RU2365388C2 - Electrotherapy method at various diseases and pathological states - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns medicine area, namely to electrotherapy at various diseases and pathological states. Transcutaneous influence by an electric bipolar pulse current is carried out by means of electrodes and the intermediate environment with the electrolyte or a chemical compound possessing properties of electrolyte solution used for it; the electrodes are placed in this medium. Influence is carried out by placing of body parts directly in a solution, thus, limbs are placed simultaneously in pairs in different reservoirs, in various possible combinations, changing their position in influence process within possible volume of movements.

EFFECT: reception of more expressed and proof clinical effect at the expense of simultaneous influence by variable current flow on the chosen body parts at bed patients, at patients with plaster limbs immobilisation and other parts of a body, and also at patients with the irradiaton-mastectomic syndrome.

3 cl, 2 ex, 1 tbl

Description

The invention relates to medicine, namely to physiotherapy, and can be used in sports medicine, as well as for independent and complex treatment of various diseases, pathological and other conditions of the nervous, vascular, lymphatic system, muscle, musculoskeletal system and internal organs.

There is a method of electrotherapy for the treatment of postmastectomy syndrome after radical mastectomy by applying an electric current to the shoulder girdle and arm muscles, which consists in the fact that the muscles of the shoulder girdle and arm are affected by a low-frequency pulse current with a bipolar asymmetric pulse shape with a trapezoidal envelope, with a frequency of 20 120 Hz, a period of 4-32 s, a current of 2-100 mA according to the individual sensations of the patient, with a course of treatment equal to 8 procedures conducted daily from 5 to 30 minutes (RU 2095095, class IPC: AG1N 1/32, 1997).

The disadvantage of this method is the inability to simultaneously affect the healthy hand, when necessary, as well as the limited frequency of the pulse current (20-120 Hz), which narrows the therapeutic possibilities of the method.

As the closest analogue, the method of low-frequency electrotherapy for diseases of the nervous system, musculoskeletal system and internal organs (M.G. Vorobyov, G.N. Ponomarenko. // Practical guide to electro and magnetotherapy. - St. Petersburg. - Hippocrates. - 2002 - p.97-106), including percutaneous exposure to electric current by applying electrodes with gaskets, impregnated with an intermediate medium - a hydrophilic solution. Certain sections of the patient’s body are affected by alternating sinusoidal currents with a frequency of 5000 Hz, modulated by low frequencies in the range of 10-150 Hz. The depth of their modulation varies from 0 to 100% or more. As a result of modulation, a series of current pulses are formed, separated from each other by gaps with zero amplitude. Sinusoidal modulated currents (SMT) cause the appearance in the tissues of significant strength currents that excite nerve and muscle fibers.

To carry out the amplipulse therapy procedure, plate electrodes with hydrophilic pads 1 cm thick are used. In this case, one electrode is applied to the skin in the area of pain projection, and the second one is nearby, at a distance equal to the diameter of the first electrode, or from the opposite side (transversely). The impact of SMT is performed using several types of work, depending on the severity of the pain syndrome. When dosing the procedures of amplipulse therapy, the patient's sensation of soft, painless vibration under both electrodes is taken into account. For electrical muscle stimulation, a second type of work is used.

At the same time, the receptors of the skin, muscles and internal organs, as well as motor and autonomic fibers, are involved in the excitation process, which causes a more effective blockade of the peripheral conductors of pain sensitivity, up to their parabiosis. In addition, a pronounced dominant of rhythmic irritation can form in the central nervous system, which leads to the rapid extinction of the pain dominant, which stimulates the trophic nervous system and the release of opioid peptides in the brain stem. SMT activate the microvasculature of ischemic tissues, reduce venous congestion and perineural edema.

However, in the known method, the effect is carried out only on individual muscles or certain muscle groups, and not on all muscles of the limbs in general, which is necessary to ensure complete stimulation of the micropump function of the entire muscle apparatus of the limbs, the so-called intramuscular peripheral heart (Arincin N.I., Egorova NF On the active intraorgan lymphatic pumping function of skeletal muscles // Peripheral lymphatic circulation disorders and methods for their correction. - M. - 1980. - P.6-8).

The method does not allow to act simultaneously and sequentially not only on all muscles or muscle groups, but also on the neurotrophic, vascular, lymphatic and ligamentous-articular apparatus of the limbs. All this reduces the effectiveness of the impact and the stability of the results.

There is no possibility to simultaneously and simultaneously act on the ipsilateral limb when necessary, for example, with post-radiation-mastectomy syndrome. In this syndrome, after complex treatment of breast cancer, motor and sensitive disorders of both upper extremities develop with demyelination of nerve fibers and axon damage (Lazarev A.F., Lyamina O.V. Disturbance of peripheral innervation of the upper limbs in patients with breast cancer after complex treatment / / Clinical Oncology. - 2003. - No. 2. - p. 12-15).

In addition, the method has limited functionality for certain diseases and injuries of the neuromuscular, vascular, lymphatic, ligamentous-bone apparatus of the extremities, accompanied by edema, vascular insufficiency with trophic or post-traumatic disorders of the skin, weakness and muscle atrophy. The application of electrodes in these cases is contraindicated or impossible (in the presence of plaster and other types of dressings, metal orthopedic structures).

The objective of the invention is to provide a method of electrotherapy for various diseases and pathological conditions, which has broad functional capabilities and allows to obtain a more pronounced and persistent clinical effect.

The essence of the invention lies in the fact that in the method of electrotherapy for various diseases and pathological conditions, including transdermal exposure to an electric bipolar pulse current with frequency-modulated pulses in the range from 1 to 1200 Hz using electrodes and an intermediate medium, an electrolyte solution is used as an intermediate medium or a chemical compound having the properties of an electrolyte in which electrodes are installed, and the effect is carried out by immersion directly in solution parts of the body, while parts of the limbs are placed in pairs, but in different containers, in various possible combinations, changing their position during the exposure within the permissible range of motion.

The tanks are filled with an electrolyte solution of one type of concentration.

Tanks are filled with electrolyte solutions of various types and concentrations.

Using the invention allows to obtain the following technical result.

The method is highly effective, it allows you to get a more pronounced and persistent clinical effect; Significant improvement or recovery occurs in the shortest possible time, treatment periods are significantly reduced, relapses of the disease occur less frequently or are not observed at all.

At the same time, rapid and pronounced

decrease in intensity, duration, resistance, frequency, radiation of pain, analgesics and relief of pain;

a decrease in the manifestations of inflammation syndrome (edema, hyperemia, pain, impaired function);

improvement and normalization of limb function (volume and quality of movements in the joints);

increase in muscle mass of the body, including individual purposefully selected muscle groups;

reduced body fat, including targeted areas of the body;

normalization of the function of the gall bladder, etc. (including the frequency of urination, pain, pain, etc.);

normalization of sexual function (libido, degree of erection, duration of sexual intercourse, etc.);

improving the regeneration of various tissues (normalizing the healing rate, regeneration, reducing the phase of inflammation, approaching the phase of epithelization, improving the quality of scarring);

increase in muscle strength characteristics (dynamometry, increased exercise tolerance).

The method has wide functional capabilities for various nosological forms of diseases: in therapy, neurology, traumatology, sports medicine, geriatrics, rehabilitation and other fields of medicine.

The method can be used in medical institutions of any type in inpatient, outpatient, spa, as well as at home.

The technical result is achieved due to the fact that the authors for the first time proposed transdermal exposure to electric current in intermediate solutions of electrolytes or chemical compounds having the properties of electrolytes by immersing body parts in them.

It allowed:

- increase the area of entry of electric current through the skin.

- simultaneously apply an electric current in pairs to the upper and lower limbs of the patient, either the whole or the right or left half of the body;

- carry out electrotherapy procedures for patients who are forced to bed with immobilized limbs or other parts of the body;

- use the reflexogenic zones of the hands of the feet, cervical and sacral segments of the spinal column, paired with areas of skin sensitivity on the extremities to affect the internal organs in order to normalize their activity.

The technical result is expressed in the reduction of pain and pain, the improvement of tissue trophism, the reduction or disappearance of puffiness, the restoration of sensitivity, the increase in the volume and quality of movements, the restoration of muscle mass, the normalization of muscle strength characteristics, the restoration (increase) of muscle sensitivity to its own impulses.

The method allows to provide a systemic therapeutic effect on the entire neuromuscular, vascular and lymphatic and bone-ligamentous apparatus of the upper and / or lower extremities as a whole, simultaneously and sequentially, starting from the fingers and distal parts of the hands and feet to the shoulder-bladder regions or hip joints (small pelvis). The use of skin reflex zones (Zakharyin-Geda) of the hands and feet, as well as various paired combinations of emerging electrical circuits (arm-leg), can have a therapeutic effect on the function of the internal organs of the chest, abdominal and pelvic cavity and on the whole organism. Changing the position of the limbs of the body during the electrotherapy procedure allows you to change the effect from a specific muscle group to others. Thus, the method allows you to have an overall healing effect on the body.

The method is as follows.

Before the start of each electrotherapy session, the doctor examines the skin. Cracks, pustules, manicure and pedicure are not allowed.

Electrotherapy is carried out by percutaneous exposure to an electric bipolar pulse with a private modulated pulse in the range from 1 to 1200 Hz using electrodes and an intermediate medium.

As an intermediate medium, a solution of an electrolyte or a chemical compound having the properties of an electrolyte is used. 10-30% solutions of sodium chloride or potassium chloride, magnesium sulfate, etc. can be used.

An electrolyte solution is prepared of a given type and concentration in a volume of at least 0.5-0.8 liters.

The prepared solution is poured into two containers - baths of polymer or other non-conductive material measuring 20-40 × 20-30 × 10-15 cm in which the electrodes are installed in pairs, separately in different containers. The electrodes are connected by wires to the generator of the amplipulse therapy device, for example, Omron-E-4. The electrodes are placed so that they do not touch the surface of the patient's body.

The impact is carried out by immersing directly in a solution of part or parts of the body. Parts of the limbs - hands, feet, elbows and other parts of the body are placed in pairs, but in different containers so that most of them are in solution, in various possible combinations depending on the nature of the disease or pathological condition according to the principle: right hand-left hand; right foot - left foot; right hand - right foot; left arm-left leg.

Depending on the problem being solved, the tanks are filled with an electrolyte solution of the same type and concentration, or of a different type and different concentration.

If necessary, the solution in the container is added in the right amount.

On the panel of the Omron-E-4 device, using the keys, the necessary initial modes of electric pulse current with frequency modulation in the range from 1 to 1200 Hz are set. The device is turned on, after which the frequency and intensity of the pulses are individually selected according to the patient's feelings. At the beginning and during the session, according to the patient’s sensations, the frequency and strength of the current (pulse intensity) and the direction of influence on certain paired combinations are regulated.

The frequency (from 1 to 1200 Hz) and current strength (from 2 to 100 mA) are regulated during the session, depending on the individual sensations of the patient (within the limits of comfort and tolerance of exposure).

During the session, the patient, under the supervision of a doctor, changes the position of parts of the limbs within the permissible range of motion so that part of the limb is always in solution (supination, pronation, back flexion, back extension, flexion and extension of one, two or more fingers).

The duration of the session is 5-15 minutes. The course of treatment is 10-15 sessions, daily or every other day. If necessary, electrotherapy courses will be repeated after 1.5-2 months.

Example 1. Patient M.I. S.M., 67 years old, May 20, 2005 (she) underwent a radical modified mastectomy according to Patty for infiltrating ductal cancer of the left breast in the 1st City Oncology Center in Moscow. Since 1974, after a traumatic brain injury, fractures of the left shoulder, pelvic bones and lower limb, he suffers from discirculatory encephalopathy, coronary heart disease. Before the operation, non-adjuvant distant therapy was performed in the classical fractionation mode, after the operation, the course of irradiation of the area of the postoperative suture was performed. Before surgery, 3 courses of polychemotherapy were carried out according to the RAS scheme, after which she took tamoxifen.

From 08/31/05 to 09/14/05, regarding post-radiation-mastectomy syndrome, excessive lead syndrome, pectoralis minor muscle syndrome, late lymphatic edema of the third degree, compression left brachial plexitis with a primary lesion (paralysis) of the left radial nerve, on a voluntary basis, a course of electrotherapy by the proposed method.

10 sessions of electrotherapy were carried out in the APT mode by separate repeating pulses with an increasing frequency from 1 to 15 Hz; pulse intensity (current) 80 mA. APT procedures were performed daily with a 2-day break on weekends.

After the treatment, the lymphatic edema of the left arm completely disappeared, the range of movements in the left shoulder-shoulder region increased.

According to the conclusion (of an independent consultant) of the leading neurologist, six months later, positive dynamics are noted. Increased range of motion in all joints of the left hand, improved muscle tone and muscle volume of the left shoulder and forearm; minimal movements appeared in the extensors of the left hand and fingers of the left hand; more lively carporadial reflexes and with m.biceps, sensitive disturbances decreased.

The persistent and pronounced effect of electrotherapy was observed for six months.

Example 2. Patient V-va T.A., 75 years old, has been suffering from chronic deforming arthrosis of both knee joints for more than 20 years. The last exacerbation since 1.10.2005 after an injury (bruise) of the right ankle joint. Concomitant diseases: ischemic stroke of 08/24/98 in the pool of the right cerebral artery due to cerebral atherosclerosis. Peptic ulcer of the duodenum, chronic form, chronic calculous cholecystitis. Hernia of the esophagus. Astheno-neurotic syndrome.

Exacerbation of right-sided gonarthrosis was accompanied by pain, swelling of the joint (1.5 cm excess of diameter compared to the left joint), range of motion, gait changes, trophic changes in the skin of the lower third of the leg. Conservative treatment (ointments, non-specific non-steroidal anti-inflammatory drugs, wearing a knee pad, vitamins) for 2 weeks without effect.

From 15 to 29.10.05, a course of electrotherapy was carried out according to the proposed method on a voluntary basis: 10 sessions, daily, lasting 15 minutes. A foot-foot technique was used, in which the patient's feet were placed in baths with hypertonic sodium chloride solution (20%, on the right side on the sore side, and 10%, on the left on the healthy side). The APT mode was used: by separate repeating pulses with increasing frequency from 1 to 15 Hz, the pulse intensity (current strength) - 90 mA.

During and after the procedures, the pain syndrome, swelling of the right knee joint completely disappeared, the normal range of motion in the knee joints and gait were restored. Trophic disorders and skin pigmentation in the region of the lower third of the right lower leg disappeared. Follow-up: for more than 8 months of exacerbation of the disease was not observed.

From April 27, 2005 to May 26, 2006, the RMPO clinic voluntarily underwent electrotherapy treatment according to the proposed method for 16 cancer patients with post-radiation-mastectomy syndrome and grade II-III lymphatic edema.

The technical result was expressed in the reduction of pain and pain, the improvement of tissue trophism, the reduction or disappearance of swelling, the restoration of sensitivity, the increase in the volume and quality of movements, the restoration of muscle volume, the normalization of muscle strength characteristics, the restoration (increase) of muscle sensitivity to own nerve impulses . The treatment results are presented in the table.

Table The dynamics of clinical indicators of treatment by electrotherapy according to the proposed method in cancer patients with post-radiation-mastectomy syndrome (n = 16) No. Clinical indicators cases (%%) one. Delayed sensations of impact on a sore arm one hundred% 2. Comparative weakness of myofibrillation on a sore arm one hundred% 3. Increased muscle strength one hundred% four. Decreased manifestations of pain 95% 5. Decrease Sensitive Disorders 90% 6. Increased range of motion in a sore arm 90% 7. Relieving spasm of individual muscles on the sore side 85% 8. Decreased lymphatic edema 80% 9. Decreased lymphatic edema 60% 10. Decreased muscle hypotrophy in a sore arm 25% eleven. The disappearance of lymphatic edema 12.5%

Claims (3)

1. The method of electrotherapy for various diseases and pathological conditions, characterized in that they carry out transdermal exposure to an electric bipolar pulse current using electrodes and an intermediate medium, which is used as a solution of an electrolyte or chemical compound having the properties of an electrolyte in which the electrodes are installed, and the effect carried out by placing parts of the body directly in the solution, while parts of the limbs are simultaneously placed in pairs in different containers In various possible combinations, varying in their exposure position within the permissible range of motion possible. 2. The method according to claim 1, characterized in that the containers are filled with a solution of an electrolyte or a chemical compound having the properties of an electrolyte of the same type and concentration. 3. The method according to claim 1, characterized in that the containers are filled with solutions of electrolytes or chemical compounds having the properties of electrolytes of different types and concentrations.