RU2704977C1 - Method for reducing blood glucose in patients with diabetes mellitus complicated by diabetic foot - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endocrinology, and concerns developing methods of treating diabetes patients. Method for lowering blood glucose level in patients with diabetes mellitus complicated by a diabetic foot involves intravenous exposure of blood on one hand to a blue laser at wavelength of 450 nm, average emissive power of which at the output of the disposable light guide is not less than 1 mW, with simultaneous ozonation of blood on the vein of the other hand, introducing for this purpose jet of 200 ml of physiological solution, with concentration of ozone in it of 2 mcg/ml. Procedure is performed in a dark room for 15–20 minutes, with the therapeutic course of 10 days.

EFFECT: invention provides lowering blood glucose level with subsequent preservation of reduced blood glucose in a prolonged effect, which affects the improvement of patients, namely, improving blood microcirculation and soft tissue wound regeneration, respectively; improved sensitivity of lower extremities.

1 cl, 4 tbl, 1 ex

Description

The invention relates to medicine, namely to endocrinology, and for the development of methods for treating patients with diabetes mellitus.

The relevance of the invention is due to the fact that the treatment of diabetes mellitus with drugs that eliminate insulin resistance is currently used only in a small number of patients, and has many side effects, including hepatotoxic effect (drug-induced hepatitis), which, in general, over the course of time, do not save from the process of development of pathology and the deterioration of the condition of patients.

A known method of treating diabetes mellitus complicated by a diabetic foot, used as a prototype, / (Shimko V.V. et al., Development of a method of combined intravenous laser irradiation of blood with a “blue” laser (λ = 532 nm) and blood ozonation in patients with sugar diabetes complicated by a diabetic foot / Political network journal "National Health", is included in the list of HAC at the Ministry of Education and Science of the Russian Federation, issue No. 1 of 04/20/18, // where patients were treated in a combined way, using a single-channel, with n the “Ukol-01-VLOK” apparatus, using which the blood was irradiated intravenously with a “blue” laser, the wavelength of which was 532 nm, and the average radiation power at the output of the single-use fiber was not less than 12 mW, together with the introduction of ozonized physiological saline 200 ml into a vein, with an ozone concentration of 2 μg / ml, in a stream, in a dark room. Ozonation of physiological solution was carried out using the apparatus "Medozon 01". The course of treatment is 10 days, the duration of one session is 15-20 minutes.

However, when working on this methodology, previously developed by us, an old-style apparatus is used (Ukol-01-VLOK, whose wavelength was 532 nm, and the average radiation power at the output of a single-use fiber is at least 12 mW) with a large number of lengths waves, and the average power at the output of a single-use fiber, which, according to our research, has a smaller therapeutic effect.

In the course of the current study, the “Solaris VLOK” “blue” laser with a wavelength of 450 nm and an average radiation power at the output of a single-use fiber of at least 1 mW are used. When using the new apparatus according to the developed technique, an improved therapeutic effect is noted in the form of a decrease in glucose and, subsequently, the preservation of lower levels of blood glucose in a prolonged effect.

The problem solved by this invention is to expand the arsenal of tools that allow, in the treatment of patients with diabetes mellitus complicated by a diabetic foot, to reduce blood glucose, thereby providing an overall improvement in the condition of patients, improving microcirculation and regeneration of soft tissue wounds, improving the sensitivity of the lower limbs.

The essence of the invention lies in the fact that in a method of reducing blood glucose in patients with diabetes mellitus complicated by a diabetic foot, including intravenous irradiation of blood on one arm with a "blue" laser, while ozonizing blood in a vein of the other hand, injecting 200 ml of physiological saline, with an ozone concentration of 2 μg / ml, performing the procedure in a dark room for 15-20 minutes, with a treatment course of 10 days, use a "blue" laser with a wavelength of 450 nm, the average radiation power of which is at the output de disposable fiber is not less than 1 mW.

For treatment, a method is proposed for combined intravenous laser blood irradiation with a “blue” laser (λ = 450 nm) with simultaneous blood ozonation in patients with diabetes mellitus complicated by a diabetic foot. The method is as follows.

With the help of the Solaris VLOK single-channel, continuous-radiation device, blood is irradiated with a “blue” laser using a vein on one arm. The laser wavelength is 450 nm, the average radiation power at the output of a single-use fiber is at least 1 mW. With the beginning of irradiation, at the same time, the procedure of blood ozonation is carried out on the vein of the other hand, introducing for this jet physiological solution of 200 ml with an ozone concentration of 2 μg / ml. The procedure is carried out in a dark room, as ozone is rapidly destroyed in the light. For the same reason, saline solution is injected jet, to ensure the maximum concentration of ozone in the solution. Ozonation of physiological saline was carried out using the apparatus "Medozon 01". The course of treatment is 10 days, the duration of one session is 15-20 minutes.

On the basis of the second surgical department of the city hospital. F.S. Ankudinova, Yuzhno-Sakhalinsk, the study of the effect of the method of combined intravenous laser blood irradiation with a “blue” laser (λ = 450 nm) with simultaneous ozonation of blood in patients with diabetes mellitus complicated by a diabetic foot was carried out to assess the level of sugar in human blood and establish the duration of the effect treatment.

The experiment included 80 patients whose average age ranged from 40 to 60 years (men and women). Of these, 2 main groups of 30 people and two control groups of 10 people were formed. The first main group with diabetic foot syndrome received antinsulin drug therapy (metformin tablets) before the experiment. The second main group with diabetic foot syndrome received insulin therapy before the experiment along with drugs that eliminate insulin resistance (for example, metformin tablets). At the time of the study, both groups did not receive drug therapy - metformin. However, the second main group continued to receive insulin therapy during the experiment. During the experiment, both main groups received therapy with combined intravenous laser blood irradiation with a “blue” laser (λ = 450 nm) with simultaneous ozonation of blood. The course of treatment was 10 procedures. Good tolerance was noted. No side effects were found over the entire study period.

The control groups received only standard treatment. So, the first control group took pharmacotherapy without special therapy. Patients received metformin treatment. The second control group received metformin and insulin therapy as a treatment.

Before the experiment, all patients — the first and second main groups, control groups — underwent high-tech research methods to determine their condition and blood glucose level: coronary angiography (CAG), lower limb angiography (AH). Laboratory studies of the biochemical composition of blood were performed on the Liasys analyzer for the presence of high blood sugar. Blood samples were taken in the morning on an empty stomach from the cubital vein, not earlier than 10 hours after the last meal.

The first and second main groups underwent therapeutic therapy in the claimed way: using a “blue” laser, blood on one arm was irradiated with a single-channel device “Solaris VLOK” with continuous radiation, the wavelength of which is 450 nm, the average radiation power at the output of a single-use fiber is not less than 1 mW, at the same time blood was ozonated intravenously on the other arm using a physiological saline solution of 200 ml with an ozone concentration of 2 μg / ml. Ozonation of physiological saline was carried out using the apparatus "Medozon 01". The course of treatment is 10 days, the duration of one session is 15-20 minutes.

The first and second control groups continued to receive standard treatment.

Exclusion criteria: smokers suffered <6 months ago; acute clinical complication of atherosclerosis; any acute inflammatory disease; chronic kidney disease ≥III stages - glomerular filtration rate (GFR) <60 ml / min / 1.73 m2; Both types of diabetes in the decompensation stage - glycated hemoglobin (HbA1c)> 7.5%; left ventricular ejection fraction (LVEF) <40%; oncological diseases; blood diseases and the immune system.

Statistical processing of the obtained data was carried out according to the recommendations of Rebrova O.Yu. (2002) using the STATISTICA 10 computer program. A 5% confidence interval was used (p = 0.05). The obtained data were considered as nonparametric; for this reason, the normality of the distribution of quantitative traits was not checked. In order to assess the distribution of continuous values in related groups, the Mann-Whitney test was used.

In both main groups, after the course of treatment by the claimed method, positive dynamics in the form of an improvement in the general condition of patients, a decrease in pain, a decrease relative to glucose were noted in 100% of cases. There were no complications during the study.

As can be seen from the table. 1, the average glucose value in the first main group was initially higher than normal (10.0 mmol / L with a norm of 3.3-5.5 mmol / L. After therapy, after 1 month, 3 months and 6 months, all indicators decreased and were noted statistically significant values of its decrease. Mann-Whitney criterion was 0.01, which corresponds to the statistics.

In the first control group (see table. 2), the patients of which were treated with standard therapy, without applying the claimed method, there was a tendency to maintain baseline values at the beginning of the study, after a month, 3 months, 6 months. The Mann-Whitney test was p <0.05, which is consistent with statistics.

In the second control group (see table. 4), which received standard treatment, without using the claimed method, there was a tendency to maintain baseline at the beginning of the study, after a month, 3 months, 6 months. The Mann-Whitney test was p <0.05, which is consistent with statistics.

From the above data it is seen that before treatment by the claimed method, glucose indicators in the main and control groups were above normal. After treatment by the claimed method, these indicators significantly decreased in the main groups, and in the control groups, where treatment continued to be carried out by generally accepted methods, there was a tendency to maintain indicators relative to the data at the beginning of the study.

Thus, the inclusion of therapy with combined intravenous laser blood irradiation with a “blue” laser (λ = 450 nm) and blood ozonation in patients with diabetic foot leads to a decrease in blood glucose, and also noted: general improvement in the condition of patients, improvement of microcirculation - regeneration soft tissue wounds, improved sensitivity of the lower extremities. The aforementioned gives reason to draw the following conclusions: treatment by the method of combined intravenous laser irradiation of blood with a “blue” laser (λ = 450 nm) and blood ozonation, together with insulin therapy, favorably affects the treatment of patients with diabetes mellitus complicated by a diabetic foot. In addition, the experiment showed that the use of metformin and its derivatives can be replaced by the claimed method of treatment for monotherapy.

Example. Patient K., 43, with a diagnosis of type 2 diabetes. Complication of the baseline: neuropathic form of diabetic foot syndrome, degree 1, was admitted for treatment to the second surgical department of the city hospital named after F.S. Ankudinova 10/18/18, Before treatment noted complaints of numbness of the toes, cooling of the feet of both lower extremities, a feeling of paresthesia on the plantar surface of the right foot, objectively: the skin of the lower extremities of physiological color. Feet are cool to the touch. Dryness and peeling of the skin is noted. The pulsation of the peripheral arteries is preserved. On the rear foot weakened. On the anterior surface of the lower third of the right lower leg, a superficial ulcerative defect of soft tissues was noted - a trophic ulcer 4 × 3 cm in size with no signs of infection. Sensitivity saved, reduced. There were no signs of critical lower limb ischemia. Laboratory analysis data: blood glucose 10.0 mmol \ L in the morning on an empty stomach from the cubital vein. The patient is under dynamic observation by an endocrinologist, a local surgeon and in the office of a diabetic foot. After conservative treatment for this pathology, using the developed technique of combined intravenous laser blood irradiation with a “blue” laser (450 nm) and blood ozonation - 10 procedures, using topical dressings with levomecol, a positive dynamics was achieved in the form of correction of blood glucose indicators: 7, 0 mmol \ l on 10/28/18. Correction of the patient's treatment was carried out (canceling metformin, prescribing a diet with procedures). A positive result was also achieved in the form of relief of paresthesias and numbness of the toes. Objectively: pain and tactile sensitivity increased. Soft tissue defect - trophic ulcer at the end of treatment - the wound edge 0.5 × 0.5 cm heals under the scab.

The technical result of the use of the invention lies in the fact that in patients with a diabetic foot, the blood glucose level decreases, which ultimately affects the improvement of the condition of the patients, namely, the microcirculation of the blood and, accordingly, the regeneration of soft tissue wounds are improved. Sensitivity of the lower extremities improves.

Claims (1)

A method for reducing blood glucose in patients with diabetes mellitus complicated by a diabetic foot, including intravenous irradiation of blood on one arm with a “blue” laser, while blood is ozonized in the vein of the other arm, injecting 200 ml of physiological saline with a concentration in it ozone 2 μg / ml, carrying out the procedure in a dark room for 15-20 minutes, with a treatment course of 10 days, characterized in that they use a "blue" laser with a wavelength of 450 nm, the average radiation power of which at the output of a one-time light oestrus is not less than 1 mW.