RU2178287C2 - Complex method for treating neuroses in adults - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering medication preparations, psychotherapy, transcutaneous electrostimulation, point massage and deep massage of cervical and collar zone, dorsal zone, lumbosacral zone and gluteal zones. Pulse and acupuncture diagnosis methods are applied for determining functional state of heart, pericardium, kidney and gallbladder meridians. Acupuncture, thermopuncture, magnetic laser puncture, photopuncture methods are applied to auricular and corporal biologically active points corresponding to changes found in carrying out diagnostic examination. EFFECT: enhanced effectiveness of treatment; accelerated treatment course. 4 cl, 1 tbl

Description

 The invention relates to medicine, namely to psychotherapy, and can be used in the treatment of neurosis in adults.

 The relevance of the invention follows from the analysis of the epidemiology of neurosis: over the past 20 years, the annual increase in patients with neurosis in 15 economically developed countries of the world amounted to 14.8% (B. D. Petrakov, B. D. Tsygankov. Epidemiology of mental disorders. M, 1996. -121 from. ). Neuroses are closely related to the disharmony of marital relations, aggravate them and contribute to an increase in the number of divorces.

 There is a method of treating neurosis (Fedorov A.P. Prolonged neurosis and their psychotherapy. Author. Abstract. Dis. Scient. Step. Doc. Medical Sciences. St. Petersburg, 1995. - 39 p.), Which consists in the use of an integrated system of personality-oriented psychotherapy with the inclusion of gestalt therapy, cognitive and behavioral psychotherapy and pharmacotherapy.

 The disadvantage of this method is the low efficiency (improvement of -67.6%, significant improvement of 17.3%, clinical recovery of 0%) and the duration of treatment (2-3 months).

 Closest to the claimed method is the phased application of methods of psychotherapy, reflexology and pharmacological agents (Macheret E. L. et al. Reflexotherapy in the complex treatment of functional disorders of the nervous system. Kiev, 1991. -31 p.).

At the first stage (1st course of reflexology), along with reflexology, rational psychotherapy and drug treatment are used: tranquilizers and antidepressants
At the second stage (2nd course of reflexology), in addition to the methods of the first stage include autogenous training.

 At the third stage (3rd course of reflexology), all medications are gradually canceled and the patient is involved in labor activity.

 Acupuncture, thermopuncture, laser puncture, surface multi-needle acupuncture are used from reflexology methods. The selection of points is carried out according to the symptoms: for depression, corporal points C-3, C-9 are used; with insomnia - MS-6, RP-6, T-20, E-36, T-14, E-14, TR-14, V-62, etc. with asthenia - C-5, C-7; with dizziness - VB-20, V-10, P-7, GI-4, GI-11, T-14, T-24, TR-5; with gastrointestinal disorders - J-12, J-15, GI-4, GI-10, GI-14, E-25; with headache - GI-14, T-23, E-36, V-10, IG-3, V-60. Auricular points are also used simultaneously: AT-55, AT-100, AT-28, AT-34, AT-22, AT-58, etc.

 The disadvantage of the prototype is the long duration of treatment (3-4 months), low efficiency (positive results - 77.5%) due to the fact that they do not use hypnotic, family and sexual psychotherapy, massage of the cervical-collar zone, back, lumbosacral and gluteal areas, abdomen, percutaneous electroneurostimulation, music therapy, color therapy, treatment with homeopathic remedies. Reflexotherapy is not effective enough due to the selection of symptomatic acupuncture points without taking into account the functional state of the main meridians.

The main objectives of the invention:
- reducing the time and increasing the effectiveness of treatment;
- increasing the level of social and labor adaptation;
- development of a clear scheme for the use of various types of therapy in the complex treatment of neurosis in adults.

 The essence of the invention is the complex treatment of neurosis, which consists in the fact that they conduct family psychotherapy with a focus on daily sexual life; prescribe homeopathic sedative drugs, perform superficial multi-needle acupuncture and percutaneous electroneurostimulation, as well as acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions, alternate with deep abdominal massage in the next session; they perform acupuncture on the 1st, 5th, 9th and 13th days of treatment at the corporal points RP-2, J-14, R-13 and the auricular point AT-100 using the tonic method, and at the points IG-8, AT-55, AT-34 sedative method, on the 2nd, 6th, 10th and 14th days to the points F-8, J-4, R-12, AT-101 by the tonic method, and to the points IG-2, AT-51, AT-28 sedative method, on the 3rd, 7th, 11th and 15th days to the points F-7, J-3, R-11, AT-100 tonic method and to the points TR-10, AT-55, AT-34 by the sedative method, on the 4th, 8th and 12th days to the points J-4, R-13, V-67, AT-95 by the tonic method , and to the points MS-7, AT-28, AT-13 by the sedative method followed by thermal puncture to the indicated corporal points tonic and sedative method; produce laser puncture at the corporal points V-13, V-14, V-15, V-23 and V-26; use color therapy with blue light, soothing music and end the treatment session with hypnotic psychotherapy, alternating with auto-training.

 In the presence of intense headache, acupuncture and thermopuncture are used at corporal points VB-20, TR-10, VB-38, VM-9 and acupuncture at auricular points AT-96, AT-55, AT-13, AT-34, AT- 35 by the sedative method, and to the F-8 point by the tonic method and at the same time, phenazepam is administered orally at a dose of 1-2 mg and amitriptyline at a dose of 12.5 mg.

 For pain in the lumbosacral region, acupuncture, thermal puncture and laser puncture are used, taking into account the revealed functional state of the meridians of the gallbladder, kidneys, bladder at the corporal points V-62, V-32, V-31, V-28, V-27, V -26, V-25, V-23, T-2, T-3, IG-3, VB-30, VB-25 and acupuncture at the auricular points AT-54, AT-58, AT-95, AT-40 , AT-38, AT-55, AT-34.

 With depression, treatment is supplemented with a tonic method to the corporal points J-14, J-7, J-4, T-18, T-19, T-20, and with fear, at the points T-12, T-14, T-24, C-7, MS-9 tonic method.

 The method is as follows. They carefully collect an anamnesis, identify psychogeny, starting from an early childhood, the course of a mother’s pregnancy and the presence of strong stressful states during this period, find out the financial situation, marital relationships, the rhythm of sexual activity, the woman’s orgasm during sexual activity, her place of work, and industrial relations, the presence of bad habits. Carefully, according to a special scheme, the main and secondary symptoms of the disease are identified. Then an objective study is carried out: blood pressure on both hands is measured, dermographism, tendon reflexes are determined, the skin condition of the hands and feet is examined.

 On the day of the examination or in the coming days, they conduct family psychotherapy with the spouses, in which they discuss the issue of harmonizing interpersonal relationships, identify the role functions of each spouse and discuss the importance of the correct role behavior for normal marital relations, explain the role of frequent, ideally daily, sexual spouses' lives for harmonious family relationships, a normal psychological climate in the family, psychological and physical health of spouses and a quick recovery. They recommend daily sex life with a mandatory orgasm in women and without ejaculation in men. The patient is prescribed phenazepam at a dose of 0.5 mg 3 times a day, and at night at a dose of 1-2 mg and amitriptyline at a dose of 6 mg 3 times a day, and at night 12.5 mg.

 In depressive and hypochondriac syndromes, as well as three vegetative-vascular crises, the dose of amitriptyline is doubled at night. At the same time, homeopathic remedies are prescribed according to the indications: Ignation 6, Naya 6, Nux vomica 6, 5-7 grains 3 times a day under the tongue.

 The patient is laid on a couch and a multi-needle hammer produces superficial multi-needle acupuncture, then electroneurostimulation with the CHENS-2 apparatus, acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal areas, at the next session alternate with deep abdominal massage.

 On the 1st, 5th, 9th and 13th days of treatment, they affect the corporal points of RP-2, J-14, R-13 and the auricular point of AT-100 by the tonic method, and on the points of IG-8, AT -55, AT-34 - sedative method. In the 2nd, 6th, 10th and 14th days, they affect the points F-8, J-4, R-12, AT-101 by the tonic method, and on the points IG-2, AT-51, AT -28 - sedative method. On the 3rd, 7th, 11th and 15th days - to the points F-7, J-3, R-11, AT-100 by the tonic method, and to the points TR-10, AT-55, AT -34 - sedative method. On the 4th, 8th and 12th days - to the points J-4, R-13, V-67, AT-95 by the tonic method, and to the points MS-7, AT-28, AT-13 - by the sedative method. After acupuncture, corporal points, which were sedated, produce thermopuncture using the PTP-01 device in a stable way, and corporal points, which have been used for tonic effect, are produced by thermopuncture using a pecking method. The “Volna” apparatus produces magnetic laser puncture for 2 minutes at the corporal points V-13, V-14, V-15, V-23, V-26.

 In the presence of intense headache, acupuncture and thermopuncture are used at corporal points VB-20, TR-10, VB-38, VM-9 and acupuncture at auricular points AT-96, AT-55, AT-13, AT-34, AT- 35 sedative method, and to the point F-8 - tonic method. At the same time, phenazepam is prescribed orally at a dose of 1-2 mg and amitriptyline at a dose of 12.5 mg.

 For pain in the lumbosacral region, acupuncture, thermopuncture and laser puncture are used taking into account the revealed functional state of the meridians of the gallbladder, kidneys and bladder at the corporal points V-62, V-32, V-31, V-28, V-27, V -26, V-25, V-23, T-2, T-3, IG-3, VB-30, VB-25 and into acupuncture at the auricular points AT-54, AT-58, AT-95, AT- 40, AT-38, AT-55, AT-34.

 With depression, treatment is supplemented with a tonic effect at points J-14, J-7, J-4, T-18, T-19, T-20, and with fear, at points T-12, T-14, T-24, C-9, MS-9 tonic method.

 Along with reflexology, glasses with a blue filter are used for color therapy for 30 minutes.

 The entire treatment session is carried out against the background of soothing music of low volume using the works of classical composers and instrumental music of modern composers. The treatment session is completed with hypnotic suggestive therapy, alternating with auto-training. The duration of the sessions is 30 minutes.

 Patients are given the task of doing auto-training at home for 15-20 minutes in the morning and evening.

 Clinical example. Patient M., 37 years old, was treated with a diagnosis of hysterical neurosis, astheno-hypochondriac syndrome with frequent vegetovascular crises. Complaints upon admission of increased irritability, suspiciousness, tearfulness, low mood, general weakness, increased fatigue, insomnia, persistent headache, pain in the heart region with radiation to the left arm, pain in the interscapular region, lumbosacral region, in the epigastrium, in the right hypochondrium, in the lower abdomen, decreased appetite, bloating, constipation, menstrual irregularities, frequent nightly urination, increased sweating of the arms and legs, increased coldness. Sick about 1 year. The disease is periodically (almost weekly) complicated by bouts of a sudden sharp deterioration in health: a sharp general weakness, dizziness, palpitations, shortness of breath, chills throughout the body, pale skin, headache, fear of death. These symptoms quickly increase and intensify, and the patient is forced to call an ambulance to stop these attacks. Blood pressure during vegetative-vascular crises rises to 150/90, and after crises it drops to 90/60 mm Hg. Art. Married since 20 years, children 2, abortion 2, technical secondary education. Currently not working due to illness. Parents of the patient constantly quarreled until the fight. Menses from 12 years, lasting 7-8 days, plentiful, painful. She became pregnant for the first time at 29 years old. Sexual life 3-4 times a week, but the orgasm is experienced 1-2 times a week, although sexual intercourse lasts 15-20 minutes. Her husband loves her, does not offend her.

 Emotionally labile, fixed on painful sensations and experiences. The pulse is 94 beats per minute, rhythmic. Blood pressure on the left hand is 130/80, on the right - 140/90 mm RT. Art. The skin is pale. The skin of the hands and feet is cool, the hands and feet are moist. Dermographism is red, persistent, narrow. Tendon reflexes are normal.

 The patient came to the reception with her husband, therefore, after examination with the spouses, family and sexual psychotherapy was carried out. The rights and obligations of spouses in family life are explained, an idea of the ideal norm of sexual life, its significance for a woman’s health is given, the harmful effect on the woman’s psyche of lack of orgasm during sexual activity is explained, details of the technique of sexual intercourse that eliminate the woman’s anorgasmia are explained. A recommendation is given to spouses to have sex on a daily basis. The patient is given for immediate oral administration of phenazepam 1.0 mg and amitriptyline 12.5 mg. It is recommended to take phenazepam in the coming week at 0.5 mg 3 times a day, and at night 1.0 mg, amitriptyline at 6 mg 3 times a day, and at night 12.5 mg. Homeopathic medicines Ignacy 6 and Naya 6 were prescribed, 5 grains 3 times a day under the tongue on an empty stomach.

 Next, superficial multi-needle acupuncture was performed with a multi-needle hammer for 5 minutes, percutaneous electroneurostimulation with the CHENS-2 apparatus for 5 minutes, acupressure and deep massage for 15 minutes of the cervical-collar zone, back, lumbosacral and gluteal areas.

 After that, acupuncture was performed at the corporal points RP-2, J-14 and R-13 and at the auricular point AT-100 using the tonic method, and at the points IG-8, AT-34, AT-55 using the sedative method. The needles are removed after 15 minutes. All painful symptoms after needle insertion disappeared. On the 5th, 9th and 13th days of treatment, acupuncture was performed on the 1st day. On the 2nd, 6th, 10th and 14th days acupuncture was performed at points F-8, J-4, R-12, AT-101 using the tonic method, and at points IG-2, AT-28, AT-51 sedative method.

 On the 3rd, 7th, 11th, and 15th days - to the points P-7, J-3, R-11, AT-100 by the tonic method, and to the points TR-10, AT-34, AT-55 - sedative method. On the 4th, 8th and 12th days - to the points J-4, R-13, V-67, AT-95 by the tonic method, and to the points MS-7, AT-13, AT-28 by the sedative method . In order to enhance the effect of corporal acupuncture, corporal points that were sedated were thermally punctured by the PTP-01 apparatus in a stable manner for 5 minutes, and corporal points where tonic effects were performed were thermo-punctured by a biting method for 2 minutes.

 The “Volna” magnetic laser apparatus punched 2 minutes on the corporal points V-13, V-14, V-15, V-23 and 26.

 For color therapy, glasses with a blue filter were used for 30 minutes.

 All medical procedures were carried out in a relaxed atmosphere with a friendly attitude from the doctor and nurse against the backdrop of quiet soothing music.

 At the end of the treatment sessions, hypnotic suggestive psychotherapy was carried out, alternating with auto-training. The duration of hypnotic psychotherapy and autotraining is 30 minutes. The entire treatment session lasted 4 hours 30 minutes.

 At the next treatment session, instead of acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal areas, a deep massage of the abdomen was performed for 15 minutes, which in the following days alternated with acupressure and deep massage of the cervical-collar zone, back, lumbar sacral and gluteal areas. Attacks of vegetovascular crises disappeared from the first day of treatment. At the end of the first week, phenazepam and amitriptyline were canceled. The patient’s sex life returned to normal: intercourse was performed 5-6 times a week with an orgasm in the patient. Conducted 15 sessions of complex treatment. The patient's well-being, mood, working capacity, and sleep were completely restored. At the second examination after a year no complaints, blood pressure 110/70 mm RT. Art.

 The method has passed clinical trials in the psychotherapy cabinet of the Temryuk district polyclinic of the Krasnodar Territory for 567 patients with neurosis. Data on the timing and effectiveness of treatment for the proposed method and prototype are shown in the table.

 Comparative data of the table show that the proposed method compared with the prototype can reduce treatment time from 3-4 months to 20 days, increase the effectiveness of treatment from 77.5% to 100% with a clinical recovery of 72.3% and a significant improvement of 27, 7% of cases.

 During follow-up observation after 1 year, stable positive results were observed in 93% of cases of all patients.

Claims (4)

 1. A method for the complex treatment of neurosis in adults, including the study of the functional state of the body, the use of tranquilizers and antidepressants and subsequent exposure to rational psychotherapy and autotraining, acupuncture, thermopuncture, laser puncture, characterized in that they conduct family psychotherapy with a focus on daily sex life, prescribe homeopathic medicines sedative action, carry out superficial multi-needle acupuncture and percutaneous electroneurostimulation, as well as Final and deep massage of the cervical-collar zone, back, lumbosacral and gluteal areas, perform acupuncture on the 1st, 5th, 9th and 13th days of treatment at corporal points RP-2, J-14, R -13 and the auricular point AT-100 by the tonic method, and to the points IG-8, AT-55, AT-34 by the sedative method, on the 2nd, 6th, 10th and 14th days - to the points F- 8, J-4, R-12, AT-101 by the tonic method, and to the points IG-2, AT-51, AT-28 by the sedative method, on the 3rd, 7th, 11th and 15th days - to the points F-7, J-3, R-11, AT-100 by the tonic method, and to the points TR-10, AT-55, AT-34 by the sedative method, in the 4th, 8th and 12th days to points J-4, R-13, V-67, AT-95 by tonic method and to the points MS-7, AT-28, AT-13 by the sedative method followed by thermal puncture to the indicated corporal points by the tonic and sedative methods, magnetic laser puncture is performed to the corporal points V-13, V-14, V-15, V-23, V-26, they use color therapy with blue light, soothing music and end the treatment session with hypnotic psychotherapy, alternating with auto-training.  2. The method according to p. 1, characterized in that in the presence of intense headache use acupuncture and thermal puncture corporal points VB-20, TR-10, VB-38, VM-9 and acupuncture at auricular points AT-96, AT-55 , AT-13, AT-34, AT-35 by the sedative method, and to the F-8 point by the tonic method, and at the same time, phenazepam is administered orally at a dose of 1-2 mg and amitriptyline at a dose of 12.5 mg.  3. The method according to claim 1, characterized in that for pain in the lumbosacral region, acupuncture, thermopuncture, and laser puncture are used, taking into account the revealed functional state of the meridians of the gallbladder, kidneys, urinary bladder at the corporal points V-62, V-32, V- 31, V-28, V-27, V-26, V-25, V-23, T-2, T-3, 1G-3, VB-30, VB-25 and acupuncture at the auricular points of the AT-54, AT-58, AT-95, AT-40, AT-38, AT-55, AT-34.  4. The method according to p. 1, characterized in that with depression supplement treatment with a tonic method to corporal points J-14, J-7, J-4, T-18, T-19, T-20, and in case of fear - points T-12, T-14, T-24, C-7, MS-9 by the tonic method.

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