RU2614209C1 - Method for glossalgia physical therapy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: mesodiencephalic modulation is performed. Pulse stimulation currents with a carrier frequency of 10,000 Hz, modulated in the low frequency range, varying from 20 to 100 Hz in a single session is used. current supply power changes from 0.5 to 4 mA during a session. The duration of each session is 30 minutes. The procedures are daily. During the first 3 days, two procedures are performed with a minimum interval of 6 hours, later - one procedure per day. The therapeutic course is 13 procedures.

EFFECT: method provides relief of pain and paresthetic feelings, restoration of normal sensation and tissue viability function, improved microcirculation and oxygenation.

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Description

The invention relates to medicine, namely to dentistry, physiotherapy, neurology, and can be used in the treatment of glossalgia.

Glossalgia (tongue burning syndrome, glossodynia, glossopyrosis, tongue vegetosis) is a pathology of the oral cavity, which is clinically manifested by the presence of long-term persistent pain and paresthetic sensations in the tongue in the absence of significant pathomorphological changes in its constituent tissues.

This disease is a variant of stomalgia and represents a complex medical problem of polyetiological origin, associated with dysfunction of the autonomic nervous system against a background of various somatic, neurological, mental and systemic metabolic disorders, which is why it is often identified by specialists as sensory neurosis of the tongue.

The absence of a clearly defined scientific vision of etiopathogenesis and a unified therapeutic strategy for glossalgia are obstacles to the successful treatment of this pathology and determine the relevance of theoretical and practical research in this area.

The pathophysiological aspects of glossodynia as its functional nature, inherent neurohumoral imbalance, as well as the syndrome of psychoemotional disorders (mainly astheno-neurotic, anxiety-depressive, hypochondriacal, dissominal circle) come to the fore in modern research papers on this topic.

This implies the special importance of therapeutic measures aimed at harmonizing and stimulating the normal working activity of the involved parts of the nervous system at the local, segmental and central levels, in connection with which much attention is paid to the methods of physiotherapy by clinicians.

Currently, there is evidence of the use of electric sleep, transcranial electrical stimulation (HES) and laser therapy (RT) and other physiotherapeutic methods for the treatment of glossalgia.

It is known that electrosleep is used as a method of physiotherapy for glossalgia - the therapeutic effect of pulsed currents on the hypnogenic structures of the brain (Nikitina TV, Khartulari NL “Treatment of patients with glossalgia electrosnom.” Dentistry, 19/1, No. 5, p. 63 -63). For electrosleep therapy, the Electroson-4T, EGASS, ES-10-5 devices are used. The therapeutic effect is carried out in the patient's position lying on the couch and requires special conditions from the room: dimming and soundproofing. The electrodes are superimposed according to the orbital-retromastoid technique. Eye electrodes are placed on closed eyelids. Characteristics of the used current: constant pulse; rectangular current pulses with a frequency of 5-160 pulses / s, duration 0.2-0.5 ms are applied. The pulse repetition rate is 5-20 imp / s. The current strength increases gradually (based on the patient’s sensations - up to slight tingling or painless vibration) and generally should not exceed 8 mA. Procedures lasting 20-40 minutes are carried out daily or every other day (Bogolyubov V.M., Ponomarenko G.N. "General physiotherapy", 1998, pp. 72-76).

The disadvantages of the technique include such medical contraindications as eye diseases, the presence of pathological elements in the area where the electrodes are applied, circulatory disorders IIB-IIIst., Fever, hysteria, as well as insufficient specificity of the method, limited by the effect on the autonomic nervous system and microvasculature, impossibility achieving a corrective effect in relation to the spectrum of neurohormonal disorders, the need for a long course of treatment.

Glossalgia laser therapy is performed using an LG-75 type helium-neon laser with a wavelength of 632.8 nm. The technique provides for the impact on biologically active points (with a focused beam), as well as on the fields of the mucous membrane with a changed sensitivity (defocused laser). The duration of the therapeutic effect on one work area is 30 s. The course of physiotherapy with a laser includes 10-14 sessions, of which the first five are daily, and the next every other day. The expected therapeutic effects are biostimulation and analgesia (Chizhikova TS and other Effectiveness of the complex treatment of glossalgia, stomalgia. Kuban Scientific Medical Bulletin. No. 1 (150), 2015, p. 128-132).

The weaknesses of the method are medical contraindications (acute and decompensated forms of cardiovascular pathology, severe cerebral blood flow disorders, oncopathology, diabetes mellitus in the stage of decompensation, blood diseases, hypotonic conditions), the lack of a clear correspondence between the pathophysiological mechanisms of the formation of this pathology with the sanogenic effect of RT, which is realized in mainly at the local level and does not affect systemic neurohormonal and metabolic changes, as well as zhnosti correction technical parameters based on the patient's individual characteristics.

Another physiotherapeutic method used is TPP. The TES methodology is based on the influence of direct electric current and rectangular pulses with a frequency of 77.5 Hz for a duration of 3.5 ms in the ratio of constant and average pulse currents from 2 to 5 to 1 (A new method of drug-free treatment. Ed. V.P. Lebedev. St. Petersburg ., 1993, 133 p.). For physiotherapeutic treatment of glossalgia by transcranial electrostimulation, the following models of devices with identical output characteristics can be used: Transair-2, Transair-4c, Etrans-1. The initial treatment session is carried out in the mode of filling pulses, all subsequent ones - in the usual. To conduct a TPP, the patient must take a sitting or lying position. One pair of electrodes is superimposed over the superciliary arches, the second - on the mastoid processes. The average duration of treatment for this pathology is 10-12 daily procedures lasting 40 minutes (the first 30 minutes). The minimum therapeutic strength of the stimulating current is at least 2.5 mA, while the severity of the analgesic effect is proportional to the current strength. The power of the supplied current increases gradually, until the appearance of characteristic unpleasant sensations, which practically disappear after 1-3 minutes. The painless period gradually increases throughout the course of TPP (Vasenev E.E. et al. Effectiveness of using transcranial electrical stimulation in the complex treatment of chronic pain of the oral cavity. Dep. In the State Central Medical Library of the Russian Federation, No. D-23679, 1993, 6 pp. - prototype) .

The disadvantages of the method associated with its technical features are the impossibility of applying electrodes to damaged skin areas. The limited use of the technique is also due to major contraindications, such as the presence of an pacemaker, thyrotoxicosis, decompensated stages of cardiovascular disease, hydrocephalus, brain tumors, and neuroinfections. In addition, TES is not equally effective for the treatment of glossalgia of various nature, which indicates a narrow focus of its therapeutic effect involving mainly the endorphin mechanism, while the etiological heterogeneity of the pathology requires universality from the therapeutic methods used. Moreover, the criteria for the effectiveness of TES therapy are quite subjective and largely depend on the threshold of individual pain sensitivity.

As a result of our studies, we have found that the most effective method of physiotherapeutic treatment of glosealgia is mesodiencephalic modulation (MDM therapy).

We have found that MDM therapy contributes to a more rapid and complete elimination of the disease, exerting a beneficial effect on various etiopathogenetic aspects involved in the formation of a pathological pain circle.

The range of therapeutic effects of the method we developed covers the following areas: correction of the patient's psychoemotional status, normalization of metabolic processes and morphological and functional state of tissues at the local level, analgesia, as well as restoration of the balance of neurohormonal regulatory systems of the body.

The procedure for conducting mesodiencephalic modulation compares favorably with ease of execution, painlessness and safety, since the electrical parameters of the technique are optimally calibrated and exclude negative consequences for the human body.

The technical results achieved when implementing the developed method for treating patients with glossalgia are: relief of pain and paresthetic sensations, restoration of normal sensitivity and functional viability of tissues, improved microcirculation and oxygenation. In the course of the studies, the presence of the alleged therapeutic effects was confirmed by a clinical improvement established on the basis of a decrease in the frequency and intensity of complaints in patients, as well as on the basis of the positive dynamics of laboratory parameters: an increase in the level of total hemoglobin in the blood (based on the results of a general blood test), as well as an increase in hemoglobin saturation (according to the results of pulse oximetry).

In addition, it provides a general antistress effect due to the weakening of the sympathicotonic effect of the autonomic nervous system and the harmonization of the activity of neurohormonal regulatory systems.

Clinically, the general sanogenic effect of MDM therapy on the patient's body is expressed in the stabilization of the psychoemotional state, the normalization of natural biorhythms and sleep, the reduction of drug loading and the reduction of treatment time to achieve a state of stable remission.

The listed effects are achieved due to the exposure regimen we developed: performing pulsed stimulation of the subcortical stem sections of the brain (mesodiencephadic region) of the patient with currents with a carrier frequency of 10,000 Hz, modulated in the low-frequency range, which varies from 20 to 100 Hz during one session. The strength of the supplied current also varies during the session from 0.5 to 4 mA, each procedure lasts 30 minutes.

Treatment sessions are held daily for 10 days, and in the first 3 days, two procedures are performed with a minimum interval of 6 hours, in the future - one procedure per day. The full course of treatment is 13 treatments. Our studies have allowed us to establish that this mode of exposure optimally matches the therapeutic objectives, allowing us to achieve maximum clinical results.

The proposed method of treatment can be implemented using the apparatus "MDM-2000/1" manufactured by ZAT a.d., Czech Republic, by which they apply pulsed currents to the subcortical-stem (mesodiencephalic) region of the brain. The device is equipped with special protection against electric shock of international class IBF. The MDM-2000/1 device is registered in the Russian Federation and entered into the State Register of medical devices and medical equipment (FSZ Registration Certificate No. 2011/09144 of 02.24.2011), and also has a sanitary and epidemiological certificate for use (Registration number of the POCC declaration of conformity CZ. MH08. D01780, dated 12/17/2015).

The patient takes a position, sitting in a chair. Then, two copper, nickel-plated electrodes connected by a headband are superimposed on his head by the fronto-occipital technique. The anode is installed in the middle of the forehead, the cathode in the middle of the nape, a disposable sixteen-layer flannel gasket placed abundantly moistened with water is placed between the skin and the electrode plate.

The minimum physical and technical parameters at which a positive therapeutic effect is achieved are as follows: the current frequency is 10,000 Hz with a modulation of 20 Hz or more, the current strength must be more than 1 mA.

A number of clinical and physiological studies have allowed to establish these values, during which a harmonizing effect on central neurohumoral regulatory mechanisms was clearly revealed.

It was also noted that with increasing values of the parameters (frequency - over 10,000 Hz, modulation - over 100 Hz, current strength - above 5 mA), patients experience discomfort in the area of electrode application.

The amperage is smoothly set using the computer keyboard. The necessary current value is established by tracking such sensations in the patient as feelings of "crawling creeps", a slight burning sensation or vibration, individual tremors, slight pressure.

During operation, the device automatically measures the state of the resistance of the electrodes, which is why a blinking message of the corresponding content appears on the monitor. The “Run”, “Cancel”, “Pause”, “Current Setting” functions allow you to interrupt the session and continue after the correction. The timer counts the time from the beginning to the end of the procedure. The device shuts off automatically at the end of the session.

Upon completion of the procedure session, it is necessary to interrupt the patient’s connection with the device, remove the electrode part of the device. If desired and possible, the patient is invited to sleep in the ward (during inpatient treatment) or in the rest room (under outpatient monitoring).

During MDM therapy, exposure to a weak electric signal on brain structures selectively activates various parts of the neuroendocrine system, mobilizes the immune system, promoting optimal use of the body’s internal reserves, balancing the activity of pro- and antisressor systems.

Normalization of the neuroendocrine complex is achieved by releasing an increased amount of specific neuropeptides into the blood - substances that have a stabilizing effect on the emotional and mental state of a person.

Thus, it seems possible to eliminate the anxiety-depressive, hypochondriacal, astheno-neurotic manifestations characteristic of patients with glossalgia, with limited use or without medication. In addition, MDM therapy has a powerful analgesic effect, which allows you to effectively deal with pain and paresthetic sensations in the tongue.

The novelty and distinguishing feature of the developed treatment method consists mainly in the polymodality of its therapeutic effect. Previously, the treatment of glossalgia was mostly symptomatic and consisted in eliminating unpleasant, subjectively significant symptoms.

In the course of further theoretical and practical research in the field of this problem, an idea was formed about the multifactorial nature of glossalgia, which is why clinicians opened up directions for finding new therapeutic solutions. In recent years, various physiotherapeutic methods (for example, electrosleep, ChKES, laser therapy and others) began to be included in the treatment plan of patients with glossalgia, aimed at optimizing metabolic processes, innervation and blood circulation in tissues. However, the lack of a clear correspondence of the therapeutic effects of such procedures and the mechanisms of formation of this pathology, their narrow focus, along with the presence of medical contraindications do not allow to approve these treatments for wide medical practice.

MDM therapy against the background of other physiotherapeutic methods for the treatment of glossalgia compares favorably with the clearly traced, versatile nature of the therapeutic effect, encompassing various etiopathogenetic mechanisms involved in the development of this pathology.

Electrical stimulation of mesodiencephalic structures, first of all, ensures the normalization of the activity of the sympathoadrenal complex - a stress system that performs neurohumoral regulation of vital processes and the implementation of an adaptive response in response to the action of an unfavorable factor, which is essentially a disease. In addition, MDM has an activating effect on the central opioid and serotonergic systems responsible for the antinociceptive effect and the regulation of the psychoemotional background. Also, an important role in the development of the therapeutic effect is played by the involvement of GABAergic structures and benzodiazepine receptors, which are antagonists of catecholamines, have a common sedative, anxiolytic, hypnotic effect. Current stimulation of the mesocortex and limbic formations makes it possible to exert a sanogenic effect on the emotional and behavioral sphere, which is invariably susceptible to negative changes in patients with glossalgia, helping to reduce the severity of their anxious, depressive, neurotic and hypochondria manifestations.

Activation of antistress mechanisms, initiated by mesodiencephalic modulation, helps to combat the phenomena of stress hypertension (which is important considering the associated pathology), as well as increase immunocompetence by optimizing the defenses of the patient’s body and rationalizing the immune response. At the local level, the therapeutic effect is based on the involvement of a system of peripheral opioid receptors, which provides analgesia, a kallikrein-kinin system that has an anti-inflammatory effect and helps to improve microcirculation, as well as antioxidant factors that prevent cell alteration.

Thus, at the system level, the therapeutic effect of MDM therapy consists in normalizing the psychosomatic and neurohumoral relationships of the patient’s body with glossalgia, while locally it is expressed in the relief of pain and paresthetic syndrome, as well as improving the functional state and trophic tissue, which is the key to restoring quality patients' lives up to a full recovery with regression of local symptoms, stabilization of the psychoemotional background and normalization of the tone of the vegetative departments ivnoy nervous system.

MDM-therapy, in fact, is a new concept of healing the human body, offering an integrated approach with the implementation of three therapeutic principles: etiological, pathogenetic and symptomatic, which is of particular interest for the full cure of patients with glossalgia. Additional advantages of the method are its availability, non-drug nature, good compatibility with other types of treatment, as well as the ability to potentiate the effects of pharmacological drugs. This allows you to avoid polypharmacy, significantly reduce the drug load on the body of patients with glossalgia, which, given the multifactorial and complex nature of the disease, are often forced to undergo massive pharmacotherapy, including antibacterial and antimycotic, anti-inflammatory, analgesic, immunomodulating, sedative, psychotropic and other groups of drugs. The use of MDM helps to reduce the incidence of toxic, allergic, gastrointestinal, cardiovascular, extrapyramidal and other side effects in patients with MDM, which favorably affects their general health, psycho-emotional status and quality of life, allowing to achieve convincing and persistent clinical results. The advantageous differences of the proposed methodology also include the absence of a wide range of contraindications, good tolerance and safety of the procedure, as well as the possibility of individual correction of input technical data in accordance with gender and clinical parameters.

Example 1. Patient C., 46 years old.

Diagnosis: psychogenic glossalgia of the paresthetic type. Concomitant pathology: early surgical menopause, hormone replacement therapy.

Complaints during treatment: the sensation of tingling, the presence of a thread or hair, spreading to the external 2/3 of the tongue, irritability, tearfulness, migraine headaches, a feeling of hot flashes, insomnia.

From the anamnesis it is known that the above symptoms progress within 3-4 years, was repeatedly examined, and a diagnosis was made: psychogenic glossalgia.

After assessing the clinical situation, a course of treatment was carried out: the impact of pulsed currents on the subcortical-stem sections of the brain (mesodiencephalic zone) using the frontooccipital technique. Current parameters: pulse mode with a carrier frequency of 10,000 Hz, modulation in the low frequency range from 20 to 100 Hz, current strength 2.5 mA. The duration of the procedure is 30 minutes, daily for 10 days. The first 3 days were carried out in two sessions with an interval of 6 hours, from 4 to 10 days, one session was conducted daily. The general course was 13 procedures. Good tolerance of MDM therapy was observed; no adverse reactions were noted during the course of treatment.

As a result of the treatment, there was a regression of paresthetic and astheno-neurotic syndromes, normalization of sleep, a decrease in the severity of hot flashes, a decrease in the frequency of headache attacks, and the patient's general well-being and psycho-emotional state improved.

In addition to subjectively determined improvement, the positive dynamics of the clinical condition of the patient was also observed according to special research methods.

The normalization of the autonomic balance was judged by assessing heart rate variability: the initial state of the autonomic nervous system was characterized by a predominance of activity of the sympathetic department (TP = 2675 ms * 2, LF = 1342 ms * 2, HF = 386 ms * 2, VLF-947 ms * 2 , LF / HF = 3.48,% LF = 50.2,% HF = 14.4,% VLF = 35.4), after the course of MDM therapy the sympathicolytic effect was determined (% LF = 32.2,% HF = 52.9,% VLF = 15), which corresponds to a balanced type of vegetative regulation. P.M. Cardiointervalography Analysis After treatment, Baevsky showed a decrease in mode amplitude (AMo) from 54% to 28.9%, the index of autonomic equilibrium decreased (IVR) from 139 to 12.3 rel.ed, the index of voltage of regulatory systems (IN) from 123.1 to 6 , 62 rel. units The presence of a vagal shift testifies in favor of reducing the regulatory costs of the body, which indicates an increase in functional viability and an increase in the adaptive reserves of the patient's body.

The study of the immune status revealed an increase in the absolute level of T-lymphocytes, from the initial 619.9 × 106 / L to the subsequent 1242.6 × 106 / L, the absolute values of the T subpopulation after treatment increased from 112.3 to 177.0 × 106 / L, the content of T-helpers / inductors increased from 13.9 to 16.41%, the absolute value of T-helpers increased from 150 to 243⋅106 / l. The dynamics of RBT at the PHA was 43892.4 imp / min versus 17855.3 imp / min. Class M immunoglobulin titers decreased to 1.6 g / l versus 1.7 g / l.

A positive effect on blood oxygenation and microcirculation was assessed by evaluating the total hemoglobin in the general blood test and non-invasive method for the diagnosis of oxygen saturation - pulse oximetry. The content of total hemoglobin of blood (Hb) increased from the initial 118 g / l to 134 g / l at the end of the course of MDM therapy. While peripheral oxygen saturation (SpO2) rose to 98% compared with the originally determined 94% before treatment. These results are convincing evidence in favor of increasing the overall oxygen capacity of the blood and oxygen saturation of peripheral tissues.

Improvement of the patient’s psychological state was detected using the shortened multifactor personality questionnaire (SMOL): there was a decrease in profiles on the 2nd scale (from 68 to 46) and the 4th scale (from 57 to 50), which was expressed in an increase in psychological adaptability, lower levels Conflict, impatience and aggression. According to the results of the SAN test, a significant improvement in well-being, activity and mood was established.

Example 2. Patient S., 36 years old.

Diagnosis: glossalgia of a mixed paresthetic-algic type.

Complaints at admission: the presence of pains of a nagging character, numbness and tingling of the entire surface of the tongue, aggravated in stressful situations, unstable mood, increased fatigue, irritability, increased sweating of the palms, anxiety, palpitations during excitement.

From the anamnesis it is known that the above symptoms are disturbed for 6 years, as a result of which I sought medical help, was comprehensively examined, no organic pathology was detected, and a diagnosis was made: glossalgia. Three times treated on an outpatient basis with an unstable positive effect.

Based on the foregoing, a course of MDM therapy was carried out: the impact of pulsed currents on the subcortical-stem sections of the brain (mesodiencephalic zone) using the frontooccipital technique.

Current parameters pulse mode with a carrier frequency of 10,000 Hz, modulation in the low frequency range from 20 to 100 Hz, current strength 1.8 mA. The duration of the procedure is 30 minutes, daily for 10 days. The first 3 days were carried out in two sessions with an interval of 6 hours, from 4 to 10 days, one session was conducted daily. The general course was 13 procedures. Tolerance of electrical effects is good, there were no negative reactions during treatment.

As a result of the treatment, such positive effects were noted: a significant regression of the pain syndrome, the elimination of paresthetic sensations, and an improvement in the general well-being of the patient. The mood background was leveled, the general tone increased, the manifestations of irritability and vegetative lability decreased.

In addition to subjectively determined improvement, the positive dynamics of the clinical condition of the patient was evidenced by the data of special research methods.

The state of the vegetative balance was evaluated by the KIT method according to P.M. Baevsky. The initial state of the autonomic nervous system was characterized by the prevalence of parasympathetic activity. After the course of correction, a decrease in the intensity of parasympathetic influence was noted (decrease in AMo from 65% to 40%, IN from 379 to 84 rel. Units), which characterizes the balanced type of vegetative regulation. According to the results of a general blood test, the initial Hb was 132 g / l, the subsequent 147 g / l. According to pulse oximetry, SpO2 increased from 95% to 99% after treatment, indicating a positive effect on oxygenation and microcirculation. Improvement of the patient’s psychoemotional status was detected on the basis of the SMOL data, which was manifested in a decrease in indicators on the scales of the anxiety triad (1, 2, 7). The results of the SAN test also reliably testified to the improvement of well-being, activity and mood: profiles decreased on the 1st scale from 56 to 47, on the 2nd scale from 59 to 51, on the 7th scale from 58 to 50, which was reflected in the improvement psychological adaptation, reducing conflict, impatience and level of aggression.

Example 3. Patient B., 30 years old.

Diagnosis: glossalgia.

Complaints during treatment: burning sensation on the outer surface of the tongue, pain, aggravated by eating.

From the anamnesis it is known that the above symptoms are disturbed for 3 years after wearing braces for 1 year, was repeatedly examined by a neurologist, dentist, psychotherapist (a course of treatment with antidepressants was prescribed with minimal effect), a diagnosis was made: glossalgia.

Based on the foregoing, a course of treatment was carried out: the impact of pulsed currents from the apparatus "MDM-2000/1" on the subcortical-stem sections of the brain (mesodiencephalic zone) using the frontooccipital technique. Current parameters: pulse mode with a carrier frequency of 10,000 Hz, modulation in the low frequency range from 20 to 100 Hz, current 2 mA. The duration of the procedure is 30 minutes, daily, for a course of 13 procedures. Tolerance of the procedures is good, no adverse reactions were detected.

As a result of the treatment, there was a regression of pain, burning; the patient’s health significantly improved, psychoemotional and autonomic disorders decreased.

The positive dynamics of the patient's condition, along with subjective sensations, were also confirmed by data from special studies.

The analysis of heart rhythm variability testified in favor of normalizing the autonomic balance: the initial state of the autonomic nervous system was characterized by a predominance of sympathetic activity (TP = 2675 ms * 2, LF = 1342 ms * 2, HF = 386 ms * 2, VLF-947 ms * 2 , LF / HF = 3.48,% LF = 50.2,% HF = 14.4,% VLF = 35.4), after the course of correction, a decrease in the level of sympathetic influences was noted (% LF = 32.2,% HF = 52.9,% VLF = 15), which reflects a balanced type of autonomic regulation.

In the analysis of cardiointervalography according to R.M.Baevsky after treatment, a decrease in AMO from 56% to 29.4%, IVR from 147 to 12.5 rel. units, ID from 122.7 to 6.51 rel. units The observed vagal shift indicates a decrease in the regulatory costs of the body, which increases the efficiency of the activity and contributes to the growth of adaptive reserves in the patient.

When examining the immune status, it was found that the absolute level of T-lymphocytes, initially reduced, increased to 1246.2⋅106 / L against 622.5⋅106 / L, the absolute values of the subpopulation of T-lymphocytes after treatment increased from 106.0 to 177 , 0⋅106 / l, the number of T-helpers / inductors increased from 12.25 to 16.38%, the absolute value of T-helpers increased from 141 to 245⋅106 / l. The dynamics of RBT at the PHA was noted - 44254.9 imp / min against 18854.6 imp / min. In the course of treatment, the titers of immunoglobulins M decreased to 1.6 g / l against 1.7 g / l.

Increased blood oxygenation, improved microcirculation and peripheral gas exchange were also determined by objective methods. In the initial general blood test, the Hb level was 128 g / l, in the final -144 g / l. With pulse oximetry, before the start of MDM therapy, SpO2 was 97%, whereas after treatment, the SpO2 value reached 99%.

Positive dynamics of the patient’s psychological state was revealed according to the SMOL data: profiles on the 2nd scale decreased from 67 to 47 and the 4th scale from 58 to 52, which manifested itself as an improvement in psychological adaptation, a decrease in conflict, impatience and aggressiveness, a significant improvement in well-being, activity was revealed and moods on the SAN test.

Claims (1)

A method of physiotherapeutic treatment of glossalgia, including physiotherapeutic effect, characterized in that mesodiencephalic modulation is used as a physiotherapeutic effect, for which pulsed stimulation is carried out by currents with a carrier frequency of 10,000 Hz, modulated in the low frequency range, varying from 20 to 100 Hz during one session, by force the supplied current, also changing during the session from 0.5 to 4 mA, the duration of each procedure is 30 minutes, the procedures are carried out daily, and in rvye 3 days performed by two procedures with a minimum interval of 6 hours later - one procedure per day, course of treatment is 13 procedures.