RU2263522C1 - Method for treating disorders in cardiac rhythm in patients with chronic obstructive bronchitis - Google Patents

Abstract

FIELD: medicine, cardiology, physiotherapy.

SUBSTANCE: during daily 15 procedures one should affect with magnetolaser radiation at wave length of infrared laser being 0.88 mcm, power density being not more than 4 mW/sq. cm and induction of direct magnetic field being 10-40 mTl at exposure of 4 min for right-hand, then for left-hand sinocarotid areas and successively in projection of pulmonary roots in combination with intravenous injection about 2.5% ozonized physiological solution, every other day. Therapy course corresponds to 8 procedures. It enables to remove disorders in cardiac rhythm in patients with chronic obstructive bronchitis, shorten the frequency of their appearance, decrease the frequency of their appearance and improve the values of external respiration function.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to cardiology and physiotherapy. It relates to a method of treating patients with chronic obstructive bronchitis caused by chrysotile asbestos dust, suffering from cardiac arrhythmias in the form of paroxysmal tachycardia and tachyarrhythmias, ventricular and supraventricular extrasystoles, including allorhythmic type extrasystoles, etc.

When using ECG monitoring, a high frequency (from 82% to 92.3%) of cardiac arrhythmias in patients with chronic obstructive pulmonary disease (COPD) is detected, which includes dust bronchitis due to asbestos dust, and during physical exertion the frequency of cardiac dysrhythmias in of these patients reaches 100% (cardiac arrhythmias in patients with chronic obstructive pulmonary diseases. // Zadionchenko BC, Grineva 3.O., Sviridov A.A., Mantsurova A.V. / Russian Journal of Cardiology, 1999, No. 2, p. 36-40). It is noted that in severe respiratory failure, the frequency of life-threatening arrhythmias approaches that of acute myocardial infarction (Ventricular arrhythmias in patients with cor pulmonale.//Xu QT, Jin WY / Chung His I Chich Ho Tsa Chin., 1991, Apr. 11: 4, 212-4, 196; Heart rhythm disturbances in patients with bronchial asthma according to ECG monitoring // Gembitsky E.V., Sinkopalnikov A.I., Alekseev V.G. / Clinical medicine, 1986, v.64, No. 2, p. 54-59).

In practice, the traditional course treatment of exacerbation of COPD practically does not reduce the frequency of heart rhythm disturbances in this category of patients. Moreover, the arrhythmogenic effect of drugs used to treat this pathology cannot be ignored in the origin of arrhythmias in COPD. One such drug is aminophylline. Eufillin is known to cause sinus tachycardia, as well as extrasystolic arrhythmias (The clinical implication of theophylline intoxication on the Emegrency Department.//Tsai J., Chern TL, Ni S.N., Lee SC, Wang RB, Deng JF / Hum. Exp. Toxicol. 1994 Oct. 13 (10) b 651-7). Sympathomimetics used in the treatment of COPD patients have a pronounced arrhythmogenic effect (Chronic obstructive pulmonary diseases // AG Chuchalin / M., BINOM Publishing House, 1998, p.510).

It is known that treatment of cardiac arrhythmias with antiarrhythmics in patients with COPD is an extremely difficult task (prognosis of the effectiveness of verapamil in patients with chronic non-specific lung diseases according to the results of electrophysiological testing of the heart // Fedosova NN, Kravchenko AI, Oferkin AI / Bulletin of Arrhythmology, 2002, No. 25, p.45). So, for example, lidocaine is of limited use in patients with respiratory failure due to the risk of inhibition of the respiratory center. Beta-blockers cannot be used in this category of patients due to the ability to cause bronchospasm. Cardiac glycosides in patients with COPD can initiate the development of almost all types of arrhythmias and their combinations (Pulmonary heart // Yakovlev V.A., Kurenkova I.G. / St. Petersburg, Medical Information Agency, 1996, p. 351).

We are not aware of the work and, accordingly, the recommendations on the use of physiotherapeutic methods of treating complex heart rhythm disturbances in patients with COPD and, in particular, chronic obstructive bronchitis due to asbestos dust.

Closest to the proposed is a method of drug treatment of heart rhythm disturbances in patients with COPD (heart rhythm disorders in patients with chronic obstructive pulmonary diseases. // Zadionchenko BC, Grineva 3.O., Sviridov A.A., Mantsurova A.V. / Russian Cardiology Journal, 1999, No. 2, pp. 36-40).

When using this method of treatment, its insufficient effectiveness against cardiac dysrhythmias is noted. In addition, in the process of individual selection or long-term treatment, any antiarrhythmic drug, in addition to “extracardiac” side effects associated with effects on the central nervous system, gastrointestinal tract and other organs, often also causes “cardiac” side reactions, manifested in worsening arrhythmia or the occurrence of life-threatening, previously not observed forms of cardiac arrhythmias (Pharmacotherapy of arrhythmias // Mazur N.A., Abdalla A. / Moscow: Overlay, 1995, p. 56).

The objective of the present invention is the elimination of cardiac arrhythmias, a reduction in the frequency of their occurrence or improvement of tolerance, as well as improvement of external respiration function by exposure to laser roots on the roots of the lungs and sinocarotid zones in combination with ozone therapy.

The problem is solved by the fact that both laser radiation and a constant magnetic field (induction of 10-40 mT) affect the right synocarotid region, then the region of the left carotene sinus, and then sequentially in the projection of the roots of the lungs. The course of treatment - 15 daily procedures. In addition, the patient is given an intravenous drip of ozonized saline. There are 8 procedures per treatment course.

The method is as follows. The patient is on the couch lying on his back. The sensor of the device for magnetic laser therapy - AMLT-01 is placed on the region of the right carotid sinus and is irradiated with laser light (wavelength 0.88 μm, power density at least 4 mW / sq. Cm) and a constant magnetic field (induction 10-40 mT) for 4 minutes. Then the sensor is transferred to the region of the left carotid sinus and irradiated for another 4 minutes. Then, for 4 minutes, successively produce an impact in the projection of the roots of the lungs. The course of treatment is 15 daily procedures. Additionally, every other day, the patient is given an intravenous drip of 100.0 ml of ozonized physiological saline (0.9% sodium chloride solution) with a concentration of 2.5 mg / L. On a course of treatment 8 procedures every other day.

Clinical trials of a method for treating patients with dust bronchitis due to asbestos dust with cardiac arrhythmias were carried out in the therapeutic clinic of the institute during 1999-2002, which is confirmed by case histories of 37 patients.

The results of applying the method are illustrated by the following examples.

Example 1

1. Patient L. - in GT, 53 years old, medical history No. 48563, was admitted to the hospital with a diagnosis of Occupational dust bronchitis due to asbestos dust, the first stage. Respiratory failure, Art. Subatrophic pharyngitis.

Extrasystolic (supraventricular, ventricular) arrhythmia. Paired ventricular extrasystole. Jogging unstable ventricular tachycardia. Arterial hypertension of atherosclerotic genesis, II art.

When instrumental studies established

Holter ECG monitoring from 09.20.02. Duration of monitoring 21 hours 26 minutes Average heart rate during the day 67 beats / min (min. - 60 beats / min, max. - 142 beats / min), during night sleep 61 beats / min (min. - 52 beats / min, max. - 126 beats / min) .

During the examination, the following heart rhythm disturbances were observed:

- single supraventricular extrasystole - 1029. Daytime 928 (73 per hour), at night - 101 (13 per hour);

- a single ventricular extrasystole - 1880 (an average of 81 per hour). During the day - 981 (75 per hour), at night - 8990 (89 per hour);

- paired ventricular extrasystole - 565 (an average of 28 per hour). During the day - 304 (24 per hour), at night - 261 (38 per hour);

- paroxysm of ventricular tachycardia - 250 (an average of 12 per hour). During the day - 96 (6 per hour), at night - 154 (20 per hour);

- a pair of supraventricular and ventricular extrasystoles - 254 (an average of 12 per hour), during the day - 118 (9 per hour), at night -136 (16 per hour);

- single supraventricular slipping complex - 17 (average 1 per hour);

- single ventricular slipping complex - 4 (on average less than 1 per hour);

- blocked atrial extrasystole - 9 (on average less than 1 per hour).

No ischemic changes in ST - T were detected.

The study of the function of external respiration from 09.20.02.

Indicators Fact. must off in %

JELL 5.01 5.25 95.5 FZHEL 5.16 5.07 101.82 FEV1 3.71 4.08 90.91 FEV1 / ZHEL 74.01 76.69 96.51 MOS 25 8.16 8.66 94.19 MOS 50 3.10 5.74 54.04 MOS 75 1.47 2,57 57.27 Pic pic 11.04 9.39 117.55 SOS 25-75 2.89 4.63 62.37

The percentage of blood oxygen saturation is 96%.

Bronchial resistance - 2.35 mm. water column

After the test with berotek.

Indicators fact. must off in % JELL 4.62 5.25 88.07 FZHEL 4.48 5.07 88.40 FEV1 3.43 4.08 84.05 FEV1 / ZHEL 74.02 76.69 96.52 MOS 25 7.83 8.66 90.38 MOS 50 3.75 5.74 65.37 MOS 75 1.47 2,57 57.27 Pic pic 8.89 9.39 94.68 SOS 25-75 2.96 4.63 63.88

The percentage of blood oxygen saturation is 95%.

Bronchial resistance - 2.33 mm. water column

The patient received 15 procedures of mannitolaser therapy in the area of carotid sinuses and roots of the lungs and a course of ozone therapy (8 sessions every other day). The treatment was well tolerated. Subjectively, heart attacks during treatment did not register, noted an improvement in overall health. According to objective examination methods.

Holter ECG monitoring from 10.10.02. Duration of monitoring 19 hours 35 minutes. Average heart rate during the day 81 beats / min (min. - 58 beats / min, max. - 133 beats / min), during night sleep 65 beats / min (min. - 57 beats / min, max. - 80 beats / min) .

During the examination, the following heart rhythm disturbances were observed.

- a single supraventricular extrasystole - 640. Day 591 (58 per hour), at night - 49 (6 per hour);

- paired supraventricular extrasystole - 15. Day 13 (2 per hour), at night - 2 (less than 1 per hour);

- a single ventricular extrasystole - 1504. In the afternoon - 1031 (151 per hour), at night 473 (75 per hour);

- paroxysm of ventricular tachycardia - 15 (an average of 1 per hour). Day 14 (2 per hour), 1 at night (less than 1 per hour);

- paroxysm of atrial fibrillation with a frequency of 120 beats per min - 1.

No ischemic changes in ST-T were detected.

Thus, against the background of the treatment complex, a pronounced antiarrhythmic effect was noted, which manifested itself in a 50% reduction in supraventricular extrasystoles, a 10-fold decrease in the number of paroxysms of unstable ventricular tachycardia, and a decrease in the morphological types of ectopic foci: the absence of paired ventricular extrasystole, steam from the supraventricular and , slipping supraventricular and ventricular complexes, blocked atrial extrasystoles.

The study of the function of external respiration from 10/11/02

Indicators fact. must off in % JELL 5.31 5.25 101.22 FZHEL 5.52 5.07 108.92 FEV1 4.09 4.08 100.22 FEV1 / ZHEL 76.90 76.69 100.27 MOS 25 8.42 8.66 97.19 MOS 50 4.29 5.74 74.78 MOS 75 1.49 2,57 58.04 Pic pic 9.08 9.39 96.68 SOS 25-75 3.30 4.63 71.21

The percentage of blood oxygen saturation is 98%.

Bronchial resistance - 2.13 mm. water column

After testing with berotek

Indicators fact. must off in % JELL 5.32 5.25 101.41 FZHEL 5.43 5.07 107.14 FEV1 4.17 4.08 102.18 FEV1 / ZHEL 78.30 76.69 102,10 MOS 25 8.75 8.66 101.00 MOS 50 4.62 5.74 80.53 MOS 75 1.49 2,57 58.04 Pic pic 10.40 9.39 110.73 SOS 25-75 3.60 4.63 77.69

The percentage of blood oxygen saturation is 98%.

Bronchial resistance - 2.65 mm. water column

That is, against the background of stabilization of the electric state of the myocardium according to the results of the study of the function of external respiration, an increase in the vital capacity of the lungs, an improvement in the bronchial patency of the small and medium bronchi, an increase in the percentage of blood oxygen saturation (saturation) were noted. In general, no increase in bronchial resistance was observed. The effectiveness of the treatment is rated as "improvement."

Example 2

2. Patient 3. - in L.I., 56 years old, medical history No. 38677, was admitted to the hospital with a diagnosis of Occupational dust bronchitis due to asbestos dust, the first stage. Respiratory failure, Art. Subatrophic pharyngitis.

IHD, angina pectoris II functional class NK 0 tbsp. Extrasystolic (supraventricular, ventricular) arrhythmia. Arterial hypertension of atherosclerotic genesis, II art.

When instrumental studies established:

Holter ECG monitoring from 11.26.02. Duration of monitoring 19 hours 24 minutes Average heart rate during the day 73 beats / min (min. - 60 beats / min, max. - 128 beats / min), during night sleep 64 beats / min (min. - 53 beats / min, max. - 77 beats / min) .

During the examination, the following heart rhythm disturbances were observed:

- single supraventricular extrasystole - 32 (average 4 per hour). Day 25 (5 per hour), at night - 7 (2 per hour.);

- single ventricular extrasystole - 299 (an average of 33 per hour). During the day - 225 (43 per hour), at night - 74 (20 per hour);

- episodes of post-extrasystolic oppression of the sinus node - 50 (an average of 6 per hour), during the day - 36 (7 per hour), at night - 12 (3 per hour). During functional load - 0;

- 5 episodes of dubious depression of the ST segment> 1 mm but <2 mm were recorded against the background of pronounced initial changes in the ST segment in the lead characterizing the potentials of the left ventricular side wall, painless, arising at rest without a previous increase in heart rate, possibly associated with lateral myocardial ischemia wall of the left ventricle.

The study of the function of external respiration from 11.25.02

Indicators fact. must off in % JELL 4.29 4.20 102.09 FZHEL 4.31 4.02 107.16 FEV1 3.07 3.29 93.26 FEV1 / ZHEL 71.05 77,20 92.03 MOS 25 6.55 7.17 91.33 MOS 50 3.02 4.67 64,42 MOS 75 0.94 2.07 40.82 Pic pic 10.04 7.14 126.45 SOS 25-75 2.21 3.89 57.43

The percentage of blood oxygen saturation is 97%.

Bronchial resistance - 2.98 mm. water column

After testing with berotek

Indicators fact. must off in % JELL 4.29 4.20 102.09 FZHEL 4.24 4.02 105.42 FEV1 3.40 3.29 103.28 FEV1 / ZHEL 79.03 77,20 102.37 MOS 25 8.74 7.17 121.86 MOS 50 4.70 4.69 100.26 MOS 75 1,69 2.07 81.24 Pic pic 9.41 7.94 119.51 SOS 25-75 3.32 3.85 86.28

The percentage of blood oxygen saturation is 96%.

Bronchial resistance - 2.06 mm. water column

The patient received 15 procedures of mannitolaser therapy in the area of carotid sinuses and roots of the lungs and a course of ozone therapy (8 sessions every other day). The treatment was well tolerated. Subjectively noted an improvement in overall health, greater tolerance of physical activity. According to objective examination methods.

Holter ECG monitoring from 09.12.02. Duration of monitoring 19 hours 08 minutes The average heart rate during the day is 77 beats / min (min. - 64 beats / min, max. - 107 beats / min), during night sleep - 61 beats / min (min. - 49 beats / min, max. - 73 beats / min. )

During the examination, the following heart rhythm disturbances were observed.

- single ventricular extrasystole - 8. In the afternoon - 5, at night - 3.

No ischemic changes in the ST segment were detected.

That is, immediately after the course of treatment, a distinct antiarrhythmic effect and the absence of ischemic changes in the myocardium were noted.

Study of the function of external respiration from 12/9/02

Indicators fact. must off in % JELL 4.06 4.09 99.36 FZHEL 3.96 3.91 101.38 FEV1 3.17 3.21 98.88 FEV1 / ZHEL 78.00 77.30 100.91 MOS 25 8.69 7.01 124.04 MOS 50 4.17 4,57 91.17 MOS 75 1,04 2.01 51.64 Pic pic 9.21 7.78 118.38 SOS 25-75 3.10 3.76 82.36

The percentage of blood oxygen saturation is 98%.

Bronchial resistance - 2.14 mm. water column

After testing with berotek

Indicators fact. must off in % JELL 4.14 4.09 101.32 FZHEL 4.27 3.91 109.32 FEV1 3.48 3.21 108.55 FEV1 / ZHEL 83.09 77.30 107.49 MOS 25 10.01 7.01 142.88 MOS 50 4.87 4,57 106.47 MOS 75 1,56 2.01 77.46 Pic pic 11.03 7.78 141.77 SOS 25-75 3.80 3.76 100.96

The percentage of blood oxygen saturation is 99%.

Bronchial resistance - 1.92 mm. water Art.

That is, by the end of the treatment course against the background of normalization of the heart rhythm according to the results of the study of the function of external respiration, an improvement in bronchial patency of the small bronchi, an increase in the percentage of blood oxygen saturation (saturation), and a significant decrease in bronchial resistance were noted. The effectiveness of the treatment is rated as "improvement."

Thus, the above examples indicate a pronounced antiarrhythmic effect of the proposed therapeutic complex, its positive effect on the function of external respiration, its high efficiency both in relation to chronic bronchitis and in relation to cardiac arrhythmias. The proposed method of treatment allowed us to solve the tasks of eliminating cardiac arrhythmias, reducing the frequency of their occurrence or improving tolerance with a positive effect on the respiratory system.

Claims (1)

A method for the treatment of heart rhythm disturbances in patients with chronic obstructive bronchitis, including 15 daily exposures to magnetic laser radiation with an infrared laser wavelength of 0.88 μm, a power density of at least 4 mW / cm ² and a constant magnetic field induction of 10-40 mT with an exposure of 4 minutes on the right synocarotid region, then on the left and sequentially in the projection of the roots of the lungs in combination with intravenous drip of 100.0 ml of ozonized physiological solution with a concentration of 2.5 mg / l every other day, No. 8.