RU2234952C1 - Method of treating focal baldness - Google Patents

Abstract

FIELD: dermatology.

SUBSTANCE: treatment comprises pharmacotherapy and affecting reflexogenic zones and biologically active sites by electric current. Reflexogenic zones involved are those from regions of projection of superior cervical sympathetic ganglions, backbone region, face region, and liver projection region. This procedure is carried out during 10 days. Electric current parameters and zone to be affected are established for each treatment cession.

EFFECT: reduced number of recurrences and complications.

3 cl

Description

The invention relates to medicine, dermatology, and specifically to methods for treating focal baldness.

Known methods of treating this disease are to prescribe physiotherapy in the form of SMT (sinusoidal modulated currents) [1], d'Arsonvalization [1], photochemotherapy [2], cryomassage [3], electric sleep, electrophoresis, EHF-therapy (millimeter-wave electromagnetic waves) extremely high frequency), laser therapy [2, 4], transcranial electrical stimulation [5], as well as pharmacotherapy with the use of drugs. The latter are used in the form of local (local irritating agents, glucocorticoids) and general therapy (microelements, vitamins, microcirculation improving drugs, biogenic stimulants, psychotropic drugs, hormones, immunosuppressants) [6-18].

However, despite the many proposed methods of treating this nosology, resistance to ongoing therapy and relapse of the disease are often observed, which is a clinical problem [19].

In addition, most treatments have disadvantages. So, physiotherapeutic methods are contraindicated in many diseases, often cause side effects, require repeated repeated courses of treatment [1-5].

The use of pharmacological agents also has a number of disadvantages. Drugs must be used for a long time, some in the form of injections, side and allergic reactions are possible [6-18].

Drug treatment is expensive due to the duration of use and the simultaneous administration of several drugs, especially in combination with physiotherapy treatment.

Closest to the proposed is a method of treating focal alopecia, including pharmacotherapy and exposure to reflexogenic zones [20]. This method of treatment is not effective in relation to resistant forms of the disease.

A new technical task is to increase the effectiveness of treatment by reducing the number of relapses and complications, expanding the scope.

The problem is solved by a new method for the treatment of focal alopecia, including pharmacotherapy and exposure to reflexogenic zones with a pulsed bipolar current, once a day, for 10 days, and on the first day they affect the spine and facial areas with a current frequency of 59.3 Hz, with a total duration of 15-20 minutes, at the site of baldness with a frequency of current from 20 to 100 Hz for a duration of 1 minute; on the second day - to the cervical-collar zone with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 15 to 60 Hz, lasting 1 minute on each side; on the 3rd day - to the region of the spine and to the zones of the face with a frequency of current from 20 to 100 Hz, with a total duration of 15-20 minutes, at the focus of baldness with a frequency of current of 59.3 Hz, lasting 5 minutes; on the 4th day - to the liver region with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 30 to 120 Hz, pause duration between pulses in a packet of 1200 μs, lasting 5 minutes from each side; on the 5th day - to the cervical-collar zone with a current frequency of 20 to 100 Hz, a total duration of 15-20 minutes, to the alopecia focus with a current frequency of 59.3 Hz, a duration of 5 minutes; on the 6th day - on the spine and on the face with a frequency of 59.3 Hz, a total duration of 15-20 minutes, on the upper cervical sympathetic nodes with a frequency of 15 to 60 Hz, a duration of 1 minute on each side; on the 7th day - to the region of the liver with a frequency of current from 20 to 100 Hz, a total duration of 15-20 minutes, to the focus of alopecia with a frequency of current of 59.3 Hz, a duration of 5 minutes on the 8th day - to the cervical-collar zone with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 30 to 120 Hz, pause duration between pulses in a packet of 1200 μs, duration 5 minutes on each side; on the 9th day - to the spine and facial areas with a frequency of current from 20 to 100 Hz, a total duration of 15-20 minutes, to the focus of baldness with a current frequency of 59.3 Hz, a duration of 5 minutes; on the 10th day - to the spine and face zones with a current frequency of 59.3 Hz, a total duration of 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 15 to 60 Hz, a duration of 5 minutes on each side, course treatment is repeated after two months, also the spinal region includes the line of the spinous processes and paravertebral lines, and the facial areas include the exit points of the three branches of the trigeminal nerve: the orbital nerve, maxillary nerve and mandibular nerve.

The method is as follows. After the diagnosis is established, the reflexogenic zones are affected by a pulsed bipolar current in the form of pulses with a current strength of up to 250 mA according to the claims 1 time per day for 10 days. This effect can be carried out by physiotherapy devices, such as, for example, “SCENAR 97.4+” (approved for use in medical practice by the Ministry of Health of the Russian Federation, registration certificate 29/0302397 / 0329-00, issued under license for the production of ZAO “OKB RITM”, Taganrog No. 42 / 98-1325-0260, TU 9444-010-05010925-97, certificate of conformity ROSS Ru IMO2.V04076).

The zones of exposure to electric pulses of the specified characteristic are defined by the following anatomical boundaries:

- the area of the spine includes a line of spinous processes and paravertebral lines;

- facial areas include the exit points of three branches of the trigeminal nerve on the face on both sides: the orbital nerve - the upper edge of the orbit; maxillary nerve - the lower edge of the orbit; mandibular nerve - in the area of the corner of the mouth;

- the cervical-collar region is limited from above by the hairline, from below by the upper scapular awns, on the sides by clavicular-acromial joints;

- the area of the projection of the liver is determined by its percussion borders;

- the center of baldness is detected visually;

- the projection area of the upper cervical sympathetic nodes is located at the level of the angle of the lower jaw at the posterior edge of the sternocleidomastoid muscle.

The current strength is selected individually to a tingling sensation. The duration of exposure to general strengthening reflexogenic zones (cervicothoracic zone, spinal area, facial area and liver projection area) during the session is 15-20 minutes; on the focus of baldness - up to 5 minutes; on the projection area of the upper cervical sympathetic nodes - up to 5 minutes on each side. In the subsequent course of treatment is repeated after 2 months according to the specified scheme. In severe forms of the disease (subtotal alopecia), the effect on reflexogenic zones is combined with the traditionally used drug therapy (ascorbic acid, zinc oxide, nicotinic acid, sodium thiosulfate, trental, external treatment).

The scheme of the impact of electric impulses of the above characteristics on the reflexogenic zones of the body for the treatment of focal baldness is as follows:

1st day:

- the region of the spine (along the spinous processes and paravertebral lines), the facial area (exit points of the orbital, maxillary and mandibular nerves): current frequency - 59.3 Hz, total duration - 15-20 minutes;

- center of baldness: current frequency - from 20 to 100 Hz, duration - 1 minute.

2nd day:

- cervical-collar zone: current frequency - 59.3 Hz, duration - 15-20 minutes;

- upper cervical sympathetic nodes: current frequency - from 15 to 60 Hz, duration - 1 minute on each side.

3rd day:

- region of the spine, facial zone: current frequency from 20 to 100 Hz, total duration - 15-20 minutes,

- center of baldness: current frequency - 59.3 Hz, duration - 5 minutes.

4th day:

- liver area: current frequency - 59.3 Hz, duration - 15-20 minutes;

- upper cervical sympathetic nodes: current frequency - from 30 to 120 Hz, the duration of pauses between pulses in a packet of 1200 μs, the duration of 5 minutes on each side.

5th day:

- cervical-collar zone: current frequency - from 20 to 100 Hz, duration - 15-20 minutes;

- center of baldness: current frequency - 59.3 Hz, duration - 5 minutes.

6th day:

- region of the spine, facial zones: current frequency - 59.3 Hz, total duration -15-20 minutes;

- upper cervical sympathetic nodes: current frequency - from 15 to 60 Hz, duration - 1 minute on each side.

7th day:

- liver area: current frequency - from 20 to 100 Hz, duration - 15-20 minutes;

- center of baldness: current frequency - 59.3 Hz, duration - 5 minutes.

8th day:

- cervical-collar zone: current frequency - 59.3 Hz, duration - 15-20 minutes;

- upper cervical sympathetic nodes: current frequency - from 30 to 120 Hz, the duration of pauses between pulses in a packet of 1200 μs, the duration of 5 minutes on each side.

9th day:

- region of the spine, facial zone: current frequency from 20 to 100 Hz, duration - 15-20 minutes,

- center of baldness: current frequency - 59.3 Hz, duration - 5 minutes.

10th day:

- region of the spine, facial zones: current frequency - 59.3 Hz, total duration -15-20 minutes;

- upper cervical sympathetic nodes: current frequency - from 15 to 60 Hz, duration - 5 minutes on each side.

The choice of zones and the type of impact on the reflexogenic zones of the human body with electric pulses of the specified characteristic for the treatment of focal baldness is due to the following:

- stimulation by physical stimuli, including electrical signals above the specified characteristic, of the reflexogenic zones of the cervicothoracic zone, the spine, face areas and the area of the projection of the liver have a general strengthening effect on the body, contributing to the restoration of homeostasis [20-22];

- exposure to physical stimuli, including electrical signals above the specified characteristics, on the projection area of the diseased organ improves its trophism, which leads to the restoration of its damaged structures and functions [21, 22];

- our proposed effect on the projection area of the upper cervical sympathetic nodes is due to the fact that these nodes carry out the vegetative innervation of the scalp [24]. In turn, it is known that stimulation of the projection area of the superior cervical sympathetic nodes (for example, SMT) improves blood supply and trophic tissue of the head, which helps to improve hair growth [1].

Both local reflex mechanisms and the general reaction of the body to the action of an external factor take part in the implementation of the impact on the body of electrical impulses above the specified characteristic [21-23].

The local effect of exposure to electric pulses is the activation of microcirculation processes and improvement of tissue trophism not only in the area of local exposure (persistent moderate hyperemia), but also in the internal organs associated with this area of the skin (according to the principle of skin-visceral reflex): increased pulse blood supply to blood vessels , decreased vascular tone, improved venous outflow.

The general effect on the body with electric impulses activates non-specific defense mechanisms, which is confirmed by:

- the formation of non-specific adaptive responses to exposure;

- immunocorrective effect, expressed in the optimization of immunity with an increase in the number of T-active lymphocytes, normalization of the balance of immunoglobulins, restoration of the ratio of T-killers and T-suppressors, increase in the number of B-lymphocytes and the total content of immunoglobulins;

- optimization of the ratio of the tone of the sympathetic and parasympathetic departments of the autonomic nervous system.

The mode of exposure, its time and sequence on the reflexogenic zones of the cervical-collar zone of the spine, the liver region, the site of baldness and the region of the upper cervical sympathetic nodes by a pulsed bipolar electric current, causing hair growth during focal baldness, was selected based on clinical observations of this category of patients.

The proposed method of treatment was treated 15 patients with focal alopecia. Of these, women (aged 10 to 37 years) accounted for 46.7%. Men (aged 16 to 45 years) accounted for 53.3%.

Clinical observations on the use of pulsed bipolar current for the treatment of focal baldness showed that during the first month after treatment, all patients showed abundant growth of cannon hair in the foci, and over the next 3 months, growth of long hair. Within 1 year after the therapy, not a single case of recurrence of the disease and complications was recorded. This indicates the high therapeutic effectiveness of the proposed method of therapy and the appropriateness of its use for the treatment of focal baldness.

Clinical example (extract from the medical history). Patient V., 10 years old, came to the clinic of skin diseases of the Siberian State Medical University on June 4, 2002 with complaints of hair loss in the form of several foci on the scalp. Sick since June 2001.

Local status. The pathological process is widespread non-inflammatory in nature with the involvement of the scalp (temporal, parietal and occipital areas). Pathological elements are represented by foci of irregular shape ranging in size from 2 to 17 cm. In some foci, hair is completely absent, in others there are fluffy and long hair. The mouths of the hair follicles are visible. The skin in the foci of normal color, no atrophy. Hair is easily epilated throughout the scalp. According to the results of further examination revealed:

- general blood test dated June 4, 2002 - red blood cells - 4.5 × 10 ¹² , Hb - 150 g / l, white blood cells - 6.9 × 10 ⁹ , lymphocytes - 37%, monocytes - 2%, segmented - 58% , eosinophils -3%, ESR - 2 mm / h;

- biochemical analysis of blood from June 4, 2002 - glucose - 4.3 mmol / l, total bilirubin - 13.3 mmol / l, total protein - 72 g / l;

- general urine analysis dated June 4, 2002: color - straw, transparency - transparent, specific gravity - 1.011, sugar - negatively, protein - negatively, bile pigments - negatively, epithelium - 2-3 in the field of view, white blood cells - 1- 3 in sight;

- Wassermann reaction (RW) and sedimentary reactions are negative;

- ultrasound examination of the abdominal organs of June 7, 2002: echo-scopically without pathology;

- immunofluorescence analysis (ELISA) of June 26, 2002: antibodies to opisthorchia were not found; antibodies to giardia - titer 1: 300.

Based on the results of the examination, the diagnosis was made: focal alopecia, severe.

The patient received the following treatment: zinc oxide 0.05 g 2 times a day, nicotinic acid 1% - 1 ml IM 1 time a day No. 10, ascorbic acid 5% - 1 ml IM 1 time a day No. 10 , pyridoxine hydrochloride 6% - 1 ml IM once a day No. 10, exposure to reflexogenic zones by a pulsed bipolar current according to the claims according to the regimen specified in it by the physiotherapy apparatus “SCENAR 97.4+”.

At the end of the course of treatment, no visible changes were noted. At the control examination after 1 month - abundant growth of vellus hair in all foci. When viewed after 3 months - abundant growth of long and bushy hair in all foci.

The proposed method of treatment meets the criterion of “industrially applicable”, since it has successfully passed clinical trials in the clinic of the Department of Dermatovenereology of the Siberian State Medical University and in the Municipal Clinic for Preventive Examinations of Tomsk.

Thus, the proposed method for the treatment of focal baldness allows to achieve a persistent clinical effect in patients with focal baldness of mild, severe and resistant forms, as well as to reduce the frequency of relapses and complications. This, undoubtedly, defines the proposed method of treatment as more effective in comparison with the currently known methods of treatment of this nosology. In addition, the non-invasiveness of the proposed method, the absence of side effects and complications make it possible to widely use this treatment method in all patients who have come up for focal alopecia, both in hospital and in outpatient settings.

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Claims (3)

1. A method for the treatment of focal alopecia, including pharmacotherapy and exposure to reflexogenic zones, characterized in that they act by pulsed bipolar current, 1 time per day, for 10 days, and on the first day they affect the spine and facial areas with a current frequency of 59 , 3 Hz, with a total duration of 15-20 minutes, to the site of baldness with a frequency of current from 20 to 100 Hz for a duration of 1 minute; on the second day - to the cervical-collar zone with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 15 to 60 Hz, lasting 1 minute on each side; on the 3rd day - to the region of the spine and to the zones of the face with a frequency of current from 20 to 100 Hz, with a total duration of 15-20 minutes, at the site of alopecia with a frequency of current of 59.3 Hz, lasting 5 minutes; on the 4th day - to the region of the liver with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 30 to 120 Hz, pause duration between pulses in a packet of 1200 μs, lasting 5 minutes from each side; on the 5th day - to the cervical-collar zone with a current frequency of 20 to 100 Hz, a total duration of 15-20 minutes, to the alopecia focus with a current frequency of 59.3 Hz, a duration of 5 minutes; on the 6th day - on the spine and on the face with a frequency of 59.3 Hz, a total duration of 15-20 minutes, on the upper cervical sympathetic nodes with a frequency of 15 to 60 Hz, a duration of 1 min on each side; on the 7th day - to the area of the liver with a frequency of current from 20 to 100 Hz, a total duration of 15-20 minutes, to the focus of alopecia with a frequency of current of 59.3 Hz, lasting 5 minutes; on the 8th day - to the cervical-collar zone with a current frequency of 59.3 Hz, lasting 15-20 minutes, to the upper cervical sympathetic nodes with a current frequency of 30 to 120 Hz, pause duration between pulses in a packet of 1200 μs, duration 5 min on each side; on the 9th day - to the region of the spine and to the zones of the face with a frequency of current from 20 to 100 Hz, with a total duration of 15-20 minutes, at the site of baldness with a current frequency of 59.3 Hz, lasting 5 minutes; on the 10th day - on the spine and on the face with a frequency of 59.3 Hz, a total duration of 15-20 minutes, on the upper cervical sympathetic nodes with a frequency of 15 to 60 Hz, a duration of 5 minutes on each side, course treatment is repeated after two months. 2. The method according to claim 1, characterized in that the region of the spine includes a line of spinous processes and paravertebral lines. 3. The method according to claim 1, characterized in that the zones of the face include the exit of three branches of the trigeminal nerve: the orbital nerve, maxillary nerve, mandibular nerve.