Method of treating patients with lumbar osteochondrosis

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely - to neurology. The method involves the integrated treatment. Azathioprine, dexamethasone and analgin are administered into the patient. Azathioprine 50 mg is administered three times a day, after meals for 21 days. Dexamethasone 4 mg is administered intramuscularly three times a day for 15 days. From the 16th to 18th day of treatment, dexamethasone 4 mg is administered 2 times a day - in the morning and afternoon. From the 19th to 20th day, the same is administered in a dose of 4 mg in the afternoon. Before bedtime, 50% analgin 2.0 ml is administered parenterally for 10 days. At 9 o'clock in the morning, patient's lumbar pain area is exposed to the magnetic laser treatment. The patient is exposed to infrared light of wave length 0.8-0.9 mcm, pulse power 5-8 Wt, pulse frequency 1000 Hz and magnetic strength 35 mT. The exposure is contact and stable, and covers the fields paravertebrally. The length of the one-field exposure is 2 minutes. The therapeutic course is 15 procedures. Trives spinal assistant is put on in the horizontal position of lying on back. The spinal assistant is taken off in the horizontal position before bedtime.

EFFECT: method reduces the length of treatment, prolongs a remission, including due to the developed modes and combinations of the various components of the exposure.

1 ex, 1 tbl

 

The invention relates to medicine, namely, neurology and orthopedics and can be used for the treatment of patients with osteochondrosis of the lumbar spine.

Osteochondrosis of the spine, as degenerative-dystrophic process, manifesting itself clinically, primarily vertebrates pain-dorsalgia, occurs in 95% of the people and causes to the population of the globe tangible harm, both physical and material. Despite the efforts of scientists from various countries etiopathogenetic treatment of degenerative disc disease does not exist. Some of the known pathogenic factors of lumbar osteochondrosis are mechanical impact due to postural stress on the spine and autoimmune processes in the intervertebral discs in the spine as a whole.

Known methods of treating degenerative disc disease are symptomatic and do not affect the pathogenic components of the formation of degenerative disc disease and its clinical manifestations. Previously offered conservative treatment of lumbar degenerative disc disease are very similar and differ only by the introduction in the complex therapy of individual drugs, which, in their opinion, the most reasonable.

There is a method of treatment of lumbar degenerative disc disease (Tarasova H., Kozlovskaya LE, Bojanovic O.K. Physiotherapy neurological manifestations of osteochondrosis POS is onecznika - journal of Medical news. - 2007. No. 1. - P.48-49), based on physiotherapy, including dynamic and sinusoidal modulated currents, amplipulse therapy, laser therapy, magnetotherapy, darsonvalization, diadynamic therapy, medicinal electrophoresis (analgin, novocaine, magnesium, heparin, aminophylline, nicotinic acid, hydrocortisone, iodine, lidz), phonophoresis (analgin, baralgina, Fastum-gel, aminophylline, troksevazina, lidz, iodine), parafinoozokeritolechenie.

The disadvantage of this method is the excessive variety of physical factors for the treatment of lumbar degenerative disc disease, the combination of which can cause unwanted reactions of the body, the lack of equipment in hospitals and outpatient health care facilities, high cost of treatment.

There is a method of manual therapy for patients with osteochondrosis of the lumbar spine (Leviticus K., Sachse I., Janda Century Manual medicine. - M.: Medicine, 1993. - 640 p; Goidenko B.C., Khabibullina A.B., Galanov VP and other Manual therapy neurological manifestations of osteochondrosis. - M.: Medicine, 1988. - 240 (C), based on manual exposure on the spine and paravertebral muscles of the lumbar spine.

The disadvantage of this method is limited availability to the spine, multiple contraindications associated with the stages of osteoarthritis, otsutstvuet the chronic course of the disease.

Closest to the claimed invention is a method of treatment of an osteochondrosis of spine (Nikiforov A.S., Mendel I. Osteochondrosis: the pathogenesis of neurological manifestations and modern approaches to treatment. Lecture for practicing physicians.- Ukrainian medical honey.- 2009.- No. 3.- p.24-29), taken as a prototype, including drug treatment, consisting of non-steroidal anti-inflammatory drugs, analgesics, vitamins, cardiovascular drugs, procaine blockade, chondroprotective (chondroitin sulfate, glucosamine, artron); exercise therapy and massage; the wearing of the corset; the traction of the lumbar spine, various methods of physiotherapy (hydrotherapy, laser therapy).

The disadvantage of this method is the inclusion in the complex therapy of NSAIDs with a wide range of contraindications, expensive protective agents, which have a low efficiency for recovery discs as the discs do not have their own vessels, which limits the penetration of the drug into its fabric, wearing a corset, without limitation, to the same complex is cumbersome, involving many drugs and methods that require large expenditures.

The claimed invention is directed to the solution of this problem involves the development of a treatment for patients with lumbar osteochondrosis what about the spine.

The solution to this problem will allow to reduce time of treatment of patients with osteochondrosis of the lumbar spine, increase the time of remission between exacerbations, reduce the cost of treatment.

To achieve this result, the claimed invention, a method for the treatment of patients with osteochondrosis of the lumbar spine, the daily use of the immunosuppressant azathioprine 50 mg three times a day after meals for 21 days and dexamethasone 4 mg three times a day intramuscularly for 15 days, 16 to 18 days of treatment administered 4 mg 2 times morning and afternoon, from 19 to 21 day - 4 mg a day, administered parenterally 50% analgin 2.0 ml in the evening before bedtime for 10 days, and every day at 9:00 spend magnetic laser therapy on the lumbar region of the contact stable paravertebral technique in the fields, the wavelength of infrared laser radiation of 0.8 to 0.9 μm, a pulse power 5-8 W, pulse frequency of 1000 Hz and a magnetic induction of 35 MT, lasting impact on one field for 2 minutes, 15 procedures, then after magnetic-laser procedures in a horizontal lying position wear orthopaedic lumbo-sacral corset Trivers, which is removed in the bed in a horizontal position before going to sleep.

Between the features and the technical result is the following causal the link in the complex therapy as part of medical treatment additional daily use of immunosuppressant azathioprine 50 mg three times a day after meals for 21 days and dexamethasone 4 mg three times a day intramuscularly within 15 days, 16 to 18 days of treatment administered is 4 mg 2 times morning and afternoon, from 19 to 21 day - 4 mg a day, administered parenterally 50% analgin 2.0 ml in the evening before bedtime for 10 days, and every day at 9:00 conduct of magnetic-laser therapy on the lumbar region of the contact stable paravertebral technique in the fields, the wavelength of infrared laser radiation of 0.8 to 0.9 μm, a pulse power 5-8 W, pulse frequency of 1000 Hz and a magnetic induction of 35 MT, and duration of exposure to one field is 2 minutes, 15 procedures, then after magnetic-laser procedures in a horizontal lying position wear orthopaedic lumbo-sacral corset Trivers, which is removed in the bed in a horizontal position before going to sleep.

The aggregate of all funds: immunosuppressant of azathioprine and dexamethasone, aspirin, and magneto-laser therapy on my lower back every morning at 9:00 followed by wearing orthopedic corset Trivers, who is dressed in a horizontal position after the magnetic-laser treatments and shoot in bed before going to sleep, is a method of treating patients with degenerative disc disease of the lumbar spine, which reduces the treatment time, increase the time of remission, reduce the cost of treatment.

According to the author's knowledge, Kosovo is upmost essential features, characterizing the essence of the invention is unknown in the prior art, which allows to make a conclusion about conformity of the invention, the criterion of "novelty".

According to the author, the essence of the claimed invention is not obvious from the prior art, since it cannot be detected by the above-mentioned influence on the resulting technical result is a new property of an object is a set of characteristics that differ from the prototype of the claimed invention that allows to make a conclusion about its compliance with the criterion of "inventive step".

The combination of existing features that characterize the invention, in principle, can be repeatedly used in medicine, namely in neurology and orthopedics in the treatment of patients with lumbar osteochondrosis with the technical result consists in the reduction of treatment time, increased periods of remission between exacerbations and reducing the cost of treatment, which allows to make a conclusion about conformity of the invention, the criterion of "industrial applicability".

The claimed invention is a method of treating patients with osteochondrosis of the lumbar spine is performed as follows. Patients with clinical manifestations of osteochondrosis of the lumbar spine comprehensively appointed medical care is, including ingestion of tablets of immunosuppressant azathioprine 50 mg three times a day after meals for 21 days. In parallel intramuscularly injected anti-allergic and anti-inflammatory agent dexamethasone 4 mg 3 times a day for 15 days. Then the daily dose of dexamethasone reduced: from the 16th to the 18th day of treatment administered 4 mg twice morning and afternoon, from 19 to 21 day - 4 mg a day. In the evening time from the first to the tenth day of treatment parenteral use 50% to 2.0 ml of dipyrone. Simultaneously with medication prescribed physical therapy, including magnetic-laser therapy apparatus "RIKTA-02/1". Of the procedures performed daily in the morning at 9:00, methods of contact, stable, paravertebral fields in areas of the greatest pain in movement and palpation of the lumbar spine in two fields above and below the painful area on the right and left, the wavelength of infrared laser radiation of 0.8 to 0.9 μm, a pulse power 5-8 W, pulse frequency of 1000 Hz and muscle induction 35 m TL, lasting impact on one field for 2 minutes of treatment 15 procedures. Immediately after the magnetic-laser procedures as immobilization of the lumbar spine in a horizontal lying position wear orthopaedic lumbo-sacral corset Trivers, reinforced by six ribs, the cat is who are in all day. Remove the corset in bed in a horizontal position before going to sleep.

Developed a method for the treatment of patients with osteochondrosis of the lumbar spine in the Republican clinical hospital in Vladikavkaz were treated 418 patients of the main group. The diagnosis of osteochondrosis of the lumbar spine was confirmed by clinical, static-dynamic, imaging, electromyographic studies and calculation of the coefficient of mobility of the spinal segment (CGSS).

To clarify the advantages of the proposed complex therapy over existing methods was analyzed the effectiveness of treatment 238 patients of the control group, treated at the RSC in Vladikavkaz according to modern medical standards, including all known methods of treatment of patients with lumbar osteochondrosis. Medical standard includes: 1. analgesics, nesteroidnyi anti-inflammatory drugs, witaminy group, thprice, beastialiaty and protective agents, Brassai and physiotherapy, monoalkyl therapy, hidrocortisona-novocaine blockade.

Then the results of treatment in the main group compared with the results of the control group (table 1).

From table 1 it is seen that after 21 days in patients of the main group treated according to the developed method, symptoms of illness who evania decreased more and indicators of corvinelli, kbps, BA and cytokines were close to the optimal value compared with patients in the control group, treated by modern medical

Table 1.
Comparison of results after 21 days of treatment in patients of the main and control groups.
SymptomsThe main groupThe control group
Lumbar pain14.1%29.3%
The tenderness of the spinous processes and paravertebral points15.07%17.46%
The strain of extensor muscle torso8.61%22.69%
Pain in the lumbar-sacral area during movement12.92%14.7%
The mobility of the lumbar spine according to
corvinelli (the optimal size 14.19 mm).
in 21-30 years13.91 mm13.13 mm
in 31-40 years13.95 mm13.5 mm
in 41-50 years12.1 mm10.93 mm
in 51-60 years8.0 mm7.93 mm
The coefficient of mobility of the lumbar segments kbps (the optimal size 3.28)
L1-L23.23.05
L2-L33.253.1
L3-L43.283.05
L4-L53.33.14
Bioelectric activity (BA) of the back muscles according to ENMG (the optimal size 9.07 µv)
in 21-30 years9.73 µv11.1 µv
9.84 µv11.25 µv
in 41-50 years11.1 µv13.0 µv
in 51-60 years11.0 µv13.94 µv
Immunological parameters of cytokines TNF-a (the optimal rate of 3.6 PG/ml)4.3 PG/ml6.3 PG/ml
IL-1 (the optimal rate of 5.3 PCG/ml)98.0 PCG/ml138.4 PCG/ml
IL-2 (the optimal rate of 319.2 PCG/ml)298.0 PCG/ml220.0 PCG/ml

standards, including all known methods of treatment.

Further monitoring of patients identified in the study group increased remission between exacerbations compared to patients in the control group. That generally leads to a reduction of costs for the treatment of disease.

Example 1. Patient, 42 years of age, was observed by a neurologist outpatient, and then in the neurology Department about severe pain in the lumbar spine. Pain in acute during physical work. History of frequent, up to 4 times in 1 year, exacerbation of lumbar the pain, which forced every year several times to go to the hospital and being treated as an outpatient or inpatient basis. During the inspection were determined significant thoracolumbar vertebral syndrome. Indicators of cytokines were reached: TNF-a is 6.8 PG/ml, IL-1-123,0 PCG/ml, IL-2-220,0 PCG/ml Spondylopathy, CT, and MRI of the spine showed degenerative effects of osteoarthritis of the lumbar spine. From the day of admission until discharge from hospital the patient was taking azathioprine 50 mg three times a day after meals. In parallel intramuscularly injected dexamethasone 4 mg three times a day for 15 days,then 3 days at 4 mg twice a day, morning and afternoon, the last 3 days - 4 mg a day. The evening was injected intramuscularly 50% to 2.0 ml of dipyrone for 10 days. From the first day of treatment was prescribed magnetic-laser therapy apparatus "RIKTA-02/1", which was held every morning at 9:00 15 days, the technique of contact, stable fields paravertebral on the area of greatest pain in movement and palpation of the lumbar spine and above and below the painful area on the right and left, long wave infrared laser radiation of 0.8 to 0.9 μm, a pulse power 5-8 W, pulse frequency of 1000 Hz and muscle induction of 35 MT, and duration of exposure on one field 2 minutes Immediately after the magnetic - laser procedures in the supine position adeva the and orthopaedic lumbo-sacral corset Trivers, reinforced six ribs, which the patient had worn all day. Filmed corset in bed in a horizontal position before going to sleep. For the 21-day treatment of low back pain was eliminated, vertebral syndrome regressed. TNF-α decreased to 4.3 PG/ml, IL-1 also decreased-98,0 PCG/ml, and IL-2 increased -298,0 PCG/ml Patient was discharged on the job.

Further clinical observation of the patient showed no relapse within 1.5 years.

Method of treatment of patients with osteochondrosis of the lumbar spine, including the integrated use of drug therapy, physiotherapy and immobilization of the lumbar-sacral spine, characterized in that the additional daily use of immunosuppressant azathioprine 50 mg three times a day, after meals, during 21 days, and dexamethasone 4 mg three times a day, intramuscularly, within 15 days from 16 to 18 day treatment administered 4 mg 2 times morning and afternoon, from 19 to 21 day - 4 mg a day, administered parenterally 50% analgin 2.0 ml in the evening before bedtime for 10 days, and every day at 9:00 conduct of magnetic-laser therapy on the area of the painful areas of the back contact stable method, paravertebral fields, the wavelength of infrared laser radiation of 0.8 to 0.9 μm, a pulse power 5-8 W, pulse frequency of 1000 Hz and magnetic in what UCLA 35 MT, lasting impact on one field 2 min, treatment of 15 procedures, then after magnetic-laser procedures in a horizontal lying position wear orthopaedic lumbo-sacral corset Trivers, which is removed in the bed in a horizontal position before going to sleep.



 

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3 ex

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to otolaryngology, and can be applied in treatment of benign neoplasms of larynx. method consists in surgical treatment with application of photodynamic therapy (PDT), which includes introduction of photosensitiser into patient's organism with further laser irradiation of neoplasm zone. Intubation of patient with endotracheal tube with inflatable cuff on end is carried out. Detachable reflector, facing the side of lower surface of vocal folds, is installed into endotracheal tube in lower part of larynx between vocal folds and inflatable cuff at 50-80° towards trachea side. Additional irradiation of lower part of larynx, including lower surface of vocal folds, is carried out simultaneously by reflected laser irradiation by means of reflector. Duration of photodynamic therapy session constitutes on average 600 s, with irradiation power being 1.5 W.

EFFECT: application of claimed invention makes it possible to increase treatment efficiency due to possibility of irradiation of lower part of larynx and lower surface of vocal folds, reduce terms of treatment of benign larynx diseases by carrying out a single PDT session.

3 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely neural diseases, neurosurgery, traumatology. A neck surface is exposed to autoresonant red emission in a projection of carotid sinus at wave length 0.63-0.66 mcm, power 24-26 mWt for 7-10 minutes and to infrared emission at wave length 0.87-0.89 mcm, power 9-10 Wt for 10-15 minutes. That is followed by pharmacological neuroprotection by intranasal electrophoresis with neuroprotective preparation at current intensity 0.5-2.0 mA for 15-20 minutes. The treatment is started from the third post traumatic day. The first therapeutic day required the exposure to red laser light followed by a 15-20-minute pause and the intranasal electrophoresis in the morning with the exposure to red laser light in the evening. On the second therapeutic day, the exposure to red laser light is performed in the morning, and in the evening the same is followed by a 15-20-minute pause and the intranasal electrophoresis. The treatment is conducted within 14-20 days.

EFFECT: method enables reducing the length of traumatic intracranial haematoma resolution ensured by the synergetic effect of the red and infrared laser light and therapeutic preparations.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to experimental medicine and may be used to treat simulated spinal ischemia in a biological object. The method involves three intraperitoneal administrations of human recombinant erythropoietin in 4-6, 24 and 48 hours after the action caused spinal ischemia. The amount of human recombinant erythropoietin per an injection is 5000 IU/kg. In 30-60 minutes after the first dose of human recombinant erythropoietin has been administered, a region in a projection of a spinal ischemia centre increased by 1-2 cm from the end above the affected region is exposed to diffuse percutaneous irradiation. The patient is exposed to infrared light generated by a diode laser at wave length 890 nm, power 2 Wt. The exposure is performed in the continuous mode for 3 minutes at 3-4 cm from the body surface of the biological object within the exposure area with the light guide movable at 5 mm/sec. The light guide moves along the exposure area spirally.

EFFECT: method provides the high clinical effectiveness in spinal ischemia in experiment.

FIELD: medicine.

SUBSTANCE: invention relates to medicine, prevention and treatment of acquired myopia. Method includes simultaneous carrying out optical-reflex and stereoscopic exercises. For this purpose created are conditions for passage of short-wave part of spectrum of day light, which consists of violet, blue, azure, green colours with wave length in range from 380 to 575 nm, for one eye, and for the other - long-wave part of spectrum of day light, which consists of yellow, orange, red colours with wavelength in range from 575 to 760 nm, with simultaneous carrying out session of optical-reflex exercises by patient. Creation of such conditions is possible due to alternation of colour light filters, placed into slots of lens-holders on apparatus "Vizotronik", before each following session of treatment.

EFFECT: method ensures simultaneous considerable improvement of monocular, binocular, stereoscopic visual acuity, increase of fusional reserves and reserves of accommodation, perfection of visual perception system on the whole, normalisation of process of refractogenesis, stopping of myopic process progressing.

2 cl, 1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to - physiotherapy, to infectious diseases. The method involves the integrated use of drug preparations, magnetic and laser therapy. The laser therapy is differentiated depending on the severity, modified leukocytal intoxication index (mLII), malondialdehyde (MDA), lipid hydroperoxide (LHP), antioxidant activity (AOA), interleukin-1β (IL-1β), tumour necrosis factor (TNF-α). The mild severity, mLII within the range of 2.8±0.09-3.44±0.07, MDA 3.7±0.08-4.2±0.07mcm/ml, LHP 10.1±0.1-11.3±0.09 mcm/ml, AOA 0.489±0.005-0.390±0.007, IL-1β 25.3±0.5-26.71±0.3 pg/ml; TNF-α 37.1±0.5-45.7±0.8 pg/ml require the daily percutaneous exposure to a constant magnetic field and low-intensity laser light of power 55 mWt, wave length 0.89 mcm, pulse frequency 80 Hz in the morning hours. The contact scanning exposure covers a projection of thymus, regional lymphatic nodes and great vascular pedicle. The length of the exposure makes 60 seconds per each region. Then, an inflammatory centre is exposed to pulse red light of wave length 0.65 mcm, output pulse power min. 5 Wt, pulse frequency 80 Hz, modulation frequency of light-emitting diodes 8 Hz generated by a light guide tip. The length of the exposure is 120 minutes. The therapeutic course consists of 5 procedures. The moderate severity, mLII 4.18±0.08-6.06±0.07, MDA 4.9±0.03-5.6±0.02 mcm/ml, LHP 12.3±0.08-14.7±0.07 mcm/ml; AOA 0.345±0.007-0.315±0.006, IL-1β 27.1±0.2-28.1±0.1 pg/ml, TNF-α 57.7±0.9-72.1±0.5 pg/ml requires the daily percutaneous exposure to the constant magnetic field and low-intensity laser light of power 60 mWt, wave length 0.89 mcm, pulse frequency 80 Hz in the morning hours. The contact scanning exposure covers a projection of thymus, regional lymphatic nodes and great vascular pedicle. The length of the exposure makes 90 seconds per each region. Then, an inflammatory centre is exposed to pulse red light of wave length 0.65 mcm, output pulse power 7 Wt, pulse frequency 80 Hz, modulation frequency of light-emitting diodes 8 Hz generated by the light guide tip. The length of the exposure is 150 minutes. The therapeutic course is 7 procedures. The severe condition, mLII 7.76±0.08-8.06±0.07, MDA 7.1±0.03-11.6±0.02 mcm/ml, LHP 16.3±0.08-19.7±0.07 mcm/ml; AOA 0.310±0.007-0.294±0.006, IL-1β 30.1±0.2-31.1±0.1 pg/ml, TNF-α 76.7±0.9-85.1±0.5 pg/ml requires the daily percutaneous exposure to the constant magnetic field and low-intensity laser light of power 60 mWt, wave length 0.89 mcm, pulse frequency 80 Hz in the morning hours The contact scanning exposure covers a projection of thymus, regional lymphatic nodes and great vascular pedicle. The length of the exposure makes 120 seconds per each region. Then, an inflammatory centre is exposed to pulse red light of wave length 0.65 mcm, output pulse power 9 Wt, pulse frequency 80 Hz, modulation frequency of light-emitting diodes 8 Hz generated by the light guide tip. The length of the exposure makes 180 seconds. The therapeutic course consists of 9 procedures. For the first five days, all the patients are prescribed with heparin electrophoresis by common technique during afternoon.

EFFECT: method reduces a rate of recurrence.

3 tbl, 3 ex

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