RU2433785C1 - Device for thermo- and photochromo-ultrasonic processing of biotissues - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment, namely to devices for thermo- and photochromo-ultrasonic therapy. Device contains ultrasonic generator, made with possibility of continuous or non-continuous generation of ultrasound, acoustic system, located in bearing case. The latter includes electromechanical converter from ring piezoceramic elements, reflecting overlay, concentrator of mechanical fluctuations and connected with it waveconductor with developed irradiating butt end for contact low-frequency ultrasonic processing of biotissues through technological padding, impregnated with ozone/NO-containing medicinal substance. Waveconductor-instrument is made in form of thin-walled unilaterally convex disk-shaped irradiator, located axis-symmetrically with respect to central axis of acoustic system and connected on its internal generatrix with concentrator of mechanical fluctuations. Concentrator represents disk-shaped conical-cylindrical element, provided from the side of larger base with cavity in form of paraboloid of rotation, and on smaller base generatrix thread for connection of reflecting overlay is made. Overlay consists of sleeve nut and support disc with ring projection and compresses ring piezoceramic elements between support disk and concentrator of mechanical fluctuations. Device is provided with ring light-diode matrix with evenly distributed on it semiconductor light-diodes, irradiating continuously or non-continuously through holes made on butt end of bearing case and located outside disk-shaped irradiator of wave-conductor-instrument. Light-diode matrix irradiates together with ultrasonic impact on biotissues, both in visible spectrum zone and in the nearest infra-red and ultraviolet regions. On butt end of bearing case installed is elastically deformed detachable protective screen, whose internal surface possesses possibility to reflect irradiations of semiconductor light-diodes.

EFFECT: application of device will make it possible to increase efficiency of treating inflammatory processes and complicated wounds by complex impact with low-frequency ultrasound, thermal radiation, light-diode radiation in combination with highly active ozone-containing medicinal substances.

1 cl; 11 dwg

Description

The invention relates to medical equipment, in particular to devices for processing biological tissues, and can be used in complex thermo- and photochromic-ultrasound therapy, for example, acute and chronic inflammatory processes complicated by postoperative wounds in various branches of clinical medicine.

The complicated course of the inflammatory or wound process with the addition of a wound infection leads to social-labor, physical and psychological maladaptation, an increase in the duration and cost of treatment. Factors leading to impaired reparative tissue regeneration are the chronicity of the process, extensive surgical trauma, edema, tissue ischemia, impaired microcirculation of blood and lymph systems, local and general immunity disorder, resorptive endogenous intoxication, pain syndrome, etc. Concomitant diseases, such as hyperlipoprotenemia, chronic heart failure, diabetes mellitus, a tumor process, etc., together with the above factors, create conditions for an unfavorable course of inflammatory and wound processes, manifestations of pain. Effective treatment of chronic inflammatory processes and wounds of various etiologies, including those arising after the combined treatment of tumors, can be achieved through a complex effect on the contents of the focus of infection, as well as activation of mechanisms for the active regeneration of biological tissues by using various physical factors in a single technological treatment process with highly active medicinal substances during optimization of technological schemes of energy and material effects on the wound at a time s phases of wound healing. The above requires the development of modern medical technologies for the treatment of complicated wounds, as well as technical means for their implementation.

Known devices for photo-ultrasonic treatment of biological tissues, containing an ultrasonic generator and an acoustic system located in a supporting body, including an electromechanical transducer, a mechanical vibration concentrator and a radiating waveguide tool connected to it, an electromagnetic radiation source (laser radiation), a hydraulic system for feeding into the wound site and removal of a medicinal solution, including a photosensitizer-detoxifier, providing ultrasonic treatment of biological tissues of the focus of infection and pathogenic microorganisms through an intermediate solution of a photosensitizer-detoxifier, followed by its removal and irradiation of the wound with electromagnetic radiation (monochrome laser radiation - red emission spectrum) [1, 2].

However, the design schemes of the known devices are mainly intended for the integrated treatment of biological tissues of the wound at the first stage of the wound process - the phase of inflammation, and cannot be used in the treatment of wounds in the second phase of the wound process - the regeneration phase, where it is necessary to ensure, in a single technological treatment process wounds, treatment of biological tissues of the focus of infection by complex exposure to the wound by physical factors, for example, contact low-frequency ultrasound, semiconductor LEDs emitting irregularly or intermittently, together with the ultrasonic effect on biological tissues, in a narrow band of the spectrum both in its visible part - red, yellow, green, blue, and in the near - infrared and ultraviolet regions of the spectrum, in combination with highly active medicinal substances (for example, ozone / NO-containing medicinal substances).

The closest in technical essence and the achieved result to the claimed invention is a device for ultrasonic treatment of biological tissues, containing an ultrasonic generator configured to continuously or discontinuously generate ultrasound, an acoustic system placed in a bearing housing, including an electromechanical transducer from ring piezoceramic elements, reflecting the pad, mechanical vibration concentrator and a waveguide-tool connected to it with a developed radiating rts for contact low-frequency ultrasonic treatment of biological tissues through a technological pad impregnated with ozone / NO-containing medicinal substances [3].

However, this device, designed to implement one of the stages of liposuction, superficial liposuction, is not multifunctional and cannot be used to increase the effectiveness of the treatment of inflammatory processes and complicated wounds, implemented in a single technological process, by a complex effect on the contents of the focus of inflammation or wounds such pathogenetically substantiated physical and physicochemical factors such as low-frequency contact ultrasound, thermal (infrared) radiation, and radiation ix visible parts of the spectrum, as well as near infrared and ultraviolet light regions of semiconductor LEDs in combination with highly active ozone / NOx-containing medicinal substances that promote active regeneration of tissues and, consequently, reduce the treatment time. The known device has disadvantages associated with the complexity of manufacturing an acoustic system, its significant weight and the use of such material-intensive components of the acoustic system as a reflective pad and a mechanical vibration concentrator from expensive materials such as stainless steel or titanium alloys mated to a waveguide-tool having a developed emitting end, but a small amplitude of the waveguide-tool oscillations (not more than 3-5 microns), insufficient for the effective contact low-frequency ultrasonic treatment of pathologically altered biological tissues.

The objective of the invention is to provide a multifunctional device that improves the treatment of inflammatory processes and complicated wounds by the combined effect of high-amplitude, low-frequency ultrasound, heat radiation and LED radiation in combination with highly active ozone / NO-containing medicinal substances on the contents of the inflammation site or wound.

The objective of the invention is achieved in that in a device for complex thermo- and photochromic-ultrasonic treatment of biological tissues, containing an ultrasonic generator configured to continuously or discontinuously generate ultrasound, an acoustic system placed in a bearing housing including an electromechanical transducer made of ring piezoceramic elements that reflects the patch , a hub of mechanical vibrations and a waveguide-tool connected to it with a developed emitting end for a contact low frequency ultrasonic treatment of biological tissues through a technological pad impregnated with ozone / NO-containing medicinal substance, characterized in that the emitting waveguide tool is made in the form of a thin-walled one-sided convex disk-shaped emitter located axisymmetrically to the central axis of the acoustic system, connected along its internal generatrix with a mechanical vibration concentrator representing a disk-shaped conical-cylindrical element provided with a cavity on the side of the large base in the form of a paraboloid of revolution, and on the generatrix of the small base, a thread is made for attaching a composite reflective lining, consisting of a union nut and a support disk with an annular protrusion, compressing the piezoelectric ceramic elements between the support disk and the mechanical vibration concentrator, in addition, the device is equipped with an LED ring matrix with semiconductor LEDs uniformly distributed over it, radiating through holes made at the end of the supporting body and located outside the disk image of a powerful emitter of a waveguide-tool, continuously or intermittently, together with ultrasonic action on biological tissues both in the visible region of the spectrum: red, yellow, green, blue, and in the near infrared and ultraviolet regions of the spectrum, while elastically deformable is installed at the end of the carrier body removable protective screen, the inner surface of which has the ability to reflect the radiation of semiconductor LEDs.

A patent search showed that, at the filing date of the application for the invention, high-tech and multifunctional devices for thermo- and photochromic-ultrasonic treatment of biological tissues with the indicated distinctive features that provide, in a single technological cycle of treatment, a complex, or individually continuous or intermittent effect on the focus, are not known infections with high-amplitude contact low-frequency ultrasound, thermal radiation, LED radiation as in the visible part of the spectrum - red, yellow, green, blue, and in the near infrared and ultraviolet regions of the spectrum in combination with highly active ozone / NO-containing medicinal substances that contribute to the regeneration of biological tissues and accelerate healing, and therefore, reduce treatment time by initiating processes: extraction of pathological contents from the focal area infections and impregnations of medicinal substances in them, pronounced bactericidal, fungicidal and virucidal effects, increased blood and lymph circulation, detoxification, immunocorre tion, analgesia and so on.

The advantages of the device for the integrated thermo- and photochromic-ultrasonic treatment of biological tissues are justified by the fact that the proposed technical solution provides the possibility of implementing each of these physical and physico-chemical factors that realize properties and indicators that are significant for the successful solution of the problem of the invention.

1) Contact heat treatment of biological tissues in the field of high-amplitude ultrasound (V.V. Pedder et al., 1980), using the low-frequency range of ultrasound (f = 26.5 kHz and f = 44 kHz), implements the thermal effect of ultrasound associated with one hand, with damping the energy of ultrasonic vibrations in the acoustic system and axisymmetric heating of the contact zone at the “waveguide-tool-biological tissue” interface, the severity of which is determined by the difference in the acoustic impedances of the contacting media in the zone of contact sounding of biological tissues and, on the other hand, with the absorption of high-frequency mechanical energy, its dissipation by biological tissues due to internal friction, followed by conversion into heat. Since in the proposed device design the conversion of high-frequency mechanical energy into thermal energy is, first of all, accompanied by heating of the “waveguide-tool-biological tissue” interface, a gradual increase in the temperature of the contact sounding zone of biological tissues and biological tissues themselves in the region of the infection site contributes to 40-45 ° С severe hyperemia of the skin, increased microcirculation (lymph and blood flow), activation of biochemical reactions and immunity, as well as metabolic and regeneration processes, increased diffusion processes removing toxins from the deep layers of tissues in infection hearth, analgesia, heat and vibrovolnovomu razvoloknyayuschemu effect on densified and sclerotic tissue, reduces the risk of formation of rough scars kelloidov contractures and so on.

2) Surface contact high-amplitude ultrasonic treatment of biological tissues (V.V. Pedder, 1980 and others), using the low-frequency range of ultrasound (f = 26.5 kHz and f = 44 kHz), implements a multifunctional effect on the lesion that is gentle on surrounding tissues infection and is a special case of ultrasonic sanitation of the focus of infection through an intermediate drug solution (A.A. Orlova, 1975; G.A. Nikolayev, V.I. Loshchilov, 1980). It provides activation of reparative processes in the biological tissues of the focus of infection and surrounding tissues by means of their surface contact high-amplitude sounding both directly and through a capillary-porous technological pad impregnated with a solution of the drug substance. In this case, a complex of physical, physicochemical and biological processes is initiated in the field of powerful low-frequency ultrasound: absorption of ultrasound by the medium and its heating (thermal effect), cavitation, acoustic flows, alternating sound pressure, sound-capillary and sound-chemical effects, etc., in turn, affecting the processes occurring at the “waveguide-instrument-drug solution-biological tissue” interface, as well as in heterogeneous systems of biological objects and biological tissues, leading to high-quality surface repair p from residues of necrotic masses, fibrin deposits, wound detritus, etc., inactivation of pathogenic microflora, extraction of pathological contents from the focus of infection, impregnation of medicinal substances deep into biological tissues, axisymmetric heating of the contact zone at the “waveguide-instrument-biological tissue” interface, and vibratory massage on cellular and tissue level, accelerate the regeneration of biological tissues of the focus of infection, etc., which reduces the time of treatment of diseases when using available drugs.

3) Processing of biological tissues with semiconductor LEDs (V.V. Pedder, 1979; A.B. Veselovsky and others, 2001; O.I. Efanov, 2002 and others) emitting in the visible spectrum: red, yellow, green, blue and other colors, as well as in the near infrared and ultraviolet regions of the spectral range. The main target of exposure to LED radiation in the visible spectrum is the skin, in the area of 1 cm ² , which contains about 6500 capillaries, 200-300 pain points, 140-330 sweat glands, up to 380 capillary glands, up to 500 hair follicles, up to 70,000 white process epidermal cells, causing a variety of local and systemic reactions to radiation. The therapeutic effect is determined, first of all, by biochemical and biophysical changes in the area of influence on biological tissues at the cellular level (Capa, 1981, etc.). Visible light is absorbed by the chromatophore (light-absorbing) groups of protein molecules and oxygen with the participation of melanin, hemoglobin, enzymes, etc. Photochemical reactions in biological tissues are initiated by excitation of vibrational processes in the molecules of a substance and activation of excitation of atomic electrons by external energy equal to or greater than the energy of molecular bonds and atomic processes . All types of excitation of biological molecules arise at a quantum energy of 0.1-5.0 eV. At the same time, it is known that the energy of photons, for example, laser infrared radiation, is 1.0-1.5 eV, the radiation of the visible spectrum is 2.0-3.1 eV, the UV-radiation of the spectrum is 3.2-12, 4 eV. The established identity of the effects of laser and LED irradiation of the body with comparable energy and dose characteristics makes it possible to use radiation through the use of semiconductor LEDs and the need for the widespread introduction of color light therapy (photochromotherapy) in healthcare. The selectivity of biological processes depending on the wavelength (color) of the incident radiation is shown. It has been established that radiation of different wavelengths has a different, but systemic effect on the course of pathological processes during local low-energy irradiation with semiconductor LEDs (N.V. Serov, 1993; E.F. Levitsky, 1998).

Each light component is the LED radiation of the visible part of the spectrum: red (λ = 0.75-0.62 μm), orange (λ = 0.62-0.586 μm), yellow (λ = 0.58-0.576 μm), green ( λ = 0.57-0.51 μm), blue (λ = 0.47-0.45 μm), purple (λ = 0.450-0.40 μm), as well as near infrared (λ = 0.98-0 , 76 microns) and ultraviolet (λ = 0.40-0.29 microns) spectral regions - has a specific effect and can be used to treat pathological conditions of the body at one stage or another of their development. Data on the role of the main wavelengths (color of radiation) adopted in photochromotherapy (N.V. Serov, 1993; A.B.Veselovsky et al., 2001; O.I. Efanov, 2002, etc.) are presented below.

Near-infrared (IR) radiation (0.76-3.0 microns) has a high penetrating ability through the skin to a depth of 60-80 mm (contact technique and moderate soft tissue compression), is absorbed by nucleic acid molecules, proteins, oxygen and activates protein synthesizing systems of cells and heat generation. Most of the energy is absorbed by the surface layer of tissues with a thickness of 10 mm (A.R. Evstigneev et al., 1987). The result is vasodilatation, increased blood and lymph flow, protein and amino acid metabolism, accompanied by a decrease in edema, removal of decay and autolysis products of cells, increased metabolism in tissues, cell proliferation, etc. It is indicated for the relief of pain syndromes of various origins due to blocking of nerve impulse conduction ( analgesic effect), in the treatment of the effects of injuries, diseases of the musculoskeletal system, flaccid paralysis and paresis of the muscles, bursitis, rheumatism, etc.

Red radiation - having good penetration through the skin, it is absorbed by molecules of the respiratory chain enzymes (cytochrome oxidase, cytochrome C), the antioxidant system (superoxide dismutase), and reparative regeneration inducers (alkaline phosphatase). It activates the catabolytic processes and fibroblasts of the connective tissue, stimulating the reparative regeneration of tissues of the focus of infection. It reduces the impulse activity of the nerve conductors of the skin and the area of the focus of infection, providing an analgesic effect, and acting on the BAP, it stimulates cellular and humoral immunity. Red radiation is indicated in the treatment of skin diseases, herpes, acne, postoperative wounds, lymphedema, trophic ulcers, including in patients with diabetes, burns, frostbite, neurological diseases with pain (myositis, neuralgia), etc.

Yellow radiation - it is well absorbed by the skin and adsorbed by cells, interacting with the receptors and the lipid layer of the cell membranes of erythrocytes, leukocytes, lymphocytes, etc., normalizes the distribution of electric charge on their surface with the restoration of the energy potential of damaged cell membranes and cellular metabolism. It increases the oxygen-binding ability of red blood cells and their deformability, improves blood microcirculation and the formation of collaterals with the restoration of blood supply to tissues. Normalizes the number of leukocytes, enhances phagocytosis, increases local and general immunity. Yellow radiation has anti-inflammatory, detoxifying and analgesic effects. It is indicated in the treatment of wounds, complications of diabetes, trophic ulcers, burns, skin diseases, etc.

Green radiation - absorbed by the flavoproteins of the respiratory chain, protein complexes of calcium ions with a change in cellular respiration in the irradiated tissues. It restores the activity of the sympatho-adrenaline system, which is inhibited by the pathological process, reduces the intensity of inflammation and autoimmune defects, reduces the pulse rate and blood pressure, reduces the release of histamine from neutrophils, and reduces skin itching. Green radiation is indicated in the treatment of diseases of the cardiovascular system (stage I and II hypertension, obliterating diseases of peripheral arteries, chronic venous insufficiency), autonomic nervous system dysfunctions, hypertonic striated and smooth muscles, etc.

Blue radiation - is absorbed by the molecules of the hematoporphyrin pyridine nucleotides with the activation of the respiratory chain, which enhances glycolysis and lipolysis in cells and accelerates the photodestruction of bilirubin to substances that are easily excreted from the body and do not have a neurotoxic effect. Blue radiation activates venous circulation and promotes lymphatic elimination, reduces the excitability of nerve conduits of the skin, reducing its tactile and pain sensitivity (analgesia). It is indicated in the treatment of diseases of the central and peripheral nervous system, pigment metabolism disorders in newborns, ENT organs, skin, viral hepatitis, etc.

Ultraviolet radiation (UV) - is able to penetrate through the skin and is absorbed by blood and lymph (E. Schubert, 1998). Ultraviolet radiation provides energy for photochemical reactions in the body, enhancing the functioning of the blood-forming organs, the reticuloendothelial system, which produces antibodies that destroy body and microbes alien to the body, causing changes in the sorption properties of the surface of red blood cells, which are important for the implementation of oxygen transport and detoxification functions of the blood. UV irradiation stimulates the formation of vitamin D from steroidal substances, which contributes to the absorption of calcium, which is involved in blood coagulation, densification of cell and tissue membranes, regulates enzyme activity, etc. UV radiation enhances skin barrier properties, improves hemodynamic parameters and formation of collaterals, increases overall and local immunity, has a powerful disinfecting and sterilizing effect, etc. It is indicated for immunodeficiencies, in the treatment of inflammatory and skin diseases, postoperative wounds, trophic ulcers, burns, etc.

4) Ozone / NO-containing medicinal substances (V.V. Pedder et al. 1985-2009; S. Rilling, R. Viban, 1985; S.P. Peretyagin, 1992; V.A. Maksimov, 1998; A. F. Vanin, 1998; A.B.Shekhter et al., 1998; K.V. Lipatov et al., 2001; G.I. Klebanov, 2003 and others) - implement the mechanisms of the therapeutic effect of ozone (O ₃ ) and exogenous nitric oxide (NO) both in the form of an ozone / NO-containing air mixture, and in combination with medicinal solutions, for example ozone / NO-containing physiological saline, 5-10% ozonide / NO-containing oil emulsion of the type “oil in water "or ozonized vegetable oil, which are azeot in relation to the body, i.e. behaving as biologically pure and compatible with the body substances that simultaneously affect many pathogenetic links of the disease (circulatory and lymphatic circulation disorders, diffuse hypoxia, anaerobic glycolysis, accumulation of toxic oxidized radicals, etc.), which include:

- in the initiation of bactericidal, fungicidal and virucidal effects;

- in the activation of oxygen-dependent processes in the body, normalization of lipid peroxidation, the acid-base state and potential of the antioxidant system, in increasing the deformability of red blood cells and the oxygen-transporting function of the blood;

- in improving the rheological properties of blood and lymph, vascular trophism and tissue metabolism, normalization of microcirculatory disorders in the blood and lymph systems;

- in stimulating angiogenesis, detoxification, immunocorrecting, vasodilating, oxygenation, antihypoxic, analgesic effects, etc.

The physiological meaning of the complex effect of heat of the field, low-frequency ultrasound, radiation from semiconductor LEDs emitting both in the visible parts of the spectrum and in the near infrared and ultraviolet regions of the spectral range, as well as ozone / NO-containing voiced through the process gasket medicinal substances, consists in their impregnation to a greater depth from the surface of the tissues of the focus of infection and saturation of the actual biological tissues of the focus of infection and tissue adjacent to the wound, plasma, interstitial fluid, blood and lymph between the surface of the skin wound and the lesion, as well as the tissues of the infection site (the creation of a long-term depot of the drug both in the tissues of the infection zone and in the body as a whole), in a change in the right direction of impaired functional and metabolic processes, relief of acidosis and endogenous intoxication, etc.

In general, the effects initiated by the complex of the above physical and physicochemical factors on the biological tissue of the focus of infection are realized in several main areas:

- sanitation and detoxification of tissues of the focus of infection with the extraction of pathological contents from them;

- disinfection of pathogenic microflora of the focus of infection and adjacent tissues;

- impregnation of a drug substance deep into the tissues of the focus of infection;

- activation of local and general immunity;

- activation of angiogenesis and trophic support of tissues of the focus of infection.

The invention is illustrated by drawings, which depict:

- figure 1 is a General view of a device for implementing complex thermo- and photochromic-ultrasonic treatment of biological tissues (in cross section);

- figure 2 is a view And a device for implementing integrated thermo-and photochromic-ultrasonic treatment of biological tissues (Figure 1);

- figure 3 - designation of semiconductor LEDs emitting both in the visible region of the spectrum: red, yellow, green, blue, and in the near infrared and ultraviolet regions of the spectrum;

- figure 4 is an image of the contact circuit of the integrated thermo- and photochromic-ultrasonic treatment of biological tissues;

- figure 5 is an image of a contact-distant scheme of complex thermo- and photochromic-ultrasonic treatment of biological tissues;

- Fig.6 is an image of a distant diagram of thermo- and photochromic-ultrasonic treatment of biological tissues;

- Fig.7 is an image of an exemplary cyclogram of complex thermo- and photochromic-ultrasonic treatment of biological tissues by exposure to them with continuous low-frequency ultrasound and LED radiation, as well as a monotonously increasing heat flux;

on Fig - image of an exemplary cyclogram of complex thermo- and photo-chromo-ultrasonic treatment of biological tissues by exposure to intermittent low-frequency ultrasound and LED radiation, as well as an almost monotonously increasing heat flux (for example, in a 1: 1 duty cycle);

- figure 9 shows the implementation of the contact circuit integrated thermo- and photochromic-ultrasonic treatment of biological tissues;

- figure 10 shows the implementation of the contact-distant scheme of complex thermo- and photochromic-ultrasonic treatment of biological tissues;

- figure 11 shows the implementation of a distant scheme of integrated thermo- and photochromic-ultrasonic treatment of biological tissues.

A device for integrated thermo- and photochromic-ultrasonic treatment of biological tissues (Figs. 1-3) contains: a power supply and control unit 1, which includes a board of an ultrasonic oscillator of low-frequency range (f = 26.5 kHz or f = 44.0 kHz) made with the possibility of continuous or intermittent generation of ultrasound, and a board of a block of semiconductor LEDs emitting both in the visible region of the spectrum: red, yellow, green, blue, and in the near infrared and ultraviolet regions of the spectrum (not shown); an acoustic system 2 placed in a supporting polymer case 3 (hereinafter referred to as a bearing case 3) connected to a power supply and control unit 1. The acoustic system 2 includes an electromechanical transducer (in the form of a packet type piezoelectric transducer of a longitudinal type), consisting of ring piezoceramic elements 4 (for example, material TsTBS-8, PKV-460, ARS, etc.), a contact electrode 5 and an annular fluoroplastic insulator 6, compressed by a composite reflective patch 7 with a central hole. Composite reflective plate 7 consists of a union nut 7.1 (aluminum alloy) and a support metal disk 7.2 with an annular protrusion 7.3, which reduces the requirements for strict parallelism of the surfaces contacting during compression, and also reduces contact friction-sliding when the union nut 7.1 rotates relative to the support disk 7.2, when tightening the annular piezoceramic elements 4 and the contact electrode 5. The union nut 7.1 of the reflective lining 7 is connected by a threaded connection to the input end of the vibration concentrator 8 (aluminum alloy), ensuring the constriction of the elements of the electromechanical transducer 4, 5 and 6. The hub of mechanical vibrations 8 is connected through a threaded connection to the waveguide-tool 9 (titanium alloy, for example VT-5) with a developed emitting end face of a large area for the contact low-frequency ultrasonic treatment of biological tissues through technological pad 10 (2-4 layers of gauze), impregnated with a solution of ozone / NO-containing medicinal substance. The radiating waveguide tool 9 is made in the form of a thin-walled one-sided convex disk-shaped radiator that continuously or intermittently generates (after turning on the board of the ultrasonic generator of the power supply and control unit 1) ultrasonic and thermal fields. The waveguide tool 9 is located axisymmetrically to the central axis of the acoustic system 2 and is connected in its internal generatrix to a mechanical vibration concentrator 8, which is a disk-shaped conical-cylindrical element provided with a cavity in the form of a paraboloid of revolution 11 from the side of the large base (other geometric shapes of radiating surfaces with total parabolic generatrix), increasing the amplitude of the oscillations to 20 microns and above. At the same time, a thread is made on the small-diameter generatrix of the cylindrical hub of mechanical vibrations 8 for attaching a union nut 7.1 of the reflective plate 7, compressing the annular piezoceramic elements 4 and the contact electrode 5 between it and the hub of mechanical vibrations 8. In addition, the device is equipped with an annular matrix 12 fixed to radially and uniformly distributed semiconductor LEDs 13, emitting both in the visible region of the spectrum: red, yellow, green, blue, and in the near x infrared and ultraviolet spectral regions, as well as providing the possibility of radiation in both continuous and intermittent modes. The semiconductor LEDs 13 are mounted flush with the plane BB of the end face of the carrier body 3 and outside the disk-shaped emitter of the waveguide tool 9. The distance L between the plane BB and the peak B of the one-sided convex disk-shaped radiator of the waveguide tool 9 should be equal to or slightly smaller the magnitude of the possible deformation of easily deformable from the skin integument of biological tissues (for example, in the chest, abdomen, thigh, etc.) that occurs when applying and moving along their surface, under Your own weight radiating waveguide 9-tool acoustic system 2 placed in the carrier body 3 in the implementation schemes of the contact (4) or contact-distant (5) integrated thermal and photochromic-ultrasonic treatment of biological tissues. The aforementioned is necessary to initiate the effect of amplification (up to 40 times) of light transmission in the tissue of the lesion site by lightly squeezing the scattering layers of soft biological tissues (G.A. Askaryan, 1982). To implement complex thermo- and photochromic treatment of biological tissues of the lesion and adjacent tissues from a distance, a distant arrangement of the device is used (Figure 6).

The contact circuit (Figure 4) of the complex thermo- and photochromic-ultrasonic treatment of biological tissues is carried out by applying a waveguide-tool 9 of the acoustic system 2, placed in the supporting body 3, on the skin 14 or wound surface 15 with direct contact with them as through a layer of drug solution substances, and without it. The acoustic system 2 can be installed stationary or with its subsequent movement in the area of pathologically altered tissues.

Contact-distant circuit (Figure 5) of complex thermo- and photochromic-ultrasonic treatment of biological tissues is carried out by applying a waveguide-tool 9 of the acoustic system 2, located in the supporting body 3, on the skin 14 or wound surface 15 with direct contact between them through an intermediate technological pad 10 soaked in a drug solution. The acoustic system 2 can be installed stationary or with its subsequent movement in the area of pathologically altered tissues.

The distance scheme (Fig.6) of complex thermo- and photochromic-ultrasonic treatment of biological tissues is carried out by placing the acoustic system 2, placed in the supporting body 3, above the skin 14 or wound surface 15 with its subsequent movement over the area of pathologically altered tissues.

To eliminate the risk of excessive exposure to the eyes of the patient and the doctor conducting the treatment session using the above schemes for the integrated thermo- and photochromic-ultrasonic treatment of biological tissues, before switching on the board of the semiconductor LED block 13, which belong to the bright and superbright class, the device is equipped with protection against open or reflected radiation by an elastically deformable removable protective shield 16, the inner surface of which is capable of reflecting radiation. In this case, the protective shield 16 is installed on the terminal part of the supporting body 3 near its end.

In the complex thermo- and photochromic-ultrasonic treatment of biological tissues of the infection site, the included board of the ultrasonic generator of the power supply and control unit 1, coupled with the acoustic system 2, provides the possibility of continuous or intermittent generation of mechanical vibrations of the low-frequency ultrasonic range with the creation of the corresponding thermal field resulting from dissipation energy of ultrasound in the acoustic system, at the “waveguide-tool-biological tissue” interface due to their difference acoustic resistances, as well as in voiced biological tissues due to the dissipation of ultrasound energy that has passed the “waveguide-instrument-biological tissue” interface.

The device can be used by applying various cyclograms, for example, presented in Figs. 7 and 8, which implement different options and stages of treatment of diseases, providing for the joint or separate use of one or another factor from the general group of physical and physico-chemical factors affecting pathologically altered tissue. The use of a device for integrated thermo- and photochromic-ultrasonic treatment of biological tissues (Figs. 1–11, see Table 1) in the treatment of patients with various forms of diseases was carried out on the basis of the Omsk Regional Oncology Center in 2007-2010.

The device for the integrated thermo- and photochromic-ultrasonic treatment of biological tissues is presented on the example of the complex treatment of patients with a chronic form of arthrosis.

EXAMPLE. Patient N., 42 years old. Diagnosis: Rheumatoid arthritis with a primary lesion of the knee joints. Bilateral gonarthrosis of the II degree in the acute stage.

After examining the patient and clarifying the diagnosis, steroidal anti-inflammatory drugs in a standard dosage and infusion therapy with vascular drugs were prescribed. The treatment was carried out in a day hospital. In addition to the prescribed treatment, the patient underwent thermo- and photochromic-ultrasound therapy on the area of the knee joints with the choice of continuous and discontinuous cyclograms of the effect on the area of the knee joints, tendons of the quadriceps of the thighs, muscles of the back of the thighs and the upper part of the calf muscles in the place of their tendon attachments. At the same time, a multi-stage medical treatment technology was implemented using the Ramis-MM therapeutic apparatus (NPP Metromed, Omsk) and the apparatus for gas ozone / NO therapy Ozotron (NPP Metromed, Omsk) . Before carrying out the treatment procedure, the patient was in a comfortable position for him in the sitting or lying position.

At the first stage of treatment of rheumatoid arthritis, in the absence of skin lesions 14, in the projections of the joint, muscles and tendons changed by the process, the skin of these surfaces is heated and the underlying tissues are heated to a temperature of about 40-45 ° C for 1 or 2 minutes (exposure 1 the minute is used in the treatment of children and patients with atrophy of the skin 14) using the contact circuit of thermo- and photochromic-ultrasonic treatment of biological tissues (Figs. 4 and 9), as well as the cyclogram of the types of exposure (Fig. 7), providing for continuous he exposure to physical factors: low-frequency ultrasound, LED radiation, thermal field. For this, a medicinal solution is applied to the skin surface 14 (within the interested zones), for example, 5-10% ozone / NO-containing oil emulsion of the oil-in-water type (or without it). The waveguide tool 9 of the acoustic system 2 is placed on it, placed in the supporting body 3 with a protective screen 16 (to protect the eyes of the patient and the doctor from direct and reflected radiation of bright or superbright LEDs 13), and then the power supply and control unit 1 are turned on. the “standby” mode includes the board of an ultrasonic generator of low-frequency oscillations and the board of a block of semiconductor LEDs that can provide radiation both in the visible spectrum: red, yellow, green, blue, and in near infrared the red and ultraviolet spectral regions. The wavelength (color) of the acting radiation is selected depending on the stage of development and severity of the disease, as well as the exposure exposure by LED and ultrasonic radiation. At this stage, in the first 7 sessions, infrared and red radiation of semiconductor LEDs are used sequentially, and in the subsequent (until the end of treatment - another 7 sessions) - green LED radiation. By switching on the “start-up” mode, thermo- and photochromic-ultrasonic treatment of biological tissues is performed by sounding, irradiation with radiation from semiconductor LEDs, as well as by heating the tissues in the sounding area before hyperemia due to the absorption of ultrasound energy in the “waveguide-instrument-biological tissue” system and infrared photon energy radiation with great penetrating power. The complex effect of these physical factors extends not only to thinly differentiated skin exteroreceptors, but also to deeper lying receptor apparatuses — proprioreceptors, tendon receptors, vascular interoreceptors, etc., which determines the nature, degree, and originality of reflex responses that arise. When carrying out thermo- and photochromic-ultrasonic treatment, the waveguide-tool 9 is in contact with the skin surface 14 (under its own weight) and linearly or circularly moves in the area of pathologically altered tissues, including along the blood stream in the veins, and lymph to the lymph nodes, including areas of congestion of the popliteal and inguinal lymphatic vessels with the exception of their trauma. At the end of the selected time exposure of the continuous sequence diagram (Fig.7), the device automatically turns off.

At the second stage of treatment of rheumatoid arthritis, a “cooling” (room temperature of about 20-25 ° C) technological pad 10 impregnated with ozone / NO-containing physiological saline or 5-10% ozone / NO-containing oil emulsion is placed on the prepared warming skin surface 14 oil-in-water type (Figs. 5 and 10), then contact-distantly (through the gasket 10), a waveguide tool 9 of the acoustic system 2 placed in the supporting body 3 is installed on the skin surface 14. Then, a temporary exposure (one or two minutes , justification see above) of an intermittent cyclogram (Fig. 8) of physical factors affecting the area of pathologically changed tissues, as well as the type of LED radiation used, which for the second stage of treatment (during all 14 sessions) are yellow and blue LED radiation (turn on sequentially for 30 or 60 seconds). By switching on the “start-up” mode, thermo- and photochromic-ultrasonic treatment of biological tissues is performed by sounding and irradiation with semiconductor LEDs, as well as by heating the tissues in the sounding area before hyperemia due to absorption of ultrasound energy and photon energy of yellow and blue LED radiation, which have anti-inflammatory, analgesic and detoxifying effects. In this case, linear and circular movements of the waveguide-tool 9 of the acoustic system 2 are carried out in the area of pathologically altered tissues, including along the course of the blood flow in the veins, and lymph to the lymph nodes, including the areas of accumulation of the popliteal and inguinal lymphatic vessels, avoiding their trauma. At the end of the implementation of the selected temporary exposure of a discontinuous cyclogram (Fig. 8), the device automatically turns off, the process gasket 10 is removed.

At the final third stage of the treatment of rheumatoid arthritis, a distant scheme of thermo- and photochromic-ultrasonic treatment of biological tissues (Fig. 6) is carried out by placing an acoustic system 2 placed in a supporting body 3 above the skin surface 14 at an optimal distance of about 10-70 mm. Choose a temporary exposure (one or two minutes, justification see above) of a discontinuous cyclogram (Fig. 8) of physical factors affecting the area of pathologically altered tissues, as well as the type of LED radiation used. At this - the third stage of treatment, ultraviolet radiation is used in the first 7 sessions, and in the next 7 sessions, the yellow and red LED radiation are successively used until the end of treatment. By turning on the “start-up” mode, photochromic processing of biological tissues by radiation of semiconductor LEDs is carried out when the acoustic system 2 is placed in the supporting body 3 with a protective screen 16 for 1 or 2 minutes over the projection areas of the joint, muscles and tendons changed by the pathological process (Fig. 6 and 11). At the end of the selected temporary exposure of continuous and discontinuous cyclograms of photochromic processing of biological tissues (Figs. 7 and 8), the device is automatically turned off, and the Ramis-MM and Ozotron devices are disconnected from the network.

During the course of treatment, 14 treatment sessions were carried out. Starting from 5-6 treatment sessions, an improvement in the patient's condition was noted, manifested in the form of a decrease in pain, an increase in the amplitude of movements in the knee joints, the disappearance of a feeling of tension in the tendons of the muscles of the back of the thighs. By the end of treatment, the patient reduced the number of NSAIDs taken, while additional injections of glucocorticosteroid drugs into the joint were not required. The patient is shown a dynamic observation by the therapist at the place of residence and, if necessary, a repetition of the course of treatment.

The treatment of joint diseases according to the multi-stage medical technology described above using the proposed device for integrated thermo- and photochromo-ultrasonic treatment of biological tissues can be combined with the prescription of drugs or can be used as an independent method of physiotherapy. The duration of the course of treatment is from 8 to 20 procedures, carried out both daily and every other day, and depends on the clinical form and stage of joint disease, as well as on the prevalence of the inflammatory process in the joint tissues and the tissues that arm them. A second course of treatment can be carried out no earlier than 3 months after the previous one.

The proposed technical solution allows the implementation of highly effective treatment methods using different schemes of thermo- and photochromic-ultrasonic treatment of biological tissues using a complex of pathogenetically substantiated and biotropic types of energy and material effects on tissues and infection sites affected by the process: continuous or intermittent low-frequency ultrasound and LED radiation of different lengths waves, as well as an almost monotonically increasing heat flux at the “waveguide-instr” interface um biological tissue. " At the same time, a multifunctional device created by a simpler and more technologically advanced manufacturing device, from affordable low-cost and lightweight construction materials, provides a 2–3 times higher oscillation amplitude of a waveguide tool having a large emitting end face compared to the prototype device. In addition, the proposed device implements a complex or individually continuous or intermittent exposure to the infection site with high-frequency contact ultrasound of low frequency, thermal radiation, radiation of semiconductor LEDs emitting both in the visible region of the spectrum: red, yellow, green, blue, and near infrared and ultraviolet spectral regions in combination with highly active ozone / NO-containing medicinal substances, which generally contribute to the suppression of pathogenic microflora, sanitation of the tissues and foci of infection affected by the process, as well as impregnation of medicinal substances in them, initiating the active regeneration of biological tissues and, consequently, shortening the treatment time for patients with various forms of diseases (see the Table), which are usually difficult to treat using traditional methods.

To date, completed prototypes of the device, which are part of the newly developed at the Research and Production Enterprise Metromed (Omsk) physiotherapy unit Ramis-MM, have been successfully tested in combination with a gas ozone / NO-therapy device Ozotron (NPP Metromed, Omsk). In accordance with the procedure established by the Ministry of Health and Social Development of the Russian Federation, for the organization of its mass production, design documentation, a design specification and a design specification, guidelines for use, and state acceptance tests of the physiotherapy apparatus Ramis-MM were developed.

Information sources

1. Pedder V.V., Ovchinnikov Yu.M., Kostyuchenok B.M. and others. "Method for the treatment of infected wounds." / Application for invention N4617248 / 14 from 10.24.1988.

2. Zharov V.P. et al. Development of photo-ultrasound technology for the treatment of infected processes // Russian Scientific and Technical Conference "Medical and Technical Technologies for the Protection of Health". - M .: MSTU, 2000. - P 45-46.

3. RF patent 2297849 "Liposuction method and device for its implementation", cl. A61M 1/00, A61M 37/00, 2005.

Claims (1)

A device for complex thermo- and photochromic-ultrasonic treatment of biological tissues, containing an ultrasonic generator configured to continuously or discontinuously generate ultrasound, an acoustic system placed in a bearing housing, including an electromechanical transducer of annular piezoceramic elements, a reflective pad, a mechanical vibration concentrator and connected to a waveguide tool with a developed emitting end for contact low-frequency ultrasonic treatment of biological tissues through a technological pad impregnated with ozone / NO-containing medicinal substance, characterized in that the emitting waveguide-tool is made in the form of a thin-walled one-sided convex disk-shaped emitter located axisymmetrically to the central axis of the acoustic system, connected along its internal generatrix with a mechanical vibration concentrator, which is a disk-shaped conical-cylindrical element, provided on the side of the large base with a cavity in the form of a paraboloid of revolution, and in the image On the small base there is a thread for attaching a composite reflective cover consisting of a union nut and a support disk with an annular protrusion, compressing the piezoelectric ceramic ring between the support disk and the mechanical vibration concentrator, in addition, the device is equipped with an annular LED matrix with semiconductor LEDs evenly distributed over it, radiating through holes made at the end of the supporting body and located outside the disk-shaped radiator of the waveguide tool, n continuously or intermittently, together with ultrasonic exposure to biological tissues, both in the visible spectrum: red, yellow, green, blue, and in the near infrared and ultraviolet regions of the spectrum, while an elastically deformable removable protective shield is installed on the end of the carrier body, inner surface which has the ability to reflect the radiation of semiconductor LEDs.

Images