RU2318488C1 - Method for carrying out recovery treatment in early postoperative period after radical surgical intervention on the mammary gland carcinoma occasion - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves applying primary drug therapy in early postoperative period after mastectomy, massage, smooth active movements in brachial and ulnar articulation are done on injured side. Sparing medical exercises are done. Biologically active points are additionally treated with infrared radiation of 1.2 mcm wavelength and 10 mW power beginning from the eighth-ninth day every day after operation. First, biologically active points from C9, IG1, GI 10, VG 14 row are treated during 2-4 procedures. Then, local and distant biologically active points are treated 8-12 procedures long on operation side. The biologically active points are treated 3-4 min long as a rule, and ones painful in palpating are treated 4-6 min long. When carrying out antitumor therapy, the arising intercurrent states are corrected also by treating biologically active points. Headaches being the case, GI4, VB1, VB20, VG 20, V 60, MC 6, F 2 points are treated. Giddiness being the case, VG 17, VG 19, VG 20, TR 15, V 11, RP 1 are treated. Dyspeptic disorders being the case, VG 24, VC 9, VC 13, VC 17, VB 28, VB 30, C 7, TR 4 are treated. Emotional lability being the case, RP 6, MC 8, VG 14 are treated. Sleep disorders being the case, F 3, V 18, P 11, VG 14, VB 20, C 7, VG 20 are treated. Asthenic states being the case, VG 14, E 36, GI 4, RP 1, VC 4 points are treated.

EFFECT: enhanced effectiveness of treatment; prevented complications in late postoperative period.

4 cl

Description

The present invention relates to medicine, namely to surgery, and can be used for the treatment of early and prevention of late manifestations of postmastectomy syndrome.

Breast cancer (BC) is one of the leading places in the oncological pathology of the female population. About 50 thousand new cases of malignant neoplasms of the breast are registered in Russia annually (V. Merabishvili, “Breast Cancer - Prevalence and Survival of Patients,” Materials of the III International Annual Conference “Problems of Diagnosis and Treatment of Breast Cancer”, St. Petersburg, 2006, p. 44-45). Recently, there has been a tendency to “rejuvenate” the disease. Increasingly, breast cancer affects women aged 25-40 years, that is, of the most working age and, often, the disease ends with the disability of patients, therefore this pathology goes beyond purely medical problems, turning into a socio-economic plane. According to VTEK, more than 80% of patients become disabled for the entire subsequent period of life after radical treatment for breast cancer, of which 40.8% remain group I and II disabled (M. Stakhanov et al. Postmastectomy syndrome: pathogenesis, classification ”, Russian Oncological Journal, 2006, No. 1, pp. 24-31).

Advances in the treatment of breast cancer are associated not only with the early detection of the disease, but also with the improvement of complex treatment methods. One of the main components of the treatment of this malignant neoplasm is surgical intervention. In addition to it, radiation, chemo and hormone therapy are used. But these methods often themselves cause a number of complications that significantly reduce the quality of life of patients in the postoperative period. Surgery is performed in the scope of sectoral resection or various options for mastectomy, which are still widely used in many clinics.

In patients with breast cancer after radical surgical treatment, a special symptom complex, called postmastectomy syndrome, occurs. The main manifestations of the syndrome are lymphatic edema of the upper limb (10.0-46.0%), limitation of mobility in the shoulder joint on the side of the operation (23.0-57.5%), brachial plexitis of varying severity (10.0-73, 0%), gross cicatricial changes in the skin and soft tissues (5%) (Welsher LZ "Combination therapy of functional disorders of the upper limb in patients radically treated for breast cancer", Abstract of diss .... cand. Honey sciences., M., 1981; Stakhanov ML “Postmastectomy syndrome - classification, diagnosis, treatment, prevention ", Author. Diss. .... Doct. Medical Sciences., M., 2001).

It should be noted that rehabilitation, that is, rehabilitation treatment, begins before the surgical operation and is expressed in planning the choice of a skin incision, incisions during the operation, measures to completely stop the bleeding, and other surgical measures. However, methods of surgical treatment remain traumatic. Thus, the majority of authors consider damage to nerve trunks during surgery, including due to prolonged hyperabduction of the upper limb on the side of the surgical intervention, as the main cause of various neurological disorders that occur in patients after radical treatment for breast cancer. In patients after radical mastectomy, sensory and motor disorders appear, which are usually accompanied by pain. Disorders of innervation in the area of the postoperative scar appear in the form of hypesthesia, anesthesia, paresthesia. Pain and temperature sensitivity in patients is restored after 3-4 years after surgery, and tactile - only after 5-6 years.

Reconstructive treatment after radical surgery for breast cancer is a difficult task. Therefore, the development of new methods of rehabilitation treatment aimed at facilitating the life of patients, improving their quality of life, reducing postoperative complications is relevant.

According to literature data, the period from 10 to 30 days after surgery is attributed to the earliest period of rehabilitation treatment, since it is during this period that post-mastectomy syndrome develops, from 35 to 80 days to the delayed period of post-hospital treatment, and from 80 to 120 days and then to the training ( M.S. Galinskaya and others in the article “Methods of therapeutic exercises in the complex of rehabilitation treatment of patients after radical mastectomy in the early post-hospital period”, Clinical Medicine, 2005, No. 5, p.13).

In the early postoperative period, the objectives of rehabilitation therapy are:

- prevention of congestion in the lungs;

- prevention of thrombosis and embolism;

- improving the outflow of fluid through the drainage tubes;

- improvement of general blood circulation;

- prevention of stiffness in the shoulder joint.

As a rule, basic drug therapy includes: cephalosporin antibiotics, detoxification therapy, antihypertensive drugs, vitamins. Prescribe drugs with lymphovenotropic action, for example, Detralex, which is a purified fraction of natural antioxidants (flavonoids), which increases vein tone, reduces capillary permeability, stimulates lymph outflow and venous outflow, helping to reduce the volume of the affected limb.

The methods of immunomodulatory effects are quite diverse. All of them relate to the possibilities of the use in clinical practice of certain immunomodulating drugs (interferons, interleukins, levamisole, immunofan, polyoxidonium, lycopid).

Of the conservative therapeutic measures, the traditional ones are: limb elevation, diuretics, bandaging with elastic bandages, use of a zinc gelatin bandage, rubbing of heparin and other ointments (T. Grishina, Physiotherapy in cancer patients. - M .: Medicine, 2001, p.24), the purpose of which varies depending on concomitant complications - the presence of erysipelatous inflammation, the stage of lymphatic edema. However, the inclusion of diuretics in the treatment of patients with lymphatic edema of the limb seems to be ineffective and, moreover, the drug negatively affects the cardiovascular system. The use of elastic bandages can also be considered ineffective, since the pressure created by bandaging does not exceed 30 mm Hg and is often incorrectly distributed along the limb. In addition, it decreases after a few hours. Special elastic contour products (sleeves, gloves, T-shirts) are more effective, providing for the creation of the necessary therapeutic pressure and its proper distribution on the body surface with a maximum in the wrist and a minimum in the shoulder / shoulder girdle.

Among the methods of conservative therapy, the most effective and physiological is pneumatic compression (pneumomassage) (Grishina T.I. Physiotherapy in cancer patients. - M .: Medicine, 2001, p.25). During the operation of the pneumatic massager, the neighboring sections of the massaged hand are alternately squeezed from the periphery to the center and the compression is subsequently weakened. The created pressure improves lymphatic and venous outflows, increases the fibrinolytic activity of the blood, and reduces the likelihood of thrombosis.

For the prototype of the present invention, a well-known method of rehabilitation treatment in the early postoperative period after radical surgery for breast cancer was selected, including basic drug therapy, massage, smooth active movements in the shoulder and elbow joints of the limb on the side of the operation and sparing physiotherapy exercises (B. I. Pronin and others. "Mastectomy and its consequences", Publishing House "Medicine", M., 1985, p. 48-50).

The method consists in the fact that in addition to the basic drug therapy, if the patient’s condition allows, physical therapy exercises begin from 1-2 days after the operation. Classes are carried out 2-3 times a day with a repetition of each exercise 6-8 times. Starting from the second day, a compression glove is put on a “sick” hand after a preliminary massage, which is carried out for 5-10 minutes with rubbing of heparin ointment (Pronin V.I. et al. Mastectomy and its consequences. - M .: Medicine. - 1985, p. 48-50).

The known method is aimed at restoring movements in the limbs on the side of the operation. However, in an oncological clinic, methods aimed at restoring the body's own defenses, stimulating the integration of the interaction of the immune and nervous systems, disrupted by the tumor process, remain practically undeveloped.

The objective of the invention is to increase the effectiveness of treatment by a complex effect on the body system and the possibility of preventing complications in the late postoperative period.

The problem is solved in that in the known method of rehabilitation treatment in the early postoperative period after radical surgery for breast cancer, which includes basic drug therapy, massage, smooth active movements in the shoulder and elbow joints of the limb on the side of the operation and gentle therapeutic physical education, in addition, from 8-9 days after surgery, the patient is prescribed reflexology and is carried out in three stages for 12-16 days, while the first stage includes 2-4% fools of exposure to adaptive biologically active points (BAT) for 3-4 minutes each, the second stage consists of exposure to pain and decongestant BAT and consists of 8-12 sessions, the third stage consists of 1-2 sessions of exposure to symptomatic BAT, which add to the BAHT of the second stage. In this case, reflexology is carried out with infrared light with a power of infrared radiation of 10 mW and a wavelength of 1.2 μm.

The present invention meets the criteria of the invention of “novelty” and “inventive step”, since the conducted patent information research did not reveal the sources of patent and scientific and technical information discrediting the novelty of the proposed method, as well as technical solutions with significant features.

Known methods of rehabilitation therapy by exposure to BAP. For example, there is a method for the reflex correction of lymphatic edema in the late postoperative period (Kuzmina EG, Degtyareva AA "Restoring immunological parameters after reflexology in the complex treatment of radiation edema of the upper extremities", Medical Radiology, 1987, No. 7, p. 42-46), which consists in the sequential use of massage, treatment of the edematous limb with a hammer for acupuncture, exposure to biologically active points with a long needle using the brake method and subsequent applications of dimexide or is irradiated BAP and helium-neon laser with a subsequent application Dimexidum.

M.S. Bardychev et al. They also suggested the use of acupuncture techniques for the correction of edema of the extremities after radiation or combined treatment of breast and uterine cancer. They used pricking with long needles, microneedle therapy, and surface pricking with a multi-pricked hammer. A segmental method of exposure was used (MS Bardychev et al. “Acupuncture for edema of the extremities after radiation or combined treatment of breast and uterine cancer.” Oncology Issues, 1988, No. 3, pp. 319-322).

N.D.Zubova et al. used acupuncture for the treatment of patients with radiation fibrosis and secondary neuritis for the relief of pain (Zubova ND, etc. "Acupuncture in the rehabilitation of patients with radiation fibrosis and secondary neuritis. Medical radiology, 1980, No. 8, s.64- 65). They acted on auricular and corporal points of a general strengthening effect. Gradually, the number of points increased. Points were selected by the syndromic method, using points of segmental zones and points of local action.

L.Z. Welsher et al. (Welsher L.Z. et al. “Restorative therapy in patients with postmastectomy syndrome”, Russian Oncological Journal, 2005, No. 5, p.31-35) have developed a complex of restorative therapy, which is a combined and combined-sequential use of laser and phototherapy (the effect is on the tissue of the anterior scalene muscle on the disease side in the postoperative period), manual and drug therapy, as well as therapeutic gymnastics and massage.

The use of LED therapy is known, which is especially indicated in the complex treatment of erysipelas, aggravating lymphadenoma. In this case, the region of edema is affected by radiation of incoherent monochromatic light, which is close in biological effects to a gel-neon therapeutic laser. As a result of treatment, local immunity increases, venous outflow improves, pain and a feeling of heaviness in the arm decrease.

Thus, there are a sufficient number of methods that use reflexology in one form or another. However, all of the above methods have the disadvantage that they were developed for the treatment and prevention of late manifestations of postmastectomy syndrome. According to the scientific and technical literature, the known methods begin to be applied at least 2 years after surgery or combined treatment of breast cancer.

The authors of the present invention have developed a method of restored treatment in the early postoperative period after radical surgery for breast cancer. To obtain low-intensity infrared radiation, the domestic serial certified device AIKP-01 was used. The method differs from the known ones in that the effect begins in the early postoperative period, 8-9 days after the surgery, that is, before the onset of early manifestations of postmastectomy syndrome begins, and is carried out in three stages, the choice of biologically active points (BAP) is carried out individually in depending on the condition of the patient. They include immunomodulating, analgesic and decongestant BAT, as well as BAT, which have a symptomatic effect.

Restorative therapeutic effect of the proposed method was carried out in the early postoperative period to 25 patients (1 group). The comparison group (group 2) consisted of 18 women who received only basic drug therapy, and 9 patients underwent the procedure - placebo (group 3) against the background of basic drug therapy. All three groups were comparable in disease stage, age, and concomitant pathology.

To assess the effectiveness of treatment, methods were used that give an idea of the range of motion of the upper limb, the state of the vascular system, the state of the immune system, the neurovegetative status and the emotional state of patients. These methods were general clinical and neurological examination of patients, measurement of the angle of elevation of the arm in the frontal plane, ultrasound dopplerography, immunophenotyping of peripheral blood mononuclear cells using monoclonal antibodies of the ICO series to surface antigens CD4, CD8, CD38, CD50, CD16, heart rate intervalography, anxiety level test according to the Spielberger questionnaire, Luscher test, SAN scale test.

In the group receiving reflexology as part of the complex treatment, the following was observed:

1) reduction of pain in the hand on the side of the operation;

2) an increase in the volume of active movements;

3) reduction of swelling of the soft tissues of the hand;

4) increase in tendon reflexes from the arm on the side of the operation.

Patients became calmer, noted a significant improvement in health and mood, the emergence of interest in the environment. There was an increase in self-esteem indicators.

Upon re-examination conducted immediately after the end of treatment, an increase in the angle of arm lift was observed in 3 patients from 60 to 90 degrees, in 7 patients from 60 to 120, in 3 patients from 90 to 180, in 12 patients from 90 to 120.

According to Doppler ultrasound, an increase in the speed of blood flow and blood filling of the vessels of the upper extremity on the side of the operation was observed, as well as an improvement in venous outflow (21 out of 25 patients).

According to pulsintervalography, there was an increase in the activity of the autonomous regulation loop, which indicated an improvement in the functioning of adaptive mechanisms.

The immunogram showed an increase in the level of CD4 + cells, CD50 + cells, the indices of the immunoregulatory index returned to normal.

In patients receiving only basic drug therapy, pain in the arm and armpit persisted, an increase in soft tissue edema was noted, and paresthesia of the hand took place. In some cases (9 out of 18), the volume of active hand movements on the side of the operation decreased markedly. The angle of rise of the arm increased from 60 to 90 ° in only 4 people. An increase in anxiety and instability of self-esteem were noted.

The analysis of pulse intervals showed the preservation of autonomic dysregulation, inadequate functioning and the possibility of failure of adaptive mechanisms. Similar changes tended to increase in 10 of 18 patients.

According to the ultrasound scan, 12 out of 18 women experienced a slowdown in venous outflow, and 11 out of 18 showed a decrease in blood supply to the main arteries.

The indicators of the immunoregulatory index in 10 patients remained virtually unchanged, and in 7 patients at the end of the course of treatment fell below 1.0. Performing the procedure - a placebo on the background of drug basic therapy did not improve treatment outcomes.

Thus, the use of the proposed method of rehabilitation treatment in the early postoperative period in breast cancer patients is effective for the correction of not only the function of the upper limb, but also the general condition of the patients.

If necessary, continue treatment with polychemotherapy and / or radiation therapy to the patient, reflexology sessions according to the proposed method are carried out before the start of combined treatment and throughout the first course of postoperative antitumor therapy daily for 12-16 days. In this case, treatment is started 1-2 days before the start of chemo and / or radiation therapy. The patient is given introductory reflex procedures aimed at stimulating the body's defenses. Next, they act on analgesic and decongestant BAT according to the proposed method. The method allows to correct the manifestations of intercurrent conditions that occur in patients during radiation and / or chemotherapy, prevent the development of clinical manifestations of postmastectomy syndrome and have an immunomodulatory effect on the patient's body.

For exposure, an indicative multivariate recipe was developed containing about 40 biologically active points for general exposure and syndromic therapy. Depending on the condition of the patient, the exposure points were selected individually (25-30 points per treatment course), and during the procedure, 6-12 BAT were processed.

The proposed method is as follows.

A patient is treated with a conservative basic drug therapy (antibiotics, detoxification therapy vitamins, antihypertensive therapy), first with the help of medical personnel, and then under his control smooth active movements in the shoulder and elbow joints of the limb on the side of the operation are performed. Spend therapeutic physical education. Taking into account the condition of the patient, they choose the necessary BAP for exposure and, on the 8-9th day after the operation, reflexology sessions are started using the AIKP-01 apparatus. Reflexotherapy is carried out in three stages for 12-16 days. The first stage includes 2-4 procedures for influencing the adaptive BAT for 3-4 minutes each. The second stage consists of exposure to analgesic and decongestant BAT and consists of 8-12 sessions. The third stage consists of 1-2 sessions of exposure to sympathetic BAP, which are added to the BAP of the second stage. Reflexotherapy is carried out with infrared light with an infrared power of 10 mW and a wavelength of 1.2 microns.

Stage 1. Consists of 2-4 procedures and is aimed at stimulating the body's defenses. Paired BAPs are used symmetrically. C9 shao-chun; IG1 shao tze; GI10 show-san-li; VG14 yeah jui.

Stage 2. It consists of 8-12 procedures, during which the effect on analgesic and decongestant BAT is carried out.

On the operation side: local BAT: V11 da-ju; VB20 Feng Chi; VB21 Jian Jing; TR15 Tien Liu; TR16 tien yu; TR12 Xia-le; GI16 ju-gu; IG10 Nao-Shu; IG12 Bin Feng; IG14 jian-wai-shu; IG15 jian-jung-shu; IG16 Tien Chuan; E12 tsue-pen; P2 yun-men.

Remote BAP: GI5 yang-si; GI14 Bi-Nao; TR4 yang chi; IG8 xiao-hai; MRZ Qu-Tse; MC7 da-lin; C4 lin-dao; C8 Shao Fu.

Symmetrical: GI3 san-jian; GI4 he-gu; MC5 Jian Shi.

Stage 3. Carry out the correction of intercurrent conditions that occur in the patient during the application of antitumor therapy. Points of this stage are simply added to the BAP of the second stage (no more than 3-4 points per procedure) and are used symmetrically.

For headaches: GI4 he-gu; VB1 Tun-Ji-Liao; VB20 Feng Chi; VG20 buy-hui; V60 Kun Lun; MC6 nei-guan; F2 Xing Jian.

With dizziness: VG17 nao-hu; VG19 hou-din; VG20 buy-hui; TR15 Tian Liao; V11 da-ju; RP1 yin bye.

In dyspeptic disorders: VG24 Shen-ting; VC9 Zhong-wan; VC13 Shan-Wan; VC17 Tan Zhong; VB28 Wei Dao; VB30 huan-tiao; C7 Shen-Men; TR4 yang chi.

With emotional lability: RP6 san-yin-jiao; MS8 lao-gun; VG14 yeah jui.

For sleep disorders: F3 tai chun; V18 gan-shu; P11 shao shan; VG14 da chui; VB20 Feng Chi; C7 Shen-Men; VG20 buy-hui.

In asthenic conditions: VG14 da-jui; E36 jiu-san-li; GI4 he-gu; RP1 yin-bye; VC4 Guan Yuan.

The total duration of the course of treatment is 12-16 daily procedures. The average exposure time is 3 minutes per point. If upon palpation, sharp pain is determined at the point selected for exposure, then the time of work with this point can be increased to 4-6 minutes. In one procedure, from 6 to 12 points from the proposed recipe are usually used. It should be noted that in eastern medicine for different pathological conditions the same BAT can be used, therefore the selection of points is made taking into account the achievement of the maximum effect from each procedure.

As clinical examples of the effectiveness of the proposed method, we provide extracts from the medical history.

Example 1. Patient F., 42 years old, medical history No. 657, was admitted to the oncology center with a diagnosis of Cancer of the left breast T2 N1 M0. In the preoperative period, the patient underwent a course of radiation therapy, then a radical mastectomy was performed. As a result of a histological examination of the postoperative preparation, the diagnosis was established: Infiltrating ductal cancer of the II degree of malignancy, metastases in 2 lymph nodes out of 6 examined. In the postoperative period, the patient was prescribed polychemotherapy according to the CAF scheme. The patient underwent standard medication, massage and sparing physiotherapy exercises. However, the patient complained of pain in the shoulder joint and on the back surface of the left shoulder, tingling and crawling in the shoulder and forearm on the side of the operation, there was a restriction in the range of active movements in the arm, numbness of the fingers of the left hand. A neurological examination revealed a decrease in tendon reflexes on the left hand compared to the right. The angle of elevation of the arm on the side of the operation in the frontal plane was 80-90 °. Slight swelling of the hand and the area of the left wrist joint was noted.

According to pulse-interval analysis: variational range of 0.14 s, mode 0.70 s, mode amplitude 64.20%, autonomic equilibrium index 586.14 units, stress index 453.69 units.

According to the ultrasound data, piOSAL was 0.99; ri OSAL - 0.99; s / d OSAL - 2.31; pi LOCL 2.39; ri LOCL 0.79; s / d LOCL - 3.74; pi BEAM - 2.36; ri BEAM - 0.96; s / d BEAM - 3.67; pi PAL - 1.65; ri PAL -0.75; s / d PAL - 3.95.

In the patient’s immunogram, the number of CD4 + cells is 29%, CD50 + cells 39%, CD16 + cells 26%, CD38 + cells 26%, a decrease to 0.96 of the immunoregulatory index was noted.

On the 8th day after the operation, before the start of the course of polychemotherapy and throughout its duration, the patient was prescribed reflexology by exposure to biologically active points by infrared light according to the method described above. Treatment was started from stage 1. 2 procedures were performed, then the second stage was appointed. Completed 9 procedures. In total, the patient received 11 procedures.

After a course of treatment, the patient noted a decrease in shoulder pain, the disappearance of swelling and the absence of a feeling of numbness in the fingers of the left hand. An objective examination showed a revitalization of tendon reflexes from the left hand. The angle of the arm in the frontal plane increased to 120-130 °.

Pulseintervalography data: variation range 0.11 s, mode 0.78 s, mode amplitude 56.12%, autonomic equilibrium index 484.0 units, stress index 394.26 units.

According to the ultrasound scan, an increase in the speed of blood flow and blood filling of the vessels of the upper limb on the side of the operation was observed. After treatment, piOCAL was: 1.53; ri OSAL - 1.53; s / d OSAL - 3.15; pi LOCL 3.28; ri LOCL 1.0; s / d LOCL - 4.56; pi BEAM - 3.49; ri BEAM - 1.26; s / d BEAM - 4.82; pi PAL - 2.29; ri PAL - 1.34; s / d PAL - 4.53.

In the patient’s immunogram, the number of CD4 + cells was 35%, CD50 + cells 46%, CD16 + cells 22%, CD38 + cells 23%, the immunoregulatory index increased to 1.2.

Example 2. Patient G., 45 years old, medical history No. 1592, was admitted to the oncology center with a diagnosis of Cancer of the right breast T2N0MO. After clinical and instrumental examination of the patient, a radical mastectomy according to Patty was performed. Histological examination of the postoperative material revealed the presence of infiltrating lobular cancer, metastases were also detected in 3 of 6 lymph nodes. The patient complained of pain on the back of the right shoulder, numbness of the fingers of the right hand. In neurological status, there was a decrease in tendon reflexes on the side of the operation, and the angle of arm lift in the frontal plane was 90-100 °. Swelling of the hands was not observed. From the 8th day after the surgery, reflex therapy was prescribed by the proposed method. Treatment was started from the 1st stage (2 procedures), then the 2nd stage was carried out - 9 procedures. From the 14th day after the operation, the patient was prescribed a course of polychemotherapy according to the CAP scheme in accordance with the results of a histological examination. Since the patient experienced severe dyspeptic disorders after the first intravenous administration of chemotherapy drugs, nausea and vomiting were repeatedly observed, the corresponding symptomatic BAT of 3 stages were added to the reflexology procedures.

After a course of infrared reflexology, the patient noted a decrease in shoulder pain and the disappearance of numbness in the fingers of the right hand. In neurological status: tendon reflexes from the hands D = S, the angle of arm lift in the frontal plane increased to 130-140 °. According to Doppler ultrasonography: before treatment, pi LAP was 2.86, ri LAP was 0.88, s / d LAP was 8.04; piOSAP was 1.41; ri OSAP - 0.63; s / d OSAP - 2.71; pi LOCP 3.81; ri LOCP 0.97; s / d LOKP - 4.63; pi LUCHP - 3,54; ri LUCHP - 0.91; s / d LUCHP - 5.29. After treatment, pi LAP -3.05; ri LAP - 0.91; s / d LAP - 11.5; piOCAL was 1.41; ri OSAL - 0.72; s / d OSAL - 3.69; pi LOCL 4.63; ri LOCL 1.0; s / d LOCL - 6.52; pi LUCHP - 4.23; ri LUCHP - 1.26; s / d LUCHP - 5.76.

Pulseintervalography indices before treatment: variational range of 0.14 s, mode 0.71 s, mode amplitude 64.26%, vegetative equilibrium index 598.65 units, stress index 459.31 units, after treatment variational range 0.12 s , mode 0.80 s, mode amplitude 55.34%, vegetative equilibrium index 463.12 units, stress index 356.67 units

In the patient’s immunogram before treatment, the number of CD4 + cells is 40%, CD50 + cells 42%, CD16 + cells 20%, CD38 + cells 25%, immunoregulatory index 1.4. After treatment, the number of CD4 + cells 38%, CD50 + cells 48%, CD16 + cells 18%, CD38 + cells 21%, immunoregulatory index was 1.6.

Claims (4)

1. A method of rehabilitation treatment in the early postoperative period after radical surgery for breast cancer, including basic drug therapy, massage, smooth active movements in the shoulder and elbow joints of the limb on the affected side and sparing therapeutic exercise, characterized in that in addition to 8-9 days after the operation, biologically active points (BAP) are daily exposed to infrared light at a wavelength of 1.2 μm with a power of 10 mW, while first, during 2-4 procedures, affect BAP from the range of C9, IG1, GI10, VG14, after which, within 8-12 procedures, act on local and remote BAP on the side of the operation, while the BAP from the series of GI3, GI4, MC5 act symmetrically. 2. The method according to claim 1, characterized in that the effect on the BAT is carried out for 3-4 minutes 3. The method according to claim 1, characterized in that the effect on the BAP, painful on palpation, is carried out for 4-6 minutes 4. The method according to claim 1, characterized in that in the case of antitumor therapy, the correction of emerging intercurrent conditions is carried out by affecting the BAP, while in case of headaches they affect the points GI4, VB1, VB20, VG20, V60, MC6, F2: when dizziness affects BAP VG17, VG19, VG20, TR15, V11, RP1, with dyspeptic disorders affect BAP VG24, VC9, VC13, VC17, VB28, VB30, C7, TR4, with emotional lability they affect BAP RP6, MC8, VG14, in case of sleep disorders, they affect BAP F3, V18, P11, VG14, VB20, C7, VG20, in case of asthenic conditions - VG14, E36, GI4, RP1, Vc4.