RU1816457C - Method of treating rheumatoid arthritis - Google Patents

Abstract

Usage: in medicine, in particular rheumatology, and can be used to treat rheumatoid arthritis. The essence of the method is that a patient is irradiated with a helium-neon laser with a wavelength of 632.8 nm through a flexible light guide into the ulnar vein at a radiation power flux density of 1 mW / cm2 for 30 minutes. At the same time, blood is taken from the patient before each laser therapy procedure (session) and the activity of rosette formation of lymphocytes with ram red blood cells (E-ROL level) and the level of rosette formation after preliminary treatment (incubation) of lymphocytes with theophylline (ETF) are examined. Laser therapy sessions are repeated once every 4 days until the patient's E-ROL level is increased to 54% or more and the coefficient K is increased to 1 or more. Then the treatment is discontinued. Subsequently, blood is taken from the patient once every 3 weeks and the level of rosette formation of lymphocytes is examined. At an E-ROL level of 54% and K 1, the laser therapy session is not repeated, if the immuno-yugic indicators deviate from these values (i.e., when the E-ROL level is less than 54% or K decreases to less than 1, even with A level of E-ROL of 54% is undergoing a laser therapy session.The positive effect is a reduction in treatment time, prevention of the development of immunosuppression, complications and exacerbations of rheumatoid arthritis. (L C

Description

The invention relates to medicine, in particular rheumatology, and can be used to treat rheumatoid arthritis.

The aim of the invention is to increase the efficiency of treatment of patients with RA by intravenous blood irradiation with a low-energy helium-neon laser, to shorten the time and to prevent complications from laser therapy.

We first established that patients with RA have an individual sensitivity to intravenous radiation

blood with a helium-neon laser and in order to achieve the optimal therapeutic effect and immunostimulation, a strictly defined number of laser therapy sessions for each patient is necessary. A smaller number of laser therapy sessions is ineffective, and a larger number of sessions (exceeding the optimal) causes immunosuppression, combined with the development of complications of laser therapy and exacerbation of RA, which cannot be stopped for a long time without the use of steroid hormones. We also install00

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It is believed that the positive therapeutic effect of laser therapy in RA is combined with immuno-stimulation - an increase in the level of E-ROL and a decrease in the sensitivity of lymphocytes to the depressive effect of theophylline (before treatment, theophylline added to the patient’s lymphocytes increases the number of E-ROL and the ratio of E-ROL / ETF 1, after the optimal number of intravenous laser therapy procedures, the E-ROL level normalizes and becomes more than 54%, and theophylline begins to suppress the E-ROL and the E-ROL / ETF ratio becomes equal to or greater than 1. We also found that for For the primary therapeutic effect of the course of internal laser therapy with a helium-neon laser in patients with RA, it is necessary to repeat the sessions of laser therapy with such a frequency as to maintain the level of E-ROL and the ratio of E-ROL / Etf in patients at an achieved level, i.e., E -ROL is more than 54%, and E-ROL / ETf is 2: 1. For the first time, we found that after the first optimal course of intravenous laser therapy, a significant change in the rosette-forming function of lymphocytes in patients with RA in the absence of additional intervention in treatment occurs no earlier than 3 weeks s, and therefore the Background of the rosette-forming activity of lymphocytes necessary to investigate Namely but these periods after treatment.

Example. Patient L., 50 years old, has been observed in the clinic since February 1990. Upon receipt of a complaint of pain in the proximal interphalangeal joints of the hands, radial, elbow, shoulder, knee, ankle, foot joints, jaw joints, cervical spine, swelling of these joints, their stiffness, stiffness in the joints, lasting throughout the day. He considers himself sick since April 1984, when pains and swelling in the joints of the hands of the hands, elbows, ankles, and small joints of the feet developed soon after hypothermia. Subsequently, the pain and swelling of the knee, elbow joints joined. Treatment with non-steroidal anti-inflammatory drugs, intra-articular injections of corticosteroids was carried out, physiotherapy with some positive effect. Subsequently, he constantly took non-steroidal anti-inflammatory drugs, quinols

new derivatives, intermittent injections of Kenalog periodically. Inpatient treatment with a positive effect was performed twice. The present deterioration of the state - since January 1990, after hypothermia - the pain intensified in all of the above 0 5 0

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lesions of the chest but clavicular joints, joints of the jaw, cervical spine joined. Conducted therapy with voltaren, rheopyrin, naprosin, methotrexate (since January 1990,)

- no effect. Hospitalized. Upon admission, configuration, swelling, and hyperthermia are determined. proximal interphalangeal, p stnophalangeal joints of the hands, wrist, elbow, knee, ankle, sternoclavicular joints, pain with active and passive movements in these joints. In addition, palpation pains, active and passive movements in the shoulder joints, jaw joints, cervical spine are noted. The ulnar deviation of the hands. Flexion contractures of the elbow, wrist joints. Symptom of balloting of the patella in the right knee joint. Amyotrophy of the muscles of the upper and lower extremities. Joint index 29, test LI 26, stiffness throughout the day (720 min), circumference of the proximal interphalangeal joints on the right 39.5 cm, left 39.3 cm, the compressive force of the hands on the right 70 mm Hg, left 50 mm Hg .art. For organs: vesicular breathing in the lungs, heart sounds are clear, heart rate 80 per minute, rhythmic pulse, satisfactory filling, AL 125/80 mm Hg. Art. The abdomen is soft, painless. Liver, spleen not enlarged. The symptom of Pasternatsky is negative. Chest x-ray - pulmonary floor transparent. Heart without features. ECG

- normal position of the electrical axis of the heart. Radiographs of the hands - osteoporoea, narrowing of the joint spaces, racemose enlightenment, erosion. Blood test: hemoglobin 118 g / l, color. 0.87, lek. 8700, wand. 4, seg. 72, lymph. 20, monots. 4. ESR 54 mm / hour. Total protein 78, albumins 61, globulins: alpha 6%, alpha2 16%, beta 13%, gamma 24%, PSA-n- +, blood sugar 4.4 mmol / L, urea 5.8, prothrombin 86, transaminases ADT-20, AST-15, cholesterol 4.3, fibronogen 9.11, rheumatoid factor 1: 160, HB d-antigen - negative. Urinalysis: UDC 1021, Lake. 1-2 at a glance, protein - no. The patient was prescribed treatment: voltarenretard, methotraoxate (7.5 mg once a week), 40 mg Kenalog intraarticular joint in the knee joints. A course of treatment was carried out with intravenous blood irradiation with a helium-neon laser, the radiation power density at the fiber was 1 mW / cm, the wavelength was 632.8 nm, and the duration of the irradiation sessions was 30 minutes. After the 1st session of irradiation, the patient's condition without pronounced positive dynamics, although the patient noted a slight decrease in stiffness. Before treatment, the E-ROL value was 31%, the Etf level was 42%, the coefficient K 1, after the irradiation session, the E-ROL was 32%, Etf 46%. K 1. On the 5th day, i.e. before the next laser therapy session. E-ROL activity reached 50%, ETf 41%, immediately after the 2nd session, a sharp increase in the E-ROL level to 78% was noted, i.e. to normal values, and Etf - up to 65%, i.e. the patient’s lymphocyte became sensitive to the depressive effect of theophylline, K 1. At the same time, pronounced positive dynamics of the state of index 5, test LI 6, was noted. The strength of the hands increased to 180 mm Hg on the right and 150 mm Hg on the left. , ESR decreased to 27 mm / h. E-ROL was 75%, ETF - 60%. After the next laser blood irradiation session, a state without pronounced dynamics. However, the level of K-ROL decreased to 52%, ETf reached 84%. After 4 days, the patient's condition worsened somewhat - pains in the knee joints intensified, pains in the hip, wrist joints joined, pains in the joints of sour hands joined in another 3 days, stiffness reappeared (up to 2 hours). - rexate in a dose of 7.5 mg once a week, noltaren retard, naprosin - the state of large progressively worsened. The pronounced swelling of the left knee joint increased. A puncture of the knee joint was performed, 75 ml of synovial fluid was extracted, 40 mg of Kenalog and 100 mg of cyclophosphamide were introduced. After a short (within 3 days) slight improvement, the condition worsened again. Pain, swelling in the right ankle joint, joints of the hands increased, stiffness increased to 5 hours. March 29, 89 g in blood tests: hemoglobin 116 g / l, white blood cells - 47.7, ESR - 60 mm / hour. Bilirubin levels increased to 28 mmol / L. Mild pain on palpation of the right hypochondrium was determined. 04.04.90 g blood test: hemoglobin 118 g / l, red blood cells - 3.7, color index - 1.0, reticulocytes - 0.4%. platelets - 259 thousand (70%), leukocytes - 3.7, rod-2, seg. 79, eos. 3, lymph. 11, mon. 5, plasma cells 2, ESR 60 mm / s. The described values were regarded as a manifestation of the myelotoxic, hepatoxic effect of methotrexate. 04/06/90 g - a significant deterioration of the condition - pain, swelling of the knee, ankle joints, joints of the hands increased, pains in the shoulder, sternoclavicular joints developed, stiffness is determined throughout the day.

The level of E-ROL was 43%. ETF - 49%. An intravenous blood irradiation session was performed with a helium-neon laser. Condition 5 patient without improvement. Severe swelling, hyperthermia of the left knee joint, and symptom of balloting of the patella are determined. 09.04.90 g joint puncture was performed, 50 ml of light yellow synovial fluid was recovered. 40 mg of Kenalog emulsion was added. In the blood tests of leukocytes 8 thousand, lymphocytes 8%, E-ROL 52%, ETF 40%. An intravenous blood irradiation session was conducted with a helium-neon laser5. .After the procedure, the condition worsened again. Swelling of the left ankle joint increased, pain in it intensified. The pronounced swelling of the left knee joint is determined, a symptom

0 run of the patella. The sizes of the left knee joint are 39-47-49 cm, the right one is 37-41-44.5 cm. Pain, swelling and stophophalangeal joints, proximal interphalangeal joints intensified. 04/13/90 g repeatedly

5 conducted an intravenous laser therapy session. 04/14/90 g E-ROL 47%, ETF 66%. The condition does not improve. Exudative effects in the joints persistently persist, fluid accumulates in the knee joints despite repeated punctures with the introduction of a canalogy, continued administration of methotrexate. 04.15.90 g the patient began to note stitching pains in the heart. With an aus cultivation, attention is drawn to the presence of

5 tachycardia, the development of severe deafness of heart sounds. An ECG study showed sinus rhythm, tachycardia, decreased electrical activity of the myocardium, negative T waves appeared in standard and

0 chest leads x. 04/17/90 g blood test: red blood cells 3.5, hemoglobin 102 g / l, color indicator - 0.9, l. 10 thousand, eos. 2, p. 2, seg. 72, lymph. 15, monots. 9, ESR 67 mm / h. Total protein 75.1, albumin 45%, globule 5 ncalphate b%, alpha2 16%, beta 15%, gamma 18%, CRP +++, fibrinogen 844 mg%, ASL-0 125, ASH negative, blood sugar 4.2 , urea 7.0, prothrombin 88, bilirubin 32 mmol / l, ACT 59, ALT 28. Urine analysis: specific weight

0 1016, lake. 6-7 in the field of vision, erythrocytes. 0-1. A puncture of the left knee joint was made. 100 ml of light yellow synovial fluid was removed, 40 mg of Kenalog emulsion was added. 40 mg of Kenalog was injected into the left ankle joint. Further, puncture of the joints with the administration of corticosteroids was repeated repeatedly without marked improvement. Methotrexate was canceled, a plasmapheresis procedure was carried out which did not lead to any improvement. The patient, according to his insistence, was discharged without a marked improvement, he was recommended to take oral corticosteroids, chlorobutin, and hemosorption.

Thus, from the above medical history it follows that intravenous radiation 5. blood low-energy radiation of a helium-neon laser has a pronounced therapeutic and immunostimulating effect in patients with rheumatoid arthritis. Odmfyu, Jacques can be seen from the example, Laz-10 sessions. in the course of the course treatment of non-UHF O & hfrmo, repeat until the UE level is> 54% at a coefficient of K 1 (in this patient after the 2nd session). After

To achieve this level, the continuation of 15 sessions of laser therapy led to a pronounced exacerbation of the disease, the appearance of visceral (in this case, cardiac) manifestations that could not be stopped using even toxic doses of methotrexate, intravenous corticosteroids, and plasmapheresis. Thus, as follows from the presented materials, the claimed method of treatment increases the effectiveness of the treatment of 25 patients with rheumatoid arthritis, reduces the time of their course, and therefore inpatient treatment, prevents the development

immunosuppression. complications of laser therapy and exacerbations of rheumatoid arthritis.

Claims (1)

The claims A method for treating rheumatoid arthritis by irradiating blood with a helium-neon laser, characterized in that. in order to shorten the treatment time, the levels of E-rosette-forming lymphocytes in the initial state and after incubation of lymphocytes with theophylline are determined. calculate the coefficient according to the formula TO E-ROLL ETF where E-ROL is the level of E-rosette lymphocytes; ETF - incubation level of lymphocytes with theophylline; K-factor and at E-ROL values of 54%, as well as at E-ROL S: 54%, but K 1, an intravenous blood irradiation session is performed with a helium-neon laser, and at E-ROL values of 54% and K 1, laser therapy is canceled.