SU1648468A1 - Method for treatment of patients with limited form of scleroderma - Google Patents

Abstract

This invention relates to medicine, namely to balneology and physiotherapy. The purpose of the invention is to prolong the remission period in the treatment of patients with a limited form of scleroderma. The goal is achieved by performing vacuum phonophoresis, while the mixture, in wt.%, Is administered as medicaments by vacuum phonophoresis: humisol 10.0 - 12.0; Teonikol 0,3-0,45; 40% dimethyl sulfoxide 10.0 - 12.0; lanolin with petrolatum equally to 100. The first 1-2 procedures are performed on the near-focal, and then daily on the focal zones, with a vacuum of 150-300 mm Hg, and ultrasound is used in a pulsed mode with a pulse duration of 4-10 ms , intensity (0.2 - 0.6) W / m2 for 3-4 minutes for each zone, the course of treatment is 12 to 15 procedures. AND

Description

This invention relates to medicine, namely to balneology and physiotherapy.

The purpose of the invention is to increase the remission period.

The treatment method is as follows.

For focal scleroderma, the drug mixture is prepared as follows: 2 tablets of Theonicol (0.15 each) are carefully ground in a Porcelain mortar, adding 10-20 g of Vaseline. After a homogeneous mass is obtained, anhydrous lanolin, humisol, and dimethyl sulfoxide are added in the indicated amounts. Everything is thoroughly mixed until the components are fully emulsified. Then the remaining part of petroleum jelly is added and mixed thoroughly.

The first two procedures apply the mixture to 3–4 near-focal zones with a wooden blade, impose an ultrasonic sensor, on the holder of which a vacuum chamber is fixed, and include a vacuum source, for example, a surgical portable electric suction device OX-10. The vacuum formed in the chamber contributes to the suction of the chamber to the part of the body which is exposed to the action. After that, a source of ultrasonic vibrations, such as an UZT-1.01F apparatus, generating oscillations with a frequency of 880 ± 8.8 kHz, is included. Ultrasonic oscillations in a pulsed mode with a pulse duration of 4–10 ms are used. The first two procedures ultrasound intensity of 0.2 W / m2, pulse duration 4 ms, duration

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3 minutes for each zone, the vacuum value is 150 mm Hg.

In the subsequent procedures, the mixture is applied to 3-4 focal zones, gradually increasing from procedure to procedure parameters of ultrasound exposure to 0.6 W / m2 with pronounced induction, pulse duration up to 10 ms, vacuum up to 300 mm Hg. duration up to 4 minutes for each zone. The total duration of the procedure is 10-12 minutes. Such procedures are performed daily with limited scleroderma (focal), for a course of 12-15 procedures.

PRI me R 1. Sick K., 12 years old. Diagnosis: limited plaque scleroderma. Sick for 3 years. Complaints at admission: the presence of the center of the seal with shine in the lower corner of the right shoulder blade. The general condition is satisfactory. The psycho-physical state is age appropriate. Visible mucous clean. Breathing over the lungs throughout is vesicular. The heart activity is rhythmic, the heart sounds are slightly muffled, clean, the pulse is 76 beats per minute, the blood pressure is 105/60 mm Hg. The abdomen during palpation of the soft, the liver and the spleen are not detected. Physiological functions without features.

In the lower corner of the right shoulder, the lesion is 5x3 cm in size, clearly limited from the healthy tissue by a compacted purple rim. The skin in the area of the lesion is hyperpigmented, does not fit into the fold, shiny, spades with the underlying tissues.

When conducting a television capillary scan, extravascular changes were found, characterized by a turbid background, a smoothed papillary layer. The random arrangement of capillaries draws attention, their spastic form, moderate blood flow velocity. Total capillary index is 17 points.

Reovasographic study of the upper and lower extremities: a decrease in the level of blood filling and changes in the elas- tonic properties of the vessels was observed, which was manifested by a change in the shape of the eographically curved curve, the shift of the pattern from the middle to the lower third. The rheographic index on the left forearm was 0.43 mm. Prescribed treatment.

The 1st and 2nd days of treatment - vacuum mixture of the medicinal mixture, wt.%: Humisol 10.0; Ternicol 0.3: 40% dimethyl sulfoxide 10.0: lanolin with petroleum jelly equal to 100, was performed at ultrasound intensity of 0.2 W / m2, pulse duration 4 ms for 3 minutes at a vacuum of 150 mm Hg. on each zone. Exposure was subjected to three zones near the pathological focus.

The 3rd day of treatment - vacuum phonophoresis of the indicated drug mixture was carried out in three zones of the nidus at an ultrasound intensity of 0.2 W / m2. pulse duration of 4 ms with a duration of 3 min at a vacuum of 150 mm Hg. on each zone.

The child’s well-being is quite satisfactory. The procedures are transferred well, a slightly pale purple rim surrounding the sclerodermic focus.

The 4th day of treatment - vacuum phonophoresis of the drug mixture was performed in three zones of the sclerodermic focus with an ultrasound intensity of 0.2 W / m2, a pulse duration of 4 ms, a duration of 3 minutes, and a vacuum of 150 mm Hg. when exposed to each zone in the outbreak.

The 5th day of treatment is the effect of the medicinal mixture by vacuum phonophoresis in four zones, the ultrasound intensity is 0.2–10 W / m, the pulse duration is 4 ms, the duration is 3 min, the vacuum is 150 mm Hg.

The condition of the child is satisfactory. In the area of the scleroderma focus, the skin became more mobile than before the treatment, the intensity of the purple rim decreased.

6–7 days of treatment — vukofonophoresis of the drug mixture was performed in four zones of the focus, ultrasound intensity 0.4 W / m2, pulse duration 10 ms, duration 3 min, vacuum 300 mm Hg.

The 8th day and all subsequent days until the end of the course of treatment - vacuum phonophoresis of the drug mixture was carried out in four zones of the focus at an ultrasound intensity of 0.6 W / m2, a pulse duration of 10 ms for 4 minutes at a vacuum of 300 mm Hg.

On the 10th day, the skin in the lesion grows into the fold, its luster diminishes, the intensity of pigmentation is less pronounced.

The child received 12 procedures. After completing the course of prescribed therapy, a significant improvement in the pathological focus was noted, the compacted purple rim bordering on healthy tissue disappeared, the edges of the hearth were recorded at the level of healthy tissue, the luster disappeared, the skin became mobile, was taken into fold. Intense yellowish skin color became less distinct, there was a tendency to normalize color. Remissi 1.5 years.

At the end of the course of therapy, the dynamics of microcirculation indices was positive. An improvement in the transparency of the background changed prior to treatment, the appearance of correctly positioned capillaries was revealed. The total capillary index has decreased to 12 points.

These revasography data indicate an improvement in the blood supply to the vessels of the upper extremities. Elastic properties of peripheral vessels improved. On the left forearm, the rheographic index is 1.13 mm. The child was discharged with significant improvement.

PRI mme R 2. Sick A., 7 years. Diagnosis: limited to scleroderma, linear form. Complaint for admission to the presence of significant compaction in the inner surface of the right thigh. State of health and condition at admission satisfactory. The mucous membranes are clear, the pharynx is pale pink, the tonsils are behind the arms, and vesicular breathing. Heart rate is rhythmic, pulse 94 beats per minute, muffled heart sounds, systolic murmur above the apex, conducted along the left edge of the sternum, blood pressure 98/55 mm Hg. The abdomen during palpation is soft, the liver is at the edge of the costal arch, the spleen is not detected.

In the area of the inner surface of the right femur there is a scleroderma lesion of linear shape, 12x3 cm in size. The skin in the area of the lesion is scarred, dense, the spa is not with the underlying tissues, is not taken into a fold, shiny. Expressed dyshromi. Hyperpigmentation in the lesion alternates with depigmentation. The boundaries of the focus are fuzzy, merging along edges with areas of healthy tissue.

The study of television capillary scans revealed the presence of a turbid background, perivascular swelling, a smoothed juicy layer, random arrangement of capillaries, their spastic form, and slowed blood flow. The total capillary index is 18 points.

With the help of the reovasographic study, a decrease in the amplitude and an increase in the anacrotic phase of the rheographic curve in the right lower extremity was revealed, which indicates a decrease in the blood filling of the vessels of the extremity involved in the pathological process. Eographic index on the right tibia 0.13 mm. Prescribed treatment.

The 1st and 2nd days of treatment - four zones near the pathological focus were exposed, i.e., two zones on the medial side and two zones on the lateral side of the focus, a caucone phonophoresis of the drug mixture was carried out, containing, in wt.%: Humisol 12 , 0; theonicol 0.45; 40% dimethyl sulfoxide 12.0; lanolin with petrolatum equally to 100.0, with ultrasound intensity of 0.2 W / m2, pulse duration 4 ms for 3 minutes

with a vacuum of 150 mm Hg on each zone.

3rd day of treatment - three zones were exposed to the upper, middle, and lower parts of the nidus. Vacuumophoresis

the drug mixture was performed at an ultrasound intensity of 0.2 W / m. The pulse duration was 4 ms for a duration of 3 minutes with a vacuum of 150 mm Hg. on each zone.

The child's well-being is satisfactory, the procedure tolerates well.

4th day of treatment - vukofonoforez drug mixture was performed in four zones of the scleroderma nidus along

process localization at ultrasound intensity of 0.2 W / m2. pulse duration of 4 ms with a duration of 3 min at a vacuum of 150 mm Hg. when exposed to each zone in the outbreak.

The 5th day of treatment - the effect of the drug mixture in the focus by vacuum phonosis in four zones of the focus, the ultrasound intensity is 0.2–10 W / m, the pulse duration is 4 ms, the duration is 3 minutes. magnitude

vacuum 150 mm Hg

Marked dynamics in the area of scleroderma. The skin is slightly more mobile, softer, less pronounced scar. The 6th and 7th day of treatment - vacuum-phonophoresis of the drug mixture was performed in three zones of the focus when exposed to each zone, ultrasound intensity 0.4 W / m2, pulse duration 10 ms, duration 3 minutes,

300 mm Hg vacuum.

The 8th and 10th days of treatment - vacuum-phonophoresis of the drug mixture was performed in four zones along the course of the focus of the lesion at an ultrasound intensity of 0.4 U W / m2.

a pulse duration of 10 ms with a duration of 4 min at a vacuum of 300 mm Hg.

After receiving the 8th procedure, a decrease in the intensity of pigmentation is noted, the skin above the nidus is better taken into the fold.

. On the 10th day of treatment, the luster of the skin was noticeably reduced, the scarring change was less pronounced, there was also a density and tangibility with the underlying tissues.

Starting from the 11th day of the course of therapy, the vacuum medication mixture was performed in four zones of the focus with the following parameters: ultrasound intensity 0.6 10 W / m2, pulse duration 10 ms, duration 4 min, vacuum 300 mm Hg.

The child received 15 procedures. After completion of the course of therapy, a significant improvement in the pathological focus was noted. The skin color is closer to the color of healthy tissue, its elasticity and mobility have noticeably improved, the luster has disappeared and a dense scar located along the center has appeared, the skin in the region of the center is noticeably softer, is taken into fold, is mobile.

After the course of treatment, improvement was registered on the part of the television capillary scan indicators in the form of a decrease in the turbidity of the capillary background, perivascular swelling, noted before the start of therapy, almost completely disappeared, the nature of the blood flow was recorded, its speed improved. The total capillary index is 11 points. Remissi 1.3 years.

In the study of the state of peripheral vessels reovasographically, an increase in the rheographic index on the right tibia to mm was observed, which indicates an improvement in blood supply. The child was discharged with significant improvement.

The proposed method was tested on 14 children suffering from limited scleroderma.

The proposed method of treatment allows to obtain a high and lasting therapeutic effect in the treatment of limited scleroderma by improving the general condition, absence of complaints, restoring impaired elasticity and mobility of the skin, normalizing its color and reducing skin swollenness with the underlying tissues, regressing the tendon-muscular contractures as well as normalization of altered peripheral circulation.

Claims (1)

Invention Formula A method of treating patients with a limited form of scleroderma, which includes conducting medicinal phonophoresis on a lesion, characterized in that, in order to increase the remission period, they additionally simultaneously have a reduced pressure of 150-300 mm Hg. the first 1-2 days at the near-focal, and then daily at the focal zones, and ultrasound is used in a pulsed mode with a pulse duration of 4–10 ms for 3-4 minutes for each zone, while the mixture, wt., is administered as a drug. %: Gumizol10,0-12,0 Teonikol0,3 - 0,45 40% dimethylsulfoxide, 10-12.0 Lanolin with petroleum jelly equal to 100