RU2440834C1 - Method of complex treatment of arterial hypertension with metabolic syndrome - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention relates to medicine, namely to cardiology, physiotherapy. Method includes basic rehabilitating treatment, by carrying out magnetic therapy. Rotating pulse magnetic fields from physiotherapeutic device "UMTI-3F" Colibri-expert is used in two stages. At the first stage impact is performed on lower extremities. Impact is realised by magnetic field in configuration "prism" for 10-15 minutes. Used are third mode, value of magnetic induction 16 mT, frequency 100 Hz. Procedures are carried out daily, 3 procedures for a course. At the second stage impact on abdomen area is performed. Impact is realised by magnetic field in configuration "prism" for 15 minutes. Used are fourth mode, value of magnetic induction 32 mT, frequency 100 Hz. Procedures are carried out daily, 10-12 procedures for a course. ^ EFFECT: method increases efficiency of rehabilitation treatment due to improvement of parameters of hemodynamics, coronary blood flow, carbohydrate and lipid exchange. ^ 2 ex, 4 tbl

Description

The present invention relates to medicine, namely to cardiology, rehabilitation medicine and physiotherapy, and can be used for the prevention and complex treatment of patients with diseases of the cardiovascular system in medical diagnostic and sanatorium institutions.

Currently, hypertension with metabolic syndrome (MS) is the most common disease. According to WHO data for 2005, Russia occupies one of the leading places in terms of mortality from cardiovascular diseases. The prevalence of metabolic syndrome is 20-40%. The presence of MS 3-6 times increases the risk of developing diseases such as type II diabetes mellitus, arterial hypertension, the development of atherosclerosis (Bykov A.T. Optimization of rehabilitation treatment of patients with coronary heart disease and metabolic syndrome / A.T. Bykov, A.V. . Chernyshev // Bulletin of regenerative medicine. - 2010. - No. 1. - P.54-56).

The use of drug therapy, including antihypertensives, diuretics, calcium antagonists and drugs of other groups, leads to the development of adverse reactions and intolerance to drugs. Therefore, doctors and researchers are looking for new and effective methods of treating patients with this pathology.

In recent years, general magnetotherapy, which has several advantages, has been actively used in the treatment of patients with arterial hypertension. Exposure to an alternating low-intensity pulsed magnetic field is carried out with a small magnitude of magnetic induction, is low-load. Magnetotherapy allows you to affect the whole body, deeply located organs and tissues, having a pronounced hypotensive effect, is an effective pathogenetic method for the treatment of hypertension with metabolic syndrome.

According to the All-Russian Scientific Society of Cardiology (GFCF), the definition of the metabolic syndrome is characterized by an increase in visceral fat mass, a decrease in insulin sensitivity, and hyperinsulinemia.

Known methods of exposure in the metabolic syndrome (exercise therapy and diet therapy) are aimed only at inhibiting the progression of the metabolic syndrome, but do not have a significant effect on the pathogenetic links of the disease, do not allow to maintain the results achieved.

General magnetotherapy meets these requirements, the distinguishing feature of which is the ability to affect most of the clinical symptom complex of the disease due to antispasmodic, hypotensive, sedative, hypolipidemic and hypocoagulation effects, has a vegetotropic effect. Magnetotherapy has the ability to consolidate the results achieved at the level of functioning of the central nervous system, which is most pronounced with its multi-course effect (Ulashchik BC General magnetotherapy and its use / BC Ulashchik, E.I. Zolotukhina // Health. - 2000. - No. 8. - C .44-46).

A new direction in the development of general magnetotherapy is the use of the physiotherapy unit UMTI-3F Kolibri-Expert. The device provides an impact on the body with a non-uniform rotating pulsed magnetic field with a modulation frequency of 100 Hz and a maximum induction of 32 mT.

For the prototype of the present invention, a method for the treatment of hypertension of the I and II stages using traveling and rotating pulsed magnetic fields has been selected. This method is carried out as follows: the exposure area on the upper half of the body and head with a frequency of 100 Hz, mode I, 5-10 minutes in the irritation mode (magnetic induction 32 mT) and 10-20 minutes in the stabilization mode (magnetic induction 16 mT ) within 2 days. In the following days of treatment, 15-30 minutes in stabilization mode. The course of treatment is 8-12 procedures (Ponomarenko G.N. Collection of methodological materials on the use of general magnetotherapy from the physiotherapy unit "UMTI-3F" Kolibri-Expert, St. Petersburg - Nizhny Novgorod, 2008; Methodological recommendations for the use of medical methods from the Kolibri device Expert, developed by IMC "Madin", Nizhny Novgorod, 1996).

The above method is not effective enough, since it does not provide for the combined pathology of arterial hypertension with the metabolic syndrome, and does not allow affecting the main links of the pathogenetic mechanism of the metabolic syndrome.

The objective of the invention is to develop a method for the treatment of arterial hypertension with metabolic syndrome, which allows to influence all links of the pathogenesis of this combined pathology.

The technical result of the proposed method is to improve hemodynamics and coronary blood flow, carbohydrate and lipid metabolism.

The proposed method is as follows: against the background of basic treatment, general magnetotherapy is used in two stages using rotating pulsed magnetic fields from the physiotherapy unit UMTI-3F Kolibri-Expert.

At the first stage, magnetotherapy is performed with the impact on the lower extremities of rotating pulsed magnetic fields in a “prism” configuration with a frequency of 100 Hz, in 3 mode and a magnetic induction value of 16 mT, for 10-15 minutes a course of 3 daily procedures. At the second stage of treatment, the abdominal region is applied using rotating pulsed magnetic fields in a “prism” configuration with a frequency of 100 Hz, in 4 modes, and a magnetic induction value of 32 mT for 15 minutes with a course of 10-12 daily procedures.

The proposed method treated 62 patients with stage I-II hypertension with a metabolic syndrome of a male aged 28 to 58 years (average age 47.4 ± 2.5 years).

Before starting treatment, all patients underwent general and biochemical blood tests, blood for sugar, urinalysis, ECG, daily monitoring of blood pressure.

The following hemodynamic indicators were used to evaluate the effectiveness of treatment: systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (SBP), pulse blood pressure (pAD), heart rate, respiratory rate, and their intersystem ratio (heart rate) / BH). To evaluate the metabolic syndrome: body mass index, waist circumference, hip circumference. To determine the psychophysical state, the SAN test was used. Measurement of parameters and assessment of well-being, activity and mood were carried out before and after the procedures of general magnetotherapy.

After the course of treatment, all patients with arterial hypertension with metabolic syndrome in the main group showed a positive dynamics of clinical symptoms. Headaches, dizziness disappeared, shortness of breath decreased, sleep recovery, increased efficiency, decreased irritability, and normalization of blood pressure were noted. Blood pressure levels decreased: SBP by 18.6% (p <0.05), DBP by 17.9% (p <0.05), BPP by 18.6% (p <0.05), and DBP by 22 , 0% (p <0.05), heart rate by 12.4% (p <0.05), which indicates the positive effect of general magnetotherapy in the rehabilitation treatment of patients with hypertension with metabolic syndrome (table 1).

Against the background of the treatment, a positive dynamics of the lipid spectrum was noted. The level of total cholesterol in the main group decreased by 37.4%, (p <0.05), LDL by 30.0% (p <0.05), TG by 26.6% (p <0.05), HDL increased by 21.1% (p <0.05) (table 2).

Against the background of the course of general magnetotherapy using rotating pulsed magnetic fields, the blood sugar level is normalized by 19.1% (p <0.05).

Anthropometric indicators of the main group and the comparison group decreased during the observation period: body weight by 2.9% (p> 0.05), waist circumference by 2.3% (p> 0.05) (table 3).

Assessment of the psychophysical state according to testing (SAN test) revealed a positive dynamics of indicators characterizing the level of well-being, physical activity, working capacity and mood (p <0.05) (table 4).

In the available scientific, medical and patent literature, there is information about the popularity of the method of treating arterial hypertension with metabolic syndrome, characterized by the fact that, against the background of basic rehabilitation treatment, general magnetotherapy is carried out using rotating pulsed magnetic fields from the UMTI-3F physiotherapy Colibri-Expert in two stage, with the first stage acting on the lower extremities with a magnetic field in the “prism” configuration, a frequency of 100 Hz, 3 mode and the magnitude of the magnetic in Injections 16 mTl for 10-15 minutes with a course of 3 daily procedures, at the second stage of treatment, they influence the abdomen with a magnetic field in a “prism” configuration with a frequency of 100 Hz, 4 modes and a magnetic induction of 32 mT for 15 minutes with a course of 10-12 daily routines not found. Thus, the claimed invention meets the criterion of "novelty."

The authors' studies proved that conducting a general magnetic therapy using rotating pulsed magnetic fields against the background of basic rehabilitation treatment from the UMTI-3F physiotherapeutic installation by Hummingbird-Expert in two stages, while at the first stage the lower limbs are exposed to a magnetic field in the “prism” configuration ", With a frequency of 100 Hz, 3 modes and a magnetic induction value of 16 mT for 10-15 minutes with a course of 3 daily procedures, at the second stage of treatment, they affect m field in configuration "prism" 100 Hz, 4 mode and the magnitude of the magnetic induction 32 mT for 15 minutes course of 10-12 daily procedures, provides improved hemodynamic and coronary flow, carbohydrate and lipid metabolism. Thus, the claimed invention meets the criterion of "inventive step".

The proposed method is illustrated by the following clinical examples.

Example 1. Patient R., 47 years old, was admitted to a spa treatment with a diagnosis of hypertension of the II stage, II degree, risk 3. Concomitant diagnosis: Obesity of I degree.

Complaints of headaches with predominant localization in the occipital region, dizziness, shortness of breath, increased fatigue, psychoemotional lability. Sick for 5 years. Antihypertensive therapy was not carried out regularly. On an ECG: Sinus rhythm with a heart rate of 74 beats per minute, impaired repolarization in the antero-apical-lateral region of the left ventricle, signs of left ventricular myocardial hypertrophy. HELL 145/95 mm Hg Biochemical analysis of blood: total cholesterol 7.3 mmol / L, LDL 2.4 mmol / L, HDL 1 mmol / L, triglycerides 2.4 mmol / L. Blood sugar - 6.1 mmol / L. Drug treatment was: diroton, cardiomagnyl. The basic treatment included: climatotherapy, diet therapy, herbal medicine, dosed walking, exercise therapy, massage.

Treatment was prescribed according to the claimed method: general magnetotherapy from the Kolibri-Expert apparatus. The first three procedures for 10 minutes each using rotating pulsed magnetic fields in the “prism” configuration on the lower extremities, at a pulse frequency of 100 Hz and a magnetic induction of 16 mT in 3 modes. From the fourth procedure - the use of rotating pulsed magnetic fields in the “prism” configuration on the abdomen, at a frequency of 100 Hz and a magnetic induction value of 32 mT in 4 modes for 15 minutes, No. 12, daily.

After 2-3 days of treatment, a positive trend was observed: improvement of well-being, sleep, reduction of headaches. Blood pressure decreased to 130/80 mm Hg. By the end of treatment, headaches in the back of the head disappeared. HELL 125/75 mm Hg, heart rate was 68 beats per minute. A blood biochemical analysis is close to normal: total cholesterol 4.5 mmol / L, LDL 1.9 mmol / L, HDL 1.6 mmol / L, triglycerides 1.7 mmol / L. Blood sugar 5 mmol / L. The daily dose of diroton was reduced from 20.0 mg to 10.0 mg. On the ECG, the processes of repolarization in the myocardium of the left ventricle improved. Assessment of the psychophysical state according to testing (SAN test) revealed a positive dynamics of indicators characterizing the level of well-being, physical activity, performance and mood (p <0.05).

Example 2. Patient K., 52 years old, was admitted to a spa treatment with a diagnosis of Hypertension stage II, II degree, risk 3. Concomitant diagnosis: Obesity II degree.

Complaints of headaches, dizziness, shortness of breath, fatigue, psycho-emotional lability. Sick for 10 years with a crisis, a frequency of 1-2 times a month. Blood pressure ranged from 140/90 to 160/100 mm Hg. Art. ECG: Sinus rhythm with a heart rate of 78 beats per minute, horizontal EOS, signs of left ventricular myocardial hypertrophy. Biochemical blood test: total cholesterol 7.9 mmol / L, LDL 2.5 mmol / L, HDL 0.8 mmol / L, triglycerides 2.7 mmol / L. Blood sugar - 6.3 mmol / L. Drug treatment was: diroton, cardiomagnyl. The basic treatment included: climatotherapy, diet therapy, herbal medicine, exercise therapy, massage.

Treatment was prescribed according to the claimed method: general magnetotherapy from the Kolibri-Expert apparatus. The first three procedures for 10 minutes each using rotating pulsed magnetic fields in a “prism” configuration on the lower extremities, at a pulse frequency of 100 Hz and a magnetic induction of 16 mT in mode III. From the fourth procedure - using rotating pulsed magnetic fields in the “prism” configuration on the abdomen, at a frequency of 100 Hz and a magnetic induction value of 32 mT in IV mode for 15 minutes, No. 12, daily.

By the end of treatment, headaches disappeared. HELL 125/75 mm Hg, heart rate was 68 beats per minute. Blood biochemical analysis is close to normal: total cholesterol 5.0 mmol / L, LDL 2.0 mmol / L, HDL 1.4 mmol / L, triglycerides 1.7 mmol / L. Blood sugar 5.0 mmol / L. Assessment of the psychophysical state according to testing (SAN test) revealed a positive dynamics of indicators characterizing the level of well-being, physical activity, performance and mood (p <0.05).

The proposed method is easily reproducible in the conditions of medical diagnostic and sanatorium institutions. Thus, the claimed invention meets the criterion of "industrial applicability".

Table 1 Dynamics of hemodynamic parameters in patients with arterial hypertension with metabolic syndrome on the background of general magnetotherapy (M ± m) Hemodynamic index Patients with arterial hypertension with metabolic syndrome. Comparison Group (n = 58) The main group (n = 62) before treatment after treatment before treatment after treatment GARDEN, mmHg 155.5 ± 0.04 135.7 ± 0.02 155.5 ± 0.04 126.5 ± 0.02 * DBP, mmHg 105.6 ± 0.05 90.4 ± 0.04 105.6 ± 0.05 86.7 ± 0.02 * Wed, mmHg 159.8 ± 0.03 136.8 ± 0.04 159.8 ± 0.03 130.1 ± 0.05 * PAD, mmHg 49.9 ± 0.03 45.3 ± 0.02 49.9 ± 0.03 39.8 ± 0.02 * Heart rate, beats in min 78.2 ± 0.04 75.1 ± 0.01 78.2 ± 0.04 68.5 ± 0.05 * * Significance of differences in indicators before and after treatment, p <0.05

table 2 Dynamics of the lipid profile of blood of patients with arterial hypertension with metabolic syndrome on the background of a course of general magnetotherapy (M ± m) Groups The main group (n = 62) Comparison Group (n = 58) Indicators before treatment after treatment before treatment after treatment OHS, mmol / l 7.21 ± 0.02 4.51 ± 0.04 * 7.21 ± 0.02 5.82 ± 0.03 HDL cholesterol, mmol / l 1.12 ± 0.03 1.42 ± 0.05 * 1.12 ± 0.03 1.13 ± 0.04 LDL cholesterol mmol / l 2.87 ± 0.04 2.01 ± 0.05 * 2.87 ± 0.04 2.34 ± 0.03 TG, mmol / l 2.41 ± 0.04 1.77 ± 0.03 * 2.41 ± 0.04 2.25 ± 0.02 * Significance of differences in indicators before and after treatment, p <0.05

Table 3 Dynamics of anthropometric indicators in patients with arterial hypertension with metabolic syndrome on the background of a course of general magnetotherapy (M ± m) Indicator The main group (n = 62) Comparison Group (n = 58) before treatment after treatment before treatment after treatment Body weight (kg) 88.8 ± 0.04 86.2 ± 0.03 88.8 ± 0.04 88.2 ± 0.03 Waist circumference (cm) 98.4 ± 0.05 96.1 ± 0.04 98.4 ± 0.05 97.1 ± 0.04

Table 4 The effect of general magnetotherapy on the psychophysical state of patients with arterial hypertension with metabolic syndrome (M ± m) The indicator of the psychophysical state Patients with cardiovascular disease Comparison Group (n = 58) The main group (n = 62) before treatment after treatment before treatment after treatment Feeling well 2.3 ± 0.6 4.3 ± 0.4 2.3 ± 0.6 2.7 ± 0.4 * Activity 2.4 ± 0.6 4.2 ± 0.4 2.4 ± 0.6 2.8 ± 0.4 * Mood 2.5 ± 0.6 4.4 ± 0.4 2.5 ± 0.6 2.9 ± 0.4 * * Significance of differences in indicators before and after treatment, p <0.05

Claims (1)

A method of treating arterial hypertension with metabolic syndrome, characterized in that, against the background of basic rehabilitation treatment, general magnetotherapy is carried out using rotating pulsed magnetic fields from the UMTI-3F Colibri-Expert physiotherapeutic installation in two stages, while the first stage acts on the lower extremities with a magnetic field in a “prism” configuration with a frequency of 100 Hz 3 mode and a magnetic induction value of 16 mT for 10-15 minutes with a course of 3 daily procedures, at the second stage of treatment Nyi effect the abdominal area with a magnetic field in a “prism” configuration with a frequency of 100 Hz 4 mode and a magnetic induction value of 32 mT for 15 minutes with a course of 10-12 daily procedures.