SU764657A1 - Method of differential diagnosis of inflammatory and distrophic diseases of joints - Google Patents

Description

The same hand is attached to the second hapy electrodes of chlorinated silver 25x10 mm in size, which are connected to a skin galvanic reflex recorder (GSR). A thin layer of electrically conductive paste is also applied to the inner surface of these electrodes. First, the voltage of an electrical stimulus is determined at which GSR occurs. For this, the forearm, through the electrodes, is subjected to an annoying electrical impulse, which is permanently long, from the electronic pulsed stimulator through the electrodes. ti 1 sec with a gap-time between them 1 min. The amplitude of the pulses, starting from 2.5 V (i.e., from such an amplitude which usually cannot cause GSR), is gradually increased every 2.5 V until the onset of the GSR, i.e. Before a change in the electrical c-resistance of the skin under study, which is indicated by the GSR recorder, the amplitude of the voltage of the irritating pulse in the onset of the GSR is determined by the attenuator of the electronic pulse stimulator. Next, the duration of the electrical stimulus is determined at which GSR occurs. By test 3: irritating pulses of constant amplitude, emitted from an electronic pulsed stimulator, are emitted equal to twice the magnitude of the irritating pulse, the duration of which was 1 sec, registered at the onset of GSR. The duration of the pulses, starting from 0.01-10 seconds (. With such a duration, which usually can not cause GSR), gradually increases after 0.002: until the appearance of the RSR -, On the occurrence of the RSR, the court of the RSR registrar, and the duration of the annoying pulse at the time of occurrence of GSR is determined by the scale of the electronic pulse stimulator. The obtained quantitative data on the voltage and duration of the electrical stimulus, the GPI of which GSH occurs, are used for the differential diagnosis of inflammatory and dystrophic joint diseases. The occurrence of GSR under the stress of irritating impulses within 12–14 ,, In a duration of 0.037–10–0.047, an inflammatory disease of the joints is judged (rheumatoid arthritis, infectious allergic polyatritis, rheumatism in the inactive phase with heart disease and polyarthralgia treatment of lower intensity - mineral chloride sodium baths of average mineralization. (-7g / 15 yi ,. every other day, a total of 10 treatments,) local applications of peat mud (, 2b min, every other day, just a course. treatment 10), massage the limbs. On the occurrence of GSR with the stress of irritating pulses from 15 to 17: 8 and duration from 0.069-10 to 0.91 10 seconds, dystrophic arrest of the joints (deforming osteoarthrosis, dystrophic benign polyarthritis) is determined, and a higher intensity balneological treatment is prescribed - mineral sodium chloride baths of high mineralization (30 g / l with bromine 0.057 g / l C ° C, 15 minutes, every other day, for a total of 10 treatments), local applications of peat mud, physical therapy. In ballistic inflammatory diseases of the joints, electrical irritability of the vegetative nervous system is 1.2 times less constant current than in patients with dystrophic diseases, and the rate of occurrence of the vegetative reaction (GSR) is 2 times greater. The data obtained by this method clearly distinguish inflammatory patients from patients with dystrophic diseases of the joints, i.e., perform differential diagnostics and thus improve the treatment efficiency (for patients with increased reactivity of the autonomic nervous system, to appoint weaker balneotherapy and therapeutic procedures intense). Example, Sick (39 years) is directed with a diagnosis of chronic polyarthritis. Sick about 4 years. The disease began gradually, for no apparent reason. At first, she felt slight transient pains in the knee and shoulder joints, especially at night, after half a year the ball caught a cold and. in joints intensified. Several times she had a fever. From this time, it began to be treated (reopirin, joint rubbing with various ointments, paraffin application). For a while, there was a slight improvement. However, during a change in the weather, fatigue, pain in the joints, especially in the knees, increases. Outpatient treatment does not help, knee joints began to swell. Swelling appears suddenly and after a few weeks, a week goes by. In childhood, viacTu had a sore throat. An objective examination - sick of medium height, the right physique; Pulse 88 beats / min, rhythmic. Heart sounds are sleepy, no noise is defined. Blood pressure 135/85 imnHg. Other internal organs are also without visible pathological changes. Patel reflexes of normal size. On palpation and pericusium, the shoulder and knee joints are painful. In the knee joints, the average crepitus is somewhat swollen,

the amplitude of active movements due to painfulness is much reduced. The strength of the upper and lower limbs is slightly reduced. ENT physician consultation - chronic tonsillitis,

Aneshiz blood: HB 14,5; leukocytes 4600, ROE 12 mm / hour, C-reactive protein - negative. On X-ray images of the knee and teschelic joints, no pathological changes were found.

The patient was diagnosed according to the proposed method, QAG appeared, with a voltage of an electrical distributor of 12.5 V, and a duration of 0.046-10 sec.

On the basis of these data and general clinical examination, the patient was diagnosed with allergic infectious polyarthritis (inflammatory disease of the joints). Assigned balneological treatment of lower intensity, i.e. chloride baths of average mineralization- (7 g / l, 15 min per day, total for a course of treatment 10), local applications of peat mud (, 20 min, every other day, total for a course of treatment 10) on the knee and shoulder joints , massage of the upper and lower extremities.

After treatment, CAG appeared with a 10 V stimulus amplitude and a stimulus duration of 0.034–10 sec. The obtained dynamics of the data on the assessment of the degree of reactivity of the organism indicates that the treatment carried out has a stimulating effect on the autonomic nervous system, which is of great importance in the processes of sanogenesis and to a certain extent determines the therapeutic effect of therapeutic physical factors.

The patient was discharged from the sanatorium with significant clinical improvement.

Long-term results of treatment of the patient are good: for 6. months. After the spa and balneotherapy treatment, I did not feel any pain in the joints.

The proposed method allows to significantly improve the accuracy of differential diagnosis and thereby the effectiveness of treatment.

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Claims (1)

Invention Formula The method of differential diagnosis of inflammatory and dystrophic diseases of the joints by conducting a general clinical examination, characterized in that, in order to improve the accuracy of diagnosis, tics impose two Electrodes on the last phalanges of the third and fourth fingers of the right hand and two electrodes an electrical stimulus is applied to the right forearm of the examined, to the right forearm and gradually: its voltage is increased until the appearance of the galvanic skin reflex recorded from the electrodes on the fingers of the hand, fixed when the galvanic reflex appears, the magnitude of the voltage of the electrical stimulus is then doubled then the voltage gradually increases - the duration of the stimulus and fix this duration with repeated occurrence of the xznogalvanic reflex and the magnitude of the voltage and: duration electrical stimuli differentiate. nature of the disease. Sources of information taken into account in the examination 1. M. Astapenko, and Pihpak E, G., Diseases of the joints, M., 1966, p. 31-52,