RU2305537C2 - Method for treating mental and speech development delay in neurologic-and-behavioral development diseases cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves taking measurements from biologically active points on classical meridians according to Nakatani method estimating first of all C, VB, IG, TR, GI, RP, V, F meridians state. Mental and speech development delay and background neurologic-and-behavioral disease elements are detected. Medical treatment is carried out via controlling biologically active points of the classical meridians. Wernike zone, Broca zone and initiative zone projections upon patient scalp are additionally included into cranial zones set. Selected cranial zones treatment is carried out via extrameridian biologically active points available in the center of mating brain area or zone projection. Meridian C hyperfunction points out to availability of residual perinatal brain cortex hypoxia phenomena. These cases are treated in mediated sedative operation mode. Meridian VB hyper- or hypofunction points out to brain cortex blood supply disorders as a result of brain blood vessels dystonia. These cases are treated in mediated sedative operation mode or mediated and direct stimulating mode, respectively. Meridian IG, TR, GI hypofunction points out to reduced endorphin system activity as a result of stress situation. The cases are treated in mediated and direct stimulating mode. Meridian RP and/or V hyper- or hypofunction points out to liquor dynamic disorders. These cases are treated in mediated sedative operation mode when hyperfunction takes place, and in mediated and direct stimulating mode in hypofunction cases, respectively. Meridian F hyperfunction points out to availability of subcortical structure disorders. These cases are treated in mediated sedative operation mode. The sedative treatment actions upon control and extrameridian biologically active points is carried out with DC of negative polarity, and stimulating treatment action is carried out current pulses of positive and negative polarity. Direct action applied to meridian in hypofunction state is applied to accomplice point, stimulating point and sympathetic point of the meridian. Mediated or direct stimulating treatment applied to meridian in hyper- or hypofunction state is applied to accomplice points, Luo-points, stimulating points, sympathetic point and connection points selected from P, MC, C, IG, TR, GI, RP, F, R, V, VB, E, VG, VC meridians according to classical acupuncture principles, taking these meridians state, determined by applying Nakatani method, into account. Wernike zone projection upon patient scalp is treated when dealing with disorders of comprehension and attention to addressed speech. Broca zone projection is treated when dealing with disorders in pronouncing words and phrases. Initiative zone is treated in reduced speech activity and hysteria phenomena cases. Corporal and auricular biologically active points are treated symtomatically. When applying sedative and stimulating treatment mode in controlling and extrameridian points, short-circuit current intensity is equal to 40-120 mcA. Positive and negative polarity pulses duration in stimulating treatment mode is equal to 2-6 s. Electrode contact area is selected equal to 0.2-12.0 mm². Exposure time in each biologically active point is equal to 45-90 s. Treatment sessions are applied in everyday mode with single session being 40-60 min long and total treatment session number being equal to 13-18 per treatment course.

EFFECT: enhanced effectiveness of treatment.

6 cl

Description

The invention relates to medicine, in particular to neurology and reflexology, and can be used to diagnose and treat delayed psycho-speech development in various neuropsychic diseases in a wide range of patients, mainly children.

Delayed psycho-speech development (ZPRR) in most cases is accompanied by various psycho-speech disorders and occurs against a background of diverse neuropsychic diseases, such as cerebral palsy with motor alalia and a decrease in intelligence, autism with mutism and elements of antisocial behavior, consequences of the perinatal pathology of the central nervous system with hyper-excitability syndrome, accompanied by whims up to hysterical manifestations and delayed psycho-speech development with literal paraphase th, hypertension-hydrocephalic syndrome with impaired associative speech and decreased speech activity, etc. Drug treatment of ZPRD often does not achieve the desired result due to the fact that it affects the cerebral cortex and its blood supply as a whole, which excludes the possibility of influencing a specific mental or speech function. Acupuncture is used mainly to stop the symptomatic manifestations of background neuropsychiatric diseases and its use for the treatment of ZPRD directly does not give the desired result. The absence of reflex treatment methods that reliably identify elements of pathogenesis with subsequent exposure to them and selectively affect specific mental and speech functions characteristic of ZPRR does not allow to effectively treat this pathology with the achievement of stable remission.

A known method of treatment of delayed speech development in neuropsychiatric diseases (see. Luvsan Gavaa. Traditional and modern aspects of oriental medicine, - JSC Moscow Textbooks and Cartolithography, 2000, p.202-204), including examination of the patient with a choice of depending on the identified speech disorder of scalping therapy zones in the form of a zone of motor aphasia in case of diction and pronunciation disorder, alexia-aphasia in reading and comprehension disorder, sensory-amnestic aphasia in case of speech comprehension disorder and s therapeutic effects on selected areas by acupuncture. The duration of exposure in each zone is 10-30 minutes with a course of treatment of 5-10 sessions.

The disadvantage of this method is the limited number of selectable zones for treatment, which do not cover the impact of the disorder of mental functions, such as intelligence, sociality and initiative. The method does not contain objective hardware research to identify elements of pathogenesis and the impact on them, and also does not provide for the parallel treatment of background neuropsychiatric disease. Acupuncture is an invasive and very painful procedure, especially undesirable in the treatment of children.

There is also known a method of treating delayed psycho-speech development in case of neuropsychiatric diseases accompanied by motor disorders (see RF patent No. 2122443, IPC ⁶ A61N 1/18, A61M 21/00, 1998), including examining a patient, conducting massage and performing functional biocontrol ( FBU) groups affected muscles with feedback for correction of muscle tone, application of the electrode to the contact surface area of 100-600 ^mm2 on the projection frontal and parietal regions of the cerebral cortex of the patient for the treatment of motor rasstroyst and projection frontal and temporal regions of the cortex to treat disorders and implementation psychoverbal transcranial constant electric current magnitude 50-800 microamps in conjunction with psychological impact by music. The duration of sessions of micropolarization is 20-40 minutes with a duration of treatment of 10-15 sessions. A stable clinical result lasts for 3-4 months.

The disadvantage of this method is the limitation of the circle of treated diseases on the basis of the presence of motor disorders with the main focus on the correction of muscle tone, carried out by means of FBU, massage and micropolarization. The treatment of psycho-speech disorders is concomitant in nature and is carried out only through micropolarization, which is not effective enough for the high-quality treatment of such disorders. In addition, when conducting micropolarization, there is no differential effect on various mental and speech zones of the frontal and temporal areas of the cortex, which is necessary for a selective approach in the treatment of mental and speech disorders. The method does not provide for the identification of elements of the pathogenesis of speech and mental disorders and the provision of a therapeutic effect on them. Given the range of used values of direct electric current, which is characteristic of physiotherapy, and the surface area of therapeutic electrodes, significantly exceeding the size of BAP, the reflex mechanism of action on zones and areas of the cerebral cortex is excluded. That is, the therapeutic effect is achieved by the direct effect of an electric current on the cerebral cortex, is limited by the time of the treatment procedure and is characterized by the absence of a persistent clinical effect. This makes it necessary to conduct repeated courses to ensure the safety of the achieved treatment result.

The technical result achieved by the present invention is to increase the effectiveness of the treatment of delayed psycho-speech development by identifying elements of the pathogenesis of ZPRD and background neuropsychiatric disease, affecting the identified elements of pathogenesis through electroreflexotherapy and a differentiated approach to the treatment of various mental and speech disorders. The technical result also consists in achieving a persistent clinical effect through the use of reflex mechanisms of action.

The technical result is achieved by the fact that in the method of treating the delay in psycho-speech development in case of neuropsychiatric diseases, including examining the patient, selecting cranial zones in the form of projections of the frontal and temporal regions of the cerebral cortex onto the patient's scalp, applying a treatment electrode to the selected zones and applying a therapeutic effect with electric current, according to the invention additionally carry out the measurement according to the Nakatani method of electrical conductivity of biologically active points (BAP) of classical meridians with a significant assessment of the condition of the meridians C, VB, IG, TR, GI, RP, V, F and the identification of pathogenesis elements of delayed psycho-speech development and background neuropsychiatric disease, the therapeutic effect on the identified pathogenesis elements is carried out through controlling BAPs of classical meridians, to the number of cranial zones additionally include projections of the Wernicke, Brocca zones and initiative zones onto the patient's scalp, and the therapeutic effect on the selected cranial zones is carried out through the extra-meridian BAT located in the center of the corresponding projection a region or zone of the brain, while with the hyperfunction of the meridian C, indicating the residual effects of perinatal hypoxia of the cerebral cortex, the therapeutic effect is carried out in the mode of indirect sedative effect; with hyper- or hypofunction of the meridian VB, indicating a violation of the blood supply to the cerebral cortex as a result of dystonia of its vessels, the therapeutic effect is carried out in the mode of respectively mediated sedative or mediated and direct tonic effect; with hypofunction of the meridians IG, TR, GI, indicating a decrease in the activity of the endorphin system due to stressful situations, the therapeutic effect is carried out in the mode of indirect and direct tonic effect; with hyper- or hypofunction of the meridians RP and / or V, indicating a violation of cerebrospinal fluid dynamics, the therapeutic effect is carried out in the mode of indirect sedation in the case of their hyperfunction and indirect and direct tonic effect in case of their hypofunction, and with hyperfunction of the meridian F, indicating dysfunction of the subcortical structures, therapeutic effect is carried out in the mode of indirect sedative effect, moreover, sedative therapeutic effect on managing and extra-meridic BA T is carried out by direct current of negative polarity, and the tonic effect - by alternately applying pulses of positive and negative polarity.

The technical result is also achieved by the fact that the direct tonic effect on the meridian, which is in a state of hypofunction, is carried out by acting on the aiding point, the tonic point and the sympathetic point of this meridian, and the indirect sedative or tonic effect on the meridian, which is in a state respectively hyper- or hypofunctions, carried out by acting on aiding points, lo points, tonic points, sympathetic points and connection points selected from meridians P, MS, C, IG, T R, GI, RP, F, R, V, VB, E, VG, VC according to the classical rules of acupuncture taking into account the state of these meridians, determined by the Nakatani method.

The technical result is also achieved by the fact that the projection of the Wernicke zone on the patient’s scalp is affected by disorders of understanding and attention to conversational speech, the projection of the Brock zone for disorders of pronunciation of words and phrases, and the projection of the initiative zone is reduced in speech activity and hysterical manifestations .

The technical result is achieved by the fact that they additionally carry out a symptomatic therapeutic effect on corporal and auricular BAT.

The technical result is aimed at the fact that with a sedative and tonic effect on the control and non-meridian BAPs, the short-circuit current is 40-120 μA, the pulse duration of positive and negative polarity with a tonic effect is 2-6 seconds, the contact surface area of the treatment electrode is chosen equal to 0.2-12.0 mm ² , and the exposure time for each BAT is 45-90 seconds.

The technical result is also directed to the fact that the therapeutic effect is carried out daily with a duration of one session of 40-60 minutes and a total number of sessions of 13-18 per treatment course.

The essence of the claimed method is as follows. During the examination of the patient, the conductivity of BAT-accomplices is additionally measured for 12 classic Nakatani paired meridians: P, MS, C, IG, TR, GI, RP, F, R, V, VB, B, which reflect the state of the corresponding meridians. In this case, the main attention is paid to the BAT conductivity of such meridians as C, VB, IG, TR, GI, RP, V, F, which allows us to identify elements of the pathogenesis of delayed psycho-speech development and background neuropsychiatric disease. Elements of pathogenesis are manifested in the form of: hyperfunction of the meridian C, corresponding to the residual phenomena of perinatal hypoxia of the cerebral cortex, hyper- or hypofunction of the meridian VB, corresponding to a violation of the blood supply to the cerebral cortex as a result of dystonia of its vessels, hypofunction of the meridians IG, TR, GI, corresponding to a decrease in endorphin activity systems in connection with a stressful situation, hyper- or hypofunction of the meridian RP and / or hypo-or hyperfunction of the meridian V, corresponding to impaired cerebrospinal fluid dynamics, and hyperfunction idial F, corresponding to dysfunction of subcortical structures. The above list of pathogenesis elements is not exhaustive and may contain additional elements with corresponding deviations of the meridians. Based on the identified mental and speech disorders, cranial zones are selected in the form of projections of areas and zones of the cerebral cortex on the patient's scalp for exposure, taking into account the following differentiation.

For disorders of understanding and attention to conversations, the Wernicke zone is used, and for disorders of pronunciation of words and phrases, the Brock zone is used. With a decrease in speech activity in the form of unwillingness to engage in speech contact, a lack of interest in speech communication and a decrease in initiative during classes on speech development, they use the initiative zone. This zone is also used in the presence of vagaries up to hysterical manifestations arising from attempts to limit the patient’s increased initiative and conduct classes on the development of speech. With delays in mental development in the form of a decrease in intellectual abilities and a slowdown in the formation of social skills, the cranial zone is used, which corresponds to the projection of the frontal region of the cerebral cortex onto the patient's scalp. In the presence of disorders of associative speech in the form of difficulty in constructing sentences, stories and descriptions, use the cranial zone corresponding to the projection of the temporal region of the cortex onto the patient's scalp. Then carry out the therapeutic effect of electric shock on the identified elements of pathogenesis and selected cranial zones.

The therapeutic effect on the elements of pathogenesis is carried out through the control BAT of classical meridians by means of electroreflexotherapy in the mode of tonic or sedative effect. In the case of hypofunction of meridians they have a direct and indirect tonic effect. In the case of hyperfunction of the meridians corresponding to the elements of pathogenesis, they have an indirect sedative effect. The direct tonic effect is exerted on meridians VB, IG, TR, GI, RP and V, which are in a state of hypofunction, which is carried out using aiding points, tonic points and sympathetic points from these meridians. Indirect tonic effect on the same meridians in a state of hypofunction is exerted through aiding points, lo points, tonic points, sympathetic points and connection points of classical meridians selected from the group P, MS, C, IG, TR, GI, RP , F, R, V, VB, E, VG and VC, taking into account the classical rules of acupuncture, depending on the state of these meridians on the patient's diagnostic card. The indirect sedative effect on the meridians C, VB, RP, V, and F that are in a state of hyperfunction is also carried out using aiding points, lo points, tonic points, sympathetic points and connection points selected from the indicated group of meridians P, MS, C , IG, TR, GI, RP, F, R, V, VB, E, VG and VC.

In addition to the therapeutic effect on the identified elements of the pathogenesis of the background neuropsychiatric disease, a symptomatic daily therapeutic effect on this disease is carried out using corporal and auricular BAT.

On the cranial zones, the therapeutic effect is carried out through the extra-meridian BAP located in the center of the corresponding projection of the area or zone of the brain on the scalp, also by means of electroreflexotherapy in the mode of tonic and sedative effects.

Sedative effect is carried out by direct current of negative polarity, and tonic effect - by alternating supply of pulses of positive and negative polarity with a pulse duration of 2-6 seconds. The short circuit current strength for both types of exposure is 40-120 μA. Used medical electrode is selected with a contact surface area of 0.2-12.0 mm ² . The contact surface area of the neutral electrode is not critical. The exposure time for each BAP is usually 45-90 seconds. Therapeutic effect is carried out daily with a duration of one session of 40-60 minutes, and the number of sessions is 13-18 per treatment course, depending on the clinical severity of symptoms and background disease.

The essential features of the claimed invention, which determine the scope of legal protection and are sufficient to obtain the above technical result, perform the following functions and relate to the result as follows.

Measurement in a patient of the electrical conductivity of biologically active points of the classical meridians C, VB, IG, TR, GI, RP, V, F according to the Nakatani method can reliably identify elements of the pathogenesis of delayed psycho-speech development and background neuropsychiatric disease in a particular patient.

The therapeutic effect on the identified elements of the pathogenesis of ZPRR through the control BAT of classical meridians, carried out by means of electroreflexotherapy, allows achieving stable remission.

Inclusion of the Wernicke, Brock, and initiative zones onto the patient’s scalp into the number of cranial projection zones allows us to expand the range of treated mental and speech disorders and differentially affect this or that function, which generally increases the effectiveness of treatment.

The therapeutic effect on selected areas and zones of the patient’s cerebral cortex is indirectly mediated through extra-meridian BAT located in the center of the corresponding projection of the region or zone of the cerebral cortex onto the scalp, which allows the use of a reflex mechanism of action, which also contributes to stable remission along with a reduction in the time of exposure to cranial zones.

The identification of pathogenesis elements in the form of residual effects of perinatal hypoxia of the cerebral cortex, impaired blood supply to the cerebral cortex due to dystonia of its vessels, decreased activity of the endorphin system due to stressful situations, impaired cerebrospinal fluid dynamics and dysfunction of the subcortical structures allows us to establish causal relationships between the occurrence and development of this pathology .

Establishing a connection between the above pathogenesis elements, respectively, with hyperfunction of the meridian C, hyperfunction or hypofunction of the meridian VB, hypofunction of the meridians IG, TR, GI, hyperfunction or hypofunction of the meridians RP and / or V and hyperfunction of the meridian F allows for targeted therapeutic effect in the mode of indirect sedation in case of hyperfunction of these meridians and direct and indirect tonic effect in case of their hypofunction.

The implementation of a sedative therapeutic effect on the control and non-meridian BAP with a direct current of negative polarity, and the tonic effect by alternating supply of pulses of positive and negative polarity allows you to simulate the classic sedative and tonic modes of acupuncture, and in both cases there is no invasiveness and pain component.

The combination of the above signs is necessary and sufficient to achieve the technical result of the invention, which consists in increasing the effectiveness of the treatment of delayed psycho-speech development by identifying elements of the pathogenesis of ZPRR and background neuropsychiatric disease, exposure of the identified elements of pathogenesis through electroreflexotherapy, a differentiated approach to the treatment of various mental and speech disorders . The combination of these signs also allows you to achieve a persistent clinical effect by using reflex mechanisms of exposure.

In particular cases of carrying out the invention, the following specific operations and operating parameters are preferred.

It is desirable to carry out a direct tonic or indirect sedative or tonic effect on the meridians C, VB, IG, TR, GI, RP, V and F identified in the state of dysfunction by means of control BATs in the form of aiding points, lo points, tonic points, sympathetic points and connection points from the group of meridians P, MS, C, IG, TR, GI, RP, F, R, V, VB, E, VG and VC, which allows you to have a reflex therapeutic effect on the causes and mechanisms of the development of this disease with achieving persistence remission.

The impact on the projection of the Wernicke zone on the scalp of the patient is preferable in cases of comprehension and attention to inverted speech, on the projection of the Brock zone on the scalp in case of disorders of pronunciation of words and phrases, and on the projection of the initiative zone on the scalp - in case of decreased speech activity and hysterical manifestations. This allows you to purposefully influence various mental and speech functions.

Symptomatic therapeutic effect on the background neuropsychiatric disease is preferably carried out by means of corporal and auricular BAT. In addition to the therapeutic effect on the identified elements of pathogenesis, this contributes to a more stable remission.

The choice of short circuit current strength with a sedative and tonic effect on the control and non-meridian BAT is preferable in the range of 40-120 μA, which allows approaching patients taking into account their individual tolerance to the therapeutic current.

The impact of alternating supply of pulses of positive and negative polarity with a pulse duration of 2-6 seconds allows you to simulate the classic tonic regimen of acupuncture.

The contact surface area of the treatment electrode 0.2-12.0 mm ² allows the therapeutic effect on the BAP to be applied according to the reflex principle, which reduces the exposure time to 45-90 seconds for each control and extra-meridian BAT and the corresponding cranial zone, while the quality of treatment increases . The area of the contact surface of the treatment electrode, close to 0.2 mm ² , is used in case of increased resistance of the patient's skin, and to 12 mm ² - with low skin resistance and low pain threshold of the patient.

The duration of the therapeutic effect of 40-60 minutes spent daily in the amount of 13-18 sessions per treatment course, it is desirable to vary depending on the number of selected cranial zones that control BAP and the severity of the background neuropsychiatric disease.

The above particular features of the invention allow the method to be carried out in an optimal mode from the point of view of achieving the technical result of the invention, which consists in increasing the effectiveness of the treatment of delayed psycho-speech development.

The above features and advantages of the claimed invention can be more clearly explained by the following Examples.

In all Examples, during the preliminary Nakatani survey, measurements were carried out according to the standard method with measuring the electrophysiological parameters of BAT-accomplices of classical meridians: P9, MC7, C7, IG4, TR4, GI4, RP3, F3, R3, V64, VB40, E42 at current a short circuit of 200 μA of negative polarity and a voltage of 12 volts. When choosing BAP managers on the Nakatani diagnostic map of the patient, the functional state of the meridians P, MS, C, IG, TR, GI, RP, F, R, V, VB, E was conditionally evaluated by the numbers 0, +1, -1, where 0 - normal state, +1 - hyperfunctional state, -1 - hypofunctional state. Electroreflexotherapy for the totality of the selected BAP and cranial zones was carried out by direct current of negative polarity in the sedative mode and alternately supplying pulses of positive and negative polarity with a pulse duration of 2-6 seconds in the tonic mode. The exposure time for each BAP was 45-90 seconds. The value of the short circuit current for both types of therapeutic effect was selected from the range of 40-120 μA taking into account the threshold of pain sensitivity of the patient, determined empirically, and the age of the patient.

Measurement of the electrophysiological parameters of BAP and the electroreflexotherapy therapeutic effect on the totality of the selected BAP and cranial zones was carried out using an industrial device "Elkor" equipped with a treatment electrode with a contact surface area of 0.2-12.0 mm ² .

Example 1

Carry out the treatment of patient M., age 5 years. Diagnosis: consequences of perinatal pathology of the central nervous system, hypertension-hydrocephalic syndrome, delayed psycho-speech development.

Complaints at admission - moderate headaches with a frequency of 1-2 times a week, increased irritability, moods. The patient is embarrassed by others, hiding behind her mother, in books she is only interested in bright pictures, flipping through them. The games are primitive: dress, undress a doll, make cake from sand. Speech activity is reduced: only communicates with parents if necessary, extremely reluctantly enters into a conversation with strangers. He speaks in monosyllables mainly on everyday topics, does not unite words in sentences, fairy-tale and descriptive speech are undeveloped. Communication with a defectologist and speech therapist is difficult due to the extremely scattered attention and high distractibility, as well as the lack of interest and initiative during classes on speech development.

Anamnesis: a child from a second pregnancy proceeding against a background of chronic placental insufficiency, the threat of termination of pregnancy in the second half, childbirth for 36 weeks, double entwining with an umbilical cord, asphyxiation in childbirth. The baby was born weighing 3200 g for 4-6 points according to Apgar. Discharged on the 6th day. Observed by a neurologist at the place of residence with a diagnosis of “consequences of perinatal pathology of the central nervous system (CNS) of hypoxic origin. Hypertension-hydrocephalic syndrome, delayed psycho-speech development.

Data from additional examinations: upon examination of the fundus - the veins are dilated, convoluted, full-blooded, with computed tomography (CT) of the brain - moderate asymmetric expansion of the anterior horns of the lateral ventricles, expansion of the vascular plexuses with the presence of calcifications in them. Confirmed the presence of hypertension-hydrocephalic syndrome.

When conducting a preliminary survey on Nakatani, the average level of electrical conductivity of BAT-accomplices of classical meridians was 85 μA, which is typical for severe sympathicotonia with excitation of the central nervous system. According to the patient’s diagnostic map, NAKATANI selects BAP managers:

Meridian R MS FROM IG TR Gi RP F R V Vb E condition 0 +1 +1 0 0 0 +1 0 -one +1 0 -one

The revealed hyperfunctional state (+1) of the meridians RP and V corresponds to a violation of cerebrospinal fluid dynamics. The hyperfunctional state (+1) of the meridian C corresponds to the residual effects of perinatal hypoxia of the cerebral cortex.

The therapeutic effect on the identified elements of pathogenesis is carried out through the control BAT of classical meridians as follows. The meridian RP is mediated by sedation with the help of points of accomplices RP3c (c - sedative effect), and E42t (t - tonic effect), lo-points RP6c and RP4c, connection points V1t. The meridian V is mediated by a sedative effect using the tonic point E41t, the accomplices points V64c, E42t, R3t, Lo-point V58c and the connection point V1t. The meridian C is mediated by a sedative effect with the help of the tonic point R7 t, the points of accomplices R3t and C7c, the sympathetic point V15c, the lo-point MC5c, the connection point VC23t.

Taking into account the patient’s mental and speech disorders, the following cranial zones were selected in the form of projections onto the scalp for therapeutic effect: the frontal region of the cerebral cortex - due to a delay in mental development, the temporal region of the cortex - due to a delay in speech development in the form of difficulty in building proposals and the slow formation of fabulous and descriptive speech, the initiative zone - in connection with a decrease in speech activity in the form of unwillingness to engage in speech contact and lack of initiative Willows when performing tasks on the development of speech.

In addition to the therapeutic effect on the identified pathogenesis elements of the background neuropsychiatric disease and selected cranial zones, a symptomatic therapeutic effect on the background disease was carried out by means of corporal BAT: VB39c, VB21c, VB20c, V11c, GI15c, V40c, V60c and auricular BAT: AT139c, AT138c, AT34t, AT51s.

Electroreflexotherapy for the totality of the selected BAP and cranial zones was carried out by direct current of negative polarity in the regimen of therapeutic sedative effect and alternating supply of pulses of positive and negative polarity with a pulse duration of 6 seconds in the tonic effect mode. The value of the short circuit current for both types of exposure selected 120 μA, the contact surface area of the treatment electrode is 0.2 mm ² . BAT exposure time - 60 seconds. During treatment, the duration of one session was 50-55 minutes. Therapeutic effect was carried out daily for 15 sessions.

As a result of the treatment, the headaches completely stopped, the patient became calmer, social behavior became more adequate: she stopped being afraid of strangers, came into contact with them, began to imitate reading while browsing books, games became more complicated and varied: she was playing in a store, school, imitating a conversation dolls. Speech activity increased: answers questions, began to communicate with other children on her own initiative. Combines words in 2, 3-complex sentences. Elements of a fabulous and descriptive speech appeared: at the request of the narrative he gives short sentences, describes what he saw in the picture. In the classroom, I became more attentive, there was a desire to draw and learn letters. A follow-up examination after 3 months and after 1 year confirmed the presence of a persistent clinical effect: during the indicated period the child continued to have an active vocabulary, complicate speech turns, began to show imagination in games, behaves actively in classes with a defectologist, takes initiative in completing tasks on the development of speech, learned the alphabet, began to master reading and counting.

Example 2

Carry out the treatment of patient B., age 4 years. Diagnosis: consequences of perinatal pathology of the central nervous system, hypertension-hydrocephalic syndrome, organic autism, delayed psycho-speech development. Complaints at admission - the child is extremely excitable, attention to conversational speech is reduced, speech understanding is difficult: he perceives only everyday speech in the form of short sentences: “let's go to bed,” “we will eat,” etc. The child is disinhibited, randomly moves around the room, there is a large number of stereotypical movements. Speech - at the level of meaningless shouting of various syllables, there are elements of echolalia, rarely consciously pronounces individual words: "mother", "woman", "give", "no". When pronouncing syllables, diction is not broken. Negativity towards strangers and the new environment is sharply expressed: refuses to enter the defectologist's office. Social skills are not developed, eats only with outside help, does not dress independently. Games are mobile, erratic, destructive in nature: everything scatters, tears, scatters. Severe sleep disturbance: wakes up 3-5 times a night, cries. There is practically no daytime sleep (sleeps for 15-20 minutes).

Anamnesis: a child from the first pregnancy proceeding against the background of chronic pyelonephritis, chronic urogenital infection, the threat of termination of pregnancy in the first and second half of pregnancy, childbirth with a gestational age of 41 weeks, a long anhydrous period. The weight of the newborn is 4350 g, on the Apgar scale 2-4 points. For 1.5 months he was hospitalized in the neonatal pathology department with a diagnosis of perinatal CNS pathology of ischemic genesis, hypertension-hydrocephalic syndrome, cerebral edema, bulbar syndrome, movement disorder syndrome. At the age of three years, due to a delay in psycho-speech development and autistic manifestations, he was diagnosed with the consequences of perinatal pathology of the central nervous system, hypertension-hydrocephalic syndrome, organic autism, and delayed psycho-speech development. During the last hospitalization during rheoencephalography (REG), an increased tone of the medium and small arteries in the frontal leads was revealed, there were signs of intracranial hypertension.

Data from additional examinations: upon examination of the fundus - the veins are dilated, full-blooded, with computed tomography of the brain - the lateral ventricles and subarachnoid space in the projection of the frontal and temporal lobes are symmetrically expanded. Mixed symmetric hydrocephalus. On the electroencephalogram (EEG) - signs of immaturity of cortical structures.

When conducting a preliminary survey on Nakatani, the average conductivity level of BAT-accomplices of classical meridians was 123 μA, which is typical for severe sympathicotonia with CNS excitation. According to the patient’s diagnostic map, NAKATANI selects BAP managers:

Meridian R MS FROM IG TR Gi RP F R V Vb E condition +1 -one +1 0 0 0 -one +1 +1 -one -one +1

The revealed hypofunctional state (-1) of the meridians RP and V corresponds to a violation of cerebrospinal fluid dynamics. The hyperfunctional state (+1) of the meridian C corresponds to the residual effects of perinatal hypoxia of the cerebral cortex, the hyperfunctional state (+1) of the meridian F corresponds to dysfunction of the subcortical structures. The hypofunctional state (-1) of the VB meridian corresponds to a violation of the blood supply to the cerebral cortex as a result of dystonia of its vessels.

The therapeutic effect on the identified elements of pathogenesis is carried out through the control BAT of classical meridians as follows. On the meridian RP, a direct and indirect tonic effect is performed using the tonic point RP2t, points of accomplices RP3t and E42c, lo points RP6c and RP4t, connection points V1t. On the meridian V, a direct and indirect tonic effect is performed using the tonic point V67t, the points of accomplices V64t and R7c, lo-point V58t, the connection point V1t. The meridian C is mediated by a sedative effect using the tonic point RP2t, points of accomplices RP3t and C7c, sympathetic point V15c, lo-point MC5c. The meridian F is mediated by a sedative effect using the tonic point MC9t, points of accomplices F3c and MC7t, lo-points RP6c and VB37t, connection points VC18t. On the VB meridian, a direct and indirect tonic effect is performed using the tonic points VV43t and V67t, the accomplices points VB40t, F3c and V64t, lo-points VB37t and VB39t.

Taking into account the patient’s mental and speech disorders, the following cranial zones were selected in the form of projections onto the scalp for therapeutic effect: the frontal region of the cerebral cortex - due to a marked lag in mental development, the Brock zone - due to the disorder in the pronunciation of words and phrases, temporal region of the cortex - due to a gross delay in the formation of coherent, fabulous and descriptive speech and the Wernicke zone - in connection with a disorder in the understanding of inverted speech and a decrease in attention to it.

In addition to the therapeutic effect on the identified pathogenesis elements of the background neuropsychiatric disease and selected cranial zones, a symptomatic therapeutic effect on the background disease was carried out by means of corporal BAT: VB34c, E36c, VB12c, VB21c, VB20c, V11c, GI15c, V40c, V60c and auricular BAT: AT55s, AT51s.

Electroreflexotherapy for the totality of the selected BAP and cranial zones was carried out by direct current of negative polarity in the sedative treatment mode and alternating supply of pulses of positive and negative polarity with a pulse duration of 4 seconds in the tonic effect mode. The magnitude of the short circuit current for both types of exposure selected 100 μA, the contact surface area of the treatment electrode is 4 mm ² . BAT exposure time is 90 seconds. During treatment, the duration of one session was 50-60 minutes. Therapeutic effect was carried out daily for 18 sessions.

As a result of the treatment, the patient has significantly decreased excitability and negativity, behavior has become more adequate: he reacts more calmly to the new situation, there is an opportunity to engage with a pathologist, social skills are developed, attempts have appeared to eat and dress yourself. He listens attentively to adults during a conversation, understands his speech much better, and fulfills simple requests such as: "bring toys," "show a book." Movement activity decreased and became more focused: it can sit on the spot for up to 20 minutes, games have become more complicated and more calm: it rolls cars, builds pyramids from cubes. Attacks of aggression are extremely rare. Stereotypical movements appear much less frequently - only in a state of excitement. The vocabulary has expanded: names objects upon request (mainly household items, toys, animals). Phrasal speech began to develop: he turns to his mother, trying to tell something, while constructing babbling phrases, among which recognizable words often appear: "cat", "chair", "soup", "juice", etc. Cognitive activity has increased: it examines pictures with interest, parses toys. The sleep normalized: it does not wake up at night, sleeps up to 1.5 hours during the day. A follow-up examination after 4 months and after 1 year confirmed the persistent clinical effect: during the indicated period, the child continued to gradually gain vocabulary, phrases began to be used more often in speech, games became more complicated - the role component began to be traced in them.

Example 3

Carry out the treatment of patient A., age 2.5 years. Diagnosis: consequences of perinatal pathology of the central nervous system, hypertension-hydrocephalic syndrome (subcompensated form), moderate delay in speech development, hyper excitability syndrome, respiratory-affective paroxysms. Complaints at admission - the child is excitable, requires increased attention, is hyperinitious, takes away toys from other children. When the mother tries to stop the disinhibited behavior, frequent moods are noted several times a day, up to hysterical manifestations with “rolling up” - short-term respiratory arrest. Cognitive activity is sufficient: it examines books with interest, listens to fairy tales, makes out toys, builds towers from cubes, draws. Despite this, when trying to conduct speech therapy classes on the development of speech, there are whims, up to hysterical manifestations, as a protest against the fulfillment of tasks. Speech activity is high: often on his own initiative he tries to tell something to his mother, while speech is more often babbling. Vocabulary is sharply limited, in words rearranges syllables, or skips them. Negatively treats surrounding children, fights. Well understands the speech addressed to him, carries out simple instructions. There is nocturnal enuresis - up to 3-5 times per night.

Anamnesis: a child from the first pregnancy proceeding against the background of toxicosis and the threat of termination of pregnancy in the first half, childbirth - with a gestational age of 37 weeks, is rapid. The weight of the newborn is 2800 g, on an Apgar scale of 8-8 points. Discharged on the 5th day. It was observed by a neurologist with a diagnosis of "consequences of perinatal pathology of the central nervous system, hypertension-hydrocephalic syndrome." Data rheoencephalography (REG): increased tone of small arteries in the temporal leads. On the electroencephalogram, paroxysmal activity was not detected. Dysfunction of the mid-stem structures. Vagaries and hysterical manifestations appeared against the backdrop of stress in connection with the divorce of parents and moving to relatives of the mother.

Data from additional examinations: upon examination of the fundus - the veins are moderately dilated, full-blooded, the arteries are narrowed, with computed tomography of the brain, a moderate expansion of the subarachnoid space is observed, mainly in the projection of the temporal lobes, the ventricular system without visible changes. The external form of hydrocephalus. Confirmed the presence of hypertension-hydrocephalic syndrome.

When conducting a preliminary survey on Nakatani, the average level of electrical conductivity of BAT-accomplices of classical meridians was 104 μA, which is typical for severe sympathicotonia with excitation of the central nervous system. According to the patient’s diagnostic map, NAKATANI selects BAP managers:

Meridian R MS FROM IG TR Gi RP F R V Vb E condition +1 0 -one -one -one -one 0 +1 +1 -one +1 +1

The revealed hypofunctional state (-1) of the meridian V corresponds to a violation of cerebrospinal fluid dynamics. The hyperfunctional state (+1) of the meridian F corresponds to the dysfunction of the subcortical structures. The hypofunctional state (-1) of the meridians IG, TR, GI corresponds to a decrease in the activity of the endorphin system in connection with a stressful situation. The hyperfunctional state (+1) of the VB meridian corresponds to a violation of the blood supply to the cerebral cortex as a result of dystonia of its vessels.

The therapeutic effect on the identified elements of pathogenesis is carried out through the control BAT of classical meridians as follows. On the meridian V, a direct and indirect tonic effect is carried out using the tonic point GI11t, points of accomplices V64t, GI4t and R3c, lo-point V58t. The meridian F is mediated by a sedative effect using the tonic point C9t, points of accomplices F3c and C7t, lo-point RP6c. On the IG meridian, a direct and indirect tonic effect is carried out with the help of the accomplice IG4t and the Lo-point TR8t. On the TR meridian, a direct and indirect tonic effect is performed using the TR4t aide and TR8t lo-point. On the GI meridian, a direct and indirect tonic effect is performed using the tonic point GI11t, the accomplice point GI4t, lo points P7c and TR8t, and the connection points E1t. The VB meridian is mediated by a sedative effect using the tonic point GI11t, aiding points GI4t and VB40c, Lo-point VB39c, and connection points TR21t.

Taking into account the patient’s mental and speech disorders, the following cranial zones were selected in the form of projections onto the scalp for the implementation of the therapeutic effect: temporal region of the cortex - due to the delay in speech development in the form of difficulty in constructing sentences and the delay in the formation of fabulous and descriptive speech; Brocca zones - in connection with a disorder in the pronunciation of words and phrases, initiative zones in connection with whims up to hysterical manifestations that arise when trying to limit the child’s increased initiative, as well as when trying to conduct classes on speech development.

In addition to the therapeutic effect on the identified pathogenesis elements of the background neuropsychiatric disease and selected cranial zones, a symptomatic therapeutic effect on the background disease was carried out by corporal BAP: VB39c, VB21c, VB20c, V11e, GI15c, V40c, V60c, E36c, V31c, V33c and auricular BAT: AT51c, AT55c, AT92c.

Electroreflexotherapy for the totality of the selected BAP and cranial zones was carried out by direct current of negative polarity in the sedative treatment mode and alternating supply of pulses of positive and negative polarity with a pulse duration of 2 seconds in the tonic effect mode. The magnitude of the short circuit current for both types of exposure selected 60 μA, the contact surface area of the treatment electrode 12 mm ² . BAT exposure time is 45 seconds. During treatment, the duration of one session was 40-45 minutes. Therapeutic effect was carried out daily for 13 sessions.

As a result of the treatment, the patient became much calmer: hypermobility and negativity decreased, began to actively come into contact with children, plays with them without showing aggression, responds more calmly to mother's prohibitions, hysterical manifestations with “rolling up” ceased, only occasional whims persist, appeared the ability to divert attention, explain or persuade. The vagaries of conducting speech therapy classes ceased, and the productivity of classes increased. The vocabulary has expanded, he began to pronounce words more correctly: he practically does not rearrange syllables, and he misses them much less often. Verbal speech actively replaces the babble. Elements of fabulous speech appeared, began to build short sentences on his own: he tells what he saw on the street during a walk. Nocturnal enuresis was reduced to an average of 1 time per night. A follow-up examination after 3 months and six months later confirmed the presence of a persistent clinical effect: during the specified period, the child continued to expand the vocabulary, began to independently build complex sentences, night enuresis was reduced to 1-2 times a week. The level of neurotization continued to decline - moods became rare.

From the above Examples it is seen that the inventive method improves the effectiveness of the treatment of delayed psycho-speech development compared to the method of the prototype. This is achieved by identifying elements of the pathogenesis of ZPRD and background neuropsychiatric disease, influencing the identified elements of pathogenesis through the control BAT of classical meridians through electroreflexotherapy and a differentiated approach to the treatment of various mental and speech disorders. The technical result also consists in achieving a persistent clinical effect with accelerated rehabilitation of patients.

The proposed method for the treatment of delayed psycho-speech development is uncomplicated and can be carried out using standard equipment and proven techniques of electroreflexotherapy.

Claims (6)

1. A method of treating delayed psycho-speech development in neuropsychiatric diseases, including examining a patient, selecting cranial zones in the form of projections of the frontal and temporal regions of the cerebral cortex onto the scalp of a patient, applying a treatment electrode to selected zones and applying a therapeutic electric current, characterized in that they additionally measure the conductivity of biologically active points (BAP) of the classical meridians using the Nakatani method with a primary assessment of the state of the meridian C, VB, IG, TR, GI, RP, V, F and the identification of elements of the pathogenesis of delayed psycho-speech development and background neuropsychiatric disease, the therapeutic effect on the revealed elements of pathogenesis is carried out through managing BAPs of classical meridians, projection additionally includes cranial zones areas of Wernicke, Brock and the initiative zone on the scalp of the patient, and the therapeutic effect on the selected cranial zones is carried out through the extramedical BAT located in the center of the corresponding projection of the brain area or zone, while the function of the meridian C, which indicates the residual effects of perinatal hypoxia of the cerebral cortex, the therapeutic effect is carried out in the mode of indirect sedation, with hyper- or hypofunction of the meridian VB, which indicates a violation of the blood supply to the cerebral cortex as a result of dystonia of its vessels, the therapeutic effect is carried out in the regime respectively mediated sedative or mediated and direct tonic effect, with hypofunction of the meridians IG, TR, GI, evidence In order to reduce the activity of the endorphin system due to a stressful situation, the therapeutic effect is carried out in the mode of indirect and direct tonic effect, with hyper- or hypofunction of the meridians RP and / or V, indicating a violation of cerebrospinal fluid dynamics, the therapeutic effect is carried out in the mode of indirect sedation in the case of their hyperfunction and indirect and direct tonic effect in case of their hypofunction, and in case of hyperfunction of the meridian F, indicating di function subcortical structures curative effect is performed in a mode-mediated sedation, sedative and therapeutic effect on the control and BAP performed vnemeridiannye DC negative polarity, and tonic effect - alternately applying pulses of positive and negative polarity. 2. The method according to claim 1, characterized in that the direct tonic effect on the meridian, which is in a state of hypofunction, is carried out by acting on the aiding point, the tonic point and the sympathetic point of this meridian, and the indirect sedative or tonic effect on the meridian, located in the state, respectively, of hyper- or hypofunction, is carried out by acting on aiding points, lo-points, tonic points, sympathetic points and connection points selected from meridians P, MS, C, IG, TR, GI, RP, F, R, V, VB, E, VG, VC according to the classical rules of acupuncture, taking into account the state of these meridians, determined by the Nakatani method. 3. The method according to claim 1, characterized in that the projection of the Wernicke zone on the patient’s scalp is affected by disorders of understanding and attention to conversational speech, the projection of the Brock zone for disorders of pronunciation of words and phrases, and the projection of the initiative zone when speech is reduced activity and hysterical manifestations. 4. The method according to claim 1, characterized in that they additionally carry out a symptomatic therapeutic effect on the corporal and auricular BAT. 5. The method according to claim 1, characterized in that with a sedative and tonic effect on the control and non-meridian BAPs, the short-circuit current strength is 40-120 μA, the pulse duration of positive and negative polarity with a tonic effect is 2-6 s, the contact surface area the electrode is selected equal to 0.2-12.0 mm ² , and the exposure time for each BAP is 45-90 s. 6. The method according to any one of claims 1 to 5, characterized in that the therapeutic effect is carried out daily with a duration of one session of 40-60 minutes and a total number of sessions 13-18 per treatment course.