RU2038102C1 - Method for treating the cases of vibration disease - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves applying alternative magnetic field to the region of upper or lower extremities and to paravertebral region with 50 Hz frequency and induction being of 30 ± 7,5 mTesla units within 10 min each time. Additionally double-cabinet contrast sulfurated hydrogen baths are administered in succession with sulfurated hydrogen concentration being 10 mg/l, hot water temperature being of 40 C, 60 s in duration, cold water temperature being 20 C, 20 s in duration, respectively. EFFECT: stable remittance period, reduced number of complications. 3 tbl

Description

 The invention relates to medicine, namely to physiotherapy of a vibrational disease.

 A known method of treating patients with vibrational disease using acupuncture, manual therapy, vacuum massage, acupressure and drugs.

The disadvantages of this method of treatment include:
the absence of persistent positive long-term results of treatment, the effect was obtained only in 69.3% of patients;
the occurrence of disease progression in 2.1% of patients;
a very complex multifactorial medical complex that requires large material costs and the use of scarce medications (Cavinton, Cinnarizine, Eleutherococcus extract).

 A known method of treating vibrational disease using applications of Dimexidum.

The disadvantages of this method of treatment include:
the absence of persistent immediate and long-term results of treatment (the effectiveness of treatment is low, the disease recurs after 3-6 months);
the absence of a positive therapeutic effect in patients with vibrational disease with acroangiospastic disorders;
intolerance to the drug in a number of patients.

 A known method of treating patients with vibrational disease using staged treatment: 1 year, the patient in the sanatorium receives hydrogen sulfide baths, ultraviolet radiation, oxygen therapy; 2 years in the hospital mud applications; 3 year at the spa rhodon baths.

The disadvantages of this milestone treatment include:
the absence of lasting long-term results in the treatment of patients for three years, the positive effect lasts only for 7.6 months;
long treatment time and significant material costs to achieve this positive effect;
deterioration in 14% of patients with vibrational disease, despite the implementation of three-year rehabilitation therapy.

 Closest to the proposed method of treatment is a method of complex treatment of patients with vibration disease with an alternating magnetic field, massage and medications. The authors used the Polyus-1 apparatus to obtain an alternating magnetic field of a continuous sinusoidal shape with a frequency of 50 Hz and a voltage of 230 Oe. The exposure was performed paravertebrally on the cervico-thoracic or lumbar sympathetic nodes and combined with the effect on the hands or feet. The duration of the first procedures is 10-15 minutes, starting from 4 to 20 minutes. The course of treatment consisted of 15-20 procedures daily.

 From drugs used antispasmodics, analgesics and B vitamins.

The disadvantages of this method of treatment include:
the absence of lasting immediate and long-term results of treatment (a significant improvement was noted in 20.7% of patients, a stable therapeutic effect lasted from six months to one year in 18% more than a year in 10%)
deterioration after treatment was observed in 1.8% of patients.

 The aim of the invention is to achieve persistent long-term results of treatment and reduce the number of complications.

 This method can be used in patients with vibrational disease not only with the syndrome of vegetovascular polyneuropathy (for which all of the above complexes have been developed), but also with the syndrome of peripheral angioedema of the upper extremities. These data are confirmed by case histories of 50 patients who were in the neurological clinic of the ISC from 1989 to 1992.

 The treatment conditions were as follows: the immediate and long-term results of treatment were studied, as well as the percentage of complications when using the combined method of therapy, which included an alternating magnetic field and two-chamber contrasting hydrogen sulfide baths.

 The method is as follows.

 The magnetic field is obtained from the portable device "Magniter" AMT-01. A patient lying on his stomach is treated in two fields.

I-field: inductors of 2 AMT-01 devices with a working surface are placed contact on the skin of the cervicothoracic spine with capture of both paravertebral zones (C ₃ D ₃ ).

2nd field: inductors of 2 AMT-01 devices with a working surface have contact on the skin of the back surface of the hands. A sinusoidal magnetic field with an intensity of 30 ± 7.5 mT for 10 minutes is supplied to each field. Procedures are carried out daily, 20 procedures are prescribed for the course. On the same day, with an interval of at least 1 hour, 2-chamber contrasting hydrogen sulfide baths with a concentration of hydrogen sulfide of 100 mg / l are prescribed. The temperature of the hot bath is 40 ^° C, the duration is 60 s, that of the cold bath is 20 ^° C, respectively, and the duration is 20 s. Start the procedure with a hot bath, change 7 times and end with a hot bath. The procedures were performed daily, on a course of 20.

 The results of therapy are presented in table. 1 in comparison with the identified methods of treatment of vibrational disease.

 It should be noted that a complete clinical and laboratory regression of disease symptoms (disappearance of clinical symptoms and normalization of the main laboratory parameters reflecting the severity of the pathological process) was observed in a significantly larger percentage of cases in the treatment of patients with the claimed method (p <0.002).

 The most pronounced differences were recorded in a comparative analysis of long-term treatment results, which are presented in table. 2.

 As can be seen from the table. 2, when using the claimed method a year after treatment revealed a significantly larger percentage of patients with complete clinical and laboratory regression than with the appointment of 1 method (p <0.001) and prototype (p <0.001). When calculating the duration of maintaining a complete regression of the clinical manifestations of the disease in months, a significantly longer duration of positive long-term treatment results was also recorded using the claimed method compared to method 2 (p <0.001) and method 3 (p <0.001).

 Positive clinical changes (immediate and long-term results of treatment) clearly correlated with the favorable dynamics of the main laboratory parameters, reflecting the severity of the course and the presence of a complete regression of the disease. The data are presented in table. 3.

 As can be seen from the data presented in table. 3, under the influence of the claimed method of treatment there is a significant positive dynamics of the initially altered indicators of autonomic tests, peripheral hemodynamics, hemostasis, which persists for a year after treatment, which determines a fundamental difference from the known treatment methods.

 The invention is illustrated by the following examples.

 PRI me R 1, Part V.V. 42 years old. Case history 8739, was in the neurological department of the ISC from 29 / X to 21 / XI-90, with complaints of constant pain in the muscles and joints of the hands, whitening of 2 phalanges of II-III fingers in the cold, in damp, numbness of the hands at night, sleep disturbance due to paresthesia in the hands, neck pain, mild memory loss for current events, irritability. The experience of the drifter is 14 years.

 Anamnesis of the disease: sick for about 6 years, when there were pains in the hands. A year later, I noticed a whitening of the fingers in the cold and in the damp. These phenomena progressed, pain in the joints of the hands, especially the elbow, intensified.

 He was treated in a sanatorium, noted an increase in pain in the hands after mud therapy.

 Status: HELL 130/90 on the right, HELL 120/80 on the left, h.s. 72 beats in 1 min.

 Neurological status showed limitations and soreness of the institution of the hands behind the back, tremor of the eyelids, hypesthesia in the upper third of the forearm on the right and middle third of the forearm on the left, pain on palpation of the extensors of the forearms, exit points of the occipital nerves, spinous processes and paravertebral diffusion points in the cervical spine, points Erba, Naderovsky, hand reflexes torpid, with legs animated by functional type. Autonomic nervous system: pulsation in the radial arteries is reduced, more on the left, acrocyanosis, acrohypothermia, a positive symptom of Palya, a positive symptom of a white spot 11 sec.

Laboratory data:
General analysis of blood, urine, ECG within normal limits.

 Biochemical analysis of blood: cholesterol 4.5 mmol / L, triglycerides 1.2 g / L, β-lipoproteins 4.0 mmol / L.

Blood coagulation system (CCK):
fibrinogen concentration 2.63 g / l
Fibrinogen In Neg
Ethanol Test Neg
Eoglobulin Lysis
fractions 160 min
Platelet count 224 thousand
Platelet Retention Index 47.7%
Dynamometry: right arm 27 kg, left arm 25 kg
Static endurance: right hand 20 s, left hand 20 s.

 Algesimetry: right hand III finger 1.03 mm, IV point 0.82 mm, left hand III finger 1.24 mm, VI finger 0.86 mm.

Cold test: t ^о air 20 ^о С, t ^о water 8 ^о С, t ^о initial III п S in 45 min 16.1 ^о С.

 RVG IIl n S brush to RI 1.66, α 11.3, DKI 0.61.

 RVG of the forearms (S) to RI 0.78, α 9.7, DKI 0.34.

 X-ray of the hands: the initial manifestations of the mushroom-like deformation of the nail tuberosity.

 Diagnosis. Vibration disease, I degree, autonomic-sensory polyneuropathy syndrome with angiospasm of the fingers. Cervical osteochondrosis, shoulder-scapular periarthrosis syndrome. Treatment: Magnetotherapy from the Magniter-AMT-01 apparatus to the area of the hands and paravertebral to the cervicothoracic region N 20 and hydrogen sulphide contrast two-chamber baths N 20, daily with an interval of 1 hour.

 After treatment: the pain in the arms and neck disappeared.

 Neurological status: acrocyanosis, acrohyperhidrosis, acrohypothermia, a 7 "white spot symptom, pain on palpation of the forearm muscles, pain on palpation of the Erb points and Naderba, as well as spinous processes and paravertebral points in the cervical spine disappeared.

Laboratory data:
SSK fibri- concentration
logen 2.5 g / l
Fibrinogen B
Ethanol test
Eoglobulin Lysis
fractions 160 min
Platelet count 225 thousand
Platelet Retention Index 38.3%
Dynamometry: right hand 35 kg, left 30 kg.

 Static endurance: right hand 25 s, left 25 s.

 Algesimetry: right hand III p. 0.75 mm, IV p. 0.60 mm, left III p. 0.94 mm, IV p. 0.65 mm.

Cold test
t ^o water 9 ^o , t ^o air 21.5 ^o
III finger on the left t ^{about the} original 27.2 ^about
after 25 ^about 27.3 ^about C.

RVG III p S brush RI 2.03, α 12.8, DKI 0.48
Forearm RVG (S) RI 0.81, α 11.5, DKI 0.20
Catamnesis. The medical history N 8739. 12 / III 25 / III-1991. Pain in the neck, no hands. Periodically whitening of 2 phalanges II-III p-in in the cold, in damp; meteorolability. Neurological status: pulsation of the hand is easily reduced dry, warm, normal color.

Laboratory data:
B / x blood: cholesterol 3.8 mmol / l
triglycerides 1.2 g / l
β-lipoproteins 3.3 mmol / L
SSK. Fibri concentration
logen 2.5 g / l
Fibrinogen B
Ethanol test
Eoglobulin fraction lysis 150 min
Platelets 230 thousand
Platelet Retention Index 42.1%
Dynamometry right hand 34 kg
left hand 30 kg
Static Stamina
right hand 25 sec
left hand 25 sec
Algesimetry, right hand III p. 0.80 mm, IV p. 0.60 mm,
left hand III p. 0.91 mm, IV p. 0.69 mm.

Cold test
t ^о water 9 ^о С t ^о air 21 ^о С
III finger on the left t ^{about the} original 26.8 ^about With
after 25 ^about 26.8 ^about C
RVG III p. S brush RI 2.0, α 12.3, DKI 0.5
Forearm RVG (S) RI 0.8, α 11.3, DKI 0.33.

 PRI me R 2. R-kov V.N. 42 years old, was in the neurological department of the ISC since 12 / XI 5 / XII 1991 with complaints of paresthesia in the hands and forearms, whitening of the terminal phalanges of II-V fingers in the cold, pain in the elbow joints and neck. Worker experience 20 years. Anamnesis of the disease: sick for about 3 years. The disease began with whitening of the fingers, then pain and paresthesia, which are progressive, joined. He was treated in a sanatorium with an effect for 1 month.

 Status: HELL 120/80 mm Hg on both hands, h. 68 beats in 1 min.

 Hyperesthesia from the level of the lower third of the shoulders, moderate soreness upon palpation of the Erb points, Naderbows, exit points of the occipital nerves. Acrocyanosis, acrohyperhidrosis, white spot symptom 9 s.

Laboratory data:
General analysis of blood, urine is normal.

 ECG sinus rhythm, 69 beats 1'. The prevalence of electrical activity of the left ventricular myocardium.

 Biochemical analysis of blood: cholesterol 7.3 mmol / L, triglycerides 3.8 g / L, β-lipoproteins 9.5 mmol / L.

SSK: The concentration of fibri-
logen 2.5 g / l
Fibrinogen In neg.

 Ethanol test neg.

Eoglobulin fraction lysis 240 min
Platelets 319 thousand
Platelet Retention Index 50.5%
Dynamometry: right hand 50 kg, left 55 kg.

 Static endurance: right hand 16 s, left 15 s.

 Algesimetry, right hand III p. 0.56 mm, IV p. 0.50 mm.

 left hand III p. 0.58 mm, IV p. 0.65 mm.

Cold test t ^о water 10 ^о С, t ^о air 23 ^о С, initial t ^о III item of the left hand 25 ^о С, in 10 '25.0 ^о .

 RVG III p. S brush RI 1.25, α 10.7, DKI 0.58.

 RVG precursor (S) RI 0.84, α 9.9, DKI 0.36.

 X-ray of the hands: fine-cellular brush-like restructuring of some bones of the wrists, in the head of the I metacarpal bone of the left hand, enostosis.

 Diagnosis: vibration disease of the I degree, autonomic sensory polyneuropathy syndrome of the upper extremities with angiospasm of the fingers. Cervical osteochondrosis, cervicalgia syndrome. Treatment: Magnetotherapy from the apparatus “Magniter” -AMT-01 to the area of the hands and paravertebral to the cervicothoracic region N 20 and hydrogen sulfide contrasting two-chamber baths, N 20. After treatment, a decrease in pain in the elbow joints and neck, the disappearance of paresthesia in the hands and forearms . Neurological status revealed the disappearance of hypesthesia, pain during palpation of exit points of the occipital nerves, Erb and Naderbows. Acrocyanosis, acrohyperhidrosis, acrohypothermia disappeared.

Laboratory data:
SSK: The concentration of fibrinogen 22 g / l
Fibrinogen B +
Ethanol Test Neg
Eoglobulin fraction lysis 190
Platelet count 315 thousand
Platelet Retention Index 50.5%
Dynamometry right hand 55 kg, left 60 kg.

 Static endurance right hand 20 s, left 20 s.

Algesimetry of the right hand III p. 0.38 mm, IV p. 0.37 mm
left hand III p. 0.45 mm, IV p. 0.34 mm.

Cold test t ^о water 10 ^о С, t ^о air 23 ^о С, t ^о III fingers of the left hand 26.8 ^о , through 13 '26.8 ^о .

 RVG III p. S brush RI 2.02, α 13.8, DKI 0.43.

 Forearm RVG (S) RI 0.89, α 12.0, DKI 0.32.

Catamnesis
Case history N 20775 17 / XII 10 / I 1991. There is no pain and paresthesia in the hands, whitening of 2 phalanges of II-V fingers in the cold and in dampness during prolonged exposure.

 Neurological status: brushes are warm, dry, normal color.

Laboratory data:
SSK: The concentration of fibri-
logen 2.0 g / l
Fibrinogen B +
Ethanol test neg.

180 'eoglobulin fraction lysis
The number of platelets 323 thousand

Platelet Retention Index 28.1%
Dynamometry: right hand 54 kg, left 60 kg.

 Static endurance right hand 20 s, left 20 s.

Algesimetry of the right hand III p. 0.40 mm, IV p. 0.38 mm
left hand III p. 0.45 mm, IV p. 0.34 mm.

Cold test t ^о water 10 ^о С, t ^о air 23 ^о С, t ^о III fingers of the left hand 26.5 ^о , through 15 '26.5 ^о
RVG III n. S brushes, RI 2.02, α 13.8, DKI 0.43.

 Forearm RVG (S) RI 0.89, α 12.0, DKI 0.32.

Claims (1)

METHOD FOR TREATING A VIBRATION DISEASE, including applying an alternating magnetic field in a continuous sinusoidal mode with a frequency of 50 Hz and a voltage of 230 Oe paravertebrally on the hands or feet, characterized in that they additionally sequentially carry out contrasting two-chamber hydrogen sulfide baths at 40 ^o With a duration of 60 s and 20 ^o C lasting 20 s at a concentration of hydrogen sulfide of 100 m ² / l.

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