RU1780741C - Method for treatment of deforming osteoarthrosis - Google Patents

Abstract

The invention relates to medicine, namely arthrology, and can be used in spa treatment. The method improves the effectiveness of treatment by shortening the treatment time and eliminating balneoreaction. For this, after an adaptation period, hydrogen sulfide balneotherapy is performed in a descending mode with a change in the concentration of hydrogen sulfide from 150-100-50 mg / l.

Description

The invention relates to medicine, namely to arthrology.

A known method for the treatment of deforming osteoarthrosis by using hydrogen sulfide baths with a gradual increase in the concentration of hydrogen sulfide after every third bath.

However, the use of known methods gives a positive effect in only 53% of cases.

The purpose of the invention is to reduce balneotherapy and shorten treatment time.

The goal is achieved in that after an adaptation period, exposure to hydrogen sulfide baths begins at a concentration of hydrogen sulfide of 150 mg / L and is reduced in subsequent procedures to 50 mg / L.

The method is carried out in a sitting manner.

During the period of adaptation, against the background of climatic procedures, exercise therapy and massage, the patient is prescribed an introduction hydrogen sulfide bath at a concentration of hydrogen sulfide from the 3rd day

mg / l, at a water temperature of 36 degrees, lasting 6 minutes. From the 5th day of stay at the resort, ten baths are prescribed every other day at a constant temperature of 36 degrees, lasting 8-15 minutes: the first three baths at a concentration of hydrogen sulfide 150 mg / l, lasting 8-10-12 minutes; the next three baths - 100 mg / l, lasting 15 minutes; the final three baths - at a concentration of hydrogen sulfide - 50 mg / l, duration 15 minutes, a total of 10 baths per course.

Example. Patient P., 41 years old, has been suffering from deforming polyosteoarthrosis for 10 years with a primary lesion of the knee and ankle joints. Actively treated, including in a hospital setting with non-specific anti-inflammatory drugs, metabolic therapy, locally physiotherapeutic procedures. The treatment effect is unstable. I did not receive spa treatment.

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At the time of admission: the condition is satisfactory, the patient is somewhat elevated. For organs - age norm. The local status is determined by the configuration of the knee joints, crunching when moving in them and in the ankle joints. The angle of flexion in the knee joints is limited to 56 degrees.

The patient is assigned a course; climatoprocedures, exercise therapy. diet. SZ-suitable for the patient’s stay, a course of treatment was prescribed according to the proposed method: inlet bath at a concentration of hydrogen sulfide 50 mg / l, 36, 6 min, and then every other day 9 baths with a change in the concentration of hydrogen sulfide from 150/100/50 mg / l in cascade methodology

The patient complex was well tolerated. With a 2-3-4 bath, a pronounced PKK (redness reaction of the skin) was observed, which lasted up to 15-20 minutes. The monitoring of heart rate, blood pressure and ECG studies did not reveal the negative effects of balneotherapy. On the 10th day of treatment, the patient noted improvement - she became more active, starting pains disappeared, dull pain towards the end of dl, increased range of motion - the angle of flexion in the knee joint was 32 °. Clinical improvement was accompanied by positive changes in laboratory data: the clinical blood count remained within normal limits, the number of PSA decreased from 2 to traces, fibrinogen from 3.87 g / to 2.86 g / l, medium molecules from 0.256 units. up to 0.216 units The transition of the initial adaptive reaction of calm activation to the training reaction has been canceled. A sufficiently pronounced immunocorrecting effect of this regimen of hydrogen sulfide balneotherapy is indicated by a decrease in the initially increased number of immune complexes: from 561 units. up to 486 units wholesale square T-lymphocytes at the end of treatment decreased from 77% to 57%. And the initially low level of B-lymphocytes (8%) - normalization. Hls (10%),

No balneoreaction was observed during treatment. The patient suffered well treatment. Discharged with significant improvement, which lasted 7 months,

In order to confirm the effectiveness of the proposed treatment complex, 39 patients with DOA (30 women and 9 men) aged 37 to 56 years were examined for treatment. The disease duration averaged 8.6 years. 8% of patients had multiple joint damage

In the initial state, in all patients treated according to the prototype and the proposed method, pain, crunching and stiffness of the joints, stiffness of the adjacent muscles were noted. Restriction of movement of the affected joints was observed in 1/3 of the patients and averaged 9.8 degrees. Reactive synovitis was detected in 4 out of 39 patients; they were moderate.

Assessment of therapeutic efficacy was carried out according to the point system. A comparative assessment of the effectiveness in both groups revealed that a more pronounced therapeutic effect was observed in the group of patients treated by the proposed method. In this case, improvement occurs earlier (by 10.2 ± day, against 15.37 ± 29 days according to the prototype). Confirmation of the pronounced effect of the cascade mode of concentration of total hydrogen sulfide baths (the proposed method) is a more lively reaction of reddening of the skin, which, in contrast to the prototype. The results of the assessment of adaptive reactions indicate active mobilization of their own protective and adaptive forces: for example, 50% of inferior reactions went into a calm activation reaction and 28% into a training reaction (according to the proposed method), while in the group of patients treated with prototype,% of inferior reactions remained the same,% of balneoreaction by the proposed method is absent, while in the group of patients treated by the prototype, their% reaches 15.6% of cases.

The cascade technique (the proposed method) also has a more pronounced immunocorrective effect. This determines the tendency to suppress B-lymphocytes and thereby inhibit autoimmune reactions in deforming osteoarthritis. At the initial voltage of the immune system, this method of releasing hydrogen sulfide baths has a more pronounced regulatory effect, which is confirmed by the dynamics of the number of T-lymphocytes (70.0 ± 3.6; 55.1 ± 5.2;, 05). Instrumental research methods confirm the priority of the proposed method. An analysis of the treatment results of both groups shows that the proposed treatment method has a much more pronounced effect on the concomitant organic and functional lesions of the peripheral nervous system (according to vibrotest) and peripheral blood circulation (according to lower limb rheovasography). So, while taking cascading baths in 52% of patients, vibration sensitivity improved (versus 42% in the prototype group).

The number of patients with normal vibrational sensitivity increased threefold. In contrast to the prototype, the peripheral blood supply of the legs was more pronounced and significantly improved, as evidenced by the normalization of the asymmetry coefficient (from 40.77 ± 5.45 to 25.69 ± 3.83), an increase in the reographic index.

Thus, the proposed method of treatment by means of hydrogen sulfide balneotherapy in a descending mode with a change in the concentration of hydrogen sulfide from 150-100-50 mg / l, i.e. in cascade mode, in patients with deforming osteoarthrosis it excludes the development of early and late balneoreac

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tion, reduces treatment time. Follow-up data indicate an increase in the duration of remission to 1.1b ± 0.08 years (versus 0.53 ± 0.06 years in the prototype group) and the frequency of relapses decreased by 3 times.

Claims (1)

SUMMARY OF THE INVENTION A method for treating deforming osteoarthrosis by exposure to hydrogen sulfide baths, characterized in that, in order to reduce balneoreaction and shorten treatment time, the treatment is started at a concentration of hydrogen sulfide of 150 mg / L and is reduced in subsequent procedures to 50 mg / L.