Method of treating osteoarthrosis with underlying hypertension
SUBSTANCE: invention refers to medicine, namely physiotherapy. The invention involves joint exposure to diadynamic currents generated by the Tonus-2 apparatus. The joints are exposed through electrodes applied on a technological fill piece impregnated with 1% placenta hydrolysate. The full-wave continuous electrical current is used for the exposure for 15 minutes. The current intensity is selected to ensure the evident vibration under the electrodes. If the hip joint is exposed, the first electrode is placed in an external area of buttock backwards to a greater trochanter, and the second one - on an anterior surface of hip in an upper mid-third. If a knee joint is exposed, the first electrode is placed from the side of pain wherein localised, in a lower and upper torsion, while the second electrode is placed below or above a knee cap respectively. It is followed by the exposure to the pulse low-frequency non-thermal intensity electromagnetic field generated by an emitter of the INFITA apparatus. The exposure is contactless, the distance of eyes and the emitter is 25 cm. Pulse repetition frequency is 30-40-57 Hz. Length of the exposure is 3-5-9 minutes, at each specified frequency respectively. The procedures are daily. The therapeutic course is 10 procedures.
EFFECT: method enlarges motion activity of the patient and maintains normal blood pressure.
2 ex, 2 tbl
The invention relates to medicine, in particular physiotherapy in the rehabilitation of patients with osteoarthritis of large joints in the period of exacerbation on the background of arterial hypertension.
Osteoarthritis is the most common form of joint damage and one of the main causes of disability, which causes deterioration in the quality of life and considerable financial costs, especially in the elderly. Meets osteoarthritis everywhere. In the U.S., it hurts 21 million people (about 7% of the population). Large-scale study in 7 cities of the former USSR have revealed manifest (accompanied by clinical symptoms) osteoarthritis have to 6.43% (41348 people aged over 15 years). The incidence of osteoarthritis increases sharply with age, reaching a third of the population in elderly and senile age. Among patients with osteoarthritis at a young age dominated by men, and elderly women [Korzh N.A., Filippenko, VA, Dedukh N.V. Osteoarthritis - treatment approaches. // Visnyk ortoped travmatolog protezuvannya. - 2004. No. 3. - P.75-79. Berlizov M.A., Ognovenko VI, Naderev V.M. Complex treatment of patients with heavy violations of function of the lower extremities in the outpatient setting. Manual for doctors. - M.: cyto, 1999. - 28 S.].
Treatment of osteoarthritis deformans is often symptomatic with the use of the funds directed the military to slow down the progression of the disease, reduce the pain. However, the use of medicines in patients with deforming osteoarthrosis frequently observed side effects and complications of the gastrointestinal tract. At the same time the appointment of physiotherapy in the age group of patients in most cases accompanied by hypertension, which cannot be assigned thermal physical factors or pulsed low-frequency currents having analgesic effect.
Note that one of the leading patterns of aging is the decrease of regulatory and adaptive capacity of the organism, the plurality of pathology. In this regard, the use of physical factors in individuals older age requires new approaches to the choice of therapeutic techniques and dosing effects as traditional methods are not always able to be used due to the high probability of inadequate and misguided response of patients to treatments. In geriatric practice in the appointment of physiotherapy treatment should be considered polymorbidity and associated with this a large range of contraindications. According to Liebergesell et al. should adhere to principles such as the selection of the main disease, the reduction in the dosage of drugs during electrophoresis, reducing the duration of exposure at the beginning of a course of treatment, use the most appropriate physiotherapeutic procedures [Sergeev LI, Ivanova N., Ponomareva T.V., She O.V. the Role of physiotherapy methods in treatment of elderly patients. // Abstracts of the 11th International scientific-practical conference "Elderly patients. Quality of life". // Clinical gerontology. - 2006. No. 9. - S]. Geedorah believes that in the treatment of elderly patients the benefits are physical factors local operations in low intensity [Egorova GI Features physiotherapy in elderly and senile age: a Training manual. - L., 1984. - 23 S.]. Implemented with success in other cases, increasing the intensity of influencing physical factors in order to achieve the required therapeutic effect here is unacceptable due to the danger of provocation pathological reactions deterioration of health and functional status of older people.
To increase the effectiveness of treatment requires a comprehensive approach to this complex and socially significant problems and the search for new promising and relatively safe factors, which include physical factors (Eleronov. International decade devoted osteo-articular disorders 2005-2010. - Breast cancer, vol.10, 22, 2002). The main task of natural and preformed factors is to improve the trophic TC is her joints and the effects on the neurohumoral mechanism of response of the organism as a whole, the increase in total system adaptation that will contribute to long-term remission and improve the quality of life of the patient. Thus, the search for methods of rehabilitation of patients with deforming osteoarthrosis today has not lost its relevance and requires new approaches to the development of medical technologies in this group of patients.
Known methods of physiotherapy treatment of osteoarthritis in patients with pronounced changes of the joints scalp-stimulating methods of low-frequency impulse electrotherapy: diadynamic currents, sinusoidal modulated currents and interference.com. Low-frequency factors at the coincidence frequency modulation and sequence of action potentials in nerve fibers In type activate the trophic influence of the sympathetic nervous system and local humoral defense mechanisms. Under the action of the pulse current by reducing the myofibrils of skeletal muscles and smooth muscles of blood vessels increases blood flow and increases the number of active communications and collaterals, which improves hemodynamics, trophic, metabolic processes in the joint [Private physiotherapy. - Edited Genpharma. Educational materials for students of the postgraduate education system. - Moscow.: Medicine, 2005, str].
However, these methods are effective only the initial stage of the disease, have contraindications to the use in cases with concomitant hypertension, the effect of the application is saved only 3-4 weeks.
The closest in technical essence is a method of treating osteoarthritis deformans method of physiotherapy by exposure diadynamic currents, their impact on the affected major joints: the hip and knee. When exposed to the hip joint method is that the patient lying on the back have the electrode with a size of 8×12 cm in the outer area of the buttocks posterior to the greater trochanter, the second electrode size 12×16 cm on the anterior surface of the femur in the upper third. When the impact on the knee method is that the patient lying on the back have the electrode with a size of 5×10-14 cm (on the side of the pain somewhat smaller in the localization of pain in the bottom or top of the inversion is applied to the electrode 6×8 cm, the second electrode 8×10 cm, respectively, above or below the kneecap. The diadynamic therapy spend apparatus of the "Tone-2". Settings current when the leave procedure: a full-wave wave - 2-3 minutes; a short period of time - 2-3 minutes; a long period of 2-3 minutes. Current gradually increases until expressed, but napoletani sensations of vibration under the electrodes. Procedures the wire is t daily or every other day for a course of 12 treatments [Technique and methods of physiotherapeutic procedures /Handbook/ edited Vmmolotova. - Moscow. - 2006, p.72].
This method causes primarily an analgesic effect. Irritation of the peripheral nerve endings, increasing the threshold to pain sensitivity, and positive influence on the processes in Semizorova tissues, the autonomic regulation, beneficial effect on the immune and reparative activity through the activation of the blood and lymph circulation (Mgorobets, Genpharma. Handbook on electromagnetotherapy. - Hippocrates. - 2002, - s - 185).
However, this method has drawbacks:
- is only effective in 20% of geriatric patients;
- pain effect short up to 3-4 weeks.
therapeutic effect is achieved only when changes 1-2 stages of the articular process;
pulse currents are contraindicated in severe hypertension in geriatric patients.
THE OBJECTIVE OF THE INVENTION.
Improving the efficiency of treatment of deforming osteoarthritis of large joints in patients with different severity of the pathological process in the background of concomitant hypertension, due to the impact of diadinamophoresis 1% solution of the hydrolyzate of the placenta on the joints and additional effects of low intensity pulsed low-frequency electromagnetic field, the overall impact of INVITE touchless sensor therefore is ktym method with a complete course of treatment without increasing blood pressure.
This object is achieved in that in the treatment of osteoarthritis in patients with hypertension conduct impact diadynamic currents of the device, "Tone 2" on the hip and knee joints with the patient lying on his back through the electrodes with the technological pad moistened with a solution. When issuing procedures use electric current full wave continuous 15 minutes Working current pick up when expressed sensations of vibration under the electrodes. The electrodes have when exposed to hip - first into the outer area of the buttocks posterior to the greater trochanter, the second on the anterior surface of the femur in the upper third. When the impact on the knee the first electrode is disposed on a side of pain in place of its localization in the area of the bottom or top of the inversion, the second electrode, respectively, above or below the kneecap.
When exposed diadynamic currents as a solution for technological strip using 1% solution of the hydrolyzate of the placenta. Then further carry out the action of the pulsed low-frequency electromagnetic field of non-thermal intensity in a non-contact method from the emitter apparatus INVITE patient is in sitting position with a distance from the eyes to the emitter 25 cm when the pulse frequency 30-40-57 Hz, 3-5-9 min is t, corresponding to each frequency. The course of treatment 10 treatments daily.
The novelty of the method:
Additionally impose a 1% solution of the hydrolyzate of the placenta method diadinamophoresis in the area of pathologically altered the hip or knee.
- Conduct impact from the apparatus INVITE low-intensity pulsed low-frequency electromagnetic field of non-thermal intensity in a non-contact method patient is in sitting position with a distance from the eyes to the emitter of the device 25 cm when the parameters of the frequency 30-40-57 Hz, 3-5-9 minutes each frequency, daily rate up to 10 treatments.
The essential features of the invention allows to obtain a new technical result:
- Significantly reduce votilitile-degenerative process and reduce pain;
To normalize the static-dynamic function of the musculoskeletal system and increase the amount of motion in the joints;
To realize the full course of treatment on the background of concomitant hypertension without increasing blood pressure.
Criterion impact on the affected joint diadynamic currents in the form of a push-pull half-cycle was the mechanism of action of factor: diadynamic currents (DDT) excite moulinsiana conductors somatosensory system (skin and muscle afferents)belonging to β-fibers. East is CNIC these types of current - the device DT-50-3 produced Malojaroslavsky instrument factory. The resulting excitation pulses thick myelination fibers extend in the direction of gelatin substance posterior horns of the spinal cord and then to the Central nervous system, activating endogenous opioid and serotoninergicheskie system of the brain stem and causing the formation of a dominant source of excitation in the cortex. Last under the law of negative induction suppresses pain dominant in the cortex and activates the parasympathetic centers of the nervous system, which leads to the reduction of the patient's pain until the complete analgesia. The development of pain-inhibitory action contributes also called DDT intense release of endorphins. Is set to decrease the conductivity and the change lability β - and C-fibers, so that the impulses from pain center is not entered in the Central nervous system.
Formed as a result of activation of cortical and subcortical centers descending efferent impulse flows increase the speed of blood flow in the affected organs and tissues, activate the trophic influence of the sympathetic nervous system and local defense mechanisms.
DDT also directly call the rhythmic contraction of the myofibrils of skeletal muscles and smooth muscles of blood vessels. This, together with the reflex mechanism is increased cabin is on blood flow and improve microcirculation, and also increases the number of functioning anastomosis and collaterals, which, in turn, activates the metabolism and slightly raises the temperature of the tissue. The contraction of smooth muscles of blood vessels causes an increase in venous outflow redistribution of ions and water in the interstitium, helps to remove the products of autolysis of cells, dehydratase tissues and reduce swelling, which is accompanied by improvement of their functional properties. At the same time the form of the current (push-pull half-cycle), selected for technique, allows the introduction of medicinal substances, as is the continuous nature of the pulse.
The result of the action of DDT is the effect of anesthesia, mineralisable, vasoactivity and tristimuli in affected joints (V.s.ulaschik. Physiotherapy. Universal medical encyclopedia. - Minsk. The book house. - 2008, str).
The selection criterion of 1% solution "of placentae was pathogenetic validity of the method of exposure of the drug in chronic degenerative and inflammatory diseases of the joints as anti-inflammatory, stimulating, immunomodulatory factor. Drug placentae" obtained from the placenta of cattle, developed by a team of creators and scientists on the basis of the production of LLC "group of All the" further laboratory and clinical testing center of plastic surgery and cosmetology MOH of Russia (certificate No. SSES. EN. The CSCS. 158 State register №ROSS RU. 0001.510346. Protocol No. 46 dated 19.09.2003. Cover letter from 26.08.2003, San. the epidemiological. the bookmark. No. D. from 01.10.2001, the Conclusion of the Institute of plastic surgery and cosmetology MOH of Russia dated 19.09.2003). The product contains highly active peptides, amino acids, mucopolysaccharides, hyaluronic and nucleic acids, trace elements. These components provide a powerful antioxidant effect, stimulating not only the processes of local immunogenesis, regeneration and phagocytosis, but also a tonic to the Central nervous system, improve cardiac muscle [Deriglazova N.A. 2006, L.G. Kozyreva, 2005]. The penetration of particles of placentae in the bloodstream and regional lymph gland has significant immunomodulatory effect not only on the local nonspecific protective barrier, but also on systemic immunity in General.
The selection criteria non-contact application of low intensity pulsed low-frequency electromagnetic fields (INAMP) nonthermal intensity from the apparatus INVITE was pathogenic action factor, the clinical effect is due to the regulatory effect on neuro - and hemodynamics, microcirculation and based on biomedical window-frequency (Window-like) resonant effects of weak electromagnetic fields, to cat the eye the human body shows very high sensitivity of the individual.
Therapeutic effect INAMP is implemented with non-contact use via opto-thalamo and the hypothalamic-pituitary system through the regulation of subcortical-cortical bioelectrical processes, sharing of endorphin neurotransmitters and the immune system, hormonal activity of the endocrine glands, improve neuro - and General hemodynamics, resulting in normal microcirculation in tissues, and total peripheral circulation, blood rheology, there is an anti-inflammatory effect.
The main application object INAMP is the membrane, where it undergoes many physiological processes necessary for the functioning of cells. The mechanism of biological action INAMP associated with guidance resemblance potential, altering the functioning of cells and tissues due to the influence of physico-chemical processes on membranes, changing the potassium/sodium pump, the plastic properties of the cells. Inducing charges on the membrane surface causes the EMF and the change vectors of the dipoles, resulting in the well-known variety of biological processes, changes in the activity of enzymes, protein complexes that affect the microcirculation, blood clotting and vascular permeability. To dilate the blood vessels terminal vascular beds, the increase in capillary blood flow, removing spasm of the arteries.
The physical basis of biological effects INAMP is the management of oscillation of protein particles, the change in volumetric charges in the walls of blood vessels, altering blood rheology, microcirculation, the rate of metabolic processes. The result is retranscription effect in the body as a whole with normalization of homeostasis (V.s.ulaschik. - Physiotherapy. - Universal medical encyclopedia. - Minsk. The book house. - 2008, str-249).
Frequency response methods 30-40-57 Hz due to the multifaceted impact with the desired clinical effect. Thus, the frequency of 30 Hz helps to relieve spasm of the smooth muscle fibers, which helps to improve both Central and peripheral blood circulation. Clinically significantly reduced pain, both General and local origin. Frequency 40 Hz reduces the influence of the sympathetic Central nervous system, has a General sedative effect, interrupts the impulses from pathological dominant in the cortex of the brain in chronic pain. Due to the impact on the autonomic nervous system marked bradycardia, contractile function of the myocardium, decreased blood pressure, ischemia and deep breathing. Frequency 57 Hz reduces signs of inflammation in the joints, stimulates local and General immune processes in General, Iset nonspecific resistance of the organism, that gives reason to call it "physical adaptogen". The exposure time is selected in increasing order: 3-5-9 minutes to reduce the adaptation of the organism to electromagnetic radiation to achieve high therapeutic effect of the impact.
The method is as follows. With the patient lying on the back have the electrode with the technological pad soaked in 1% solution of the hydrolyzate of the placenta, size 8×12 cm in the outer area of the buttocks posterior to the greater trochanter and connect it to the "+", the second electrode with the technological pad soaked in 1% solution of the hydrolyzate of the placenta, by size 12×16 cm on the anterior surface of the femur in the upper third is connected to the "-" machine "Tone 2".
When the impact on the knee with the patient lying on the back include a first electrode size 6x8 cm with technological pad soaked in 1% solution of the hydrolyzate of the placenta, on the side of pain in the place of its localization in the lower or upper inversion and connect it to the "+" device "Tone-2". The second electrode with the technological strip size of 8×10 cm are placed respectively above or below the patella, it is connected to "-". The diadynamic therapy spend apparatus of the "Tone-2". Settings current when the leave procedures: current full wave continuous 15 minutes. Si is the current gradually increases until expressed, but napoletani sensations of vibration under the electrodes and the resulting current is taken for an operation amount. The current strength can be increased from procedure to procedure.
Then further carry out the exposure apparatus of INFIT low-intensity pulsed low-frequency electromagnetic field of non-thermal intensity in a non-contact method patient is in sitting position with a distance from the eyes to the emitter of the device 25 cm when the parameters of the frequency 30-40-57 Hz, 3-5-9 minutes each frequency. Procedures carried out daily for a course of 10 treatments.
The method is used in the treatment of joints affected deforming osteoarthrosis of any localization in patients with hypertensive disease and geriatric patients.
The study included 60 patients (47 women, 13 men) with different forms of OA and disease duration of 6 months to 20 years (average 5,97±3.8 years) and concomitant hypertension II-a, II-b stage. The age of the patients varied from 54 years old to 81 years (average of 67.6±9.6 years). Patients were divided into two groups - primary and control. The main group consisted of 30 patients, 17 of them are diagnosed with mono - or oligoesters knee joints, 13 - poliosteoartroz (POA) with a primary lesion of the knee. Depending on the radiographic stage Kellgen-Lawrence patients of the main group b is Lee presents: 7 patients (6 women and 1 male), the age average of 60.7±7.1 years, disease duration was 2.1±1.1 years. 2 of them are diagnosed with monarcas knee I x-ray stage, the 5 - monarcas knee II radiographic stage; 13 patients (11 women and 2 men), average age average amounted to 65.2±7.3 years, disease duration of 4.5±1.9 years. All patients in this subgroup diagnosed by II x-ray stage 3 of them - the damage to the hip joint II radiographic stage; 10 patients (7 women, 3 men), whose age averaged 66,6±8.8 years, disease duration was 12.2±3.2 years. All patients in this subgroup diagnosed by with a primary lesion of the knee and hip joints III radiographic stage. Patients of the main group received treatment by the present method.
The control group included 30 patients (23 women, 7 men) aged from 54 to 70 years (average of 56.4±7,8 years) with disease duration from 2 to 9 years (average of 5.4±1.8 years). In 33 patients in the control group diagnosed with mono-, oligoethers knee joints, 7 - POA; 22 - OA II radiographic stage, 8 - III x-ray stage. Patients of the control group received physiotherapy according to the prototype.
All the patients before and after treatment were calculated index Richie, who citymouse the severity of pain (0 to 2 points), inflammatory (0 to 2 points) and articular symptoms (0 to 3 points); functional index Lekena, taking into account the severity of pain symptoms at rest and during motor load (from 0 to 18 points) (table 2); pain intensity on YOUR (mm) (table 1).
The local impact of a 1% solution of the hydrolyzate of the placenta with diadynamic currents on the affected joint, and the use of avoidant method through optical-thalamo and the hypothalamic-pituitary system of low intensity pulsed low-frequency electromagnetic fields allowed us to obtain new result:
- To increase the amount of motion in the joints: all patients of the main group significantly increased range of motion in affected joints for functional studies on YOUR index compared to the prototype (P<0,01). There was a trend to increase leads, external and internal rotation in the hip joints in patients of the main group compared to the prototype (P<0,05).
- Significantly reduce the activity of inflammatory-degenerative process, which can be judged by articular, pain and inflammatory index Richie (all patients of the main group showed a significant positive trend index Richie: pain index decreased on average by 63%, joint - 78%, vospitatel the th - 75% vs. 34%, 43% and 54% respectively in patients treated according to the prototype P<0,01).
For YOUR pain intensity continuously, significantly decreased in all patients of the main group to the 5-th day of treatment was 22% for all indicators, and by the end of the course at 58-60% (table 1). While patients who have been treated for the prototype, only the 10-th day of the severity of the pain syndrome decreased by 29% (P<0.01) and index Lekena (so the patients of the main group index Lekena before treatment was 13.5±1,3, in the control group - 14,1±0,7 P>0.5, and 10 of the procedure, respectively, was 8.1±1.1 and 13,8±1,2 P<0,01).
To realize the full course of treatment on the background of concomitant hypertension (all patients of the main group treatment by the present method has been fully implemented, while patients treated according to the prototype, in 58% interrupted treatment after 3-5 treatments due to persistent high blood pressure).
To attain a stable positive remission of clinical symptoms in 98% of patients of the main group versus 27% in the prototype (in the main group remission was 10-11 months compared to 1-2 months in the prototype P<0,001).
The results showed that the proposed method has a pronounced positive effect in the form of a reduction in pain intensity at rest, walking is when descending the stairs, when performing various types of work that led to the expansion of motor activity patients with OA, and can cut pain, restore social activity, to maintain the normal blood pressure level.
Example 1. Patient P. Year of birth - 1949. The number of historical observations 128. Diagnosis: primary - deforming osteoarthrosis of the hip joints II-III degree; concomitant diagnosis of osteochondrosis of the lumbar spine, hypertension II And stage. From the anamnesis it is known that he was sick for 9 years, when I first was diagnosed with osteoarthritis deformans of the hip joints at the sanatorium card in connection with preventive health as a worker in the coal industry. Clinically worried about the pain in the lumbar region and hip joints. The patient linked data quickly arising characteristics with physical loads and fluctuations of temperature regime during operation. However, in subsequent years, the disease was progressing rapidly, about which annually patient underwent various courses of conservative therapy in the form of drugs (anti-inflammatory, hormonal, local circulation and complex physical therapy (massage, magnetic field, phonophoresis the joints and lower back, balneotherapy who I am). However, no improvement was noted. Every year the patient was forced to be a piece of incapacity to 29±4 days. In the last 1.5 years has increased pain when walking and appeared limited mobility in the joints, especially in the left. Index Lekena totaled 8 points, the index Richie 6 points. Index YOUR especially pronounced pain the patient experienced during the descent down the stairs and when doing homework. So, when analyzing the intensity of the pain in YOUR while descending the stairs, the index was 60 mm, and when doing heavy housework 71 mm Radiographically detected changes in the hip joints in the form of degenerative changes of the II degree. Blood pressure was 135/85 mm Hg Gets antihypertensive drugs. On both hip joints were assigned to the treatment in accordance with the inventive method, according to which conducted the impact of physiotherapy factor in patient lying on his back. Had the electrode with the technological pad soaked in 1% solution of the hydrolyzate of the placenta, and connected it to the "+". The size of the electrode 8×12 see Set the electrode in the outer area of the buttocks posterior to the greater trochanter. The second electrode size 12×16 cm were placed on the anterior surface of the femur in the upper third and was connected to "-". The diadynamic therapy was performed from the "Tone-2". Print the current market when issuing procedures: current full wave continuous 15 minutes. The current strength gradually increased until expressed, but napoletani sensations of vibration under the electrodes and at a given amperage carried out the procedure. At the first procedures current strength 8 mA, the seventh procedure current of 10 mA.
Then further conducted the exposure apparatus of INFIT low-intensity pulsed low-frequency electromagnetic field in a non-contact method patient is in sitting position with a distance from the eyes to the emitter 25 cm when the parameters of the frequency 30-40-57 Hz, 3-5-9 minutes each frequency. Treatments were carried out daily for a course of 10 treatments.
After treatment by the claimed method of the study showed a significant positive trend indicators: Index Lekena amounted to 2 points (P<0.01), and YOUR while descending the stairs decreased more than 2 times (23 mm, P<0.01)and when doing heavy housework 1.7 times (41 mm, P<0,01). Over the course of physiotherapy was not observed rise in pressure. Observations continued for 2 years showed that clinical remission was 14 months vs. 1.7 months in the prototype (P<0,01). Within 14 months, the patient did not use medication, was on the sick-list.
Example 2. Sick So born in 1947. The number of historical observations 206. Diagnosis: primary - deforming osteoarthrosis of the knee joints II-III degree; Oslon the deposits; flexion contracture knee joints; concomitant diagnosis of osteochondrosis of the lumbar spine, hypertension II-A stage. From the anamnesis it is known that ill for 15 years, when I first was diagnosed, deforming osteoarthrosis of the knee in connection with complaints of recurrent pain in these joints continuous. With 27 years working in the coal industry. Clinically bothered by recurrent pain in the lumbar region and knee joints. The patient linked data quickly arising characteristics with physical loads and fluctuations of temperature regime during operation. However, in subsequent years, the disease was progressing rapidly, about which annually patient underwent various courses of conservative therapy in the form of drugs (anti-inflammatory, hormonal, local circulation and complex physical therapy (massage, electric stimulation therapy, balneotherapy). However, no improvement was noted. Every year the patient was forced to be a piece of incapacity to 23±7 days. In the last 5 years has increased pain when walking and appeared limited mobility in the joints. A study was conducted: index Lekena totaled 8 points, the index Richie - 6 points. Index YOUR highest observed when descending stairs (65 mm), when you is ode of the car (56 mm) and shopping (44 mm). Blood pressure was 135/90 mm Hg Gets antihypertensive drugs. Was prescribed treatment on both knees alternately in accordance with the inventive method, according to which conducted the impact of physiotherapy factor in patient lying on his back. Had the electrode with a size of 6×8 cm in the lower inversion, technological strip soaked in 1% solution of the hydrolyzate of the placenta, put the electrode in the "+". The second electrode with a size of 8×10 cm was placed above the kneecap and was connected to "-". The diadynamic therapy was performed from the "Tone-2". Settings current when the leave procedures: current full wave continuous 15 minutes. The current strength gradually increased until expressed, but napoletani sensations of vibration under the electrodes and the resulting current was taken as a working value. On the first procedures currents from 5 mA to the seventh procedure 10 mA.
Then further conducted the exposure apparatus of INFIT low-intensity pulsed low-frequency electromagnetic field in a non-contact method patient is in sitting position with the distance from the eyes to the emitter 25 cm when the parameters of the frequency 30-40-57 Hz, 3-5-9 minutes each frequency. Treatments were carried out daily for a course of 10 treatments.
After treatment by the claimed method of the study showed a significant pologitelno the dynamics of the indices: index Lekena amounted to 3 points (P< 0.01), and YOUR while descending the stairs was reduced to 27 mm (P<0.01)and when shopping to 28 mm (P<0.01), and when leaving the machine up to 38 mm For physical therapy was not observed rise in pressure. Observations continued for 3 years showed that clinical remission was 14 months vs. 1.7 months in the prototype (P<0,01). Within 13 months, the patient did not use medication, was on the sick-list.
The effect obtained from the proposed method, which consists in the following:
- Reduced pain, as measured by reduction index Lekena, Richie, YOURS.
- Reduces the period of normalization of the functional changes, as measured by the index of YOUR multifactor functional definition of motor activity and severity of pain.
- Increased adaptation reactions to functional loads on the basis of the index data Richie and YOURS.
- Maintained the stability of peripheral pressure, which contributes to the complete course of physiotherapy.
- Reduced economic costs of medications, reduced the loss of days of work incapacity working patients.
Treated 60 patients of different ages based at city clinical hospital №5 core.
|Dynamics of indicators of functional activity in patients with osteoarthritis (on YOUR, mm) (X±Δ)|
|Index||The main group (n=30)||Control group (n=30)|
|Before the treatment||After the treatment||Before the treatment||After the treatment|
|The descent but the stairs||59,45±2,47||21,76±2,63*||57,90±to 21.77||42,68±8,84**|
|Rise from a chair without using your hands||47,12±3,79||13,3±4,37*||44,54±22,79||39,89±to 9.91**|
|Entrance/exit Masha is s||54,66±2,77||31,52±2,20*||51,00±to 26.02||46,101±3,29**|
|Dress socks||24,45±is 6.78||13,61±2.26 and*||23,36±25,79||20,21±3,312**|
|Sit/stand in the toilet||44,16±3,97||30,00±2.57 m)*||42,18±22.98mm||36,57±2,42**|
|Performing heavy housework||70,25±1,47||42,52±1,53*||68,81±19,94||63,89±7,32**|
|Performing light housework||29,54±3,84||to 10.09±1,09*||26,90±19,51||23,47±7,35**|
* - significant difference before and after treatment in the main group
** - significant difference in performance of the control group with a primary after the treatment
|Indicators of clinical manifestations (indexes Lekena, Richie) before and after treatment in patients of the main and control groups (X±Δ)|
|Index||The main group(n=30)||Control group (n=30)|
|Before the treatment||After the treatment||Before the treatment||After the treatment|
|Index Lekena (points)||19,1±1,5||8,2±1,4*||18,5±1,7||15,7±3,1**|
|Index Richie: (points)|
* - significance of differences from the original measure P<0,01
** - significance of change with the index of the control group, P<0,01
The method of treatment of osteoarthritis on the background of hypertension, including the effects of diadynamic currents of the device, "Tone 2" on the hip and knee joints with the patient lying on the back, through the electrodes with the technological pad moistened with a solution, at vacation procedures use electric current full-wave, continuous, 15 min, the working force of the current pick up when expressed sensations of vibration under the electrodes, the electrodes have when exposed to the hip joint: the first is in the outer area of the buttocks, posterior to the greater trochanter, the second - on the front of the thigh, in the upper third; when exposed to the knee joint first electrode is disposed on a side of pain, in the place of its location, in the area of the bottom or top of the inversion, the second electrode is respectively above or below the patella, characterized in that when exposed diadynamic currents as a solution for technological strip using 1%solution of the hydrolyzate of the placenta, and then conducted additionally impact of pulsed low-frequency electromagnetic field of non-thermal intensity, non-contact method from [Izl] is the switch apparatus INVITE, patient is in sitting position, with the distance from the eyes to the emitter 25 cm, when the pulse frequency 30-40-57 Hz, 3-5-9 min, corresponding to each frequency, in the course of 10 treatments daily.
SUBSTANCE: invention refers to medicine, namely cardiology, and may be used for myocardium protection against ischemic and reperfusion injures. That is ensured by the target drug delivery to the ischemic-reperfused myocardium. Aminated silica nanoparticles of the diameter of 10 nm wherein a spacer is grafter are used as a drug carrier. A drug substance is immobilised on a functional group of the spacer by one of the following methods: covalent binding, coordination ion interaction, immobilisation by adsorption.
EFFECT: technique provides the selective accumulation of the drug substance within ischemia-reperfusion after the systemic introduction of the specified complex with the minimum effect of the preparation on intact organs and tissues and good biodegradability of the carrier; surface functionalisation of said nanoparticles also provides a binding ability of the drug substances of different chemical compositions in various proportions.
SUBSTANCE: invention refers to medicine, namely cardiology, and concerns prediction of the developing life-threatening ventricular arrhythmias in the patients with no structural cardiac changes. That is ensured by determining a blood serum interleukin 6 level by a quantitative method, and the value > 14.9 pg/ml enables predicting the developing life-threatening ventricular arrhythmias in the given category of patients.
EFFECT: method provides specifying the indications to well-timed antiarrhythmic therapy.
FIELD: medicine, pharmaceutics.
SUBSTANCE: claimed is application of 2,6-diphenyl-4-("п"-methoxyphenyl-4H-selenopyran as medication for treatment and prevention of poisoning with mercury compounds. It was established that in case of poisoning with mercury salts application of 2,6-diphenyl-4-("п"-methoxyphenyl-4H-selenopyran leads to improvement (normalisation) of state of internal organs and biochemical parameters of blood of tested animals.
EFFECT: possibility of reducing degree of severity of poisoning with mercury nitrate is shown.
SUBSTANCE: invention relates to medicine, namely to toxicology and cardiology, and deals with prevention of chronic toxic arterial hypertension and cardiopathy in experimental animals. For this purpose 1 time per day lead acetate in dose 40 mg/kg and detoxicant are simultaneously introduced to animals intragastrically. As detoxicant introduced is preparation of melatonin melaxen in dose 10 mg/kg.
EFFECT: method ensures reduction of lead cytotoxicity due to membrane-protecting and antioxidant action of melatonin.
1 tbl, 1 ex, 2 dwg
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention relates to chemical-pharmaceutical industry and represents medication for treatment of hemorrhoids, proctitis and other inflammatory proctological diseases in form of rectal suppository, characterised by the fact that it contains as active substances Juglanex and Tycveolum, as auxiliary substances contains polyethylene glycol 1500 and emulsifier T2, components in medication are in specified ratio in grams per 1 suppository, with weight 2.6 g.
EFFECT: invention ensures anti-inflammatory and regenerating action, and possesses good penetrating ability.
SUBSTANCE: endothelial dysfunction is diagnosed if observing the twofold increase of a rat's blood glucose level. The technique involves determining antioxidant system values, a concentration of total NO metabolites, eNOS activity, a micro- and macrohaemodynamic status, a MDA concentration and Na+ K+ ATP-ase activity in myocardial and hepatic cell membranes. The values variations enables stating the presence of endothelial dysfunction in alloxan diabetes. Such dysfunction is corrected by the subcutaneous introduction of the preparation Ubiquinone (Coenzyme Q10) 0.11 mcl/100 g of animal's weight once a day for 30 days.
EFFECT: more accurate and reliable diagnosis of the vascular disorders accompanying said type of diabetes, and effective correction of such disorders also provides reproducibility, ease, availability, safety and low cost of performing the experiment.
2 cl, 2 tbl, 6 dwg, 1 ex
SUBSTANCE: before the drug prescription and during the therapeutic progression, patient's peripheral venous blood is sampled, ultracentrifuged to recover endotheliocytes to be incubated with PTS-marked annexin-V. It is followed by endotheliocyte count with using an immersion microscope in 10 vision fields and the prevailing content of annexin-V negative endotheliocytes prevailing over annexin-V positive endotheliocytes enables stating the low involvement of vascular endothelium in the pathological process or the efficacy of vascular therapy; annexin-V positive endotheliocytes prevailing over annexin-V negative endotheliocytes makes it possible to state the high involvement of the endothelium in the pathological process or the inefficacy of vascular therapy: normal average number of circulating endotheliocytes 1-3, annexin-V positive - 0; in degree 1 endothelial dysfunction, the number of circulating endotheliocytes 4-6 wherein 1-3 - annexin-V positive; in degree 2 endothelial dysfunction, the number of circulating endotheliocytes 7-12 wherein 4-6 annexin-V positive; in degree 3 endothelial dysfunction, the number of circulating endotheliocytes 13-18 wherein annexin-V positive 7-10; in degree 4 endothelial dysfunction, the number of circulating endotheliocytes 19-25, annexin-V positive 12-24, in critical endothelial dysfunction with a high risk of cardiovascular complications, the number of circulating endotheliocytes more than 25, all of them are annexin-V positive.
EFFECT: use of the declared method enables the proved selection of the therapeutic agents and their doses improving a morphological and functional condition of the vascular endothelial cells that reduces a risk of the onset and the progression of endothelial dysfunction and the development of a severe vascular pathology.
2 ex, 2 dwg
SUBSTANCE: invention refers to medicine. The method of pharmacological correction of extremity ischemia by mixed solutions of homoeopathic dilutions in an experimental laboratory animal suffering experimental extremity ischemia, consists in the intragastric introduction of the mixed solutions of homoeopathic dilutions of monoclonal VEGF -C12, C30, C200 antibodies 4.5 ml/kg (9 ml/kg/day) to the laboratory animals twice a day for 28 days following ischemia simulation.
EFFECT: method provides clinical effectiveness in ischemia.
1 tbl, 1 ex
SUBSTANCE: group of inventions refers to medicine, and concerns a vascular ageing inhibitor which contains as a basic ingredient collagen of low molecular weight approximately 3000 Da of fish skin prepared by enzymatic decomposition with using anacanthe or flatfish skin. The anti-ageing compositions contain the vascular ageing inhibitor in the granulated form.
EFFECT: invention provides better elasticity of the whole vascular wall and prevented adhesion of thrombocytes and cholesterol.
4 cl, 2 ex, 1 tbl, 3 dwg
SUBSTANCE: invention refers to medicine, namely agents for treating constipations in the patients suffering cerebrovascular diseases. A herbal tea for treating constipations contains common licorice roots, black currant leaves, linseed, wild chamomile heads, pale indian plantain leaves, alexandrine senna leaves, common nettle leaves, an elevated part of field sow thistle, burdock roots, an elevated part of peppermint, an elevated part of melancholy thistle, fennel fruits, anise fruits, coriander fruits, alder buckthorn bark, an elevated part of common St. John's wort, red haw, an elevated part of meadow crane, an elevated part of wild germander taken in certain proportions. The tea is intended for long-term unremarkable administration in treating constipations in the patients suffering cerebrovascular diseases.
EFFECT: herbal tea has an effective laxative effect, eliminates bloat, has no limitations with a wide spectrum of somatic and neurological diseases and differs by economic availability.
2 ex, 1 tbl
SUBSTANCE: invention refers to medicine, namely traumatology and orthopaedics, and is applicable for the purpose of treating the patients suffering osteoarthrosis of knee. That is ensured by introducing platelet rich autoplasma prepared 1-2 hours before the procedure and containing 725 to 3029 thousand/mcl of platelets (normally - 162 to 358 thousand/mcl) in the affected joint and paraarticular tissues. The autoplasma is activated with 0.25% CaCl2 in the ratio 3:1, in the amount of 10-15 ml. The platelet rich autoplasma is introduced twice within the therapeutic course every 5-7 days.
EFFECT: method allows ensuring repair of knee tissues and paraarticular tissues due to stimulated metabolism and regeneration abilities of the affected joint by means of using the autologous growth factors and biologically active proteins contained in the prepared autoplasma.
SUBSTANCE: invention refers to medicine and pharmacology, and represents the use of a pharmaceutically acceptable salt of alpha-ketoglutaric acid for preparing a pharmaceutical composition for treatment or prevention of cartilage diseases in response to weight loss and/or nutritional disorder, poor nutrition, gastrectomy, partial gastrectomy or gastric ligation.
EFFECT: invention provides effective relief and management of articular pain and arthritis.
20 cl, 8 tbl, 3 dwg
FIELD: medicine, pharmaceutics.
SUBSTANCE: present invention refers to pharmaceutics and medicine, and concerns application of sophoricoside.
EFFECT: preparing the drug applicable for preventing and/or treating articular cartilage degeneration or osteoarthritis in postmenopausal females, exhibiting side-effect-free high efficacy.
6 cl, 11 dwg, 5 tbl, 7 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to pharmacology, and represents a sterile injectable water-based composition in the form of gel for iintra-articular injection containing hyaluronic acid of molecular weight 0.1 to 10×106 Da in the amount of 1-100 mg/ml of water or one of its salts and optionally one or more other natural polysaccharides specified in a group consisting of chondroitin sulphate, keratan, keratan sulphate, heparin, heparan sulphate, cellulose and its derivatives, chitosan, xanthan, alginate and their salts, and also one or more polyalcohols in the amount of 0.0001-100 mg/ml of water, prepared by making a water-based formulation containing hyaluronic acid or one of its salts, optionally one or more other natural polysaccharides, and also one or more polyalcohols, sterilising it with wet steam; the prepared gel shows a coincidence frequency of the elasticity modulus G' and the viscosity modulus G" within the range 0 to 10 Hz preferentially 0.41 Hz ±0.41 Hz with G" exceeding G' if the coincidence frequency is found to be high.
EFFECT: invention provides higher degradation resistance of the gel, and also makes the gel visco-elastic.
11 cl, 8 ex, 11 dwg
SUBSTANCE: invention refers to medicine and pharmaceutical industry, particularly to a method for making a drug for osteoarthrosis and to a method of treating osteoarthrosis. The method for making the herbal preparation for osteoarthrosis applied for the purpose of electrophoresis wherein grinded dry raw herbs, including wild rosemary shoots, elecampane inula rhizomes and roots, common St. John's wort herb, wild camomile blossom, cowberry rhizomes and roots, black poplar buds, hop cones taken in certain proportions, extracted in 70% ethanol under certain conditions; the extracts are combined, purified by double separation, boiled out in vacuum, dried up in a spray dryer; the dry powder is used to prepared 20% herbal preparation in 25% aqueous dimethylsulphoxide. The method of treating osteoarthrosis aiding electrophoresis wherein the herbal preparation described above is applied on a pad to perform an electrophoresis procedure with modulation diadynamic currents.
EFFECT: preparation made by the method described above, and a method for diadynamic-current electrophoresis are effective for osteoarthrosis.
2 cl, 1 tbl, 2 ex
SUBSTANCE: invention refers to medicine. Substance of the method for rehabilitation of patients suffering osteoarthrosis involves pelotherapy and herbal medicine. The method applied a mixture of dry extracts of cowberry (5 portions), lucerne (5-10 portions), dimethylsulphoxide (10-15 portions) added to peat peloid (up to 100 portions). The composition and peat peloid is applied in layers in osteoarthrosis not associated with synovitis: by applying the composition on the injured joint in a layer 0.5-1 cm coated with peat peloid to the thickness of 2-3 cm, at temperature of the composition and peat peloid - 38-42°C, duration of procedure 20-30 minutes, every second day or two days running with a pause for one day, therapeutic course - 10-15 procedures. In osteoarthrosis associated with moderate synovitis: by applying the composition on the injured joint in a layer 0.5-1 cm coated with peat peloid to the thickness of 2-3 cm, at temperature of the composition and peat peloid - 20-24°C, duration of procedure 15-20 minutes, every day or two days running with a pause for one day, therapeutic course - 8-10 procedures.
EFFECT: presented method of the combined use of herbal and pelotherapy provides higher effectiveness of rehabilitation of the patients with osteoarthrosis and simplifies the method.
SUBSTANCE: invention refers to medicine, and may be applied for the purpose of stimulating cartilage hyaline neogenesis accompanying early destructive diseases. That is ensured by recovering and culturing self-specific multipotent mesenchymal stem cells (MMSCs) from fatty tissue. Then said cells are mixed with the gel carrier Lintex-Mesogel. The prepared cell suspension in gel is introduced into the joint.
EFFECT: method provides effective cartilage hyaline neogenesis without fibrocartilage formation due to optimal selection of the cell material and the specified gel carrier promoting maintained intraarticular viability, proliferative activity and MMSC chondrogenic potentialities.
2 tbl, 6 ex
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to azaadamantane derivatives of formula (I), to their pharmaceutically acceptable salts possessing the properties of nAChR ligands, their application, a method of treating and based pharmaceutical compositions, and also to intermediate compounds of formula (VI) and (VII) and to application of the compound of formula (V) for preparing the compound (I). In general formulas
L1 represents -O- or -NRa-; A represents -Ar1 or -Ar2-L2- Ar3; Ar1 represents 5-9-member heteroaryl wherein said heteroaryl is optionally substituted by alkoxy, alkoxycarbonyl, alkyl, alkylcarbonyl, carboxy, carboxyalkyl, cyano, halogenalkoxy, halogenalkyl, halogen, hydroxy, nitro, -NH2, (NH2)carbonyl and oxido; Ar2 represents 5-6-member heteroaryl wherein said heteroaryl is optionally substituted by alkoxy, alkoxycarbonyl, alkyl, alkylcarbonyl, carboxy, carboxy alkyl, cyano, halogenalkoxy, halogenalkyl, halogen, hydroxy, nitro, -NH2 and (NH2) carbonyl; Ar3 represents aryl, optionally substituted alkoxy, alkoxyhalogenalkyl, alkyl, aryl, halogenalkoxy, halogen, hydroxy and -NH2; or Ar3 5-9-member heteroaryl wherein said heteroaryl is optionally substituted by alkoxy, alkoxycarbonyl, alkyl, alkylcarbonyl, aryl, carboxy, carboxyalkyl, halogenalkyl, heterocyclyl and tritylaryl; L2 represents a bond, -O- or -C(O)NRa-; and Ra represents hydrogen.
EFFECT: preparing the pharmaceutically acceptable salts possessing the properties of nAChR ligands.
41 cl, 11 dwg, 162 ex
SUBSTANCE: invention relates to medicine, in particular orthopaedics. A whirlbone is centred; four to ten wires of the diameter 2.0 mm from a subtrochanteric region into a femoral neck. It is followed by draining irrigation of the joint with furacilin and isotonic solution. A perforator is used to form four-five canals ended in an epiphysis which are used to introduce 2 to 3 ml of the content from a medullary cavity of shin bone. A width of the joint space is adjusted by distraction.
EFFECT: local stimulation of repair processes and transosseous fixation provide restoration and reduced length of inpatient treatment.
1 ex, 8 dwg
FIELD: medicine, pharmaceutics.
SUBSTANCE: invention refers to medicine, particularly oncology, and may be applied in treating cancer. A method involves producing stem CD8+T-cells from a subject, introducing cladribine into the subject; contacting the CD8+ T-cells with xenogenic antigen-representing cells loaded with one or more peptide antigens with generating thereby the activated cytotoxic T-lymphocytes (CTL) which are targeted on the cells expressing said one or more peptide antigens. Then the activated CTLs and at least two cytokines which have an effect on CTL persistence are introduced into the subject.
EFFECT: use of the invention provides higher clinical effectiveness ensured by prolonged persistence of the activated CTLs and reduced number of complications, namely opportunistic infections.
10 cl, 1 tbl, 2 dwg, 1 ex
SUBSTANCE: invention relates to medicine, namely to physiotherapy, gastroenterology. Method includes introduction of diet No5, internal intake of mineral water with the following carrying out transverse galvanisation of epigastrium area, general coniferous baths and impact with physical factor. As physical factor used is electromagnetic radiation of extremely high frequency (EHF). Impact is performed by broad-band noise emitter with frequency 40-63 GHz. Impact is performed on 3 and 4 projection zones in area of the right hypochondrium and on the area of sternum. Impact is performed daily, 10 minutes on each zone. Course includes 10-12 procedures.
EFFECT: method improves physical-chemical properties of bile, contributes to bile secretion due to normalising action on motor and secretory function of gastrointestinal tract, improves blood circulation and liver regeneration, increases non-specific resistance and adaptive possibilities of organism, normalises psycho-emotional status.
2 ex, 2 tbl, 1 dwg