RU2212219C1 - Method for treating patients for psoriatic arthritis - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering radon baths. Radon concentration is equal to 180-200 nCu/l, temperature of 36-37 C, duration is 10-15 min. The treatment course is 10-15 every other day procedures long. EFFECT: prolonged remission period.

Description

 The present invention relates to the field of medicine, in particular rheumatology and dermatology, in particular to the treatment of severe psoriasis, and can be used in spa facilities with radon waters.

 In recent years, there has been an increase in patients with the most severe form of psoriasis, in which progressive damage to the joints and spine leads to a decrease in the quality of life, limited ability to work, and disables patients.

 The treatment of psoriatic arthritis has received much attention. Many works have been published on this issue (Dovzhansky S.I., 1973; Filimonov A.N., 1974, Maryasis E.D., 1983; Militenko S.A., 1983; Dorogina V.M., 1987; Maryasis E. D., 1987; Badokin N.V., 1990; Mashkillayson A.L. S. et al., 1987; Vladimirov V.V., 1995, Skripkin Yu.K., 1995; Mordovtsev V.N., Rasskazov N. M., 1996, Termzniy O.V., 1998).

 The uncertainty of the etiology and pathogenesis of this disease, the chronicity of the process with frequent exacerbations, often with resistance to drug therapy, determines a large number of therapeutic methods, including resorting to resort factors. Therefore, the questions of finding new methods of treating psoriatic arthritis remain one of the urgent problems in dermatology and rheumatology.

 A known method of treating patients with psoriatic arthritis with multiple joint damage using sulfide (50-100 mg / l), iodine-bromine, dry air radon baths in combination with phonophoresis of hydrocartisone, and when changing in single joints - electrophoresis with mud, or an alternating magnetic field of low frequency , SMV and DMV therapy, inductothermy and DDT. In diseases of the joints of the arms and legs, galvanization and drug electrophoresis of dipyrone or novocaine with the help of one or two-chamber baths are shown (Dovzhansky S.I., 1973; Militenko S.A., 1983; Filimonov A.N., 1974; Maryasis E.D. . et al. 1978, 1981, 1983, 1987 and others).

 The disadvantages of this method are the low effectiveness of treatment, the occurrence of side effects, short duration or lack of remission.

The closest in technical essence to the proposed method is a method of treating patients with psoriatic arthritis, which consists in the appointment of patients with radon baths with a concentration of radon of 40 nCi / l at 37 ^o C for 15 minutes, 10 procedures per treatment course (Filimonov A.N. Clinical and functional parallels in balneotherapy of patients with psoriasis with radon and carbon dioxide-hydrogen sulfide waters of the Pyatigorsk resort // Abstract of thesis, Candidate of Medical Sciences, Stavropol, 1974, p.24).

 The disadvantage of this method is the low effectiveness of the treatment, it not only does not eliminate, and often does not reduce the main clinical manifestations of the disease, namely pain in the joints and pathology of the skin. With this method, a short remission is achieved - 3-6 months.

 The technical result of the proposed method for the treatment of patients with psoriatic arthritis is the prevention of disease progression, a decrease in the activity of the pathological process, and an extension of the period of remission with an increase in the therapeutic effect is achieved.

The specified technical result is achieved by the appointment of radon baths with a concentration of radon of 180-200 nCi / l at 36-37 ^o C for 10-15 minutes spent every other day for a course of treatment of 8-10 procedures.

 The use of bathtubs with a concentration of radon of 180-200 nCi / l is optimal for these patients, affecting inflammatory processes in the joints, pathology of the skin, immune status and hormonal metabolism. Concentrations below 180 nCi / l less effectively affect the skin, articular syndrome and the activity of the pathological process, and above 200 nCi / l - it causes an exacerbation of the skin process and increased exudative changes in the joints, often accompanied by the development of leukemia and lymphopenia. 8-10 procedures are enough to obtain a therapeutic effect.

 Description of the method.

The method is as follows: the patient is assigned radon baths with a concentration of radon of 180-200 nCi / l at 36-37 ^o C for 10-15 minutes, conducted every other day, for a course of treatment of 8-10 procedures.

 The method is illustrated by the above observations.

 Example 1

 Patient K., 37 years old, medical history 1259, 2002

 Diagnosis: Psoriatic arthritis with spinal lesions (clinical sacroileitis), ACT 1, NPS 1.

 Before treatment, he complained of pain in the left knee joint and spine at rest and during physical exertion, psoriatic rashes and itching of the skin. Sick psoriasis for 11 years. Pain in the spine notes for 20 years. Repeatedly conducted inpatient and outpatient treatment without a visible effect.

 Upon admission to the clinic objectively: on the scalp erythema, plaques with silver scales, profuse peeling, behind the ears, plaques on an eretematic basis, thickened, with dense silver scales, in the chest area plaques of bright pink color, grouped with silver scales, on elbows papules. Palpation of the iliac sacs is more painful on the left. Shoulder, elbow, wrist painless. In the left knee joint, moderate proliferative changes (1.5 points), sharply painful on palpation in the projection of the joint space. In the blood test, ESR 10 mm per hour, HB 110 g / l, Ig G - 23.6 mg / ml, Ig A - 3.8 mg / ml, Ig M - 1.02 Ig / ml, CEC - 50 units. , PASI - 11 points.

Conducted spa treatment with radon baths with a concentration of radon of 180 nCi / l at 37 ^o C for 15 minutes, conducted every other day, for a course of treatment of 10 procedures.

 After the treatment, the rashes on the skin of the scalp, behind the auricles became pale, flattened, there was slight peeling, in the chest area the plaques turned pale, and foci of healthy skin appeared. Palpation of the iliac sacs - slight pain is noted. Proliferative phenomena in the knee joint decreased to 0.5 points, slight pain on palpation was noted. In the blood test: ESR - 3 mm per hour, HB - 130 g / l, Ig G - 20.0 mg / ml, Ig A - 2.8 mg / ml, Ig M - 1.02 Ig / ml, CEC - 40 units, PASI - 7.8 points.

 Thus, after a course of radon therapy, a positive clinical effect is noted, positive dynamics of the process activity and immunological status are noted. The patient was discharged with significant improvement.

 Example 2

 Patient E., medical history 927, 2002

 Diagnosis: Psoriatic arthritis with damage to the small joints of the feet, ACT 2, NFS 2.

 Before treatment, she complained of pain in the small joints of the feet, in the knee and ankle joints, for psoriatic rashes and skin integuments of the trunk and limbs. Morning stiffness 20 min. Sick with psoriasis for 25 years. Joint pain for 14 years. Repeatedly conducted inpatient and outpatient treatment without a visible effect.

 Upon admission to the clinic objectively: on the scalp, on the skin of the body, in the back, on the chest, on the upper and lower extremities, there are many papules and plaques of bright pink color with laminar peeling. The nail plates on the arms and legs are yellow, thickened and have a linear striation. Gait gentle. Small joints of the hands, hips and knees are painful on palpation. Ankle joints: right edematous, movement is difficult, sharply painful on palpation. Left - painful on palpation, movement preserved. Small joints of the feet are slightly deformed, painful in the peripheral regions. In the blood test, ESR 41 mm per hour, HB 100 g / l, Ig G - 13.9 mg / ml, Ig A - 4.3 mg / ml, Ig M - 2.47 Ig / ml, CEC - 100 units. , PASI - 30 points.

Conducted spa treatment with radon baths with a radon concentration of 200 nCi / l at 37 ^o C for 10 minutes, conducted every other day, for a course of treatment of 8 procedures.

 After the treatment, rashes on the skin of the scalp, on the skin of the body, in the back, on the chest, on the upper and lower extremities of the papule and plaque turned pale, flattened. The gait became more free. Pain in all joints decreased significantly. The period of morning stiffness was reduced to 5 minutes. Significantly reduced swelling in the right ankle joint, the movement is restored. In the blood test: ESR - 30 mm per hour, HB - 115 g / l, Ig G - 12.0 mg / ml, Ig A - 2.8 mg / ml, Ig M - 2 Ig / ml, CEC - 80 units ., PASI - 20 points.

 Thus, after a course of radon therapy, a positive clinical effect is noted, positive dynamics of the process activity and immunological status are noted. The patient was discharged with improvement.

 The proposed method was carried out in 54 patients with psoriatic arthritis. To characterize the functional state of the body, clinical and laboratory studies were performed (clinical, biochemical blood analysis, immunological status).

 The data obtained were compared with the parameters of patients in the control group (26 people) who did not receive radon baths.

 As a result of the treatment, skin manifestations significantly decreased in 49 patients of the main group (91.0%), while in the control group - in 16 (61.5%). Pain syndrome decreased in 52 people of the main group (96%), in the control - in 21 (80.7%). ESR normalized in 47 (87%) and 15 (57.6%), respectively. Hemoglobin increased in 45 (83.3%), in the control - in 18 (69.2%). There was a tendency toward a decrease in the initially elevated Ig G, Ig A indices in both groups, although this was observed in 96.0% in the main group and 53.8% in the control group. Ig M values remained virtually unchanged in all patients. The circulating immune complexes returned to normal in 44 (81.5%) and 15 (57.6%) patients, respectively.

 Compared with the prototype, this method has a positive effect on the clinical course of the disease: the skin syndrome significantly decreased (psoriatic rashes turned pale, flattened, healthy skin areas appeared, peeling decreased), articular syndrome (proliferative-exudative phenomena, joint pains, and morning stiffness decreased) ) According to laboratory studies, there is a decrease in the activity of the inflammatory process, an improvement in the immune status.

 As a result of treatment, the proposed method prevents the progression of this disease, reduces the activity of pathological skin and joint processes, and forms a stable remission that persists for 10-12 months.

 A distinctive feature of the proposed method is the preventive focus, implemented by solving problems associated with increasing the adaptive capabilities of patients in order to restore and strengthen their health, and, accordingly, increasing professional reliability and preventing disability based on the predominant use of natural and artificial physical factors.

Claims (1)

A method of treating patients with psoriatic arthritis, including the appointment of radon baths, characterized in that the patient is prescribed radon baths with a concentration of radon of 180-200 nCi / l at 36-37 ^o C for 10-15 minutes, conducted every other day, for a course of treatment of 8-10 procedures.