RU2144347C1 - Method of cholelithiasis treatment - Google Patents

Abstract

FIELD: medicine, particularly, therapy. SUBSTANCE: method includes daily exposure to EHF electromagnetic radiation of one of the following biologically active points: E-24; E-28; E-36; V-27; V-60; RP-1; RP-6; RP-9; administration of radon baths with concentration of 40 nCi/l, temperature of 36-37 C, 8-9 procedures for course. EFFECT: reduced lithogenic properties of bile. 2 tbl, 2 ex

Description

 The invention relates to medicine and can be used in the treatment of patients, and especially women suffering from chronic cholecystitis, in order to prevent the development of gallstone disease (cholelithiasis) in them.

 Spa therapy is one of the most effective methods of treating the pathology of the biliary system. For these purposes, therapeutic drinking mineral water, balneotherapy and physiotherapy, peloids are used.

 Closest to the claimed method is the treatment of chronic cholecystitis with electromagnetic waves of extremely high frequency (EHF) to biologically active points (BAP) of the gallbladder - EHF puncture conducted against the backdrop of complex spa therapy (medical and protective regimen, therapeutic nutrition, internal intake of mineral water Essentuki source No. 4, physiotherapy exercises, mineral baths) (Novozhilova LI, Buchko AA, etc. Treatment of chronic stoneless cholecystitis using natural and preformed therapeutic factors .// Newsletter. Essentuki, 1995, 16 pp.). This method involved exposure to the UHF millimeter waves created by the Yav-1 apparatus with a wavelength of 5.6 mm and a flux density of 10 mW / cm power on the following BAT of the gallbladder: E36, VB24, VB36, VB37, VB40, V19, RP6 , F5, with an exposure of 10 minutes for hypomotor and 30 minutes for hypermotor biliary dyskinesia, for a course of 8-10 procedures. One BAP was used at the session: at the first and final procedure, points of a wide spectrum of action of E36 or RP6 were used.

 Existing methods of treating the pathology of the biliary system do not provide for a targeted effect on the hormonal status of the female body, the presence of hyperestrogenemia, necessary to reduce the lithogenic properties of bile in order to prevent cholelithiasis.

 The essence of the proposed method is as follows. A complex of treatment and preventive measures is prescribed for patients, including a sanatorium-resort treatment and protection regimen, medical nutrition (diet No. 5 according to the nomenclature of the RAMS Institute of Nutrition), physiotherapy exercises, internal intake of medium-mineralized carbon dioxide chloride-hydrocarbonate sodium mineral water of the Essentuki source No. 4 at the rate of 3 , 0 - 3.5 ml per 1 kg of patient’s body weight 3 times a day 30-45-60 minutes before a meal, depending on the state of the secretory function of the stomach; radon baths with a concentration of 40 nCi / l, temperatures 36-37 degrees. Celsius every other day, 8-10 procedures per course, as well as EHF-puncture for BAT of the genital area (E24, E28, E36, V27, V60, RP1, RP6, RP9), the effect is carried out by the device "Yav-1" with a wavelength of 5 , 6 mm at a flux density of 10 mW / cm with an exposure of 10 or 30 minutes, depending on the type of biliary dyskinesia, 8-10 procedures per treatment course. One BAP was taken per session; In the first and final procedure, broad-spectrum points of E36 or RP6 were used.

 The basis for the use of natural (radon baths) and preformed (EHF-puncture) physical factors was the results we obtained about a reliable, by the sign-on Dixon-Mud criterion, reduction of the level of exogenesis under the influence of both their single and course use in this category of patients (table 1).

 The method is illustrated by the following examples.

 Observation 1. Patient M., 48 years old (source: no 93, 1997), was admitted for treatment for chronic non-calculous cholecystitis. At admission, she noted pain in the right hypochondrium in the form of heaviness, bursting, bitterness, dry mouth, general weakness, fatigue, irritability. The patient considers himself about 3 years old. The onset of the disease is associated with irregular nutrition and stress. The patient took choleretic and antispasmodic drugs with temporary improvement. Objectively ill patient of proper physique, increased nutrition. Palpation was determined soreness of the right hypochondrium, positive symptoms of Kera, Ortner, Mussi, Lepene. A survey in the conditions revealed the presence of a physicochemical phase of cholelithiasis. Thus, an ultrasound of the biliary system confirmed the presence of echoes of chronic stoneless cholecystitis (gallbladder wall thickness 0.3 cm) and biliary dyskinesia of the hypomotor type: biochemical blood test - hypercholesterolemia (6.35 mmol / l): study of the physicochemical properties of the portion " B "bile - elevated cholesterol (430 mg / 100 ml), a decrease in the concentration of bile acids (1450 mg / 100 ml) and, consequently, a low level of CCK - 3.4. After the complex spa therapy, which includes dietary nutrition, internal intake of mineral water from the spring of Essentuki No. 4, exercise therapy, radon baths with a concentration of 40 nCi / l, temperature 36-37 degrees. Celsius, 10 procedures, 10 daily sessions of EHF puncture on the BAT of the genital area with an exposure of 10 minutes. Tolerance of the procedures was good, no adverse reactions were observed. After the treatment, the patient did not show complaints. Palpation in the right hypochondrium disappeared and the symptoms of cholecystitis decreased. There was a decrease in blood cholesterol to normal values - 5.1 mmol / l; a decrease in bile cholesterol to 240 mg / 100 ml and an increase in bile acid levels to 3500 mg / 100 ml with a decrease in CHK to 14.6.

 The result of treatment is a significant improvement. Here we observed a sharp improvement in the clinical and paraclinical manifestations of the pathology with a significant decrease in the lithogenic properties of bile and, therefore, a significant preventive effect against cholelithiasis of the physical factors used.

 Observation 2. Patient Sh., 50 years old (source no. 146, 1997), was admitted for treatment for chronic stoneless cholecystitis. On admission, she complained of decreased appetite, pain in the right hypochondrium with radiation to the right shoulder and subscapular region, bitterness, dry mouth, nausea, weakness, fatigue, and increased irritability. Sick for 2 years when, after irregular eating and eating fatty foods, the above complaints appeared. Taking choleretic drugs improved well-being. Objectively ill patient of proper physique, increased nutrition. On palpation, pain in the right hypochondrium, positive symptoms of Kera, Ortner, Mussi, Lepene were determined. During the examination, data were obtained indicating the presence of a physico-chemical phase of gallstone disease in a patient. These are echographic signs of chronic non-calculous cholecystitis (gallbladder wall thickness 0.3 cm) against a background of biliary dyskinesia in a hypomotor type with ultrasound of the hepatobiliary system; hypercholesterolemia - 6.3 mmol / l; increased bile portion “B” bile cholesterol level - 420 mg / 100 ml, low bile acid level - 1500 mg / 100 ml and as a result - low level of CHC - 3.6. Against the background of spa therapy, including dietary nutrition, internal intake of mineral water from the source of Essentuki No. 4, exercise therapy, mineral baths at a temperature of 36-37 degrees. Celsius, 10 procedures per course, the patient took 10 daily sessions of EHF puncture on BAT of the gallbladder with an exposure of 10 minutes. The patient tolerated the prescribed treatment easily. No adverse reactions were observed. After the treatment, the patient showed no complaints, the palpation of the right hypochondrium disappeared, the symptoms of cholecystitis decreased; there was a decrease in blood cholesterol to normal values - 5.2 mmol / l; there was a decrease in the level of bile cholesterol to 290 mg / 100 ml, an increase in the level of bile acids to 3000 mg / 100 ml and an increase in CHC to 10.3.

 The result of treatment is improvement. Thus, the treatment contributed to the positive dynamics of the clinical and paraclinical manifestations of the disease and to reduce the risk of development of cholelithiasis in this patient. However, here the prophylactic effect of physical factors in relation to cholelithiasis was less pronounced than in the previous observation.

 Treatment according to the proposed methodology was carried out for 30 women with the physicochemical phase of cholelithiasis, in the control group there were 36 women who received treatment according to the prototype method (EHF puncture for BAT gallbladder and mineral baths). Patients were predominantly aged 20 to 55 years and the disease lasted from 2 to 10 years, 80% and 80.6% of them, respectively, were in the phase of incomplete remission of the disease.

 In addition to a detailed clinical examination, the following indicators were determined in patients: the content of bilirubin and its fractions in the blood according to the Yendrashek method (N 3.4 - 20.5 μmol / l), cholesterol according to the Ilka method (N 3.9-6.5 μmol / l ), duodenal sounding with the determination of the concentration of the main components of the “B” portion of bile - bilirubin by the Yendraszek method (N 25-100 mg / 100 ml), cholesterol by the Ilk method (N 70-410 mg / 100 ml), bile acids by the Shirei and Curie methods (N 1600-3500 mg / 100 ml), cholesterol-cholesterol coefficient (CLC) (N 15.5 - 21.2), ultrasound examination (ultrasound) is desirable th bubble.

 In the main group, 25 (83.3%) of the patients had a pain syndrome characteristic of the pathology of the gallbladder; dyspeptic symptoms - bitterness, dry mouth, heartburn, nausea in 23 (76.7%); asthenoneurotic manifestations were noted in 21 (70.0%); palpation tenderness of the right hypochondrium occurred in 26 (86.7%) patients. Hypercholesterolemia was determined in 8 (26.7%) (M ± m 5.79 ± 1.59 μmol / L); an increased content of bile cholesterol was found in 14 (35%) (M ± m 415.5 ± 16.2 mg / 100 ml), a decrease in bile acid level in 8 (26.7%) (M ± m 1549.4 ± 140 , 9 mg / 100 ml), and as a result, a decrease in CHC in 24 (80%) patients (M ± m 3.74 ± 1.15).

 In the control group, pain was detected in 29 (80.6%), dyspeptic in 28 (77.8%), asthenoneurotic in 25 (69.4%), pain in the right hypochondrium during palpation - in 30 (83.3%) individuals . Hypercholesterolemia was diagnosed in 10 (27.8%) (M ± m 5.78 ± 1.37); an increase in the level of bile cholesterol in 13 (36.1%) (M ± m 416.8 ± 41.0), a decrease in bile acid level in 9 (25.0%) (M ± m 1561.3 ± 167.2 ) and decreased CHC - in 28 (77.7%) patients (M ± m 3.95 ± 1.73).

 In all patients, the diagnosis was verified by ultrasound. The combination of these data allows us to diagnose the presence of the physicochemical phase of gallstone disease in this group of patients.

 Analysis of the results of the treatment of the proposed and known method showed the following. In the main group, pain decreased in 73.3%, in the control - in 69.5%, dyspeptic - in 63.4% and 63.9%, asthenoneurotic - in 63.4% and 58.3%, decrease and disappearance palpation tenderness of the right hypochondrium - in 66.7% and 63.9% of patients, respectively. There were no significant differences in the given indicators. This indicates a rather high positive effect of the applied methods of therapy on the clinical manifestations of the disease in both groups. The advantages of using the considered methods of treatment according to hypercholesterolemia were also not identified. As for the dynamics of the levels of biochemical parameters of bile, the main group of patients looks clearly preferable here (table 2).

 As can be seen from the table, a decrease in cholesterol, an increase in the content of bile acids and, consequently, an increase in CHK, i.e. prevention of the development of cholelithiasis, was observed using both the proposed treatment methodology and the prototype method. However, these positive changes were significantly more pronounced when using radon baths in combination with EHF puncture on the BAT of the genital area. In patients receiving the proposed method of treatment, the risk of developing cholelithiasis significantly decreased compared to the prototype method. These advantages are explained by the targeted effect of physical factors on the mechanisms of pathogenesis (lithogenesis) in patients with pathology of the biliary system (hypoestrogenic effect of radon baths and EHF puncture on the BAT of the genital area) - in addition to the well-known healing properties of drinking mineral waters.

Claims (1)

A method for the prevention of cholelithiasis in women, including exposure to biologically active points of a wide spectrum of effects of E ₃₆ , RP ₆ with extremely high frequency radiation with a wavelength of 5.6 mm, with a flux density of 10 mW / cm ² , exposure of 10 min with hypomotor and 30 min with hypermotor dyskinesia and mineral baths, characterized in that they affect biologically active points of the genital area from the series E-24, E-28, V-27, V-60, RP-1, RP-9, with one session take one biologically active point, and at the first and final procedure point using broad spectrum carried radon bath at 40 nCi / l, temperature 36 - 37 ^o C, at the rate of 8 - 10 procedures.

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