Method for rehabilitation of patients suffering urolithiasis following lithotripsy

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely rehabilitation medicine, physiotherapy and urology and may be used for the purpose of rehabilitation of the patients suffering urolithiasis following lithitripsy. That is ensured by the intake of the herbal tea "Veres" containing wild camomile blossom, knotgrass herb, nosebleed herb and horsetail herb, juniper fruits, sage leaves, birch leaves, red bilberry leaves, linseeds taken in equal proportions. The infusion is taken in a dose of 100 ml 3 times a day 30 minutes before meals for 5-7 preoperative days. The common background therapy follows the lithotripsy procedure. That is combined with the additional intake of the herbal tea "Veres" for 10 days following the above procedure and hydrocarbonate sulphate calcium-magnesium mineral water "Kazachinskaya" of mineralisation 1.44g/l for 24 days following lithotripsy. The mineral water "Kazachinskaya" is taken in a dose of 200-250 ml 3 times a day before meals. Further, after the lithotripsy procedure, a projection of the involved kidneys and renal duct is exposed to the apparatus Bemer-3000 at AC field frequency 30-1000 Hz and magnetic field intensity 8.5-100 mcT. The exposure is generated by an intensive contact applicator from 2 fields in the mode-1 (2-4 stages) of 8 minutes. The therapeutic course makes 10 daily procedures. The background therapy is followed by another one-month intake of the herbal tea "Veres", as well as by another exposure to the apparatus "Bemer-3000" at the same parameters of the electromagnetic field. The contact exposure also covers the kidneys and the lower one-third of the renal duct by means of the intensive application from 2-4 fields in the mode-2 (2-4 stages) of 12 minutes. The exposure is daily, two times a day.

EFFECT: method provides reducing the length of calculus fragments discharge following the lithotripsy procedure, improving the clinical and biochemical blood and urine statuses, renal blood flow, treating and preventing the postoperative complications, recovering the immunological responsiveness and antioxidant protection.

4 dwg, 3 tbl, 2 ex

 

The present invention relates to medicine, namely to regenerative medicine, and can be used for the rehabilitation of patients with urolithiasis after lithotripsy in medical and sanatorium-and-Spa institutions.

Urolithiasis (ICD) is one of the most common urological diseases, ranked second in the world after nonspecific inflammatory diseases of the kidneys, urinary tract and meets not less than 3% of the population in the most productive age is 30-50 years (Ollectively, 2000).

Introduction in urological practice lithotripsy fundamentally changed the approach to the treatment of urolithiasis, opened new prospects for reducing morbidity and disability, allowing to refuse surgical treatment.

Timely correction of violations in the early postoperative period is relevant and is of particular importance sanatorium rehabilitation with the use of natural and preformed therapeutic physical factors.

Physical factors in the complex of therapeutic measures leading role as political moment in any way lithotripsy is traumatic in nature. Physical methods have a beneficial effect on disease pathogenesis and is aimed at slimming the size of the stones, the removal of fragments, the relief of pain, normalization of hemo - and lymphopenia kidney, elimination of inflammatory processes.

Proven high therapeutic efficacy of low-frequency magnetic therapy, superhigh-frequency therapy, amplipulse, laser therapy, infrared irradiation in patients after lithotripsy with improved hemodynamics [Ponomarenko G.N. Private physiotherapy. - M., 2005. - P.189-195].

The above necessitates the use of factors with a pronounced anti-inflammatory, reparative action for faster relief of symptoms after lithotripsy.

The known method of complex treatment of urolithiasis, characterized by the fact that the effect of weak low-frequency modulated electromagnetic field through a set of frequencies simultaneously on the entire body under the scheme, sequentially: kidney stones: 2,8+3,5+8,1+43,0+53,0+54,0+63,0+86,0+3,3+17,0+27,0+84,0+85,0+88,5+94,5+96,0 Hz 300 seconds each, 2 times a day for 10-30 days. With any type of stone formation - oxaluria, phosphaturia, uraturia: 2,8+3,3+4,0+4,6+5,5+8,1+9,2+9,6+10,0+15,0+21,5+72,0 Hz 300 sec every 1 every 3 days for a course of 10 sessions, ciston 1 tablet 3 times a day for 30 days [patent RU 2278700, 2006]. The method allows to normalize the metabolism, to restore the balance of calcium, phosphorus, oxalates, urates.

It is known that some mineral waters (MB) contribute to the removal of stones or reduce their size, interfere with their education due to the antispasmodic and anti-inflammatory action, diuretic effect, change the properties of the urine (pH, viscosity). Preference is given to low - mineralized mineral water [Ponomarenko G.N. Private physiotherapy. - M., 2005. - P.á192-193].

There is a method of treatment of urolithiasis and secondary pyelonephritis, including the introduction of patient magnesium-calcium bicarbonate water of low salinity from the source "Kirensky" the Irkutsk region of 10-15 ml per 1 kg of body weight of the patient per day before meals [patent RU 2112520, 1998].

<> Along with physiotherapy and balneophtotherapy widely used herbal medicine as preparation for lithotripsy, and after the conference. Actual is the rational creation of medical facilities that use herbs and cultivated on the territory of the Russian Federation, in particular in Bashkortostan. One of the main advantages of preparations based on vegetable raw materials over synthetic drugs is their maltogenase and the possibility of long-term use without side effects, which is especially important in chronic diseases, which include ICD. Litolitic activity detected in some medicinal plants, has important practical significance in the conservative treatment of patients with small stones in the kidney and the ureter normal patency of the urinary tract.

There is a method of treatment of patients with ICD after lithotripsy, namely, that on the background of basic treatment was introduced endoscopically into the cavity of the pelvis drug "Eubacteria" (polyvalent, purified, liquid, R FS 42-3898-99, NGOs, the plant, Ufa) in the amount of 5-10 ml during contact lithotripsy. In the pre - and postoperative periods at a dose of 0.3 ml per 1 kg of body weight, per os three times a day, during 5-7 days is th. Another drug that has been used to treat secondary infections of the urinary system - Immunogenic" (P No. 000296 01-2001 Fund 42-0061-0493-00 (NGOs the plant, Ufa) in a dose of 50 ml, which was administered by intravenous infusion at a rate of 30-40 drops per minute, per course of treatment 2 infusion produced after 24 hours [Musin D.R. Prevention and treatment of complications of urolithiasis after contact lithotripsy when infected urolithiasis. Abstract of thesis...KMN - Saratov, 2008. - 22 S.].

A prototype of the invention taken treatment of patients after lithotripsy, including within 2-4 weeks of electrical stimulation with sinusoidal modulated currents on the area of projection of the affected kidney and ureter by a standard method, followed 30 minutes later by the laser therapy apparatus of the "Effect", power pulsed laser radiation 50 W, frequency of 50-500 Hz. The course of treatment was 10-12 treatments two days with a break on the third [Vasiliev F, Li AA Combined physical therapy for urolithiasis and chronic pyelonephritis. - Moscow, 2011].

The above method is not effective enough, because it does not provide for a maximum individualization of treatment, the impact on the basic parts of the pathogenetic mechanism of the ICD.

In recent years it became known about the positive effects of the new physio is terapevticheskii method - Boehmer-therapy using a variable low-frequency electromagnetic fields on clinical and functional parameters in patients with inflammatory gynecological diseases and inflammatory diseases of the prostate [Rudakov B.E. Rehabilitation medical center National medical surgical center. Pirogov Russian Ministry of health, Moscow]. Information about applying Boehmer-therapy in patients with ICD after lithotripsy missing.

The objective of the invention is to develop a method of rehabilitation of patients with ICD after lithotripsy with the use of therapeutic factors - plants, hydrocarbonate-sulfate calcium-magnesium mineral water and a variable low-frequency electromagnetic fields, allowing you to affect the basic pathogenesis of this disease.

The technical result of the proposed method is to reduce the length of the discharge of stone fragments after lithotripsy, improvement in clinical, General and biochemical blood and urine indices, indices of renal blood flow, treatment and prevention of postoperative complications, restoration of immunological reactivity.

The proposed method of rehabilitation of patients with urolithiasis after lithotripsy is performed as follows: on the background of basic therapy prescribed tincture ficoba is a "Veres" 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery within 10 days after the surgery and within one month after the completion of basic therapy. The composition of herbal "Veres" (LLC "Grass Bashkiria) includes chamomile flowers, grass, knotweed, yarrow and horsetail, the fruits of juniper, sage leaves, birch and cranberries, flax seeds, taken at equal ratio of components.

In addition, in the postoperative period prescribed ingestion hydrocarbonate-sulfate calcium-magnesium mineral water with a salinity of 1.44 g/l (MB Kazaninca") 200-250 ml 3 times daily before meals duration of treatment 24 days.

Simultaneously with the tincture of herbal and MB in the postoperative period are physiotherapy alternating low-frequency electromagnetic field on the projection area of the affected kidney and ureter of the device, "Boehmer-3000" (Switzerland) contact, consistently with 2 fields, intensive applicator in mode-1 (2-4 degrees) for 8 minutes frequency alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT. Course 10 daily procedures, starting from the 2nd day after surgery. The device generates oscillations of a wide range of frequencies on the basis of specific impulses "BEMER", causing the complex physiological effects.

A second course Boehmer-therapy spend a month with the use of intensive applicator contact is on the kidneys and the lower third of the ureter, with 2-4 fields in mode-2 (2-4 degrees) for 12 minutes, with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT, daily two times a day for a course of 12 treatments.

The proposed method is illustrated by the following figures: figure 1 shows the sonogram of the right kidney patient R. (example 2) with visualization of ureteral stones size 8 mm in the parenchyma of the middle segment of the right kidney before treatment; figure 2 - dopplergram right kidney patient R. arterial range of blood flow at the level of localization of the calculus before treatment with an increased resistance index (P1=1,00); figure 3 - echogram right kidney patient R. visualization of ureteral stones with a size of 3 mm in the parenchyma of the middle segment of the right kidney after treatment; figure 4 - dopplergram right kidney patient R. arterial range of blood flow at the level of localization of ureteral stones after treatment with reduced resistance index (P1=0,98).

The proposed method is used in 56 patients with ICD, which were treated in the clinics of Basementality with further direction in the sanatorium "tonyp" of the Republic of Bashkortostan. All underwent extracorporeal shock wave lithotripsy, the age of the patients varied from 19 to 69 years, including men - 32 (53,5%)and 24 females (46.5 per cent). Depending on therapy of patients with ICD after lithotripsy razdelenia group. The first group consisted of 26 patients who received a basic package (comparison group). The second group (main) included 30 patients with ICD after lithotripsy, which on the background of treatment received infusion creation of phyto compositions "Veres" MB "Kazaninca", the influence of an alternating low-frequency electromagnetic fields on the developed technique.

The reception of the phytocomplex "Veres" 100 ml was carried out 3 times a day 30 minutes before meals for 5-7 days before surgery, within 10 days after the operation, and within one month after the completion of basic therapy. Brackish mineral water "Kazaninca" hydrocarbonate-sulfate calcium-magnesium composition (M - 1.44 g/l) was administered at 200-250 ml 3 times daily before meals duration of treatment 24 days.

Boehmer-therapy alternating low-frequency electromagnetic field conducted on the area of projection of the affected kidney and ureter of the device, "Boehmer-3000" contact, with 2 fields, intensive applicator in mode-1 (2-4 degrees) for 8 minutes frequency alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT. At the rate of 10 daily procedures, starting from the 2nd day after surgery.

Basic package included clinical nutrition, analgesic and antispasmodic drugs indicated.

Before treatment all Bo inim was conducted clinical, laboratory and instrumental examination. Performed ultrasound examination of the kidneys, ureters, urinary bladder with Doppler ultrasonography, plain and excretory urography.

As a result of treatment with the use of herbal and MB, and a variable low-frequency electromagnetic fields on the 5-7 day there was complete passage of stone fragments in 20 patients of the main group and 10 patients in the comparison group. To a 14-day elimination destroyed concretions were observed in the majority (28) of the patients of the main group and 17 in the comparison group. At 28 days of purification of the urinary tract in the study group was 93%. In 3 patients in the kidney remained clinically insignificant single microliths (3 mm) without acoustic shadow by ultrasonography. In the comparison group elimination fragments were slower full discharge to 28 days was observed in 57% of patients. Occlusive complications in the study group there was also less in comparison with the control group.

Positive dynamics in the urine. Before treatment of 30 patients of the main group leukocyturia of different severity (from 4500 to 28000 in 1 ml Nechiporenko) occurred in 16 (53.3 percent) patients. One week after the beginning of reception MB Kazaninca", Fiorella "Veres" and a variable low-frequency electromagnetic field the degree of pyuria decreased significantly (up to 8000 the 1 ml) in most patients, and in 7 out of 16 with leukocyturia urine normalized reducing the total number of patients with leukocyturia in the main group up to 9 (30%). Subsequent dynamic control (2 weeks) for patients treated with MB, phyto-and low-frequency electromagnetic alternating field, allowed to assess their effectiveness in relation to the inflammatory process. So, after 2 weeks the number of patients with leukocyturia decreased to 6 (20%). After 4 weeks in the group of patients treated with MB, phyto complex and variable low-frequency electromagnetic fields, leukocyturia was preserved in 2 (6.6%) in patients who continued antibiotic therapy drugs in combination with MB, the phytocomplex "Veres" and a variable low-frequency electromagnetic field. In the comparison group who had only basic therapy, 14 patients (53.3 percent) leukocyturia 4 weeks in 9 (34.6 per cent) remained leukocyturia.

After 4 weeks in patients of the main group marked decrease in the number of patients with bacteriuria. If to treat bacteriuria occurred in 9 (30%) patients of the main group, then one month after treatment of bacteriuria 10 CFU/ml was detected only in 2 (6.6%) in patients.

The results of ultrasound examination in patients of the main group testified to the normalization of hemodynamics in a shorter SRO and relative to the comparison group, in 2 days after lithotripsy indicators index pulse (PI) and resistance (RI) corresponded with those before the intervention and remained so during the entire observation period (table 1).

In the comparison group who had only basic therapy, the recovery of renal hemodynamics was only 7 days after crushing.

Revealed that exposure to MB, phyto-and low-frequency electromagnetic alternating field does not violate the functional state of the kidneys, does not affect the concentration of potassium, sodium and total calcium in plasma. At the same time under the action of herbal medicine, MB and AC low-frequency electromagnetic fields has been a statistically significant increase in the volume of urine, reducing the level of nitrogen products.

All patients of the main group was recovering parameters of humoral and cellular immunity to a significant reduction of T-lymphocytes through the T-helper cells and b-lymphocytes (p<0.05), and reliable reduction in the content of IgG and IgA (p<0.05) in the increase in IgM. There was a reliable decrease in the level of Pro-inflammatory cytokines - IL-1b, α (p<0.05), IL-6, increasing the content of anti-inflammatory cytokines-IL-4 (table. 2).

In the preoperative period in patients with ICD has decreased activity of antioxidant enzymes with intense activity is the situation of peroxidation processes in the form of a significant reduction in the activities of superoxide dismutase (SOD) and increasing the level of malondialdehyde (MDA). Patients of the main group after a month of treatment by the proposed method revealed a significant increase of SOD activity and decrease in MDA level, which indicates the increase in antioxidant capacity of blood plasma. In the comparison group dynamics of the immune and antioksidantnoi systems wore insignificant in nature (table 3).

Thus, using the proposed method in patients of the main group in contrast to the comparison group showed restoration of parameters of cellular and humoral immunity, recovery antioxidant potential.

In the available scientific and medical and patent literature information about known method of rehabilitation of patients with ICD after lithotripsy, characterized in that on the background of basic therapy applied phytocomplex "Veres" 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery and within 10 days after lithotripsy, and within one month after the completion of basic therapy in combination with taking bicarbonate sulfate calcium magnesium brackish mineral water "Kazaninca" 200-250 ml 3 times a day before meals with a duration of 24 days, and spend Boehmer-therapy alternating low-frequency electromagnetic field on the projection area of the affected kidney and ureter of the device, "Boehmer-300" contact, with 2 fields, intensive applicator in mode-1 (2-4 degrees) for 8 minutes frequency alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT rate 10 daily procedures, not detected. Thus, the claimed invention meets the criterion of "novelty".

The authors proved that the application on the background of basic treatment of the phytocomplex "Veres" 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery and within 10 days after lithotripsy, and within one month after the completion of basic therapy, receiving bicarbonate sulfate calcium magnesium brackish mineral water 200-250 ml 3 times a day before meals with a duration of 24 days and Boehmer-therapy alternating low-frequency electromagnetic field on the projection area of the affected kidney and ureter of the device, "Boehmer-3000" contact, with 2 fields intensive applicator in mode-1 (2-4 degrees) for 8 minutes frequency alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT rate 10 daily procedures after lithotripsy provides shorter discharge of stone fragments after lithotripsy, improvement in clinical, General and biochemical blood and urine indices, indices of renal blood flow, treatment and prevention of postoperative complications, restored the e immunological reactivity and antioxidant protection. Thus, the claimed invention meets the criterion of "inventive step".

Example 1. Patient W., 55 years old, was admitted to the hospital bgmu with a diagnosis of ICD. The stone in the lower third of the right ureter, the stone in right kidney. Chronic pyelonephritis in the phase of incomplete remission.

Was held extracorporeal shock wave lithotripsy (DUVET) stone of the right ureter and ureterolithotomy the lower third of the right ureter, in which the stones were fragmented.

Urinalysis to DUVET: color - light yellow, share-1005, transparency, muddy, stab - 2-3-5 in sight, the blood in large quantities, erythrocytes - 1-3 in the field of view, protein - 0,19%, mucus "++".

Conclusion ultrasound to DUVET: ICD. Right nephrolithiasis. Dilatation of the urinary system of the right kidney. The right kidney - Cup-pelvis system expanded, the size of the average Cup - 18 mm, the size of the pelvis - 35×22 mm, extended pelvis lazerette calculus size 16 mm, the resistance Index increased to 1.02. Conclusion excretory urography to DUVET: the Stone on the right. In the projection of the right kidney shadow of calculus size up to 17 mm in the lower third of the right ureter up to 9 mm, not blocking the kidney.

Basic medical complex after lithotripsy included clinical nutrition, analgesic and antispasmodic drugs on p is the punishment.

Were treated according to the claimed method: on the background of the complex was used by the phytocomplex "Veres" 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery and within 10 days after lithotripsy, and within one month after the completion of basic therapy in combination with bicarbonate sulfate calcium magnesium brackish mineral water in 200-250 ml 3 times a day before meals with a duration of 24 days after lithotripsy and Boehmer-therapy alternating low-frequency electromagnetic field on the projection area of the right kidney and ureter of the device, "Boehmer-3000" contact, with 2 fields, intensive applicator in mode-1 (2-4 degrees) for 8 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT rate 10 daily procedures after lithotripsy.

As a result of treatment, improvement was noted in the urine: color - light yellow, share - 1005, transparency - transparent, stab - 0-1 in the field of view, the leukocytes in a single quantity, erythrocytes - 0-1 in the field of view, the protein "negative"slime "+" and the positive dynamics of divergence of stone by ultrasound and excretory urography.

Conclusion ultrasound: Right nephrolithiasis. On the right is the size of the average Cup - 15 mm, the size of the pelvis - 30×15 mm in the pelvis lazerous crayons the crystalline sizes 2-3 mm. The resistance index decreased to 0.93. Was the passage of fragments of a stone.

Conclusion excretory urography: the Shadow of a stone is not revealed. After base treatment, the course is repeated within one month from the application of intensive applicator contact on the kidneys and the lower third of the ureter, with 2-4 fields in mode-2 (2-4 degrees) for 12 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT every day twice a day.

Example 2. Patient R., 25 years old, was admitted to the hospital bgmu with a diagnosis of ICD. The stone in right kidney, the middle third of the right ureter.

Was held DUVET stone in right kidney and the right ureter. Urinalysis to DUVET: protein - 0,19%, color - pale yellow, share - 1005, transparency, muddy, leukocytes - 2-3-4 in the field of view, erythrocytes 1 -3 in the field of view.

Conclusion ultrasound to DUVET: ICD. Calculus right kidney. Dilatation of the urinary system, kidneys. Right - hinge-pelvis system the kidneys are enlarged, the size of the average Cup - 16 mm, the size of the pelvis - 32×20 mm, in the parenchyma of the middle segment of the right kidney lazerette calculus size 8 mm, in the middle third of the ureter up to 4 mm, the resistance Index increased to 1.00.

Conclusion excretory urography to DUVET: the projection of the middle third of the right ureter ten the concrement sizes up to 4 mm The stone on the right.

Basic medical complex after lithotripsy included clinical nutrition, analgesic and antispasmodic drugs indicated.

Were treated according to the claimed method: on the background of the complex was used by the phytocomplex "Veres" 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery and within 10 days after lithotripsy, and within one month after the completion of basic therapy in combination with bicarbonate sulfate calcium magnesium brackish mineral water in 200-250 ml 3 times a day before meals with a duration of 24 days after lithotripsy and Boehmer-therapy alternating low-frequency electromagnetic field on the projection area of the right kidney and ureter of the device, "Boehmer-3000" contact, with 2 fields, intensive applicator in mode-1 (2-4 degrees) for 8 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT rate 10 daily procedures after lithotripsy.

As a result of treatment, improvement was noted in the urine.

Urinalysis: protein - negative, color - pale yellow, share 1005, transparency - transparent, leukocytes - 1-2 in sight, erythrocytes - 0-1 in the field of view.

Conclusion ultrasound: Stone on the right. The kidney on the right: the size of the average Cup - 9 mm, the size of the lo is Anki - 30×15 mm In the parenchyma of the middle segment of the right kidney lazerous small crystalline size of 2-3 mm In the lumen of the bladder lazerette calculus size of 3-4 mm, the resistance Index decreased to 0.98. Marked the passage of stones through the day.

Conclusion excretory urography: the stone migrated from the lower third of the right ureter into the lumen of the bladder. After the base treatment was repeated course Boehmer therapy within one month from the application of intensive applicator contact on the kidneys and the lower third of the ureter, with 2-4 fields in mode-2 (2-4 degrees) for 12 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT, daily two times a day.

The proposed method is easily reproducible in medical and sanatorium-and-Spa institutions. Thus, the claimed invention meets the criterion of "industrial applicability".

Table 1
Dynamics of renal blood flow in patients of main group ICD on the background of the developed method for the treatment
IndexBefore lithotripsy Indicators after lithotripsy
After surgeryH/C 2 daysH/C 7 daysH/C 2 weeksH/C 4 weeks
RI1,04±0,021,03±0,010,94±0,02*0,95±0,04*0,94±0,05*0,95±0,04*
PI0,62±0,010,72±0,0*0,6±0,01*0,6±0,01*0,58±0,02*0,56±0,05*
*- reliability of differences in comparison with the figures before lithotripsy (p<0,05).

Table 2
Dynamics of cellular and humoral immunity in patients with ICD after lithotripsy after 3 months of treatment
IndexBefore lithotripsyThe main group (n=30)The comparison group (n=26)
Fit is+MV+Boehmer Basic therapy
CD3, %22,5±0,552,6±0,5*36,1±0,7*
CD4 %19,5±0,342,5±0,3*28,4±0,5*
CD8, %45,1±0,322,2±0,3*39,0±1,2
Phagocytosis, %38,7±0,664,0±1,1*44,0±0,9
FC2,9±0,25,9±0,3*3,6±0,1*
Nst - spontaneous, %12,8±0,116,1±0,1*14,3±0,1
IgA, g/l1,2±0,032,5±0,02*2,0±0,01
IgM, g/l3,9±0,021,9±0,02*2,7±0,09
IgG, g/l9,7±0,311,1±0,1*9,8±0,1
Fnoa, PCG/ml 495,0±7,0110,0±8,3*312,0±7,1*
IL-1b, PCG/mlof 128.6±3,252,1±1,3*for 96.1±3,3
IL - 6, PCG/ml75,9±1,443,6±0,8*61,0±1,2
IL - 4, PCG/ml68,6±2,0113,5±0,5*77,6±1,3
* the significance of differences compared to the figures before lithotripsy (p<0,05).

Table 3
Dynamics of parameters of the oxidant-antioxidant system in patients with ICD after lithotripsy
IndicatorsBefore lithotripsyAfter 1 monthAfter 3 months
the main group (n=30)the comparison group (n=26)the main group (n=30)the comparison group (n=26)
HMM, mmol/l of 5.40±0,12,78±0,02*3,9±0,03*3,12±0,02*4,2±0,3
SOD, Wedto 82.1±6,0117,1±0,05*93,8±7,1109,1±0,04*to 90.4±4,9
*- reliability of differences in comparison with the figures before lithotripsy (p<0,05).

The method of rehabilitation of patients with urolithiasis after lithotripsy, including physiotherapeutic effect on the area of projection of the affected kidney and ureter on the background of basic treatment, characterized in that it further prescribe tincture of herbal "Veres", containing chamomile flowers, grass, knotweed, yarrow and horsetail, the fruits of juniper, sage leaves, birch and cranberries, flax seeds, taken in equal proportions of the components, and 100 ml 3 times a day 30 minutes before meals for 5-7 days before surgery and within 10 days after lithotripsy, and within one month after the completion of basic therapy, hydrocarbonate-sulfate calcium-magnesium mineral water "Kazaninca" with mineralization 1.44 g/l in a volume of 200-250 ml 3 times a day before meals with a duration of 24 days, and the area Projektierung kidney and ureter is affected by alternating low-frequency electromagnetic field of the device, "Boehmer-3000" contact, with 2 fields-intensive applicator, in mode-1 (2-4 degrees) for 8 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT from the 2nd day after lithotripsy rate of 10 daily procedures, and after base treatment, the course is repeated within one month from the application of intensive applicator contact on the kidneys and the lower third of the ureter, with 2-4 fields in mode-2 (2-4 degrees) for 12 minutes with a frequency of an alternating electric field 30-1000 Hz, magnetic field intensity of 8.5-100 MT every day twice a day.



 

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3 cl, 1 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly urology. It is ensured by introduction of Blemaren in a dose 2 g in the morning and in the evening after meal with water or juice with increased level of uric acid in blood more than 0.472 mmol/l, and pH of urine 6.2-6.8. Introduction is carried out for 2 months in spring and autumn.

EFFECT: method provides fast normalisation of the content of uric acid in blood, daily urine, and decreased uraturia.

4 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: invention is related to medicine, in particular to urology, and is related to removal of residual concrements in patients who sustained surgical procedure. For this purpose patients who sustained surgical procedure receive irrigation of kidney cavities with litholytical solution, which contains ampicillin in amount of 0.1 - 0.3 wt % and complexon in amount of 4-5 wt %. As complexon they use either trilon B or sodium citrate or their mixture with content of each in the mixture of 2-2.5 wt %. Irrigation is carried out at solution temperature of 36.8-37.2°C and constant speed of litholytical solution feed, which is selected within the limits of 1-10 ml/min.

EFFECT: method provides for possibility of simultaneous removal of concrements of various composition and prophylaxis of complications stipulated by kidney injury because of residual concrements and bacterial infection.

1 tbl

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly urology and urolithiasis recurrence prevention and treatment for men. General testosterone level in blood serum of all men is determined preliminarily. If androgenic deficiency is detected, patients not suffering from prostate cancer are treated with any available testosterone medicine, additionally to standard therapy: Androgel - 5 g externally daily, Nebido - 4 ml intramuscularly one time in 3 months, Sustanol-250 - 1 ml intramuscularly one time in 3 weeks, Omnadren-250 - 1 ml intramuscularly one time in 4 weeks. In the course of therapy, medicines can be changed or alternated. Minimum course comprises 3 months. Treatment is implemented with account of general testosterone level in blood serum, which should exceed 12 nmol/l. Therapy efficiency is indicated by increased or stabilised level of mineral density of osseous tissue by T and Z criteria determined by densitometry, and by the absence of stone formation recurrence confirmed clinically and by ultrasonic kidney scanning.

EFFECT: ethiopathogenetic effect on stone formation process, resulting in recurrence-free course of urolithiasis for 1-1,5 years.

2 ex

FIELD: pharmacology.

SUBSTANCE: invention concerns N-phenylphosphoric acid triamides of general formula (I), method of their obtainment and application as inhibition agents in enzymic hydrolysis of carbamide , where X is oxygen or sulphur; R1, R2, R3, R4 are selected out of hydrogen, C1-C8 alkyl, alcoxy, fluorine, chlorine, bromine, iodine, trifluoromethyl.

EFFECT: obtaining novel efficient urease inhibitors.

12 cl, 4 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely ophthalmology, and may be used for treating postoperative corneal oedemas in age-related cataract surgery. For this purpose, 0.25% derinate is instilled for 3 times for 1 minute from the first postoperative day. Immediately after the last instillation, the cornea is exposed to a travelling pulse magnetic field generated by the AMO-ATOS apparatus with its radiation head placed at 3 mm from the external cornea. It is combined with the laser light exposure. A laser beam generated by the LAST-01 apparatus is directed through an axial hole in the field radiation head. Radiator frequency is 5-10 Hz; diaphragm position is 4; exposure time is 5 min; the therapeutic course is 2-3 sessions.

EFFECT: method improved the surgical outcomes and reduces the length of treating the gerontological patients suffering the declared pathology ensured by reducing the length of recovering the normal anatomic-physiological and optical corneal state, reducing the rate of chronic bullous keratopathy, recovering developed mechanisms causing energy and metabolic cell reserves.

1 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: magnetic fluid (MF) AM-01 55 mg/kg is introduced subcutaneously in white mature outbread rats suffering grafted sarcoma 45 having reached the size of 0.7-1.0 cm3 into a region surrounding the tumour, 2 cm away from the tumour borders, with the entire volume distributed over 3 injections into various loci of the introduction area. There are performed 4-5 injections every 3 days. The therapeutic course makes 2-2.5 weeks. MF AM-01 represents a colloidal suspension of magnetite nanoparticles (Fe3O4) in size 10±2 nm in water dissolved to the concentration of 20 mg/ml. Additionally, starting from the first day of the MF introduction, the tumour and the adjoining region are exposed to electromagnetic emission of frequency 7.8 Hz and induction 20 mT at exposition of 15 minutes every 1-2 days. On the days of the MF introduction, an interval between the introduction and the following electromagnetic emission, makes 10-30 minutes.

EFFECT: achieving the anti-cancer effect in the form of suppression of tumour growth and regression in an anti-stress effect on a body without the use of cytostatics and ionising emission ensured by limiting the magnetic effect of the tumour on neighbouring tissues with the use of a magnetic screen generated by a combination effect with the specific parameters of low-intensity very-low-frequency electromagnetic emission eliminating a possibility of tumour heating ensured by motion of the paramagnetic nanoparticles, as well as other energy deposition on the tumour.

1 tbl

FIELD: medicine.

SUBSTANCE: invention is applicable in medicine and medical equipment, namely for physiotherapy and rehabilitation of the patients. A method for systemic exposure for physiotherapy and rehabilitation consists in the fact that the patient is exposed to constant and variable magnetic field. The exposure requires placing the patient in mineral water for excitation of alternating microcurrent closing on the patient's body within high conductivity areas. An apparatus for implementing the method comprises a systemic exposure inductor presented in the form of Helmholtz coils, a power supply and a control attachment. Within a coverage of the magnetic field of the inductor, there is a dielectric bath filled with therapeutic mineral water.

EFFECT: use of the invention provides higher clinical effectiveness and outcomes quality.

5 cl, 2 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to restorative medicine and neurology, and can be used at treating cerebral damages in children suffering type 1 diabetes. That is ensured by combined transcerebral exposure to magnetic field pulses by a bitemporal technique with electric current pulse trains by a frontomastoid technique with magnetic field induction 10-30 mT, field frequency 1-12 Hz, current intensity 10-25 mA at pulse repetition rate 50-70 Hz. Magnetic and electric stimulations are combined and synchronous at first on one hemisphere, then on the other, at alternation rate 9.5-10.5 Hz. Current pulse train frequency is 2.5-3.5 kHz. Length of procedure is 7-15 minutes.

EFFECT: method allows normalising cerebral structure functions responsible for psychovegetative, cognitive, mnestic, behavioral and other cerebral functions due to considerable exposure on bioelectric cerebral activities, particularly, on basic α-rhythm differentiation.

1 dwg, 2 tbl, 2 ex

Cancer therapy // 2407562

FIELD: medicine.

SUBSTANCE: nanoparticles are enabled to be delivered to tumour cells by means of polymer fictionalisation with attached protein molecules or antibodies. Then, the tumour cells are exposed to radio-frequency LF modulation electromagnetic radiation characterised by the parametres: power density 10-1 - 10-2 Wt/cm2 with carrier frequency 13.56 MHz, and modulation frequency - 1-100 Hz to enable tumour cell cytotoxicosis.

EFFECT: method allows to invoke tumour brain cell cytotoxicosis, as well as to reduce a portion of healthy tissues involved due to reduced radiation power.

2 cl, 1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, and is intended for conservative treatment of anal incontinence in children. Electric stimulation is performed by magnetic field. Patient is in clothes, sitting on magnetic coil 15 cm in diametre. Rectal repeated magnetic stimulation with induction 0.2 Tesla, frequency 3 HZ, for 20 minutes 1 time per day 5 procedures running, 2 days break, after that from 2 to 5 more procedures. Total number of procedures is from 5 to 10.

EFFECT: method allows to recover or improve tonic activity of anal sphincters.

2 dwg, 4 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly - to physiotherapy. The method involves that the patient is exposed to extremely-high frequency electromagnetic waves of wave length 5.6 mm pulse modulated at frequency 9-10 Hz and pulse duration 1 mcs. The exposure is daily. For 5 procedures, it covers the paravertebral points of the cervical spine within C4 and C6. Then 5 procedures involve the successive exposure on the humeral, elbow and radiocarpal joints. Each region is treated for 8 minutes. Total exposure time is 32-48 minutes. Thereafter, 1 - 1.5 hours later, the exposure involves the application of sapropel of Moltaevo lake. The collar region and hands are covered. Mud temperature is 38 - 40° C, exposure length is 15 - 20 minutes. The therapeutic course is 10 procedures every second day.

EFFECT: method eliminates vegetative imbalance, improves microhemocirculation, eliminates venostasis, metabolic disorders, tissue hypoxia, improves peripheral nerve conductance, reduces manifestations of polyneuropathy and neuropathic pain in the upper extremities.

1 tbl, 3 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely neurology and physiotherapy, and it can be used in treating the patients with stage I-II hypertensive discirculatory encephalopathy. It involves antioxidant and antihypertensive drug therapy and exposure to bipolar low-frequency rectangular electric current pulses of frequency 77 Hz, current intencity 1-2 mA and variable magnetic field. Electromagnetic inductors are arranged to place their N-marked similar poles on the carotid sinus. A magnetic field generation mode is intermittent, the magnetic field shape is sinusoidal, frequency is 50 Hz, magnetic induction is 25 mT. The magnetic field exposure length is 10 min, the initial electrotherapy length is 15 min to be prolonged to 30 minutes during the therapeutic course. The therapy is daily and involves alternating transcranial electric current and variable magnetic field exposures. The therapeutic course makes 10-12 procedures.

EFFECT: method allows improving clinical effectiveness in the patients with stage I-II hypertensive discirculatory encephalopathy due to better clinical functions.

3 ex, 3 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to apparatuses for flashing signal therapy. An applicator comprises a lifting body, at least two signal generators which are placed on the lifting body or therein, with the signal generators being series connected, and each comprising at least two parallel signal generator units which are aligned with their longitudinal axis perpendicularly to a surface structure of the lifting body. The applicator can be applied for cosmetic and therapeutic skin treatment, and for stimulation of new collagen type II, IX, XI and X formation. Also, the applicator is used as a component of an apparatus for flashing signal therapy which also comprises a control device for control signal supply to the signal generator units.

EFFECT: application of the inventions allows improving effectiveness of collagen stimulation.

18 cl, 8 dwg

FIELD: medicine.

SUBSTANCE: device contains hamlet in form of fabric wrap on which placed are sources of magnetic field, electrically connected via pulse distributor with power unit. Into it additionally transverse straps included are generator of high-frequency bipolar pulses, electronic interrupter, transverse straps and current-conducting elements. Current-conducting elements are installed on one of free parts of wrap with possibility of travel on wrap, transverse straps are fixed to other free part of wrap with possibility of mutual rigid fixation of their free ends. Each strap is provided with at least one current-conducting element, current-conducting elements respectively on wrap and straps are electrically connected with each other and are connected via electronic interrupter with outlet of generator of high-frequency bipolar pulses, whose inlet is connected with power unit.

EFFECT: application of claimed device allows to stimulate deep structures.

6 cl, 1 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, education science. The method involves the brain exposure to electric current following frontal-mastoid technique. The exposure is generated by pulse current of frequency 800 Hz - 1200 Hz. A pulse length is 0.25 ms + 20%. The procedures are performed for 5 days before noon. A duration of the exposure is 25 minutes. It is followed by 10-minute self-massage of the head and neck regions.

EFFECT: method provides the higher effectiveness of mental activity ensured by the successive exposure to electric current of the above parameters, and self-massage.

1 tbl

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