RU2103983C1 - Method of treatment of heart ischemic disease - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method consists in acting with electromagnetic waves of millimeter band on paravertebral region on level of $$$, on the left for 15-20 min every other day. Course of treatment includes 10-12 procedures. Pine baths are prescribed for days free of the above-indicated procedures. EFFECT: higher treatment results. 2 cl

Description

 The invention relates to medicine, in particular to physiotherapy and cardiology, and can be used to treat coronary heart disease.

A known method of using electromagnetic waves of the millimeter range (MM therapy) in the treatment of coronary heart disease [1], in which the area of the left shoulder joint of patients with coronary artery disease with angina pectoris II - III functional classes (FC) is affected by electromagnetic waves of the millimeter range of 5.6 mm at a power flux density of 10 mW / cm ² (apparatus "Yav-1") lasting 20-30 minutes daily for 10 days. MM therapy is carried out against the background of drug treatment.

 The disadvantage of this method is its low efficiency: blood pressure, pulse rate, blood coagulation system and other biochemical parameters do not change.

 In one of 7 patients, treatment had to be suspended due to the appearance of an adverse reaction in the form of a burning sensation behind the sternum.

 There is also known a method of MM therapy of coronary heart disease with angina pectoris, according to which the xiphoid process is exposed to 7.1 mm electromagnetic waves for 30 minutes daily for 10-15 days, with breaks on Saturdays and Sundays, while for patients with angina pectoris tension III and IV FC additionally prescribe drug therapy [2]. The method is effective for angina pectoris I, II, III FC. With IV functional class, the method is ineffective.

 According to its technical nature and the achieved effect, the method [2] is the closest to the claimed one and is therefore selected as a prototype.

 The disadvantage of this method is a wide range of contraindications. In particular, the method is contraindicated in case of circulatory failure of stage II, in violation of atrial-ventricular conduction, with severe hypotension; there is no effect with IV functional class.

In order to reduce the number of contraindications while increasing the effectiveness of treatment, a method for the treatment of coronary heart disease is proposed, including drug therapy and exposure to electromagnetic waves of the MM range on the skin of the patient with a power flux density of 5-10 mW / cm ² . Exposure to electromagnetic waves on the paraventral zone on the left is C ₆ - D ₄ for 15-20 minutes every other day with a total number of procedures 10-12 per treatment course and additionally coniferous baths 10-12 procedures are prescribed on days free from radiation. The length of the electromagnetic waves is selected depending on the magnitude of the blood pressure. At normal and high blood pressure, they act with electromagnetic waves 7.1 ± 0.1 mm, and at normal and low blood pressure - 5.6 ± 0.05 mm.

The proposed method allows to treat with good effectiveness patients with coronary artery disease with angina pectoris IV functional class, patients with coronary artery disease with severe concomitant complications, previously attributed to contraindications:
- circulatory failure stage II A;
- atrial ventricular conduction disorders;
- severe hypotension, as well as with a number of other complications and their combinations.

 Regarding the mechanism of influence of MM therapy, at least 7 hypotheses are currently being discussed. The most common is the general idea of the effect of MM therapy on the information-managing system of the patient’s self-regulation, on the effects on cells and the organization of cellular structures, leading to the restoration of homeostasis.

 It should be borne in mind that the change in biotropic parameters of MM therapy (frequency, waveform, intensity, localization or exposure) alters the response of living organisms.

 In severe forms of the disease, when the reserve capacity of the body is weakened, attempts to force the MM to mobilize the body can do nothing but harm.

 Any effects on a weakened organism should be weak and gradual, and the area of influence should be chosen so that during the procedure a more selective and at the same time mild effect on the body occurs.

In connection with the foregoing, in the proposed method, designed for the treatment of both mild and severe forms of coronary heart disease with a number of complications, previously attributable to contraindications, significant adjustments were made:
- the impact zone is more rationally selected;
- reduced exposure time;
- There are significant breaks between the procedures (two days);
- on intermediate days, baths with a sedative effect are prescribed;
- the wavelength is selected in accordance with the condition of the patient.

 Distinctive features of the proposed method.

a) zone of exposure
In the known method, electromagnetic waves of the millimeter range act on the xiphoid process; in the proposed method on the paraventral zone on the left C ₆ - D ₄ ;
b) Exposition
The exposure time in the known method of 30 minutes daily for 10-15 days; in the proposed 15-20 minutes every other day, with a total number of procedures 10-12 per treatment course;
c) Accounting for the patient's condition
In the known method, when prescribing treatment, the blood pressure of the patient is not taken into account; in the proposed one, exposure to electromagnetic waves is 7.1 ± 0.1 mm at normal and high blood pressure and 5.6 ± 0.05 mm at normal and low.

 d) In addition, coniferous baths are prescribed every other day, on days free from MM therapy.

 Thus, the proposed method differs from the well-known in a number of ways and, therefore, is new.

 The inventive step is due to a combination of distinctive features. In none of the known methods of MM therapy, such a combination is used.

 It should be emphasized that if at least one of the distinguishing features of the proposed method is missed, then MM therapy may be ineffective in severe forms of coronary heart disease, and the contraindications noted above will need to be maintained.

 The applicability of the proposed method is not in doubt, because Many medical institutions of Russia are equipped with devices for MM-therapy like "Yav-1".

 Example 1. Patient S., 53 years old. He was admitted with a diagnosis of coronary heart disease, stable angina pectoris IV FC. Postinfarction cardiosclerosis (X-94 g). Concomitant diagnosis: chronic cholecystitis, cholelithiasis.

 Upon receipt of a complaint of bouts of intense burning behind the breastbone with radiation to the left hand with slight acceleration of walking and at rest, it takes up to 4-5 tablets per day. nitroglycerin (NTG), heart pain, shortness of breath. Blood pressure 80/60 and 90/60 mm RT. Art., heart rate 78 in 1 min. With bicycle ergometry, the threshold power is 25 W, the criterion for stopping the sample is burning behind the sternum. On an ECG before treatment: sinus rhythm 70 in 1 min. Cicatricial changes in the posterior wall of the left ventricle. Violation of intraventricular conduction in the left leg of His. QT interval lengthening. Prothrombin index 100%.

The patient was prescribed treatment according to the proposed method with medication: aspirin 0.5 table. per day, nitrong 1 table. per day, Eleutherococcus 30 cap. 2 times a day, Ravkin's potion. MM therapy from the Yav apparatus 5.6 ± 0.05 to the paravertebral region on the left C ₆ - D ₄ 15 min alternated with 4-chamber coniferous baths 36 ^o C 10 min every other day, for a course of 12 procedures. During the reception of MM-therapy, the patient noted drowsiness. From the middle of treatment, blood pressure (AL) increased to 100/70 - 120/70 mm RT. Art. and remained so until the end of treatment, without declining. Attacks of angina pectoris became less intense, irradiation to the arm disappeared, intake of NTG decreased to 1-2 tablets. in a day. The threshold power increased to 50 W; the criterion for terminating the sample was shortness of breath. The value of the prothrombin index decreased to 90%. On the ECG after treatment, the reduction in heart rate to 57 in 1 min and the normalization of the QT interval. The patient was discharged with improvement.

 Example 2. Patient C., 40 years old. Diagnosis: coronary heart disease, stable angina pectoris II - III FC. Postinfarction cardiosclerosis (1990, 1993). Aneurysm of the interventricular septum, ventricular extrasystole V degree. on Laun Wolf. NK 1 stage.

 Complaints of contracting pain in the heart during exertion, rarely at rest, rare interruptions. Daily takes Sustak Forte 1 table. 3 times a day. On the ECG - sinus rhythm, a-b block 1 degree. Cicatricial changes in the myocardium of the left ventricle in the anterolateral wall and violations of the repolarization process. Signs of left ventricular myocardial hypertrophy. On a daily ECG: sinus rhythm irregular from 120 to 240 ventricular extrasystoles at 1 h (including early R on T). Periodic reduction of the ST segment below the contour to 1 mm. HELL at admission 120/80 mm RT. Art.

The patient was prescribed treatment according to the proposed method: MM therapy 7.1 ± 0.1 mm on the paraventral region on the left C ₆ - D ₄ lasting 20 min N 10 alternated with 4-chamber coniferous baths 36 ^o C 10 min, 10 days after the procedure . Sustac-forte was continued to be taken at the same doses and etazicin was added 150 mg / day, ATP v / m N 15. The treatment was well tolerated. Towards the end of treatment, less often and less intensively pain in the heart during exercise, interruptions in the work of the heart disappeared. On the ECG after treatment: reduction in heart rate to 61 in 1 min, Ab blockade persists. On the daily ECG after treatment, extrasystoles were not registered, no decrease in the ST segment was detected. Drug treatment is reduced: Sustak-forte to 2 tablets. per day, etatsizin up to 50 mg / day. Discharged with improvement.

 Example 3. Patient S., 61 years old, was admitted 3 weeks after an acute heart attack with a diagnosis of coronary heart disease, small focal posterolateral myocardial infarction, circulatory failure, stage II A. Concomitant diagnosis: stage II hypertension. Astheno-depressive syndrome.

 Complaints of general weakness, decreased performance, poor sleep, shortness of breath when walking, headaches, noise in the head. On an ECG before treatment: sinus bradycardia, a change in the left ventricular myocardium in the posterior-lateral wall and apex, as a manifestation of small focal myocardial infarction. Daily ECG: there is an occasional transition of T (-) to two-phase and positive. HELL 160/90, pulse rate 66 in 1 min, respiratory rate 24 in 1 min. With bicycle ergometry, the threshold power is 75 W, the termination criterion is general clinical complaints, the lack of an adequate heart rate gain. In the lungs in the lower sections, important fine-bubble rales are heard.

Assigned treatment by the proposed method. MM therapy 7.1 ± 0.1 with the Yav apparatus on the paraventral left side C ₆ - D ₄ 17 min N 10 every other day alternated with 4-chamber 36 ^° C coniferous baths lasting 10 min N 10 every other day. The drug treatment was continued the same as in the department of simple cardiology: nitrosorbide 1 table. 3 times a day, aspirin 1/2 tab. in a day. During each MM procedure, the patient fell asleep. Gradually, the patient's condition improved: weakness disappeared, sleep normalized, shortness of breath decreased, headaches stopped, head noise decreased. Blood pressure from the middle of treatment ranged from 130/90 to 140/90, respiratory rate of 16-18 per minute. Wet wheezing in the lungs after treatment is not heard. The threshold power for bicycle ergometry remained the same - 75 watts. On a daily ECG: sinus rhythm, no changes recorded. On the ECG after treatment, a sinus rhythm of 61 per min. The patient was discharged with improvement in health.

 Example 4. Patient T., 41, was admitted with a diagnosis of coronary artery disease, stable angina IV FC. Postinfarction cardiosclerosis (MI 1993) NK stage 1.

 Complaints of a burning sensation in the chest with radiation to the left arm during exertion and at rest, a feeling of lack of air. HELL 140/100 mm RT. Art. The prothrombin index is 112.5%. On the ECG - sinus rhythm. Cicatricial changes in the posterior wall of the left ventricular myocardium with a transition to the lateral, as well as violations of the repolarization process. The daily ECG rhythm is sinus. With bicycle ergometry, the threshold power is 50 W, the termination criterion is a deterioration in well-being, general weakness, a decrease in the ST segment by 2 mm horizontally. Coronoventriculography: conclusion. Stenosing atherosclerosis of the coronary arteries. Subtotal stenosis at the mouth of the right coronal artery. Stenosis is more than 50% at the site of discharge of the II diagonal artery. Stenosis in the envelope of the artery and the right coronary (10 - 50%). The patient refused the operation.

The treatment was prescribed according to the proposed method: MM therapy 7.1 ± 0.1 mm from the Yav apparatus to the paraventral region on the left C ₆ - D ₄ for 15 minutes every other day, N 10 alternated with 4-chamber coniferous baths 36 ^o C, 10 min N 10 every other day. Drug treatment was continued: nitrosorbide 20 mg 4 times a day, Corinfar 1 tablet, 3 times a day.

 He tolerated the treatment well, less often a burning sensation in the chest during exertion, burning sensations at rest disappeared, the feeling of lack of air persists. With bicycle ergometry, the threshold power increased to 66 W, the criterion for the termination of the sample is a horizontal decrease in the ST segment. The patient moved to FC III according to clinical and instrumental criteria. HELL after treatment 110/80 mm RT. Art. The prothrombin index decreased to 106%. On the ECG, heart rate reduction by 7 beats per minute. The patient was discharged with improvement.

 Example 5. Patient V., 42 g. Diagnosis: coronary heart disease, stable angina pectoris II FC, circulatory failure stage 1.

 Complaints of constricting pain behind the sternum with significant physical exertion, a feeling of lack of air. HELL 130/80 mm RT. Art. On an ECG, sinus tachycardia is 93 per minute. Deviation of the electrical axis of the heart to the left. Signs of the load of intraventricular conduction along the right leg of the bundle of His. Increased cholesterol to 8.5 mm / L. With bicycle ergometry, the threshold power is 87 W, the termination criterion is an increase in blood pressure to 220/110 mm Hg. Art., heart rate 140 in 1 min.

The patient was prescribed treatment according to the proposed method: MM therapy 5.6 ± 0.05 mm from the apparatus "Yav" on the paraventral region on the left C ₆ - D ₄ , 20 minutes every other day N 12, in the days free from irradiation conducted general coniferous baths 36 ^o C, duration 10 min N 12.

 The treatment was well tolerated. During the treatment, the compressive pains behind the sternum were not disturbed, the feeling of lack of air disappeared. On the ECG after treatment, heart rate returned to normal (77 per minute). According to bicycle ergometry, the threshold power increased to 100 W, the criteria for terminating the load are the same as before treatment. The cholesterol level decreased to 6.42 mm / l. The patient was discharged with improvement.

 Thus, the use of electromagnetic waves of the millimeter range (MM therapy) of the range of the proposed method can successfully treat both mild and severe forms of coronary heart disease with angina pectoris I-IV functional classes (tested 72 patients) with a number of complications previously attributed to contraindications. In particular, with circulatory failure stage IIA, with atrial-ventricular conduction disturbance, with severe hypotension.

Claims (2)

1. A method of treating coronary heart disease, including drug therapy and exposure to millimeter-wave electromagnetic waves (MM therapy) on the skin of a patient, characterized in that the effect is performed on the paravertebral region on the left C ₆ D ₄ for 15 20 minutes every other day, a course of 10 12 procedures, and on days free from MM therapy, coniferous baths are additionally prescribed.  2. The method according to claim 1, characterized in that at normal and high blood pressure they are exposed to electromagnetic waves with a wavelength of 7.1 ± 0.1 mm, and at normal and low blood pressure 5.6 ± 0.05 mm.