RU2434627C1 - Method of correcting body weight gain after giving up smoking - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to therapy, reflexology. Method includes introduction of low-calorie diet. Simple carbohydrates are limited to 10% of calorie content, general fats - to 30-35% of calorie content, animal fats - to 10%. Diet is enriched with proteins to 25%, vitamins, minerals, with magnesium - to 500 mg, cellulose - to 30 g. If body weight index is 25-30 units, food calorie content is limited to 1800 kcal per day for men and 1500 kcal - for women, course of auricular acupuncture is carried out. Course includes carrying out 10 sessions for 30 minutes in points AP 17 and AP 18. If body weight index is higher than 30, food calorie content is limited to1500 kcal for men and 1400 kcal - for women. Additionally to auricular acupuncture after 20-30 days carried out are 10 30-minute long procedures of corporal acupuncture every second day or daily. Corporal acupuncture is performed in points of intersection of anterior, medial and posterior axillary lines with horizontal line, drawn through crests of iliac bones.

EFFECT: method ensures body weight correction without application of drug therapy, does not have side effects.

2 ex

Description

The claimed invention relates to medicine and relates to smoking and obesity.

Tobacco smoking is a serious medical and social problem and one of the main preventable causes of death and disability worldwide. Despite the fact that many smokers express a desire to quit smoking, their initial attempts, as a rule, do not lead to success (Centers for Disease Control and Prevention, 2005a, 2005b).

That is why, along with political, legislative and educational measures, the selection of individual methods of treatment for a smoking person is of paramount importance. A modern arsenal of behavioral, pharmacological and non-pharmacological methods for long-term smoking cessation should be aimed not only at consolidating the patient’s attitude to completely quit smoking and eliminate or significantly reduce tobacco dependence, but also with the aim of effectively preventing smoking relapses, preventing and correcting withdrawal symptoms and mainly weight gain.

Fear of overweight and obesity is a serious obstacle to making a decision to quit smoking, and the inability to cope with these conditions is the main reason for those who made an attempt to quit smoking.

Many large scientific studies in Europe, Asia, and America have revealed the fact of weight gain during smoking cessation and demonstrated the need to take into account its negative effects when implementing appropriate anti-smoking programs (Filozof C, Fernandes Pinilla MC, Fernandez-Cruz., 2004; Teramoto T, Sasaki J, Ueshima H, Egusa G et al, 2008). Thus, Japanese scientists (Unai Tamura, Taichiro Tanaka, Tomanori Okamura, 2010), studying the risk of cardiovascular disease in 2,000 workers after quitting smoking, found that in people who quit smoking, after 4 years, the levels of total cholesterol and sugar in blood and blood pressure, both systolic and diastolic, are higher than those of people who continue to smoke. And this is due to an increase in their body weight. Considering this problem to be the most relevant in the issue of quitting smoking, they propose the development of new programs that take this fact into account (Tamura U., 2010).

In addition, it was found that overweight negatively affects the function of external respiration, which is so impaired in these individuals, which is one of the main points for them that motivates the patient to quit smoking. An even greater deterioration of this indicator as a result of weight gain can also be an obstacle to quitting smoking or relapse (Murugan AT, Sharma G. Chronic Respiratory Disease, 2008).

Modern methods of therapy for tobacco dependence are designed to cope with withdrawal symptoms, on which, in fact, their effectiveness depends. However, drug methods are aimed at specific links in a complex neurobiological scheme of nicotine addiction (nicotine replacement, selective inhibition of serotonin and antidepressant activity, partial stimulation of nicotine receptors) and sometimes their effectiveness depends on the genetic characteristics of the smoker. Therefore, the use of well-known medications for the treatment of tobacco dependence often has to be combined with each other (which, according to statistics, does not lead to an increase in effectiveness) and / or with other drugs (for example, antidepressants, tranquilizers, anorexigens) to maximize the elimination of symptoms of withdrawal symptoms .

In conditions of smoking cessation, control over nutrition and body weight is of particular importance, since improved metabolism and increased appetite during the treatment of smoking can lead to the acquisition of an alternative habit of uncontrolled, compulsive eating.

This is due to the fact that smoking cessation, the gradual elimination of the symptoms of chronic tobacco intoxication are accompanied by improved taste sensitivity, appetite, normalization of the secretion of digestive glands, which in general leads to an increase in food intake and, consequently, an increase in body weight.

Smoking speeds up the metabolism, which allows you to lose 100-200 kilocalories per day more. Accordingly, when you stop smoking, the metabolism slows down again, the same calorie content leads to a calorie count. Smoking suppresses hunger. Nicotine causes the liver to secrete glycogen, which causes blood sugar levels to rise and appetite to drop.

Smoking tones and improves mood. Nicotine intake raises dopamine levels in the brain, a substance that accompanies a sense of pleasure. The effect is similar to that of having sweet and alcohol, so that after giving up cigarettes, the patient may experience an urgent need for chocolates and spirits.

Cigarettes occupy the mouth and hands. The process of absorbing food, too. So, having quit smoking, the patient instinctively replaces the cigarette with food. Weight gain can reach an average of 3-4 kg in 2-3 months of smoking cessation. If overeating becomes a persistent habit, then after quitting smoking, you will have to get rid of the habit and excess weight.

Pharmacological agents used in the treatment of nicotine addiction (buprapion, nicotine replacement therapy (NRT), and possibly varenicline) can contribute to weight loss during their use, but this effect does not persist for a year (Parsons AC, Shraim M, Inglis J, Aveyard P, Hajek P. Cochrane Database of Systematic Reviews, 2009).

Physical activity and exercise can help reduce / overcome withdrawal symptoms (Ussher, 2003); as for other methods, such as aversion therapy and hypnotherapy, there is no evidence base for their effectiveness in the treatment of smoking (World Heath Organization Traditional Medicine, 2003; White, Rampes, & Campbell, 2006).

A widespread method of exposure to the body with nicotine-containing chewing gums (US 2009005423 A1). However, they can cause irritation of the oral mucosa up to ulcers, nausea, and an uncontrolled increase in the level of nicotine in the blood. NRT treatment, which binds nicotine receptors in the brain and has a number of side effects, is trying to replace alternative therapy: nutritional supplements and vitamins. However, this does not come down to the complex purpose of the diet, but to various nutrition components - sulfur, vitamin B6, and the amino acid tryptophan, which stimulate the release of endorphin (US 2008103111 A1).

Chewing gums, vanilla, peppermint and peach flavors are suggested. They not only have antibacterial properties, but also have anti-stress effects. So, in a double-blind, placebo-controlled study (EP 1928259 A2), lollipops during the first 4 days of smoking cessation reduced the level of cortisol in saliva. Some authors prescribe salicylic acid, vitamin D, green tea extract (CN 101249130 A). These methods offer only individual food components, ignoring complex dietary intervention and, very importantly, the issue of increasing body weight.

In order to prevent weight gain, the method of prescribing sibutramine 10-15 mg for 2 weeks of smoking cessation and continued for another 6 months was patented for smoking cessation (D. Mitchell Anti smoking device and method, CA 2368093 A1). But it is known that the drug has a number of its side effects and contraindications (IHD, uncontrolled arterial hypertension, arrhythmias, prostate hyperplasia, cerebrovascular diseases, etc.). Moreover, drug therapy of excess body weight is effective only against the background of a diet.

Methods of psychotherapeutic influence are proposed when self-hypnosis is carried out (RF Patent 2330689 C2); a method of meditative trance with aversion therapy with irrigation of the oral cavity with dibazole, lidocaine, papaverine (RF Patent 2234950). In the latter case, a powerful mental effect is combined with the possible uncontrolled toxic effects of a number of drugs, which can reduce weight.

Regardless of the problem of smoking, the literature cites a wide variety of diets for treating overweight and obesity. They are described in various guidelines (European guideline on cardiovascular disease prevention in clinical practice 2007; WHO, 2007; School of Health, 2009). All these diets are made without taking into account the problem of quitting smoking, that is, without taking into account the etiology of the process, therefore:

- they do not have the detoxification function so necessary for smokers,

- do not take into account the disturbed acid-base balance and the development of hypovitaminosis,

- they do not take into account the "distracting" and "provocative" role of products,

- There is no differentiation in the diet between women and men by calorie content, although their energy expenditures vary.

Along with this, reflexologists have developed their own methods for treating obesity, again without taking into account the problem of smoking as one of the causes of weight gain (Drobysheva N.A., 1988, Luvsan G., 1990 and others). Traditionally, long corporal needles are inserted horizontally from F13 to VB25 c two sides and T25 and RP9 also on both sides. Duration of sessions is 20-30 minutes. Course up to 10 sessions. The method does not meet the requirements for influencing the pathogenetic mechanisms of obesity, there is no pronounced stimulation of metabolism, lipolysis activation, since auriculotherapy is not used here, the effectiveness of which is generally recognized. In addition, its influence on the psycho-emotional sphere is not taken into account; the course of treatment is not differentiated in dependence on the initial body weight and increased appetite; smoking cessation is also not taken into account

Pokatilov I.O., Mukhina M.M. in his work, “Methods of Correcting Overweight (Patent RF 2176496), pay attention to the psycho-emotional sphere, evaluate it using the SMOL technique. But such a stressful effect on this area as smoking cessation is not taken into account. A comprehensive corporal and auricular reflexology is carried out. AT constant - at points 17, 18, 55, 87 - for 14 days. The needles are inserted into the main fat depots. On the anterior abdominal wall is F13 VB26. E19-28; in the back, these are VV25, V19, 48; on the outer surface of the thigh VB29,31,33,34. There are three such sessions with an interval of one to three days. After 14 days, an auricular reflexology session is again performed. Old microneedles are removed. Both auricles are pointed out, but only AT 17, 18.

- The methodology does not take into account such an important factor as diet therapy.

- Sessions of corporal therapy are conducted insufficiently (only 3).

- The location of the points is standard.

Golden needles proposed by M. Mukhina for the treatment of obesity, used in the point of “hunger” and “thirst” (Patent RU 2233149 (C1) can not be of wide practical importance. They are expensive and can have, from the point of view of Chinese traditional medicine, an exciting effect on centers of hunger and thirst. Although endorphins are secreted during auriculotherapy, and even if it is possible to inhibit the corresponding centers, the effect of ear needles on adipose tissue is doubtful, since there is no corporate therapy.

- here, too, is not related to the problem of quitting smoking;

- the intervention is not differentiated depending on the body mass index, gender and time,

- there is no combination of needles.

Elbaev A.D., Akaeva S.A. (RF Patent 2163478) in the treatment of obesity, a low-calorie diet of 1000 kcal is prescribed against the background of reflexology. The impact of electric current is on the points E36, E45, MC6, RP6, B67, B20, on the symmetrical auricular points of the hypothalamus, thyroid gland, “hunger” and “thirst”. Diet per 1000 kcal. However, this diet is designed to treat obesity without regard to the problem of weight gain in smoking cessation. Since there is no accounting for the problem of smoking, the diet is low in calories, but structurally it does not take into account metabolic disorders, hypovitaminosis, changes in acid-base balance, the need for detoxification of the smoker's body.

Tukaev R.J. (RF Patent 2008028) for the correction of body weight in alimentary forms of obesity pre-conducts psychotherapy, carries out an auto-heterosuggestive effect, instills an indifferent attitude to food, causes anorexic-dysphanic sensations and intensifies them with mechanical irritation of the anterior projection of the stomach, esophagus the session is repeated 1-2 days. The next session begins with irritation using the acupuncture or acupressure method of reflexogenic zones or points of the hypothalamic-pituitary system, autonomic nervous system and gastrointestinal tract, a program for reducing body weight is calculated, it is combined with a program for introducing into a meditative state, using the combined program, the patient is introduced into a meditative condition and repeat the auto-suggestive effect on the background of irritation of reflexogenic zones.

Here, reflexology is combined with a psychotherapeutic effect, but at the same time, the problem of combating obesity is solved without regard to smoking cessation.

There are attempts to combine the treatment of smoking cessation by replacing the effects of nicotine on the hypothalamic-pituitary adrenal system of the body by mesodiencephalic modulation with alternating current amperage in the range 0.07-047 mA. An electrode with a positive polarity is placed between the frontal tubercles and an epididymis in the center of the frontal region, and a dermal electrode with a negative polarity is placed on the occipital region in the center of the large occipital foramen, with a central current frequency of 76 Hz, with a frequency deviation of 20 Hz, a frequency variation period of 80 At the same time, the patient receives 150-300 mg of diazepine, which increases the effectiveness of treatment to 57% (RF Patent 2234954). Although the method is combined and affects the pituitary-hypothalamic region responsible for the feeling of hunger and thirst, it does not take into account the problem of increasing body weight when quitting smoking.

On the other hand, it was found that with the combination of microigloauricular therapy with cranial acupuncture, a good smoking cessation effect is observed (92%). This combination causes a more effective reflex activation of the limbic-reticular complex of the central nervous system, which provides viscero-endocrine functions of the body with the release of endorphins (Davydov O.V. et al., 1999). Obviously, the release of endorphin during acupuncture, due to the anti-stress, antidepressant effect, inhibits the corresponding centers in the brain. But there are no dietary recommendations in this work.

- His influence on the psycho-emotional sphere is not taken into account.

- The course of treatment is not differentiated depending on the initial body weight and increased appetite.

- Excessive reflex load, which can exacerbate concomitant diseases.

Known work Shakirzyanova G.Z. and Novikova O.V. (RU 2132203) “A method for treating tobacco dependence and an anti-tobacco combination drug”, which describes a comprehensive method for treating tobacco dependence, combining the methods of psychotherapy, drug therapy and diet therapy: it is recommended to follow an unloading diet at the end of smoking cessation, but the authors give neither calorie nor structure, no sample diet menu; the problem of weight gain during smoking cessation is not specifically considered.

Finnish scientists have developed a special diet for smokers (Food from Smoking, 2008). The diet was based on the results of a 13-year study, which was attended by more than 26 thousand smoking citizens of Finland. According to scientists, smokers are useful products with a high content of magnesium, only thanks to them can reduce the risk of stroke by 15%. Researchers suggest using whole grains, black beans, peanuts, broccoli, spinach, halibut and oysters as sources of magnesium. However, the diet paid attention to only one component of the diet - magnesium salts, which have a positive effect on the walls of blood vessels, reducing the risk of stroke, and in addition, the diet is designed for people with stroke and smokers, and not for those trying to give up tobacco addictions.

Closest to the claimed method is the correction of weight gain during smoking cessation described in Smoking Cessation Treatment with Appetite Suppression (US 2008103111 (A1). The patent proposes a multicomponent appetite suppressant. In this complex, in the form of a pharmaceutical capsule, colloidal sulfur, which, by linking nicotinic receptors, reduces cravings for nicotine, provides the tryptophan amino acid, a precursor to serotonin, and the latter as an antidepressant suppresses appetite, but a special diet has not been developed in this work. and smoking cessation for persons of both sexes, with different weight based metabolic disorders, vitamin deficiencies, changes in the acid-base balance, the need for detoxification smoker and with a lasting effect of treatment.

Based on the foregoing, we set out to develop and test a methodology for the comprehensive correction of weight gain during smoking cessation without the use of additional drug therapy, which would not have additional side effects and take into account a sharp increase in appetite, nicotine intoxication, hypovitaminosis, acid-base imbalance in the body when smoking, conditioned reflex connection in nutrition with certain foods, etc.

In the process of quitting smoking, we used a method that allows you to adjust the increase in body weight, consisting of a combination of the method of acupuncture (IRT) and diet therapy.

Comprehensive correction of the increase in body weight includes auricular acupuncture if the body mass index (BMI) (weight in kg: height in m squared) is 25 or more and / or the patient has increased appetite - at points AP 17 and AP 18 from 5 - 10 daily (1-2 weeks) procedures. In persons with a BMI above 30, 20-30 days after the main course, an additional 10-day course of daily or every other day of corporative RTI procedures is prescribed. Dietological correction includes limiting the caloric content of the daily diet with a BMI of 25-30 units. - up to 1500 kcal per day for women and 1800 kcal for men, and with a BMI of more than 30 - up to 1500 kcal per day for men and up to 1400 kcal for women. In all cases, the diet includes the following structural changes: the restriction of simple carbohydrates and animal fats to 10% of each calorie content, enrichment of the diet with proteins up to 25% of calories, vitamins, fiber (30 g or more), magnesium salts (500 mg or more), and vegetable fats (up to 20% of calories).

Sessions of auricular and corporal acupuncture are conducted both during and after the therapeutic measures used to quit smoking.

The claimed invention is as follows.

The patient is warned in advance about the possibility of increasing body weight when quitting smoking and so that this does not adversely affect his decision to quit smoking. We developed recommendations in advance for weight control based on the patient’s body mass index, and proposed their implementation from the very beginning in the process of quitting smoking and for 6-12 months after complete quitting.

If the body mass index does not exceed 25 units (weight in kg: height in m squared), the patient is given a balanced, healthy, enriched with vitamins and minerals diet, without special calorie restrictions. If the body mass index exceeds its normal values and is 25 and higher and / or with complaints of increased appetite, nutrition with limited calorie content and auricular acupuncture are carried out, and with a BMI of more than 30 (obesity) - also a corporative ИРТ.

Particular attention should be paid to complaints that appear immediately after quitting smoking, in order to interrupt the possibility of forming a causal relationship with the patient in time and remove the reason for the return of this bad habit.

Quit Smoking Diet

The organization of a "healthy diet" when quitting smoking is of great importance and performs several functions.

1. Replacing, "distracting" function

The patient in the process of quitting smoking should be offered a “substitute” process of smoking a cigarette dietary “equivalent”. The choice depends on the taste preferences of the patient. It is desirable that these were non-nutritious, leafy vegetables. But in some cases, in order to "replace" within the daily calorie content, it is possible to recommend sunflower and / or pumpkin seeds.

2. Detoxification function

In order to detoxify the body, it is desirable that the diet contains a large amount of fiber, better soluble, i.e. pectin (berries, beets, etc.). Pectin will help reduce toxins in the intestines. The diet should be enriched with vitamins and mineral salts. In connection with the intensification of lipid peroxidation processes during smoking, special attention should be paid to the content of vitamins - antioxidants - C, beta-carotene and vitamin E.

It is recommended to increase the intake of sources of vitamin C (rosehip, blackcurrant, green onions, cabbage, lemons, etc.), beta-carotene - orange and yellow fruits, with high antioxidant potential (figs) of vitamin E (wholemeal bread, vegetable oil, green vegetables, wheat germ). Antioxidants in the form of beta-carotene and vitamin E should be treated strictly with foods, not drugs.

Vitamins of group B are also important; their synthesis may be impaired due to a violation of the microbiological environment of the intestine synthesizing vitamins of group B and due to their excessive consumption during smoking. It is necessary to increase vitamin B ₁ (whole grain bread, cereals), vitamin B ₁₂ (green peas, oranges, melons), vitamin PP (beans, cereals, yeast, cabbage, dairy products, potatoes).

3. Normalization of acid-base balance

Nicotine addiction, accompanied, as a rule, by a violation of the acid-base balance of the body towards an increase in acidity, reduces alkaline drinking (mineral water, juices, vegetable broths) and citrus fruits.

4. Accounting for concomitant diseases.

When giving individual nutritional recommendations, it is necessary to take into account the risk factors and diseases associated with smoking: hypercholesterolemia, arterial hypertension, diabetes mellitus, osteoporosis and others. In case of hypercholesterolemia, even more animal fats should be limited (up to 7-10% of calories), and in case of arterial hypertension - table salt (up to 5 g per day), in case of diabetes, sharply limit and even exclude sugar (less than 30 g), and in case of osteoporosis - Add low-fat dairy products (up to 500 g per day) and fish (2-3 servings per week) or fish oil (up to 5 g per day).

5. Refusal of provocative products

You should avoid those foods and dishes that possibly provoke smoking. For example, coffee, strong tea, alcohol.

6. Body weight control

It is necessary to develop nutritional recommendations in advance for losing excess weight, based on the patient’s body mass index, and begin their implementation in the process of quitting smoking and within 3-6-12 months after complete cessation.

Calorie content is limited only if the body mass index exceeds its normal values. Basically, calorie restrictions should apply to animal fats, since high consumption of animal fats, like smoking, is a risk factor for cardiovascular and oncological diseases. Correction of both behavioral risk factors at the same time is necessary: both smoking and malnutrition. It is very important to limit carbohydrates, especially simple ones. The fact is that smoking enhances tissue insulin resistance and, thus, the likelihood of developing a metabolic syndrome. This is due to the toxic membranotropic effect of smoking, as a pathogenetic factor, on the development of the “defect” of cell membranes. Calorie intake and its limitations depend on the initial level of body weight and the degree (if any) of obesity.

The initial position in the body mass index (25-30) is calorie restriction of up to 1500 kcal per day for women and 1800 kcal for men per day. With an index of more than 30, the limit is respectively to 1,500 kcal per day for men and 1,400 kcal for women. The diet in all cases has structural changes: restriction of simple carbohydrates (up to 10% of calories), fats (up to 30-35% of calories) mainly due to animal fats (up to 10% of calories), enrichment of the diet with proteins (up to 25 %), vitamins, minerals, fiber (30 g) and vegetable fats (up to 20% of calories).

A sample menu for the day for overweight people who quit smoking (1800 kcal) Name of dishes Yield (g) Protein (g) Fats (g) Carbohydrates (g) Kcal First breakfast Buckwheat porridge with 1% milk 300 11.6 3,1 28.8 189.5 Braised Beets 200 4.2 - 16,4 82,4 Green tea with 5 g sugar 200 0.4 0.6 6.1 31,4 Lunch Low-fat cottage cheese 150 22.6 5,6 8.4 111.4 Dinner Vegetarian borsch (1/2 servings) 200 1.8 6.8 9.45 106,2 Boiled meat 90 13.6 6.9 3.4 130 Green peas without oil fifty 1.3 0.1 0.5 47.2 Figs fifty 0.5 - 10.8 47 Orange - 1 medium 150 1,2 - fifteen 64.8 High tea Sunflower seeds fifty 9 24 8.0 284 Rosehip broth 180 - - - - Dinner Boiled fish (halibut) one hundred 12.8 10.6 0.02 149.3 Vegetable stew (broccoli, spinach) 125 7.6 7.8 15,2 161.4 For the night Kefir and fat 180 7.0 1.8 8.1 75.6 All day Bran rye bread 200 8.4 1.65 69.9 320 Total grams 100 g 68 g * 200 g ** 400 600 800 1800 Kcal kcal kcal kcal kcal Structure (22.2%) (33.3%) (44.5%) (one hundred%) Note: If you remove both bread and sugar, then we get a diet of 1450-1500 kcal. * Vegetable fats more than half of all fats 20 g (20% of calories). ** Complex carbohydrates - fiber - 30 g.

Thus, it is possible to give the nutrition structure, the composition of the diet for smoking cessation and various calories depending on gender and initial body weight.

The chemical composition of the daily diet for smoking cessation Structure Squirrels Fats Carbohydrates Calorie content Upon refusal 20-25% 30-45% 40-45% 1200-1800 kcal from smoking WHO recommendations (2003) for 10-15% 20-30% 55-70% About 2000 kcal Healthy eating

With a BMI of 25 or more and / or complaints of increased appetite, 5 to 10 daily auricular acupuncture reflexology procedures are performed at points (AR 17 and AP 18). If technically feasible, the sessions are carried out during therapy used to quit smoking, and it is possible after that, when withdrawal symptoms are less pronounced and side effects need to be influenced more.

Needles and microneedles are used for single use, sterile. After treating the skin with 70% alcohol, the needles are inserted perpendicularly or at an angle to the points of “hunger” and “thirst”. The needle should penetrate to the cartilage, but never enter it. After the introduction of needles, in order to enhance the therapeutic effect, they should be rotated. With mild stimulation, rotate 1-2 times per session; with strong stimulation up to the effect of intentional sensations. You can use special microneedles and leave them for 7-10 days, sealed with adhesive plaster. The patient is instructed to press at certain points of the ear at certain intervals.

Patients with initially overweight are more prone to increase when quitting smoking. Although weight gain remains largely standard (3-4 kg, as indicated above), additional efforts may be required to motivate the patient to treat tobacco dependence.

In patients with a body mass index greater than 30, body weight correction is more difficult than in others. Therefore, along with recommendations for low-calorie nutrition, we performed an IRT to further adjust the "extra pounds" gained after quitting smoking. Corporate acupuncture is carried out 20-30 days after completion of the course for the treatment of tobacco dependence, consists of 10 daily or every day IRT procedures at the points of intersection of the anterior, middle and posterior axillary lines with a horizontal line drawn through the iliac crests. After treating the skin with 70% alcohol, the needles are inserted perpendicularly or at an angle; the needle should penetrate deep into the adipose tissue, but not touch the peritoneum. After the introduction of needles, in order to enhance the therapeutic effect, they should be rotated. With mild stimulation, rotate 1-2 times per session; with strong stimulation up to the effect of intentional sensations.

The duration of the session is 30 minutes.

During the treatment period, it was mainly possible to completely get rid of the "extra" kilograms gained as a result of quitting smoking.

In 18 patients out of 30, with a BMI of 25 or more, an auricular acupuncture course was conducted against the background of smoking cessation with a positive effect - prevention of weight gain after 1 year in 12 patients (66.5%). In 5 patients of them with a BMI of more than 30, in addition to the auricular patients treated with corporal RTI for obesity, the average weight loss was 4 ± 0.5 kg, and no weight gain was achieved. In 10 patients there was no indication for acupuncture (index below 25, appetite was not increased), in 2 patients acupuncture was contraindicated (benign neoplasms).

The invention is illustrated by the following examples.

Clinical example 1

A man, 36 years old, married, a smoker with 18 years of experience, 20 cigarettes a day, with arterial hypertension. In the process of treatment and smoking cessation, there was a slight increase in appetite, which required additional reflexotherapy intervention in the form of auricular acupuncture from the very first day. A 10-day course of treatment at the points of “hunger” and “thirst” was carried out against the background of treatment for tobacco dependence.

With a growth of 180 cm, the patient's weight was initially 102 kg; body mass index is 31.5. The level of blood pressure is 150/95 mm Hg. Art. Blood cholesterol - 280 mg / dl (moderate hypercholesterolemia according to WHO criteria, 2003). Since the body mass index exceeded 30, a corporal ИРТ course was carried out - 10 procedures every other day at the points of intersection of the anterior, middle, and posterior axillary lines with a horizontal line drawn through the iliac crests.

During the course of treatment and further throughout the year, the patient remained non-smokers. Diet was prescribed: given memos, reference material, examples of the menu.

Diet therapy suggested:

- calorie restriction up to 1500 kcal / day due to the restriction of animal fats and simple carbohydrates,

- enrichment of the diet with vegetables and fruits (up to 800 g) with a high "saturation index", rich in vitamins, minerals,

- enrichment of the diet with dietary fiber with antitoxic effects,

- restriction of cholesterol-containing products - offal, shrimp, egg yolks (taking into account hypercholesterolemia),

- restriction of salt due to pickled products, pickling, smoking due to high blood pressure.

By the second visit, a month after the end of the course, an improvement in the patient’s well-being and general condition was noted, and withdrawal symptoms were not observed. I tried to adhere to the recommendations given to him. The acid-base balance was normalized: the pH from 7.32 rose to 7.38.

Body mass indicators varied from the first visit to the fourth, i.e. 1, 6 and 12 months after the end of the course. During the observation period, slight fluctuations in body weight within 2 kg were noted: 1 month after the end of the course of treatment for tobacco dependence, the patient added 2 kilograms. Conducted 10 sessions of IRT therapy. After 6 months, the patient's weight recovered to its original values, and after a year with further dieting, it was 98 kg, which corresponds to an index of 30.3 units. Although the diagnosis of grade 1 obesity (according to the WHO classification, 2003) remained, the body mass index itself decreased by 1.2 units. Blood pressure a year after quitting smoking and dieting remained within normal limits. The cholesterol level decreased from 280 mg / dl at first to 250 mg / dl after a year (decrease by 10.7%). And this is already insignificant hypercholesterolemia according to WHO criteria (2003).

Clinical example 2

Patient E., 38 years old, asked for help with the goal of quitting smoking. Complains of fatigue, irritability, coughing in the morning, overweight, and increased appetite. Smoking experience - 20 years, 10-15 cigarettes per day. Repeated attempts to quit smoking ended in an increase in weight of 2-3 kg, after which she again lit a cigarette.

Currently, with a growth of 164 cm, the patient's body weight was 71 kg. The body mass index is 26.4 kg / m ² (BMI more than 25 units, but not more than 30 units). The diagnosis is overweight.

Conducted complex therapy using the standard scheme, auricular acupuncture - 10 sessions at the points of "hunger" and "thirst" and diet. A conversation was held with the patient, the necessary memos and tables were presented to determine the energy expenditure and calorie content of the products. Diet therapy suggested:

- calorie restriction up to 1500 kcal due to the restriction of animal fats and simple carbohydrates,

- enrichment of the diet with vegetables and fruits (up to 800 g) with a high "saturation index", vitamins, minerals,

- enrichment of the diet with dietary fiber with antitoxic effects,

- The additional purpose of vitamin C is 150 mg per day.

During the treatment, there was a slight increase in appetite, which required additional reflexotherapy correction in the form of auricular acupuncture from the first day.

By the second visit, a month after the end of the course, there was an improvement in the patient’s well-being and general condition, withdrawal symptoms were not observed, breathing became freer, increased appetite ceased to bother, and the appearance improved. Acid-base equilibrium shifted to the alkaline side within normal values: the pH from 7.36 rose to 7.40.

During the observation period, slight fluctuations in body weight within 1-2 kg were noted: 1 month after the end of the course of treatment for tobacco dependence and overweight, the patient did not add a single kilogram, lost 4 kg to the second visit (after 6 months), and by the end years, continuing to follow a diet, stabilized this weight. Currently, with a growth of 164 cm, the patient's body weight was 67 kg. Body mass index equal decreased by 1.5 units. and amounted to 24.9 kg / m ² , which corresponds to the norm.

During the treatment period, it was mainly possible to completely get rid of the "extra" kilograms gained as a result of quitting smoking.

Thus, the claimed invention made it possible to correct the increase in body weight during smoking cessation without the use of additional drug therapy, without side effects, given the sharp increase in appetite, nicotine intoxication, hypovitaminosis, acid-base imbalance in the body when smoking, conditioned reflex in nutrition with certain foods, helping to maintain long-term remission.

Literature

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Claims (1)

A method for correcting weight gain during smoking cessation, characterized in that they carry out a low-calorie diet with a restriction of simple carbohydrates to 10% of calories, total fats - up to 30-35% of calories, animal fats - up to 10%, with protein enrichment up to 25%, vitamins, minerals, and magnesium - up to 500 mg, fiber - up to 30 g; with a body mass index of 25-30 units, calorie restriction of food to 1800 kcal per day in men and 1500 kcal in women, a course of auriculo-acupuncture is prescribed - 10 sessions of 30 minutes at the points of AR 17 and AP 18; with a body mass index of more than 30, calorie restriction of food to 1,500 kcal per day in men and 1,400 kcal in women, in addition to auricular acupuncture with a body mass index of more than 30, 10 corporal acupuncture procedures are carried out every other day or every 30 minutes every 20 minutes , at the points of intersection of the anterior, middle, and posterior axillary lines with a horizontal line drawn through the iliac crests.