RU2706385C1 - Method of treating patients with metabolic syndrome - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to therapy, can be used for treating patients with metabolic syndrome. Initial examination is performed. Simultaneously, drug-induced treatment and laser irradiation are used. Preparations are Metformin 500 mg 2 times a day, Atorvastatin 10 mg in the evening, Lysinopril 5 mg 1–2 times a day. Intravenous laser blood irradiation (ILBI) is performed with a differentiated approach. Depending on the initial laboratory and physical data, different courses of laser therapy are selected. If the initial body weight index (BWI) is equal to 34.9 kg/m², with LDL cholesterol level to 4.11 mmol/l, HDL cholesterol 1.55 mmol/l, TG to 1.69 mmol/l, cystatin C to 1.20 mg/l, level of hsCRP up to 3.0 mg/l, pulse wave velocity values for vessels of elastic type (PWVe) to 9.90 m/s are 7 daily procedures of ILBI, wavelength 0.405 mcm, output power at end of main light guide 1–1.5 mW for 15 minutes in continuous illumination mode. With BMI values of 35 kg/m², at the level of LDL cholesterol higher than 4.12 mmol/l, HDL cholesterol up to 1.54 mmol/l, TG higher than 1.69 mmol/l, cystatin C level more than 1.21 mg/l, hsCRP level more than 3.01 mg/l, rate of propagation of pulse wave along vessels of elastic type (PWVe) higher than 10 m/s is performed by 10 daily procedures of ILBI, wave length of 0.405 mcm, output power at end of main light guide 1–1.5 mW during 15 minutes in continuous illumination mode.

EFFECT: method provides treating the patients with metabolic syndrome by selecting parameters of laser blood irradiation based on the initial laboratory and physical data of the patient.

1 cl, 6 tbl, 3 ex

Description

The invention relates to medicine, namely to the sections: “cardiology”, “therapy” and for the treatment of patients with metabolic syndrome. Metabolic syndrome is one of the most pressing problems of modern medicine. The metabolic syndrome is recognized as a non-infectious epidemic because of its widespread prevalence in the population (Berezina, M.V. 2012). According to WHO, 1.7 billion people on the planet are overweight, and by 2025 the number of people in the world with obesity will reach 300 million people (Ganchar E.P., 2013).

The metabolic syndrome is characterized by the presence of several criteria: an increase in the mass of visceral fat, a decrease in the sensitivity of peripheral tissues to insulin and hyperinsulinemia, which cause disturbances in carbohydrate, lipid metabolism and arterial hypertension. Currently, it is believed that one of the key factors in the development and progression of MS is abdominal obesity. It is an increase in the amount of visceral fat that is usually combined with hyperinsulinemia, insulin resistance, arterial hypertension and lipid disorders.

It is known that a violation of carbohydrate and lipid metabolism leads to various pathological processes, such as: a decrease in the elasticity of the vascular wall and as a result of an increase in the speed of propagation of the pulse wave, initiation of the inflammatory process in the intima of the vessels, an increase in the concentration of CRP, and as a result of these processes, atherosclerosis appears - an increase cystatin C. concentrations

Their further study of the markers of these processes can open up enormous prospects not only in the study of the pathogenesis of MS, but also in the creation of new, and most importantly effective methods of treating MS.

Improving the treatment of patients with metabolic syndrome is one of the most pressing issues of modern cardiology due to the continuous increase in the incidence and the identification of numerous side effects of drugs. Against this background, in recent years, the attention of many researchers has been attracted by non-drug methods of treatment. One of the modern methods of non-drug treatment is low-intensity laser irradiation of blood.

The pathogenetic effect of low-intensity laser irradiation is manifested by a number of effects: a vasodilating effect, improved microcirculation, normalization, rheological properties of blood, increased antioxidant activity, normalized blood ion composition, increased oxygen transport function of blood, normalized metabolic processes, as well as immunomodulating, analgesic effects. But until now, aspects of the effect of laser blood clotting on some parts of the pathogenesis of the metabolic syndrome remain unexplored.

A known method of treating patients with metabolic syndrome using laser therapy (Complex correction of the metabolic syndrome using low-intensity laser radiation in patients with bronchial asthma. Thesis Chernaya Lyudmila Sergeevna, 2013. Scientific library of dissertations and abstracts). Laser therapy was carried out with a course of 8 procedures for the intravenous laser blood irradiation using a KL-VLOK emitting head with a power at the end of the fiber of 1.5 mW and a wavelength of 0.63 μm., The duration of the procedure was 15-20 minutes. The disadvantage of this method is the lack of a differential approach to the appointment of laser therapy, insufficient to assess all the pathogenetic mechanisms of action of laser therapy, the choice of supravenous blood irradiation methods.

There is a method of treating patients with metabolic syndrome (Berezina A.V. Non-drug methods of treatment and prevention of cardiovascular diseases in patients with abdominal obesity. Thesis for the degree of Doctor of Medical Sciences. FSAI Federal Center for Heart, Blood and Endocrinology named after V.A. Almazov ”Of the Ministry of Health of the Russian Federation. St. Petersburg -2013), which consists in treating the metabolic syndrome using a specially selected program of physical activity and diet.

The disadvantage of this method is that it does not significantly affect the basic pathogenetic mechanisms of the development of the metabolic syndrome, and can only be used in the early stages of obesity, without the presence of concomitant complications.

Closest to the claimed method is a method of treating patients with metabolic syndrome using laser therapy (The effectiveness of drug and non-drug correction of carbohydrate metabolism disorders in the metabolic syndrome., Donts A.V., Voronezh State Medical Academy named after N.N. Burdenko), including the use in combination of the drug Dalargin (endonasally 2 mg per day in two divided doses for 10 days, followed by use in the same dosage for 10 days over the next two months (all about 3 courses in 3 months). As a source of low-intensity laser blood clotting, i used the Matrix-VLOK laser semiconductor therapeutic apparatus (Russia), with a KL-VLOK-405 radiating head with a power at the end of the fiber of 2.5 mW and a length waves 0.63 μm. A modified VLOK-405 technique using pressure access was used. The course of therapy included 10 procedures of 30 minutes daily.

The selected prototype and the claimed invention have the following common essential features: the simultaneous use of drugs and laser therapy, that is, the mutual potentiation of the effect. In our opinion, the disadvantages of the prototype is that patients are prescribed; laser therapy using supravenous access, since when passing through the skin important properties of laser radiation are lost - spatial coherence, polarization and radiation scattering in nearby tissues are completely unpredictable, not allowing a sufficient degree of accuracy to control the dose of exposure, i.e. to provide the optimal effect, as well as a significant disadvantage of the prototype is the lack of a differentiated approach to the appointment of laser therapy, which does not allow to achieve the greatest efficiency in patients with varying degrees of severity of the pathology. These disadvantages are eliminated by our invention.

The invention is aimed at solving the problem, which consists in creating a differential approach to the treatment of patients with metabolic syndrome using intravenous laser blood transfusion.

The solution to this problem reduces the clinical manifestations of the metabolic syndrome, increases the effectiveness of drug therapy and provides a rationale for the effectiveness of laser therapy in the complex treatment of patients with metabolic syndrome, taking into account the most important pathogenetic links in the development of MS (disorders in lipid and carbohydrate metabolism).

To achieve this technical result, the claimed invention of a method for treating patients with metabolic syndrome includes the following essential features - the initial examination of the patient, the simultaneous use of drug treatment and laser irradiation, characterized in that Metformin 500 mg 2 times a day, Atorvastatin, are prescribed to the patient as drugs 10 mg in the evening, Lisinopril 5 mg 1-2 times a day and use the intravenous method of laser irradiation of blood with a differentiated approach.

Complex therapy is prescribed differentially depending on the initial indicators of body mass index (BMI), the level of lipid metabolism, the level of concentration of cystatin C and CRP determined by a highly sensitive method in blood serum.

At baseline body mass index (BMI) of up to 34.9 kg / m ² , at a level of LDL cholesterol up to 4.11 mmol / l, HDL cholesterol from 1.55 mmol / l, TG up to 1.69 mmol / l, level cystatin C up to 1.20 mg / l, hsCRP level up to 3.0 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) up to 9.90 m / s - 7 daily VLOK procedures are performed, wavelength 0.405 μm , output power at the end of the trunk fiber 1-1.5 mW for 15 minutes in a continuous mode of coverage. With BMI values from 35 kg / m ² , at a level of LDL cholesterol higher than 4.12 mmol / l, HDL cholesterol up to 1.54 mmol / l, TG above 1.69 mmol / l, cystatin C level more than 1.21 mg / l, hsCRP level of more than 3.01 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) above 10 m / s, 10 daily VLOK procedures are carried out, with a wavelength of 0.405 μm, output power at the end of the main fiber 1-1.5 mW for 15 minutes in continuous flash mode. In relation to the prototype, the claimed invention has the following distinctive features - along with traditional drug therapy, intravenous laser blood bleeding is prescribed differentially depending on the initial indicators of body mass index (BMI), the level of lipid metabolism, the level of cystatin C and CRP determined by a highly sensitive method in blood serum. At baseline body mass index (BMI) of up to 34.9 kg / m ² , at a level of LDL cholesterol up to 4.11 mmol / l, HDL cholesterol from 1.55 mmol / l, TG up to 1.69 mmol / l, level cystatin C up to 1.20 mg / l, hsCRP level up to 3.0 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) up to 9.90 m / s - 7 daily VLOK procedures are performed, wavelength 0.405 μm , output power at the end of the trunk fiber 1-1.5 mW for 15 minutes in a continuous mode of coverage. With BMI values from 35 kg / m ² , at a level of LDL cholesterol higher than 4.12 mmol / l, HDL cholesterol up to 1.54 mmol / l, TG above 1.69 mmol / l, cystatin C level more than 1.21 mg / l, hsCRP level of more than 3.01 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) above 10 m / s, 10 daily VLOK procedures are carried out, with a wavelength of 0.405 μm, output power at the end of the main fiber 1-1.5 mW for 15 minutes in continuous flash mode. There is the following causal relationship between the distinguishing features and the technical result: as a result of using the matrix-differential differential blood irradiation technique Matrix-VLOK, a normalizing effect on the dynamics of the indicators of vascular wall elasticity, carbohydrate metabolism, hsCRP and cystatin C is noted, as well as the effectiveness of the drug therapy, expressed in the possibility of reducing the doses of drug therapy, and therefore the risk of full-time phenomena of drug therapy.

According to the information available to the authors, the set of essential features characterizing the essence of the claimed invention is not known, which allows us to conclude that the invention meets the criterion of "novelty." According to the authors, the essence of the claimed invention does not follow explicitly from the known level of medicine, since it does not reveal the above treatment method for the Matrix - VLOK, which distinguishes the claimed invention from the prototype, which allows us to conclude that its criterion is “inventive step”.

The set of essential features characterizing the essence of the invention, in principle, can be used repeatedly in medicine with obtaining a technical result consisting in increasing the efficiency of laser therapy for patients with metabolic syndrome, which allows us to conclude that the invention meets the criterion of "industrial applicability".

This method is as follows.

All patients with metabolic syndrome undergo complex drug therapy (lipid-lowering therapy, hypoglycemic drugs, antihypertensive therapy) with the simultaneous use of a course of intravenous laser therapy. The proposed method for the treatment of patients with metabolic syndrome was used in 154 patients, of whom 106 were women, 48 were men, and the average age was 36.5 ± 8.6. All patients with metabolic syndrome were randomly divided into two groups: control (32 people) and main (122 people). In the I-th (control) group, only traditional drug therapy was used, patients of the II group (main), in addition to drug therapy, received one of two options for intravenous laser bleeding of blood, depending on the initial data.

The criterion for inclusion in the study group was the presence of MS diagnosed by the recommendations of GFCF experts on the diagnosis and treatment of MS (second review, 2010):

- the main criterion is the central (abdominal) type of obesity - waist circumference (OT) of more than 80 cm in women and more than 94 cm in men,

- additional criteria:

- blood pressure> 140 and 90 mm RT. Art.

- increase in triglycerides (≥1.7 mmol / l),

- a decrease in HDL cholesterol (<1.0 mmol / L in men; <1.2 mmol / L in women),

- increasing the level of LDL cholesterol> 3.0 mmol / l,

- impaired glucose tolerance (NTG) - increased plasma glucose 2 hours after loading 75 g of anhydrous glucose,

- impaired fasting glycemia (NGN) -≥6.1 and <7.0 mmol / L.

If there are 3 criteria: 1 primary and 2 additional patients were included in the study.

Exclusion criteria were severe somatic diseases, renal, hepatic, cardiac, respiratory failure, a history of stroke, heart attack, and oncological diseases.

For intravenous laser therapy, the Matrix-VLOK apparatus (Matrix Russia) was used with a wavelength of 0.405 microns and an output power of 1-1.5 mW at the end of the main fiber. Laser irradiation of blood was performed differentially. At baseline body mass index (BMI) of up to 34.9 kg / m ² , at a level of LDL cholesterol up to 4.11 mmol / l, HDL cholesterol from 1.55 mmol / l, TG up to 1.69 mmol / l, level cystatin C up to 1.20 mg / l, hsCRP level up to 3.0 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) up to 9.90 m / s - 7 daily VLOK procedures are performed, wavelength 0.405 μm , output power at the end of the trunk fiber 1-1.5 mW for 15 minutes in a continuous mode of coverage. With BMI values from 35 kg / m ² , at a level of LDL cholesterol higher than 4.12 mmol / l, HDL cholesterol up to 1.54 mmol / l, TG above 1.69 mmol / l, cystatin C level more than 1.21 mg / l, hsCRP level of more than 3.01 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) above 10 m / s, 10 daily VLOK procedures are carried out, with a wavelength of 0.405 μm, output power at the end of the main fiber 1-1.5 mW for 15 minutes in continuous flash mode. Examination of patients was carried out in the morning on the first - second day and 14 days after the end of the course of laser therapy.

All patients underwent an in-depth general clinical study, including anthropometric examination, clinical blood and urine tests, biochemical and hormonal blood tests, instrumental methods of study - blood pressure measurement by Korotkov’s method, electrocardiography.

Fasting glucose and impaired glucose tolerance were determined for all patients.

To determine impaired glucose tolerance, an oral glucose tolerance test (GTT) was performed.

During the study, insulin levels and insulin resistance (IR) were determined. To determine the IR used the calculation method for assessing the homeostatic index of IR (HOMA-IR).

HOMA-IR = (Fasting insulin kmk U / ml × fasting glucose mmol / L) / 22.5)).

To assess the state of the elastic properties of the vessels, we used the method of determining the pulse wave propagation velocity (SRWP) using the Poly-Spectrum-12 sphygmographic attachment (Neurosoft LLC, Russia).

The study of the level of cystatin C in the blood serum was determined by the method of enzyme-linked immunosorbent assay (ELISA) using a set of reagents "HumanCystatin With ELISA" company "BioVendor" (Czech Republic).

In this study, the level of hsCRP was determined on a BeckmanCoulter AU480 analyzer (USA) using BeckmanCoulter diagnostic kits.

Work with diagnostic kits was carried out according to the generally accepted plan for this technique.

We also studied the indicators of the elasticity of the vascular wall, expressed in the speed of propagation of the pulse wave through the vessels of the elastic type (SRPVe) in patients with metabolic syndrome.

The dynamics of SRPVe during treatment is presented in table 1.

* p <0.05 - differences before and after treatment within the same group.

^# p <0.05 - differences with the healthy group.

As can be seen from table 1 after treatment in the main group, the propagation velocity of the pulse wave through the vessels of the elastic type significantly decreased, reaching 9.01 ± 1.09 m / s. (p <0.05) and almost reached the indicators obtained in the group of healthy individuals. In the control group, despite the fact that the indicators of PWV E also decreased slightly, this decrease was statistically unreliable.

Thus, in patients with metabolic syndrome, the inclusion in the complex therapy of intravenous laser bleeding of blood is accompanied by a significant decrease in PWV in the elastic vessels, therefore, it normalizes the elastic properties of the arteries.

Table 2 shows the data reflecting the dynamics of hsCRP during treatment.

* p <0.05 - differences before and after treatment within the same group.

^# p <0.05 - differences with the healthy group.

As can be seen from table 2, the concentration of CRP after treatment significantly changed only in the group where patients along with conventional MS therapy received laser blood irradiation. So, the value of CRP after treatment in the main group almost reached the level of healthy people and amounted to 2.03 ± 1.07 mg / l. (p <0.05). At the same time, in the control group, in which patients received only standard therapy, the concentration of hsCRP remained almost unchanged and exceeded normal values.

Table 3 presents the data obtained by studying the concentration of cystatin C in patients with metabolic syndrome.

* p <0.05 - differences before and after treatment within the same group.

^# p <0.05 - differences with the healthy group.

As can be seen from table 3 after treatment in the main group, the concentration of cystatin C decreased significantly, reaching 0.75 ± 0.18 mg / L. (p <0.05) and reached the indicators obtained in the group of healthy individuals. In the control group, despite the fact that the cystatin C concentration indicators also decreased slightly, this decrease was statistically unreliable.

Thus, in patients with metabolic syndrome, the inclusion in the complex therapy of intravenous laser bleeding of blood is accompanied by a significant decrease in the concentration of cystatin C.

Fasting glucose was determined for all patients, and an oral glucose tolerance test (GTT) was performed to determine impaired glucose tolerance. The interpretation of the test results was carried out according to the WHO criteria presented in table 4.

In all patients, insulin levels were determined, the norm of which for a healthy person is 2.6-24.9 μU / ml. Also, the HOMA-IR index was calculated to detect insulin resistance.

HOMA-IR Reference Values: 0-2.7

As can be seen from the data presented in table 5, before treatment in both groups of patients, fasting glucose did not exceed normal values and amounted to 5.5 ± 0.88 mmol / l in the main group and 5.8 ± 0.87 mmol / l ( in the control group). However, a glucose tolerance test revealed impaired glucose tolerance in both groups before treatment.

* p <0.05 - differences before and after treatment within the same group.

^# p <0.05 - differences with the healthy group.

After treatment in both groups, the fasting glucose level significantly decreased compared to the initial level, amounting to 4.03 ± 0.72 mmol / L in the main group and 4.9 ± 0.81 mmol / L in the control group. At the same time, the data obtained during the GTT test show that only in the patients of the main group the glucose level reached the norm, while in the control group, despite a significant decrease in glucose to 8.25 ± 1.18 mmol / l, this indicator remains elevated, which indicates the preservation of impaired glucose tolerance in patients. Before treatment, all patients with metabolic syndrome of both the control and the main group showed a statistically insignificant increase in plasma insulin levels. The values of HOMA-IR before treatment significantly exceeded the values of normal indices in both groups. Table 6 shows data reflecting the dynamics of these indicators in the treatment process.

* p <0.05 - differences before and after treatment within the same group.

^# p <0.05 - differences with the healthy group.

After the treatment, the insulin level in the main group significantly decreased, amounting to 16.53 ± 3.10 ng / ml (p <0.05), which corresponds to the norm, which cannot be said about the control group, where the insulin level decreased slightly and amounted to -22, 61 ± 2.78 μU / ml.

We obtained similar data when calculating the HOMA-IR index. Before treatment, both in the main and in the control group, the IR index significantly exceeded the normal values and amounted to 6.16 ± 1.31 and 6.35 ± 1.12 (p <0.05), respectively. After the treatment, we noted a significant decrease in the IR index only in patients of the main group (3.61 ± 1.04), while in the patients of the control group who did not receive intravenous laser bleeding, the HOMA-IR index remained almost unchanged and remained at a high level (6.25 ± 1.18).

Thus, the results of our study indicate that the inclusion in the complex therapy of the metabolic syndrome of intravenous laser bleeding of blood leads to a significant decrease in insulin resistance.

Thus, from the above it follows that the use of combination therapy with the course of Matrix - VLOK is superior to traditional drug therapy.

Brief examples are given to illustrate a method of treating patients, including the use of drugs and laser therapy (Matrix-VLOK), as well as the normalizing effect on carbohydrate metabolism, the cytokine system, leptin level, adiponectin.

Example 1. Patient A., 37 years old. I was hospitalized in the 1st therapeutic unit of the Emergency Hospital of the Hospital for the first detected increase in blood pressure to 160/90 mm. Hg. Has excess body weight since childhood, but over the past 5 years, body weight has increased by 20 kg. About 3 years notes an increase in blood pressure to 150/90 mm RT art. Objectively: the skin is pale pink, increased nutrition. Height - 170 cm, body weight - 110 kg; BMI = 38.6 kg / m ² , OT = 84 cm. There are no peripheral edema. Auscultatory vesicular breathing is over the lungs, there are no secondary respiratory sounds. Coronones are clear, the rhythm is preserved. HELL 150/85 mm RT art, heart rate 88 per minute. The abdomen is enlarged due to subcutaneous fat, palpation is soft, painless. The liver is at the edge of the costal arch, the spleen is not palpable. The symptom of "striking" in the lumbar region is negative on both sides. Physiological administration is normal.

In the biochemical analysis of blood: blood glucose - 4.8 mmol / L, HDL cholesterol 1.09 mmol / L, LDL cholesterol 4.37 mmol / L, TG - 2.38 mmol / L.

An additional blood test revealed an increase in hsCRP to 3.8 mg / l, an increase in the concentration of cystatin C to 1.34 mg / l, fasting insulin in the blood -20.7 mcU / ml; HOMA-IR index = 4.03, as well as an increase in SRPVe to 11.70 m / s.

Thus, based on the results of the examination, the main criterion for the metabolic syndrome — abdominal obesity — and additional criteria — increase in the level of TG, LDL cholesterol, decrease in HDL cholesterol, and elevated blood pressure were identified.

A course of intravenous laser blood bleaching was prescribed for 10 days using the Matrix-VLOK apparatus, a laser head with a wavelength of 0.405 microns, and an output power of 1-1.5 mW at the end of the main fiber for 15 minutes in continuous bleaching mode. Procedures were performed daily, seven days a week. Laser therapy was carried out while taking medications.

By the 7th procedure, the patient began to note normalization of blood pressure, decreased appetite. In the study of the biochemical analysis of blood after treatment, positive dynamics were noted: a decrease in the level of TG-1.6 mmol / l, the level of LDL cholesterol 3.1 mmol / l, an increase in HDL cholesterol level 1.83 mmol / l. We noted a decrease in the level of hsCRP to 2.34 mg / l, a decrease in the concentration of cystatin C to 0.83 mg / l, a decrease in the level of HOMA-IR-3.5, as well as a decrease in the values of SRPV e to 8.84 m / s.

Example 2. Patient K., 30 years old. Was in the 1st therapeutic department of the KBSP for the first detected arterial hypertension. Over the past year, headache, increased fatigue, palpitations, and an increase in body weight of 12 kg, mainly in the abdomen, were accompanied by chronic overeating and inactivity.

Objectively: the skin is pale pink, increased nutrition. Height - 183 cm, body weight - 107 kg; BMI = 31.95 kg / m ² , OT = 104 cm. There are no peripheral edema. Auscultation of vesicular breathing is over the lungs, there are no secondary respiratory sounds. Coronones are clear, the rhythm is preserved. HELL 155/95 mm Hg, heart rate 87 per minute. The abdomen is enlarged due to subcutaneous fat, palpation is soft, painless. The liver is at the edge of the costal arch, the spleen is not palpable. The symptom of "striking" in the lumbar region is negative on both sides. Physiological administration is normal.

In the biochemical analysis of blood: blood glucose - 5.1 mmol / l, cholesterol-HDL 1.84 mmol / l, cholesterol-LDL 3.54 mmol / l, TG-1.57 mmol / l.

An additional blood test revealed an increase in the level of hsCRP to 2.9 mg / l, an increase in the concentration of cystatin C to 1.13 mg / l, and the fasting blood insulin content was -15.7 mU / ml; HOMA-IR index = 3.03, as well as an increase in SRPVe to 9.70 m / s.

Thus, based on the results of the examination, the main criterion for the metabolic syndrome — abdominal obesity — and additional criteria — increase in the level of TG, LDL cholesterol, decrease in HDL cholesterol, and elevated blood pressure were identified.

A course of intravenous laser blood bleaching was prescribed for 7 days using the Matrix-VLOK apparatus, a laser head with a wavelength of 0.405 microns, and an output power of 1-1.5 mW at the end of the main fiber for 15 minutes in continuous bleaching mode. Procedures were performed daily, seven days a week. Laser therapy was carried out while taking medications.

By the fourth procedure, the patient began to note the normalization of blood pressure.

In the study of biochemical analysis of blood after treatment, positive dynamics were noted: a decrease in the level of TG-1.32 mmol / l, the level of LDL cholesterol 2.9 mmol / l.

We noted a decrease in the level of hsCRP to 1.98 mg / l, a decrease in the concentration of cystatin C to 0.78 mg / l, a decrease in the level of HOMA-IR-3.2, as well as a decrease in SRPVe to 8.32 m / s.

Example 3. Patient O., 28 years old. Was admitted to the 1st therapeutic unit of the KBSP with complaints of severe headache, a feeling of interruptions in the heart, a periodic increase in blood pressure of a maximum of 150/90 mm. Hg. Over the past year, headache, increased fatigue, palpitations bothered. In the history of childhood obesity, the heredity of obesity is also burdened.

Objectively: the skin is pale pink, oversized adipose tissue is distributed according to the female type. Height - 168 cm, body weight - 94 kg; BMI = 33.3 kg / m ² , FR = 96 cm. There are no peripheral edema. Auscultatory vesicular breathing over the lungs, no adverse respiratory sounds. Cor-tones are clear, the rhythm is preserved. HELL 145/90 mm Hg, heart rate 87 per minute. The abdomen is enlarged due to subcutaneous fat, palpation is soft, painless. The liver is at the edge of the costal arch, the spleen is not palpable. The symptom of "striking" in the lumbar region is negative on both sides. Physiological administration is normal.

In the biochemical analysis of blood: blood glucose - 4.8 mmol / L, HDL cholesterol 1.72 mmol / L, LDL cholesterol 3.23 mmol / L, TG-1.43 mmol / L.

An additional blood test revealed an increase in hsCRP to 3.9 mg / l, an increase in the concentration of cystatin C to 1.67 mg / l, fasting insulin in the blood -14.1 mcU / ml; the HOMA-IR index is 3.03, and an increase in SRPVe up to 10.58 m / s was also revealed.

Thus, based on the results of the examination, the main criterion for the metabolic syndrome — abdominal obesity — and additional criteria — increase in the level of TG, LDL cholesterol, decrease in HDL cholesterol, and elevated blood pressure were identified.

A course of intravenous laser blood bleaching was prescribed for 7 days using the Matrix-VLOK apparatus, a laser head with a wavelength of 0.405 microns, and an output power of 1-1.5 mW at the end of the main fiber for 15 minutes in continuous bleaching mode. Procedures were performed daily, seven days a week. Laser therapy was carried out while taking medications.

By the fourth procedure, the patient began to note the normalization of blood pressure.

In the study of biochemical analysis of blood after treatment, positive dynamics were noted: a decrease in the level of TG-1.22 mmol / l, the level of LDL cholesterol 2.6 mmol / l.

We noted a decrease in the level of hsCRP to 2.17 mg / l, a decrease in the concentration of cystatin C to 0.63 mg / l, a decrease in the level of HOMA-IR - 2.9, as well as a decrease in the values of SRPV e to 8.03 m / s.

Claims (1)

A method of treating patients with metabolic syndrome, including an initial examination, the simultaneous use of drug treatment and laser irradiation, characterized in that Metformin 500 mg 2 times a day, Atorvastatin 10 mg in the evening, Lisinopril 5 mg 1-2 times day and use the intravenous method of laser irradiation of blood with a differentiated approach, depending on the initial laboratory and physical data, different courses of laser therapy are selected, and with the initial STUDIO body mass index (BMI) to 34.9 kg / m ^2, and LDL cholesterol level to 4.11 mmol / L, HDL cholesterol by 1.55 mg / dL, triglycerides to 1.69 mmol / l, the level of cystatin C up to 1.20 mg / l, hsCRP level up to 3.0 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) up to 9.90 m / s; 7 daily VLOK procedures are performed, wavelength 0.405 μm, output power at the end of the main fiber 1-1.5 mW for 15 minutes in continuous flash mode, and with BMI values from 35 kg / m ² , at a level of LDL cholesterol higher than 4.12 mmol / l, HDL cholesterol up to 1.54 mmol / l, TG above 1.69 mmol / l, ur outside of cystatin C more than 1.21 mg / l, hsCRP level more than 3.01 mg / l, pulse wave propagation velocity in elastic vessels (SRPVe) above 10 m / s 10 daily VLOK procedures are carried out, wavelength 0.405 μm, output power at the end of the trunk fiber 1-1.5 mW for 15 minutes in a continuous mode of coverage.