RU2077311C1 - Method to treat chronic tonsillitis in children - Google Patents

Abstract

FIELD: medicine, pediatrics. SUBSTANCE: method deals with an impact upon corporal points of acupuncture by thermovibromassage by using certain impact parameters at 8-10 procedures per one daily course. EFFECT: higher efficiency. 3 tbl

Description

 The invention relates to medicine, pediatrics and relates to methods for treating chronic tonsillitis in children.

 Known methods for the treatment of chronic tonsillitis, which are the prescription of drug therapy [I] However, these methods have the following disadvantages: side effects of drugs due to polypharmacy, the risk of allergic reactions, the complexity of the adequate selection of drugs, which leads to a decrease in the effectiveness of the therapy and increase the treatment time .

 Known methods of treating chronic tonsillitis, including exposure to the lesion (tonsil region) with a laser or ultrasound transducer [2] [3] However, these methods require the use of sophisticated equipment and trained personnel, and can not be used in the presence of purulent-caseous contents in the tonsils, those. contribute to the diffusion of infection through the lymphatic and blood vessels.

Closest to the proposed is a method of treating chronic tonsillitis, which consists in the impact of acupuncture on corporal and auricular acupuncture points [4] tai-si (3 VIII), chi-shi (52 VII), chjung-fu (II), he-gu ( 4 II), Tien Rong (17 II), Ren-Ying (9 III), Shui-Tu (10 II), Tien-Tu (22 XIV), Lian-Quan (23 XIV). The main auricular points: AP73 tonsil first, AP74 tonsil second, AP75 third tonsil, AP15 throat and larynx; auxiliary points: AP72 ₁ -AP72 ₆ curl, AP 87 stomach, AP101 lung.

 This method has several disadvantages: the invasiveness of exposure to acupuncture points and the associated possibility of infection with serum hepatitis, AIDS, there is also no direct sanitizing effect on tonsils, and the use of the method is limited due to the fact that it can be used for compensated forms of the disease, and the use with decompressed forms does not give the desired effect, because may cause exacerbation of the process.

A new technical result: a decrease in the number of complications and relapses due to an increase in local protective factors, achieves a new method of treating chronic tonsillitis, which consists in treating BAP (he-gu (4 II), chung-fu (II), and preliminary medical rehabilitation of the lesion is performed then they are subjected to thermal vibration massage additionally on BAT: tsu-san-li (36 III), jing-qui (8 I), tai-yuan (9 I), fai-shu (13 VII), yin-bai (I IV) , tai-bye (3 VI), da-du (2 IV), pishu (20 VII), chang-man (13 XII) with a frequency of 60 Hz, amplitude 0.3-0.5 mm at a temperature of 38 ^o C for 1.5-2 min at one point.The points of symmetric meridians are acted in pairs, on the course of 8-10 daily procedures.

 The method is as follows: the patient is washed for 3-5 days with lacunae of the tonsils with a 1% sterile solution of “dry” brine using a syringe with a special needle in an amount of 20.0-30.0 ml per wash, then inhalations are connected of the same drug, daily, course of 15 procedures, the first 2-3 inhalations lasting 5 minutes, the next 7-8 minutes. At the same time, therapeutic procedures for thermal vibration massage are prescribed for acupuncture points: tsu-san-li (36 III), he-gu (4 II), chjung-fu (1 I), jing-qu (8 I), tai-yuan (9 I) , fei-shu (13 VII), yin-bye (1 IV), tai-bye (3 IV), da-du (2 IV), pi-shu (20 VII), zhan-man (13 XII). Points are searched based on known topographic features, taking into account the sensitivity and tissue turgor in the palpable area (5,6). Ball vibrators are applied to the selected acupuncture points, which are actuated using a Wizard type massager, commercially available.

An impact of 60 Hz is carried out for 1.5 minutes at one point in children from 6 to 10 years, 2 minutes from 11 to 15 years. Heated nozzles carry out up to 38 ^o C, the amplitude of the oscillations of 0.3-0.5 mm They process points of symmetric meridians in pairs, in a course of 8-10 procedures, daily. The patient is in a comfortable position for him or lying on the couch. When the vibrator is correctly installed above the acupuncture point, the vibration initially causes a feeling of light aches and bursting, turning into a feeling of warmth and numbness. After the procedure, the patient is recommended to rest for an hour in a supine position.

 Example 1. Patient Peninsula, 14 years old, medical history No. 14, was admitted to the children's department of the TNIIKiF with complaints of relapses of tonsillitis 2-3 times a year, malaise, sometimes stitching pains in the heart, weakness. Suffers from chronic tonsillitis 5 years with exacerbations in spring and autumn.

 Objective status: satisfactory condition. Periorbital cyanosis, pallor of the skin is determined. In the throat of the tonsil of the 1st degree, with scar-adhesive changes, in the lacunae caseosis, palatine arches are infiltrated, hyperemic. Angular lymph nodes up to 2 cm in diameter, densely elastic, mobile, painless.

Analyzes: general blood test 5 / 193g. Er. 4.8x10 ¹² / l, Н 148 g / l, L4, 9x10 ⁹ / l, P-2% С-61% Lim. 30% M 4% E-3% ESR-5 mm / h. The total protein content (OB) in tonsillar secretion before treatment is 1.76 mg / ml. Lysozyme activity in tonsillar secretion (L) before treatment 7% Concentration of secretory immunoglobulin A (SIg A) in tonsill secretion before treatment - only traces were determined. The cytological characteristic of smear impressions from the mucous membranes of the tonsils: cylindrical epithelium (EC) 9.6, squamous epithelium (EP) 68.9, neutrophils (H) 21.5. The phagocytic activity of neutrophils (FAN) is 10.7. Adsorption of squamous epithelium (APE) 22.3. Differentiated cell destruction cytogram (DCD): EC-III-IV Art. EP IV Art. H III-IV Art.

 Diagnosis: Chronic decompensated tonsillitis (relapses of tonsillitis, caseosis) without exacerbation.

The patient was prescribed complex treatment, including washing the tonsils lacunae and inhalation of a 1% solution of “dry” brine for 5-7 minutes, daily, a course of 15 procedures, in order to correct the protective properties of tonsils thermal vibration massage on acupuncture points: tsu-san-li (36 III ), he-gu (4 II), chjung-fu (II), jing-qu (8 I), tai-yuan (9 Ш) - fei-shu (13 VII), yin-bai (I IV), tai -bye (3 IV), da-du (2 IV), pishu (20 VII), chang-men (13 XII). The frequency of exposure is 60 Hz, the amplitude is 0.3-0.5 mm, T 38 ^o C for 2 min per point, the number of points 11, 10 daily procedures. During thermal vibration massage, no side effects were observed.

 As a result of the therapy, the patient's condition improved significantly: weakness, malaise, periorbital cyanosis disappeared. In the pharynx, stagnant, inflammatory changes from the mucous membranes of the palatine tonsils, arches, and lacunae of the latter were less pronounced from purulent contents.

Analyzes after treatment: general blood test 2/11.92 g. ER 5.0x10 ¹² / l, Н 150 g / l, L 4.0x10 ⁹ / l, П 2% С 61% Lim. - 32% M 3% E 2% ESR 3 mm / h. The content of about 1.12 mg / ml in tonsillar secretion. The activity of lysozyme in the secret of tonsils is 31%. The concentration of SJgA is 0.2 g / l.

 The cytological characteristic of smears-prints from the mucous membranes of the tonsils: EC 19.8, EP 60.4, N 198. FAN 1.8. APE 35.8. DCD: EC II-III, EP II-III, H I-II Art.

 The patient was discharged in satisfactory condition. In the follow-up, the patient has no recurrence of angina for more than a year.

 Example 2. Patient Winer, 8 years old, medical history No. 2, was admitted to the TNIIKiF doc with complaints of colds up to 3-4 times a year. Angina suffered the last time 2 years ago, meteorolability, fatigue. It is observed at the local pediatrician as a frequently ill and ENT doctor.

Objective status: satisfactory condition. The skin is pale. In the throat there is congestive hyperemia of the lateral pharynx of the pharynx, palatine tonsils of the II degree of hypertrophy, friable, sometimes soldered with arches, there are no purulent-caseous contents in the gaps. Laboratory data before treatment: general blood test 5 / 1.93 g. ER 4.6 × ^{10 12} / l, Н 124 g / l, L 6.8 × ^{10 9} / l, П 2% С - 57% Lim. 33% M 3% E 5% ESR 9 mm / h.

 Tonsillar secretion studies showed lysozyme activity of 38% SIgA concentration of 0.125 g / l, OB content of 1.22 mg / ml. The cytological characteristic of smear impressions from the mucous membranes of the tonsils: EC - 15.8, EP 50.8, H 33.4, FAN 7.4, APE 23.4, DCD: EC III art. EP - III-IV, H II-III Art.

 Diagnosis: chronic compensated tonsillitis.

The patient was prescribed complex treatment: washing the gaps of the tonsils and inhalation of 1% dry brine for 5-7 minutes, daily N 15. Thermo-vibration massage from the Charode apparatus to the points of apuncture: he-gu (4 II), tsu- sai-li (36 III), chjung-fu (II), jing-qu (8 I), tai-yuan (9 I), fei-shu (13 VII), yin-bye (I IV), tai-bye (3 IV), da-du (2 IV), pishu (20 VII), chang-men (13 XII) with a frequency of 60 Hz, an amplitude of 0.3-0.5 mm, T 38 ^o C, 1, 5 minutes per point, 11 points in total, daily, course of 8 procedures.

 No side effects from the treatment were observed.

 At the end of the course of treatment, the patient's condition improved significantly, meteorolability was less pronounced. Locally: palatine tonsils decreased in size to the first degree, hyperemia of the lateral pharyngeal ridges, palatine arches decreased.

Test results after treatment: a general blood test 1/11. 93 g. ER 4.6x10 ¹² , Н 133 g / l, L 9x10 ⁹ / l, P 3% C 58% Lim. 32% E 3% ESR 7 mm / h.

 Tonsillar secretion lysozyme activity 48%. Concentration of secretory SJg A 0.25 g / l. The total protein content is 1.38 mg / ml.

 The cytological characteristic of smear impressions from the mucous membranes of the tonsils: EC 20.1, EP 58.9, N 21.1, FAN 18.6, APE 37.8, DCD: EC II st. EP II Art. H I-II Art.

 The patient was discharged in satisfactory condition. Follow-up for 6 months. not sick.

 The mode of exposure and the totality of BAP are selected on the basis of a study of the literature and clinical observations.

 The expediency of choosing a thermal vibration massage for acupuncture points is due to the fact that the latter relate to the energy channels of the body, which are responsible for a particular organ, system in the body. So, in chronic tonsillitis, the channels of the lungs (I) and the spleen of the pancreas (IV) are primarily affected. The most appropriate irritant for skin receptors is mechanical, an example of which can be acupuncture, acupressure, finger massage, and hammering with a multi-needle. However, these methods are time-consuming, have an invasive nature of the irritation of acupuncture points associated with a violation of the integrity of the skin and deeper tissues, complications associated with damage to blood vessels and nerves are possible. The impossibility of sufficiently strict observance of asepsis rules does not exclude infection with hepatitis B, AIDS. A child’s fear of needles also reduces the effectiveness of acupuncture.

 The use of thermal vibration massage at acupuncture points eliminates these disadvantages. Due to the physical features of vibration and tissue warming at acupuncture points, a pronounced absorption of vibrational energy is created, which is important for the therapeutic effect of acupuncture.

 In Chinese reflexology, there is an idea of a tonic (15-30 min) and scattering (40-60 min) method of influencing acupuncture points [4] [5] and exposure to a frequency of 60 Hz and warming the point has a harmonizing-tonic effect on it. The optimal exposure power at these parameters will be achieved by an amplitude of 0.3-0.5 mm.

 Acupuncture points for exposure to vibration were selected on the basis of their belonging to the affected energy channels (I, II) and which are inadequate in patients with chronic tonsillitis during remission, which explains the tonic effect on them with vibration.

 So, the tzu-san-li point (36 III) has a special systemic effect in violation of the yang-yin energy ratio in the body, a specific psycho-harmonizing effect. He-gu (4 II) regulates the relationship of yang-yin in the body, acts specifically for diseases of the throat. Zhong Fu (I I) lung channel control point, the starting point of a large circle of energy circulation, Mo is the lung channel point. Ching-qu (8 I) point of metal on the lung channel. An item in an item. Tai Yuan (9 I) point of the Earth on the channel of the lungs.

 Tonic.

 Fai Shu (13 VII) Shu lung channel point. Yin-bai (I IV) is the point of energy flow into the pancreatic spleen canal. Tai-buy (3 IV) - point of the Earth on the channel of the spleen of the pancreas. An item in an item. Da-do (2 IV) point of fire on the pancreatic spleen canal. Tonic. It has a special systemic effect in reducing the body's immune reactivity. Pis-shu (20 VII) Shu-channel point of the spleen - pancreas. Zhang-men (13 XII) - Mo point of the channel of the spleen - pancreas.

 Treatment is carried out daily, based on the biorhythmological characteristics of the body. The number of procedures 8-10 is associated with the maximum therapeutic effect by this time. An attempt to increase the number of procedures can lead to an overdose of vibration exposure, which in turn leads to a breakdown of the adaptive and protective capabilities of the body, neurosis, exacerbation of the disease.

 For the first time, a point thermal-vibration massage in children's practice is proposed in combination with sanitizing measures of tonsill in the form of washing of the latter and inhalation. This allowed us to use the method of reflexology not only in children with a compensated form of chronic tonsillitis, but also with decompensated, because in the latter case, exposure to acupuncture points alone is not enough due to the high bacterial characteristics and significantly low tonsil resistance.

 We observed 63 patients with chronic tonsillitis: 31 people with a compensated form and 32 people with a decompensated one. The age of patients is from 6 to 15 years.

 Each sick child was analyzed clinical data, the state of the humoral link of local immunity of the tonsils (determination of the concentration of total protein in tonsillar secretion according to J. Gornall, 1949, lysozyme activity in tonsillar secretion according to V.G. Dorofeychuk, 1968, concentration of secretory immunoglobulins And according to Mancini, 1965), a quantitative cytological analysis of smear impressions from the mucous membranes of the tonsils (Matveeva L.A. Osin A.Ya. 1976-82) before and after treatment.

 As follows from the tables (1 3), the claimed method is reliably effective when comparing the results of local factors of protection of tonsillitis and long-term results of treatment (there is a restoration of indicators of local factors of protection of tonsils).

 In conclusion, it should be said that the application of the proposed method has clinical and economic significance: the damaged protective properties of the tonsils are improved, which increases their compensatory capabilities and promotes long-term remission; when using this method, no adverse reactions were detected; the method is simple to execute. The Wizard device is available in circulation, technically safe, and can be used for treatment at home. The method does not require the use of expensive drugs and equipment.

 The "Wizard" device is mass-produced by the Tomsk Instrument Plant. There is practical guidance on its operation and use.

Claims (1)

 1 A method for the treatment of chronic tonsillitis in children, which consists in influencing biologically active points of he-gu (4 II), chung-fu (1 I), characterized in that they preliminarily undergo medical rehabilitation of the lesion, after which they are subjected to thermal vibration massage, while additionally biologically active points: tsu-san-li (36 III), jing-qu (8 I), tai-yuan (9 I), fei-shu (13 VII), yin-bai (1 IV), tai-bai ( 3 IV), da-du (2 IV), pe-shu (20 VII), chang-men (13 XII) with a frequency of 60 Hz, an amplitude of 0.3 0.5 mm at a temperature of 38 <198> C for 1 , 5 2 min to one point, and to points of symmetrical meridians in effect in pairs, a course of 8 to 10 procedures daily.

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