RU2262960C1 - Method for preventing gestosis in the cases of high risk of its development - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves acting with electromagnetic waves of extremely high frequency upon biologically active points of general activity like MC 6 (nei-guan), C7(shen-men) and E36(zu-san-li) and specific action like R 3(tai-si), R 7 (fu-lu) and VG 14(da-zhui) taking a single point from each row. Not more than 2 points per one procedure. Oscillation frequency is 50 GHz. Wavelength is 7.1 mm. Power is 10 mW/cm². Exposure time is equal to 20 min per each point. The total treatment course is 10 procedures long given daily or each other day. The treatment is administered at 12-20th pregnancy week.

EFFECT: enhanced effectiveness in stabilizing vascular tone, increasing excretory renal function and increasing contraction myocardium activity.

3 cl

Description

The invention relates to medicine, namely to obstetrics, and relates to methods for the prevention of gestosis with a high risk of its development.

Currently, there is a known method for the medical prevention of gestosis [6], according to which multivitamin preparations are prescribed to women with a high risk of developing this obstetric complication from 7-8 weeks of pregnancy along with a rational regime of work and rest, a protein diet and treatment of extragenital diseases. From 15-16 weeks. In pregnancy, phyto-collections that improve renal function, vascular tone and the state of the central nervous system, as well as antispasmodics and drugs that affect metabolism are added to the prevention complex. Patients with combined extragenital pathology, hypertension, and chronic pyelonephritis at this stage of gestation are additionally prescribed antiplatelet agents (trental), membrane stabilizers (essentiale forte) and antioxidants (tocopherol acetate, ascorbic acid and glutamic acid). Taking medications is provided for a month, the number of courses of prevention carried out during the gestation period is 2-3, the interval between courses is 2-3 weeks.

Despite a significant decrease in the frequency of clinically manifest gestosis and perinatal mortality, as well as the complete elimination of severe forms of gestosis, this method has significant disadvantages:

1) the need for continuous long-term use of a large number of pharmacological preparations;

2) the late onset (from 15-16 weeks.) Correction of mechanisms of adaptation to pregnancy impaired by gestosis;

3) the possible development of the effect of prooxidation and aggravation of fetal suffering.

There is a method of treating the initial forms of gestosis based on laser irradiation of biologically active points of the pregnant woman's body [4]. In addition to light puncture, the complex of therapy includes following a balanced diet, oxygen-herbal cocktails, as well as substances of sedative, antispasmodic and hypotensive effects in minimal quantities. This method of treatment of gestosis allows to reduce the pharmacological load on the fetus by 2-5 times and increase the therapeutic effect by 32.66%.

The disadvantages of this method:

1) a possible adverse effect of laser radiation on organogenesis excludes the use of this method in the early stages of pregnancy as an early prevention of gestosis;

2) requires a special room and special training for working with laser radiation.

Closest to the proposed is a method for the prevention of gestosis, which consists in conducting vibration massage on biologically active points of the skin. This method is combined with the use of adaptogens (extracts of Eleutherococcus, Leuzea, Zamaniha) in therapeutic doses and a complex of multivitamins (RF patent No. 2152201, BI No. 19 of July 10, 2000). This method allows you to correct the processes of adaptation to pregnancy that are impaired during gestosis, stabilize vascular tone, strengthen the concentration and excretory functions of the kidneys, and increase contractile activity of the myocardium.

However, this method is not effective enough in case of non-compliance with vibration parameters and improper selection of biologically active points. The method requires the presence of a reflexologist during the procedure, which complicates the widespread use of the method. It is proposed to start gestosis prevention at 8-12 weeks of gestation, which may have a negative effect on the formation of the fetus and placenta.

A NEW TECHNICAL RESULT - increasing the efficiency of the method by reducing the incidence of gestosis - achieve a new method of preventing gestosis with a high risk of its development, which consists in exposure to biologically active points of the body in patients with a high risk of gestosis, and the exposure is carried out in the morning by electromagnetic waves of extremely high frequencies (EHF) to biologically active points of the common {MS 6 (nei-guan), C 7 (shenmen) and E 36 (tsu-san-li)} and specific action {R 3 (tai-si) , R 7 (f -lyu) and VG 14 (da chzhuy)} selected in pairs one from each row, with the oscillation frequency 57 GHz, the wavelength of 7.1 mm, a power of 10 mW / cm ^2, the exposure time of 20 minutes for each point, course 10 procedures carried out daily or every other day. Exposure is carried out at 12-20 weeks of gestation. If necessary, the treatment is repeated with an interval of 2-3 months.

When signs of pregestosis appear, EHF-therapy in the indicated mode is carried out against the background of traditional pregestosis therapy, including antiplatelet agents, antispasmodics, vitamins, phyto-collections.

METHOD CARRY OUT as follows:

1. According to the prognostic scale [5], the sensitivity of which was 76%, specificity - 92% and overall accuracy - 84%, determine the degree of risk of gestosis (high, low).

2. Women with a high risk of developing gestosis are exposed to millimeter-wave electromagnetic waves (EHF waves) on biologically active skin points: MS 6 (nei-guan), R 3 (tai-si), E 36 (tsu-san-li) , VG 14 (da-chui), C 7 (shen-ming), R 7 (fu-lu). The exposure is carried out by EHF-waves with a length of 7.1 mm, a power of 10 mW / cm ² , a frequency of 57 GHz, the duration of the procedure is 20 minutes for each point. In one session, the effect is carried out at two points (one from the group of general and specific action), the total exposure time is 40 minutes. The diameter of the emitter used for point exposure is 2.5 cm. The course consists of 10 procedures conducted daily or every other day. If necessary, the course is repeated 2 times with an interval of 2-3 months. Prevention begins in the first half of pregnancy, after 12 weeks, upon completion of organogenesis.

3. When signs of the preclinical stage of gestosis (pretoxicosis) appear, drug treatment is carried out according to the method generally accepted for this condition (antiplatelet agents, membrane stabilizers, antihypoxants, antispasmodics, etc.), but the principle of EHF exposure remains unchanged.

The advantages of the proposed method is illustrated by the following examples.

EXAMPLE 1. First-pregnant K., 25 years old, was assigned to the high-risk group for the development of gestosis, as she had a combination of a number of unfavorable factors: mixed type neurocirculatory dystonia, chronic pyelonephritis, grade 1 obesity, mild anemia (the total score on the prognostic scale was equal to 21). From 14 weeks she began a course of exposure to millimeter-wave electromagnetic radiation on biologically active points of the skin. The course of reflex treatment consisted of 10 sessions of exposure to the points of MS 6 (nei-guan), R 3 (tai-si), E 36 (tsu-san-li), VG 14 (da-ju), R 7 (fu-lu ), C 7 (Shen-Ming). The procedures were carried out daily with the following parameters: wavelength 7.1 mm, exposure power 10 mW / cm ² , frequency 57 G Hz, action time 20 minutes at one point, two biologically active points were irradiated during the session. At 20 weeks of gestation, the patient showed an increase in blood coagulation potential — fibrinogen concentration of 4.5 g / l, paracoagulation tests were weakly positive, platelet count decreased to 160 · 10 ⁹ / l. In a day hospital, a woman received 5 intravenous infusions of trental followed by enteral administration of the drug for 24 days. Hypercoagulable syndrome was eliminated and with further progression of pregnancy did not resume. Reflex therapy was repeated at 28 weeks of gestation due to signs of hypercoagulation.

During pregnancy, blood pressure did not rise above 130/80 mm Hg. Art., the total increase in body weight during pregnancy was 9 kg. The pregnancy ended with an urgent spontaneous birth of a live fetus with a body weight of 3400 g, which was rated on the Apgar scale at the 1st minute of life 8 points, at the 5th minute - 9 points.

EXAMPLE 2. Patient O., 31 years old, had a history of 3 pregnancies, the first 2 of which were artificially interrupted in the early stages at the request of a woman. The third pregnancy ended with a caesarean section performed on an emergency basis at 35 weeks of gestation with progressive severe gestosis (preeclampsia). After giving birth for 6 months she was registered in the dispensary with a nephrologist, extragenital pathology was not diagnosed. For the first time, a woman turned for medical help during a real pregnancy at 18 weeks. At the initial examination, the symptoms of pretoxicosis were revealed: lability of blood pressure during functional tests, accelerated McClure-Aldrich test, decreased daily urine, retinal angiopathy (total score is 14). In order to prevent preeclampsia, renal tea was prescribed at 200 ml / day, vitamin E at 0.4 g / day. At the same time, a course of EHF-therapy of biologically active points was started: MS 6 (nei-guan), R 3 (tai-si), E 36 (tsu-san-li), VG 14 (da-chu), R 7 (fu-lu ), C 7 (Shen-less) with a frequency of 57 GHz, a wavelength of 7.1 mm, a radiation power of 10 mW / cm ² , an exposure time of 20 minutes at each point, the procedure was also carried out at two points in one session. Conducted 10 procedures daily. From 26 weeks of pregnancy, the woman has recorded an excessive increase in body weight - up to 700 g per week. At 28 weeks of gestation while taking renal tea, antiplatelet agents and antispasmodics, the course of EHF-therapy of biologically active points of the body was repeated. Under the influence of therapy, total diuresis increased, blood flow in the uteroplacental pool improved. Normal body weight was restored by the 31st week of gestation. Clinical manifestations of gestosis (edema, hypertension, proteinuria), as well as fetal suffering, were not diagnosed until the end of pregnancy. At 38 weeks, the woman underwent a cesarean section, the indication for which was the presence of a scar on the uterus. A live fetus with a body weight of 3450 g was extracted with an Apgar rating of 8 points in the 1st minute, and 8 points in the 5th minute. The postoperative period and the condition of the newborn remained normal.

The exposure regimen is selected based on clinical observations. 50 patients were treated.

For carrying out EHF-therapy, the optimal number of biologically active points of the body was chosen, through the stimulation of which it is possible to change blood pressure, improve kidney function, eliminate asthenia, increase adaptation, and stimulate immunity. Points MC 6 (Nei-Guan), C 7 (Shen-Ming) and E 36 (Zu-San-Li) are points of general action, affecting the whole organism sanogenetically, points VG 14 (Da Zhui), E 36 (Zu -san-li) are the points of control of vascular tone. In addition, the point VG 14 (da-jui) directly affects the trophism and bioelectric activity of the brain, the functional state of the anterior pituitary and thyroid gland. The points R 3 (tai-si), R 7 (fu-lu) contribute to the improvement of water-salt metabolism, and the point C 7 (shen-less) activates the contractility of the myocardium. These points are used in classical acupuncture for arterial hypertension, diffuse edema, headache, tachycardia, neurosis, insomnia, as well as kidney and heart diseases.

EHF-therapy was performed with the Stella apparatus, the emitter diameter of which is 2.5 cm. Therefore, we can talk about the effect on the biologically active zone, which includes the corresponding biologically active point and the surrounding part of the skin surface.

The use of no more than 2 points in one procedure is explained by the fact that the combination of irritation of one point of the general sanogenetic and one point of specific influence is sufficient to achieve a regulatory effect in pregnant women against the background of increased vegetative lability.

Exposure to EHF-waves with a length of 7.1 mm is due to their immunostimulating activity, as well as a more pronounced effect on the adaptive reserves of the myocardium and hemodynamic changes in patients with cardiovascular diseases [2, 3].

The applied range of the radiation power flux density can vary from 0.2 mW / cm ² to 20 mW / cm ² . According to numerous experimental data [2], a change in power within these limits does not lead to significant differences. In our work, an exposure power of 10 mW / cm ^{2 was used} , as the most effective for normalizing autonomic reactions and increasing the reserve capacity of the cardiovascular system.

An oscillation frequency of 57 GHz has a hypotensive effect, improves microcirculation, and also stimulates the immune system.

The duration of the procedure should be sufficient for the development in the body of adequate reactions of “training” and “activation” [1], with the help of which a therapeutic effect is realized that does not stop after the end of irradiation. To achieve it, the necessary exposure time is 20-40 minutes. The selection of the number of procedures is based on numerous data on the effectiveness of EHF-therapy in the pathology of other organs and systems ..

The optimal time of day for treatment helps to restore the violated temporal structure of the body, therefore, it is recommended that EHF procedures be performed in the morning (9.00-12.00), and also in the afternoon (14.00-17.00), which coincides with the transition period in the circadian rhythm of the activity of the autonomic nervous system and more adequate to the reserve capabilities of the body [7].

The timing of the start of prophylaxis of gestosis (12-20 weeks of pregnancy) was selected with the aim of timely correction of violations of adaptation mechanisms to the gestational process. A later start of gestosis prevention reduces the effectiveness of the method.

Since the therapeutic effect of any physiological reflex effect lasts no more than 2 months, and gestosis manifests itself most intensively in the second half of pregnancy, courses of EHF-therapy and adaptive prophylaxis of gestosis can be repeated twice if necessary (interval 2-3 months). In the presence of signs of pregestosis, repeated courses of EHF-therapy are carried out against the background of traditional drug therapy of this condition (antiplatelet agents, antispasmodics, vitamins, herbal medicines, etc.). The combination of physical and pharmacological effects increases the intensity and effectiveness of pregestosis therapy.

Thus, the use of this method allows you to correct the processes of adaptation to pregnancy that are impaired during gestosis, stabilize vascular tone, enhance renal excretory function, and increase myocardial contractile activity. As a result of this effect, it is possible to lower average blood pressure, eliminate latent edema, improve blood supply to the kidneys and the fetoplacental system. Also, the advantage of this method is the possibility of its use in the form of monotherapy, the absence of side effects, non-invasiveness, a good combination with other treatment methods, general sanitizing effect. In addition, the proposed optimal combination of biologically active points makes it possible to exert influence on one procedure for 1-2 points, which allows the use of this method by practical doctors who do not have specialization in reflexology. And also this method is simple to implement, easily tolerated by patients, does not require a special room, can be used on an outpatient basis and in obstetric hospitals, if necessary, it is possible to educate patients on their own use.

INDICATION FOR USE: determination in a pregnant woman of a high risk of developing gestosis.

CONTRAINDICATIONS:

1) common to physiotherapy (malignant neoplasms and suspicions on them; active forms of pulmonary tuberculosis; metal objects (fragments, pins, etc.) in the field localization area; the patient has extragenital pathology at the stage of subcompensation or decompensation);

2) a febrile state (body temperature over 37 degrees);

3) a high risk of miscarriage of a real pregnancy (bleeding, increased uterine tone);

4) a sharp violation of pain and temperature sensitivity ;.

5) violation of the integrity of the skin in the affected area.

There were no specific contraindications.

LIST OF USED LITERATURE.

1. Garkavi L.X., Kvakina E.B., Ukolova M.A. Adaptive reactions and body resistance. - Rostov-on-Don, 1977 .-- 120 p.

2. Kirichuk V.F., Golovacheva T.N., Chizh A.G. EHF therapy. - Saratov, 1999 .-- S. 3-20.

3. Levitsky E.F., Laptev B.I., Sidorenko G.N. Electromagnetic fields in balneology and physiotherapy. - Tomsk, 2000. - S.9-45.

4. Malevich K.I., Gerasimovich G.I., Rusakevich P.S. Laser therapy methods in obstetrics and gynecology. - Mn .: Vysh. school., 1992 .-- 124 p.

5. Mikheenko G.A. Prevention and treatment of obstetric pathology with low-frequency mechanical vibrations: Author's abstract. dis ... doctor. honey. sciences. - Tomsk, 2000. - P.35.

6. Savelyeva G.M., Shalina R.I., Dzhivelegogva G.D. // Bulletin of the Russian Association of Obstetricians and Gynecologists. - 1995. - No. 4. - S.83-88.

7. Chernyakov G.M. The use of EHF radiation of low intensity in biology and medicine // Proc. doc. 7th All-Union. a workshop. - M., 1989 .-- P.23.

Claims (3)

1. A method for the prevention of gestosis with a high risk of its development, consisting in exposure to biologically active points of the body by a physical factor in patients with a high risk of gestosis, characterized in that the exposure is carried out in the first half of the day by electromagnetic waves of extremely high frequencies (EHF) on biologically active points general MS 6 (nei-guan), C 7 (shenmen) and E36 (tsu-san-li) and specific actions - R 3 (tai-si), R 7 (fu-lu) and VG 14 (yes- Zhuy), selected from one of each row, not more than 2 points in one procedure, with an oscillation frequency of 57 GHz, a wavelength of 7.1 mm, a power of 10 mW / cm ² , an exposure time of 20 minutes at each point, a course of 10 procedures carried out daily or every other day, the effect being carried out at 12-20 weeks of pregnancy. 2. The method according to claim 1, characterized in that, if necessary, the treatment is repeated with Interval for 2-3 months. 3. The method according to claim 1, characterized in that when signs of pregestosis appear, exposure to extremely high frequencies is carried out against the background of traditional pregestosis therapy, including antiplatelet agents, antispasmodics, vitamins, phyto-collections.