Method of treating patients with gallbladder dyskinesia

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to physiotherapy, gastroenterology. The method involves dietary therapy No. 5, general pine baths, magnetic laser therapy, intake of mineral water with underlying sparing training regimen followed by transverse galvanisation of the epigastrial area. The transverse galvanisation immediately follows the intake of mineral water between 10 to 11 o'clock. Additionally, the right hypochondrium and sternum are exposed to EHF radiation generated by a broadband noise transducer with a frequency of 40-63 GHz, for 10 minutes per each area, every day; the therapeutic course is 10-12 procedures.

EFFECT: method enables higher clinical effectiveness ensured by using a chronobiological approach to treating the patients for the purpose of relieving the functional disorders of the bile system with underlying increased adaptive capacities of the body.

2 ex, 2 tbl

 

The invention relates to medicine, namely to rehabilitation medicine, physical therapy and gastroenterology and can be used for the treatment of patients with dyskinesia of the gallbladder.

Closest to the present invention is a method of treatment of diseases galcheva-separating system [1], including the appointment of magnetic-laser therapy, shared baths, domestic mineral water and intragastric electrophoresis. However, the known method is not effective as it does not take into account the peculiarities of the biorhythm of the functional activity of the biliary system.

New technical problem - reducing the time relief of clinical symptoms, normalization of indicators of the functional status of the biliary system, while increasing the adaptive capacities of the organism at the expense of chronobiological approach to treatment.

To solve the problem in the treatment of patients with dyskinesia of the gallbladder, including on the background of gently-training regime health food according to the diet №5, total coniferous baths, magnetic therapy, internal reception mineral water followed by the transverse galvanization epigastrium, cross galvanisation is conducted immediately after the reception of mineral water in the period from 10.00 to 11.0 hours at the same time, additionally spend EHF-influence on the 3-th and 4-th projection zones in the right hypochondrium and on the sternum area broadband noise emitter frequency 40-63 GHz, 10 minutes on each zone, daily, at the rate of 10-12 procedures.

The method is as follows: on the background of gently-training mode and therapeutic limited supply of products, providing chemical, thermal and mechanical irritation of the mucous recommended by the Institute of nutrition of Russian Academy of medical Sciences (corresponding to a diet №5, Pevzner), appointed: internal reception mineralized hydrocarbonate-sulphate (9 groups, Zheleznovodsk type) total mineralization of up to 5 g/DM3(Slavic, Smirnovskaya), temperature +38 to+40°C, 3 times a day for 30-40 minutes before meals, 100-150 ml on admission for treatment; galvanization epigastrium carried out immediately after the internal patient 150 ml of mineral water (which he takes during the course of treatment), heated to 38-40°C, and the electrodes are superimposed as follows: anode (+) area of 200 cm2the front of the epigastric region and the cathode (-) area of 200 cm2back on the scope of the segments D-6-D-9, current up to 15 mA, the time required 20 minutes, every day, on the course of 10-12 treatments, the procedure is valid from 10.00 to 11.00; total coniferous baths (cooking baths: 50,0 ml XB is logo concentrate dissolved in 200,0 l tap water), with water temperature 36-37°C for 15 minutes, every day, in the 2nd half of the day, in the course of 10-12 treatments; laser therapy apparatus "MILTA" consistently for 3 zones (zone Abkhazia, left and right hypochondrium on crenelations lines), contact with a frequency of 5 Hz for 3 min on each zone, at a rate of 10-12 [1]; EHF-therapy apparatus "SEM-TESN-BF" is carried out by acting on two projection zones - 3-th and 4-th (in the right hypochondrium and on the sternum area) broadband noise emitter frequency 40-63 GHz (emitter marked: No. 4), 10 minutes on each zone; daily, at the rate of 10-12 procedures; Placement procedures in treatment was carried out with the observance of the principles of physiotherapy: a break between the procedures shall be not less than 40 minutes.

Components of treatment ensure restoration of the functional state of the gall bladder, while increasing the adaptive capacities of the organism. One of the tools that contribute to the improvement of physico-chemical properties of bile and improve bile secretion, is an internal intake of mineral water, among which the most widely used low-mineralized hydrocarbonate-sulphate (9 groups, Zheleznovodsk type) total mineralization of up to 5 g/DM3

Galvanization has a positive effect on atorney and secretory function of the biliary system, improves blood circulation in the liver, promotes favorable changes in the system of nonspecific immunity. To improve choleretic action and enhance the drainage of the biliary ducts transverse galvanized epigastrium is recommended immediately after taking mineral water inside, in the ascending phase of the rhythm of the functional activity of the biliary system (10.00-11.00).

Total coniferous baths reduce asthenic syndrome, normalizing and have a slight sedative effect, have a nonspecific action, causing a total body response aimed at maintaining and preserving homeostasis.

Laser therapy has a positive effect on the functional state of the liver and biliary system and the adaptive capacity of the organism as a whole.

EHF-therapy has a positive effect on the functional state of the hepatobiliary system, promotes protective and adaptive abilities of the body and has a normalizing effect on the structure of the biological rhythms of the functional systems of the organism [3, 10].

A distinctive feature of the proposed method is the use of chronobiological approach when prescribing the treatment, in General, aimed at reduction of functional disorders in relavitely the compulsory system, while increasing the adaptive capacities of the organism.

The proposed method is based on clinical observations of patients in the clinics of the Tomsk scientific research Institute of balneology and physiotherapy. Conducted the examination and treatment of 57 patients. Verification of the diagnosis of dyskinesia of the gallbladder was performed on the basis of who recommendations.

The main group (1 gr.) comprised 27 patients treated with the inventive method of complex treatment. As the comparison groups were patients (n 30), who had received the same main group treatment, but without using chronobiological approach (2 gr.).

Tolerability and therapeutic efficacy of the complex was estimated on the basis of the severity of the main clinical symptoms of reducing the intensity of pain, heartburn, nausea, bitter taste in the mouth, the disappearance of the symptom Kera (gallbladder symptom), as well as improve the functional activity of the liver and biliary system: normalization index of contractile function of the gallbladder (PSHIP), according to the dynamic ultrasound, enhancing the adaptive capacity of the organism (Garkavi LH et al.), improve the health index calculated based on all clinical, laboratory and instrumental data, ranked in points. Immediate treatment efficiency was calculated from the growth rate ind the KSA health, as well as the number of patients with positive treatment outcomes ("improvement" and "significant improvement"). Data treatment effectiveness is reflected in tables 1 and 2.

From table 1 it is seen that in the group of patients treated by the claimed method marked with higher efficiency compared with the control. After the complex treatment was noted improvement in functional status biliary system against the background of significantly improving the overall health of patients.

So, immediately after treatment, 81.4 per cent of patients of the main group was completely absent clinical complaints, and the rest (18,6%) the intensity of the main complaints (in points) was significantly decreased (p=0,0011): intensity of pain decreased from 3.0±0,07 1,1±0,02, heartburn from 2.3±0,11 to 1.1±0,12, bitterness - from 2.9±0,13 1,0±0,10, nausea from 2.3±0,09 to 1.1±0,08. In the control group dynamics of clinical complaints were similar, but the importance of reducing the intensity of clinical symptoms was lower (p=0,0068).

All patients of the main group significantly improved functional status of the biliary system. So, most of the patients of the main group (74.1 per cent) indicators of motor function of the gallbladder is normalized, and in the control group - only 53.4 per cent.

When analyzing the dynamics of quantitative values PSPIP based in the Noah group of patients with hypomotor type of dyskinesia of a gall bladder immediately after treatment was detected, he rose from 23,7±6,1% to 46.2±9,7% (p=0,0017)in the comparison group - from 24.3±6.3 per cent to 41.9±11,2% (p=0,0038). PSPIP in patients of the main group, with hypermotor type of dyskinesia of a gall bladder, decreased from 71.3±9.6 per cent to 56.7±8,4% (p=0,0011), and in the comparison group - to 70.7±8.9 per cent to 65.3±10,2% (p=0.013). As can be seen from the above data, the functional condition of the gall bladder has improved in both groups, regardless of the type of dyskinetic disorders (p<0,031 and p<0,043).

Analysis of the dynamics of the levels of reactivity - UR (Phharmacy) revealed the following: total number of patients with high UR in the study group increased from 63.0% to 88.9% (increase +25,9%)and in the comparison group with 66,7% to 80.0% of (growth +13,3%). The data obtained indicate a positive impact of treatment on the performance of adaptive capabilities of the organism.

When analyzing the dynamics of health index (table 1) revealed that this indicator has increased in the study group from 52.6±9.6 per cent to 73.3±4,9% (p=0.0001), and in the comparison group - from 52.9±9,1% to 67.5±7,1% (p=0.0001). Moreover, the average OF the after treatment in the study group were higher than in the comparison group (p=0,016).

When calculating the immediate effectiveness of the treatment was taken into account only such results as "significant improvement" and "improvement". Immediate efficiency (table 2) in the main group was 92.6%, which is higher than in the comparison group - 80,0%. When it is revealed that the difference in the structure of efficiency (table 2). So, in the main group the number of patients with "significant improvement" (when the increment OF greater than 15,0%) was 77.8%, and in the comparison group to 46.7%. The number of patients with "improved" (when the increase OF=a 10.1-15%) accounted for 14.8% and 33.3%, respectively.

Clinical tolerability of the treatment was as good, negative load on the functional state of individual systems and the organism as a whole have been identified. The overall effectiveness of the proposed method is higher than in the control. In General, the inventive method of complex treatment, using chronobiological approach avoids the drawbacks of the existing methods and to improve the quality and efficiency of complex treatment of patients with dyskinesia of the gallbladder.

Example 1

Patient P., 39 years old, was admitted to the medical Department clinics Tiiki with a diagnosis of Dyskinesia gallbladder on geometria type, chronic cholecystitis, remission stage. Considers herself a patient for over 4 years. Sick, worried about the pain and heaviness in the right hypochondrium, occur after disturbances in the diet, and emotional experiences, bitter taste in mouth, nausea, noted headaches.

With the first day spent in the clinic the patient was scheduled examination, and 3-day - treatment in accordance with the claimed method, namely: gently-training regime and healthy food restriction is Reducto, providing chemical, thermal to mechanical irritation of the mucous recommended by the Institute of nutrition of Russian Academy of medical Sciences (corresponding to a diet №5, Pevzner), internal reception mineralized hydrocarbonate-sulphate (9 groups, Zheleznovodsk type) total mineralization of up to 5 g/DM3temperature - 38 to+40°C, 3 times a day for 30-40 to food to 100-150 ml on admission for treatment; galvanization epigastrium immediately after the internal patient 150 ml of mineral water (which she takes during the course of treatment), heated to 38-40°C, and the electrodes are superimposed as follows: anode (+) area of 200 cm2the front of the epigastric region and the cathode (-) area of 200 cm2back on the scope of the segments D-6-D-9, current up to 15 mA, the time required 20 minutes daily, at the rate of 10-12 procedures, the procedure was carried out from 10.00 to 11.00; total coniferous baths (cooking baths: 50,0 ml coniferous concentrate dissolved in 200,0 l tap water), with water temperature of 36-37°C for 15 minutes, every day, in the 2nd half of the day, in the course of 12 treatments; laser therapy apparatus "MILTA" consistently for 3 zones (zone epigastria, left and the right hypochondrium on crenelations lines), contact with a frequency of 5 Hz for 3 min on each zone, in the course of 12 [11]; EHF-therapy apparatus "SEM-TESN-EPH" is carried out by means of the PTO impact on the projection 2 zone 3-th and 4-th (in the right hypochondrium and on the sternum area) broadband noise emitter frequency 40-63 GHz (emitter marked: No. 4), 10 minutes on every zone, every day, in the course of 12 treatments; Arrangement of treatments in treatment was carried out with the observance of the principles of physiotherapy: a break between the procedures shall be not less than 40 minutes.

Treatment the patient was well tolerated, on the 3rd day from the start of treatment observed decrease in the severity of pain and dyspeptic syndrome, on the 7th day were relieved of pain in the right hypochondrium, bitter taste, nausea. At physical examination there was no symptom Kera (gallbladder symptom). According to dynamic ultrasound normalized PSFTP, increasing by 21.9% to 46.1 per cent, increase in the level of lymphocytes in the General analysis of blood from 21% to 32% testified to increase the adaptive capacities of the organism, the health index increased from 54.6 to 87.8, suggesting a direct effect of the treatment and meant "significant improvement".

Example 2

Patient S., 43 years old, was admitted to the medical Department clinics Tiiki with a diagnosis of Dyskinesia of the gallbladder on hypermotor type in combination with chronic cholecystitis, remission stage. Considers herself a patient for over 5 years. The patient was bothered by paroxysmal pain in the right hypochondrium, occur after stressful situations and emotional surges, disturbances in the diet, and bitter taste in the mouth, nausea.

From the first DN is spent in the clinic the patient was scheduled examination, and with 3-day - treatment in accordance with the claimed method, namely: gently-training regime and healthy food with a limit of products, providing chemical, thermal and mechanical irritation of the mucous recommended by the Institute of nutrition PAMI-I (corresponding to a diet №5, Pevzner), internal reception chloride-hydrocarbonate water salinity up to 5 g/DM3temperature +38 to+40°C, 3 times a day for 30-40 minutes before meals, 100-150 ml on admission for treatment; galvanization epigastrium was made immediately after the internal patient 150 ml of mineral water (which he took during the course of treatment), heated to 38-40°C, and the electrodes were imposed as follows: anode (+) area of 200 cm2the front of the epigastric region and the cathode (-) area, 200 cm2back on the scope of the segments D-6-D-9, current up to 15 mA, the time required 20 minutes daily, at the rate of 10-12 procedures, the procedure was carried out from 10.00 to 11.00; total coniferous baths (cooking baths: 50,0 ml coniferous concentrate was dissolved in 200,0 l tap water), with water temperature of 36-37°C for 15 minutes, every day, in the 2nd half of the day, on a course of 10 treatments; laser therapy was performed from the apparatus. MILTA" consistently for 3 zones (zone epigastria, left and right hypochondrium on crenelations lines), contact the but with a frequency of 5 Hz for 3 min on each zone, at a rate of 10 [11]; EHF-therapy apparatus "SEM-TESN-BF" was performed by exposure to 2 projection zones in the right hypochondrium and on the sternum area 3-th and 4-th wideband noise emitter frequency 40-63 GHz (emitter marked: No. 4), 10 minutes on each zone, daily, for a course of 10 treatments. Placement procedures in treatment was carried out with the observance of the principles of physiotherapy: a break between the procedures shall be not less than 40 minutes.

Patient treatment was well tolerated after 3 days of treatment was a decrease in the intensity of pain and dyspeptic syndromes, with the 5th procedure was stopped pain and right hypochondrium, bitter taste, nausea, improved overall sense of well-being, there was no symptom of Kera (gallbladder symptom), upon physical examination. According to dynamic ultrasound, normalized PSFTP, decreasing from 70.6% to 56.2%, increase in the level of lymphocytes in the General analysis of blood from 20% to 31% testified increases adaptive capacity, health index increased from 52.6 to 84,7 that testified to the effectiveness of the treatment is meant to "significant improvement".

Thus, the claimed method of treatment, using chronobiological approach allows to increase e the efficiency of complex treatment due to the relief of clinical symptoms, improvement and normalization of the functional state of the biliary system, enhancing the adaptive capacity of the organism in the absence of complications and side effects.

Table 1. The dynamics of clinical and functional parameters in complex treatment (M±σ).

Note: PSF ha - the index of contractile function of the gallbladder: p - significance of differences between groups compared to baseline; p1-2the significance of differences of the results obtained after treatment between groups.

Table 2. The immediate efficacy of complex treatment (%)

Note: n is the absolute number of patients from all surveyed; % relative number of patients from all surveyed;

Application
Table 1
The studied parametergroupSoil j
before the treatmentafter the treatmentPbefore the treatmentafter the treatmentpp1-2/sub>
PSF ha when hipopotamo dyskinesia ha (<50,0%)23,7±6,146,2±9,70,001724,3±6,341,9±11,20,00380,031
PSF ha with hypermotor dyskinesia ha (>60,0%)from 71.3±9,656,7±8,40,0011to 70.7±8,965,3±10,20,0130,043
Health index (%)52,6±9,673,3±4,90,000152,9±9,167,5±7,10,00010,016

Table 2
IndexThe main group (n=27)Control group (n=30)
Significant improvement77,8% (n=21)63,3% (n=19)
Improvement14,8% (n=4) 16,1% (n-S)
A slight improvement7,4% (n=2)16,7% (n=5)
Without change(n=0)3,3% (n=1)
Deterioration(n=0)(n=0)
Immediate effectiveness92,6% (n=25)80,0% (n=24)

Sources of information

1. Method for the treatment of patients with gastroduodenal diseases and biliary systems. RF patent №2257215 from 27.07.2005. Bull. No. 21.

2. Vigodner E.B. Physical factors in gastroenterology. / Abbyadnez. - M.: Medicine, 1987. - 304 S.

3. Galkin, VA gallbladder Dyskinesia. The principles of diagnosis and treatment. / Vagulkin // Therapeutic archive. - 2005. No. 8. - P.55-57.

4. Garkavi LH anti-stress response and activation therapy. Part I, II. / Phharmacy, Ebouaney, Tschulena etc. - Ekaterinburg: Philanthropist, 2002-2003. - 336 S.

5. Gosstandart (GOST 13273-88 "mineral drinking Water treatment m medicinal-table").

6. Levitsky E.F., Poddubnaya O.A. Biological rhythms in improving the treatment of patients with chronic opisthorchiasis. // Questions of balneology, physiotherapy and Leche. Phi is culture, 2007, No. 5, ñ.38-42.

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8. Ouran I.E. EHF-therapy: problems and prospects. / Yeolhansie, Vousi // Questions of balneology, physiotherapy and Medi. physical culture. - 2003. No. 1. - P.46-48.

9. Smirnova, I.N. Multi-objective system for evaluating the effectiveness of rehabilitation treatment of patients with essential hypertension. / Internova, AIA, Vbon, Efreesky // Sat. mater. jubilee scientific and practical use. Conf. "Topical issues of balneology, rehabilitation medicine and prophetology". Pyatigorsk, 2010. - C.189-190.

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11. Khetagurov L.G. Application of chronopia - and as chronopotentiometry in surgery. / Lghetealusega, Marketiva, Irdayeva. // Proc. Dokl. 3rd scientific conference. "Herbal medicine, laserotherapy, biologically active substances of natural origin in the 21st century". - M., 2000. - c.321.

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13. Yakovenko EP Chronic diseases in pechenochnyi biliary tract. Diagnostics and treatment. / Epekeina, Plagiaries // Method. manual for doctors. - M.: Malpractice. - 2001. - 31 S.

A method of treating patients with dyskinesia of the gallbladder, including on the background of gently-training regime health food according to the diet №5, total coniferous baths, magnetic therapy, internal reception mineral water followed by the transverse galvanization epigastrium, characterized in that the transverse galvanisation is conducted immediately after the reception of mineral water in the period from 10 to 11 hours, with an additional spend of EHF-influence on the right hypochondrium and the sternum area broadband noise emitter frequency 40-63 GHz, 10 min on each zone, every day, on the course of 10-12 treatments.



 

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3 ex

FIELD: medicine.

SUBSTANCE: to induce cytological action on tumour cells, culture of human tumour cells linear - K562 or freshly isolated - cells of primary epidermoid carcinoma of oral cavity are subjected to combined impact of colloidal solution of silver nanoparticles in concentration 34 mcg/ml and SHF-irradiation with frequency 915 MHz. Impact is performed during 30 minutes.

EFFECT: essential increase of cytotoxic effect.

1 tbl

FIELD: medicine.

SUBSTANCE: invention relates to physiotherapy. Method includes contact impact on lesion focus. Impact is performed with extremely high-frequency electromagnetic field. Preliminary impact is performed on the area of lymph nodes in inguinal region. Impact is performed with wavelength 5.6 mm, frequency 53.5 GHz, intensity 10 mW/cm2. Impact lasts 20 minutes. After that, impact is performed on lesion focus. Impact is performed with wavelength 7.1 mm, frequency 42.2 GHz, intensity 10 mW/cm2. Impact lasts 20 minutes. Procedures are performed daily. Course of treatment includes 10 procedures.

EFFECT: method can be used in treatment of children of any age, in presence of metal constructions, wet bandages.

2 ex

FIELD: medicine.

SUBSTANCE: device comprises a cylindrical waveguide 1 short circuited on one end 2 with the other end being emitting, and provided with a coaxial-waveguide excitation element 3. On the emitting end of the cylindrical waveguide, there is a focusing element 4 in the form of a convex dielectric lens. Along an internal surface of the cylindrical waveguide 1, there are at least two T-ribs parallel along a wider border and forming a capacitor gap along a symmetry axis of the contact microwave applicator. The coaxial-waveguide excitation element 3 is presented in the form of internal and external conductors and inserted into a narrow border of one of the ribs perpendicular to a wider wall of the T-rib with its internal conductor passing through the entire conductor gap.

EFFECT: use of the declared invention enables decreasing power supplied to the tumour and downsizing the applicator with enhanced electrodynamic values of the device.

1 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely - to physiotherapy, neurology. The method involves exposure to extremely high-frequency radiation. The exposure is performed at wave lengths 4.9 mm and 7.1 mm alternated every second day. The exposure is performed in a continuous mode of power 10 mWt/cm2. The four fields are exposed. At first, the exposure is performed on side of the greatest cerebral involvement. The exposure on a projection of a vertebral artery is suboccipital. The exposure is directed forward under base of the skull. It is followed by the exposure on a projection of a neurovascular beam behind angle of the jaw under an auricle. The exposure is directed backwards under base of the skull. Then the exposure is applied to a contralateral side. The exposure takes 4 minutes for each field. The therapy is assisted by EEG-control. The procedures are daily. The therapeutic course is 10 procedures.

EFFECT: method provides higher clinical effectiveness ensured by optimising activation of cerebral adaptation-compensatory systems.

4 ex

FIELD: medicine.

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

FIELD: medicine.

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

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology and can be used for treatment of diabetic diffuse macular edema. For this purpose 0.5 ml of 1% dexason solution and 0.5 ml of emoxipin are successively introduced in injection into parabulbar space and magnetic stimulation of optic analyser is performed. Magnetic stimulation is performed by pulse alternating magnetic field with growing strength within 6-12 mT with 50 Hz frequency and 10 min duration. Course of treatment constitutes 10 sessions.

EFFECT: method ensures efficient non-traumatic treatment of the last stage of proliferative diabetic retinopathy.

24 dwg, 4 ex

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