RU2203020C2 - Method for complex therapy of diffuse toxic goiter - Google Patents

Abstract

FIELD: medicine, endocrinology. SUBSTANCE: one should carry out both pulse and acupuncture diagnostics to determine functional body state. Intake of tranquilizers, antidepressants, homeopathic preparation should be prescribed. One should conduct surface multi-needle acupuncture, percutaneous electroneurostimulation, point-to-point and deep massage of cervicobrachial area, back and gluteal areas. It should be alternated with deep massage of stomach. Thyroid gland tissue should be daily introduced with silver needles to its whole thickness. Acupuncture of corporal and auricular points is carried out daily for 15 d. Thermopuncture and light puncture are performed into the same corporal points. Magnetolaseropuncture is carried out for 15 seances. Simultaneously, one should perform chromatotherapy by using spectacles with color filters of blue, light-blue and green colors. Relaxing music should be applied during seances. Curative seance is finished by hypnosuggestive psychotherapy and autotraining. EFFECT: shortened terms of therapy. 1 cl, 1 ex, 1 tbl

Description

 The invention relates to medicine, namely to endocrinology, and can be used in endocrinology and psychotherapy in the treatment of neuroses complicated by diffuse toxic goiter.

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

 Diffuse toxic goiter is one of the complications of protracted neurosis. On our material in a sample for 1997-2000. of 395 patients with neurosis, it was detected in 66 cases (16.7%), and in the sample for 1994-2000. out of 550 patients - in 107 cases (16.9%). Diffuse toxic goiter is quite resistant to drug treatment.

 There is a method of treating diffuse toxic goiter (Baranov V.G., Nikolaenko N.F. Thyroid diseases // Manual of Internal Medicine. L.: Medicine, 1996. - T.7. - P.29-88), which consists in the use of mercazolil at a dose of 10 mg 2-3 times a day, potassium perchlorate at a dose of 800-1000 mg per day, reserpine at a dose of up to 1.5 mg per day, prednisolone at a dose of 20-30 mg per day, radioactive iodine-131.

 The disadvantage of this method is the toxic effect of mercazolil and potassium perchlorate on the bone marrow, gastrointestinal tract (nausea, vomiting, diarrhea, pain in the epigastric region), skin rashes, fever, sore throat, joint pain, swelling and others. The duration of treatment with this method is several months, and the effectiveness is 50-75%. The use of radioactive iodine-131 is contraindicated for persons under 40 years of age, pregnant, during lactation, with a combination of diffuse toxic goiter with tuberculosis, hypertension, myocardial infarction, blood, kidney, gastric ulcer and 12 duodenal ulcer. The effectiveness of treatment does not exceed 85%.

 Closest to the claimed is a method of treating diffuse toxic goiter with acupuncture (Zosya A.A. Method for the treatment of thyrotoxicosis // RF Patent 2014066, class A 61 H 39/08, 1994).

 This method consists in the fact that the treatment is carried out in 1 session: a 12 cm long needle is inserted into the point J-22 (Tien-Tu) to a depth of 4 cm retrosternally until the patient experiences a sensation of current passing behind the sternum and diffuse heat in the mediastinum, and two needles are inserted into the "points of the parathyroid glands." The duration of the session is 25-30 minutes.

 The disadvantage of the prototype is the danger of damage to the aortic arch, the upper edge of which is located at the level of the middle of the sternum handle. The acupuncture point J-22 (Tien-tu) is located at a depth of 0.5 to 1.0 cm, and the length of the sternum handle is on average 4.5 cm, therefore, in domestic and eastern reflexology manuals, the injection at this point is deeper than 1, 0 cm is prohibited. Judging by the clinical symptoms a week after the treatment described in the prototype, the patient showed a significant improvement, but not recovery, and one case of a positive treatment result cannot lead to conclusions about the effectiveness of the treatment method. In addition, with this method, they do not treat functional disorders of the nervous system, which are the trigger in the development of diffuse toxic goiter, and also do not restore the function of other organs and systems, i.e. they treat one specific organ, and not the whole organism, which affects the effectiveness of treatment.

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

 The technical result of the proposed method is clinical recovery in 100% of cases, long-term positive results in 97.2%, treatment periods for patients of the 1st and 2nd degree diffuse toxic goiter - up to 20 days, patients of the 3rd degree - up to 55 days. Treatment is performed on an outpatient basis. During the treatment period, the normal function and size of the thyroid gland are completely restored, the function of the central and autonomic nervous system, endocrine system and internal organs is normalized: normal sleep, appetite and mood are restored, headaches, pains in the heart, stomach and spine are stopped, blood pressure is normalized , restore normal family relationships and an intense sex life, completely restore working ability and significantly improve the quality of life.

 The essence of the invention is the complex treatment of diffuse toxic goiter, which consists in the fact that pulse and acupuncture diagnostics are performed daily to determine the functional state of acupuncture meridians and internal organs; prescribe tranquilizers, antidepressants and homeopathic medicines; produce superficial multi-needle acupuncture, percutaneous electroneurostimulation, acupressure and deep massage of the cervical-collar zone, back, lumbosacral and gluteal regions, alternating every other day with deep massage of the abdomen; they perform acupuncture on the 1st, 6th and 11th days of treatment at corporal points RP-2, J-3 and at the auricular point AT-100 using the tonic method, and at points JG-8, J-21, J-23 , E-9, AT-34, AT-45, AT-55 sedative method; silver needles are injected into the thyroid gland along its entire surface daily on its entire thickness; in the 2nd, 7th and 12th days acupuncture is performed at the points F-8, J-4, AT-101 by the tonic method, and at the points IG-2, J-22, E-10, BM-117, AT-22, AT-37, AT-51 - sedative method; on the 3rd, 8th and 13th days - to the points R-7, J-3, AT-100 by the tonic method, and to the points TR-10, J-21, E-8, T-17, AT -28, AT-45, AT-55 sedative method; on the 4th, 9th and 14th days - to points V-67, AT-95 by the tonic method, and to points MS-7, J-22, J-23, E-9, AT-22, AT -37, AT-51 sedative method; on the 5th, 10th and 15th days - to the points J-4, AT-91, AT-101 by the tonic method, and to the points IG-11, RP-6, J-21, E-10, VM -117, AT-34, AT-45, AT-55 by the sedative method, followed by thermal puncture and light puncture at the indicated corporal points by sedative and tonic methods; produce laser-laser puncture for 2 min on the 1st, 6th and 11th days to the corporal points V-14, V-15, 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, VB-21, T-8; simultaneously with reflexology, color therapy is carried out using glasses with light filters of blue, blue and green colors; use soothing music during the entire treatment session and end the treatment session with hypnotic psychotherapy and auto-training.

 When treating adults, they examine sexual function, conduct rational, family and sexual psychotherapy to harmonize interpersonal relationships and establish a daily rhythm of sexual life with an orgasm in a woman and without ejaculation in a man. This symptom does not apply to children.

 The method is as follows. The history is carefully collected, the main psychogenies, starting from childhood, are identified, sexual function is examined, blood pressure on both hands is measured, dermographism and skin condition of the hands and feet are examined, the pulse rate is examined, acupuncture and pulse diagnostics are performed to determine the functional state of acupuncture meridians and internal organs.

 On the day of the examination of the patient or in the coming days, they conduct family and sexual psychotherapy with the spouses and identify the role behavior of each spouse, discuss the importance of the correct role 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 diffuse toxic goiter. 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 1-2 mg and amitriptyline at a dose of 6 mg 3 times a day, and at night 12.5 mg with a gradual decrease in the dose of both drugs in the second week and their complete cancellation from the beginning of the third week, as well as homeopathic medicines Iodine 6, Ignation 6 or Nux vomica during the entire treatment period and 1 month after the end of the course of treatment.

 Then the patient is laid 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 for 15 minutes, alternating every other day with deep massage the abdomen.

 Pulse and acupuncture diagnostics are performed daily to determine the functional state of the acupuncture meridians of internal organs and to select acupuncture points. All of our patients revealed functional insufficiency of the meridians of the heart, lungs, pericardium and kidneys.

 Acupuncture begins with the restoration of the functional state of the heart meridian, then the lungs, pericardium and kidneys.

 On the 1st, 6th and 11th days of treatment, corporal points RP-2, J-3 and the auricular point AT-100 are affected by the tonic method with gold needles with the needles tilted along the meridian, and on the points IG-8, J -21, J-23, Е-9, АТ-34, АТ-55 by the sedative method with silver needles with an inclination against the course of the meridian. Silver needles are inserted into the thyroid gland tissue daily over its entire thickness with a bias to the trachea and a distance between the needles of 0.8-1.0 cm.

 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, J-22, E-10 , VM-117, AT-22, AT-37, AT-51 sedative silver needles.

On the 3rd, 8th and 13th days, they affect the points R-7, J-3, AT-100 with the tonic method of gold needles, and on the points TR-10, J-21, E-8, T-17 , AT-28, AT-45, AT-55 sedative silver needles;
On the 4th, 9th and 14th days they affect the points V-67, AT-95 with the tonic method of gold needles, and on the points MC-7, J-22, J-23, E-9, AT-22 , AT-37, AT-51 sedative silver needles.

 On the 5th, 10th and 15th days, they affect the points J-4, AT-91, AT-101 with the tonic method of gold needles, and on the points IG-11, RP-6, J-21, E-10 , VM-117, AT-34, AT-45, AT-55 sedative method with silver needles.

 The duration of an acupuncture session is 15-20 minutes. Patients with hypersensitivity to pain and very weak patients begin treatment with a duration of an acupuncture session of 5-7 minutes.

 After acupuncture, thermopuncture is made at the same corporal points by the PTP-01 apparatus with a stable method for sedative action for 5 minutes and a peeling method for 2 minutes for toning, then light puncture is applied with the AIKP-01 apparatus to the same points with a sedative method for 2 minutes for each point , and by the tonic method - for 30 seconds.

The apparatus of the laser wave laser "Point" is affected for 2 minutes:
- on the 1st, 6th and 11th days - to the 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 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, color therapy is carried out using glasses with blue, blue, and green filters for 30 minutes per filter.

 The entire treatment session is carried out against the background of quiet soothing music. End the session with hypnotic suggestive therapy, alternating with autotraining every other day.

 The patients are given the task: to do auto-training at home for 15-20 minutes daily in the morning and evening, morning hygienic gymnastics, walking for 2 km, take cool water procedures in the morning, and a warm shower or bath in the evening, exclude watching TV shows and videos from 20.00 and go to bed no later than 22.00, and adults - spend as often as possible (ideally, daily) sex life with an orgasm in a woman and without ejaculation in a man.

 Example. Patient V., 40 years old (outpatient card 17/99), was treated in a psychotherapeutic hospital of the Temryuk district polyclinic of the Krasnodar Territory from January 17 to March 19, 1999 for hysterical neurosis, astheno-hypochondria syndrome, hypotonic vegetative-vascular dystonia, bilateral diffuse toxic goiter of the 3rd degree. Complaints of increased irritability, suspiciousness, tearfulness, poor sleep, persistent headache, pain in the region of the heart, in the interscapular region, in the epigastrium, in the lower abdomen, in the lower back, frequent day and night urination, frequent diarrhea, general weakness, increased fatigue, chilliness . Sick about 6 years. Due to illness, it does not work for 6 years. Relations with her husband are good. Sexual life 1-2 times a week, rare orgasm - no more than 50% of sexual acts. Childbirth - 2, abortion - 3, menstruation - normal.

 Mood is sharply reduced due to severe headache and general weakness. Oriented in the environment, fixed on pain. High growth, proper physique, satisfactory nutrition, skin of hands and feet is cool and moist. Pulse 98 in 1 minute, rhythmic, blood pressure on both hands - 90/60 mm Hg Pulse diagnostics: pulses of the heart, lungs, pericardium, kidneys, triple heater, bladder, small and large intestines - in the "void", pulses of the stomach, pancreas, liver and gall bladder - moderately reduced. The thyroid gland is palpated above the jugular notch on both sides for 6 cm, soft elastic consistency, homogeneous, knotless, clearly visible when examining the neck.

 The patient came to the reception with her husband, therefore, after her clinical examination, rational, family and sexual psychotherapy was carried out with the spouses: the rights and obligations 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 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 Ignatia 6 5 grains 3 times a a day under the tongue on an empty stomach and Iodine 6 5 grains 3 times a day.

 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.

 The patient was laid on a soft couch and she underwent superficial multi-needle acupuncture with a multi-needle hammer for 5 minutes, transdermal electroneurostimulation with the CHENS-2 apparatus for 5 minutes, acupressure and deep massage for 15 minutes of the cervical-collar zone, back, lumbosacral and buttock .

 After this, acupuncture was performed at the corporal points RP-2 and J-3 and at the auricular point AT-100 using the tonic method with gold needles, and at the points IG-8, J-21, J-23, E-9, AT-34, AT -45, AT-55 sedative silver needles. Silver needles were inserted into the tissue of the thyroid gland over its entire thickness with the tip of the needle tilted to the trachea and the distance between the needles 0.8-1.0 cm. Acupuncture on the 1st day was performed on the 6th and 11th days; on the 2nd, 7th and 12th days - to the points F-8, J-4, AT-101 by the tonic method with golden needles, and to the points IG-2, J-22, E-10, VM-117 , AT-22, AT-37, AT-51 sedative silver needles; on the 3rd, 8th and 13th days - to the points R-7, J-3, AT-100 by the tonic method with golden needles, and to the points TR-10, J-21, E-8, T-17 , AT-28, AT-45, AT-55 sedative silver needles; on the 4th, 9th and 14th days - to the points V-67, AT-95 by the tonic method with golden needles, and to the points MS-7, J-22, J-23, E-9, AT-22 , AT-37, AT-51 sedative silver needles; on the 5th, 10th and 15th days - to the points J-4, AT-91, AT-101 by the tonic method with golden needles, and to the points IG-11, RP-6, J-21, E-10 , VM-117, AT-34, AT-45, AT-55 sedative method with silver needles. The needles are removed after 20 minutes. Thermopuncture was performed at the same corporal points by the PTP-01 apparatus for a stable method of 5 minutes each for sedative action and 2 minutes pecking method for the tonic effect, as well as light puncture with AIKP-01 apparatus using the sedative method for 2 minutes for each point and the tonic method for 30 seconds.

 The “Volna” magnetic laser apparatus punched 2 minutes on the corporal points V-14, V-15, T-11. On the 6th and 11th days, laser laser puncture was carried out at the points of the 1st day; 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, VB-21, T-8.

 At the same time as reflexology, color therapy was carried out and glasses with blue, blue, and green color filters were used for 30 minutes for each light filter.

 All medical procedures were carried out in a calm atmosphere, with the most friendly and sincere attitude of the doctor to the patient against the background of quiet soothing music throughout the session. The treatment session ended with hypnotic suggestive psychotherapy lasting 30 minutes. All medical procedures were carried out by a psychotherapist in the same room. The treatment session lasted 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 areas.

 Autogenous training, starting from the 2nd day, was carried out every other day for 30 minutes, accompanied by soothing music.

 After the 1st course of treatment, the patient’s condition improved significantly: headache disappeared, sleep, stool, mood normalized, abdominal and lower back pain stopped, general weakness, increased fatigue, chilliness disappeared. The thyroid gland decreased in size by 2 times. Nighttime urination was reduced to 1 time, and daytime urination to 4 times a day. After 2 weeks, the 2nd course of complex treatment of diffuse toxic goiter was carried out, as well as 15 sessions. All painful complaints completely disappeared, the thyroid gland returned to normal in size. Blood pressure 110/70 mm Hg Mood and ability to work were fully restored, sexual life 4-5 times a week with an orgasm.

 When viewed after 1.5 years, the patient has no complaints, the thyroid gland is not enlarged.

 The method has passed clinical trials in a psychotherapeutic day hospital in the Temryuk district polyclinic of the Krasnodar Territory for 107 patients with diffuse toxic goiter for 7 years. 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 to the prototype allows to achieve 100% clinical recovery in the treatment of diffuse toxic goiter of the 1st-2nd degree in terms of up to 20 days, and 3rd degree - up to 55 days.

 During follow-up observation from 1 year to 5 years, stable positive results were noted in 97.2% of cases.

Claims (2)

 1. A method for the complex treatment of diffuse toxic goiter, including the study of the functional state of the body and subsequent exposure to acupuncture, characterized in that pulse and acupuncture diagnostics are performed daily to determine the functional state of acupuncture meridians and internal organs, tranquilizers, antidepressants and homeopathic preparations are prescribed, and multi-needle surface is produced acupuncture, percutaneous electroneurostimulation, as well as acupressure and deep massage of shane o-collar zone, back, lumbosacral and gluteal regions, alternating every other day with a deep massage of the abdomen; they perform acupuncture on the 1st, 6th, 11th days to the corporal points of RP-2, J-3 and to the auricular point of AT-100 by the tonic method, and to the points of IG-8, J-21, J-23, E-9, AT-34, AT-45, AT-55 by the sedative method, silver needles are injected throughout the entire thickness of the thyroid gland tissue over its entire surface, on the 2nd, 7th and 12th days acupuncture is performed to the points F-8, J-4, AT-101 by the tonic method, and to the points IG-2, J-22, E-10, BM-117, AT-22, AT-37, AT-51 by the sedative method, 3rd, 8th and 13th days - to the points R-7, J-3, AT-100 by the tonic method, and to the points TR-10, J-21, E-8, T-17, AT- 28, AT-45, AT-55 sedative method, on the 4th, 9th and 14th days - to the points V-67, AT-95 by the tonic method, and to the points MS-7, J-22, J-23, E-9, AT-22, AT-37, AT-51 by the sedative method, in the 5th, The 10th and 15th days - to the points J-4, AT-91, AT-101 by the tonic method, and to the points IG-11, RP-6, J-21, E-10, BM-117, AT- 34, AT-45, AT-55 by the sedative method followed by thermal puncture and light puncture at the indicated corporal points by sedative and tonic methods; produce laser laser puncture for 2 min on the 1st, 6th and 11th days to corporal points V-14, V-15, T-11, on the 2nd, 7th and 12th days - to 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, 9- the 14th and 14th days - to the points V-23, V-24, V-25, T-14, on the 5th, 10th and 15th days - to the points V-18, V-19, VB-21 T-8; at the same time as reflexology, color therapy is carried out using glasses with blue, blue and green color filters, soothing music is used during the entire session and the treatment session is completed with hypnotic psychotherapy and autotraining.  2. The method according to claim 1, characterized in that in the treatment of adults, sexual function is examined, rational family and sexual psychotherapy is carried out to harmonize interpersonal relationships and establish the rhythm of daily sexual life with an orgasm in a woman and without ejaculation in a man.

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