes are manufactured from platinum group metal. Electrochemical destruction is carried out with the same current intensity in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. Superficial scleral flat is returned to its place and fixed with interrupted sutures. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg after having carried out vitrectomy and retinotomy. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous laser radiation is carried out in parallel light beam of wavelength equal to 661-666 nm is applied at a dose of 30-120 J/cm2. The transformed retina and tumor destruction products are intravitreally removed using vitreotome. Boundary-making endolasercoagulation of retinotomy area is carried out after having smoothed and compressed retina with perfluororganic compound. The operation is finished with placing sutures on sclerotomy and conjunctiva. Platinum, iridium or rhodium are used as the platinum group metals. The number of electrodes is equal to 4-8.

EFFECT: reduced risk of metastasizing.

4 cl, 13 dwg

FIELD: medicine.

SUBSTANCE: method involves building tunnel to posterior eyeball pole in inferoexterior and superexterior quadrants. The tunnel is used for implanting flexible polymer magnetolaser implant to the place, the subretinal neovascular membrane is localized. The implant has a permanent magnet shaped as a cut ring and is provided with drug delivery system and a short focus scattering lens of laser radiator connected to light guide. The permanent implant magnet is axially magnetized and produces permanent magnetic field of 5-7 mTesla units intensity. It is arranged with its north pole turned towards sclera at the place of the subretinal neovascular membrane projection with extrascleral arrangement of laser radiator lens membrane being provided in the subretinal neovascular membrane projection area. The other implant end is sutured to sclera 5-6 mm far from the limb via holes made in advance. The implant is covered with conjunctiva and retention sutures are placed thereon. Light guide and drug supply system lead is attached to temple with any known method applied. Drugs are supplied via the implant drug supply system in retrobulbary way in any order. Triombrast is given in the amount of 0,4-0,6 ml and dexamethasone or dexone in the amount of 0,4-0,6 ml during 3-4 days every 12 h. 0.1-1% aqueous solution of khlorin is intravenously introduced at the third-fourth day after setting the implant as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, at a bolus dose of 0.8-1.1 mg/kg. Visual control of subretinal neovascular membrane cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the subretinal neovascular membrane with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at general dose of 30-120 J/cm2. The flexible polymer magnetolaser implant is removed and sutures are placed on conjunctiva. Permanent magnet of the flexible polymer magnetolaser implant is manufactured from samarium-cobalt, samarium-iron-nitrogen or neodymium-iron-boron system material. The photosensitizer is repeatedly intravenously introduced at the same dose in 2-3 days after the first laser radiation treatment. Visual intraocular neoplasm cells fluorescence control is carried out using fluorescent diagnosis techniques. Maximum level of saturation with the photosensitizer being achieved in the subretinal neovascular membrane via laser light guide and implant lens, repeated laser irradiation of the subretinal neovascular membrane is carried out with radiation dose of 30-60 J/cm2.

EFFECT: accelerated subretinal edema and hemorrhages resorption; regression and obliteration of the subretinal neovascular membrane; prolonged vision function stabilization.

6 cl

FIELD: medicine.

SUBSTANCE: method involves filling vitreous cavity with perfluororganic compound. Two electrodes manufactured from platinum group metal are intravitreally, transretinally introduced into intraocular neoplasm. Electrochemical destruction is carried out with current intensity of 10-100 mA during 1-10 min in changing electrodes polarity and their position in the intraocular neoplasm space, and the electrodes are removed. 0.1-1% aqueous solution of khlorin as photosensitizer, selected from group containing photolon, radachlorine or photoditazine, is intravenously introduced at a dose of 0.8-1.1 mg/kg. Visual control of intraocular neoplasm cells fluorescence is carried out by applying fluorescent diagnosis methods. After saturating the intraocular neoplasm with the photosensitizer to maximum saturation level, intravitreous, transretinal laser radiation of 661-666 nm large wavelength is applied at a dose of 30-120 J/cm2 in perfluororganic compound medium. The transformed retina and tumor destruction products are intravitreally removed with perfluororganic compound volume being compensated with its additional introduction. Boundary-making endolasercoagulation of retinotomy area is carried out. The perfluororganic compound is substituted with silicon oil. The operation is ended in placing sutures over sclerotmy areas and over conjunctiva. Perfluormetylcyclohexylperidin, perfluortributylamine or perfluorpolyester or like are used as the perfluororganic compound for filling vitreous cavity. Platinum, iridium or rhodium are used as the platinum group metals.

EFFECT: complete destruction of neoplasm; reduced dissemination risk.

6 cl, 12 dwg

FIELD: medicine, applicable for stopping of pains of various nature.

SUBSTANCE: the device has a quantum-mechanical oscillator located in a casing, magnet, vessel for medicinal agent and a hollow cylinder. The magnet is installed between the oscillator and the vessel. Positioned in the vessel is a hollow cylinder having through holes on its surface.

EFFECT: quick and absolute anestesia.

2 ex, 1 dwg

FIELD: medicine.

SUBSTANCE: method involves administering laser radiation therapy once a day using low intensity pulsating radiation of wavelength equal to 890nmand power density of 0.03 mW/cm2. Injured organ projection to frontal abdominal wall is exposed to radiation at the first laser therapy stage in two fields acting upon each field for 2 min with radiation pulse succession frequency equal to 80 Hz in applying stable contact-type method. Total treatment dose on two fields is equal to 0.008 J/cm2. The second laser therapy stage begins immediately after having finished the first one in applying radiation along the large intestine path using labile contact-type method in a way that radiation pulse succession frequency equal to 80 Hz is applied first during 1 min and then frequencies of 600, 150 and 300 Hz are applied also during 1 min, respectively. Total treatment dose is equal to 0.032 J/cm2 at the second stage. Total treatment dose is equal to 0.04 J/cm2 at both stages.

EFFECT: enhanced effectiveness in inhibiting dysbacteriosis; reduced frequency of postoperative complications.

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