RU2322274C1 - Method for adjusting posttraumatic vegetative dysfunctions at health resort stage - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves prescribing radon baths. Treatment with reversed running low frequency magnetic field is applied to cervical vertebral column segment in paravertebral way 40 min later after taking radon bath. Modulation frequency is selected to be 8-10 Hz in alternating mode. Procedure exposure time is 12-15 min with 8-10 proc per treatment course.

EFFECT: improved diencephalic stem structures blood supply; improved blood saturation; eliminated vegetative nervous system unbalance.

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Description

The invention relates to medicine, in particular to neuropathology. Close to the claimed is a method of treating the long-term consequences of a traumatic brain injury (V.N. Ayvazov, L.A. Cherevashchenko, R.G. Krinchiyan, S.M. Ilyaeva, N.V. Ayvazov, N.N.Kulikov. Craniocervical “Whiplash” injury. - Pyatigorsk: State Research Institute of Balneology. - 2000. - P.82-85).

This method involves the use of radon baths with a radon concentration of 1.5 kBK (40 nCi / l), a temperature of 36-37C, a duration of 10-15 minutes, a frequency of 3-4 times a week, a total of 10-12 procedures.

Radon baths have a positive effect on the state of the central nervous system due to a sedative inhibitory effect, improve blood circulation in the pool of carotid and vertebral arteries, and increase the level of adaptive and adaptive reactions. In most cases, this method of treatment provided a reduction in the main clinical symptoms of the disease, however, in some cases, the treatment results were not effective enough; there was insufficient duration of remission of the clinical symptoms of the disease.

Also described is a method of treating children with a traumatic brain injury with an electromagnetic field of ultrahigh frequency decimeter range (DMV) (L. M. Babina, V. V. Arzumanova, I. I. Iordanova, T. V. Afanasyeva. Craniocerebral injury in children, its consequences and treatment methods. - Nalchik. - 1999. - P.74-77).

This method involves the use of DMV therapy in the region of the upper cervical sympathetic nodes from the Romashka-2 apparatus with a frequency of 915 MHz at a power of up to 30 W, exposure time of 10 minutes, with a frequency of administration 2-3 times a week, for a course of 10 procedures. But the response to exposure at an initial power of 10 watts was mixed. Some children (10 people) increased complaints of headaches after the procedure. Children felt nauseous, dizzy. In this regard, the power of DMV therapy was reduced to 5 watts.

The technical result of the proposed method is that 40 minutes after taking a radon bath, a reverse traveling low frequency magnetic field is applied paravertebrally to the cervical spine with a modulation frequency of 8-10 Hz, the mode is variable, with an exposure of 12-15 minutes taken every other day, on a course of 8-10 procedures.

An examination of the state of autonomic functions is carried out by the method of cardiointervalography (CIG). The method is based on a mathematical analysis of the variability of sinus heart rhythm as an indicator of the adaptive-compensatory activity of the whole organism (M.B. Kuberger, N.A. Belokon, 1985). A cardiointervalogram is a continuous recording of at least 100 consecutive cardiocycles (R-R intervals) in one of the electrocardiographic leads. Registration is carried out in a supine position after 10 minutes of rest. The initial autonomic tone, as well as autonomic reactivity after conducting a clino-orthostatic test, which characterizes the direction and degree of change of indicators reflecting the state of the autonomic nervous system at the time of transition from one state to another, are fixed. The initial vegetative tone (IWT) is evaluated as follows: eutonia (balanced state of the ANS regulatory systems) - the stress index is 30-90 conventional units; vagotonia IN less than 30 srvc; moderate sympathicotonia - IN from 90 to 160 conventional units; hypersympathicotonia - IN more than 160 conventional units; Vegetative reactivity (vegetative support of activity) is estimated by the ratio of IN2 after a wedge-orthostatic test to IN1 when it is in a horizontal position and characterizes the degree of change in the functioning of the ANS at the time of transition from one state to another. (D.M. Zhemaitite, 1975; F.E. Zarubin, 1993; V.M. Troshin, 1993; D.A. Alymkulov et al., 1997). Thus, this method allows obtaining objective information about the state of non-specific suprasegmental structures of the autonomic nervous system.

The method is illustrated by the following examples.

Example 1. Patient D., 42 years old, was treated in the neurological department of the Pyatigorsk clinic. Upon admission, she complained of periodic headaches in the frontal and temporal areas of a pulsating nature, aggravated by changes in weather, overwork, nausea, irregular dizziness, increased fatigue, poor sleep, irritability, memory loss, fluctuations in blood pressure, periodically occurring pains in all parts of the spine feeling of numbness and tingling in the fingers. From the anamnesis it is known that in January 2006 the patient fell on the back of the head (during ice). Short-term loss of consciousness was noted for several seconds, then nausea, headache, dizziness. The above complaints appeared after the injury. According to cardiointervalography, there is a predominance of the influence of the sympathetic nervous system at rest (IN-270 units). When conducting a clino-orthostatic test, a hypersympathicotonic type of autonomic reactivity. After the balneological treatment in the form of taking radon baths (according to the prototype method), headaches, dizziness, irritability decreased, sleep improved, sleep capacity improved, spinal pains decreased. According to cardiointervalography, the state of HYPERSIMATICOTONIA Slightly DECREASED (ID within 170 units). A clino-orthostatic test is a normal type of reactivity. A complete restoration of the autonomic nervous system was not noted.

Example 2. Patient A., 47 years old, was treated in the neurological department of the Pyatigorsk clinic. Upon admission, she complained of periodic headaches in the occipital areas of a aching character, aggravated by a change in head position, overwork, moderate dizziness, fatigue, superficial sleep, irritability, memory loss, fluctuations in blood pressure. An injury was noted 5 weeks ago. According to cardiointervalography, the influence of the sympathetic nervous system at rest is predominant (IN-300 units). When conducting a clino-orthostatic test, a vagotonic type of autonomic reactivity. Balneological treatment was carried out in the form of radon baths (according to the prototype method), as well as receiving, after 40 minutes after the bath, a running reversing magnetic field with a frequency of 8 Hz paravertebral to the cervical spine, the regimen was variable at an exposure of 12 minutes in the amount of 8 procedures. According to cardiointervalography, the initial vegetative status is EYTHONIA (IN within 80 units). Clinoorthostatic test is a normal type of vegetative reactivity. A complete restoration of the indices of the autonomic nervous system in normal conditions and during exercise was noted.

Example 3. Patient S., 49 years old, was treated in the neurological department of the Pyatigorsk clinic. Upon admission, he complained of periodic headaches of a diffuse nature without a clear localization, aggravated by emotional stress, overwork, dysfunctional dizziness, fatigue, irritability, memory loss, mood swings. An injury was noted 4.5 weeks ago. According to cardiointervalography, the influence of the PARASIMAPTIC nervous system at rest is predominant (IN-25 ED. When conducting a clino-orthostatic test, it is a vagotonic type of autonomic reactivity. Balneological treatment was carried out in the form of radon baths (according to the prototype method), as well as taking 40 minutes after the traveling reversing bath magnetic field with a frequency of 10 Hz paravertebral to the cervical spine, the regimen is variable at an exposure of 15 minutes, in the amount of 10 procedures.According to cardiointervalography, the initial vegetative tive status - Ayton (MI within 50 units). clinoorthostatic sample - normal type noted vegetative reactivity complete recovery performance of the autonomic nervous system in health and stress..

Example 4. Patient Sh., 47 years old, was treated in the neurological department of the Pyatigorsk clinic. Upon admission, she complained of periodic headaches in the parietal areas of a pulsating nature, aggravated by changes in weather, overwork, irritability, periodically occurring pains in all parts of the spine, numbness and tingling sensations in the fingers. From the anamnesis it is known that she was injured 5 weeks ago. According to cardiointervalography, there is a predominance of the influence of the sympathetic nervous system at rest (IN-190 units). When conducting a clino-orthostatic test, a normal type of vegetative reactivity. Balneological treatment was carried out in the form of radon baths (according to the prototype method), as well as exposure 20 minutes after taking a bath of a running reversible magnetic field with a frequency of 15 Hz paravertebrally to the cervical spine, the regimen was variable at an exposure time of 20 minutes in the amount of 12 procedures. According to cardiointervalography - the initial vegetative status - HYPERSIMATICOTONIA STRENGTHENED (ID within 250 units). When conducting a clinostatic test - HYPERSYMPATHIC TYPE of vegetative reactivity. An increase in the tension of the indices of the autonomic nervous system in normal and under load was noted.

Example 5. Patient T., 42 years old, was treated in the neurological department of the Pyatigorsk clinic. Upon admission, he complained of asthenia, drowsiness, emotional stress, overwork, dyspeptic dizziness, irritability, decreased concentration, and mood swings. An injury was noted 4 weeks ago. According to cardiointervalography, the influence of the PARASIMAPTIC nervous system at rest is predominant (IN-20 ED When conducting a clino-orthostatic test, it is a HYPERSIMATIC type of autonomic reactivity. Balneological treatment was carried out in the form of radon baths (according to the prototype method), as well as taking 30 minutes after running a radon bath magnetic field with a frequency of 6 Hz paravertebral to the cervical spine, the regimen is variable at an exposure of 6 min in the amount of 8 procedures. According to cardiointervalography - ref projectile loader vegetative status - vagotonia REMAINS (MI within 27 pcs.) wedge orthostatic test -. hypersympathicotonic type of autonomic reactivity Full recovery rates were observed autonomic nervous system.

Treatment according to the proposed method was carried out for 30 patients with a condition after suffering a mild traumatic brain injury with autonomic dysfunction syndrome and 23 patients with the same pathology (control group) who received treatment by the prototype method, i.e. reception of isolated radon baths. Both groups of patients according to the main clinical characteristics were approximately the same (table 1).

Table 1
Clinical characteristics of patients Sign Groups Primary (n = 30) Control (n = 23) Abs. % Abs. % Floor women 19 63.3 10 43.5 men eleven 35.6 13 56.5 Age 17-30 10 33.3 8 34.7 31-50 twenty 66.7 fifteen 65.3

Analysis of the treatment results by the proposed and known methods revealed clinical and paraclinical parameters in patients of both groups, but it turned out to be more significant in patients treated with the proposed method (table 2).

table 2
Clinical Symptom Dynamics Symptoms Dynamics The main group n = 30 Control group n = 23 Before treatment After treatment P1 Before treatment After treatment P2 Headache one hundred 30.1 <0.001 one hundred fifty > 0.05 Dizziness 73,4 6.7 <0.001 26 Nausea 36.6 - - 52.1 39.1 Vomiting 25.6 - - 43,4 30,4 > 0.05 Fast fatiguability one hundred 6.7 <0.001 one hundred 69.5 Sleep disturbance 66.6 16.6 <0.01 34.7 26.0 > 0.05 Coordination violations 56.6 6.6 <0.01 65,2 30,4 > 0.05 Tremor 56.6 6.7 <0.01 43,4 21.7 > 0.05 Violation of FMN: Visual 13.3 6.7 > 0.05 52.1 26.0 Oculomotor 16.6 6.7 > 0.05 65,2 47.8 > 0.05 Facial 60 26.6 <0.05 86.9 60.8 <0.05 Reflex disorder 40 16.6 <0.05 82.6 65,2

The data in the table indicate that in patients of the main group, headache, dizziness, and symptoms of autonomic dysfunction significantly decreased. No vomiting or nausea was observed. Patients became calmer, asthenic manifestations decreased, memory, attention improved, anxiety significantly decreased, sleep improved, mood improved.

When examining the neurological status from the side of the craniocerebral innervation, positive dynamics was observed in more than half of the cases, from the reflex sphere in 33.5%. Patients have decreased tremor of outstretched arms, trembling of the eyelids - 49.7% and coordinating disorders - in 55%.

Among the patients of the control group of 17 main signs of the disease, only 7 had significantly positive changes.

Studies of the bioelectric activity of the brain revealed some changes (table 3).

Table 3
The dynamics of electroencephalography Indicators Dynamics Main group Control group Before treatment After treatment R Before treatment After treatment R α-index (%) 54.03 ± 2.9 67.5 ± 2.0 <0.05 53.23 ± 2.87 53.25 ± 3.5 - Amplitude of α waves (μV) 75.65 ± 4.74 89.78 ± 5.60 <0.05 79.70 ± 3.37 79.41 ± 4.10 - Amplitude asymmetry coefficient (%) 26.8 ± 0.6 20.4 ± 0.5 <0.01 25.11 ± 1.21 26.58 ± 1.20 > 0.5

During the spa treatment, the number of patients with a regular alpha rhythm increased in patients of the main group. The leading beta rhythm was preserved in 5 out of 8 patients who had it before. Of 43.4% of cases in which disorganization of biopotentials was detected before treatment, dysrhythmia persisted in 34.7%. Slow-wave activity after treatment was observed only in 4 patients, paroxysmal activity in 3 people. In patients there was an increase in the alpha index and the amplitude of the alpha waves. The coefficient of amplitude asymmetry tended to decrease.

In the control group, the type of electroencephalogram practically did not change. An increase in the number of patients with a regular alpha rhythm did not occur, in 2 patients a slow activity appeared on the background of the alpha rhythm, in 6 - the initial background rhythm was preserved, in patients there was dysrhythmia, which indicates a deterioration in bioelectric activity.

The amplitudes of alpha waves and the alpha index remained the same in the vast majority of patients as before treatment, the coefficient of amplitude asymmetry tended to increase.

As shown by the analysis of the rheoencephalogram, the state of blood supply and peripheral resistance underwent a number of positive changes. In the main group, the amplitude pulse blood supply increased on average from 0.15 ± 0.01 to 0.18 ± 0.01 (p <0.05), the initially increased vascular tone decreased (from 80% to 52%, P <0, 05). Patients in the control group showed a slight decrease in pulse arterial blood filling - from 0.18 to 0.17 Ohms and an increase in the asymmetry coefficient. There was also a slight increase in the tone of cerebral vessels (by 1.2%) along with a decrease in vascular resistance (by 10%) (table 4).

Table 4
Dynamics of rheoencephalogram indicators Indicator Dynamics Main group Control group Before treatment After treatment R Before treatment After treatment R Ri ohm On right 0.174 ± 0006 0.19 ± 0.007 > 0.05 0.18 ± 0.001 0.17 ± 0.002 > 0.5 Left 0.18 ± 0.006 0.19 ± 0.007 > 0.05 0.17 ± 0.001 0.17 ± 0.001 > 0.5 A / T (%) On right 12.08 ± 0.03 13.05 ± 0.54 > 0.05 13.3 ± 0.63 14.28 ± 0.45 > 0.5 Left 11.6 ± 0.29 12.3 ± 0.28 > 0.05 13.37 ± 0.30 13.74 ± 0.39 - VA (%) On right 52.7 ± 2.4 60.5 ± 2.1 <0.01 68.28 ± 4.98 55.31 ± 4.29 <0.05 Left 56.48 ± 3.37 58.67 ± 2.36 > 0.1 69.62 ± 4.64 59.78 ± 5.23 > 0.1 KA (%) 34.6 ± 3.2 32 ± 2,4 > 0.5 21.71 ± 3.64 26.47 ± 3.5 > 0.1

Summing up the dynamics of clinical and functional indicators in patients of the main and control groups, we evaluated the treatment results as follows (table 5):

Table 5
The results of the treatment of the proposed and known methods Treatment Evaluation Criteria Main group Control group Abs. % Abs. % Significant improvement 5 16.7 - - Improvement 25 83.3 fourteen 60.8 Slight improvement - - 6 26.2 No change - - 3 13

The advantage of the proposed method of treatment is associated with the effect on the central nervous system of a reversing traveling magnetic field of low frequency paravertebrally on the cervical spine, as a result of which the blood supply to the diencephalic stem structures improves (through the arteries of the vertebro-basilar pool), oxygen saturation is noted, and oxygen oxidation recovery processes, and therefore, the neurodynamic and hemoliquorodynamic processes in the central departments are improved nervous system, the imbalance in the suprasegmental parts of the autonomic nervous system is eliminated, the adaptive reserves of the body increase.

The pathogenetic effect of the reversible traveling magnetic field is due to the regulatory effect on neuro- and hemodynamics, microcirculation, normalization of the functions of the suprasegmental parts of the autonomic nervous system, improvement of regional blood circulation, intensification of metabolism and redox processes in the central nervous system.

The proposed method of treatment is more effective and can be used at the stage of spa treatment.

Claims (1)

A method for the correction of post-traumatic autonomic dysfunctions, characterized in that 40 minutes after taking a radon bath, a reverse traveling low-frequency magnetic field is applied paravertebrally to the cervical spine with a modulation frequency of 8-10 Hz, the mode is variable, with an exposure of 12-15 minutes taken through day, on a course of 8-10 procedures.