RU2494708C1 - Method of treating progressing myopia in children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to ophthalmology and pediatrics, and can be used for treatment of progressing myopia in children. For this purpose homeopathic medication placenta compositum is introduced into acupuncture points BL1 (UB1), ST1, EX-HN7(QIUHOU), GB1, EX-HN4(YUYAO) in dose 0.2 ml into each point. After that head area is subjected to exposure to pulse low-frequency electromagnetic field (PLEMF). Course of treatment constitutes 10 procedures, performed every second day.

EFFECT: method ensures reduction of rate of myopia progress and elimination of impairment in regional hemodynamics of eye, developed as a result of existing for a long time myopic defocus, at the background of stabilisation of processes of cell metabolism in connective tissue.

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Description

The invention relates to medicine, namely to ophthalmology, pediatrics, and can be used to treat progressive myopia in children as a manifestation of connective tissue dysplasia (DST).

DST is a systemic disease of connective tissue, a genetically heterogeneous and clinically polymorphic pathological condition due to impaired development of connective tissue in the embryonic and postnatal periods. It is characterized by defects in the fibrous structures and the main substance of the connective tissue, leading to a disorder of homeostasis at the tissue, organ and organism levels in the form of various morphological and functional disorders of visceral and locomotor organs with a gradient course.

Pathology of the organ of vision is extremely common with connective tissue dysplasia. So, myopia takes first place among the ocular manifestations of DST (Vorontsova T.N., Brzhevsky V.V., 2009).

A known method of non-pharmacological treatment of acquired myopia using acupuncture, post-isometric relaxation (myotherapy) and pharmacopuncture with Alloplant biomaterial (RF patent No. 2329029 of 04/03/07). A combination of acupuncture techniques is performed (pointing to the paraorbital points E1, 2, V1, 2, VB1, TR23, VB14, PC3, 5, 6, PN1, 8 lasting 10-15 minutes, points of general action on the meridians lasting 20-30 minutes, auricular points responsible for vision lasting 10-20 minutes 10 sessions), myotherapy (by eliminating subluxation in the atlanto-axial articulation by traction of the skull up the axis of the spine with simultaneous maximum rotation alternately in both directions during exhalation of the patient and turning the eyes in the same direction one hand and fixer her second spinous processes of the lower cervical vertebrae and with the other hand and then consolidate the results of the same name in turn turns the head and eyes in both directions on exhalation by the patient 3 times per year), diluted in saline pharmacopuncture biomaterial "biomaterials".

However, this technique has several disadvantages: the pain of this procedure in connection with the duration and frequency of injections. The combination of acupuncture and the additional introduction of Alloplant biomaterial into acupuncture points limits the use of preschool and primary school children. The disadvantages of the technique include the lack of a systemic effect on the body, since the main effect is due to the neurotrophic effect of the pharmacopuncture procedure and a local change in hemodynamic parameters in the membranes of the eye, as well as the lack of immunomodulating action necessary for systemic mesenchymal dysfunction. Given the lack of effect after a single procedure according to the proposed treatment regimen, the clinical significance of the course of treatment is questioned.

The prototype adopted a method of treating myopia in children, combined with extraocular pathology in the form of inflammatory kidney diseases (RF patent 2371146 C1 from 4.07.2008). The principle is to combine the use of a pulsed low-frequency electromagnetic field (INEMP) with a daily exposure of at least 9 minutes against the background of ongoing drug therapy of inflammatory kidney diseases. In this case, the effect of INEMP on the body and in particular the pathology of the kidneys was studied, but the effect of this technique on the body with clinically significant manifestations of systemic mesenchymal dysfunction, which determines the course of myopia and requires changes in the principles of therapy, was not considered. In addition, the therapeutic effect is observed only after a course of treatment, while performing a single procedure to improve subjective visual acuity by patients was not observed.

An object of the present invention is to provide a method for treating progressive myopia as a manifestation of connective tissue dysplasia in children.

The problem is solved due to the fact that in the method of treating progressive myopia in children, a combination of therapeutic methods of local exposure to the accommodation apparatus of the eye is applied using the local biopuncture method - the introduction of the homeopathic preparation Placenta compositum of the Heel company (Germany) intradermally into acupuncture points located in the perorbital region, and the action of INEMP on the head region remotely using the INFITA apparatus according to the standard method.

The technical result of the proposed method is the amplification of immediate reactions from the organ of vision resulting from biopuncture, which reduces the rate of further progression of myopia, and the elimination of disorders existing in the regional hemodynamics of the eye due to the long-term myopic defocus against the background of stabilization of cellular metabolism in the connective tissue.

The method is as follows: The subject is in a prone position. The search for acupuncture points in the periorbital region of the eyelids is carried out in a standard way, for example, using the “Acu Vision-04” or “Search” device. For therapy, the following points must be found:

- BL1 (UB1) - on both sides of the nose bridge, in the inner corner of the eye;

- ST1 - the middle of the lower eyelid in the projection of the pupil;

- EX-HN7 (QIUHOU) - lower eyelid in the middle between points ST1 and GB1;

- GB1 - in the external commissure of the eyelids;

- EX-HN4 (YUYAO) - the skin of the upper eyelid at the level of the middle eyebrow.

After the detection of acupuncture points, an “Anla” anesthetic cream of less than 1 g was applied to the skin, an occlusive dressing was applied for 15-20 minutes. Then, intracutaneously, in the area of visualized acupuncture points, an injection with a mesotherapy needle of 30g × 4mm was made with the introduction of a homeopathic preparation in an amount of 0.2 ml per point. After the introduction of a homeopathic remedy, the INFITA apparatus is turned on. The patient is in a sitting position at a table at a distance of 20-30 cm from the device, eyes at the level of the emitter. The effect of INEMP on the head area. The course of treatment consists of 10 treatments every other day.

The impact of INEMP was carried out according to the following scheme:

The first procedure - 40 Hz, duration 9 min;

The second procedure - 60 Hz, duration 9 min;

The third procedure - 80 Hz, duration 9 min;

In the following procedures, the INEMP is exposed from the INFITA apparatus with a change in the frequency of exposure in each procedure: 60-40-60-80-60-40-60-60 Hz, with an exposure of at least 9 minutes in each procedure. Thus, each procedure has its own frequency of INEMP, which avoids the problem of getting used to this type of physiotherapeutic effect.

The INFITA device is an electromagnetic physiotherapeutic device intended for use in physiotherapy departments, offices of medical institutions. The pathogenetic effect of INEMP is due to the regulatory effect on neuro- and hemodynamics, microcirculation. The therapeutic effect of the apparatus is realized with non-contact use through the opto-thalamo and hypothalamic-pituitary system due to the regulation of subcortical-cortical bioelectric processes, the exchange of neurotransmitters of the endorphin and immune systems, hormonal activity of the endocrine glands, and the improvement of neuro- and general hemodynamics, as a result of which it normalizes microcirculation in tissues, general and peripheral blood circulation, blood rheology, anti-inflammatory effect occurs.

The placenta compositum is a homeopathic anti-homotoxic drug. Thanks to its microdoses of potentiated biologically active components, the placenta compositum normalizes the trophism of the walls of blood vessels, has a venotonic, antispastic and vasodilating effect.

The pathogenetic rationale for the combined use of INEMP and local biopuncture of the eyelids is due to the complex effect of the techniques on general and local neuro- and hemodynamics.

Thus, according to our data, a single procedure of exposure to INEMP using the INFITA apparatus leads to a redistribution of blood flow with increased blood supply at the level of the retinal layers (ganglion cells, etc.) against the background of a significant decrease in blood supply to the choroid vessels, which leads to a decrease in trophism of the photoreceptor layer and pigment epithelium the retina. As a result of our experimental study, such a redistribution of blood flow is necessary to reduce the delivery of retinoic acid and slow the stretching of the sclera, i.e. slowing the progression of myopia (J.R. Mertz and J.Walman "Choroidal Retinoic Acid Synthesis: A Possible Mediator between Refractive Error and Compensatory Eye Growth", 2000).

As a result of a single biopuncture procedure in children, according to computer accommodation data, a significant increase in the accommodation response without excessive ciliary muscle tension was revealed.

Clinical studies of recent years have proved that the region of the skin of the eyelids acts as a receptive field, a reflexogenic zone that interacts with the accommodation apparatus of the eye, the function of which changes with myopia. The communication mechanism is explained by the distribution in the eyelids of the nerve branches of the optic nerve. The nasociliary nerve is the largest branch of the first branch of the trigeminal nerve. Several branches (long ciliary nerves) depart from it, perforating in the posterior sclera and extending further into the perichoroid space of the eyeball. These nerves provide the trophic innervation of the cornea, iris, ciliary body, which is a continuation of the choroid itself. With the introduction of various drugs into the skin of the eyelids, the effect is directly on the acupuncture point - the exit point of the nerve endings, which leads to local microcirculatory changes and an improvement in the state of accommodation. The introduction of a medicinal substance provides prolonged stimulation and trophic acupuncture points through prolonged drug infiltration of the zone of its localization. In addition to trophic effects, a locally irritating effect is carried out - a reaction to “pain” with immediate activation of the autonomic nervous system, which stimulates the ciliary muscle.

It is known that the regulation of the activity of the ciliary muscle is carried out both by the parasympathetic and sympathetic departments of the autonomic nervous system and the effect of the two systems is not reduced to their simple antagonism (E.S. Avetisov, 1986). And the therapeutic effect of the INFITA apparatus is realized with non-contact application through the opto-thalamo and hypothalamic-pituitary system due to the regulation of subcortical-cortical bioelectric processes, the exchange of neurotransmitters of the endorphin and immune systems. According to our data, the course of infatherapy combined with biopuncture led to an even greater increase in the accommodation response.

When assessing long-term results after a combined use of local biopuncture of the eyelids and the systemic effects of INEMP, stabilization of clinical refraction and the lack of growth of the anterior-posterior size of the eye were revealed by echobiometry.

Thus, along with changes in general and local neuro- and hemodynamics and systemic effects on tissue metabolism, INEMP has a unidirectional effect with the biopuncture method on the accommodation apparatus of the eye with a long-term therapeutic effect. Due to the combination of the effects of the two methods, an immediate response from the organ of vision is obtained, which reduces the rate of further progression of myopia, and the elimination of violations existing in the regional hemodynamics of the eye due to stabilization of the processes of cell metabolism to the connective tissue is created due to biopuncture.

According to the method of the claimed method, 43 children were treated with progressive myopia from 1.0 to 6.0 diopters at the age of 7-14 years.

The treatment results are illustrated by the following examples, confirming the effectiveness of the proposed method for the treatment of progressive myopia in children.

Example 1. Child K., 14 years old, observed since 9 years of age due to progressive myopia, has signs of DST in organs and systems. On examination, he complained of increased fatigue, periodic pain in the epigastrium and in the right hypochondrium, lethargy, drowsiness with changing weather, rapid visual fatigue, decreased vision in the distance over the past year. On examination, specialists revealed: high growth, kyphoscoliosis, flat feet, gastroduodenitis, biliary tract dysfunction, vegetovascular dystonia, anomaly of subvalvular heart structures, marfan-like syndrome. In ophthalmic status, clinical refraction is 4.5 diopters, anteroposterior eye size (PZR) is 25.45 mm. Over the past year, clinical refraction has increased by 0.75 diopters, despite the ongoing therapy: accommodation training according to Avetisov-Matz, vitamin therapy with blueberries. Complex treatment was carried out, consisting in the application of the method of local biopuncture of the eyelids using the placenta-compositum preparation and remote exposure of the head area of the INFITA apparatus with a course of 10 procedures. From the first day, the child noted such changes as an improvement in mood, general well-being, an increase in vitality, and a decrease in visual fatigue. Immediately after the procedure of eyelid biopuncture, a subjective increase in visual acuity was noted. According to accommodation data, after the procedure of eyelid biopuncture, the overall accommodation response significantly increased compared to the initial state, the weakness of the accommodation response: the growth rate (CD) OD increased from 0.488 to 0.588, OS from 0.585 to 0.6, and the accommodation response coefficient (CAO) OD from 0.099 ± 0.017 to 0.12 ± 0.011, OS from 0.319 ± 0.019 to 0.42 ± 0.014, decrease in microfluctuation coefficient (HFC) OD from 53.42 ± 0.829 to 52.42 ± 0.7, OS - the indicator has not changed . In combination with the effect of INEMP after a course of procedures, a significant increase in the accommodation response was observed against the background of relaxation of the ciliary muscle. So, the growth of CR OD indicators from 0.588 to 0.6, OS from 0.6 to 0.65, KAO OD 0.12 ± 0.011 to 0.15 ± 0.018, OS from 0.42 ± 0.014 to 0.45 ± continued 0.014, decrease in HFC OD from 52.42 ± 0.7 to 52.00 ± 0.6, OS - indicators did not change. In addition, according to the ultrasound dopplerography of the eye vessels, the following changes were noted after the procedure: an increase in the systolic blood flow velocity in the central retinal artery (CAS) from 8.71 to 12.63 cm / s and from 13.5 to 14.81 cm / s (p <0.05); increase in the speed of venous outflow from the central retinal vein (CVS) from 5.66 to 6.53 and from 6.10 to 6.53 cm / s (p <0.05); decrease in systolic blood flow velocity in OS choroid from 21.78 to 11.32 cm / s (p <0.05) against the background of an increase in OU resistance indices from 0.72 to 0.76 and from 0.68 to 0.81 (p <0.05); an increase in systolic blood flow velocity in the posterior long ciliary artery (ZDCA) from OD 8.71 to 10.02 cm / s (p <0.05), OS - no significant changes were detected. When the child was observed after 12 months in ophthalmic status, stabilization of clinical refraction at the previous level of -4.5 was found, the PZR remained the same 25.45 mm, and during the last year the patient had no pain in the epigastric region and in the right hypochondrium, increased endurance to school loads.

Example 2. Child M., 10 years old, observed from 8 years of age due to progressive myopia. On examination, complained of increased rapid visual fatigue, decreased vision in the distance over the past year. On examination, specialists revealed single signs of DST: malocclusion, caries, vegetovascular dystonia, mitral valve prolapse, joint hypermobility. In ophthalmological status, clinical refraction is 3.0, and a PZR of 24.92 mm. Over the past year, refraction increased by 0.5 diopters, despite the ongoing therapy (vitamin therapy with blueberries, spectacle correction, eye gymnastics). A complex treatment was carried out, consisting in the use of local biopuncture of the eyelids using the placenta compositum preparation and remote exposure of the head area of the INFITA apparatus for 10 procedures. According to accommodation data, after a single biopuncture procedure in combination with the influence of INEMP, an increase in KAO indicators (OD from 0.098 ± 0.014 to 0.190 ± 0.023, OS from 0.12 ± 0.009 to 0.13 ± 0.1), and CR (OD from 0.463 ± 0.07 to 0.512 ± 0.009, OS from 0.55 ± 0.014 to 0.61 ± 0.023), HFC reduction (OD from 54.95 ± 0.5 to 53.01 ± 0.34, OS from 55.80 ± 0.52 to 55.70 ± 0.7), which indicates an improvement in the accommodation response, but less pronounced. According to the results of Doppler ultrasound, an increase in systolic blood flow velocity in the CAC was detected only on OS from 10.81 to 13.95 cm / s (p <0.05); increased venous outflow from CVS from 6.81 to 5.58 cm / s; decrease in resistance indices in the choroid OU from 0.64 to 0.56 and from 0.71 to 0.66 against the background of a decrease in systolic blood flow velocity from 15.34 to 12.55 cm / s and from 19.18 to 12.20 cm /from. There was no general trend in blood flow changes in the CDCA. After 6 months, the patient filed repeated complaints of increased visual fatigue. After a repeated course of local biopuncture in combination with infatherapy, complaints of visual fatigue decreased significantly, refraction remained the same - 3.0D growth of the anteroposterior segment was not detected according to echobiometry, 24.92 mm.

Thus, the above examples confirm the effectiveness of the proposed method for the treatment of progressive myopia in children as manifestations of connective tissue dysplasia in children.

Claims (1)

A method for treating progressive myopia, including exposure to a pulsed low-frequency electromagnetic field (INEMP) on the head area, characterized in that, in addition to the impact of INEMP, the homeopathic preparation Placenta compositum is introduced into the acupuncture points BL1 (UB1), ST1, EX-HN7 (QIUHOU), GB1 , EX-HN4 (YUYAO) 0.2 ml at each point, exposure is carried out by a course consisting of 10 procedures, carried out every other day.