RU2414938C1 - Method of treating patients suffering gastric and duodenal ulcer - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gastroenterology, and concerns treating the patients suffering gastric and duodenal ulcer. Simultaneously, the therapy involves noninvasive supervenous laser irradiation with the Azor-2K apparatus over a projection of a cubital vein in a bend of elbow and local transcutaneous irradiation within an ulcer defect with using the ADEPT-Euro laser apparatus in a quasi-frequency range. During the procedure, a patient is laid in a prone position or seated; the supervenous red laser blood irradiation with using the Azor-2K apparatus is executed within the cubital vein at wave length 0.63 mcm, power 50 mlWt in a continuous mode, an average dose in the given field for a procedure is 10 J. Simultaneously, a terminal of the ADEPT-Euro apparatus is placed on an abdominal wall over the ulcer defect; the exposure is characterised by frequency 30000 Hz and power 17 Wt in an impulse; over one procedure, the patient receives 10 J per a field. For the first 3-5 days, the integrated laser therapy is performed 2 times a day from 8 o'clock to 12 o'clock and from 16 o'clock to 18 o'clock, and a procedure interval makes not less than 4 hours, for the next days of therapy, the patients receive 1 procedure a day from 8 o'clock to 12 o'clock. The length of course exposure makes 10 days, the therapeutic course makes 10-15 procedures, average course irradiation dose for one patient makes 200-300 J.

EFFECT: method allows higher clinical effectiveness due to reduced length of symptomatology of a gastric ulcer to 5-8 days, cicatrisation of the ulcer defect at the end of the executed therapeutic course and non-detection of Helicobacter antibodies.

4 tbl, 1 ex

Description

The invention relates to medicine, namely to the section "gastroenterology", and for the treatment of patients with peptic ulcer (UB) of the stomach and duodenum (UBDP).

One of the problems of modern medicine is the rapid increase in the consumption of drugs of a specific action, including antibiotics. With prolonged use of drugs, allergic reactions occur, tolerance increases and refractoriness to drugs develops. All this determines the increasing interest of doctors in non-specific treatment methods that provide the necessary result indirectly, through an increase in the body's resistance.

The high prevalence of peptic ulcer of the stomach and duodenum, dissatisfaction with the treatment results in the need to find alternative methods of treatment, which can influence both local and general mechanisms of peptic ulcer. When using modern physiotherapeutic treatment, a search is made for non-invasive methods with a multilateral positive effect. It has been shown that laser transcutaneous blood irradiation is used to stimulate the immune system, enhance the regeneration of a peptic ulcer, enhance metabolic processes, normalize the gastrointestinal tract (GIT), obtain a general sedative effect, and relieve the main symptoms of the disease. Local exposure to a peptic ulcer is carried out in order to stimulate its regeneration, relieve pain symptoms, and normalize the digestive tract.

Laser radiation, penetrating into tissues, has a positive effect on the course of metabolic processes, enhances microcirculation of blood and lymph, stimulates the synthesis of nucleic acids, proteins, enzymes, normalizes general metabolism (V.E. Illarionov. "Basics of laser therapy", ed. Respect ", Moscow, 1993; V.E. Illarionov, reference book" Technique and methods of laser therapy procedures ", ed." Laser Market ", Moscow, 1994; V.I. Kozlov, V.A. Builin." Laser therapy ", Publishing House "Astr", Moscow, 1993). Having a general effect on the body, laser therapy causes clinical effects: anti-inflammatory, regenerative, desensitizing, analgesic, immunocorrective, bacteriostatic and bactericidal, improves regional blood circulation.

There is no data in the literature on the use of the quasifrequency range in the treatment of gastroduodenal ulcers. At the same time, positive effects in this range were noted in the treatment of trophic ulcers in diabetes mellitus, infectious ulcers. There are studies on the effective action of quasifrequency irradiation in metabolic disorders of the liver, kidneys and even in the combined treatment of cancer.

A known method of treating patients with peptic ulcer of the stomach and duodenum using combined exposure: cutaneous magnetic laser therapy (apparatus "Mustang-bio") and intravenous radiotherapy (apparatus "Mulat"); (Patent for the invention "A method for the treatment of patients with gastric ulcer and duodenal ulcer", application registration number: 2003133074/14, publication date: 2005.06.27). The disadvantage of this method of treatment is the use of an invasive method of laser therapy.

The closest in the set of essential features to the claimed invention is a method for the treatment of patients with ulceration of the stomach and duodenum, including the use of various methods of laser therapy (RT) (Myslovich L.V. Peptic ulcer of the stomach and duodenum: a comparison of the effectiveness of three methods of laser therapy. // Laser medicine . - 2001. - No. 5. - Issue 1. - S.38-39). This method was adopted as a prototype. The disadvantage of this method of treatment is the use of an invasive method of laser therapy.

The objective of the claimed invention is the use of a non-invasive method of laser therapy in combination according to the general and local methods with the aim of reducing the time of the main symptoms of peptic ulcer of the stomach and duodenum, and, as a result, shortening the bed / days to 3-5 days.

The task is achieved by the fact that at the same time a non-invasive supravenous laser irradiation with the Azor-2K apparatus is performed over the projection of the cubital vein in the elbow bend and local transcutaneous irradiation of the ulcerous defect area with the ADEPT-Euro laser apparatus in the quasi-frequency range is performed during the procedure in a supine or sitting position, supravenous blood irradiation with a red laser by the Azor-2K apparatus is performed in the region of the cubital vein with a wavelength of 0.63 microns, a power of 50 mW in continuous mode, average the dose to this field per procedure is 10 J, at the same time, the terminal from the ADEPT-Euro apparatus is located on the abdominal wall above the area of the ulcer defect, exposure is performed at a frequency of 30,000 Hz and a power of 17 W per pulse, the patient receives 10 J of energy per procedure on the field , the first 3-5 days, complex laser therapy is carried out 2 times a day from 8 to 12 hours and from 16 to 18 hours, and the interval between procedures is at least 4 hours, the following days of treatment, patients receive 1 procedure per day from 8 up to 12 hours, course duration ystviya is 10 days, the course is 10-15 procedures per course of patient radiation dose on average is 200-300 J.

The solution to the problem is achieved by adding to the standard therapy of peptic ulcer (UB) simultaneous irradiation of blood with a red laser in the region of the cubital vein using the so-called "laser complex" (LC): laser therapy apparatus "Azor-2K" and local transcutaneous irradiation of the ulcerous defect using laser device "ADEPT-Euro" in the quasi-frequency range.

In relation to the prototype of the claimed invention has the following distinctive features.

During the procedure, the patient is in a supine position or sitting. Able blood irradiation with a red laser by the Azor-2K apparatus is carried out in the region of the cubital vein with a wavelength of 0.63 μm and a power of 50 mW in a continuous mode. The average dose to this field per procedure is UJ. At the same time, the terminal from the ADEPT-Euro apparatus is located on the abdominal wall above the area of the ulcer defect. The exposure is carried out with a frequency of 30,000 Hz and a power of 17 watts per pulse. On the field, the patient receives 10 J of energy per procedure.

The course was 10-15 procedures. Thus, for a course the patient’s radiation dose averages 200-300 J.

The first 3-5 days, complex laser therapy is carried out 2 times a day (from 8 to 12 hours and from 16 to 18 hours). The interval between procedures is at least 4 hours. The following days of treatment, patients receive 1 procedure per day from 8 to 12 hours.

After 3 procedures, patients experienced drowsiness, weakness, a feeling of slight hunger, which was the criterion for a successful session. Subsequently, weakness disappeared with a simultaneous decrease in symptoms. In addition to general clinical studies, antibodies to Helicobacter pylori were determined in addition to general clinical studies as a control of the effectiveness of treatment for patients with UBJ and UBDPK.

Antibodies to Helicobacter pylori were determined using an enzyme-linked immunosorbent assay system to detect total antibodies to the CagA Helicobacter pilory antigen CJSC VECTOR-BEST (Novosibirsk).

The main property of the test system is the ability to detect specific immunoglobulins of classes M, A and G in human serum or plasma to the Cag Helicobacter pilory antigen due to their interaction with the recombinant antigen immobilized on the surface of the holes of a collapsible tablet (strips) and which is part of the conjugate.

The test system is designed to detect total antibodies (IgM, IgA and IgG) to the Cag Helicobacter pilory antigen in human serum (plasma) and is recommended for epidemiological screening of blood, diagnosis of diseases of the stomach and duodenum as the main part of a comprehensive examination of a patient with this pathology.

The antibody content was defined as weakly positive (+); positive (++) and strongly positive (+++).

Antibodies to Helicobacter pylori were determined before and after treatment, both in the group receiving only standard therapy and in the group receiving combination therapy.

As a control, a group of patients with ulcer who did not receive physiotherapeutic treatment was examined for antibodies to Helicobacter pylori.

Before treatment, in all patients during a simultaneous endoscopic examination of the stomach, single and multiple wall defects with a diameter of 0.6 to 2.9 cm were identified.All patients received standard pharmacotherapy: antibiotic therapy, ventr, squamate, almogel, motilak, omez, vitamin therapy.

Physiotherapeutic effects were added to the treatment of 63 patients with UBJ and 68 patients with UBDH using the general and local methods using laser devices Azor-2K and ADEPT-Euro.

At the same time, a non-invasive non-invasive intravenous laser irradiation with the Azor-2K apparatus was performed over the projection of the cubital vein in the elbow bend as a general effect and local transcutaneous irradiation of the ulcerous defect using the ADEPT-Euro laser in the quasifrequency range. During the procedure, the patient was in a sitting position and / or lying on his back, adrenal blood irradiation with a red laser by the Azor-2K apparatus was performed in the region of the cubital vein with a wavelength of 0.63 μm, a power of 50 mW in a continuous mode, the average dose in this field for the procedure - 10 J. At the same time, the terminal from the ADEPT-Euro apparatus was located on the abdominal wall above the area of the ulcer defect, the exposure was performed with a frequency of 30,000 Hz and a power of 17 W per pulse, the patient received 10 J of energy per procedure on the field. The first 3-5 days, complex laser therapy was carried out 2 times a day from 8 to 12 hours and from 16 to 18 hours, and the interval between treatments was 4-6 hours, the following days of treatment, patients received 1 procedure per day from 8 to 12 hours. The duration of the course exposure was 10 days, the course was 10-15 procedures, for the course the patient's radiation dose averaged 200-300 J.

Antibodies to Helicobacter pylori in dynamics: before and after treatment were determined as a control of the effectiveness of treatment for patients with ulcer.

We did not reveal differences in the dynamics of clinical indicators depending on the location of the ulcer and gender of the patients, but we revealed clear differences depending on the age of the patients.

In patients with ulcer up to 39 years, regardless of the severity of the course, the duration of the pain symptom was 10.11 ± 0.12 days (Table 1). Adding to the standard therapy the simultaneous use of the Azor-2K and ADEPT-Euro devices made it possible to stop this symptom within 2.02 ± 0.31 days (p <0.05 when compared with art. Therapy).

Symptoms such as bitterness in the mouth, heartburn and flatulence in patients with ulcer of this group who received only standard therapy continued, respectively, 15.04 ± 0.13; 10.21 ± 0.11 and 9.15 ± 0.16 days. Against the background of treatment with Azor-2K and ADEPT-Euro devices, the duration of each of these symptoms decreased to 2 days.

Gastrointestinal symptoms, frequent in ulcer, such as belching, loose stools, decreased appetite, and nausea lasted an average of 8 days against standard therapy. The use of a complex of laser devices “Azor-2K” and “ADEPT-Euro” made it possible to stop belching after 2.01 ± 0.23 days (p <0.05 when compared with the therapy), and the remaining symptoms after the first days physiotherapy.

The symptoms of the autonomic nervous system were also significantly reduced after the use of laser therapy. So, in patients with ulcer up to 39 years old, the headache lasted 9.16 ± 0.25 days, and after the addition of laser therapy passed through 2.02 ± 0.11 days (p <0.05 when compared with art therapy). Sleep disturbance on the background of standard therapy lasted 8.11 ± 1.14 days, and after laser therapy - 2.31 ± 0.15 days (p <0.05 when compared with art. Therapy).

Irritability and weakness with standard therapy continued, respectively, 7.92 ± 0.17 and 9.12 ± 0.12 days. Adding to the treatment of complex laser therapy reduced the duration of this symptomatology to 1 day.

In the group of patients with ulcer from 40 to 60 years, the use of two laser devices led to the following changes in the duration of clinical symptoms (Table 2).

The pain symptom in patients of this group against the background of standard therapy lasted 15.21 ± 0.12 days. The addition of laser-therapy devices Azor-2K and ADEPT-Euro reduced the duration of the pain symptom to 6.12 ± 0.21 days (p <0.05 when compared with art. Therapy).

Symptoms such as bitterness in the mouth and heartburn in patients of this age group lasted 15.16 ± 0.14 and 16.11 ± 0.17 days, respectively. The addition of laser therapy reduced the duration of this symptomatology to 7.43 ± 0.16 and 7.14 ± 0.16 days (p <0.05 when compared with art. Therapy).

Flatulence and belching bothered patients with ulcer of 40-60 years, respectively, 15.25 ± 0.10 and 19.26 ± 0.18 days. After laser therapy, flatulence stopped at 8.01 ± 0.11, and belching - at 9.01 ± 0.04 day of treatment (p <0.05 when compared with art. Therapy).

Against the background of standard therapy, the appetite in patients of this age group was restored on the 19.13 ± 0.29 day of treatment, and nausea disappeared by 16.15 ± 0.33 days, while with the addition of laser therapy these symptoms stopped at 8.12 ± 0. 22 day (p <0.05 when compared with art. Therapy).

Among the symptoms of the autonomic nervous system in patients with ulcer of 40-60 years, irritability lasted the longest against the background of standard therapy (19.32 ± 0.16 days). The addition of laser therapy to treatment reduced this symptom to 9.01 ± 0.42 days (p <0.05 when compared with art. Therapy). A little less on the background of standard therapy continued headache (18.32 ± 0.45 days). When laser exposure was added by the Azor-2K and ADEPT-Euro devices, the symptom stopped for 6.21 ± 0.31 days (p <0.05 when compared with art. Therapy). Sleep in patients of this age group on the background of standard therapy was restored on 12.27 ± 0.11 days of treatment, weakness disappeared on 10.16 ± 0.21 days, while when laser therapy was added, sleep recovery was 7.23 ± 0. 34 days, and weakness disappeared on 8.12 ± 0.33 days of treatment (p <0.05 when compared with art. Therapy).

In the AT study, we did not reveal differences in their content depending on gender, but differences were found depending on the location of the ulcer, shape and age (Tables 3, 4).

Helicobacter pylori antibodies were detected in all patients with UB, irrespective of gender, age, localization of the ulcer defect, and severity of the course before treatment. In patients with mild forms of ulcer in all age groups before treatment, AT were positive (++). After carrying out. the course of standard therapy in all age groups, the antibody titer decreased (+).

In the case of moderate severity of UJ, before treatment in patients of the age groups up to 20 years, 20-29, and 30-39 years old, the AT titer was evaluated as positive (++). In the other two groups (40–49 and 50–60 years), the AT titer was strongly positive (+++). After the course of standard therapy, in all age groups of patients with moderate form of UB, the AT titer decreased to positive (++).

In all patients with severe UJ, regardless of age before treatment, a positive AT titer (+++) was determined, which decreased to ++ after a course of standard therapy.

In patients with mild UBDHTK (Table 4), AT was not found in any of the age groups either before or after treatment.

In patients with moderate severity of ulcer disease in the first three age groups, the AT titer was regarded as weakly positive (+), and in the other two groups (40-49 and 50-60 years) - as strongly positive (+++). This ratio continued after a course of standard therapy.

In patients with severe form of YABDPK, the antibody titer was regarded as strongly positive in all age groups before treatment and against standard therapy (Table 4).

After the Azor-2K and ADEPT-Euro laser devices were added to standard therapy with physiotherapeutic treatment, antibodies to Helicobacter pylori completely disappeared in all patients, regardless of the localization of the ulcer process, the severity of the course, and age.

The proposed method was tested in 131 patients who were treated in the gastroenterological department 3 of the City Clinical Hospital of Astrakhan in the period 2006-2009. Clinical examples are given to illustrate the use of combined laser therapy to normalize the clinical symptoms and eradication of Helicobacler pylori in ulcer.

Example 1

Patient D., 37 years old, manager, (case history No. 5444/1357), was admitted to the gastroenterological department on September 22, 2007, was discharged on October 7, 2007.

Complaints of pain in the epigastric region 2-3 hours after eating, heartburn, belching, bitterness in the mouth, nausea, flatulence, poor sleep, irritability, headaches. Sick stomach ulcer 10 years. The last time she was treated in a hospital 3 years ago. The above complaints appeared 10 days ago. She was treated with a diet, took quamatel without effect. Heredity due to peptic ulcer is not burdened. Has no bad habits.

Objectively. The condition is satisfactory. Lowered power. The skin is of normal color, visible mucous pink. In the lungs, vesicular breathing. Heart sounds are clear. Heart rate 76 beats / min. HELL = 110/70 mm Hg The tongue is moist, evenly coated with a white coating. The abdomen of the correct form, participates in the act of breathing, painful in the epigastric region upon palpation. Liver on the edge of the costal arch. The spleen is not palpable. The chair is decorated, irregular.

Screening at admission. Blood analysis; Er-3.81 × 10 ¹² / l, HB-113 g / l, Tsp-0.8, L-4.3 × 10 ⁹ / l, n-2, s-44, l-50, m-4 , ESR-8 mm / hour. Fecal analysis: negative response to occult blood. Fractional study of gastric secretion:

fasting free HCL-178, total HCL-37; free basal secretion HCL-0, flow rate / hour-0; total HCL-12, flow rate / hour - 1.2 mg / equiv; stimulated secretion: free HCL (30, 45, 60 minutes) 30-4-10; flow rate / hour - 3.14 mg / equiv, total HCL (30, 45, 60 minutes) 50-10-20; flow rate / hour - 5.4 mg / equiv. FGDS from 09/23/2007: on the lesser curvature of the ulcer 0.7 × 0.3 cm. Helicobacter (3 microbial bodies in the field of vision) was revealed during histological examination of the biopsy material of the coolant.

Diagnosis: gastric ulcer in the acute stage, helicobacteriosis.

Treatment: omeprazole 20 mg 2 times a day, clacid 250 mg 2 times a day, metronidazole 500 mg 2 times a day. She received a course of complex laser therapy (devices "Azor-2K" + "ADEPT-Euro") for 10 days.

Complex therapy: Lasers "Azor-2K" + "ADEPT-Euro"

During the procedure, the patient was in a sitting position. Above-blood red laser irradiation with the Azor-2K apparatus was performed in the region of the cubital vein with a wavelength of 0.63 microns and a power of 50 mW in continuous operation. The average dose in this field per procedure is 10 J.

At the same time, the terminal from the ADEPT-Euro apparatus was located on the abdominal wall above the area of the ulcer defect. The exposure was carried out with a frequency of 30,000 Hz and a power of 17 watts per pulse. On the field, the patient received 10 J of energy per procedure.

The course was 10 procedures. Thus, the patient received an average dose of 200 J. per course.

The first 3 days, complex laser therapy was carried out 2 times a day (from 8 to 12 hours and from 16 to 18 hours). The interval between the procedures was 4-6 hours. The following days of treatment, the patient received 1 procedure per day from 8 to 12 hours.

After 3 procedures, the patient experienced drowsiness, weakness, a feeling of light hunger, which was the criterion for a successful session. Subsequently, the weakness disappeared with a simultaneous decrease in symptoms.

On the 2nd day of treatment of LC, complaints of pain in the epigastric region, heartburn, belching disappeared. By the 3rd day, the sleep returned to normal, the feeling of inner anxiety disappeared. By the time of discharge, the ulcer defect was healed according to the control FGDS.

Helicobacter pylori AT content

Admission Statement ++++ 0

In this clinical example, in a 37-year-old patient suffering from gastric ulcer for about 10 years, an exacerbation of peptic ulcer was noted upon receipt of severe clinical symptoms. The diet and the drug used for 10 days had no effect. The prescribed pharmacotherapy in combination with complex laser therapy, carrying out 10 procedures according to the general and local methods using the Azor-2K and ADEPT-Euro laser devices reduced the duration of the symptoms of peptic ulcer by 2–3 times, had an immunocorrective and regenerative effect and At the end of the course of treatment, complete healing of the gastric ulcer occurred, as evidenced by the control data of FGDS. A pronounced effect of the treatment on the eradication of Helicobacter pylori was noted according to the dynamics of the determination of antibodies, the content of which was not detected after a 10-day course of combined treatment - standard drug and laser complex therapy.

Example 2

Patient R., 64 years old (case history No. 4432/1298) was received on 04/04/08. Upon admission, she complained of severe epigastric pain about 20 minutes after eating, night pain, heartburn, nausea, dry mouth, decreased appetite, sleep disorder, irritability, frequent headaches. From the anamnesis it was found that for 15 years he has been suffering from peptic ulcer of the stomach. Every year in the period of exacerbation falls on treatment in a hospital. The last exacerbation notes 1 week before admission. An objective examination: Undernutrition, the skin is pale, visible pink mucous membranes. In the lungs, vesicular breathing. Heart sounds are clear. Heart rate-80 beats / min. HELL = 140/90 mm RT. Art. tongue of low humidity, coated at the root with a white coating. On palpation - pain in the epigastric region and the left hypochondrium. The liver and spleen are not palpable. From other organs and systems without pathological changes.

On FGDS from 04/06/08 g: According to the lesser curvature of the stomach, the ulcer is up to 1.0 cm, covered with fibrin. WPC bulb without features. Conclusion: Gastric ulcer.

Treatment: quamatel 40 mg 2 times a day, bismuth 0.8 mg 5 times a day, metronidazole 200 mg 5 times a day, tetracycline 250 mg 5 times a day.

She received a course of complex laser therapy (devices "Azor-2K" + "ADEPT-Euro") for 10 days.

Complex therapy: Lasers "Azor-2K" + "ADEPT-Euro"

During the procedure, the patient was supine. Above-blood red laser irradiation with the Azor-2K apparatus was carried out in the region of the cubital vein with a wavelength of 0.63 μm and a power of 50 ml W in a continuous mode. The average dose in this field per procedure is 10 J.

At the same time, the terminal from the ADEPT-Euro apparatus was located on the abdominal wall above the area of the ulcer defect. The exposure was carried out with a frequency of 30,000 Hz and a power of 17 watts per pulse. On the field, the patient received 10 J of energy per procedure.

The course was 15 procedures. Thus, for the course of the dose, the patient averaged 300 J.

For the first 5 days, complex laser therapy was carried out 2 times a day (from 8 to 12 hours and from 16 to 18 hours). The interval between the procedures was 4-6 hours. The following days of treatment, the patient received 1 procedure per day from 8 to 12 hours. After 3 procedures, the patient experienced drowsiness, weakness, a feeling of light hunger, which is the criterion for a successful session. ”Subsequently, the weakness disappeared with a simultaneous decrease in symptoms.

After the 6th session of physiotherapy, the patient recovered sleep, irritability disappeared, weakness disappeared. On the 8th day of physiotherapy, the pain symptom and gastrointestinal symptoms stopped.

By the time of discharge according to the results of the control of FGDS, the ulcer defect healed.

Helicobacter pylori AT content

Admission Statement ++++ 0

In this clinical example (15 years suffering from gastric ulcer with frequent exacerbations), the patient was especially pronounced with pain and upset by the autonomic nervous system; combined pharmacotherapy and complex laser therapy using a non-invasive general exposure to the Azor-2K apparatus and local transcutaneous exposure to a quasifrequency irradiator in the area of the ulcer defect using the ADEPT-Euro apparatus for 15 procedures, within 10 days the duration of the course of the clinical symptoms of peptic ulcer was reduced in the early days of the therapy, and by the end of the course of treatment, the gastric ulcer was completely healed, antibodies to Helicobacter pylori were not detected.

findings

The proposed method achieves the following positive effect:

- improving the treatment of patients with peptic ulcer of the stomach and duodenum, expressed in a significant reduction in the duration of the symptoms of peptic ulcer up to 5-8 days compared to the prototype, scarring of the ulcer at the end of the course of treatment and not detecting antibodies to Helicobacter pylori;

- reduction of patients in hospital by 2-4 k / days;

- rapid restoration of active working capacity and improving the quality of life, and non-invasiveness and painlessness of procedures, obtaining an early and noticeable effect in patients causes a positive reaction to this type of therapy.

Table 1 The duration of clinical symptoms in patients with ulcer up to 39 years who received complex therapy (standard therapy + laser complex) (days) (M ± m) Symptom Art. therapy Art. + LC Pain 10.11 ± 0.12 2.02 ± 0.31 * Headache, dizziness. 9.16 ± 0.25 2.02 ± 0.11 * Bitterness in the mouth 15.04 ± 0.13 2.12 ± 0.21 * Heartburn 10.21 ± 0.11 2.06 ± 0.24 * Flatulence 9.15 ± 10.16 2.11 ± 0.41 * Sleep disturbance 8.11 ± 1D4 2.31 ± 0.15 * Burping 8.82 ± 0.72 2.01 ± Q, 23 * Chair relaxation 8.17 ± 0.21 1.51 ± 0.51 * Irritability 7.92 ± 0.17 1.06 ± 0.17 * Weakness 9.12 ± 0.12 1.32 ± 0.11 * Decreased appetite 8.10 ± 0.24 1.42 ± 0.23 * Nausea 8.11 ± 0.16 1.13 ± 0.21 * * p <0.05 when compared with art. therapy

table 2 The duration of clinical symptoms in patients with ulcer from 40 to 50 years depending on the treatment (standard therapy + laser complex) (days) (M ± m) Symptom Art. therapy Art. + LC Pain 15.21 ± 0.12 6.12 ± 0.21 * Headache, dizziness. 18.32 ± 0.45 6.21 ± 0.31 * Bitterness in the mouth 15.16 ± 0.14 7.43 ± 0.16 * Heartburn 16.11 ± 0.17 7.14 ± 0.16 * Flatulence 15.25 ± 0.10 8.01 ± 0.11 * Sleep disturbance 12.27 ± 0.11 7.23 ± 0.34 * Burping 19.26 ± 0.18 9.01 ± 0.04 * Chair relaxation 8.17 ± 0.13 6.12 ± 0.53 * Irritability 19.32 ± 0.16 9.01 ± 0.42 * Weakness 10.16 ± 0.21 8.12 ± 0.33 * Decreased appetite 19.13 ± 0.29 8.12 ± 0.22 * Nausea 16.15 ± 0.33 8.12 ± 0.14 * * p <0.05 when compared with art. therapy

Table 3 The content of AT for Helicobacter pilory in patients with ulcer, depending on age, course and treatment (standard therapy + laser complex) Age Light form Moderate form Heavy form Before treatment Art. therapy Art. + laser Before treatment Art. therapy Art. + laser Before treatment Art. therapy Art. + laser Up to 20 ++ + 0 ++ ++ 0 +++ ++ 0 20-29 ++ + 0 ++ ++ 0 +++ ++ 0 30-39 ++ + 0 ++ ++ 0 +++ ++ 0 40-49 ++ + 0 +++ ++ 0 +++ ++ 0 50-60 ++ + 0 +++ ++ 0 +++ ++ 0 The control 0 0 0 0 0 0 0 0 0

Table 4 The content of AT for Helicobacter pilory in patients with UBDDK depending on age, course and treatment (standard therapy + laser complex) Age Light form Moderate form Heavy form Before treatment Art. therapy Art. + laser Before treatment Art. therapy Art. + laser Before treatment Art. therapy Art. + laser Up to 20 0 0 0 + + 0 +++ +++ 0 20-29 0 0 0 + + 0 +++ +++ 0 30-39 0 0 0 + + 0 +++ +++ 0 40-49 0 0 0 +++ +++ 0 +++ +++ 0 50-60 0 0 0 +++ +++ 0 +++ +++ 0 The control 0 0 0 0 0 0 0 0 0

Claims (1)

A method for the treatment of patients with peptic ulcer of the stomach and duodenum, including the use of drugs and laser therapy, characterized in that they simultaneously conduct non-invasive supravenous laser irradiation with the Azor-2K apparatus over the projection of the cubital vein in the elbow bend and local transcutaneous irradiation of the ulcerous defect using laser apparatus "ADEPT-Euro" in the quasi-frequency range, during the procedure the patient is in a supine position or sitting, pressure-induced irradiation of blood with a red laser rum apparatus "Azor-2K" is carried out in the region of the cubital vein with a wavelength of 0.63 μm, a power of 50 mW in continuous mode, the average dose to this field per procedure is 10 J, at the same time the terminal from the ADEPT-Euro apparatus is located on the abdominal wall over the area of a peptic ulcer, the effect is carried out with a frequency of 30,000 Hz and a power of 17 watts per pulse, the patient receives 10 J of energy per procedure on the field, the first 3-5 days, complex laser therapy is carried out 2 times a day from 8 to 12 hours and 16 to 18 hours, and the interval between procedures is at least 4 hours, the following days of treatment, patients receive 1 procedure per day from 8 to 12 hours, the duration of the course exposure is 10 days, the course is 10-15 procedures, for the course the patient’s radiation dose averages 200-300 J.