RU2638683C2 - Method for treatment of hypoplastic anemia with application of laser radiation of infrared diode laser - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: laser radiation of an infrared diode laser is applied to spongy bones: on the projections: sternum - 3 minutes, ilium - 2 minutes each, sacral spine vertebrae - 2 minutes, vertebrae of the remaining parts of the spine - 1-3 minutes. The exposure is provided from a distance of 0.3-0.5 cm from the skin surface, moving the light guide in a zigzag manner in the scanning mode. Laser radiation with a wavelength of 970-980 nm is used. Depending on the subcutaneous fat thickness, the laser recovery power from 0.5 to 5 W is used. The number of sessions is 1 to 5.

EFFECT: stimulation of proliferation and differentiation of red blood cell precursors, accelerated erythropoiesis in the hematopoietic tissues and an increase in the yield of red blood cells in the blood.

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Description

The invention relates to medicine, namely to hematology, and can be used to treat anemia, in particular hypoplastic anemia.

Anemia syndrome is observed in various diseases. The most favorable in terms of prognosis are iron deficiency and posthemorrhagic anemia. They are treated with diet therapy, the appointment of iron and vitamin preparations. Primary hypoplastic and aplastic anemia, anemia in radiation sickness, and secondary myelodepression while taking cytostatics in the treatment of cancer are difficult to treat. The causes of the development of anemic syndrome in these diseases are usually associated with a violation of erythropoiesis at the bone marrow level. Inadequate formation of erythroblastic progenitor cells, starting from stem cells and ending with reticulocytes, disruption of the processes of migration of red blood cell cells into the blood lead to a decrease in the quantitative characteristics of the peripheral blood erythroid unit and such qualitative indicators as the hemoglobin content.

The treatment of patients with anemia due to myelodysplastic syndrome is still an unresolved problem.

Erythroid aplasia (damage to only the erythroid germ) is often combined with lesions of leukemia and thrombocytopoiesis. The method of choice in such cases is allogeneic bone marrow transplantation. Survival after this for 5 years is achieved in 70-80% of patients. But transplantation gives good results in young patients, is performed in patients no older than 55-60 years old in the absence of severe visceral pathology, and is complicated by the search for a bone marrow donor compatible with the patient by the characteristics of cell typing, which significantly narrows the possibilities of such treatment. The main disadvantage of this method of treating anemia is the limited applicability, multicomponent and difficult to perform.

In this case, the pathogenetic therapeutic agent is finding methods to stimulate the production of erythropoiesis progenitor cells in the red bone marrow, i.e., activation of bone marrow hematopoiesis.

Beta-adrenoblockers of non-cardioselective action (see patent RU No. 2061475), Scutellaria baicalensis extract (see patent RU No. 2052992) are used as hemopoietic stimulants for hypoplastic bone marrow conditions. To enhance hematopoiesis, thymic polypeptides are used (see patent RU No. 2320354).

In the treatment of hematopoiesis disorders associated with a chromosome defect, the introduction of fragmented DNA into the body is used (see patent RU No. 2322264).

All of the listed drugs are not specific enough, have a weak stimulating effect, in addition to affecting the bone marrow, cause an imbalance in other body systems, such as cardiovascular and immune, against the background of activation of leukopoiesis can lead to inhibition of red blood cell bone marrow. In addition, the known methods include a long course of treatment (from 2-3 weeks to 2-3 months).

A known method of treating anemia of various origins (a method of stimulating hematopoiesis), including a single laser osteoperforation simultaneously on both sides with an infrared diode laser of the red bone marrow of large flat and cancellous bones, as well as epiphyses of large tubular bones. Use an infrared diode laser in a pulse-periodic mode 100 × 50 with a power of 25 W and a wavelength of 970 nm. Processing is performed for 2-3 seconds at 3-5 points for each pineal gland at a distance of 1.0-1.5 cm. This method is used to treat animals, and all parameters were obtained during the experiments (see patent RU No. 2290231, M.cl. A61N 5/067; A61N 5/06; A61P 7/00, published on December 27, 2006).

The purpose of this known method is to develop a method of stimulating the functions of the red brain in animals - stimulating bone marrow hematopoiesis.

However, the known method negatively affects the condition of the animals in the first two days: a depressed state, a decrease in appetite, an increase in body temperature. In animals on the third day there is a sharp increase in the content of leukocytes (47.2%), which is associated with an inflammatory reaction in places of perforations.

A known method of treating anemia of various origins, selected as the closest analogue, including a single laser osteoperforation of large flat cancellous bones: sternum, scapula, iliac and metaepiphyses of large tubular bones: collarbones, humerus, radial, ulnar, femoral, tibial two sides infrared diode laser with red bone marrow irradiation, while processing is performed for 3-5 s at 3-6 points of each metaepiphysis and each of the flat spongy bones at a distance of 1.5-2.0 cm apart from each other in a pulse-periodic mode of 150 × 50 μs, with an average power of 15-30 W and a peak power of 32-40 W, while the wavelength is 810-940 nm (see patent RU No. 2387404, M.cl. A61B 18/20, publ. 04/27/2010).

The task to which the known method is directed is to reduce the treatment time and reduce the recurrence of the disease during stimulation of bone marrow hematopoiesis in the treatment of patients with certain types of anemia of non-oncological origin.

However, as the authors of this known method themselves indicate, the positive effect of laser osteoperforation without the use of other stimulating hematopoiesis drugs lasts, depending on the type of anemia, from 1.5, 2 and 9 months. Thus, the known method does not provide a sufficient reduction in the risk of relapse of the disease.

In addition, the known method is performed surgically using general anesthesia under stationary conditions of the operating room, it requires additional monitoring of the condition of wounds on the skin and anesthesia in the postoperative period, since pain in the laser irradiation area persists after it is performed for at least 2 days.

Thus, the technical result, the solution of which the claimed method is directed, is to develop a method for the treatment of non-traumatic hypoplastic anemia, performed on an outpatient basis, painless and providing a long-term positive effect without relapse.

The claimed technical result is achieved in that a method of treating hypoplastic anemia using laser radiation from an infrared diode laser, including the action on the spongy bones, according to the invention, effect on the projection: sternum - for 3 minutes, ilium - 2 minutes each, sacral vertebrae spine - within 2 minutes, the vertebrae of the remaining parts of the spine - within 1-3 minutes, the effect is carried out from a distance of 0.3-0.5 cm from the surface of the skin, moving lights However, it is zigzagged in the scanning mode using laser radiation with a wavelength of 970-980 nm and, depending on the thickness of the subcutaneous fat, use laser healing power from 0.5 to 5 W, and the number of sessions in this case is from 1 to 5.

The authors of the proposed method experimentally found that it is the implementation of 1-5-fold laser exposure from the surface of the skin on the projection of the spongy bones: sternum, vertebrae, ilium with irradiation of the areas of the red bone marrow, the irradiation of the red bone marrow in the sternum is carried out during 3 minutes, the ilium for 2 minutes each, the sacral spine for 2 minutes, the rest of the spine for 1-3 minutes, irradiation from a distance of 0.3-0.5 m from the surface of the skin by moving the waveguide in a zigzag scanning mode and using laser light of a wavelength of 970-980 nm, depending on the thickness of subcutaneous fat, the power of radiation from 0.5 to 5 W, allows to achieve the claimed technical result.

Since, according to modern views, hypoplastic anemia is a bone marrow disease, which is manifested by its inability to produce red blood cells, the applicant experimentally established that it was the laser modes he claimed in the invention that stimulate the proliferation and differentiation of red blood cell progenitor cells, thereby leading to to accelerated erythropoiesis in the blood-forming tissues and to an increase in the release of red blood cells into the blood.

Other modes of laser radiation either do not cause stimulation of the red blood cell of the red bone marrow, or, conversely, inhibit it.

The method is simple, does not require the patient to be in the hospital, painless. In addition, the period of remission after treatment is from 6 to 15 months.

The inventive method is as follows.

In the position of the patient on the back with zigzag scanning movements, the radiation of a diode laser with a power of 970-980 nm and a power of 0.5 to 5 W is applied:

- in the supine position on the sternum for 3 minutes;

- in the supine position on the right side, a laser with a power of 0.5-5 W is applied to the area of the left ilium for 2 minutes;

- in the supine position on the left side, a laser with a power of 0.5-5 W is applied to the area of the right ilium for 2 minutes;

- in the position of the patient lying on his stomach - exposure to a laser with a power of 0.5-5 W on the region of the sacral spine for 2 minutes and on the remaining parts of the spine - for 1 minute, the light guide is located at a distance of 0.3-0.5 cm from skin surface. Sessions are held daily. The procedure is performed on an outpatient basis in departments equipped with laser systems of the appropriate type. A doctor who monitors anemic patients issues a referral for treatment - therapist, hematologist, chemotherapist ..

Examples of the method.

Example 1. Patient G., 36 years old. Diagnosis: Dynastic anemia with pancytopenia and moderate hemorrhagic syndrome.

Complete blood count at the time of admission: hemoglobin 85 g / l, red blood cells 2.9 × 10 ¹² / l, reticulocytes 2%, white blood cells 3.8 × 10 ⁹ / l, platelets 56 × 10 ⁹ / l,

5 laser therapy sessions were performed.

In the position of the patient on the back with a zigzag scanning movement, a 9 W nm laser with a power of 2 W was applied to the sternum area (moderately fatty tissue) for 3 minutes, while lying on the right side was exposed to radiation from a 5 W diode laser (fatty tissue strongly expressed) - on the area of the left iliac bone for 2 minutes, in the supine position on the left side, a 5 W laser was applied (fatty tissue is strongly expressed) - on the area of the right iliac bone for 2 minutes, in the position of pain oh pronation - laser exposure 5 watts and sacral spine region (fatty tissue is highly expressed) for 2 minutes and the remaining parts of the spine - within 1 minute (moderately expressed in adipose tissue). The light guide was located at a distance of 0.5 cm from the surface of the skin. Senas spent daily on an outpatient basis.

Blood test at the time of discharge: Hemoglobin 105 g / l, red blood cells 3.4 × 10 ¹² / l, reticulocytes 6%, white blood cells 5.8 × 10 ⁹ / l, platelets 100 × 10 ⁹ / l. The duration of remission is 6 months.

Example 2. Patient E., 58 years old. Diagnosis: Erythroid aplasia of mild severity.

Complete blood count at the time of admission: Hemoglobin 105 g / l, red blood cells 3.0 × 10 ¹² / l, reticulocytes 1%, white blood cells 6.8 × 10 ⁹ / l, platelets 350 × 10 ⁹ / l,

1 session completed

In the position of the patient on the back, zigzag scanning movements were performed by radiation of a 970 nm diode laser with a power of 0.5 W on the sternum (fatty tissue is weakly expressed) for 3 minutes, while lying on the right side was exposed to a 2 Watt laser (moderately fatty tissue expressed) - on the area of the left iliac bone for 2 minutes, in the supine position on the left side, a 2 W laser was applied (moderately fatty tissue) - on the area of the right iliac bone for 2 minutes, lying on top e - laser exposure at 2 watts region sacral spine 2 minutes, and the remaining parts of the spine - 3 minutes (adipose tissue moderately expressed), the light guide was located at a distance of 0.3 cm from the skin surface.

General blood test at the time of discharge: Hemoglobin 120 g / l. erythrocytes 3.5 × 10 ¹² / L, reticulocytes 12%, white blood cells 7.1 × 10 ⁹ / L, platelets 345 × 10 ⁹ / L. The duration of remission is 15 months.

Example 3. Patient C., 76 years. Diagnosis: Mild hypoplastic anemia (with chemotherapy).

Complete blood count at the time of admission: Hemoglobin 95 g / l, erythrocytes 3.2 × 10 ¹² / l, reticulocytes 2%, leukocytes 5.8 × 10 ⁹ / l, platelets 125 × 10 ⁹ / l.

3 sessions held

In the patient’s position on the back with a zigzag scanning movement, a 5 W laser with a power of 5 W was applied to the sternum region (fatty tissue is strongly expressed) for 3 minutes, while in a lying position on the right side, a 3 W laser was applied (fatty tissue is strongly expressed) - on the area of the left iliac bone for 2 minutes, while lying on the left side, a 3 W laser was applied (fatty tissue is strongly expressed) - for the area of the right iliac bone for 3 minutes, in the position of the patient lying on his stomach - a laser with a power of 2 W on the region of the sacral spine (adipose tissue is strongly expressed) for 2 minutes, and on the remaining parts of the spine for 1 minute (adipose tissue is moderate), the light guide was located at a distance of 0.3 cm from the skin surface. Sessions were conducted daily.

Complete blood count at the time of discharge: Hemoglobin 110 g / l, red blood cells 3.9 × 10 ¹² / l, reticulocytes 20%, white blood cells 6.9 × 10 ⁹ / l, platelets 155 × 10 ⁹ / l. The duration of remission is 12 months.

Claims (1)

A method for the treatment of hypoplastic anemia using laser radiation from an infrared diode laser, including the action on the spongy bones, characterized in that they act on the projection: sternum - for 3 minutes, ilium - 2 minutes each, vertebrae of the sacral spine - during 2 minutes, the vertebrae of the remaining parts of the spine - within 1-3 minutes, the effect is carried out from a distance of 0.3-0.5 cm from the skin surface, moving the light guide in a zigzag fashion in scanning mode using a laser The radiation with a wavelength of 970–980 nm and, depending on the thickness of the subcutaneous fat, use laser healing power from 0.5 to 5 W, and the number of sessions in this case is from 1 to 5.