RU2202331C2 - Complex method for treating the cases of vegetative vascular crises in adults suffering from neuroses - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering medication treatment and carrying out family, sexual and hypnosuggestive psychotherapy. Superficial multi-needle acupuncture, transcutaneous electric neurostimulation, point and deep massage of cervical collar zone, dorsal zone, lumbosacral and gluteal areas are carried out alternating it with deep massage of abdomen. Corporal and auricular point acupuncture followed by heat and light puncture is applied. Magnetic laser puncture is carried out. Color therapy with blue and green filters is applied. Calming music is applied during a session. Medical treatment session is finished with hypnosuggestive psychotherapy and autotraining. EFFECT: enhanced effectiveness of treatment. 2 tbl

Description

 The invention relates to medicine, namely to psychotherapy, and can be used in the treatment of neurosis complicated by vegetative-vascular crises.

 The relevance of the invention is due to the significant spread of neurosis: according to V.G. Kosenko et al. (1999), in the modern world every third inhabitant suffers from some form of mental pathology with an apparent predominance of neurosis (Kosenko V.G., Ramhen I.F., Smolenko L.F. et al. On the true detection of mental patients in the general structure of mental disorders among residents of the Kuban // Kuban Scientific Medical Bulletin. - 1999. - 1-3. - P. 62).

 Vegetative-vascular crises are one of the complications of protracted neurosis and are quite resistant to their treatment.

 There is a method of treating vegetative-vascular crises (Dyukova G.M., Shepeleva I.P. Vorobyova O.V. Treatment of vegetative crises (panic attacks) // Journal of Neuropathology and Psychiatry named after S.S. Korsakov. - 1991.- T.91, 5. - P. 3-5.), Which consists in the use of antidepressants amitriptyline 75 mg per day or closepam 2 mg per day.

 The disadvantage of this method is its low efficiency (vegetative-vascular crises when using amitriptyline stopped at the end of the 3rd week in 77%, and clozepam in 84% of cases). In addition, in all patients taking amitriptyline, after 8-10 days, a worsening of the condition was observed, manifested by an increase in severity and a greater severity of crises. In the treatment with clozepam, a rapid formation of drug dependence was noted. By stopping vegetative-vascular crises, antidepressants did not solve the remaining problems in the treatment of neurosis.

 Closest to the claimed is a method of complex treatment with the phased use of psychotherapy, acupuncture and a biotron (Matyash M.N. Comprehensive treatment of vegetative-vascular disorders in neurosis: Abstract ... dis .... Candidate of Medical Sciences. - Kiev, 1992. - 19 p.).

 At the first stage (2-3 days), psychotherapeutic contact is established, rational psychotherapy is carried out.

 At the second stage, group psychotherapy, autotraining, individual and collective hypnotic suggestive therapy and acupuncture are used (40 sessions).

 After a course of psychotherapy with acupuncture, patients are placed in a biotron for treatment for a period of 14 days.

 When conducting corporal acupuncture, the data of electro-puncture diagnostics are taken into account and medium-intensity stimulation is applied.

 The disadvantage of the prototype is the low efficiency and long treatment time. The immediate results of treatment according to the prototype: recovery - 0.0%, a significant improvement of 33.6%. improvement - 59.8%, unchanged - 6.6%. The duration of treatment is at least 60 days.

 The reasons for the low efficiency and long duration of treatment are: inaccurate selection of acupuncture points, non-use of massage of the cervical-collar zone, back, lumbosacral and gluteal regions, abdomen: lack of family and sexual psychotherapy, thermal, infrared light puncture and magnetic laser puncture, percutaneous electroneurostimulation, music therapy , color therapy, pharmacotherapy with tranquilizers and antidepressants, treatment with homeopathic remedies.

The main objectives of the invention:
- reducing the time and increasing the effectiveness of treatment;
- increasing the level of social and labor adaptation and the quality of life of patients;
- development of a clear algorithm for the use of various types of treatment in the treatment of vegetative-vascular crises;
- continuous monitoring of treatment results and timely correction of treatment tactics using pulse and acupuncture diagnostics;
- ensuring the individualization of treatment.

 The essence of the invention is the complex treatment of vegetative-vascular crises, which consists in the fact that prescribe tranquilizers, antidepressants and homeopathic drugs of sedative effect; examine sexual function; conduct family and sexual psychotherapy to harmonize interpersonal relationships and establish the rhythm of frequent (ideally daily) sexual life with an orgasm in a woman and without ejaculation in a man; conduct superficial multi-needle acupuncture, percutaneous electroneurostimulation, as well as acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions, alternating every other day with deep massage of the abdomen; pulse and acupuncture diagnostics daily determine the functional state of acupuncture meridians; Acupuncture is performed on the 1st, 6th and 11th days to the corporal points RP-2, J-14, R-13 and to the auricular point AKT-100 by the tonic method, and to the points IG-8, J-17, AT-13, AT-34, AT-55 sedative method; on the 2nd, 7th 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-28, AT-51 by the sedative method ; on the 3rd, 8th and 13th days - to the points R-7, R-11, AT-100, AT-23 (for women) or AT-32 (for men) by the tonic method, and to the points TR-10 , J-16, AT-34, AT-55 sedative method; on the 4th, 9th and 14th days to the points V-67, R-13, J-4, AT-13, AT-95 by the tonic method, and to the points MS-7, T-20, AT- 25, AT-51 sedative method; on the 5th, 10th and 15th days - to the points VB-20, VB-1, BM-9, TR-3, AT-35, AT-96 by the tonic method, and to the points F-2, AT -28, AT-55, AT-97 - by the sedative method followed by thermal puncture and infrared light puncture to the indicated corporal points by sedative and tonic methods; produce magnetic laser puncture for 2 min on the 1st, 6th and 11th days to the corporal points V-14, V-15, V-21, T-11; on the 2nd, 7th and 12th days - at points V-12, V-13, T-12; on the 3rd, 8th and 13th days at points V-11, V-14, V-15, T-13; on the 4th, 9th and 14th days - at points V-23, V-24, V-25, T-14; on the 5th, 10th and 15th days - at points V-18, V-19, V-21, T-8; at the same time as reflexology, color therapy is carried out using blue and green filters; they use soothing music during the entire session and end the treatment session with hypnotic psychotherapy and auto-training.

 The method is as follows. They carefully collect an anamnesis, identify psychogeny, starting from early childhood; measure blood pressure on both hands, determine dermographism and examine the condition of the skin of the hands and feet; produce acupuncture and pulse diagnostics to determine the functional state of acupuncture meridians and internal organs.

 On the day of the examination, spouses conduct family and sexual psychotherapy and reveal the role behavior of each spouse; discuss the importance of proper role-playing behavior for normal marital relations; explain the role of the most frequent (ideally daily) sexual life of spouses for harmonious family relationships, a positive psychological climate in the family, psychological and physical health of spouses and a quick recovery from neurosis with vegetative-vascular crises. They recommend daily sex life with a mandatory orgasm in women and without ejaculation in men.

 In the first 3 days, the patient is prescribed phenazepam at a dose of 1 mg 3 times a day, and at night 2 mg and amitriptyline at a dose of 12.5 mg 3 times a day, and at night 25 mg. From the 4th day, the doses of phenazepam and amitriptyline are gradually reduced to the 10th day, and from the 11th day both drugs are canceled.

 At the same time, from the first day homeopathic remedies are prescribed according to the indications: Ignation 6, Naya 6, Nux vomica 6 5-7 grains 3 times a day on an empty stomach under the tongue for the entire treatment period and 1 month after the end of the course of treatment.

 The patient is placed on a soft couch and a multi-needle hammer produces superficial multi-needle acupuncture and electroneurostimulation with the CHENS-2 apparatus for 5 minutes, acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions - 15 minutes, alternating with deep abdominal massage. Pulse and acupuncture diagnostics are performed daily to determine the functional state of acupuncture meridians and select acupuncture points.

 Acupuncture begins with the restoration of the functional state of the heart meridian, then the lungs, pericardium, kidneys, gall bladder. In the 1st, 6th and 11th days, they affect the corporal points of RP-2, J-14, R-13 and AT-100 with the tonic method of gold needles with the needles tilted along the meridian, and on the points IG-2, J-17, AT-13, AT-34, AT-55 sedative silver needles with an inclination against the course of the meridian.

 In the 2nd, 7th and 12th days, they affect the points F-8, J-4, R-12, AT-101 with the tonic method of gold needles, and on the points IG-2, AT-28, AT-51 sedative method of silver needles.

 On the 3rd, 8th and 13th days, they affect the points R-7, R-11, AT-100, AT-23 (for women) or AT-32 (for men) by the tonic method with golden needles, and on the points TR -10, J-16, AT-34, AT-55 sedative silver needles.

 On the 4th, 9th and 14th days, they affect the points V-67, R-13, J-4, AT-13, AT-95 with the tonic method of gold needles, and on the points MS-7, T-20 , AT-25, AT-51 sedative silver needles. On the 5th, 10th and 15th days, they affect the points VB-20, VB-1, BM-9, TR-3, AT-35, AT-96 by the tonic method with gold needles, and on the points F-2 , AT-28, AT-55, AT-97 sedative silver needles.

The duration of the acununcture session is 15-20 minutes. Patients with hypersensitivity to pain and very weak patients begin treatment with a session duration of 5-7 minutes. After acununcture, thermal puncture is performed at the same corporal points by the PTP-01 apparatus using a stable method for 5 min for sedative action and a 2-min pecking method for toning. Next, an infrared light puncture is used with the AIKP-01 apparatus at the same acununcture points using the sedative method for 2 minutes per point, and for tonic for 30 seconds. The apparatus of the laser wave puncture "Wave" is affected for 2 minutes:
- on the 1st, 6th and 11th days to the points V-14, V-15, VB-21, T-11;
- on the 2nd, 7th and 12th days - to the points V-12, V-13, T-12;
- on the 3rd, 8th and 13th days to the points V-11, V-14, V-15, T-13;
- on the 4th, 9th and 14th days - to points V-23, V-24, V-25, T-14;
- on the 5th, 10th and 15th days - to points V-18, V-19, VB-21, T-8.

 Along with reflexology, glasses with blue and green filters 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 domestic and foreign composers. The treatment session is completed with hypnotic suggestive therapy, alternating with auto-training, also using soothing music.

 Patients are given the task to do auto-training every day at home, for 15-20 minutes in the morning and in the evening, morning hygienic gymnastics, at least for a distance of 2 km; take cool water procedures in the morning, and in the evening a warm shower or bath and hand and foot baths lasting 15-20 minutes; exclude watching television programs and video films from 20.00; go to bed no later than 20.00; as often as possible (ideally daily) to have sex with an orgasm in a woman and without ejaculation in a man.

 1. A clinical example of sympathetic-adrenal crises. Patient M. E.V., 37 years old (outpatient card 190/99), shoe technician, was treated in the day psychotherapy center of the Temryuk district polyclinic of the Krasnodar Territory from 02.08. on August 23, 1999. She complained of increased irritability, suspiciousness, tearfulness, a significant decrease in mood, severe weakness in the arms and legs, general weakness, increased fatigue, insomnia, impaired gait, nervous trembling, numbness and goose bumps all over, com throat, persistent headache, pain in the region of the heart radiating to the left hand, pain in the interscapular region, lumbosacral region, in the epigastrium, in the right hypochondrium, lower abdomen, decreased appetite, bloating, constipation, menstrual irregularity Foot cycle, frequent nighttime urination, excessive sweating of hands and feet, increased sensitivity to cold. Sick about 1 year. The disease was complicated twice a week by bouts of a sudden sharp deterioration in health: there was a sharp general weakness, pain in the region of the heart, dizziness, palpitations, numbness and cooling of the extremities, chills throughout the body, pale skin, headache, fear of death, rising arterial pressure up to 150/90. These symptoms quickly increased and intensified, and the patient was forced to call an ambulance. After stopping the attack by ambulance, blood pressure decreased to 90/60 mm RT. Art. Married since age 20, children 2, abortion 2. Secondary technical education. Currently not working for 1 year due to illness. In childhood, the sick her parents constantly quarreled until the fight. The father was a military man, often abused alcohol, offended not only his wife, but also children. The drunkenness of the father and the quarrels of the parents was very painful, since 10 years old she suffered from headaches. Menstruation from 12 years, lasts 7-8 days, profuse and painful. She became pregnant for the first time at 29 years old. Sexual life is 3-4 times a week, but an 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 arm is 130/80, on the right - 140/90 mm Hg. The skin is pale. The skin of the hands and feet is cool and moist. Dermographism is red, persistent, narrow. The thyroid gland is not enlarged.

 Diagnosis: hysterical neurosis, astheno-depressive syndrome, sympathetic-adrenal vegetative-vascular crises, arterial hypotension, dysmenorrhea.

 The patient came to the reception accompanied by her husband, therefore, after her examination with the spouses, rational, family and sexual psychotherapy was carried out. The rights and responsibilities 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 psyche of a woman is the absence of orgasm during sexual activity, the details of the technique of sexual intercourse that restore the normal frequency of an orgasm in a woman are explained. Spouses are recommended daily sex life with an orgasm in the wife and without ejaculation in the husband.

 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, electropuncture 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 with gold needles, and at the points IG-8, AT-34, AT-55 by the sedative method with silver needles. Needles removed after 15 minutes All painful symptoms after needle insertion disappeared. The acupuncture session was calmly transferred. 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 GI-2, AT-28, AT-51 sedative method. On the 3rd, 7th, 11th, and 15th days - to the points R-7, J-3, R11, 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 . To enhance the effect of corporal acupuncture, corporal points that were sedated were thermopuncture using PTP-01 in a stable manner for 5 minutes, and corporal points where tonic effects were performed were thermopuncture pecked for 2 minutes and AIKP-01 sedative method for 2 minutes, and tonic - 30 s for each point.

 The “Volna” magnetic laser apparatus punched for 2 minutes: on the 1st, 6th and 11th days - at points V-14, V-15, T-11; on the 2nd, 7th and 12th days - to the points V-12, V-13, T-12; on the 3rd, 8th and 13th days - to the points V-11, V-14, V-15, T-13; on the 4th, 9th and 14th days - to the points V-23, V-24, V-25, T-14; on the 5th, 10th and 15th days - to points V-18, V-19, VB-21; T-8.

 For color therapy, glasses with blue and green filters for 30 minutes were used. All medical procedures took place against the backdrop of quiet soothing music. At the end of treatment sessions, hypnotic suggestive psychotherapy was carried out for 30 minutes, accompanied by quiet soothing music. A day later, an autogenous training was also accompanied by music. The duration of hypnotic psychotherapy and autogenic training is 30 minutes. The entire treatment session lasted 5 hours 30 minutes.

 From the next treatment session, acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions alternated with deep abdominal massage lasting 15 minutes. Panic attacks (vegetative-vascular crises according to ICD-9) ceased from the first day of treatment and no longer arose. At week 2, the doses of phenazepam and amitriptyline gradually decreased and were completely canceled at the end of week 2. Homeopathic medicines are recommended to be taken within a month. 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. All the painful symptoms disappeared, normal health and good mood, working capacity and sleep were restored. Blood pressure - 110/70. At the second examination after 2 years, there were no complaints, there was no panic disorder, the blood pressure on both hands was 110/70 mm Hg. Art.

 2. A clinical example of a mixed type of vegetative-vascular crisis. Patient S., 37 years old (outpatient card 35/98), was treated in the psychotherapeutic day hospital of the Temryuk district clinic of the Krasnodar Territory from 21.08. on September 13, 1998, regarding hysterical neurosis, astheno-hypochondriac syndrome, and vegetative-vascular crises. Complaints upon receipt of a constant, very severe headache, accompanied by dizziness, nausea, vomiting, tinnitus; general weakness, increased fatigue; pain in the region of the heart with radiation to the interscapular region and to the left arm; increased irritability, suspiciousness, tearfulness, a sharp decrease and instability of mood; pain in the lumbosacral region, pain throughout the body, pain in the epigastrium, lower abdomen; bloating, decreased appetite; shortness of breath during physical exertion, negative emotions, as well as at rest; frequent day and night urination; increased sweating of the whole body, increased chilliness, palpitations, vomiting after unrest.

 Two or three times a week, the disease was suddenly complicated by an attack of a sharp deterioration in well-being: there was a sharp general weakness, severe shortness of breath, headache, dizziness, nausea, increased palpitations, chills, increased tinnitus, fear of death, fainting.

 The disease began 2 months ago with the appearance of nasal congestion and noise in the left ear, a severe headache. Attacks of vegetative-vascular crises began 1 month ago, were only in the afternoon and ended after emergency medical assistance was provided by abundant urination. Within a month, she was unsuccessfully treated by an otolaryngologist and neurologist at the Temryuk regional clinic. From 07/28. until 18.08. 1998 was treated in the neurological department of the Krasnodar Regional Clinical Hospital with a diagnosis of vegetative-vascular dystonia with vegetative-vascular crises, astheno-neurotic syndrome. The treatment was carried out: bellataminal, piracetam, vinpocetine, amitriptyline, physiotherapy, acupuncture, at night - eglonil. Discharged from the hospital without change.

 Relations with her husband are bad: frequent quarrels, sex life once a week, orgasm always. Childbirth -1, abortion - 5, menstruation - normal.

 Anxious-suspicious, emotionally labile, fixed on painful sensations. Pulse 94 beats per minute, blood pressure - 110/70 mm RT. Art. on both hands. The skin of the hands and feet is cool and moist. The thyroid gland is not enlarged.

 Acupuncture diagnostics: failure of the meridians of the heart, small intestine, stomach, pancreas, lungs, colon, bladder, kidneys, triple heater, pericardium, gall bladder and liver.

 Pulse diagnostics: the pulse of the gallbladder is significantly weakened, the pulses of the remaining meridians are “in the void”.

 The patient appeared with her husband, therefore, after examination with the spouses, rational, family and sexual psychotherapy was carried out. Clarified rights and obligations of spouses in family life; an idea of the ideal norm of sexual life is given, its importance for the health of spouses, the harmful effects of sexual abstinence for the psyche are explained, and daily sexual life with an orgasm in the wife and without ejaculation in the husband is recommended. The patient is given for immediate oral administration of phenazepam at a dose of 1.5 mg and amitriptyline 25 mg. It is recommended to take phenazepam daily on an empty stomach 1 mg 3 times a day, and at night 2 mg and amitriptyline daily 12.5 mg once a day, and at night - 25 mg. From the 4th day the dose of phenazepam and amitriptyline gradually decreased, and from the 11th day both drugs were completely canceled. From the first day of treatment, homeopathic medicines were prescribed: Ignatia 6 and Naya 6, 5 grains 3 times a day on an empty stomach, under the tongue.

 The patient was laid on a soft couch and she underwent superficial multi-needle acupuncture 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-4, R-13 and at the auricular point AT-100 using the tonic method with gold needles with an inclination along the meridian, and at the points IG-8, O-17, AT-13, AT-34, AT-55 sedative silver needles with an inclination against the course of the meridian. Needles removed after 20 minutes. All painful symptoms disappeared after the injection of needles and did not appear until the next morning. In order to enhance the effect of corporal acupuncture at the same points, a thermal puncture was performed using the PTP-01 apparatus for a stable method of 5 min for sedative action and a peeling method for 2 minutes for each point for tonic effect, as well as infrared light puncture with AIKP-01 apparatus for sedative methods 2 min per point and tonic for 30 s. The apparatus of the laser-laser-puncture "Wave" effected for 2 minutes:
- on the 1st, 6th and 11th days - to the points V-14, V-15, VB-21, T-11;
- on the 2nd, 7th and 12th days - to the points V-12, V-13, T-12;
- on the 3rd, 8th and 13th days - to the points V-11, V-14, V-15, T-13;
- on the 4th, 9th and 14th days to the points V-23, V-24, V-25, T-14;
- on the 5th, 19th and 15th days - to points V-18, V-19, VB-2L T-8.

 For color therapy, glasses with blue and green filters for 30 minutes for each filter were used.

 All treatment procedures were carried out in a relaxed atmosphere with a friendly and sincere attitude of the doctor to the patient against the background of quiet soothing music throughout the treatment session.

 The treatment session ended with hipposuggestive psychotherapy, the duration of gynosuggestive psychotherapy was 30 minutes. The entire treatment session was carried out by the same doctor in the same room and lasted 5 hours.

 Acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions alternated every other day with a deep massage of the abdomen for 15 minutes.

 At the 6th and 11th treatment sessions, reflexology was performed on the points of the 1st day. In the 2nd, 7th and 12th days, they affected the points F-8, J-4, R-12, AT-101 with the tonic method of gold needles, and on the point IG-2, AG-28, AT-51 sedated method of silver needles. In the 3rd, 8th and 13th days, they affected the points R-7, R-11, AT-100, AT-123 with the tonic method of gold needles, and on the points TR-10, J-16, AT-34 , AT-55 sedative silver needle method. In the 4th, 9th and 14th days, they affected the points V-67, R-13, J-4, AT-13, AT-95 with the tonic method of gold needles, and on the points MS-7, T-29 , AT-25, AT-51 sedative silver needles. In the 5th, 19th and 15th days, they affected the points VB-20, VB-1, TR-3, VM-9, AT-35, AT-96 using the tonic method with gold needles, and on the points F-2 , AT-28, AT-55, AT-97 sedative silver needles.

 Autogenic training was carried out from the 2nd day every other day for 30 minutes accompanied by soothing music. Attacks of vegetative-vascular crises disappeared from the first day of treatment. Sex life was normalized: sexual intercourse was carried out 6-7 times a week, always experienced an orgasm. The patient conducted 1 course (15 sessions) of complex treatment. Normal health, mood, working capacity and sleep were fully restored.

 After 1.5 years, decompensation occurred as a mild form of hysterical neurosis, but without vegetative-vascular crises. The decompensation was caused by a severe illness of the son, which required surgical treatment, severe financial problems, prolonged neuropsychic and physical overwork and, as a result, a rare sexual life (1-2 times a week). From 02.25. On March 17, 2000, a full course of treatment was carried out, similar to the previous one. A full recovery has come. When re-examined after 4 months, no complaints.

 3. A clinical example of vaginal crisis. Patient L-va N.I., 34 years old, (outpatient card 38/99), a nurse, was treated in the day psychotherapy center of the Temryuk district polyclinic of the Krasnodar Territory from 05.02. on 04/05/1999, she complained of increased irritability, suspiciousness, tearfulness, low mood, mood instability, sharp general weakness, severe weakness in the arms and legs, gait disturbance, nervous trembling, numbness and goosebumps, fainting, com throat, poor night sleep, constant headache, shortness of breath during physical exertion and negative emotions, pain in the heart, in the interscapular region, in the epigastrium, in the lower back, lumps in the throat, rapid nightly urination, bloating, constipation, general weakness, fatigue, chilliness. A patient has a hyperglycemic coma almost daily in the morning, and a hypoglycemic coma in the evenings. First aid is provided by an ambulance. Sick for 2 years. Married, marriage 2nd. Her husband is a doctor, a child neuropsychiatrist, a month ago he came to work in Temryuk from the Crimea. A patient with two children temporarily lives in Crimea with her grandmother. Due to illness, 2 years does not work. Examined in Simferopol and Dnepropetrovsk regional clinical hospitals with suspected adrenal tumor. The diagnosis of the tumor as a result of the examination is rejected. The reason for the regular occurrence of coma in the mornings and evenings has not been established. The husband suspected a neurotic disorder and brought the patient to a consultation in a psychotherapy room. Relations with her husband are good. Sexual life once a week, orgasm always. Childbirth - 2, abortion - 2, menstruation - normal. The first marriage broke up 5 years ago due to a bad relationship with her husband: he abused alcohol, often fought, there were always quarrels.

 The patient's mood is sharply reduced, crying. The patient is upset that for 2 years the doctors could not only cure her, but even the exact diagnosis was not established. Oriented in the environment, fixed on painful sensations and experiences. Of medium height, proper physique, satisfactory nutrition, the skin of the hands and feet is cool and moist. Pulse 84 in 1 min, rhythmic, blood pressure on both hands -120/80 mm RT. Art. The thyroid gland is not enlarged.

 The patient came to the reception with her husband, therefore, after a clinical examination, she and her spouses underwent rational, family and sexual psychotherapy: the rights and responsibilities of the spouses in family life were explained, an idea of the ideal norm of sexual life was given, its significance for the health of spouses, the harmful effects of sexual abstinence for the psyche, and recommended daily sexual life with an orgasm in the wife and without ejaculation in the husband.

 The patient was prescribed phenazepam at a dose of 0.5 mg 3 times a day, and at night -1.0 mg, amitriptyline at a dose of 6 mg 3 times a day, and at night -12.5 mg, homeopathic medicines: Ignatation 6 5 grains 3 times a day under the tongue on an empty stomach. The doses of phenazepam and amitriptyline gradually decreased from the second week, and from the beginning of the 3rd week of the day both drugs were canceled. Homeopathic medicines are recommended to be taken within two months.

 The patient was laid on a soft couch and she underwent superficial multi-needle acupuncture 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-21, and J-3 and at the auricular point AT-100 using the tonic method with golden needles, and at the points IG-8, J-16, AT-13, AT-34, AT-55, AT-96 sedative silver needles. On the 5th, 9th and 13th days acupuncture was performed on the 1st day; on the 2nd, 6th, 10th and 14th days - to the points F-8, J-4, J-20, AT-101 by the tonic method with golden needles, and to the points IG-2, J -17 , AT-28, AT-51 sedative method with silver needles, on the 3rd, 7th, 11th and 15th days - to the points R-7, J-3, J-22, AT-100 by the tonic method golden needles; and to the points TR-10, AT-34, AT-55, AT-96 by the sedative method with silver needles; on the 4th, 8th and 12th days - to the points V-67, R-13, J-20, AT-95, using the tonic method with golden needles, and to the points MS-7, AT-22, AT- 51, AT-96 sedative silver needles. Needles removed after 20 minutes. Thermal puncture was performed at the same corporal points by the PTP-01 apparatus for a stable method of 5 min each for sedative action and 2 min pecking method for a tonic effect, as well as infrared light puncture with AIKP-01 apparatus using the sedative method for 2 min for each point and tonic method - for 30 s.

 The “Volna” magnetic laser apparatus punched for 2 minutes: on the 1st, 6th and 11th days on the corporal points V-13, V-14, V-15, V-23, V-26; on the 2nd, 7th and 12th days - to the points V-12, V-13, T-12; on the 3rd, 8th and 13th days - at points V-11, V-14, V-15, T-13; on the 4th, 9th and 14th days - at points V-23, V-24, V-25, T-14; on the 5th, 10th and 15th days - at points V-18, V-19, VB-21, T-8.

 For color therapy, glasses with blue and green filters for 30 minutes were used.

 All medical procedures were carried out against the backdrop of quiet soothing music throughout the session. The treatment session ended with hypnotic suggestive psychotherapy lasting 30 minutes. The session lasted 5.5 hours.

 In the second treatment session, a deep abdominal massage was performed for 15 minutes, which was then alternated every other day with acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions.

 Autogenic training, starting from the 2nd day, was carried out every other day with a duration of 30 minutes, accompanied by soothing music.

 Conducted 15 sessions of complex treatment. After the 1st course of treatment, the patient's condition improved significantly: panic attacks stopped, headache disappeared, sleep, stool, mood normalized, and abdominal and lower back pain stopped. However, anxiety and fear of panic attacks, general weakness, and increased fatigue persisted. Night urination was reduced to 1 time. After 2 weeks, the 2nd course of complex treatment was carried out, similar to the first, also 15 sessions. All painful complaints completely disappeared. Panic attacks no longer arose. Blood pressure 110/70 mm RT. Art. Mood and ability to work were fully restored, sexual life 4-5 times a week with an orgasm. Examined after 2 years: no complaints, no panic attacks. Works as a nurse in a kindergarten. Sexual life 4-6 times a week with orgasm, good mood.

 The method has passed clinical trials in the psychotherapy cabinet of the Temryuk district polyclinic of the Krasnodar Territory for 119 patients with neurosis with vegetative-vascular crises for 10 years. Data on the immediate results of the treatment of vegetative-vascular crises by the proposed method and prototype are shown in table 1.

Comparative data of the table show that the proposed method compared to the prototype allows to achieve 100.0% relief of vegetative-vascular crises during treatment on an outpatient basis, to reduce treatment time by 3 times, without using expensive equipment (biotron)
Long-term results of the treatment of vegetative-vascular crises are shown in table 2.

 From table 2 it follows that the number of re-examined patients in the follow-up history of the prototype is unrepresentative in relation to the total number of patients with vegetative-vascular crises. Re-examined patients should be at least 90% of their total number (Karvasar BD Neurosis. - M .: Medicine, 1990.- S. 474.), while the prototype re-examined amounted to 77.9%, which makes long-term treatment results statistically unreliable.

 On our material, observation of 116 patients (97.5%) from 1 year to 5 years showed a significantly high efficiency of the proposed method for the treatment of vegetative-vascular crises (95.8%).

Claims (1)

 A method for the complex treatment of vegetative-vascular crises in adult patients suffering from neurosis, including the study of the functional state of the body and the subsequent exposure to rational psychotherapy, hypnosuggestive psychotherapy, autotraining, acupuncture, characterized in that they prescribe tranquilizers, antidepressants and homeopathic drugs sedative function, examine conduct family and sexual psychotherapy to harmonize interpersonal relationships and establish rhythm often , in the ideal of daily sexual life with an orgasm in a woman and without ejaculation in a man, they perform superficial multi-needle acupuncture, percutaneous electroneurostimulation, as well as acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions, alternating every other day with deep massage the abdomen, pulse and acupuncture diagnostics daily determine the functional state of acupuncture meridians, produce acupuncture on the 1st, 6th and 11th days to corporal points RP-2, J-14, R-13 and to the auricular point AT-100 then by the lowering method, and to the points IG-8, J-17, AT-13, AT-34, AT-55 - by the sedative method, on the 2nd, 7th, 14th days to the points F-8, J- 4, R-12, AT-101 - by the tonic method, and to the points IG-2, AT-28, AT-51 - by the sedative method, on the 3rd, 8th and 13th days - to the points R-7 , R-11, AT-100, AT-23 for women or AT-32 for men by the tonic method, and to the points TR-10, AT-34, AT-55 - by the sedative method, in the 4th, 9th and 14- days to the points V-67, R-13, J-4, AT-14, AT-95 - by the tonic method, and to the points VC-7, T-20, AT-25, AT-51 - by the sedative method, on the 5th, 10th and 15th days to the points VB-20, VB-1, BM-9, TR-3, AT-35, AT-96 by the tonic method, and to the points F-2, AT- 28, AT-55, AT-97 - sedative method with subsequent using thermal puncture and infrared light puncture to the indicated corporal points by sedative and tonic methods, magnetic laser puncture is performed for 2 minutes on the 1st, 6th and 11th days to the corporal points V-14, V-15, V-21, T -11, on the 2nd, 7th and 12th days - to the points V-12, V-13, T-12, on the 3rd, 8th and 12th days - to the points V-11 , V-14, V-15, T-13, on the 4th, 9th and 14th days - at points V-23, V-24, V-25, T-14, on the 5th, 10th and 15th days - at points V-18, V-19, V-20, at the same time as reflexology, they carry out color therapy using blue and green filters, use soothing music during the entire session and end the treatment session with hypnotic psychotherapy and auto-training.

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