RU2383369C2 - Ter-asaturov's method of controlling tone of microcirculatory channel vessels - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: local exposure of examined area to alternating magnetic field is realised. Frequency of exposure is selected from spectrum of frequencies of spontaneous ascillation of microcirculatory channel vessels, limited by range 10-30 Hz. In order to reduce increased tone exposure is carried out at dominating frequency, and in order to increase tone - exposure is carried out on frequencies, not less than 1 Hz different from frequency of registered spectrum of spontaneous oscillation.

EFFECT: method extends arsenal of means for controlling tone of microcirculatory channel vessels.

3 dwg, 3 ex

Description

The invention relates to medicine, namely to means of functional diagnostics and management of peripheral hemodynamics.

The inventive method and device are designed to determine spontaneous fluctuations of the vessels of the microvasculature and control their tone by exposure to an alternating magnetic field with a selected frequency.

The prior art (RF patent No. 2069572) is known for the treatment of vascular diseases of the extremities by regulating central and peripheral hemodynamics and a device for conducting magnetic therapy.

The known device consists of a power source, a pulse generator of an adjustable pulse frequency, including a pulse frequency ratio unit and a background regulator.

In the implementation of the known method, the patient is placed in a magnetic field generated using a known device, and for 20 minutes the field is applied with a magnetic induction value of 0.5 to 5 mT, with an individually selected frequency synchronized with the patient’s heart rate, and vector of magnetic induction, unidirectional with the vector of the main blood flow.

This effect is produced within 10 sessions. In the next 10 sessions, in order to prevent the adaptation reaction from becoming addictive while maintaining all of the above field parameters, one more effect of a constant magnetic field with a magnetic induction value of up to 100 of the value of a traveling pulsed magnetic field is added, i.e. the traveling wave is formed on a constant "magnetic background", the vector of which is equally directed with the vector of the traveling pulsed magnetic field.

It should be noted that the effect of improving blood flow under the influence of vibrational effects was noted by many researchers (see, in particular, Prince IK Razumov "Fundamentals of the theory of the energy effects of vibrations on humans", M .: Medicine, 1975). In the case of using known means, the effect of improving blood flow is achieved by modeling the self-oscillations of the pulse wave, causing an increase in the pressure gradient in the direction of blood flow. However, as the pulse wave propagates from the central region to the pressure gradient, it changes significantly towards a decrease up to small (less than 1 mm in diameter) vessels, where the pressure drops sharply.

Thus, in the case of using known means, the expected effect of improving peripheral blood flow may not be achieved due to the fact that the blood flow velocity and the pressure correlated with it will be minimal in this area.

The researchers also found that hemodynamic processes are accompanied by other oscillatory phenomena, whose frequency characteristics significantly exceed the heart rate. Such phenomena are caused by the natural oscillations of the vessels, the frequency of which is strictly individual. It was noted that the vibration effect with the frequency of the natural oscillations of the vessels leads to an extreme acceleration of blood flow.

When developing the proposed inventions, the problem of modeling the physiological mechanisms of regulation of peripheral blood flow at the level of spontaneous high-frequency oscillations of pulsating vessels was solved.

The inventive device and method are intended to enhance or suppress the natural mechanisms of hemodynamics by regulating the tone of the vessels of the microvasculature by exposure to an alternating magnetic field with an individual frequency of natural oscillations of the vessels and diagnosing the natural frequency of the vessels of the microvasculature by Fourier spectrometry photoplethysmogram.

If necessary, normalize the vascular tone index of the microvasculature using a vibrational effect on a portion of the patient’s body at the dominant frequency of the spectrum of spontaneous vascular oscillations in the range of 10-30 Hz. If necessary, to increase the vascular tone index, local vibration is applied at a frequency that differs from the recorded frequencies of the spectrum of spontaneous vascular oscillations by at least 1 Hz.

It should be noted that, in contrast to known means, such an impact is local, short-term in nature. Given the indicator of the patient's magnetotropy (individual reactivity to the magnetic field), the local principle of exposure used in the claimed invention minimizes the negative consequences for the patient in comparison with the known means.

The inclusion of a digital photoplethysmograph with a specifying function in the circuit of the inventive device solves the complex task of diagnosing the state of the vessels of the microvasculature, generating the parameters of the electromagnetic field individually for each patient, and monitoring the information exchange with the patient’s body — the patient’s response to electromagnetic effects.

The technical result achieved by the implementation of the invention is to regulate peripheral blood flow by adjusting the vascular tone index of the peripheral region.

The invention consists in the following.

When implementing the proposed method, the vascular tone of the microvasculature is controlled by local exposure to this area for 15 minutes by an electromagnetic emitter with a frequency selected in the range of 10-30 Hz from a previously recorded frequency spectrum of spontaneous vessel fluctuations in the studied area. Registration of all the main parameters of the blood flow of pulsating vessels of the microvasculature is carried out in an automated mode in real time using a photoplethysmograph with a spectrometer, which is part of the inventive device.

In medicine, photoplethysmographs are widely used, which record the change in the brightness of the light transmitted through the test tissue, which is traditionally regarded as a characteristic of the volume of transmitted blood over time. Usually, based on this dependence, a differential photoplethysmogram (dI / dt) is constructed, which reflects the speed of blood in the tissue under investigation. There are a number of methods for analyzing these curves, based on finding characteristic points in each pulse of blood movement and calculating certain criteria based on them that characterize the state of the circulatory system, its tone, etc.

When implementing the proposed method, the device registers directly the differential signal of the brightness of light (dI / dt) passing through the test tissue. After computer processing, three time-consistent harmonic curves are displayed on the monitor: a graph of the initial differential signal of light brightness (dI / dt), which reflects the volume of transmitted blood in time; the second graph obtained by integrating the initial differential signal of light brightness (dI / dt) is a direct photoplethysmogram reflecting the speed of blood in the tissue under study (the horizontal axis of the graph shows the frequency of the signal bands (in hertz), and the corresponding coefficients on the vertical axis to _i . When integrating the initial differential signal (dI / dt), the photoplethysmogram is automatically cleaned from noise.

The third graph is the result of differentiation of the original differential brightness signal, i.e. (dI ² / dt ² ), reflecting the change in acceleration (a) of the pulsating blood flow over time. This graph can also be interpreted as a change in the strength of the beat of the pulse over time.

Researchers have identified the property of activating the functions of an organ or organ system in response to neuro-reflex or humoral stimuli that cause a change in the metabolism of their constituent tissues. It was found that a change in the chemistry of tissues leads to a change in the mechanical properties of organ tissues, including an increase in transmural pressure of blood vessels in a certain area. The effect of an increase in transmural pressure of blood vessels is accompanied by an increase in the number of their collapses after a pulse wave travels through them. As a result of the collapse of blood vessels, self-oscillations of their walls occur, which leads to an acceleration of pulse blood flow and an increase in volumetric blood flow. As tissue trophism and oxygenation normalize, their mechanical parameters and the transmural pressure depending on them gradually return to the initial value. In proportion to the decrease in the level of transmural pressure, the number of vessels in the microvasculature decreases, in which there are processes leading to their self-oscillating oscillations, until their intensity approaches the level corresponding to the resting blood flow.

When implementing the proposed method, an increase or decrease in the effect of self-oscillations of blood vessels is achieved due to local vibration exposure by an electromagnetic emitter with an individual frequency of natural oscillations of the vessels, automatically selected according to the results of computer processing of the three graphs.

If necessary, to normalize the increased vascular tone index of the microvasculature in a separate area of the body, local vibration is applied at the dominant frequency, selected in the range of 10-30 Hz of the harmonic spectrum of spontaneous oscillations of the microvasculature.

If it is necessary to increase this indicator, local vibration is applied at frequencies different by no less than 1 Hz from the frequencies of the spectrum of spontaneous vessel oscillations in a given region.

The effect of changes in vascular tone index, gradually decreasing, lasts about 1 hour.

A device for controlling the vascular tone of the microvasculature consists of a digital photoplethysmograph with a spectral function and an electromagnetic emitter with a magnetic field frequency of 8 to 200 Hz, with a strength of not more than 150 mT. The photoplethysmograph is based on a signal microprocessor, which includes an analog-to-digital converter, with a photosensor connected to it. The microprocessor provides control of the operating modes of the photosensor, registration of changes in the brightness signal in the frequency range from 0 to 300 Hz, digitization and accumulation of data in RAM, interaction with the control program of a personal computer. To a personal computer in series through a sinusoidal signal generator, made on the basis of a signal microprocessor, and an electromagnetic emitter with an inductor is connected through a power amplifier.

The parameters of the signal generation by the sinusoidal signal generator are controlled using a personal computer according to a specially developed program. The frequency range of the generator lies in the range from 0.01 Hz to 50 kHz. The amplitude of the generated signal can be adjusted within 2..600 mV.

For the operation of the device, a photoplethysmograph and an electromagnetic emitter are switched with a computer and a power source is connected.

The photocell, made in the form of an opto-pair, is fixed on the studied area of the body. Modulated (at constant brightness) red light with a wavelength of 0.62 microns is passed through the tissues of the test site. Unlike other light sources, such light does not change the state of the microvasculature.

The change in time of the luminance signal along the path between the emitting LED and the photodetector is recorded. To ensure higher signal-to-noise characteristics, the photoplethysmograph of the claimed device does not register absolute fluctuations in the brightness of transmitted light, but its rate of change (dI / dt), i.e. differential photoplethysmogram.

A high-speed microprocessor provides control of the operating modes of the photosensor, registration of an array of data, their digitization and accumulation in RAM with subsequent transfer to a personal computer for processing and displaying three graphs on the screen.

The differential photoplethysmogram carries complex information about the dynamics of blood movement in the tissue under study, and is also, inevitably, complicated by extraneous noise signals due to random oscillations of the photosensor, illumination of the studied region from external light sources (lighting devices, monitor screen, etc.) as well as electrical interference. To suppress noise and extract a useful signal from a digitized array of primary data, the direct and inverse Fourier transforms of the signal are used.

This method allows you to get a set of coefficients k _i characterizing the intensity of the harmonic components of the processed data array. In graphical form, the dependence of the amplitude k; from their respective frequencies (amplitude-frequency characteristic) is known as the Fourier spectrum and allows you to judge the structure of the signal under study. For the photoplethysmogram signal, the main harmonic should be the heart rate (about 1 Hz), and the rest appear as high and low frequency “overtones” of this rhythm or as technogenic noise. Frequency bands of 50 and 100 Hz, as a rule, are associated with the possibility of interference from AC networks. These pickups can be included in the signal along the power circuits of the device-computer complex, but mainly due to the light from the lamps fed by alternating current and the screen of the computer monitor. The latter factor gives a characteristic narrow band in the indicated interval, the frequency of which depends on the model and monitor settings (for example, 75 or 85 Hz). The intrinsic noise of the electronic unit and the photosensor can occur in the entire operating frequency range from 0.1 Hz to 400 Hz. They are random in nature of white noise and their level depends mainly on the brightness of the recorded signal and the selected gain K _y : the weaker the signal and higher K _y - the more noticeable the noise.

To clean from industrial noise, a direct Fourier transform of the digitized signal is performed and the coefficients k _i characterizing the intensity of the harmonic components of the processed data array for frequencies in the vicinity of 50 and 100 Hz are reset. Then, with the corrected array of coefficients k _i , the inverse Fourier transform is performed, the result of which is the restored brightness signal, freed from network interference and displayed on the monitor. The filter bandwidth can be adjusted depending on the result.

To clean the photoplethysmogram from broadband white noise, the Dolby filtering principle is used.

The efficiency of the Dolby filter depends on the filtering threshold, which is either set or calculated automatically as the average signal level at frequencies above 200 Hz (white noise registration area). All harmonics, the amplitude of which is below a given threshold, are reset, which ensures that the spectrum is cleaned of weak signals without affecting the main data array.

After a 10-second exposure, three time-consistent diagrams are displayed on the monitor:

- graph of the initial differential signal of light brightness (dI / dt - in arbitrary units);

- a graph of the Fourier spectrum (direct photoplethysmogram), the horizontal axis of which shows the frequency of the signal bands (in hertz), and the vertical axis shows the corresponding coefficients to _i ;

- a graph of the change in acceleration (a) of the pulsating blood flow over time.

Based on the data obtained, an automatic search for the characteristic points of the curves and their color indication in the diagrams is performed.

The dominant frequency from the frequency spectrum of spontaneous oscillations of the studied vessels in the range of 10-30 Hz, which are clear peaks of the graph curve, or a frequency that differs from the recorded spectrum frequencies by at least 1 Hz, is used to adjust the vibration frequency of the electromagnetic emitter.

The selected computer signal through the sinusoidal signal generator is fed to a power amplifier, which provides amplification of the generator signal to an operating voltage that is consistent with the design of the inductor so that at a maximum signal of the generator at a frequency of 50 Hz, an inductance of about 30 mH is provided. The operating inductance of the coil will depend on the selected frequency of the signal. But in the range of 10 ... 100 Hz it will remain relatively constant.

The inclusion of a microprocessor with a photosensor in the circuit of the device allows you to study the response (of the patient) in the process of performing electromagnetic exposure.

Examples of carrying out the invention

Example 1

Patient T., 72 years old. Diagnosis: Stage 2 hypertension, exertional angina. HELL 200 and 110 mm Hg

The data of PPG measurements in the area of the nail phalanx of the third finger of the right hand.

T f b Pulse Ad but at b 0.8 0.1 0.71 76.1 745.1 70.7 0.08 483.6 Title = 90.2%, where T - cycle time
f - time of rapid blood supply
b - the ascending time of the ascending part
Pulse - heart rate
Ad - differential FPG amplitude
a - amplitude of rapid blood supply
at - time of the decline of the downward part
b - amplitude of maximum blood supply
PTS - an indicator of vascular tone

The patient's vascular tone index (PTS) is significantly higher than normal.

Figure 1. Spontaneous fluctuations in the vessels of the ICR of patient T. in the range of 10-30 Hz.

On the graph (figure 1), a lot of narrow-band peaks are determined, occupying almost the entire range of 10-30 Hz and having an intensity of 180,000-100,000 cu

Of the narrow-band peaks shown on the graph, the one with the maximum amplitude of 180,000 units was selected. (dominant), marked with the symbol M (Max) at the upper boundary of the graph (15 Hz).

After a 15-minute exposure to an alternating magnetic field with a frequency of 15 Hz and an intensity of 25 mTl on the area of the right hand of the TCP (it was 90.2% - became 28.3%) and other PPG indicators changed sharply towards normalization:

T f b Pulse Ad but at b 0.8 0.12 0.22 76.3 1.84 0.18 0.57 0.3 Title = 28.3%.

Example 2

Patient T., 47 years old. Almost healthy. DifFPG region of the nail phalanx of the third finger of the left hand showed the following results:

T f α Puis Ad a β b Average 0.831 0.129 0.262 72,2 14.02 1,252 0.569 2,351 Title = 31.5%

They indicate the normal function of the ICR, including TCP. In this case, the following frequencies of spontaneous oscillations of the vessels of the ICR were recorded (figure 2).

Figure 2. Spontaneous fluctuations in the vessels of the ICR of patient T. in the range of 10-30 Hz.

At one of the frequencies (18 Hz) present on the graph of the harmonics of the DifPH signal (Fig. 2), a 15-minute session of vibrational impact on the palm area of the left hand was performed. DifFPG of the studied tissue area recorded the following indicators:

T f but Puis Ad a β b Average 0.842 0.128 0.259 71.2 8.62 0.787 0.584 1,415 Title 30.7%

Their comparison with the background states a slight decrease in the TCP with adequate changes in other parameters.

The example demonstrates the absence of the effect of increasing the initially normal vascular tone (PTS = 31.5%) if the conditions (paragraph 3) are not met about the need for this to be affected by a frequency that differs from any of the histograms by at least 1 Hz. In this example, the effect was carried out at a frequency present in the histogram - 18 Hz (figure 2).

Example 3

Patient N. 34 years. Almost healthy. Studies of ICR in the manner described earlier stated the results indicating the absence of pathological changes:

T f α Puis Ad a β b Average 0.895 0.128 0.284 67.1 7.57 0.706 0.611 1,283 Title = 31.8%

Figure 3. Spontaneous oscillations of the vessels of the ICR of patient N. in the range of 10-30 Hz.

Spontaneous oscillations of the vessels of the ICR are represented by low-amplitude peaks located in the lower part of the observation spectrum (figure 3). A 15-minute vibration at a frequency of 18 Hz (absent in the frequency spectrum) led to a sharp increase in PTS and an adequate degree of increase in blood flow resistance of other DifPH indicators.

T f α Puis Ad a β b Average 0.889 0.14 0.81 67.5 712.0 58.8 0.08 463.63 Title = 91.0%

The example illustrates an increase in the initially normal vascular tone (almost threefold) when exposed to PeMP with a frequency (18 Hz) that differs from the frequencies (10-11.5) presented in the histogram by no less than (more) than 1 Hz.

Claims (1)

A method for controlling the vascular tone of the microvasculature (ICR), including local exposure to the investigated area with an alternating magnetic field, characterized in that the frequency of exposure to the magnetic field is selected from the frequency spectrum of spontaneous oscillations of the ICR vessels, limited to a range of 10-30 Hz; in order to reduce the increased tone, the effect is carried out at the dominant frequency, and to increase the tone, the effect is carried out at frequencies different from the frequencies of the recorded spectrum of spontaneous oscillations by at least 1 Hz.

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