RU2212838C2 - Method for training patient suffering from pulmonary disease to master breathing mechanics - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves teaching patient to normalize respiration mechanics with system and organs of influence to breathing process being concurrently normalized. The training is organized dependently on sympathetic and parasympathetic vegetative nervous system division innervation state. Normal innervation of these divisions being the case, breathing in rest state is taught step-by-step when lactate concentration is no greater than 20 mg%, nasal breathing, low abdominal breathing and diaphragmal breathing patterns are taught under inhalation-exhalation ratio being equal to 1:1. When applying moderate physical loads with lactate concentration being not greater than 40 mg%, inhalation-exhalation ratio is equal to 1:1. When applying medium intensity physical loads with lactate concentration being not greater than 70 mg%, nasal or oral breathing, low abdominal, diaphragmal and thoracic breathing patterns are taught with inhalation-exhalation ratio equal to 2:1. When applying heavy intensity physical loads with lactate concentration being greater than 70 mg%, inhalation-exhalation ratio is equal to 2:1, 3;1, 4:1 and 5:1. Sympathetic innervation being predominant, exhalation is accented and/or on pause after the exhalation with inhalation-exhalation ratio and/or exhalation pause being equal to 1:2, 1:3, 1: 4 and 1:5. Parasympathetic innervation being predominant, inhalation is accented and/or on pause before the inhalation with inhalation-exhalation and/or inhalation pause ratio being equal to 2:1, 3:1, 4:1 and 5:1. Respiratory minute volume is brought to norm at the following training stage when blood pH is equal to 7,4±0,05,. The pH being greater than 7.45, respiratory minute volume is brought down to normal value. The value being less than 7.35, respiratory minute volume is increased to normal value. Then, perfusion-ventilation debit is normalized, when ratio of breathing frequency to heart beat rate is equal to 1:5 under any physical loading mode and in rest state. EFFECT: accelerated recovery from pulmonary diseases.

Description

 The invention relates to pulmonology, physiotherapy and health, and can be used for the appointment of persons with lung diseases.

 The well-known "Method for the treatment of hemogypocarbia", in which it is recommended to reduce lung ventilation in a patient-transported volume by controlling the level of carbon dioxide in the exhaled air and maintaining its rate of increase of not more than 3-7 mm RT. Art. per day to a level of 45-55 mm Hg (see AS USSR 1067640, MKI A 61 N 1/00. A method for the treatment of hemogypocarbia / K.P. Buteiko (USSR) N762074 / 28-13 and 3500850 / 28-13: Publ. 29.01.82).

The disadvantage of this method is:
1. Given only one of three conditions in which the patient may be in a state of pulmonary disease, namely with hemogypocarbia. According to our data, only 46% of patients with bronchial asthma have a state of hemogipocarbia, the remaining 54% have a state of hemogipercarbia or hemonormocarbia. In our method, all states of blood saturation with carbon dioxide are taken into account.

 2. The author has not given the ratio of the phases of respiration, although it is known that inhalation and pause on inspiration stimulate sympathetic innervation, and exhalation and pause on exhalation induce parasympathetic innervation, as a result of improperly performed respiration phases, one section may become overexcited and the other section of the vegetative section may be inhibited. nervous system, which is one of the causes of bronchospasm.

 3. The author has no information about the perfusion-ventilation rate, which is carried out due to a strictly defined volume of ventilated air in the lungs to a strictly defined volume of blood flowing through the pulmonary capillaries, regulated by the short-lived receptors of the carotid arteries. This neglect can cause acidification or alkalization of the blood, which leads to a state of alkalosis or acidosis, which is one of the reasons that violate the smooth muscle condition of the alveoli and bronchioles, leading to bronchospasm, normal perfusion ventilation rate is determined by the ratio of heart rate to respiratory rate as 5: 1, which provides a normal reaction of blood pH within 7.4 ± 0.05, and therefore, the normal state of smooth muscles of the alveoli and bronchioles.

 4. The method does not indicate how to breathe under various physical activities that are found in the daily life of the patient, how to adjust the "depth of breathing" (the volume of inhaled and exhaled air), because this plays a paramount role in the state of blood pH.

 5. The method does not indicate the mechanics of breathing at rest and during various physical activities (breathing through the nose, mouth, chest, diaphragm, stomach), and this plays a big role in the state of the lungs.

 6. The method does not specify a method for controlling the "depth of breath" (the volume of inhaled and exhaled air), which is of great practical importance in the treatment. In this method, it is assumed to control the "depth of breath" (the volume of ventilated air) the use of a gas analyzer, which costs a lot of money, is inconvenient for transportation, which limits the practical application of the method.

 7. Breathing is a complex mechanism of activity of many organs and systems of the body that work on one common idea, providing oxygen to the tissues of the body and removing excess carbon dioxide from the body, the quality of oxygen supply to tissues depends on each organ and system, so breathing should be considered in aggregate, and not its individual components, which is the method for the treatment of hemogypocarbia.

 8. The method does not take into account the subjective sensations of the patient, which he will have to face when practicing breathing exercises, which plays an important role in self-control, with normalization of respiration and adaptation of short-lived receptors to the currently existing blood gas compositions.

 9. The method does not take into account the role of the vagus nerve rhythm that innervates the heart and lungs, a violation of this rhythm causes a disturbance of the innervation of the lungs, normally the vagus nerve rhythm has a ratio of heart rate to respiratory rate of 5: 1.

 10. The method does not take into account the role of the adrenal cortex in the production of corticosteroids that stimulate pulmonary activity.

 11. The method does not take into account the relationship of the large intestine with the lungs, we found that 86% of patients with lung diseases have diseases of the large intestine. Normalization of the colon, in combination with other factors of normalization, leads to a complete and rapid recovery of the lungs.

 12. The method does not take into account that there are three ways of supplying oxygen to tissues, one of which is supplying oxygen to tissues with food products, mainly carbohydrates. The share of this transport route, according to our estimates, reaches 15-20% of the total oxygen consumption by the body, so switching to plant food during the treatment facilitates lung function and contributes to their recovery.

 13. The method does not take into account the processes of warming the air through the airways, where the warming occurs mainly due to the breakdown of fats. In addition, oil consumption is necessary for the body to produce surfactants, an important element of pulmonary activity.

 14. The method does not take into account the importance of motor activity in the treatment of pulmonary diseases, due to which an excess of carbon dioxide is formed in the body, which relieves bronchospasm and stimulates pulmonary activity.

 15. The method does not take into account the influence of the state of the spine, it is known that vertebral neurogenic diseases directly impair the activity of the lungs and other organs functionally associated with the lungs.

 16. The method does not take into account the temperature factor and the body's ability to maintain a constant temperature of the internal environment of the body in pulmonary activity and the ability to lower temperatures provoke bronchospasis in violation of this mechanism.

 17. The method does not take into account the beneficial factor of aerophytotherapy with certain substances that contribute to recovery.

 18. The method does not take into account the mental and psychological state of the patient with pulmonary diseases, especially during periods of exacerbation of the disease, when the syndrome of "fear of incurable disease" and "fear of death" intensifies.

 19. The method does not take into account the beneficial role of exercises for the development of flexibility and relaxation for people with pulmonary diseases who have muscle contracture.

 The closest in technical essence and the achieved effect to the claimed method and selected as a prototype is a method of applying therapeutic gymnastics to a patient with tuberculosis with excessive and ineffective ventilation, in which breathing exercises are carried out in a state of rest with holding the breath in the breath with performing physical exercises. (see AS USSR 210335, IPC A 61 h 1/00. Method for the use of therapeutic exercises for patients with pulmonary tuberculosis with excessive and ineffective ventilation / E.M. Tsallagova, N.A. Fudin, G.A. Melkumov (USSR ). N1130050 / 31-16: Declared 1/30/1967: Published 06/11/1968. Bull. Discoveries. Inventions. 1968. N6).

 The disadvantages of this method are all the features inherent in the analogue. Additional signs include the fact that breathing exercises often become an aggravating disease, can lead to rupture of the alveolar capillaries, enhances the innervation of the sympathetic part of the autonomic nervous system.

 The prototype has common drawbacks with the analogue, which are that there is no integrity of the approach to the respiratory system, individual characteristics of the state and the response of the patient are not taken into account.

 The objective of the present invention is the creation of such a method in which there was a holistic approach and individual characteristics of the patient’s state were taken into account, which will increase the effectiveness of treatment and help to avoid a negative effect.

 The technical result is the possibility of a fairly accurate determination of the state of the body and targeted normalization of the function of the lungs, organs and systems, on which the activity of the lungs to one degree or another depends.

 This goal is achieved by the fact that, taking into account the individual characteristics of the patient’s body, normalize the mechanics of pulmonary respiration at rest and with various physical exertion, normalize the functions of the organs and systems of the body, on which normal pulmonary activity depends.

 Studies on patent and scientific and technical sources of information have shown that the proposed set of techniques for normalizing respiratory function, organs and systems on which the activity of the respiratory system depends is not known and does not follow explicitly from the material studied, i.e. meets the criteria of "novelty" and "inventive step".

 The proposed method can be applied in clinics, hospitals, LFK offices, kindergartens, schools, universities, factories and institutions without special equipment, because involves the use of a single instrument - a chronometer, which makes the method affordable, and therefore practically applicable.

 The proposed method is a set of techniques to improve the effectiveness of classes for the treatment of patients with pulmonary diseases.

 All of the above allows you to more effectively treat patients with pulmonary diseases. The proposed method is controlled by visual, palpation and chronometric research methods.

 The proposed monitoring method is as follows: 1st option - the doctor turns on the chronometer and calculates through the palpation sensations of the patient the frequency of pulse waves on the wrist for, for example, 15 s, at the same time the patient counts the number of breaths, then the indicators are recorded in the study protocol: 2nd option - the patient turns on the chronometer and counts at first for 15 s the frequency of pulse waves, and then the number of breaths at home.

 Example N1.

 Alekseeva E.V., 40 years old, the disease is bronchial asthma, was treated in the city hospital N 2, Chelyabinsk.

 After 10 years of illness, she was prescribed a method for the complete normalization of the function of the respiratory system, in particular, a vegetable diet with balanced salt and butter, physical exercises at a minimum of breathing, hardening procedures, a set of exercise therapy for normalizing the spine, cleansing enemas and laxatives were taken once a week, after which the patient went hungry for a day, took a contrast shower every day, went to the bathhouse once a week, breathed mint in the steam room, pidara, he held a two-week course of rational therapy, morning and evening engaged in gymnastics on flexibility and relaxation. As a result, after 2 months I stopped taking medications, the attacks disappeared after 8 days, after 4 months at VTE I removed the disability, was observed for a year, the disease did not resume.

 Example N2.

 Matyushin A.A., 10 years old. disease - bronchial asthma, was treated in the medical unit of the plant. Kolyuschenko, Chelyabinsk.

 After the appointment of a method for the holistic normalization of the function of the respiratory system according to the full treatment program, the attacks stopped after 3 days, after 12 days he stopped taking the medicine. Observation for 2 years showed that the child is in good health, no relapses were observed.

The proposed method for the holistic normalization of the function of the respiratory system, in comparison with traditionally existing in the clinic and exercise therapy, provides:
reduction of rehabilitation periods for patients with respiratory diseases by an average of 50-70%;
allows you to prevent attacks and relapses of the return of the disease;
allows you to get rid of hormonal dependence within 1.5-2 months.

Claims (1)

 A method of teaching a patient respiratory mechanics in the treatment of pulmonary diseases, characterized in that the training is conducted depending on the state of innervation of the sympathetic and parasympathetic sections of the autonomic nervous system, while in the case of normal innervation of the sympathetic and parasympathetic sections of the autonomic nervous system, they are taught breathing at rest when the concentration of lactate up to 20 mg%, breathing through the nose, lower abdomen and diaphragm, while exhaling, the air flow is felt with the fluff or the back of the hand, at a distance of 4 cm from nose, inhalation-exhalation ratio, as 1: 1, with moderate physical exertion, when the concentration of lactate is up to 40 mg%, breathing through the nose, lower abdomen and diaphragm, while exhaling, air flow is felt at a distance of 8 cm from the nose, inhalation-exhalation ratio as 1: 1, with moderate physical exertion, when the concentration of lactate is up to 70 mg%, breathing through the nose or mouth, lower abdomen, diaphragm and chest, while exhaling, air flow is felt at a distance of 18 cm from the nose, the inspiratory-expiratory ratio is 2: 1, with large physical exertion, when the concentration of lactate is more than 70 mg%, breathing with the mouth, lower abdomen, diaphragm and chest, on exhalation, the air flow is felt at a distance of more than 12 cm from the nose, the inspiratory-expiratory ratio is 2: 1, 3: 1, 4: 1, 5: 1, in the case of a predominance of sympathetic innervation , the emphasis is on exhalation and / or pause on the exit, in the ratio of inhalation-exhalation and / or pause on exhalation, as 1: 2, 1: 3, 1: 4, 1: 5, in the case of a predominance of parasympathetic innervation, the emphasis is on inspiratory and / or pause on inspiration, in the ratio of inspiration and / or pause on inspiration-expiration, as 2: 1, 3: 1, 4: 1, 5: 1, at the next stage, the minute volume of respiration is normalized, at which p blood is 7.4 ± 0.05, and if the pH is more than 7.45, reduce the minute volume of breathing to normal, while the patient takes a short breath until a feeling of a small lack of air, in case the blood pH is less than 7, 35, increase the minute volume of breathing to normal, while the patient feels a slight dizziness, then normalize the perfusion-ventilation rate, when, at any exercise mode and at rest, the ratio of the respiratory rate to the heart rate is 1: 5.