RU2659146C2 - Method for treatment of biliary dyskinesia in hyperkinetic and hypokinetic types using a physiotherapeutic method and device for influencing the gallbladder and bile ducts - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, namely to gastroenterology and physiotherapy. Portable physiotherapeutic device for the treatment of biliary dyskinesia (BD) by hypokinetic and hyperkinetic type contains an autonomous power source, two reusable electrodes, buttons for switching on and selecting one of the two modes of operation. Device also has: remote control unit, on which the buttons for controlling the parameters of the electroimpulse effect are located; electronic display; built-in delayed turn-on timer with the regulation of the time interval of inclusion, with the possibility of setting the delayed start time of the procedure and the duration of electrical stimulation; built-in memory with the ability to memorize selected operating modes and time indicators. Device also has a LED operation indicator, switch recessed in the case of the device, disconnecting the device in case of failure or malfunction, additional connector for connecting a remote control unit or a computer interface, electrode device comprising connectors for connection to the contact receptacles of the electrostimulator, conductive elastic cable, reusable electrodes, the use of which does not require additional lubrication, area of the passive electrode is 200 cm², active electrode – 10 cm². Device is configured to generate asymmetrical combined pulses close to rectangular ones with a maximum intensity of 160 mA in the positive part and exponential with a maximum intensity of 20 mA in the negative part, and in 1 operating mode it generates single pulses, and in 2 operating mode – generation of a series of 500 ms pulses with pauses between them of 600 s. Method of treatment of biliary dyskinesia in hyperkinetic and hypokinetic type includes conducting a ten-day course of electropulse action on the area of the gallbladder projection on the anterior abdominal wall. Electrically impulsive bipolar asymmetric oscillatory current is applied with pulse generation in the form of a pulse in the positive part, close to rectangular, with a maximum intensity of 160 mA, and in the negative part close to exponential, with a maximum intensity of 20 mA. Affect in two modes: in the first mode of operation in the hyperkinetic type of BD generate single pulses, in the second mode of operation in the hypomotor type of BD – generation of a series of pulses of 500 ms duration with pauses between them of 600 ms, area of the passive electrode is 200 cm², active electrode – 10 cm².

EFFECT: elimination of pathological process of spasm or atony of the gallbladder and bile ducts.

2 cl, 2 ex, 1 tbl, 8 dwg

Description

The invention relates to medicine, namely to gastroenterology and physiotherapy.

The prevalence of digestive tract (PT) pathology is more than 100 per 1000 population. In the structure of non-infectious pathology of PT, diseases of the biliary system make up at least 60% of cases, most often biliary dyskinesia (DZHVP) [E.S. Terry]. The relevance of studying this problem is associated both with the high frequency of occurrence of this pathology, and with the presence of recurring exacerbations, complications in the form of gallstone disease, and a decrease in the quality of life of patients.

The constant introduction of new methods of treatment of biliary dyskinesia into the practice of healthcare indicates the low efficiency of the applied traditional methods of treatment [I.R. Kokolatze.]. The presence of various clinical forms of DZhVP (hypokinetic and hyperkinetic type) often requires directly opposite approaches to treatment, which complicates the use of standard algorithms, and in the case of the appointment of physiotherapeutic techniques, the use of various medical equipment.

1. As analogues of the claimed device, the authors propose the apparatus "ASM-2" (generates pulses of direct current) and "Tone-1" (diadynamic currents), the effects of which the nerves and muscles respond with a motor reaction. Technical characteristics of the devices are presented in table. one.

The disadvantages of analogues are the possibility of use only in a medical institution, the bulkiness of the equipment, high cost, use mainly in pathology of nerves and muscles.

As a prototype of the claimed device, the authors propose an electric stimulator STIMEL-01 [instruction for the device http://elamed.com/catalog/catalog/elektrostimulyatory-myshts/stimel-01], including the device itself, electrodes and conductive conductors. Technical characteristics of the device are presented in table. 1. "STIMEL-01" generates impulses of a neuro-like shape (in the "+" area - close to triangular, in the "-" - close to sinusoidal). The device has two exposure modes - fixed frequency mode (mode I) and cyclically changing frequency mode (mode II), it works from the network and from autonomous power sources.

The disadvantages of the prototype are the same therapeutic effect when the device is in different modes, the lack of internal memory and the possibility of delayed inclusion, the large size of the device, high cost, the need to use additional grease for the electrodes.

The authors propose a portable device for electrical stimulation “Kivichol”, placed on the patient’s body due to its low weight (0.12 kg), dimensions (8 × 8 × 2 cm), and mounting the device directly on one of the electrodes. Technical characteristics of the device are presented in table. 1. Power supply of the electric stimulator is made from 2 elements of the CR2032 type. An electric pulse asymmetric combined current is used (in the "+" part the pulse shape is close to rectangular, in the "-" - it has a steep edge and an exponential cut) in the form of single pulses (operation mode 1) or a series of pulses with a duration of 500 ms with pauses between them 600 ms (operating mode 2), which have a different therapeutic effect on the motor function of the gallbladder (GI) and biliary tract (GIT) (contraction and relaxation). The portable electrical stimulator has a built-in timer [TA in FIG. 7] delayed inclusion with an adjustable interval of inclusion time. The operation of the apparatus will begin after a predetermined period of time after pressing the power button and due to the presence of a timer for the duration of exposure [AP in FIG. 7] will end after the expiration of the electrical stimulation procedure. The device has a separate remote control unit [9 in FIG. 5] with a stimulator for setting using the buttons [11 in FIG. 5] current strength [14 in FIG. 5], a type of electric pulse [15 in FIG. 5], the stimulator on-time interval [17 in FIG. 5] and the time interval of the electrostimulation procedure [16 in FIG. 5], entering all the settings into the device [13 in FIG. 5], an electronic display [10 in FIG. 5]. The presence of an external, detachable unit prevents the patient from changing the stimulation parameters independently while wearing the device. The doctor once sets the necessary parameters, they are stored in the device’s memory. The device has the ability to configure the delayed start of the procedure (from 2 to 3 hours) and the time of electrical stimulation (10-20 minutes). The set parameters from the control unit when it is turned off remain in the memory of the stimulator [memory in FIG. 7]. The remote unit is connected to the stimulator using the Micro-USB connector [4 in FIG. 2]. The electrode device contains connectors - contact buttons [20; 23 in FIG. 6] for connection to the contact sockets of the electric stimulator [6 in FIG. 3; 7 in FIG. 4], the current-carrying elastic cable [25 in FIG. 6], electrodes [19; 22 in FIG. 6]. The connector contact (button) for connecting the electric stimulator with an elastic current-supply cable is connected to the corresponding contact socket [6 in FIG. 3]. Flexible self-adhesive electrodes are used [19; 22 in FIG. 6] with fixing hypoallergenic conductive lubricant [21; 24 in FIG. 6] equipped with quick-detachable push-button connectors [20; 23 in FIG. 6]. The area of the passive electrode [22 in FIG. 6] is 200 cm ^{2 of the} active electrode [19 in FIG. 6] 10 cm ² . The stimulator is provided with a mating connector [7 in FIG. 4] and is attached directly to the active electrode. The passive electrode is connected to the device connector [6 in FIG. 3] with an elastic conductive cable [25 in FIG. 6]. Electrode No. 1 — active — and a contact socket for its connection are located on the back of the apparatus [7 in FIG. four]. The electrode No. 2 - passive - and a contact socket for connecting it to the device through an elastic conductive cable is located on the side of the device [6 in FIG. 3]. The stimulator has one round power button [1 in FIG. 1] 5 cm ² in size with a built-in LED indicator of device operation [3 in FIG. 1] on the front side of the apparatus [2 in FIG. 1], facing during operation from the patient’s body outwards. Switching off the device in the event of a malfunction or malfunction is carried out by a switch recessed into the device casing from the side [5 in FIG. 2]. This arrangement of the switch prevents accidental shutdown of the device when the patient’s body position changes in space during active physical activity (walking, bending, etc.) during operation of the device.

The advantages of the Kiwihol device are:

- asymmetric combined pulses that are close to rectangular in the positive part and exponential in the negative part of the form with single pulses at 1 operating mode and a series of pulses with a duration of 500 ms at intervals of 600 ms between them at 2 operating modes, providing a different therapeutic effect on the motor function of the pancreas and GVP (contraction and relaxation);

- remote control unit, including control buttons, electronic display;

- built-in delayed-on timer with regulation of the on-time interval, which allows setting the delayed start time of the procedure and the duration of electrical stimulation (10-20 minutes);

- built-in memory that allows you to remember the selected operating modes and time indicators;

- two-color indicator of work;

- a switch recessed into the body of the device, turning off the device in the event of a malfunction or malfunction;

- an additional connector for connecting a remote control unit or pairing with a personal computer;

- self-adhesive personal reusable electrodes, the use of which does not require additional lubrication;

- smaller dimensions and weight;

- lower cost.

2. As an analogue of the proposed method, the authors propose a method for the treatment of biliary dyskinesia by electrical stimulation of the muscles of the gallbladder. This is a method of electrotherapy using various pulsed currents obtained using various devices (AFM-2, ultrasound-1, Neuropuls, Mioritm-040, as well as diadynamic devices (Tonus-1, Tonus-2) and sinusoidal modulated currents (Amplipuls-4, Amplipuls-5, Stimul-1, Stimul-2), is described in the book “Physiotherapy” [L. Klyachkin, MN Vinogradova, Physiotherapy : Textbook. - 2nd ed., Revised and enlarged. - M .: Medicine, 1995. - 240 pp .: ill.]. In accordance with the specified methodology for using AFM-2, a cathode of 30 cm ² is placed in the right under eberya in place projection gallbladder, an anode area 200 ^cm2 -. on his back against the cathode current type - exponential pulse with a duration of 50 ms, at a frequency of 8-12 Hz, the modulation frequency of 1 8-48 minutes, and porosity 3. Amperage - up the appearance of contraction of the muscles of the anterior abdominal wall.The duration of exposure is 10-20 minutes Procedures are prescribed daily or every other day.The course of treatment is 10-20 procedures.

The disadvantages of this method are:

- the lack of a differentiated approach to the appointment of physiotherapeutic treatment depending on the clinical type of biliary dyskinesia, in any case, the result of the action is a reduction in the gallbladder, which is desirable only with the hypokinetic type of biliary dyskinesia;

- the possibility of treatment only using stationary bulky equipment.

As another analogue of the proposed method, the authors propose a method for the treatment of DZhVP by the method of diadynamic therapy (DDT). This is a method of electrotherapy, based on the influence of a low-frequency pulse current of a constant direction of a half-sinusoidal shape with an exponential trailing edge with a frequency of 50 and 100 Hz in various combinations, described in the book "Physiotherapy" [Physiotherapy: a training manual / Gafiyatullina G.Sh. [and etc.]. - 2010 .-- 272 s: ill .; chapter 2]. A current with a frequency of 50 Hz has a predominantly myostimulating effect, 100 Hz has an analgesic effect. Irritation by a rhythmic pulse current of a large number of nerve endings leads to the appearance of a rhythmically ordered flow of afferent impulses. This flow blocks the passage of pain impulses at the level of the gelatinous substance of the spinal cord, providing an analgesic effect.

Diadynamic therapy on the area of the JP is performed as follows: an active electrode (cathode) with an area of 40-50 cm ^{2 is} placed on the projection area of the JP in front, a second electrode (anode) of 100-120 cm ² is placed transversely on the back. Apply a half-wave wave current in constant or alternating mode of operation (in the latter, the period is 10-12 s, the rise time of the leading edge and the falling edge of the trailing edge - 2-3 s each). The current strength is increased until, under the electrodes, pronounced contractions of the muscles of the anterior abdominal wall begin. The duration of the procedure is 10-15 minutes daily or every other day, the course of treatment consists of 10-12 procedures.

The disadvantages of this method are:

- the lack of a differentiated approach to the appointment of physiotherapeutic treatment depending on the clinical type of biliary dyskinesia, in any case, the result of the action is a reduction in the gallbladder, which is desirable only with the hypokinetic type of biliary dyskinesia;

- the possibility of treatment only using stationary bulky equipment.

As a prototype of the proposed method, the authors propose a method for the treatment of DZhVP according to the hypomotor type using the STIMEL-01 electric stimulator [instructions for the device http://elamed.com/catalog/catalog/elektrostimulyatory-myshts/stimel-01]. The device has two exposure modes - fixed frequency mode (mode I) and cyclically changing frequency mode (mode II). Both regimes have the same therapeutic effect, cause a decrease in GP. The choice of mode is carried out according to the patient’s feelings - the effect should not cause the patient unpleasant sensations, the intensity - to visible contractions of the abdominal muscles. In this case, the electrodes are located in the right hypochondrium (zone of projection of the junction) and symmetrically on the back. The exposure time is 10-15 minutes. The course of treatment is 10-15 days.

The disadvantages of this method are:

- only one type of therapeutic effect on the PI, leading to a reduction in the PI, which can only be used with the hypokinetic type of DZhVP. Both pulse operating modes of the device have the same effect. With the hypermotor type of DZHVP, other types of physiotherapy should be prescribed using appropriate equipment;

- the need to use during the procedure wipes with a solution of sodium chloride or a special conductive gel to increase the efficiency of the interaction between the silicone electrodes and the patient's body;

- the high cost of equipment (9000 r), which increases the cost of treatment.

The objective of the invention is to develop a method for the treatment of DZhVP of various clinical types using a single physiotherapeutic device. The problem is solved due to the fact that in the method using the STIMEL-1 apparatus, 2 operating modes are used, which in both cases cause a shortening of the SP, the following differences are provided for here: the use of 2 operating modes of the Kivichol apparatus with different characteristics of the pulse action, causing a reduction or relaxation of ZhP and ZhVP at different operating modes of the device. In addition, the proposed method is characterized by the use of apparatus of lower cost, smaller dimensions and weight, the use of reusable electrodes that do not require additional acquisition of lubricant.

The authors propose a method of treating DZhVP taking into account its clinical type using, in addition to standard drug therapy, the Kiwihol universal portable physiotherapeutic apparatus. This apparatus has an autonomous power source, a compact control device, and self-adhesive reusable electrodes. The control device generates a bipolar pulse current of a special shape (the pulse type is asymmetric combined, the pulse shape, which is close to rectangular, in the positive part, in the negative part, has a steep edge and exponential slice; the amplitude value of the impact current pulses in the load circuit is 500 Ohms at the maximum exposure intensity: positive polarity - 200 mA, negative polarity - 25 mA), which is supplied to the affected area through electrodes. This unit is compact (8 × 8 × 2 cm), light (120 g), inexpensive (800 rubles), runs on standard stand-alone replaceable power supplies.

The Kivichol device operates in 2 modes, which differ: mode 1 - single pulses, mode 2 - a series of pulses with pauses between them. When working in the 1st mode, the effect of the Kiwihol device eliminates the hypertonicity of the smooth muscles of the stomach and biliary system, relaxes it, promotes timely relaxation and filling of the stomach, which is advisable to use with the hyperkinetic type of DWI. When working in the 2nd mode, the effect of the Kivichol apparatus eliminates the hypotonicity of the smooth muscles of the stomach and biliary system, stimulates the contraction of the stomach, and ensures adequate and timely evacuation of bile by the gastrointestinal tract, which is recommended for use with the hypomotor type of biliary tract.

The procedure is as follows: flexible self-adhesive reusable individual electrodes with fixing hypoallergenic conductive lubricant equipped with quick-release push-button connectors are used. The area of the passive electrode is 200 cm ² active electrode 10 cm ² . The arrangement of electrodes on the patient’s body during the procedure is shown in FIG. 8.

The active electrode is located on the region of the right hypochondrium along the midclavicular line along the edge of the costal arch (projection point of the glomerulus); the passive electrode is placed symmetrically on the back opposite the active electrode at the same level. The adjustment of the intensity of exposure is determined by the appearance of visible contractions of the muscles of the anterior abdominal wall. In this case, the patient should not have unpleasant painful sensations. The exposure time is 10-15 minutes. The course of treatment is 10-15 days. Contraindication to the procedure - the presence of stones in the gallbladder.

The described course of treatment of DZhVP on the hypokinetic and hyperkinetic type can be carried out in inpatient or outpatient settings, as part of the work of a round-the-clock or day hospital, clinic or private reception. The compactness of the equipment, ease of use, low cost of the Kiwihol device make it possible to use it under medical supervision at home. During the calendar year, patients must twice, with an interval of 6 months, receive physiotherapeutic treatment in the indicated volume in addition to standard drug therapy or, as decided by the attending physician, as the only therapeutic effect.

The result of using the proposed method for the treatment of biliary dyspepsia is the relief of pain, a decrease in the severity of cholestasis with the hypokinetic type of biliary dyskinesia, digestive disorders with the hyperkinetic type, prevention of relapse, lowering the risk of gallstone disease, improving the quality of life of patients, maintaining their working capacity. The technical result is based on the selection of the optimal characteristics of the current used with pulses of a strictly defined shape and sequence for each mode, as well as electrodes of certain sizes located in the projection zones of the gallbladder, which generally eliminates the pathological process of spasm or atony of the gallbladder and biliary tract.

Using this method, 56 adolescents and young people from 12 to 26 years old suffering from DZhVP on the basis of hypokinetic or hyperkinetic type were treated. Only physiotherapeutic treatment without the use of drugs was used. The effectiveness of the effect on the gallbladder in all patients was monitored by ultrasound-cholecystography with the calculation of the volume of the gallbladder before and after the first physiotherapeutic exposure in 1 or 2 modes of operation of the Kivichol device. According to ultrasound data, the effectiveness of the proposed method of treatment in 93% of cases with the hypokinetic type of DZhVP and 86% of cases with the hyperkinetic type of DZhVP is established. Course treatment and additional use of drugs in accordance with the clinical type of biliary dyskinesia have achieved a positive effect of treatment in all patients. Most patients included in our study did not need to take choleretic or other drugs, which significantly reduced the cost of their treatment. All patients showed normalization of the function of the gallbladder and biliary tract according to clinical observation and repeated ultrasound cholecystography.

The advantages of this method of treatment of biliary dyspnea are:

- the possibility of differentiated treatment of various clinical types of DZhVP (hypo - and hypermotor) using the same physiotherapeutic apparatus;

- reducing the risk of stone formation in the stomach;

- the compactness of the “Kivichol” apparatus, ease of use make it possible to apply this method of treatment not only in inpatient, but also in outpatient, and even at home;

- the possibility of a delayed start of the procedure;

- adjustment by the doctor of the parameters of the future procedure and the inability of the patient to cancel the set parameters;

- the ability to use one control unit under the supervision of a doctor for several devices, which reduces the cost of treatment for each patient;

- the low cost of the Kiwihol device makes this method of treatment of DZhVP generally available, does not require large material costs;

- the use of physiotherapeutic treatment can reduce the intake of drugs and, accordingly, significantly reduce the cost of treating a patient, especially taking into account the need for repeated courses of therapy (usually 2-3 times a year for several years).

Examples of practical use of the proposed method for the treatment of DZhVP.

Example 1. Patient Yu., 14 years old, diagnosed with biliary dyskinesia of the hyperkinetic type. Over the past six months, cramping pains in the right hypochondrium radiating to the right shoulder have periodically been disturbed. Mom has gallstone disease.

According to ultrasound cholecystography, the initial volume of the gallbladder on an empty stomach is 13 ml; after physiotherapy according to the scheme described above in the 1st mode - the volume of the gallbladder is 24 ml, i.e. physiotherapeutic effect contributed to the relaxation of spasmodic muscles of the gallbladder. After a course of treatment for patient Yu, the normokinetic function of the gallbladder was recorded in repeated studies.

Example 2. Patient I., 19 years old, with a diagnosis of "Dyskinesia of the biliary tract according to the hypokinetic type." Over the past three months, he was periodically bothered by pulling pains in the right hypochondrium. When examining the contractile function of the gallbladder after physiotherapy by the Kivichol apparatus in the 2nd mode of operation, patient I. registered a gallbladder contraction: the initial fasting volume was 35 ml, after physiotherapy according to the above scheme, 15 ml. The patient was given a course of treatment according to the claimed method. After the end of the course of treatment during ultrasound, patient I. recorded the normokinetic function of the gallbladder.

The given examples illustrate the possibility of using this method for the treatment of DZhVP with various clinical types of disease.

Figure captions:

FIG. 1. Front view of the device

1 - power button

2 - device housing

3 - LED operation indicator

FIG. 2. Left view of the device

2 - device housing

4 - Micro-USB connector for connecting the control unit

5 - device shutdown button

FIG. 3. Device view on the right

2 - device housing

6 - pin socket for connecting a passive electrode

FIG. 4. Rear view of the device

2 - device housing

7 - pin socket for connecting an active electrode

8 - battery cover

FIG. 5. Remote control unit

9 - control unit housing

10 - electronic display

11 - control unit buttons

12 - on / off, pulse mode selection

13 - entering settings into memory

14 - selection of current regulation

15 - selection of pulse frequency adjustment

16 - selection of adjustment of the duration of the procedure

17 - delay timer setting

18 - increase or decrease the selected parameter

FIG. 6. Electrode device

19 - active round electrode with an area of 10 cm ²

20 - quick-detachable push-button connector for connecting an electrical stimulator

21 - fixing hypoallergenic conductive grease

22 - passive square electrode with an area of 200 cm ²

23 - quick-detachable push-button connector for connecting an electrical stimulator

24 - fixing hypoallergenic conductive lubricant

25 - conductive cable

26 - quick-detachable push-button connector for connecting a passive electrode to a conductive cable

27 - quick-detachable push-button connector for connecting a conductive cable to an electrical stimulator

FIG. 7. Scheme electrical structural apparatus "Kivichol" IP - power source

TA - integrated delay timer

Memory - storage device

TD - built-in timer for exposure duration

GI - rectangular pulse generator

E - electrodes

UU - remote control unit

FIG. 8. The location of the electrodes on the patient’s body during the procedure.

Table 1. Device Specifications

AFM-2 Tonus-1 (DDT) Stimel Kiwihol cathode 30 cm ² 40-50 cm ² 9 cm ² 10 cm ² anode 200 cm ² 100-120 cm ² 9 cm ² 200 cm ² current exponential half wave neuro-like (in the "+" area - close to triangular, in the "-" - close to sinusoidal) The type of pulse is asymmetric combined, the shape of the pulse is close to rectangular, in "-" - has a steep front and an exponential cut momentum T 1.5-50 ms 5-10 ms + 100 μs, - 450 μs + 1ms
- 1.5 ms cycle - 10-12 s 24 s - frequency 8-12 Hz 50-100 Hz 5.5—> 18.5 Hz and vice versa 5-20 Hz frequency
modulation 8-48 in 1 min rise time of the leading edge and falling of the trailing edge for 2-3 s




-




- amplitude
momentum 50 mA 50 mA + 160 mA, - 20 mA + 200 mA, - 25 mA time 1 10-20 min 10-15 minutes 10-15 minutes 10-20 min course 10-20 10-12 10-15 10-20 dimensions 30x16x20 cm 41.8 x 15.4 x 28.3 cm 9x4x14 cm 8x8x2 cm the weight 6 kg 9 kg 250 g 120 g price - 22000 p. 6000 r 800 r

Literature

E.S. Tertyshnaya. Biomedical basis for the prevention and correction of functional changes in the hepatobiliary system in young athletes: abstract. dis. Cand. honey. sciences. - M., 2008 .-- 24 p.

I.R. Kokolatze. Clinical options and increasing the effectiveness of the treatment of functional disorders of the biliary system in children using EHF-therapy: abstract. dis.kand. honey. sciences. - St. Petersburg, 2006 .-- 21 p.

Instructions for the device "STIMEL-01" http://elamed.com/catalog/catalog/elektrostimulyatory-myshts/stimel-01

L.M. Klyachkin, M.N. Vinogradova, Physiotherapy: Textbook. - 2nd ed., Revised. and additional.-M.: Medicine, 1995. - 240 s: ill.

Physiotherapy: a training manual / Gafiyatullina G.Sh. [and etc.]. - 2010. -272 s: ill .; chapter 2.

Medical Rehabilitation / Ed. V.M. Bogolyubov. Book I. - Ed. 3rd, fix and additional - M.: Publishing house BINOM, 2010.

Claims (8)

1. A portable physiotherapeutic device for the treatment of biliary dyskinesia (DZHVP) of the hypokinetic and hyperkinetic type, containing an autonomous power source, two reusable electrodes, power buttons and the selection of one of two operating modes, characterized in that it has: - a remote control unit, on which there are buttons for controlling the parameters of electric pulse exposure, an electronic display, a built-in delayed timer with regulation of the on-time interval, with the ability to set the delayed start time of the procedure and the duration of electrical stimulation, built-in memory with the ability to memorize selected operating modes and time indicators ; - LED work indicator; - a switch recessed into the body of the device, turning off the device in the event of a malfunction or malfunction; - an additional connector for connecting a remote control unit or pairing with a computer; - an electrode device containing connectors for connecting to the contact sockets of the electric stimulator, conductive elastic cable, reusable electrodes, the use of which does not require additional lubrication, and the area of the passive electrode is 200 cm ² , the active electrode is 10 cm ² ; - the device is configured to generate asymmetric combined pulses that are close to rectangular with a maximum intensity of 160 mA in the positive part and exponential with a maximum intensity of 20 mA in the negative part, and in 1 operation mode, single pulses are generated, and in 2 operation mode, series generation pulses with a duration of 500 ms with pauses between them of 600 s. 2. A method of treating biliary dyskinesia of the hyperkinetic and hypokinetic type, comprising conducting a ten-day course of electrical pulse exposure on the projection area of the gallbladder on the anterior abdominal wall, characterized in that the electrical pulse effect is carried out by a bipolar asymmetric vibrational current with the generation of pulses having the shape of a pulse in the positive part close to rectangular, with a maximum intensity of 160 mA, and in the negative part, close to exponential, with a max with a maximum intensity of 20 mA, they operate in two modes: in the 1st mode of operation with the hyperkinetic type of DZhVP, single pulses are generated, in the 2nd mode of operation with the hypomotor type of DZhVP - generation of a series of pulses with a duration of 500 ms with pauses between them of 600 ms, and the area of the passive electrode is 200 cm ^{2 the} active electrode is 10 cm ² .

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