Method of complex treatment of arterial hypertension in case of metabolic disorders

FIELD: medicine.

SUBSTANCE: method includes carrying out drug treatment, diet therapy, physical exercise, balneotherapy. Drug treatment includes intake of an ACE inhibitor or a beta-blocker 30-40 minutes before the first breakfast. 2-2.5 hours after supper methmorphine in a dose of 500-1000 mg/day is taken in. Diet therapy includes fractional feeding with the calorie content of 1200 kilocalories from Monday to Friday. On Saturday the calorie content is reduced to 800-900 kilocalories, and on Sunday - to 600-700 kilocalories. The physical exercise is carried out in the form of walking in a slow tempo, with stops, with the total duration of 90-120 minutes. Balneotherapy is started with carrying out in the morning of a rain fresh water shower. Then, manual superficial massage of the neck zone is carried out. Baths take place in the period from 12 to 17 o'clock. For their carrying out hydrocarbonate-sulfate-sodium mineral water from Belokurikha resort with an increased content of silicic acid and fluorine, and mineralisation of 0.4 g/l is applied. Radon concentration for bath realisation constitutes 3.9-4.6 nCi/dm3, water temperature is 36-37°C. The duration of the bath time is five minutes on the first day, on the second day - eight minutes, on the third day - ten minutes, on the fourth day - rest, on the fifth and sixth days - twelve minutes, on the seventh day - fifteen minutes, on the eighth day - rest, on the following three days the baths are being carried out for 15 minutes.

EFFECT: method increases remission duration due to an increase of the non-specific resistance of the organism protection factors, normalisation of oxygenation and metabolic processes in tissues.

4 cl, 2 tbl, 2 ex

 

The invention relates to medicine, in particular to internal medicine and balneotherapy, and relates to methods of treatment of adults with hypertension and disorders of carbohydrate, lipid metabolism, overweight.

In numerous studies conducted in patients with arterial hypertension, it is shown that the use of drug antihypertensive therapy reduces vascular complications by 40% and reduce the risk of developing coronary heart disease by 15%. Meanwhile, the high prevalence of hypertension, the presence of the complex risk factors of metabolic disorders, especially in patients of older age confirm the relevance of timely diagnosis, prevention and adequate treatment of pathology of the cardiovascular system. Currently in the principles of treatment of arterial hypertension and disorders of carbohydrate, lipid metabolism, overweight practically limited to medical therapy with mandatory compliance by patients assigned to a treatment regimen. Meanwhile, the use of Spa methods in complex therapy of this disease is still very limited. In this regard, we have had an important and necessary use of natural factors of the resort Belokurikha in treatment of adults with ar is realnoe hypertension and disorders of carbohydrate, lipid metabolism, overweight.

There is a method of treatment of mild forms of hypertension, the essence of which consists in conducting dosed muscular work on the background of the action of the centrifugal force direction vector "head - lower limb", and the impact of conduct depending on the stage of the disease: at the first stage of hypertension procedure is carried out every day, the session duration is gradually increased from 6 minutes on the first procedure to 12 min to the third speed from 30 to 36 rpm, the power of the performed work the lower extremities adjusted from 20 to 100 watts, then this mode remain for the entire period of treatment, the course shall 10-12 sessions; at the second stage hypergravity treatment is carried out twice a day with an interval between procedures 5-6 hours, the duration of the session to the 3rd procedure increase from 5 to 10 min, the speed from 25 to 33 rpm, the power dynamic from 20 to 80 watts. The method allows to reduce the load on the heart, increase the number of functioning capillaries, reduce peripheral vascular resistance and, ultimately, to reduce the level of blood pressure (Askov V., Bogatyrev M.V., Kotelnikov MG treatment of mild forms of hypertension. Patent RU No. 2196628, IPC 7 A63B 22/00, A61H 1/00, publ. 20.01.2003).

However, the decree is but in combination with any other methods of treatment is provided a therapeutic effect. The method is not sufficiently specific. Consequently, as a result of treatment in the nearest time possible progression of the disease with the need for re-treatment (requires additional cost and effort on the part of the patient) and the shortening of the period of remission.

There is a method of treatment of hypertension, including a course of diet. Exercise and hardening combined with datacollecting daily for 10 days. In particular, unlike other methods in the diet include fatty sea fish, pork meat and fat as sources of protein and polyunsaturated essential fatty acids. This leads to a decrease in blood pressure normalize blood circulation indices and lipid metabolism to the age norm that allows you to prolong the period of remission and limit side effects (Khananashvili AA, : Netreba G.K., Odintsova VI, Drobot N.V. method for the treatment of hypertension. Patent RU No. 2136255, M CL A61H 1/00, A61K 35/00, A23L 1/29, publ. 10.09.1999).

However, the described method of treatment has drawbacks:

1) there are no criteria for the selection of patients for applying this method;

2) there is no monitoring of the functional status of the body;

3) psychophysiological assessment with the situation of patients is carried out subjectively on the basis of complaints;

4) the effectiveness of treatment is monitored by the doctor 2 times during the year;

5) do not indicate the sequence of the reception of the physical stress and hardening;

6) in patients on background treatment may develop hypertensive crises, fluctuations of blood pressure during the day;

7) the method does not forecast the duration of remission and the need for repeated courses.

The closest is the method of complex treatment of patients with pathology of the cardiovascular system, including patients with arterial hypertension and metabolic syndrome, including drug therapy, diet therapy, physical activity, holding tanks (A.T. Bull, etc. Sanatorium-resort treatment of patients with isolated and combined pathology of the cardiovascular system and metabolism, J. "Questions of balneology, physiotherapy and physical culture". - M.: Medicine, 2010, No. 3, p.48-50).

However, the described method has drawbacks:

1) there are no criteria for the selection of patients in groups to apply this method, namely the form of baths;

2) there is no description of methods of vacation total artificial baths, no characteristics of the composition;

3) not conducted a study of the functional state of the organism after treatment;

4) do not specify the composition and schemes of drug therapy;

5) the method does not forecast the duration of remissi is and the need for repeated courses.

The OBJECTIVE of the INVENTION

Increasing the efficiency of treatment of hypertension with disturbances in carbohydrate, lipid metabolism, overweight due to the use of a combination of medication and non-medication treatment to achieve moderate stable for days in blood pressure, increase the period of remission the influence of natural factors of the resort Belokurikha in combination with diet therapy, dosed walking, hand superficial massage of a collar zone.

This object is achieved by a method of complex treatment of hypertension metabolic disorders, including medication, diet, physical activity, balneotherapy baths.

Medical treatment involves taking antihypertensive agents, such as ACE inhibitor or beta-blocker for 30-40 minutes before the first Breakfast and Metformin at a dose of 500-1000 mg/day in 2-2,5 hours after dinner. Nutritional therapy includes split meals with low calories to 1200 calories from Monday to Friday, with the reduction of calories on Saturday to 800-900 calories, and Sunday to 600-700 calories. Physical activity is carried out in the form of walk at a slow pace, with stops, for a total duration of 90-120 minutes. Spa treatments start provedenia in the morning from 8 to 10 hours rain shower with fresh water, after which perform manual superficial massage of a collar zone. In the period from 12 to 17 hours spend baths hydrocarbonate-sulphate-sodium mineral water resort Belokurikha with a high content of silicic acid and fluorine, a salinity of 0.3 g/l, with the concentration of radon in the procedure, 3,9-4,6 NCI/DM3at a temperature of 36-37°C. the duration of the bath is on the first day of 5 minutes, the second day, 8 minutes, in the third day - 10 minutes, the fourth day is a rest day, the fifth day is 12 minutes, on the sixth day - 12 min, on the seventh day - 15 minutes, on the eighth day is a rest day, and then in the subsequent three days tubs hold for 15 minutes.

Rain shower with fresh water carried out for 3 minutes at a temperature of 35-36°C, the course of 7 treatments a day.

Manual superficial massage of a collar zone hold for 15 minutes, a course of 10 treatments daily.

Fractional power carried out according to the scheme: welcome drink at 7 : 30, Breakfast at 8 a.m., lunch - lunch at 12 o'clock, lunch at 14 o'clock, afternoon tea in 16 hours, the reception of unsweetened drink at 18 hours and 30 minutes, dinner at 19 o'clock.

The novelty of inventions

- In remission the patient has a complex medical procedures. The course combined non-pharmacological effects of healing waters resort Belokurikha (balneotherapy) in the complex treatment increases efficiency and ensures the t more stable remission of the disease by increasing the separation of biologically active substances, the speed of the local blood flow in the bronchi and minute volume of respiration; stimulation of Central hemodynamics - increased shock and cardiac output, shortening of systole and lengthening of diastole while maintaining heart rate and blood pressure; normalize tone of the sympathetic and parasympathetic divisions of the autonomic nervous system.

- Medical treatment includes patients receiving antihypertensive - ACE inhibitor or beta-blocker individually for 30-40 minutes before the first Breakfast and Metformin at a dose of 500-1000 mg/day in 2-2,5 hours after dinner.

- Diet therapy includes split meals with low calories to 1200 calories from Monday to Friday with the reduction of calories on Saturday to 800-900 calories Sunday - up to 600-700 calories. Fractional power ensures a steady supply of nutrients throughout the day on a specially designed circuit with respect to time of food intake during the day to stabilize the exchange processes. Developed diet therapy given day of the week and time of food intake during the day, preventing the accumulation of free lipids and low density lipoprotein in the body cells and blood vessels; in conjunction with balneotherapy is activated cortical layer of the adrenal glands and in wineproducing the function of the pancreas, promoting lipolysis and glycolysis, reduction of body weight.

- Physical activity is carried out in the form of walk at a slow pace, with stops for exploring the countryside, lasting 90-120 minutes. The climate factor of the resort Belokurikha is provided by the presence of eurointervention therapeutic effect of the atmosphere of the resort, due to the content in surface air of a large number of negatively charged ions. A more deep breathing with severe alveolar ventilation, the stimulation of redox processes in cells and tissues in the periphery.

Spa treatments begin with a morning from 8 to 10 hours rain shower with fresh water, after which perform manual superficial massage of a collar zone. Rain shower with fresh water carried out for 3 minutes at a temperature of 35-36°C, the course of 7 treatments a day. Manual superficial massage of a collar zone hold for 15 minutes, a course of 10 treatments a day. These procedures provide stimulation of capillary blood flow and trophic processes in peripheral tissues.

In the period from 12 to 17 hours spend baths hydrocarbonate-sulphate-sodium mineral water resort Belokurikha with a high content of silicic acid and fluorine, a salinity of 0.3 g/l, with concentric what she radon during the procedure 3,9-4,6 NCI/DM 3at a temperature of 36-37°C.

- Split meals carried out according to the scheme: welcome drink 7 : 30, Breakfast at 8 a.m., lunch - lunch at 12 o'clock, lunch at 14 o'clock, afternoon tea in 16 hours, the reception of unsweetened drink at 18 hours and 30 minutes, dinner 19 hours.

The essential features of the invention allows to obtain a new technical result.

The use of non-drug and drug treatment in combination with the achievement of temperate stable for days in blood pressure, with increase in the period of remission the influence of natural factors of the resort Belokurikha in combination with diet therapy, dosed walking, and hand superficial massage of a collar zone, rain soul is allowed to obtain a new result

1. The combined effect of the used factors shown in synergy enhances the action of each, increasing the effectiveness of the treatment.

2. Fractional diet ensures a steady supply of nutrients throughout the day with regard to time of food intake during the day and contributes to the stabilization of metabolic processes, activating the work of the liver, gallbladder, pancreas, intestines, enrichment of salts of potassium and magnesium, vitamins that improve cardiac muscle, smooth muscles of the gastrointestinal tract is. In the aggregate, is preventing the accumulation of free lipids and low density lipoprotein with the breakdown of fat (cholesterol) in the body cells and blood vessels.

3. The effect of balneotherapy stimulates intracellular and intercellular processes, i.e. affects the pathogenetic mechanisms of the formation of arterial hypertension and metabolic disorders.

4. Holding rain shower fresh water helped to reduce the load on the cervical-thoracic spine to improve comprehensive treatment effect.

5. Significantly prolong remission for up to 6 months, particularly as a result of repeated courses of treatment.

6. Climatic eurointervention impact while walking in the natural conditions of the landscape made it possible to carry out correction of the emotional sphere of the patient, to improve the mood of the patient to recover, to give confidence in achieving a positive result, and use of preventive influence of natural factors of the resort.

As a result of exposure balneological factor of healing waters resort Belokurikha happen bioinformatics reactions at the level of cellular and intercellular structures of the body. The chemical composition of water hydrocarbonate-sulphate-sodium, low salinity of 0.3 g/l, pH 9,18, with a high content of silicic acid (is about 78 mg/l) and fluoride (15,1 mg/l). The water contains calcium (3,17 mg/l), magnesium (0.27 mg/l), chloride (19.1 mg/l), and trace elements - lithium (0.7 mg/DM3), manganese (0,00141 mg/DM3), titanium (0,0028 mg/DM3), lead (0,0014 mg/DM3and in Addition to other chemical substances in water are dissolved and free gases: nitrogen (95%), radon, helium (0,54), argon, xenon, krypton, neon. The amount of radon directly in the wells is 5.5 to 8.2 NCI/DM3and admission procedures 3,9-4,6 NCI/DM3.

In the balneotherapy native thermal nitrogen-siliceous waters is balanced neurohumoral regulation of cellular, intercellular structures of the body with increased excretion of the products of radiolysis of proteins, cytokines, macrophages, biologically active substances; there is an increase of local blood flow in the bronchi, increased respiratory minute volume; stimulation of Central hemodynamics - increased shock and cardiac output, shortening of systole and lengthening of diastole while maintaining heart rate and blood pressure. Normalization of sympathetic tone and parasympathetic divisions of the autonomic nervous system, in this case the activation of the cortical layer of the adrenal glands and insulinproducing functions of the pancreas promotes lipolysis and glycolysis, reduction of body weight.

Nutritional therapy includes a fractional power, ensuring smooth flow of nutrients throughout the day on a specially designed circuit with respect to time of food intake during the day to stabilize the exchange processes. Fragmentation of power optimizes liver, gallbladder, pancreas, intestines. Diet includes low-calorie ingredients, additionally drink unsweetened fruit drink (rose, cranberries, raisins) for the enrichment of body salts of potassium and magnesium, vitamins that improve cardiac muscle, smooth muscles of the gastrointestinal tract; 2 breakfasts, afternoon tea. In the aggregate, is preventing the accumulation of free lipids and low density lipoprotein with the breakdown of fat (cholesterol) in the body cells and blood vessels. Nutritional therapy includes split meals with low calories to 1200 calories from Monday to Friday and reducing the calories on Saturday to 800-900 calories Sunday - up to 600-700 calories.

Metered who walk daily in the form of walks in the morning and evening for 90-120 minutes. The climate factor of the resort Belokurikha is provided by the presence of eurointervention therapeutic effect of the atmosphere of the resort due to the content in surface air of a large number of negatively charged ions with their maximum conductivity and concentration along the route of the path along the river Belokurikha resort, mostly in the early morning and evening hours. The resort's climate is moderately continental with a predominance of calm clear weather during the year. Effects of negative ions is formed deeper breathing, alveolar ventilation with increasing partial pressure of oxygen in the alveoli and excretion of carbonic acid; the stimulation of redox processes in tissues and metabolism, which forms the synchronicity of the vascular and cardiac components of blood circulation, improves the performance of the heart, stimulates mental and physical activity. When repeated daily walks increased thermoregulatory muscle tone of the neck, trunk and flexor tendons of the extremities, heat production of the body on a background of hormonal thermoadaptation. The conductivity of the negative ions in the surface layer of air is practically on the whole territory of the resort Belokurikha imeediate high, compared with city size that allows this parameter to characterize the air of the resort as "comfortable"that have a positive therapeutic effect on the body. A walk in the lush vegetation of coniferous mixed forests contribute to creating a positive emotional reactions - "landscape reflex".

Additionally spend a morning rain shower fresh water in the cabins Department hydropathy for 3 minutes before Breakfast a temperature of 35-36°C, the course of 7 treatments a day. Manual surface massage the neck area spend 9 to 12 hours a day for 15 minutes, in the course of 10 procedures in a separate dedicated room, position: lying horizontally on the couch. In the morning shower and hand massage is a short-term periodic deformation of the skin in the neck area with subsequent irritation laid here numerous mechanoreceptors and temperature-sensitive structures. The result increases the content in the skin local vasoactive peptides (histamine, bradykinin, prostaglandins and others), the stimulation of capillary blood flow, contractility and tone of the arterioles Podmoskovie layer of the dermis, the microvessels and their blood, which improves oxygenation and trophic processes in peripheral t is the an. Increases metabolism, vascular permeability in local areas of the vascular bed with the phenomena of stagnation. As a result - increased nonspecific resistance of organs and tissues and the whole organism to adverse environmental factors.

The method of complex treatment of adults with hypertension and disorders of carbohydrate, lipid metabolism, overweight permits the continued appointed domiciliary medical treatment in the form of reception:

1. antihypertensive agents (ACE inhibitors, beta-blockers) individually at a dose of 1.25-5.0 mg/day in the morning for 30-40 minutes before the first Breakfast;

2. Metformin (glucophage) at a dose of 500-1000 mg/day in 2-2,5 hours after dinner.

Medical therapy: antihypertensive morning helps to maintain during the day an optimal level of HELL; Metformin after dinner - normalization of carbohydrate and lipid metabolism and indirectly to the reduction of overweight. This contributes to the pinning effect of balneotherapy, prolonged remission.

The method is as follows.

Upon admission to the sanatorium patient falls on the initial reception to the doctor internist-endocrinologist. This involves a clinical examination to study the functional state of the organism, the study showing the indices of carbohydrate and lipid metabolism, the study of sanatorium-resort card patient's place of residence, clarification of the diagnosis and its compliance with the indications for treatment at the resort Belokurikha. Then individually assigned to treatment with the corresponding entries in the list of appointments. On the first day balneological procedures are not carried out, since it is necessary to create the mood for the perception of the treatment, to relax and adapt to the climate. Recommended for short trips on the territory of the sanatorium. Assigned to drug treatment, which includes patients receiving antihypertensive ACE inhibitor or beta-blocker individually at a dose of 1.25-5 mg/day in the morning for 30-40 minutes before the first Breakfast and Metformin at a dose of 500-1000 mg/day in 2-2,5 hours after dinner.

The next day, and later in the morning from 8 to 10 hours in the medical Department patients undergoing rain shower fresh water for 3 minutes in a day, the course of 7 treatments. Shower is released in a separate cabin temperature of 35-36°C.

The massage is carried out manually superficial massage the neck area, on a course of 10 treatments 15 minutes. Massage uses specially equipped classrooms massage Department. Collar zone includes the area from C7to Th7-8spine, the area of the shoulder blades and shoulders. After warm-up strokes for 5 minutes are always on the kneading surface of the skin, subcutaneous tissue and muscles pie and scatter movements for 10 minutes, then the patient cover and allow to soak for 5-10 minutes.

Balneotherapy is held from 12 to 17 hours in the medical Department. The procedure is controlled by the nurse. In a separate cabin to prepare the bath, controlling the temperature of the water. Spend baths hydrocarbonate-sulphate-sodium mineral water resort Belokurikha with a high content of silicic acid and fluorine, a salinity of 0.3 g/l, with the concentration of radon in the procedure, 3,9-4,6 NCI/DM3at a temperature of 36-37°C. the Patient is immersed in water, reclining on his right side - the level of the nipple line, and within the appointed time resting quietly. After 10-15 minutes after the bath the patient go into my room.

Shared bath patients with arterial hypertension and disorders of carbohydrate, lipid metabolism, overweight carried out according to the scheme: the first day - 5 minutes, the second day is 8 minutes, the third day - 10 minutes, the fourth day is a rest day, the fifth day is 12 minutes, the sixth day is 12 minutes, the seventh day is 15 minutes, the eighth day is a rest day, and then in the subsequent three days tubs hold for 15 minutes, a total of 12 tubs.

Walks in the morning and in the evening held in the resort according to the marked routes (specify length in meters) at a slow pace dosed walk with stops to explore acres the values, duration 90-120 minutes. During an evening stroll, patients are advised to sit on the bench, then inhale deeply several times to close my eyes and think about the forest, trees, bushes, about those around them, or some other. Listen to the sounds, birds singing, enjoy the smells around him: perhaps the smell of damp earth, the breeze brings the smell of the forest, and freshness. To breathe, to feel that through every cell in your body runs something new, healthful, what you can bring and, opening my eyes, will feel good, relaxed mood will be smooth, clear consciousness.

Nutritional therapy includes split meals with low calories to 1200 calories from Monday to Friday and reducing the calories on Saturday to 800-900 calories Sunday - up to 600-700 calories.

Week course

Diet on Monday (1200 kcal/day, 26 g fat/day)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(300 kcal)

- 1 slice (30 calories, 0.2 g fat) cheese <30% fat (Adyghe cheese) 30 g - 1 slice (75 calories, 5 g fat)

- a Cup of coffee or tea with sweetener and milk with 0.5% fat 1/2 Cup - 100 g (37 calories, 0.5 g fat)

- 1 small Apple - 100 g (45 kcal)

- raisins, dried fruit (100 kcal, 30 g - tablespoon with slide)

Second Breakfast - l is NP 12 00(180 kcal)

1 Cup of milk with 0.5% fat (200 ml, 74 calories, 1 g fat)

- 1 orange - 120 g of peel (40 kcal)

- 2 biscuits 8 g (74 calories, 0.8g fat)

Lunch 1400(about 420 kcal)

a small portion of the captured soup beef broth - 200 ml (86 kcal, 4,2 g fat) or rice soup vegetarian - 300 ml (96 calories, 0.6 g fat without adding oil or 3.3 g fat butter for the passivation of the bow)

- 125 g any cabbage without oil (25 kcal)

- 1 chop beef - 100g (218 kcal, 11,0 g fat)

- 1 small baked potato - 100 g (80 calories, 0.4 g fat)

- tea without sugar - 1 Cup

Afternoon tea 1600(about 120 kcal)

- 130 g fat-free cottage cheese - 4.5 table. spoons (1.3 g fat)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(180 kcal)

- rice porridge without milk 4 table. spoons - 100 g (120 calories, 0.2 g fat)

- 1 tomato - 70 g (10 kcal), 1 cucumber - 30 g (7 kcal)

fish baked in foil (flounder, perch, cod) - 60 g (48 calories, 1 fat)

Diet on Tuesday (1200 kcal/day, 31 g fat)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(300 kcal)

- 1 slice (30 kcal), smeared fish eggs - 1 tablespoon (96 kcal, 5 g fat)

- coffee or tea with sugar substitute - 1 Cup, 4-5 crackers (88 kcal, 3 g fat)

- eggs 1 piece (55 kcal, 4 g fat)

- 1/2 grapefruit - 100 g (35 kcal)

Second Breakfast - La is h 12 00(180 kcal)

- yogurt 1.5% of the portion 125 g (62 kcal, 2 g fat)

- 1 Apple 100 g (45 kcal)

- 1 diets/caramel (54 kcal), unsweetened tea with milk 0,5% 1/4 Cup (18.5 kcal, 0.25 g of fat)

Lunch 1400(about 420 kcal)

soup with noodles in chicken broth 200 ml - 1 faceted glass (96 kcal, 4,2 g fat)

- 125 g fresh cabbage without oil (25 kcal)

- boiled chicken 100 g (170 calories, 7.4 g fat)

- boiled potatoes 100 g (80 calories, 0.4 g fat)

- kissel from cranberries - 1/2 Cup (100 g, 54 kcal)

Afternoon tea 1600(about 120 kcal)

- 1 pear - 100 g (42 kcal), kefir 1.8% to 1 Cup 200 g (80 calories, 1.3 g fat)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(180 kcal)

- dumplings with cabbage - 100 g (180 calories, 3.3 grams of fat)

- decoction of rose hips - 1 Cup

Diet on Wednesday (1200 kcal/day, 33,6 g fat)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(300 kcal)

- 1 slice (30 kcal), salad with fresh cucumbers and tomatoes with 1 teaspoon (5 grams) vegetable oil - 100 g (57 kcal, 5 g fat)

- squid boiled - 100 g (90 calories, 3.2 g fat)

- coffee or tea with sugar substitute - 1 Cup, 4-5 crackers (88 kcal, 3 g fat)

- 1/2 grapefruit - 100 g (35 kcal)

Second Breakfast - lunch 1200(180 kcal)

- yogurt 1.5% of the portion 125 g (62 kcal, 2 g fat)

- 1/2 Apple - 50 g (22.5 kcal)

- decoction of rose hips - 1 Cup

corn is lopia unsweetened - 3/4 Cup (90 kcal) or sweet (100 kcal)

Lunch 1400(about 420 kcal)

- slice (30 kcal)

- 125 g fresh cabbage without oil (25 kcal), dressed with lemon juice

- meatballs pork + beef 100 g (166 calories, 9.4 g fat)

- porridge "Hercules" - 6 table. spoons (85 kcal, 2 g fat)

- jelly blackcurrant 200 ml - 1 Cup (110 kcal)

Afternoon tea 1600(about 120 kcal)

- 3 Mandarin (60 kcal), 3 walnut (54 kcal, 6 g fat)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(180 kcal)

- beans boiled (42 kcal)

- fish (halibut, mackerel, herring, sturgeon) - 45 g (74 kcal, 3 g fat)

- compote of dried fruits without sugar - 1/2 Cup (100 g, 62 kcal)

Diet on Thursday (1200 kcal/day, 29,5 g fat)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(300 kcal)

olives - canned 5 PCs (30 calories, 2.8 g fat)

- canned corn - 2 tablespoons - 60 g (46 kcal)

- buckwheat porridge crumbly 200 g = 5 the table. spoons (222 calories, 0.9 g fat)

- coffee or tea with sugar substitute - 1 Cup

Second Breakfast - lunch 1200(180 kcal)

- decoction of rose hips - 1 Cup

- yogurt 1,5% - 150 g (74.4 calories, 2.4 g fat)

- Adyghe cheese - 30 g (75 calories, 5 g fat)

- 1 slice (30 calories, 0.2 g fat)

Lunch 1400(about 420 kcal)

- 1 slice (30 kcal)

- pea soup (maps of the portfolio, peas, onions, carrots, vegetable or olive oil for the passivation, cold beef broth) - 200 g (126 calories, 4.4 g fat)

- boiled beef - 70 g (177 kcal, 11.4 g fat)

- beet 100 g (50 kcal)

- tomato juice-200 g - 1 faceted glass (40 kcal)

Afternoon tea 1600(about 120 kcal)

- 1 orange - 120 g of peel (40 kcal)

- fruit jellies 125 g (79 kcal)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(180 kcal)

- baked potatoes - 100 g (80 calories, 0.4 g fat)

- shrimp - 100 g (100 kcal, 2 g fat)

- mineral water or herbal teas

Diet on Friday (1200 kcal/day, 29,5 g fat)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(300 kcal)

- 1 piece trubnogo bread 25 g (50 calories, 0.3 g fat)

- processed cheese 1 teaspoon to 10 grams (40 calories, 4 g fat)

- muesli with dried fruit and nuts table 5. spoons - 25 grams (100 calories, 5 g fat)

currant (strawberry) - 1/2 Cup (60 g, 24 kcal)

- tea with a slice of lemon to 1 Cup of

Second Breakfast - lunch 1200(180 kcal)

- 150 g low-fat cottage cheese - 5 table. spoons (135 calories, 1.5 g fat)

- 2 Mandarin - 100 g (40 kcal)

Lunch 1400(about 420 kcal)

- 1 slice (30 kcal)

- hash with meat 200 g (165,2 kcal, and 8.4 g fat)

- pepper, passirovanny vegetables in tomato sauce 100 g (109 calories, 6.6 g fat)

- boiled rice 100 g (3 with whom. spoons, 80 calories, 0.5 g fat)

- the juice of black chokeberry (Apple) without sugar 1/2 Cup - 100 g (40 kcal)

Afternoon tea 1600(about 120 kcal)

- 1 pear - 100 g (42 kcal)

- fruit jellies - 125 g (79 kcal)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(180 kcal)

- pancakes 73 g (180 calories, 4.7g fat)

- tea with lemon without sugar

Diet on Saturday (800 kcal/day)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800(about 187 kcal)

- fruit (carrot) juice without sugar 1 Cup 200 g (100 kcal)

- Yabloko - 100 g (45 kcal), raspberry, currant - 100 g (42 kcal)

Second Breakfast - lunch 1200(130 kcal)

- 100 g fat-free cottage cheese (90 calories, 1 g fat)

- 2 Mandarin - 100 g (40 kcal)

Lunch 1400(280 kcal)

- soup or soup vegetarian - 300 g (about 60 calories, 0.6 g fat)

- chicken boiled - 60 g or boiled beef lean - 70 grams (100 calories, 4.4 g fat)

salad from fresh cabbage with lemon juice without oil - 200 g (40 kcal), green peas - 2 table. spoons (42 kcal)

- 1 pear - 100 g (42 kcal)

- decoction of rose hips - 1 Cup

Afternoon tea 1600(80 kcal)

- tomato juice 1 Cup (40 kcal)

- orange - 120 g of peel (40 kcal)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900(120 kcal)

salad of raw vegetables - 200 g (40 kcal), 1 pear - 100 g (42 kcal)

- herb broth 1 article shall Cana

- low-fat yogurt 3/4 Cup - 150 g (40 calories, 0.5 g fat)

Diet on Sunday (640 kcal/day)

Unsweetened berry drink - 1 Cup 730

First Breakfast 800

- decoction of rose hips - 1 Cup

- baked potatoes - 100 g (80 calories, 0.4 g fat)

Second Breakfast - lunch 1200

- decoction of rose hips - 1 Cup

- baked potatoes - 100 g (80 calories, 0.4 g fat)

Lunch 1400

- decoction of rose hips - 1 Cup

- baked potatoes - 200 g (160 calories, 0.8g fat)

Afternoon tea 1600

- tomato juice 1 Cup (40 kcal)

- baked potatoes - 100 g (80 calories, 0.4 g fat)

Unsweetened berry drink - 1 Cup 1830

Dinner 1900

- baked potatoes - 200 g (160 calories, 0.8g fat)

- herb broth - 1 Cup

- low-fat yogurt 3/4 Cup - 150 g (40 calories, 0.5 g fat)

The study included 33 patients (men and women) aged from 35 to 55 years with hypertension and metabolic disorders (disorders of carbohydrate and lipid metabolism, overweight).

Each patient during treatment (1-2, 12-14 a day) the claimed method was carried out to evaluate the functional state of the cardiovascular system (dynamics of blood pressure, assessment of heart rate variability), laboratory parameters, anthropometric data. The results showed that the proposed method lichenification pronounced positive effect in hypertension and metabolic disorders.

1. The parameters AD (table 1).

Table 1
Dynamics of systolic and diastolic blood pressure (SBP and DBP) in groups (M±M)
GroupGARDEN (mm Hg)DBP (mm Hg)
ToAfterToAfterP
1212
1st group145,0±19,8of 127.5±10,893,7±10,983,3±7,0<0,01
2nd group148,1±26,4of 124.1±11,6to 100.4±13,582,7±6,5<0,01

Patients in the selected groups differed in age and BMI:

in group I the average age was 39.5±1,2 years, the average value of the BMI - 31,05±1,18 kg/m2;

in group II - 49,3±1,0 years, mean BMI - 31,43±0.54 kg/m2.

2. Laboratory data (table 2).

Table 2
Laboratory data of patients before and after Spa treatment (M±M)
ToAfter
Glucose fasting (mmol/l)5,47±0,174,17±0,12
Total cholesterolof 6.68±0,154,63±0,19
Triglycerides2,35±0,151,75±0,19
The national glycohemoglobin7,33±0,155,63±0,19

3. Assessment of heart rate variability (HRV) is one of the most informative methods for quantitative assessment of sympathetic and parasympathetic tone of the ANS and, accordingly, the functional state of the cardiovascular system. With the aim of studying the peculiarities of vegetative provision of the cardiovascular system was the analysis of HRV in patients in the dynamics until the after the indicated treatment in the sanatorium.

In patients with overweight and hypertension after the treatment the magnitude of HRV indices underwent the following changes: the amount of tension index (ti) increased by 7.7% (p<0.05), and decreased values of HF at 144% (p<0.01), and VLF 79.1% (p<0.05)and the ratio monotonicity of 7.7% (p<0,05). The survey results indicate that in patients after a course of balneotherapy there was an increase in activity of both the sympathetic and parasympathetic divisions of the ANS, increased centralization of control heart rhythm and tension of regulatory systems. After the treatment by the absolute values of some indicators were statistically significantly lower than in the comparison group: SDNN by 35.1%, VLF by 142%, AMO by 29.1% and triangular index of 23.1%.

Correlation analysis revealed that HRV indices were statistically significantly associated with disease duration, the parameters of blood pressure, BMI in patients with overweight and hypertension.

Thus, after the treatment showed increase in activity with subsequent normalization of both the sympathetic and parasympathetic divisions of the autonomic nervous system, the centralization of heart rhythm management. This suggests that the optimal hormonal, metabolic, who eacce on balneological treatment, aimed at the compensation of disturbances in the mechanisms of endocrine regulation of carbohydrate and lipid metabolism, which, in turn, can contribute if necessary to reduce hyperactivity of the sympathetic nervous system and the normalization of autonomic regulation of the cardiovascular system.

Given the dynamics of the functional state during treatment demonstrate pronounced pampering effect of the proposed method, which is expressed on the perspective in achieving temperate stable for days in blood pressure, forming the motivation of a healthy lifestyle, correction of carbohydrate and lipid metabolism.

Example 1

Patient S., 49 years old, he enrolled in SSI diagnosed with hypertension stage II, risk 2 NC. Impaired carbohydrate tolerance. Obesity 1 tbsp. Chronic cervicalgia. Family history aggravated by hypertension, diabetes.

Suffers from the disease within 10 years. Once treated in the hospital. In the past 6 months selected antihypertensive therapy can provide optimal levels of blood pressure.

In the initial examination the blood pressure was 150 mm and 90 mm Hg Electrocardiographic examination showed a hypertrophy of the left ventricle of the heart, increased the E. peripheral vascular resistance with increased minute volume of blood. The laboratory examination of blood rate exceeded the levels of total cholesterol 6,69; triglycerides 2,33; glycosylated hemoglobin of 7.9.

The patient is held above the full course of complex therapy.

Already for the third day in a sanatorium blood pressure steadily dropped to 125 and 80 mm Hg, and by the tenth day decreased body weight of 2 kg, glycated hemoglobin 5,8; total cholesterol 3,98.

Data functional studies showed a significant reduction in peripheral resistance with very little increase in cardiac output. Electrocardiography showed no negative dynamics on the background of sinus rhythm with a frequency of 70 in 1 min, hypertrophy of the left ventricle.

Clinical and functional monitoring showed positive dynamics of the disease in the sanatorium. Dose: the antihypertensive agents (beta-blocker Concor) at a dose of 5 mg/day in the morning, taking 30-40 minutes before the first Breakfast and Metformin (glucophage) at a dose of 1000 mg/day, taking in 2-2,5 hours after dinner - were reduced by 50%. The result of treatment is "improving". Resistance long-term results of 7 months.

Example # 2

Patient A., 37 years of age he entered the SCR with a diagnosis of hypertension stage I risk 2 NC. Obesity 2 tbsp. Chronic cervicalgia. Family history is burdened by And is.

Suffers from the disease within 5 years. Not treated in hospital. In the last 3 months of outpatient selected antihypertensive therapy can provide optimal levels of blood pressure with preservation of overweight.

In the initial examination the blood pressure was 140 and 90 mm Hg In a laboratory study of blood rate exceeded the levels of total cholesterol 7,73; triglycerides 2,11.

The patient is held above the full course of complex therapy.

Already for the third day in a sanatorium blood pressure steadily dropped to 110 and 70 mm Hg, and by the tenth day decreased body weight by 3 kg, glycated hemoglobin 4,9, total cholesterol 5,58.

Data functional studies demonstrated a lower adaptive reserves of the body. Electrocardiography showed no negative dynamics.

Clinical and functional monitoring showed positive dynamics of the disease in the sanatorium, in ANS balance the predominance of parasympathetic activity of the Department and adequate activation of the sympathetic. The dose of an antihypertensive (ACE inhibitor enalapril) from 5 mg/day in the morning, taking 30-40 minutes before the first Breakfast was reduced by 25%. The result of treatment is "improving". Resistance long-term results - 6 months.

P is obtained the effect of using the proposed method, which are as follows:

1. maintaining a normal stable during the day the AD;

2. the increase in the period of remission, the expediency of carrying out repeated courses of sanatorium treatment;

3. stabilization of the main indicators of systemic hemodynamics, lipid and carbohydrate metabolism on the values of the age regulations;

4. the enhancement of nonspecific resistance of local factors defenses;

5. normalization oxygenation and metabolism in peripheral tissues, internal organs, vascular tone and homeostasis;

6. reduction of overweight;

7. the combined effect of the used factors shown in synergy enhances the action of each, increasing the effectiveness of the treatment.

1. The method of complex treatment of hypertension metabolic disorders, including medication, diet, physical activity, balneotherapy baths, characterized in that the medical treatment involves taking antihypertensive agents, such as ACE inhibitor or beta-blocker for 30-40 minutes before the first Breakfast and Metformin at a dose of 500-1000 mg/day in 2-2,5 hours after dinner, diet therapy includes split meals with low calories to 1200 calories from Monday to Friday, with a decrease in the feces is rimasti on Saturday to 800-900 calories, and Sunday to 600-700 calories, physical activity carried out in the form of walk at a slow pace, with stops, for a total duration of 90-120 minutes, with Spa treatments begin with a morning from 8 to 10 hours rain shower with fresh water, after which perform manual superficial massage of a collar zone, and in the period from 12 to 17 hours spend baths hydrocarbonate-sulphate-sodium mineral water resort Belokurikha with a high content of silicic acid and fluorine, a salinity of 0.3 g/l, with the concentration of radon in the procedure, 3,9-4,6 NCI/DM3at a temperature of 36-37°C, the duration of the bath is on the first day of 5 minutes, the second day, 8 minutes, in the third day - 10 minutes, the fourth day is a rest day, the fifth day is 12 minutes, on the sixth day - 12 min, on the seventh day - 15 minutes, on the eighth day is a rest day, and then in the subsequent three days tubs hold for 15 minutes.

2. The method according to claim 1, characterized in that a rainfall shower with fresh water carried out for 3 minutes at a temperature of 35-36°C, the course of 7 treatments a day.

3. The method according to claim 1, characterized in that manual superficial massage of a collar zone hold for 15 minutes, a course of 10 treatments daily.

4. The method according to claim 1, characterized in that the fractional power is carried out according to the scheme: welcome drink at 7 : 30, Breakfast at 8 o'clock, W is Roy Breakfast - lunch at 12 noon, lunch at 14 o'clock, afternoon tea in 16 hours, the reception of unsweetened drink at 18 hours and 30 minutes, dinner at 19 hours.



 

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9 cl, 2 tbl

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2 cl, 2 ex, 5 tbl

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25 cl, 10 tbl, 12 ex

FIELD: medicine.

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