RU2511068C1 - Method of treating obesity - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves a combination of peloid applications and ultrasonic exposure. Peloid is applied on anterolateral thighs and an anterior abdominal wall. The applications are alternated every second day. Peloid is silt sulphide mud of Melkovodnenskiy deposit. The mud is applied in layer 10 mm thick at temperature 34-36°C. The applications are exposed to ultrasound at frequency 880 kHz in a continuous mode. The applications of the anterior abdominal wall are exposed to ultrasound at intensity 0.2-0.4 Wt/cm² for 5 - 10 minutes. The anterolateral thighs are exposed to ultrasound at intensity 0.4-0.6 Wt/cm², for 6-8 minutes for each thigh. Upon the completion of the procedure, the patient is covered with a hydrophobic tissue and left for 10 minutes. The therapeutic course is 10 procedures.

EFFECT: reducing obesity effectively by exposing on the hormonal activity of fat tissue, maintains the results obtained within three months.

2 ex

Description

The invention relates to medicine, namely to physiotherapy, and can be used in a spa, outpatient practice for the rehabilitation of obese patients with metabolic disorders.

The obesity epidemic is an unprecedented health problem, which is also underestimated, poorly understood and not fully recognized as a government problem with significant economic consequences. Obesity has a significant impact on morbidity and mortality in the population. This is evidenced by large epidemiological studies that have proved that obesity is one of the main risk factors for type 2 diabetes and cardiovascular diseases (myocardial infarction, ischemic stroke). In this regard, the prevention of obesity is an urgent medical and social problem that can be solved through the introduction of innovative approaches [1, 2].

The main recommendations for the treatment of obese patients are based on non-drug approaches and, first of all, lifestyle correction (rational nutrition, smoking cessation, dosed physical activity, etc.). Existing pharmacological therapy and surgical treatment are methods of “despair”, have many contraindications, complications, are prescribed in exceptional cases.

Among non-drug methods for treating obesity, natural and preformed physical factors occupy an important place. Important advantages of physiotherapeutic treatment are accessibility, physiological effects on the whole body [3, 4].

Such properties as the ability to form compensatory-adaptive reactions, the absence of toxicity and allergization of the body, the absence of adverse reactions and long-term aftereffect, together with good compatibility with other treatment methods, have led to the use of physiotherapeutic methods in the treatment of patients with obesity.

Traditionally, the use of physiotherapeutic treatment of obese patients recommends the use of methods that affect the central mechanisms of regulation of fat metabolism (transcranial electrostimulation, bitemporal inductothermy, carbon dioxide, radon baths) that enhance thermogenesis (electromyostimulation, contrast baths) and intestinal motor function [5].

However, the above methods do not have a pronounced effect on metabolic disorders in the adipose tissue itself. Modern studies have proved that adipose tissue itself is an endocrine organ and secretes hormones and cytokines involved in the regulation of energy, lipid, carbohydrate metabolism [6, 7].

The direct effect of ultrasound on adipose tissue has a biological effect - it enhances blood circulation and causes muscle relaxation. In addition, ultrasonic vibrations change the structure of cell membranes, increase their permeability, and increase the permeability of the skin.

A known method for complex weight correction, the essence of which is a combined therapeutic effect both directly on adipose tissue, and on the zones responsible for the metabolism of fat in the body. For direct exposure, it is proposed to use individually or in various combinations of light-induced photothermal, photoacoustic and photodynamic effects that induce ultrasonic vibrations. Fat removal is achieved both by converting it to other compounds or destruction by heat, oxidation, acoustic or ultrasonic vibrations. Control of selective exposure is carried out using ultrasound and magnetic resonance imaging. The method allows for effective regulation of human weight [8].

However, the method involves the use of complex expensive equipment, the destruction of adipose tissue is achieved by exposure to heat, and not by changing its hormonal activity.

Mud therapy has been widely used in the complex treatment of various forms of obesity. This is due to the fact that, being a natural formation, therapeutic mud has a complex physiological and therapeutic effect with the whole complex of its chemical, mechanical, and temperature components. The therapeutic effect of dirt is carried out through the neuro-endocrine-humoral regulatory mechanisms. At the same time, adaptation mechanisms are activated, impaired functions are restored. Under the influence of mud therapy, blood and lymph circulation are restored, metabolic processes, redox processes are normalized, tissue respiration is improved, regeneration processes and nonspecific immunological resistance of the body are stimulated. The effect of mud therapy is largely due to chemically and biologically active substances contained in the therapeutic mud: macro- and microelements, vitamins, hormones, humic bases, biogenic stimulants. Increased metabolism in collagen fibers and in the main substance of connective tissue normalizes muscle tone and improves trophic skin [9].

The use of mud therapy in patients with various forms of obesity, as a rule, is limited to the following options for peloid therapy [10]:

the first option is the application of mud applications to the collar zone for patients with hypercorticism, rare forms of obesity, severe forms of secondary obesity, with mixed forms of obesity;

the second option is to conduct mud applications on the collar zone and the area of projections of the adrenal gland. It is prescribed for all forms of obesity without the phenomena of hypercorticism and for any degree of obesity.

These methods should be prescribed with caution, since in addition to the imperfection of thermoregulation mechanisms, obese patients often have concomitant diseases of the cardiovascular system (arterial hypertension, coronary heart disease, cardiac arrhythmias), in which peloid therapy is limited.

A known method of using peloid therapy, which allows to reduce the level of glycemic profile, reduce lipid metabolism, improve regional blood flow [11]. However, it is limited to use only for patients with diabetes mellitus with angiopathies, peloid therapy is carried out on the lower extremities in order to improve regional hemodynamics, and this method also includes the alternation of peloid therapy and carbon dioxide baths, which have a pronounced metabolic effect (reduces glucose, total cholesterol and triglycerides in the blood), and in no way does it affect the endocrine function of adipose tissue.

Strengthen or optimize the effect of therapeutic mud can be done by combining it with exposure to ultrasound (peloidophonophoresis). At the same time, a synergistic effect is observed from various physical factors that act simultaneously on different links of the pathogenesis of the disease.

In some cases, the combined effects of dirt and other physical factors (phonophoresis) have a more gentle effect on the body. Combined procedures are more economical, as they significantly reduce the consumption of mud.

The closest technical solution adopted for the prototype is a method of treating obesity with applications of Tambukan silt mud. The mud is heated in a water bath to 45 ° C, applied to the thighs, upper and lower extremities, covered with compress paper or cellophane and wrapped in a blanket. The duration of the application is 60 minutes [12].

As a result of this, the volume of fat deposits decreases, however, the parameters of the physiotherapeutic effect cannot be considered adequate for the treatment of obese patients with concomitant diseases of the internal organs.

Given the above effects from the use of mud therapy and ultrasound therapy, it was of interest to develop a method for the treatment of obesity aimed at correcting the hormonal activity of adipose tissue, carbohydrate and lipid metabolism.

The objective of the invention is to increase the effectiveness of treatment by simultaneously affecting the peloid and ultrasound factors on the areas of greatest fat deposition to correct the hormonal activity of adipose tissue, carbohydrate and lipid metabolism in patients with concomitant diseases of internal organs.

To solve the problem in a method of treating obesity, including peloid therapy on the patient’s hips, according to the invention, the procedures are prescribed on the anterolateral thigh surfaces and the anterior abdominal wall, alternating application areas every other day, and combining peloid therapy with ultrasound, while as a peloid for applications use sulphide silt mud of the Melkovodnensky deposit, which is applied with a layer thickness of up to 10 mm at a temperature of 34-36 ° C, then using a mud application as the contact medium is affected by ultrasound at a frequency of 880 kHz in a continuous mode on the area of application of the anterior abdominal wall at an intensity of 0.2-0.4 W / cm ² for 5-10 minutes, and on the anterolateral thigh surfaces at an intensity of 0.4-0.6 W / cm ² for 6-8 minutes on each thigh, after ultrasound exposure, the patient is covered with hydrophobic tissue, a blanket and left for 10 minutes, the course of treatment is 10 procedures.

The technical result consists in the effectiveness of the treatment of obesity, provided by the use of applications of sulfide silt mud of the Melkovodnensky deposit as a contact medium for ultrasonic treatment of the areas of greatest fat accumulation with adequately selected exposure parameters reflected in the claims; there is a decrease in the level of glycemic profile, indicators characterizing lipid metabolism improve, regional blood flow indicators improve, and as a result, a decrease in obesity; the result achieved from treatment is maintained after three months.

It is proposed, as an adequate method, potentiating the therapeutic effect, to use in patients with obesity thin-layer applications of silt mud, which on the one hand act as a contact medium for ultrasound therapy, while biologically active substances of therapeutic mud can directly penetrate the tissues through the intact epithelium, exerting pronounced therapeutic effect, on the other hand, the quantitative consumption of dirt is minimal. In addition, a slightly cold application is recommended, i.e. the temperature of the dirt applied to the surface of the human body corresponds to 34-36 ° C. This is because the thermal effect of dirt is minimized, because obesity is combined with disorders of the cardiovascular and autonomic systems, and the therapeutic effect is achieved due to the rich mineral and biological composition of the mud. To enhance the penetrating ability of dirt and increase the effectiveness of the developed method allows ultrasound therapy directly to the area of mud applications. The choice of exposure intensity parameters (on the area of application of the anterior abdominal wall at an intensity of 0.2-0.4 W / cm ² , on the anterolateral thigh surfaces at an intensity of 0.4-0.6 W / cm ² ) is explained by the fact that small doses of ultrasound therapy (0.1-0.4 W / cm ² ) activate capillary circulation, improve trophism, stimulate metabolic processes, and medium (0.5-0.7 W / cm ² ) have anti-inflammatory effects, as well as the fact that the border thermal action of ultrasound is 0.4-0.5 W / cm ² for continuous ultrasonic vibrations (those lovoe action arises as a result of transformation of mechanical energy into thermal and tissue temperature rises).

Common features with the prototype are:

- the use of peloid therapy on the patient's hips

Distinctive features are

- procedures are prescribed on the anterolateral thigh and anterior abdominal wall,

- alternation of application areas every other day,

- a combination of peloid therapy with ultrasound exposure (phonophoresis),

- as a peloid for applications, sulfide silt mud of the Melkavodnensky deposit is used, which is applied with a layer thickness of up to 10 mm at a temperature of 34-36 ° C,

- mud application is used as a contact medium when exposed to ultrasound at a frequency of 880 kHz in continuous mode

- the application area of the anterior abdominal wall is affected by ultrasound at an intensity of 0.2-0.4 W / cm ² for 5-10 minutes,

- on the anterolateral thigh surfaces are affected by ultrasound at an intensity of 0.4-0.6 W / cm ² for 6-8 minutes per thigh,

- after ultrasound exposure, the patient is covered with a hydrophobic tissue, a blanket and left for 10 minutes, a course of treatment of 10 procedures.

To substantiate the claimed invention in the clinic of the Research Institute of Medical Climatology and Rehabilitation (Vladivostok), clinical trials were conducted.

The study, on the basis of voluntary informed consent, included 65 patients with degree I obesity: 30 men and 35 women 24-73 years old (average age 55.7 ± 2.1). When making a diagnosis of obesity, they were guided by WHO guidelines (1998).

Patients were divided into 2 groups comparable in terms of clinical and functional characteristics. All patients followed the recommendations on diet and dosed physical activity.

In the 1st group (n = 30), the treatment included thin-layer applications of sulphide-silt mud on the abdomen and anterolateral thigh surface (according to the prototype).

In the 2nd group (n = 35), phonophoresis of sulfide silt mud was used according to the claimed method.

The method is as follows.

Sulphide silt mud of the Melkovodnensky deposit (TU 9318-001-10239943-2008) is applied with a brush to the area of the anterior abdominal wall and the anterolateral thighs to a thickness of mud layer up to 10 mm, temperature + 34 + 36 ° C. To prevent drying of the healing mud, the application area is wrapped with a hydrophobic tissue (or covered), a film or oilcloth can be used.

An ultrasound transducer is installed on the mud application area (the abdominal region and the anterolateral thigh surfaces alternate every other day), the apparatus is turned on (UZT-1.03f, UZT-105, etc.). Slowly move the emitter over the surface of the application area, maintaining good contact of the emitter with dirt, act with ultrasound at a frequency of 880 kHz: on the area of the front wall of the abdomen at an intensity of 0.2-0.4 W / cm ² , and on the anterolateral thigh surfaces (the area of one field - 250 cm ² ) at an intensity of 0.4-0.6 W / cm ² .

Continuous mode, labile technique, contact method. The duration of exposure on the abdomen is 5-10 minutes, on the hips 6-8 minutes on each thigh. Then wrap the patient with plastic wrap, a sheet and cover with a woolen blanket for 10 minutes. After the procedure, wash off the dirt with warm water, wipe the body, dress and rest for 30-40 minutes.

The procedures are performed daily, 5 times a week, in the morning, for a course of 10 procedures.

To control the dynamics in the patient's condition, the following indicators were selected:

- growth and weight: Ketle index (IR), waist circumference (OT), hip circumference (OB), OT / OB ratio; carbohydrate metabolism: glucose, insulin, HOMA index; lipid profile: triglycerides (TG), total cholesterol (OXS), high density cholesterol lipoproteins (HDL cholesterol), low density cholesterol lipoproteins (LDL cholesterol); Atherogenicity index (IA), which characterizes the ratio of atherogenic and anti-atherogenic lipid fractions, as well as hormones: adiponectin, as the most highly expressed transcript of adipose tissue, and leptin, which regulates the processes of fat deposition in adipose tissue, and the anti-inflammatory cytokine - TNF-α.

The results of a comparative analysis of the effectiveness of the treatment in patients are presented in the table. The analysis of the results indicates the effectiveness of the treatment in patients. The positive dynamics of objective data is proved, while the changes in patients receiving phonophoresis of the mud were more pronounced due to the action of ultrasound and the action of mud. So, the change in the ratio of the waist circumference to the circumference of the hips in the 2nd group decreased on average by 6.45%, and in the 1st only by 3.3%. In addition to the decrease in volumes, in the 2nd group the growth-weight indicator of IR significantly decreased (table).

Changes also affected carbohydrate metabolism. Conducting phonophoresis of dirt according to the method of the invention led to a significant decrease in insulin levels from 14.21 ± 0.69 µIU / ml to 11.09 ± 1.56 µIU / ml (p <0.05) and a significant factor in the progression of obesity (insulin resistance index) - NOMA index decreased by 1.5 times. While in the 1st group, the index of IR (insulin resistance) remained unchanged.

An analysis of laboratory parameters showed that after course treatment in the 2nd group, the content of serum cholesterol significantly decreased by 19% (p <0.001), LDL cholesterol by 42% (p <0.001) (table). The atherogenic index in these patients after the course of treatment significantly decreased by 43.5%. The level of HDL cholesterol significantly increased by 18% and reached target values (p <0.001). In the 1st group, changes in lipid metabolism are less pronounced.

As you know, a significant role in the progression of obesity belongs to cytokines, which are synthesized in adipose tissue. In obesity (in both groups), a decrease in the synthesis of adiponetkin by adipocytes is observed. Phonophoresis of sulphide silt mud at the sites of maximum deposition of adipose tissue contributed to a change in its content. The initially low concentration of adipokine in the 2nd group during treatment increased (table.). An increase in adiponectin can explain the decrease in plasma concentrations of LDL cholesterol (table), as well as a decrease in waist and hips, since adiponectin reduces adipocyte hypertrophy.

Changes also affected leptin levels. Its initially high level in both groups is associated with an increase in the mass of adipose tissue in the body and with an increased size of adipocytes. The combined effect of two factors (ultrasound and sulphide silt mud) contributed to a significant decrease in leptin levels by 41%. In both groups, a decrease in the level of proinflammatory cytokine TNF-α is noted, moreover in the 2nd group.

Table The dynamics of clinical and laboratory parameters in patients with obesity during treatment Indicator 1st group receiving mud applications (n = 35) 2nd group receiving phonophoresis of mud (n = 30) Ketle index, kg / m ²

$$\frac{33.34\pm 0.68}{33.04\pm 0.70}$$

$$\frac{\mathrm{32,45}\pm 0.43}{31.05\pm 0.32*}$$

Waist circumference, cm $$\frac{102.27\pm 1.30}{98.73\pm 1.05*}$$

$$\frac{103.66\pm \mathrm{1,03}}{97.41\pm 1.24***}$$

Thigh circumference, cm $$\frac{113.27\pm 1.48}{109.07\pm 1.23*}$$

$$\frac{113.68\pm 1.01}{107.11\pm 1.21**}$$

OT / V ratio $$\frac{0.92\pm 0.04}{0.89\pm 0.01*}$$

$$\frac{0.93\pm 0.02}{0.87\pm 0.01***}$$

Glucose, mmol / L $$\frac{5.74\pm 0.16}{5.66\pm 0.17}$$

$$\frac{6.08\pm 0.21}{5.31\pm 0.20*}$$

Insulin, µIU / ml $$\frac{13.29\pm \mathrm{1,67}}{15.22\pm 1.81}$$

$$\frac{14.21\pm 0.69}{11.09\pm \mathrm{1,56}*}$$

HOMA Index $$\frac{3.35\pm 0.40}{3.79\pm 0.48}$$

$$\frac{4.34\pm 0.4}{\mathrm{2,8}\pm 0.13**}$$

OHS, mmol / l $$\frac{5.25\pm 0.08}{4.95\pm 0.09*}$$

$$\frac{5.79\pm 0.06}{4.66\pm 0.15***}$$

TG, mmol / l $$\frac{\mathrm{1,5}\pm 0.15}{1.36\pm 0.13}$$

$$\frac{1.44\pm 0.13}{\mathrm{1,02}\pm 0.09*}$$

HDL cholesterol, mmol / l $$\frac{1.14\pm 0.01}{1.26\pm 0.06*}$$

$$\frac{1.05\pm 0.05}{1.24\pm 0.05***}$$

LDL cholesterol, mmol / l $$\frac{3.6\pm 0.16}{\mathrm{3,1}\pm 0.14*}$$

$$\frac{4.00\pm 0.06}{2.95\pm 0.17***}$$

IA, cu $$\frac{4.35\pm 0.09}{\mathrm{3,5}\pm 0.3**}$$

$$\frac{4.05\pm 0.27}{2.29\pm 0.19***}$$

Adiponectin, mcg / ml $$\frac{11.06\pm 1.91}{10.26\pm 1.44}$$

$$\frac{10.04\pm 1.12}{13.87\pm \mathrm{1,02}*}$$

Leptin, mcg / ml $$\frac{35.48\pm 3.01}{32.26\pm \mathrm{3,55}}$$

$$\frac{37.13\pm 3.24}{21.87\pm 3.41**}$$

TNF-α, μg / ml $$\frac{26.02\pm \mathrm{2,37}}{18.54\pm 2.17*}$$

$$\frac{27.10\pm 2.11}{16.81\pm 2.41**}$$

Note: the significance of differences in the average values of indicators compared with the data before treatment: * - p <0.05; ** - p <0.01; *** - p <0.001

The results of the study indicate that the use of the method of treatment of patients with obesity of the first degree allows not only to normalize the clinical manifestations of obesity, lipid and carbohydrate metabolism, but also have a significant effect on secreted peptide factors of adipose tissue, which play a leading role in the progression of obesity and insulin resistance.

The essence of the claimed invention is illustrated by clinical examples.

Example 1. Patient K., 51 years old, lives in Vladivostok. I was treated at the Clinic of the Research Institute of MKVL from 06/16/2010 to 08/08/2010 with a diagnosis of Abdominal obesity. Hypertension I tbsp., Arterial hypertension 2 tbsp., Risk 2 tbsp. (obesity, dyslipidemia). CHF 0.

Upon admission, she complained of overweight, periodically arising severe headaches in the occipital region, dizziness.

Objective research data at the time of admission: proper physique, increased nutrition (weight 79 kg with height 160 cm, Ketle index 30.86, OT-104 cm, OB-110 cm, OT / OB-0.95). HELL 140/80 mm Hg No swelling.

Additional study data:

Blood chemistry:

Glucose 6.4 mmol / L, Insulin 15 µIU / ml, HOMA 4.27 Index, Total Cholesterol 6.1 mmol / L, Triglycerides 0.68 mmol / L, High Density Cholesterol 1.1 mmol / L, Atherogenicity Index 4.55, low density lipoprotein cholesterol 4.69 mmol / L, adiponectin 9.02 μg / ml, leptin 38.7 μg / ml, TNF-α 26.1 μg / ml.

From the second day of her stay in the clinic, the patient received peloid therapy in combination with ultrasound exposure according to the developed technique.

As a result of the treatment, by the 21st day the patient's condition improved significantly: weight decreased (IR 29.8 kg / m), the OT / OB ratio of 0.88 decreased, headaches, dizziness disappeared, blood pressure stabilized at 125/75 mm Hg. Art.

Upon repeated investigation, the following data were obtained:

Blood chemistry:

Glucose 5.2 mmol / L, Insulin 7.9 µIU / ml, NOMA index 1.83, Total cholesterol 5.33 mmol / L, triglycerides 1.36 mmol / L, high density lipoprotein cholesterol 1.5 mmol / L, atherogenicity index 2.55, low density lipoprotein cholesterol 3.21 mmol / L, adiponectin 11.52 μg / ml, leptin 28.1 μg / ml, TNF-α 17.2 μg / ml.

Thus, the use of the recommended technique showed a significant improvement in both anthropometric and biochemical parameters.

After three months after treatment, an additional examination of the patient was carried out. It was found that the control indicators corresponded to those obtained during the second study, there was no recurrence of obesity.

Example 2. Patient K., 32 years old, lives in the village of Chernigovka, Primorsky Territory. He was treated at the Clinic of the Research Institute of MKVL from 08/08/2010 to 08/08/2010 with a diagnosis of Abdominal obesity. Hypertension I tbsp., Arterial hypertension 2 tbsp., Risk 1 tbsp. (dyslipidemia). CHF 0.

Upon receipt complained of excess weight, noise in the head.

Objective research data at the time of admission: weight 115 kg with an increase of 190 cm, Quetelet index 32.05, OT-110, OB-108, OT / OB -1.01). HELL 140/90 mm Hg No swelling.

Additional study data:

Glucose 7.4 mmol / L, Insulin 17.9 µIU / ml, NOMA index 5.89, Total cholesterol 6.9 mmol / L, triglycerides 1.01 mmol / L, high density lipoprotein cholesterol 1.45 mmol / L, atherogenic index 4.99, low-density lipoprotein cholesterol 3.76 mmol / L, adiponectin 9.45 μg / ml, leptin 38.8 μg / ml, TNF-α 25.3 μg / ml.

From the second day of his stay in the clinic, in order to correct metabolic disorders, the patient received treatment according to the developed technique.

As a result of the treatment, by the 21st day the patient's condition improved significantly: weight decreased to 109 kg, IR 30.45 kg / m ² , OT-106 cm, OB-108 cm, OT / OB-0.96.

In a second study, the following data were obtained: Glucose 6.2 mmol / L, Insulin 11 µIU / ml, NOMA index 3.03, Total cholesterol 5.9 mmol / L, triglycerides 0.99 mmol / L, high density lipoprotein cholesterol 1, 63 mmol / L, atherogenicity index 2.62, low density lipoprotein cholesterol 3.82 mmol / L, adiponectin 11.8 μg / ml, leptin 24.9 μg / ml, TNF-α 13.4 μg / ml.

After three months after treatment, an additional examination of the patient was carried out. It was found that the control indicators corresponded to those that were obtained during the second study.

The second example also confirms the high efficiency of the method according to the invention.

Literature

1. Obesity. Etiology, Pathogenesis, Clinical Aspects: A Guide for Physicians / Ed. I.I. Dedova, G.A. Melnichenko. - M.: Medical News Agency, 2004. - 285 p.

2. Chubrieva S.Yu. Glukhov N.V., Zaychik A.M. Adipose tissue as an endocrine regulator (literature review) // Vestn. SPb. un-that. - 2008. Cep. 11. Issue 1. - S. 32-43.

3. Natural healing factors. Fundamentals of balneology: a Guide / ed. EAT. Ivanova, M.V. Antonyuk. - Vladivostok: Publishing house Dalnevost. University, 2007 .-- 311 p.

4. Kholopov A.P., Shashel V.A., Perov Yu.M., Nastenko V.P. Mud therapy. - Krasnodar: Periodicals of the Kuban, 2002 .-- 305 p.

5. Physiotherapy and balneology / ed. V.M. Bogolyubov. - Book II. - M .: Publishing house BINOM, 2008. - 415 p.

6. Schwartz V. Adiponectin: Pathophysiological aspects // Pathologich. physiology and experiment. therapy. - 2009. - No. 3. - S. 34-38.

7. Weisberg S.P. McCann D., Desai M. et al. Obesity is associated with macrophage accumulation in adipose tissue // J. Clin. Invest. - 2003. Vol. 112. - P.1796-1808.

8. Pat. No. 2203112 Ru, Method for integrated photocorrection of weight / Zharov V.P. - Publ. 04/27/2003

9. Tsarfis P.G., Kiselev V.B. Therapeutic mud and other natural coolants. -M., 1990.

10. Kiryanova V.V. Physiotherapy for obese patients // Physiotherapy, Balneology and Rehabilitation. - 2007. - No. 5. - S. 38-47.

11. Pat. No. 2321386 Ru, A method for the treatment of patients with diabetes mellitus with angiopathies using peloids. / Botvineva L.A., Kesidi E.G., Krashenitsa G.M. and other Kondratov A.N. - Publ. 07/26/2006.

12. Mud treatment with tambukan silt mud: method, recommendations / Yu.A. Rodin, A.A. Ushakov. - Heads. military man. the clinic. hospital to them. Acad. N.N. Burdenko. - M.: GVKG im. N.N. Burdenko, 2004 .-- 33 p.

Claims (1)

A method of treating obesity, including peloid therapy to the patient’s hips, characterized in that the procedures are prescribed on the anterolateral thighs and the anterior abdominal wall, alternating application areas every other day, and combining peloid therapy with ultrasound, while sulfide is used as a peloid for applications silt mud of the Melkovodnensky deposit, which is applied with a layer thickness of up to 10 mm at a temperature of 34-36 ° C, then using the mud application as a contact medium, is affected azvukom frequency of 880 kHz in a continuous mode of application area of the abdominal wall at an intensity of 0.2-0.4 W / cm ² for 5-10 minutes, and anterolateral thigh surface at an intensity of 0.4-0.6 W / cm ² 6-8 minutes on each thigh, after ultrasound exposure, the patient is covered with hydrophobic tissue, a blanket and left for 10 minutes, the course of treatment is 10 procedures.