RU2319522C2 - Method for affecting human physical and psycho-emotional state with the help of double-phase phototherapy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: it is necessary to apply uninterrupted ultraviolet radiation in spectral range of 360-380 nm along with the impact with light radiation in spectral range of 390-680 nm. Impact seances should be carried out in the morning and in the evening. On the first day the interval between the séances mentioned corresponds to not less than 6 and not more than 8 h. but then the initial daily interval between the seances should be prolonged for 10-30 min by starting the morning seance a bit earlier against the previous one or the evening seance a bit later against the yesterday's one to achieve daily interval up to 14 h. The innovation in question enables to correlate physical and psycho-emotional state associated with heliophysical factors.

EFFECT: higher efficiency of light therapy.

2 ex

Description

The invention relates to physiotherapy and chronotherapy, and is intended for the treatment and correction of the condition of people, referred to in the literature as “desynchronosis”. Desynchronosis is called “disorganization of the circadian system” of regulation of the rhythms of the physiological functions of the human body (2). Signs of desynchronosis: disturbances of falling asleep, night awakenings, restless sleep, early awakening, daytime drowsiness, appetite disorders, changes in eating patterns, decreased working capacity, lethargy, irritability, decreased mood, disturbance of the daily rhythm of body temperature, as well as other phenomenological and laboratory manifestations (5 ; 10; 16). This condition may be associated with night work (7; 17), rapid transmeridional movements (8), geographical conditions of residence and / or work (1; 13), as well as a number of other factors (5; 7; 19). Of particular relevance is the problem of desynchronosis in medical practice (9; 13; 15). The method can be used to increase the physical and mental performance of personnel in the workplace, to eliminate night drowsiness, regulate a person’s emotional state, create a subjective feeling of comfort, increase a person’s motivational stress, regulate alcohol consumption, and prevent premenstrual stress syndrome. The method makes it possible to influence the physical and psycho-emotional state of a person in other cases.

Known methods of exposure to light, based on a single-component exposure or in combination with other physiotherapeutic procedures for psychopathological symptoms (9; 15).

The disadvantages of these methods include: the use of exposure in a limited part of the spectrum (p. No. 1766424), the effect on peripheral biological tissues (p. No. 2039580, p. No. 1697854), the indirect effect on the etiopathogenetic links of the disease process (p. No. 206357, p. No. 1827271).

A significant drawback of these methods is the therapeutic focus, which limits their use to the contingent of patients with nosologically verified diagnoses. Meanwhile, the imperfection of statistical diagnostic classifications assumes a difference in qualifying features. Thus, ICD-10 (International Classification of Diseases), unlike DSM-IV (American Diagnostic System), does not single out “seasonal affective disorder”, which undoubtedly is a clinical reality, into an independent diagnostic section (12). In addition, the disorders under consideration may not be of a painful nature at all, but may be included in the structure of the body's adaptive response (16).

The closest biological and medical essence to the invention is a method of exposure to light in the UVA range of 360-370 nm, an intensity of 0.04-0.3 W / m ² on the patient’s retina in order to stop psychopathological symptoms - patent RU 2134137 since March 11, 1998.

The implementation of the prototype method is based on the action of ultraviolet radiation in the range of 360-370 nm, on the retina, with the aim of resynchronizing the rhythm-organizing structures of the brain (11; 17, p. 65-66).

The disadvantages of the prototype method, reducing the effectiveness of the application and limiting its functional use are:

1. Exposure only in the spectral range of 360-370 nm.

2. Orientation to the contingent of patients with a diagnosis of seasonal affective disorder.

3. The absence in the method of using the effect of "phase adjustment" (17, p. 68-70).

The first of these drawbacks is associated with the limited use of the spectral continuum with a very narrow zone of the long-wavelength “near” ultraviolet (UVA), which does not correspond to the theoretical recommendations “use full-spectrum light” (9). In addition, the isolated use of long-wave ultraviolet radiation limits the radiation intensity to the declared range (0.04-0.3 W / m ² ), which does not correspond to the proportion of ultraviolet radiation in the composition of even diffused sunlight. The indicated intensity restriction was introduced taking into account the safety standards adopted by the World Health Organization (18, p. 51-95) for isolated ultraviolet radiation and undoubtedly reduces both the synchronizing and stimulating effects of exposure. At the same time, it is known that the damaging effect of isolated ultraviolet light is much higher than in the full-spectrum radiation flux (sunlight). The neutralizing effect of the optical parts of the spectrum on the ultraviolet component that damages the ocular media is also preserved in artificial light sources (14, p. 24), allowing them to increase their efficiency by approaching the ratio of intensities of individual parts of the spectrum in sunlight. The enrichment of optical radiation with long-wave ultraviolet, recreating the structure of natural sunlight, in part of the Fraunhofer lines (3, p. 21) makes it possible to reduce the intensity of optical radiation used in phototherapeutic installations, and which can also cause damage to ocular environments, in recommended doses.

The absence of the use of the “phase adjustment” effect sharply limits the therapeutic and corrective potential of the prototype method, in which only part of the chronotherapeutic and chronoprophylactic mechanism is realized.

The purpose of the invention is the creation of methods of treatment and correction of the physical and psycho-emotional state associated with heliogeophysical factors (reducing the duration, intensity and other natural lighting), increasing the effectiveness of light therapy, expanding the functionality of the method.

The specified goal is achieved:

- the simultaneous use of electroluminescent lamps emitting visible light (390-680 nm) and lamps emitting light in the range of 360-380 nm. For example, LB-80, LD-80, LBC 60, LDZUF-80 and PHILLIPS-L / 73 and similar light sources can be used.

- two-phase exposure (two sessions daily), followed by an increase in the initially smaller interval between sessions up to 14-15 hours.

The invention consists in light exposure simulating the structure of natural sunlight (spectral regions of the visible and long-wave ultraviolet radiation) on the retina of the human eye. Phototherapy sessions are held twice a day. This ensures the "interaction of biological and heliogeophysical rhythms" (4, pp. 739-740; 5, pp. 136-137; 19, pp. 10-12), which leads to "rhythm capture" and the implementation of the chronotherapeutic mechanism of "phase adjustment" ”(13, pp. 9-20; 17, pp. 56-73; 19, pp. 12-13).

The method is as follows.

The patient is located at a distance of 1-3 meters from 4-10 working light sources (LB-80, LD-80, LBC 60, LDTSUF-80 and PHILLIPS-L / 73, or analogues), lamp height 0.5-1 5 m above the floor. With this arrangement, the intensity of ultraviolet radiation at the level of the patient’s external ocular media is from 0.04 W / m ² to 0.5 W / m ² . Illumination - about 1500-4000 lux. The duration of the session is from 20 minutes to 3 hours. Accordingly, the exposure dose of ultraviolet radiation per session ranges from 200 J / m ² to 10,000 J / m ² , remaining within the recommended safe level. The duration of the course of exposure is 6-18 days, daily in the morning and in the evening. On one day, two sessions are carried out, of the same or different duration. A shorter time interval between sessions - not less than 6 hours and not more than 10 hours, should be in the daytime or for a period corresponding to the daytime. Every next day, the interval increases by 10-40 minutes until the interval (the time between the end of the "morning" phase of exposure (morning session) and the beginning of the "evening" phase of exposure (evening session) is reached for at least 14 hours.

An example implementation of the method. Patient S., 37 years old. She was repeatedly hospitalized and treated on an outpatient basis with the following diagnoses: “recurrent depressive disorder”, “cyclotymia”. Deterioration of well-being is always in the autumn-winter period. I visited 12 sessions of phototherapy by the specified method. Light sources: 1 lamp "PHILLIPS" L / 73 and from 3 to 7 lamps LB-80 and LD-80. Illumination is 1500-3000 lux, the intensity of ultraviolet light is 0.1-0.2 W / m ² . The initial interval between sessions is 8 hours. The duration of the morning session is 1 hour, evening 1 hour 20 minutes. Each subsequent day, the interval between sessions was increased by 30 minutes, “shifting” the beginning of the evening session to a later time. There is a significant positive dynamics of the state associated with a reduction in psychopathological symptoms.

Patient M., 46 years old. I took a course of phototherapy in this way in connection with seasonal-dependent sleep disorders. Visited 12 sessions. Light sources: 1-2 PHILLIPS L / 73 lamps and 5 LB-80 lamps and 2 LD-80 lamps. Illuminance 2000-3000 lux, the intensity of ultraviolet light 0.1-0.2 W / m ² . The initial interval between sessions is 8 hours. The duration of the morning session is 1 hour, evening 1 hour 20 minutes. Each subsequent day, the interval between sessions was increased by 30 minutes, “shifting” the beginning of the evening session 15 minutes later than the previous evening and the beginning of the morning session 5 minutes earlier than the previous morning. There was a significant positive dynamics of the state associated with the reduction of psychopathological symptoms.

INFORMATION SOURCES

1. Agadzhanyan N.A., Vlasova I.G., Alpatov A.M. Adaptation and biorhythms. In the book: Adaptation of humans and animals to extreme environmental conditions. M., 1985, pp. 138-184.

2. Alyakrinsky B.S. The problem of circadianity. In: Problems of Space Biology. T.64 Biorhythmological research in space biology and medicine. 1989, pp. 12-34.

3. Ashurkov S.G., Kondratiev K.Ya., Sarychev G.S., Fedchenko P.P. Fine structure of the solar spectrum and environmental aspects of lighting. In the book: Lighting Engineering, 1993, No. 1, pp. 19-22.

4. Degtyarev P.A., Fukshansky L.Ya. Criteria for the influence of light rhythms on the phase of a biological clock. In: Journal of General Biology. 1973, No. 5, pp. 738-744.

5. Deryapa N.R., Moshkin M.P., Poeny B.C. Problems of medical biorhythmology. M., 1985, 207 p.

6. Druzhinin Yu.P., Podduzhnaya G.N., Rodina G.P., Seraya V.M. On some patterns of changes in daily periodicals under various light conditions. In the book: Problems of the temporary organization of living systems M., 1979, pp. 135-142.

7. Siderman A.A. Some issues of chronobiology and chronomedicine. Riga, 1988, 214 p.

8. Kolpakov V.V. Chronophysiology of human meridian movements during shift-expeditionary organization of labor. In: Chronobiology and chronomedicine. Tyumen, 1982, p. 61.

9. Levin Y.I., Artemenko A.R. Phototherapy. M., 1996, 80 pp.

10. Makarov V.I. Mechanisms of adaptive adjustment of circadian rhythms. In the book: Problems of the temporary organization of living systems. M., 1979, pp. 70-72.

11. Markman G.S. About stochastization of biological systems. external periodic exposure. Biophysics 1983, issue 3, pp. 467-470.

12. Ostryanina N.L. To the problem of seasonal (autumn-winter) depressions. - Psychiatry and psychopharmacotherapy. 2002, No. 4, pp. 158-160.

13. Recommendations for predicting and preventing desynchronosis. Novosibirsk, 1984, 52 p.

14. Skobareva Z.A. The state of some vision functions when exposed to long-wave ultraviolet radiation. In the book: Lighting Engineering, 1967, No. 3, pp. 23-25.

15. Solovyova A.D., Fishman E.Ya. Phototherapy of psycho-vegetative disorders. - Journal of Neuropathology and Psychiatry. 1996, No. 3, pp. 67-71.

16. Stepanova S.I. Biorhythmological aspects of the problem of adaptation. M., 1986, 244 p.

17. Winfrey A.T. Biological Clock Time. M., 1990, 208 p.

18. Ultraviolet radiation. Geneva, 1984, 115 p.

19. Feldman G.L. Biorhythmology. Rn-D., 1982, 80 pp.

Claims (1)

The method of light exposure on the physical and psycho-emotional state of a person, including exposure to the retina with ultraviolet radiation, characterized in that they use continuous ultraviolet radiation in the spectral range of 360-380 nm and simultaneously act with light radiation in the spectral range of 390-680 nm, and the exposure sessions morning and evening, while on the first day the interval between sessions is at least 6 and not more than 8 hours, then the daily initial interval between sessions is daily increase by 10-30 minutes, starting the morning session earlier than the previous one or evening later than the previous one, or at the same time starting the morning session earlier, and the evening session later than the last day, bringing the daily interval to 14 hours.