RU2297824C1 - Method for treating spondylogenic and primary-myogenic vertebral lesions - Google Patents

Abstract

FIELD: medicine, reflexotherapy, curative physical training.

SUBSTANCE: the suggested method consists of seven exercises and to fulfill them one should perform slow movements accompanied with concentrating attention onto acupuncture points. Due to slowly performing rhythmic breathing one should simultaneously mentally imagine that external energy, the so-called energy "tsi" enters the body and comes into acupuncture point J(XIV)6 tsi-khai and while concentrating there causes the feeling of heat, and/or heaviness, and/or burning, and/or fire, and/or vibration. Each out of 7 exercises is constructed so to activate all the areas of vertebral column along its muscular-ligamentous system, and, also, the muscles of anterior abdominal wall. While performing these exercises it is necessary to mentally transform the energy as the feeling of heat, and/or heaviness, and/or burning, and/or fire, and/or vibration along the some acupuncture meridians. Thus, a patient's attention due to mental moving the energy as feelings of heat, or occasional pains, or fire, or vibrations "moves" along closed circle in sagittal plane along the following 12 acupuncture points: 1 - MC(1X)8 (lao-gun) (volar surface), 2 - J(XTV)6 tsi-khai (hypogastric area, inferior dan'-tyan'), 3 - J(XIV)1 khuey-in' (perineum), 4 - T(XIII)4 min-man' (lumbar vertebral department), 5 - T(XIII)12 schen'-chzhu (superior-thoracic vertebral department), 6 - T(XIII)14 da-chzhuj (cervical vertebral department), 7 - T(XIII)17 nao-khu (occipital area), 8 - T(XIII)20 baj-khuej (occipital area), 9 - P3C in'-tan (the center of glabella, the upper dan'-tyan'), 10 - J(XIV)17 tan'-chzhun (sternum, the middle dan'-tyan'), 11 - J(XIV)6 tsi-khaj (hypogastric area, inferior dan'-tyan'), 12 - V(VII)23 shen'-shu (kidneys and adrenal glands). This complex is divided into exercises hypothetically. One movement steadily comes into another, every previous movement induces the next one. Mentally a patient should successively and constantly pass 12 acupuncture points along anterior median, posterior median meridians, those of pericardium and urinary bladder, that is through all departments of vertebral column, muscles of anterior abdominal wall and perineum, kidneys and adrenal glands. Additional stimulation of 2 acupuncture points of "magic meridians" releases body reserve abilities. This stimulates the outburst of endogenous opioids, hormones of antiphlogistic orientation, enables to carry out therapy without usage of medicinal preparations. Remission terms, moreover, prolong up to 3-5 yr.

EFFECT: higher efficiency of therapy.

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Description

The present invention relates to medicine, reflexology, physiotherapy.

Various forms of movement as a result of the impact of mechanical energy on the patient's body were widely used as a prophylactic and therapeutic agent even at the time of the origin of medicine. In one of China's first purely medical books, Huangdi Nei Ching (2698 BC), the general principles of treatment and preventive measures and health-improving exercises are described (Alekseenko I.P., 1959, Luvsan G., 1986; Shuai Xuezhong , 1997).

The achievements of biology, dynamic anatomy, biophysics, biomechanics, on the one hand, and clinical medicine, on the other, are the basis of the theoretical positions of modern physiotherapy exercises (Manniche C. et al., 2002; Danneels LA et al., 2002; Van Dillen LR et al., 2003).

The current successes of the clinical and physiological doctrine of motor-visceral regulation completely support the practical value of physiotherapy as a biological factor in reflex therapy for neuro-orthopedic diseases, as well as for the prevention of hypokinetic disease (Skovycheva L.D. et al., 2000; Bubnovsky S.M. , 2000; Lively MW, 2002; Rasmussen-Barr E. et al., 2003).

Exercise enhances the functional "restructuring" of all parts of the nervous system, exerting a stimulating effect on both efferent and afferent systems (Cohen I. et al., 2002). Due to the fact that the mechanism of the influence of physical exercises is based on the process of exercise, the dynamic "restructuring" of the nervous system covers both the cells of the cerebral cortex and peripheral nerve fibers (Hodges P.W. et al., 2003).

The general principles of therapeutic exercises and rehabilitation measures have been developed, which are specified in relation to individual nosological forms of a nervous system disease, including neurological manifestations of osteochondrosis of the spine (Naydin V.L., 1973-1988; Kogan O.G., 1975-1988 ;. Moshkov V.N., 1982; Handa N. et al., 2000; Descarreaux M. et al., 2002; Taylor MF et al., 2003; McNeely ML et al., 2003; Analay Y. et al., 2003; Casso G. et al., 2004).

The few literary sources are united in one thing: physical rehabilitation means (physical exercises, massage, motor mode, etc.) are classified as non-specific therapeutic factors that can change the general reactivity of the body, increase its non-specific resistance, and destroy the pathological dynamic stereotypes resulting from the disease , and create new ones that provide the necessary adaptation (Skvoznova T.M. 1996; Guseva M.E. 1997; Zaporozhets N.A. et al., 1999; Genet F. et al., 2002; Storheim K. et al., 2003; Moseikin IA, 2003; Rebain R. et al., 2004).

Along with this, physical rehabilitation means are also pathogenetic therapy (Brealey S. et al., 2003; Kolt GS et al., 2003; Rainville J. et al., 2004), and a change in the functional state of muscle proprioceptors during movements serves as a signal for formation of corrective impulses in the central apparatus of motion control (feedback, according to N. A. Bernshtein).

Regulation A.D. Speransky that “the nervous system innervates the tissue to the same extent as the tissue“ innervates the nervous system ”relates most of all to muscles and their receptions. Proprioception stimulates primarily the metabolism in neurons of the motor analyzer, adapting accordingly their vascularization Through them, proprioception has a trophic effect on the musculature of the body and on the internal organs, that is, ultimately on the whole organism. Without sufficient afferent stimulation of the processes of nutrition and metabolism in the central yronah may not be reliable reflex trophic regulation of body organs (Akuthota V. et al., 2004).

At present, enough scientific data has been accumulated on the effect of physical exercises on neurodynamics, and physiotherapy physiologists have practical material on this issue (S. Migachev, et al., 1994; V. Matov, et al., 1995; Bubnovsky S.M., 2002). So, it is known that active exercises performed with sufficient muscle tension enhance the process of arousal; breathing exercises and exercises in voluntary relaxation of skeletal muscles, on the contrary, contribute to the strengthening of the inhibitory process (Skikic E.M. et al., 2004). Exercise enhances the functional "restructuring" of all parts of the nervous system, providing a stimulating effect on both efferent and afferent systems (Moopeu V. et al., 2003).

However, very often all practical recommendations for the use of physiotherapy exercises are mainly aimed at "pumping weakened muscles", "creating a muscle corset." Often the very idea of movement is purely "mechanistic" in nature, when performing exercises there is no orientation toward the inclusion of "cortical control of movements", and physical exercises occupy an honorable rehabilitation place in the hierarchical chain of therapeutic measures.

As a result of intense physical exercises for all muscle groups, A.B. Sitel, (2001), a muscle cord is formed from skeletal muscles, often of stony density as a result of their pronounced tonic tension. Such physical training "to strengthen muscles" is absolutely contraindicated in patients with clinical manifestations of osteochondrosis of the spine (Hutchinson M.R., 1999; Chosa E. et al., 2004).

The basis of physical exercises should be the effect on skeletal muscles that increase their tension during pathology, the effect should be relaxing, such as yoga exercises (Maheshvarananda S.P., 1999; Jacques de Langres., 1999; Sitel AB, 2001).

Therefore, we carefully got acquainted with the very numerous therapeutic gymnastics of China, India, Japan, Tibet, Vietnam, which are based on the idea of the movement of "energy" circulating along the "meridian channels" and "chakras". In China, this is the energy of "qi", in India - "prana", in Japan - "ki", the name of energy is different in different countries, but it is not disputed everywhere and its presence is recognized by all authors in all medical and health systems.

Many authors (Krasnoselsky G.I., I960; Vogralik V.G., Vyazmensky E.S., 1961; Luvsan G., 1986; Li Ding, 1988; Zang Mingwu, 1991; Li Ding, 1993; Ma Folin, 1992 ; Wu Bin, 1995; Bi Yongsheng, 1997; Li Ding, 2003 and others) Chinese therapeutic gymnastics is considered as an independent and main means of therapeutic effect, capable of influencing through the movement of energy in the channel-meridian system, where physical movement only contributes to its implementation to all links of the pathogenetic process and the whole organism as a whole. And in this sense, since physical rehabilitation means have the main goal of restoring or contributing to the compensation of upset function, as well as to promote the training of the cardiovascular, respiratory and other systems that limit the physical performance, it is in the nature of specific therapy.

A special role in such practices is given to physical and energy exercises that affect the state of the immune system, as a way to prevent diseases, eliminate inflammation, and preserve the vitality of the whole organism (Xie Zhu-Fan, 1995).

The experience of using eastern therapeutic gymnastics is not adequately described in European and domestic medical literature (Belyaev AF, 2004; Graves N. et al., 2004), however, the experience of using separate, fragmented methods of breathing gymnastics, in particular diaphragmatic ("abdominal") breathing, known and successfully used by some doctors (Stefanidi A.V. et al., 2004; Balabanova N.V., 2004).

The idea of the mutual convertibility of the opposite of yin and yang lies at the basis of almost all varieties of health-improving complexes (tai chi chuan, do-in, bagua, wushu, qigong, etc.), including a complex of certain body movements in combination with concentration, which leads to to the active flow of "vital energy", elimination of pathological reasons for its blocking, relieving all tension, achieving internal and external harmony (Krasnoselsky G.I., 1960; Vogralik V.G., Vyazmensky E.S., 1961; Viktor Wu, 1983 ; Luvsan G., 1986 and others.).

Qigong breathing exercises (Luvsan G., 1986; Hu Keven, Marchenko OK, 1995; Bei Xi, 1988; Lun Homing et al., 1988; Zhang Minwu et al., 1988; Zhang Minwu, Song Sintang 1989; Cen Ynefang, 1996 ; Xu Mingtang, 2001; Jiao Guojui, 2003; Petrov V.V., 2003), is an important element of oriental traditional medicine and is considered as one of the main means for maintaining and strengthening health, as well as treating many diseases. It is rest, peace, and relaxation that are important in meditative breathing exercises (Hu Bin, 1991). Through these exercises, one must achieve an internal, natural state of rest, since only then is a true, undistorted perception of the environment and the fusion of the body and mind into a single whole possible (Jin Ce et al., 1996). Psychosomatic factors were recognized and taken into account in ancient Eastern medicine (Wiseman N., 1995). Meditative breathing exercises consist of two interconnected and simultaneously flowing components: physical - breathing exercises, and psychological - meditative exercises (Yang Qiyuan, 1998). The term "meditation" is defined in the philosophical encyclopedia as a mental action aimed at bringing the human psyche into a state of deep concentration, at achieving a balanced mind and non-reactivity of the psyche. Thanks to a certain sequence of mental acts, the elimination of extreme emotional manifestations and a significant decrease in the body's reactivity to individual internal experiences and external stimuli are achieved. At the same time, the mood of a person acquires a certain calm elation, and the somatic state acquires a calm relaxation. Modern researchers justify meditation and breathing exercises from the standpoint of modern medicine and physiology. The function of external respiration is directly dependent on the state of the central nervous system. Physiological studies have shown that pulses from the respiratory chain, radiating along the central nervous system, affect the tone of the cerebral cortex, the dynamics of cortical potentials and the periodicity of α-rhythms that occur during the transition of the body from rest to physical activity and vice versa, i.e. affect the mental activity of a person.

With the help of meditative breathing exercises, it is possible to reduce the excitability of many nerve centers, in particular the motor analyzer, and often the general inhibitory effect on nervous activity, general sedation, sensitization of the psychoemotional state. When performing this kind of exercise, various reflex connections (cortico-muscle, cortico-vascular and cortico-visceral, as well as muscle and muscle-cortical) are enhanced, which contributes to a more coordinated functioning of the basic systems of the body. The active involvement of the patient in the process of conscious and dosed exercise serves as a powerful stimulus for subordinate influences. Meditative breathing exercises alone are sufficient in many cases, their combination with other treatment methods, for example with acupressure, can significantly expand the range of medical indications (Luvsan G., 1986; Yu Gongbao, 1995).

Thus, G.K. Nedzved, K.V. Murzich (1999), sharing their experience, describe in detail the technology and successful use of kinesitherapy with the "Hai Hyue Nam Zang" qigong method in patients with neurological manifestations of lumbar spinal osteochondrosis.

In the process of training, exercises are selected in such a way as to act on channel-meridian systems (CCM) in accordance with the laws of energy circulation and regulation of energy balance (Zhu Lien, 1959; Tabeeva D.M., 1980; Goidenko BC et al., Macheret E .L., Samosyuk I.Z., 1986; Luvsan G., 1986; Leung, 1979). Physical movements here are aimed at stimulating the reflex response as the main one in the chain of sanogenetic reactions, entailing a change in proprioreception and, ultimately, affecting not only the motor stereotype, but also all functional systems associated with the movement (cardiovascular, respiratory and other).

The characteristic combination of movements with breathing, as well as concentration of attention, determines psychosomatic, energetic, and physiological shifts throughout the body (Petrov KB, 2002).

Closest to the claimed invention is a treatment complex consisting of 5 exercises, including qigong exercises, many years of experience of which has proved its effectiveness (A.V.Solonsky "Spondylogenic neuromuscular syndromes", St. Petersburg, "Polytechnic", 1999 , 119 p.).

Further in-depth study of gymnastics made it possible to modify and expand the complex, increasing its effectiveness with exercises that included the mental “conducting” of the so-called “qi” energy, in the form of a sensation of warmth, from the patient’s palms (points of MC (IX) 8 lao-guns) to zones of pathologically (“painful”) tissues of the spine, kidneys and adrenal glands. Additional techniques, including mental radiation, the so-called "qi" energy in the form of a sensation of heat, or tingling, or fire, or vibration from the points of the MC (IX) 8 Lao-gun and its mental conduct (moving) to the adrenal gland, stimulates the release of endogenous opioids, anti-inflammatory hormones.

Based on the well-known medical complex, more effective and simple, with a small set of exercises, new medical complexes were developed. The following requirements were taken into account: a) the complex was individualized depending on the constitutional characteristics of the patient, gender, age, previous fitness and physical fitness, premorbid state of personality: b) the restrictions that predetermined pathomorphological changes in the lumbar-motor segment, on the one hand, were taken into account the need to influence pathobiomechanical changes, on the other.

Based on these tasks, the general principles of individualizing exercise complexes for the rehabilitation and treatment of patients with spondylogenic and primary myogenic lesions of various parts of the spine were formed:

I. Creation of a certain psycho-emotional state, focus on the movements performed.

II. Smoothness, slowness, harmony of movements in a moderately limited volume without pain and other unpleasant sensations, with its gradual increase, together with an increase in tension in relaxed muscles until there is slight discomfort in them.

III. The orientation of the exercises, depending on the pathobiomechanical changes, on the correction of the interaction between the muscles of one locomotor pattern, on the relaxation of shortened muscles and the optimization of the tone of the relaxed muscles.

V. Focus on the resolution or prevention of functional blocks, on the stabilization of the locally hypermobile segment by isometric exercises.

VI. Focus on the restoration of an adequately optimal state of the autonomic nervous system, the functions of internal organs and on the harmonization of their interaction.

VII. Systematization of conscious-volitional regulation of respiration and control of the movement of qi energy flows along the main acupuncture meridians.

Viii. An increase in the patient’s total energy potential due to the accumulation of qi energy.

IX. Involvement in the treatment process of the cortical analyzer of motor functions and the conscious-volitional orientation of the so-called “qi” energy in the areas of pathologically altered tissues of the vertebral-motor segments.

X. The focus of the impact is not only on the musculoskeletal system, but also through the reflex pathways to the cardiovascular and respiratory systems, cellular metabolism, venous blood flow and the autonomic nervous system.

The task that the proposed method solves is to increase the effectiveness of treatment by including exercises that activate 12 acupuncture points along the anterior median, posterior median meridians, meridians of the pericardium and bladder, i.e. through all sections of the spine, muscles of the anterior abdominal wall and perineum, kidneys and adrenal glands, and additional stimulation of 2 acupuncture points of "wonderful meridians" releases the reserve capacity of the body. This stimulates the release of endogenous opioids, anti-inflammatory hormones, which allows treatment without the use of any medications, increasing the duration of remission up to 3-5 years.

The method is as follows. It consists of 7 exercises, the sequential execution of which requires an area of approximately 2 sq.m. This complex is mastered by almost all patients in 3-5 days, subject to a one-hour lesson daily. In the complex, the main focus is on the internal movement of qi energy with minimal volumes of external movements. The initial position of the patient provides for maintaining a comfortable position for the patient.

All movements are performed with the relative preservation of the vertical axial load on the spine, mainly in the joints of the shoulder girdle. Maintaining a fixed initial posture contributes to the formation of a muscle corset due to the isometric tension of the body immobilizers.

Each of the 7 exercises is constructed in such a way as to activate all areas of the spine with its musculo-ligamentous apparatus, as well as the muscles of the anterior abdominal wall. In the philosophy of eastern medicine, exercises are considered as activation of the anterior median and posterior median canals, which leads to an increase in the so-called qi energy in the remaining 12 paired canals and tendon-muscle meridians. Additional stimulation of the zone of the kidneys and adrenal glands (the "root of life" in Chinese medicine), offered by us, increases the energy potential, which in turn affects the links of immunity and the protective properties of the body.

Exercises can be performed while sitting or lying down. When performing exercises, patients should focus on breathing and mentally imagine the “movement” of the so-called “qi” energy as a sensation of heat inside the body along the projection lines on the heat of the acupuncture channels, i.e. along the lines of the so-called canapo-mervdian system.

Exercise 1.

Starting position: the legs are slightly wider than the shoulders, the feet are slightly turned with the socks inward: the back is straightened, the muscles are relaxed, the stomach is tightened.

The patient concentrates his attention below the navel, at point J (XIV) 6 qi-hai (lower dan-tien). It carries out breathing with the stomach, free, rhythmic, which goes into tissue (body breathing). On inspiration, before starting to move, vigorously rub his palms until a sensation of warmth appears. He exhales. He puts his palms on top of each other, placing them on the lower dan-tian, point (J (XIV) 6, (qi-hai). The points MC (IX) 8 lao-gun combines with point J (XIV) 6 qi-hai. in men, the palm is superimposed on the right, in women - vice versa. On inspiration, the patient mentally imagines that the external energy, the so-called "qi" energy, enters the body through the pores, enters point J (XIV) 6 qi-hai and, concentrating there, it causes a sensation of warmth, or heaviness, or burning, or fire, or vibration.

Exercise 2.

The starting position is the same. Performing a slow exhalation, the patient mentally transfers the "qi" energy in the form of a sensation of warmth along the anterior middle meridian from the acupuncture point J (XIV) 6 qi-hai to the acupuncture point J (XTV) 1 (hui-yin); located in the perineum.

Exercise 3.

The starting position is the same. Slow breath. The patient slowly raises his arms up to shoulder level, the hands hang freely, mentally conducting the so-called “qi” energy in the form of heat from the acupuncture point J (XIV) 1 hui-yin located in the perineum to the acupuncture point T (CP1) 4 min -men (lumbar spine) and acupuncture point T (HP1) 12 shen-zhu (upper thoracic spine).

Exercise 4.

The starting position is the same. The patient continues a slow breath, while the hands turn outwards with their palms and slowly move upward, turning inward and connecting above the crown. The left hand in a man is placed on the right (in a woman, on the contrary, the right on the left). External movements contribute to the mental conduction of the so-called "qi" energy in the form of heat from the acupuncture point T (X1) 12 shenzhu to the acupuncture point T (XIII) 14 da-jui (cervical spine), to the acupuncture point T (XIII) 17 nao-hu (occipital region of the head) and at the acupuncture point T (XIII) 20 by-hui (on top). Inhalation ends, exhalation begins.

Exercise 5.

The starting position is the same. The patient exhales slowly. At the same time, hands slowly fall down. The hands glide smoothly over the anterior-median canal, successively mentally activating the upper tant-tien (acupuncture point RSZ yin-tan), the middle dan-tien (acupuncture point J (XIV) 17 tien-chung), the lower tant-tien (J (XIV ) 6 qi-hai). Brushes are connected in the lower tian-tien (acupuncture point J (XIV) 6 qi-hai). The exhalation ends.

Exercise 6.

The starting position is the same. The patient takes a slow breath. At the same time, the hands slowly move up to the level of the acupuncture point J (XIV) 17 tien-chung. The palms are parallel in a vertical plane. The acupuncture points of the palms of MS (IX) 8 lao-guns are located at a distance of 8-10 cm from each other. The patient should mentally cause and feel the appearance of heat in the form of an elastic "energy" ball or spring between the palms, mentally strengthening it.

Exercise 7.

The starting position is the same. The patient exhales slowly. In this case, the brush slowly turns outwards and imposes with the palmar surfaces (the acupuncture points of MC (IX) 8 lao-guns) are applied to the adrenal gland (acupuncture points V (VII) 23 shen-shu). Mentally radiated from the brushes through the points of MC (1X) 8 lao-gong, the energy is directed to points V (VII) 23 she-shu, causing them to feel warmth, vibration, tingling.

All exercises are repeated first. In subsequent repetitions, when the seventh exercise is performed, the palm of the hand with the acupuncture points MS (IX) 8 (lao-gun) is applied to the area of pain impulse emanating from the muscles and spine, i.e. to the area of the pain area.

Thus, the patient’s attention, by mentally moving energy in the form of sensations of heat, or tingling, or fire, or vibrations, “moves” in a closed circle in the sagittal plane along the following 12 acupuncture points,

1. MS (IX) 8 lao-gun (palmar surface of the hands).

2. J (XIV) 6 qi-hai (hypogastric region, lower dant-tien).

3. J (xiv) 1 hui-yin (crotch).

4. T (XIII) 4 min-men (lumbar spine).

5. T (XIII) 12 Shen-Zhu (upper thoracic spine).

6. T (XIII) 14 da-chui (cervical spine).

7. T (XIII) 17 nao-hu (occipital region).

8. T (XIII) 20 buy-hui (occipital region).

9. RSZ yin-tan (center of the head, upper tributory).

10. J (XTV) 17 tien-jung (sternum, middle tribute-tien).

11. J (XIV) 66 qi-hai (hypogastric region, lower dant-tien).

12. V (VII) 23 shen-shu (kidneys and adrenal glands).

The division of the complex into exercises is conditional. One movement smoothly flows into another, each previous movement generates the next.

Mentally, the patient successively and continuously passes 12 acupuncture points along the anterior median, posterior median, meridians, meridians of the pericardium and bladder i.e. through all parts of the spine, muscles of the anterior abdominal wall and perineum, kidneys and adrenal glands. Additional stimulation of 2 acupuncture points of "wonderful meridians" releases the reserve capacity of the body.

The method we developed, including qigong exercises, was performed in 350 patients. During the first lesson, the general principles and features of treatment using the proposed method were explained, the whole range of exercises was demonstrated. Then the patient consistently mastered the implementation of all exercises. In the following days, control and repetition of what was learned was carried out. After the fifth day of classes, the main parameters characterizing the biomechanical changes were monitored. The general course of studies ranged from 5 to 28 days. Patients were given recommendations on the continuation of classes at home.

The effectiveness of the proposed method.

The treatment was carried out in the main and control groups. In the control group, treatment was carried out using a known method, including five exercises

The treatment results were evaluated by the following criteria:

I. Significant improvement or practical recovery - the disappearance of all neurological symptoms, the full restoration of disability with its preservation for a year or more.

II. Improvement - a significant reduction in the severity of symptoms that determine the severity of the disease, the restoration of disability for a period of less than a year.

III. Without effect - the lack of dynamics of all clinical manifestations during the period of the complex of therapeutic measures.

VI. Deterioration - the absence of a regression of clinical manifestations and the addition of new neurological symptoms against the background of active therapeutic and rehabilitation measures (Table 1).

Table 1 Immediate Treatment Results Outcomes Control group Main group R Total % Practical recovery 61 201 <0.05 267 59.3 Improvement 36 143 <0.05 179 39.7 No effect 3 6 <0.05 9 1,0 Total one hundred 350 450 one hundred

Direct results in the main and control groups are given in table 1.

The table shows that in the main group significantly better results were achieved than in the control group (P <0.05), which was reflected in a higher percentage of clinical recovery and significant improvement.

Along with qualitative results in the effectiveness of treatment and rehabilitation complexes in the compared groups, a significant decrease in the length of stay of patients in the hospital with their direct discharge to work was noted.

In the control group, patients spent 36.0 days in the hospital, in the main - 22.4 days (P <0.05), i.e. the difference was 13.6 days. The economic effect of such a reduction in bed days was 6,800 rubles per patient or 234.4 cu (1 y.e. is equal to 29.0 rubles - the average annual (2004), the dollar exchange rate). A follow-up survey using the questionnaire survey of 100 patients of the main group and 50 patients of the control group established the persistence of the achieved results for 12 months in 90% of the main group and in 79.2% of the control group (P <, 0.05), which was manifested by the absence of exacerbations with temporary disability and feeling good for a period of time after completion of treatment.

To objectify the sanogenic effect of qigong gymnastics, we studied the dynamics of the immune status of patients.

table 2 PATIENT IMMUNE STATUS STUDY CARD Name _________ Age ___ Date of examination ________________________ Diagnosis ____________________________________________________________ The number of leukocytes and their subpopulations in peripheral blood before treatment after treatment Relates. (%) Absolute (10 ⁹ / L) Common white blood cells 5,4 4.2 4.0-8.0 Monocytes 6.6 6.2 6-8 0.3-0.6 Lymphocytes 41.2 34.2 28-39 1.6-2.4 CD3 (T-lymphocytes) 77.6 68,2 50-76 1.1-1.7 CD4 (T-helpers) 47.1 44.1 31-46 0.7-1.1 CD8 (T-killers) 52.1 38,2 26-40 0.5-0.9 CD4 / CD8 Ratio 0.90 1.15 1.0-1.5 CD22 (B lymphocytes) fifteen 14.9 11-16 0.2-0.4 CD16 (Natural Killers) 24 18.1 9-19 0.2-0.4 CD38 (activated) 22 17 9-19 0.2-0.4 Functional activity of neutrophilic granulocytes HCT test (% of cells actively restoring dye) 5-15 In the presence of S.aureus ____________________________ up to 30 Serum immunoglobulins (mg / ml) ______ before treatment after treatment IgM 2.1 0.9 (0-15-1.9) IgG 26 12 (8-16) IgA 1,5 1.4 (1.4-4.2) CEC (5% PEG) 65 46 (0-50 conventional units) (7% PEG) 152 138 (up to 150 conventional units)

A complete immunological study conducted in 50 of our patients with compression and reflex pain syndromes with herniated discs before and after treatment included a study of the number of CD cells, the functional activity of neutrophils, the level of immune complexes and immunoglobulins G, M and A.

The obtained data were entered into the immune status map of 50 patients with hernias of the intervertebral discs. In 30 patients who made up the control group, neurological manifestations of osteochondrosis were expressed by a prolonged tonic and pain syndrome, caused by a hernia, i.e. were the same as in the main group, but they did not perform qigong exercises and were treated with traditional pharmacotherapy.

Based on the data obtained by the averaged indicators, a table was built (Table 2).

As can be seen from the table, the indicators of the immune status of patients with hernias of the intervertebral discs before treatment obviously differed from those in patients after treatment. While indicators of the immune status in patients of the control group under the influence of pharmacotherapy remained practically unchanged.

According to our data, analyzing the individual components of the immune status in the complex, it was possible to tentatively assess the qualitative state of immunity. A decrease in the immunoregulatory index was noted below normal due to a decrease in the content of T-helpers. In general, the content of T-helpers, both relative and absolute, did not change significantly during treatment. The relative content of CD8 ranged from 21% to 56% (at a rate of 26% -40%).

So, the analysis of immunological parameters in 50 patients with hernias of the intervertebral discs before and after treatment with qigong gymnastics showed that after such treatment normalization of the immune status is noted, both from the state of immunodeficiency and delayed hypersensitivity. During the observation period, during and after treatment, activation of the immune mechanisms of humoral and nonspecific anti-infection protection was noted. These immunograms indicate a positive dynamics of immunity to the therapy.

At the same time, 83% of respondents believe that qigong exercises helped them, and 60% of patients continued to study at home, although irregularly.

Persistence of complete remission observed during 96% of patients in the main group is noted; whereas 60% (36% difference) of the control group had incomplete remission (P <0.05), Table 3.

Table 3 Outcomes Control group % Main group R % Complete remission 60 60 336 <0.05 96 Relapse throughout the year 28 28 5 <0.05 1.4 Relapse within 2 years 10 10 four <0.05 1,2 Relapse within 3 years 2 2 5 <0.05 1.4 Total one hundred one hundred 350 one hundred

EXAMPLE 1. Patient I-s V.I., 61 years old, complained of severe, constant back pain radiating to the right buttock and thigh, inability to walk and sit. Similar pains previously occurred after hypothermia and weight lifting, passed independently without treatment. The last exacerbation occurred about 5 months ago after lifting. At first, the pain was localized in the lower back, and after a day it became very intense and radiated to the right buttock and along the posterior-outer surface of the right thigh.

Somatic status without pronounced features. Neurological status: the patient in a standing position takes an antalgic posture, resting on a crutch and a healthy leg. S-shaped left-sided scoliosis. Lumbar physiological lordosis is smoothed. The muscles of the lumbar region are extremely tense, painful on palpation. Sensitivity disorders in the innervation zone of the roots L ₃ -L ₄ , L ₅ -S ₁ on the right. The knee and Achilles reflexes on the right are not caused, a positive symptom of Laseg on the right from an angle of 20 °.

On a series of MRI scans performed in sagittal and axial projections, in the modes of spin and gradient echoes, images of the lumbosacral spine are obtained. On the myelographic section, the decrease in the MR signal from the discs L ₁ -L ₂ , L ₅ -S ₁ , the height of which is significantly reduced, is determined. The dural space is narrowed at the level of disks L ₁ -L ₂ , L ₅ -S ₁ . The posterior fragment of the disk L ₁ -L ₂ protrudes into the lumen of the spinal canal by 2.5 mm; on the axial section of this level, it is most lateralized to the right. The posterior fragment of the disk L ₅ -S ₁ protrudes 4.5 mm, has a left-sided paramedial localization. On the axial section of this level in the projection of the lumen of the left intervertebral foramen there is a significant narrowing (inhomogeneous MR signal). The MR signal from the structure of the dural space is also heterogeneous at this level. Conclusion: Osteochondrosis of the discs L ₁ -L ₂ , L ₅ -S ₁ , with the presence of posterior exostosis at the level of L ₅ -S ₁ . Medial disc protrusion L1-L2, with moderate lateralization to the right. Left-sided paramedial disk protrusion L ₅ -S ₁ .

Based on the patient’s complaints, objective and additional examination methods, a clinical diagnosis was established: osteochondrosis of the lumbar spine, disc herniation L ₁ -L ₂ , L ₅ -S ₁ . Right-sided discogenic lumbar ischialgia with severe pain and static-dynamic disorders.

Medication and physiotherapy for 4 months was ineffective. The patient categorically refused the proposed surgical treatment.

For 21 days, the patient, under the supervision of a doctor-instructor, did qigong gymnastics once a day according to the method specified by us. After 4 days of regular training, the pain syndrome disappeared, the gait normalized, scoliosis decreased, but the tension of the paravertebral muscles remained. All neurological symptoms disappeared on the 12th day of classes, however, to fix the result of the session, they decided to continue.

After treatment, after 21 days of regular classes, no complaints. Knee and Achilles reflexes uniform average liveliness. There are no sensitive disorders and Laseg symptom. It moves independently without support. On a series of control MRI scans performed in sagittal and axial projections, there is a clear positive trend. A disc herniation L ₁ -L _{2 is} not detected, the posterior fragment of a hernia of the disc L ₅ -S _{1 is} significantly reduced (up to 1.5 mm), dural space is not compressed, degenerative-dystrophic changes are preserved.

Conclusion: MRI signs of osteochondrosis of the lumbosacral spine, clinically significant intervertebral hernias are not determined.

EXAMPLE 2. Patient S.-B.C., 41 years old, complained of severe pain in the neck and left arm, difficulty in moving. Considers herself ill for about 4 months. The disease is associated with weight lifting (wore buckets with water). After lifting the weight, pain and aches in the neck suddenly appeared, and the next morning the pain from the neck spread to the left arm. Somatic status without pronounced features.

Neurological status: cranial nerve function is not impaired. Pronounced tonic muscle tension of the upper shoulder girdle. There is swelling and cyanosis of the left forearm and hand. Sensitivity disorder on the lower third of the left forearm and hand. The muscle strength of the left hand is reduced to 2 points, due to pain, active movements in all departments of the left upper limb are sharply limited.

On a series of MRI tomograms weighted by T ₁ and T ₂ in three projections, the cervical lordosis is straightened. The height of the disks of the study area and the signals from them at T ₂ reduced. Diffuse protrusion of a C ₃ -C ₄ disk. Rear medial hernia C ₅ -C ₆ to 8 mm, compressing the dural sac. The lumen of the spinal canal is narrowed at the disc herniation, the spinal cord is structural, the signal from it in the T ₁ and T ₂ modes is not changed.

Conclusion MR picture of degenerative-dystrophic changes in the cervical spine, complicated by multiple herniation (C ₃ -C ₄ ; C ₅ -C ₆ ).

Qigong treatment was carried out according to the following scheme. For 14 days, the patient, under the supervision of a doctor-instructor, did qigong gymnastics once a day according to our methodology. After 6 days of regular classes, the pain syndrome disappeared, active movements in all parts of the left arm were restored, the muscle strength of the hand increased to 4 points, however, the tonic muscle tension of the upper shoulder girdle remained. To improve the result, the classes decided to continue. After treatment on the 14th day of regular classes, there are no complaints. Movement in the upper limbs recovered. The range of motion in the cervical spine is sufficient. No sensitive disorders have been identified.

On a series of control MR tomograms weighted by T ₁ and T ₂ in 3 projections, compared with MR tomograms of 2 weeks ago, positive dynamics is determined in the form of a decrease in the size of a hernia C ₅ -C ₆ (up to 4 mm). The hernia C ₃ -C ₄ also decreased noticeably (up to 3 mm). The rest of the MR picture of degenerative-dystrophic changes in the cervical spine.

The follow-up history was traced for 5 years. The patient is almost healthy continues to work.

EXAMPLE 3. Patient B. s. V.I., 28 years old, complained of pain in the chest and upper thoracic spine, limitation of range of motion, difficulty breathing deeply. Considers himself ill for about 6 years, when during sports activities fell from a height of about 2 meters. Marks periodic subsidence and exacerbation of the process. The last exacerbation 3 months ago is associated with hypothermia.

Objectively. Somatic status without pronounced features.

Neurological status: cranial nerve function without features. Deep reflexes from the arms and legs are uniform, no sensitive disorders were detected. On palpation of the spinous processes of Th ₅ -Th ₁₀ soreness. Restriction of movements in the thoracic spine during flexion.

With additional examination on a series of MRI tomograms weighted by T ₁ and T ₂ in three projections, the kyphosis in the thoracic region is not changed. The height of the discs Th ₆ -Th ₇ , Th ₈ -Th ₁₁ and the signals from them at T ₂ reduced. Schmorl's hernia Th ₇ -Th ₈ and Th ₉ -Th ₁₀ (up to 4 mm). The lumen of the spinal canal is normal, the signal from the bone marrow is not changed, the spinal cord is structural.

Conclusion MR picture of degenerative-dystrophic changes in the thoracic spine. Multiple hernias of Schmorl (Th ₇ -Th ₁₁ ).

The patient refused surgical treatment.

For 28 days, the patient, under the supervision of a doctor-instructor, did qigong gymnastics once every other day according to the method we specified. After 8 days of regular classes, the pain syndrome disappeared, the range of movements in the thoracic spine increased. The disappearance of all neurological symptoms stopped on the 12th day of classes. To consolidate the result, classes decided to continue.

After the end of treatment after 28 days of regular classes, there are no complaints. On a series of control MR tomograms weighted by T ₁ and T ₂ in three projections compared with MR study 2 weeks ago, there is a clear positive dynamics. Schmorl's hernia Th ₇ -Th _{8 is} not determined. A marked reduction in the size of the hernia Th ₉ -Th ₁₀ (up to 2 mm). In the rest of MR, the picture in the thoracic spine is the same.

The follow-up history was traced for 5 years. At the time of exacerbation, qigong is engaged in a self-monitoring method. Healthy, continues to work.

EXAMPLE 4. Patient Yves-ova V.I., 31 years old, complained of severe, persistent lower back pain radiating to the right buttock and thigh, inability to walk and sit. He considers himself ill for about 5 months, when after lifting weights and hypothermia, pain in the lower back and buttocks appeared. Notes the appearance of similar pains earlier after hypothermia and weight lifting, which took place without treatment.

Objectively. Somatic status without pronounced features. Neurological status: occupies an antalgic posture with support on a healthy leg. The muscles of the lumbar region are extremely tense, painful on palpation, large buttock muscles of "stony" density, multiple (up to 15) painful muscle seals of various sizes and densities, S-shaped left-sided scoliosis are palpated. Lumbar physiological lordosis is smoothed. A sensitivity disorder in the innervation zone of the roots L ₃ -L ₄ , L ₅ -S _{1 was} not detected. Knee and Achilles reflexes are caused by the Laseg symptom on the right from a 60 ° angle.

With an additional study on a series of MRI scans performed in sagittal and axial projections, images of the lumbosacral spine were obtained in the spin and gradient echo modes. On the myelographic section, the decrease in the MR signal from the discs L ₁ -L ₂ , L ₅ -S ₁ , the height of which is significantly reduced, is determined. The dural space is not narrowed.

Conclusion: Osteochondrosis of the discs L ₁ -L ₂ , L ₅ -S ₁ , with the presence of posterior exostosis at the level of L ₅ -S ₁ .

Based on complaints, data from objective and additional research methods, a clinical diagnosis was made: osteochondrosis of the lumbar spine, muscle-tonic gluteal muscle syndrome with severe pain and static-dynamic disorders.

Medication for 4 months is ineffective.

Qigong treatment was carried out. The patient for 15 days under the supervision of a doctor-instructor did qigong gymnastics once a day according to the technique we specified. After 6 days of regular training, the pain syndrome disappeared, the number of painful muscle tightness decreased, however, tonic muscle tension of the lumbar region and buttocks remained. To improve the result, the classes decided to continue.

After treatment on the 14th day of regular classes, there are no complaints. Laseg's symptom is negative, knee, Achilles reflexes are caused on both sides, no sensitive disorders have been identified. It moves independently without support. On the series of control MRI performed in sagittal and axial projections, there is a clear positive dynamics in the form of a decrease in degenerative-dystrophic changes. The follow-up history was traced for 4 years. No relapses were noted.

Thus, a new original treatment complex for non-drug treatment of patients with discogenic and primary myogenic neurological syndromes of any localization has been developed. The effectiveness of this complex is determined both by the dynamics of the neurological status (radicular pain decreases or disappears, deep segmental reflexes and peripheral paresis of myotomes are restored, which leads to normalization of the volume of active movements in the limbs and the motor stereotype as a whole), and the results of magnetic resonance imaging (decrease sizes of hernial protrusion, the statics and dynamics of the spine are improved.

Thus, qigong therapeutic gymnastics is one of the appropriate methods of exposure and its inclusion in the complex of therapeutic and rehabilitation measures for spondylogenic and primarily multiple spinal injuries contributes to a more complete therapeutic and definite economic effect.

The proposed method allows for treatment in patients with discogenic and primary myogenic neurological syndromes of any localization, carrying out it without drug therapy. The effectiveness of the method is confirmed both by the dynamics of neurological status (radicular pain decreases or disappears, deep segmental reflexes and peripheral paresis of myotomes are restored, which leads to normalization of the range of active movements in the limbs and the motor stereotype as a whole), and the results of magnetic resonance imaging (sizes are reduced hernial protrusion, improves the statics and dynamics of the spine) and laboratory test data, confirming an increase in its use the release of edogenic opioids, anti-inflammatory hormones.

Claims (1)

A method of treating spondylogenic and primary myogenic lesions of the spine, which consists in performing exercises in which the legs are wider than the shoulders in the initial position, the feet are turned with the toes inward, the back is straightened, the muscles are relaxed, the stomach is tightened, while focusing on the acupuncture point during the first exercise J (XIV) 6 qi-hai, performing rhythmic breathing with the abdomen, rub their palms before starting the movement on the inhale until they feel warm, exhale, place their palms on top of each other and combine acupun Turning points of the palms MS (1X) 8 (lao-gun) with an acupuncture point J (XIV) 6 (qi-hai), with the men placing the left palm on the right and the women on the contrary, while simultaneously imagining that external energy enters the body , falls into the acupuncture point J (XIV) 6 (qi-hai) and, concentrating there, causes a sensation of warmth, or heaviness, or burning, or fire, or vibration, when performing the second exercise, performing a slow exit, mentally transfer energy in the form sensations of heat along the anterior middle meridian from the acupuncture point J (XTV) 6 (qi-hai) to the acupuncture the point J (XIV) 1 (hui-yin), during the third exercise, taking a slow breath, raise your hands up to shoulder level, the hands hang freely, while mentally conduct energy in the form of a sensation of heat from the acupuncture point J (XIV) 1 (hui-yin), to the acupuncture points T (XIII) 4 (min-men) and T (XIII) 12 (shen-chu), while performing the fourth exercise, continuing to inhale, the hands unfold with their palms outward, slowly move upward, turning inward , and connect over the top of the head, moreover, men put the left hand on the right, and women - on the contrary, while Vibrantly conduct energy in the form of a sensation of heat from the acupuncture point T (XIII) 12 (shen-ju) to the acupuncture points T (XIII) 14 (da-zhui), T (XIII) 17 (nao-hu) and T (XIII) 20 (bai-hui), complete the inhalation and begin the exhalation, during the fifth exercise, while exhaling slowly, the arms are lowered, the hands glide over the body along the front-mid-channel, while mentally activating the acupuncture points of the upper tian-tien with energy in the form of a sensation of heat (RSZ, yin-tan), middle Dan-tien (J (XIV) 17, Tien-jung) and lower tribute-tien (J (XIV) 6, qi-hai), combining brushes in the lower tribute -tien at the acupuncture point J (XIV) 6 (qi-hai) exhale is completed, during the sixth exercise, take a slow breath, lifting the hands up to the level of the acupuncture point (J (XIV) 17 (tien-jung) and place the palms parallel in vertical plane, and in a position in which the acupuncture points of MC (IX) 8 (lao-gun) are located at a distance of 8-10 cm from each other, mentally cause the appearance of heat in the form of an elastic "energy" ball or spring between the palms, when performing the seventh exercise exhale by turning the brush and pad palm surfaces, the area of the acupuncture point MS (1X) 8 (lao-gun), to the adrenal glands at the acupuncture point V (VII) 23 (shen-shu), while mentally radiate from the hands through the acupuncture points MS (IX) 8 (lao-gong) energy in the form of a sensation of warmth, tingling, which is mentally directed to the acupuncture points V (VII) 23 (shen-shu), causing sensations of heat, vibration, tingling there, then all exercises are repeated first, and with subsequent repetitions at performing the seventh palm exercise with acupuncture points MS (IX) 8 (lao-gong ) impose on the pain zone in the area of the spine or muscles, exercises are carried out daily or every other day.