RU2366474C1 - Therapy of inflammatory and dystrophic ophthalmopathies - Google Patents

Abstract

FIELD: medicine; ophthalmology.

SUBSTANCE: method includes pharmacotherapy and exposure of biologically active points (BAP) to low intensity laser light. At first, exposure covers 1-6 points locally within eye region as specified from V 1, V 2, VB 1, E 1, VB 14, TR 23, PC 6, PC 3, E 2, E 3. Then there are involved 1-4 points within head and collar region as follows VB 16, VB 20, TR 20, TR 17, E 8, T 20, T 24, T 23, T 14, IG 15. Thereafter there are exposed 1-5 distant limb points including TR 5, GI 4, GI 11, C 5, C 7, MC 6, IG 1, IG 2, V 63, VB 40, E 36, E 37, E 38, E 39, F 2, F 3, R 6, RP 6. Exposure frequency is 8.0-73.0 Hz, or modulated frequency 1000-3000 Hz. The duration per one point is within 20 seconds to 2 minutes. Total exposure time is 10-15 minutes. Therapeutic course includes 6-7 sessions.

EFFECT: reduced time of treatment owing to improved intraocular hemodynamics and stimulation of metabolic processes.

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Description

The invention relates to medicine and can be used in ophthalmology in the treatment of various eye diseases.

There are various methods of treating inflammatory and dystrophic eye diseases, including:

- physical exercises and medicines (Medvetskaya G.I., Bubolts L.P. // Collection of scientific works. Helmholtz Research Institute of Eye Diseases. - M., 1984. - P.50-52);

- methods of stimulation of the ciliary muscle using electropuncture (Stishkovskaya N.N., Nurenberg O.Yu. Electropuncture reflexotherapy of myopia. // Collection of scientific works. Pathogenesis of myopia, prevention of its progression and complications. - M., 1990. - S. 107-108);

- instrumental methods of treatment using computer programs, low-energy helium-neon and infrared lasers, vacuum massage, infrasound vibrations, magnetotherapy, color-pulse therapy, electrophoresis of pharmaceuticals (Konovalova N.A. et al. // Abstract of the International Symposium. - M ., 2001. - P.44-45; Ryabtseva A.A. et al. // Materials of the International Symposium. - M., 2001. - P.72-73; Chentsova O.B., Shatalov O.A. / / Materials of the International Symposium, - M., 2001. - P.95-96).

There is, for example, a method for treating visual fatigue in computer users (RF Patent No. 2276596, class A61F 9/00, publ. May 20, 2006), which involves irradiating continuously detected pathologically active orbital biologically active points (BAPs) with infrared radiation to reducing the pathological activity of the point and taking the drug "Mirtikam" 1 teaspoon three times a day after meals.

The disadvantages of this method are its lack of effectiveness and limited functionality.

A known method of treating accommodation spasm (RF Patent No. 2070024, class A61H 39/00, publ. 10.12.96), which includes exposure to pulsed laser radiation with an output power of 2 mW with a wavelength of 0.76-0.83 microns on auricular acupuncture points, with unstable spasm of accommodation, they act on points located in the zone of sympathetic innervation (AR-24 _a , AR-24 _b , AR-51, AR-76, AR-77) with pulses of 3-5 Hz for 6-8 seconds per point, and with a moderately persistent and persistent spasm of accommodation, they act on points located in the parasympathetic innervation zone (AR-55, AR-96, AR-97, AR-98), pulses having a frequency of 30-34 Hz for 43-47 seconds per point.

The disadvantages of this method are:

- does not provide for the impact on regional and cerebral hemodynamics, which is a trigger factor in the occurrence of a spasm of accommodation,

- the difficulty in developing an optimal exposure regimen, and with different types of spasm they are of multidirectional action, due to the lack of clear differential clinical signs of each type of accommodation spasm in ophthalmic practice,

The closest to the claimed method, the prototype, is a method for the treatment and prevention of the progression of myopia in children (RF Patent No. 2265464, class A61N 5/067, publ. 10.12.2005), which includes the combined effect of pulsed laser infrared (IR) radiation, pulsed incoherent infrared radiation, pulsed red radiation and a constant magnetic field with magnetic induction of 35 ± 10 mT on the occipital-parietal region of the head, neck, carotid sinuses and biologically active points (BAP), then act on the symmetrical BAP powerfully be IR laser radiation 8 watts with a frequency of a pulse laser and incoherent PC radiation 1000Hz initially at point general operation: F _2, F _3, E _36, Gi _4, IG _3, TR _10, V _62, then pulsed power laser IR 8 W radiation, with a frequency of pulsed laser and incoherent IR radiation of 5 Hz to local action points around the eyes: E ₁ , E ₂ , TR ₂₃ , VB ₁ , V ₁ , V ₂ , BT ₆ and auricular points: AT ₈ , AT _24a , AT ₂₄ , with an exposure of 20-30 s for each point with a duration of exposure of 6-9 minutes, a course of 8-12 sessions.

The disadvantages of this method are its duration and limited functionality of the method (only for the treatment of progressive myopia).

An object of the invention is to reduce the duration of the method, increase its therapeutic effectiveness and expand the functionality.

The stated technical problem is achieved by the proposed method, which consists in the fact that the patient against the background of traditional anti-inflammatory treatment undergo laser reflexology.

Laser reflexology is performed on the LA3-EXPERT (PHYSIOMED) apparatus using a laser pen with a wavelength of 785 nm, an effective power of 30 mW (multi-frequency mode, Nogier frequency), which has a modulation mode (constant radiation or pulse modulation) by acting on biologically active points ( BAP) of the patient. During the procedure, the doctor uses a laser pen to act on the paired points located around the patient’s eyes, on the points of the head and collar zone and on the distant points of the upper and lower extremities.

Depending on the diagnosis and the phase of the process, the patient's BAP is exposed to low-intensity laser radiation with a frequency of 8.0-73.0 Hz, or in multi-frequency mode in the range of 1000-3000 Hz with modulation, with a duration of exposure to one point from 20 seconds to 2 minutes in the following sequence: first act on 1-6 points of local action in the eye area selected from V 1, V 2, VB 1, E 1, VB 14, TR 23, PC 6, PC 3, E 2, E 3, then act on 1-4 points of the head and collar zone, selected from VB 16, VB 20, TR 20, TR 17, E 8, T 20, T 24, T 23, T 14, IG 15, then 1- 5 remote then on the extremities selected from TR 5, GI 4, GI 11, C 5, C 7, MC 6, IG 1, IG 2, V 63, VB 40, E 36, E 37, E 38, E 39, F 2 , F 3, R 6, RP 6. The total duration of exposure (procedure) is 10-15 minutes. In this case, the radiation dose is calculated automatically in the range from 1 to 2 J / cm ² . The course of treatment consists of 6-7 procedures

The combination of drug therapy and laser reflexology can increase blood supply in the orbital artery pool, improve intraocular hemodynamics, as a result, metabolic processes are stimulated, and tissue trophism improves. Under the action of laser radiation, photobiological stimulation of specific cell activity (immunological, anti-inflammatory) occurs, phagocytosis intensifies, and the degree of anti-inflammatory humoral defense increases. This has a positive effect on visual function, which is manifested by an increase in visual acuity.

Laser reflexology uses a small amount of light energy to photoactivate the nerve structures involved in the body's reflex response. The advantages of laser reflexology are: a small exposure area, the non-specific nature of the photoactivation of receptor structures, the ability to induce directed reflex reactions, non-invasive effects, asepticity, comfort, the ability to accurately dose the effects, the possibility of using the method either alone or in combination with drug treatment.

The general reaction of the body to laser reflex exposure is carried out in two main ways: neurogenic and humoral. The synthesis of ACTH, glucocorticoids and other hormones is stimulated, the synthesis of prostaglandins E and F, enkephalins and endorphins increases, blood composition normalizes and microcirculation is activated.

The invention is illustrated by the following examples of specific performance.

Example 1

Patient Kosheleva N.N., 70 years old, medical history 207911-03, was treated at the NF FSI MNTK “Eye Microsurgery” from 09/17/07 to 09/26/07. Diagnosis: Macular degeneration OU. Operated retinal detachment OS.

Visual acuity before treatment:

OD 0.15 with 0.2 correction

OS 0.005 without correction.

Against the background of traditional anti-inflammatory therapy, the patient underwent laser reflexology. The patient was seated in a comfortable chair in a reclining position and 7 sessions of laser irradiation (laser puncture) were performed on the BAT using the LAZ-EXPERT apparatus using a laser pen with a wavelength of 785 nm, effective power of 30 mW. From session 1 to 3, the following points were exposed to laser radiation with a frequency of 36.5 Hz: first, paired V 1, unpaired PC 3, then paired points of the head and collar zone VB 16, IG 15, then paired points on the limbs TR 5, MC 6, 1 minute per point, total exposure time 11 minutes, 4 and 5 sessions were performed at a frequency of 36.5 Hz per pair points in the eye area VB 1, E 2, VB 14, then to the points paired heads VB 20, unpaired T 24, then to paired points on the limbs TR 5 and GI 4 for 1 minute per point, the total duration of the session 13 minutes Sessions 6 and 7 were performed at a frequency of 73.0 Hz for paired points in the eye area VB 1, VB 14, then for paired points of the head VB 20, then for paired points on the limbs TR 5, VB 40, F 3, E 36, 1 minute per point, total exposure time 14 minutes.

Visual acuity after treatment:

OD 0.15 with 0.3 correction

OS 0.01.

Example 2

Patient Zharova RS, 72 years old, medical history 168215-05, was treated at the NF FSI MNTK “Eye Microsurgery” from 09/17/07 to 09/26/07. Diagnosis: Primary open-angle glaucoma simple stage 4 (terminal). Secondary cataract for glaucoma OD. Primary o / u glaucoma simple stage 2 (developed) A. Secondary cataract with glaucoma OS.

Visual acuity before treatment:

OD 0

OS 0.02 with a correction of 0.6.

The treatment was carried out by the claimed method: against the background of anti-inflammatory therapy, 6 sessions of laser puncture were performed. From session 1 to 2, we used laser radiation with a frequency of 36.5 Hz for paired points in the eye area V 1, unpaired point PC 3, then for paired points on the head of VB 16 and unpaired point in the collar zone IG 15, then to paired points on limbs TR 5, MC 6, 1 minute at each point. The total session time is 10 minutes. Sessions 3 and 4 were performed at a frequency of 36.5 Hz for paired points in the eye area VB 1, E 2, BV 14, paired points on the head of VB 20, an unpaired point on the head of T 24, then to paired points on the limbs TR 5, GI 4 1 minute per point, total session time 13 minutes. Sessions 5 and 6 were performed at a frequency of 73.0 Hz for paired points in the eye area VB 1, VB 14, then for paired points on the head of VB 20, then for paired points on the limbs TR 5, VB 40, F 3, E 36 1 minute per point, total exposure time 14 minutes.

Visual acuity after treatment:

OD 0

OS 0.1 with a correction of 0.8.

Example 3

Patient Kuncheva N.A., 56 years old, medical history 160083-04, was treated at the NF FSI MNTK “Eye Microsurgery” from 08.10.07 to 10.17.07. Diagnosis: Partial atrophy of the optic nerve OU.

Visual acuity before treatment:

OD 0.04 with 0.05 correction

OS 0.02 with a correction of 0.05.

The treatment was carried out using the claimed method: against the background of anti-inflammatory therapy, 7 laser puncture sessions were performed. From 1 to 3 sessions, laser radiation was used in the multi-frequency mode 1000-3000 Hz for paired points in the eye region V 1 - 60 s, VB 1 - 30 s, E 1 - 30 s, unpaired point in the eye area PC 6 - 30 s, further to the paired points on the limbs GI 4 - 60 s, C 5 - 60 s, C 7 - 60 s. The total exposure time is 11 minutes 30 seconds. From 4 to 7 sessions, the frequency of laser radiation was 9.12 Hz per pair points in the eye area V 1, VB 1, TR 23 for 20 s, VB 14 for 30 s, unpaired point in the eye area for PC 6 for 20 s, then on paired points of the head VB 20 - 30 s, E 8 - 20 s, unpaired point of the head T 20 - 30 s, then on paired points of the limbs E 36 - 2 minutes. The total exposure time is 10 minutes.

Visual acuity after treatment:

OD 0.05 with 0.1 correction

OS 0.02 with a correction of 0.05.

Example 4

Patient Yurchenkova A.S., 63 years old, medical history 180154-03, was treated at the NF FSI MNTK “Eye Microsurgery” from 08/10/07 to 10/17/07. Diagnosis: Hypertensive retinal angiopathy. Initial senile cataract OU.

Visual acuity before treatment:

OD 0.35 with 0.8 correction

OS 0.45 with a correction of 0.95.

The treatment was carried out by the claimed method: against the background of anti-inflammatory therapy, 7 laser puncture sessions were performed using laser radiation with a frequency of 18.15 Hz for paired points in the eye area VB 14, then for paired points of the head and collar zone VB 20, unpaired point T 20, then to distant paired points on the extremities GI 4, GI 11, TR 5, MC 6, RP 6 for 1 minute, the total exposure time of 15 minutes.

Visual acuity after treatment:

OD 0.5 with 1.0 correction

OS 0.55 with a correction of 1.0.

Using the proposed method will improve the effectiveness of the treatment of inflammatory and dystrophic diseases of the eyes, as well as expand the functionality of the method.

Claims (2)

1. A method for the treatment of inflammatory and dystrophic diseases of the eye, including drug treatment and laser exposure to the patient's BAT, characterized in that the patient's BAT is exposed to low-intensity laser radiation with a frequency of 8.0-73.0 Hz, or in a multi-frequency mode in the range of 1000 -3000 Hz with modulation, with a duration of exposure to one point from 20 s to 2 minutes, a total exposure time of 10-15 minutes, a course of 6-7 sessions in the following sequence: first they affect 1-6 points of local action in the eye area, selected from V 1, V 2, VB 1, E 1, VB 14, TR 23, PC 6, PC 3, E 2, E 3, then they affect 1-4 points of the head and collar zone selected from VB 16, VB 20, TR 20, TR 17, E 8, T 20, T 24, T 23, T 14, IG 15, then act on 1-5 distant points on the limbs selected from TR 5, GI 4, GI 11, C 5 , C 7, MC 6, IG 1, IG 2, V 63, VB 40, E 36, E 37, E 38, E 39, F 2, F 3, R 6, RP 6. 2. The method according to claim 1, characterized in that the laser effect on the patient's BAP is carried out on the apparatus LA3-EXPERT using a laser pen with a wavelength of 785 nm, a power of 30 watts.