RU2098072C1 - Method for treating rheumatoid arthritis patients - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves treating three symmetric acupuncture points of general kind of influence and the joint that is injured most of all, with 3000 Hz frequency laser radiation during 32 s exposure time. The treatment is to be carried out daily. The whole course is 8-10 procedures long. EFFECT: enhanced effectiveness of treatment; prolonged remission period. 2 tbl

Description

 The invention relates to medicine, namely to the field of rheumatology.

 A method of treating patients with rheumatoid arthritis of the RA using low-intensity laser radiation is invented. In this method, a pulse frequency of 1500 Hz was used, and the exposure was from 10 to 40 s. Irradiation was performed locally, on the day no more than 4 joints irradiated from 3 sides, and the course of treatment ranged from 16 to 30 procedures, i.e. long course of treatment (Collection of scientific works. Edited by A.R. Evstigneev, A.K. Polonsky. Issue No. 2, 1988. "The use of semiconductor lasers and LEDs in biomedicine and medical instrumentation." S.Yu. Leshakov and others. "Experience in the treatment of patients with rheumatoid arthritis using a pulsed laser device").

 The essence of the invention lies in the fact that they are affected by low-intensity laser radiation on 3 acupuncture symmetric points of general action and one of the most affected joint. Exposure is at a frequency of 3000 Hz, lasting 32 s. The course is prescribed 8-10 procedures.

 The method is as follows. The course of treatment is 24 days. The treatment complex includes dietary nutrition, carbon dioxide and hydrogen baths in the amount of 8-10 procedures, therapeutic massage and exercise therapy.

Laser irradiation procedures are carried out according to the following scheme:
I day T 20, VB ₂₄ , E ₃₆ and the affected joint;
II day TR ₅ , VB ₃₄ , 9V ₄ and the affected joint;
III day TR ₅ , VB ₃₄ , VB ₂₀ and the affected joint;
IV day E ₃₆ , V ₆₀ , V ₄₀ and the affected joint,
then irradiation is repeated according to the indicated order, for a total of 8-10 procedures per treatment course.

 The method is illustrated by the following examples.

 Observation 1. Patient Zotova L.N. 28 years, duration of treatment 25.1 17.06.93. DZ rheumatoid arthritis, Art. 1, act. 1, NSF 0 1 Art. seropositive. Complaints of pain in the wrist, knee and elbow joints, stiffness in the morning up to 30-40 minutes. Sick for 6 years. The onset of the disease after a sore throat. Repeated treatment in a hospital with antirheumatic drugs.

About: HB 116 g / m L 65 • 10 ⁴ , ESR 28 mm / h. rheumatoid factor positive reaction, "C" react. ⁺⁺ , sialic tests 0.220, gamma globulins 25.5 g / l.

 Joints of the hands and wrist pronounced proliferative changes, pain on palpation, slightly limited movement.

 When irradiated by the proposed method, but with an exposure of 16 s, the pain slightly decreased after the procedure, but after 1.5-2 hours after laser therapy they resumed with the same intensity. Laboratory data without dynamics.

 Observation 2. Patient Salimova T.A. 26 years old, treatment term 7.06.93 - 30.06.93. DZ rheumatoid arthritis, Art. 1, act. 1, NSF 0-1 Art. Complaints of pain in the hands, wrist joints and elbows, stiffness for 30-40 minutes, pain even at rest. The patient considers himself for 5 years, when after sore throat appeared redness, pain and swelling in the wrist joints and small joints of the hands. Repeatedly treated in a hospital, diagnosed with rheumatoid arthritis, was observed at the Institute of Rheumatology, received anti-rheumatic drugs.

About-but: HB 114 g / l, L 4800 • 10 ⁴ , ESR 29 mm / h, rheumatoid factor is positive, "C" react. ⁺ , sialic tests 0.210, gamma globulins 24.5 g / l. In the miniflange joints and wrist, proliferative changes, soreness on palpation, expressed slightly limited movement. When irradiated for 32 s after the second session, the pain decreased, the effect persisted for a day, i.e. before the next procedure, proliferative changes decreased, stiffness disappeared, ESR decreased to 12 mm / h, gamma globulins to 19 g / l, "C" react, neg. An increase in exposure to 64 s caused side effects in the form of dizziness, nausea. This is illustrated by observation 3.

 Patient A. Selezneva 26 years old, and.b. 174, the term of treatment is 9.07. 07/28/93. Rheumatoid arthritis, Art. 1, act. 1, NSF 0 1 Art. Complaints of pain in the joints of the hands, stiffness, proliferative changes in the joints of the fingers and wrist.

About: HB 108 g / l, L 6.8 • 10 ⁴ , ESR 20 mm / h, positive rheumatoid factor, sialic tests 0.200, gamma globulins 25.5 g / l, "C" reactive protein ⁺ . Proliferative phenomena in the wrist joints, pain on palpation are expressed.

 After two procedures at exposure of 64 s, the patient developed weakness, dizziness, and nausea. In connection with this circumstance, the patient was transferred to an exposition of 32 s and she completed the treatment with improvement; pains passed, stiffness does not bother, proliferative phenomena disappeared, ESR decreased to 12 mm / h, gamma globulins to 18.7 g / l, "C" react. negatively.

 In the proposed methodology, we also changed the frequency compared with the prototype (1500 in the prototype and 3000 Hz the maximum frequency in the apparatus "Pattern", which was used by us, since the higher the frequency, the more pronounced analgesic effect).

 The indicated position is explained by the following observations. Observation 1. Patient Galiev G.I. 26 years old 268, the term of treatment is 19.10. 11.11.92. DZ rheumatoid arthritis 1, act. 1, NSF 0-1 Art. Complaints of joint pain, stiffness, the presence of proliferative phenomena. Sick for 4-5 years, when after exacerbation of chronic tonsillitis swollen and reddened wrist joint, then fingers and knee joints. The diagnosis was made immediately, was observed at the Institute of Rheumatology, where he received anti-rheumatic drugs.

Objectively: HB 112 g / l, L 62 • 10 ⁴ , ESR 20 mm / h, gamma globulins 25.5 g / l, positive rheumatoid factor, sialic acids 0.220, “C” react. ⁺ , proliferative phenomena are expressed in the wrist and knee joints, movements in them and palpation are painful.

At a frequency of 1500 Hz used during irradiation, the pain decreased, but did not disappear completely, and proliferative changes lasted until the 8th procedure, after which they slightly decreased, but did not normalize, stiffness remained, ESR decreased to 17 mm / h, gamma globulins up to 20 g / l, "C" reactive ⁺
Observation 2. Patient Aleshin L. I., 28 years old, and. 245, the term of treatment is from 27.09. 10.20.93. DZ rheumatoid arthritis 1, act. 1, NSF 0 1 Art. Complaints of joint pain, stiffness, proliferative effects in the joints of the hands and knee joints.

Objectively: HB 116 g / l. L 45 • 10 ⁴ , "C" reactive protein ⁺⁺ , gamma globulins 26.1 g / l, rheumatoid factor positive. Proliferative phenomena in miniphalangeal, knee and wrist joints are expressed, movements in them are painful, palpation of the tissue is painful.

 When using a frequency of 3000 Hz, pain disappeared after the second procedure, stiffness disappeared after the third, after the 4th proliferative phenomenon, the movements are painless, tissue palpation is painless, ESR decreased to 15 mm / h, the “C” reactive protein is negative, sialic acids and gamma normalized -globulins.

 Thus, the frequency of 3000 Hz gave a faster and more pronounced effect.

 We have also changed the number of procedures in connection with our observations. When the number of procedures was 11 or more, most patients noted negative phenomena in the form of weakness, fatigue and dizziness.

 Let us explain the following observation.

 Patient Eitakuliev A.B. 52 years old 32, the duration of treatment is 1.06. 3.07.93, DZ rheumatoid arthritis, Art. 1, act. 1, NSF 0 1 Art. He was admitted with complaints of pain in the joints of the hands and knees, was ill for 5-6 years, was repeatedly treated in hospitals with antirheumatic drugs, the disease developed gradually, with involvement of the knee joints.

Objectively: HB 120 g / l, ESR 20 mm / h, "C" react. ⁺⁺ , rheumatoid factor positive, gamma globulins 28.7. In the joints of the wrist, knee, proliferative phenomena, movements in them and palpation are painful. After the 11th procedure, weakness appeared, after the 12th weakness intensified, dizziness and nausea joined, pain in the joints did not disturb, the movements were painless, proliferative phenomena disappeared, ESR decreased to 7 mm / h, “C” reactive protein was negative, sialic acids unchanged, but overall well-being is much worse due to weakness and nausea. When the number of procedures was less than 8, as a rule, the pain passed by this time, proliferative phenomena and stiffness disappeared, ESR decreased, but sialic acids did not normalize, and after 2-3 days the pain reappeared.

 Explained by observation 2.

 Patient Shalimova V.T. 29 years old 91, the term of treatment is 9.04. 05/31/93. DZ rheumatoid arthritis 1, act. 1, NSF 1 tbsp. Sick for 6 years, the disease began after childbirth, pains appeared in the wrist joints, elbows, fingers and toes. The diagnosis is established immediately. She was treated repeatedly in the hospital with antirheumatic drugs.

Objectively: HB 120 g / l, L 42 • 10 ⁴ , ESR 21 mm / h, sialic acids 0.200, "C" reactive protein ⁺⁺ , rheumatoid factor ⁺ , gamma globulins 27.2 g / l. Limitations of movements in the wrist joints, proliferative phenomena in the miniphalangeal and elbow joints, pain on palpation are expressed.

 After the 5th procedure, stiffness and pain disappeared, there were no proliferative changes, ESR decreased to 17 mm / h, gamma globulins to 24 g / l, "C" react. negative, sialic acids are at the same level. Took 7 treatments, the effect lasted. Due to employment, the patient did not come for treatment, after 3 days the pain appeared, and after 2 days she was stiff, which forced the patient to continue the course for up to 10 procedures, after which the pain did not resume, the stiffness did not bother. All analyzes returned to normal.

 Reception of 8 procedures, as a rule, gave a lasting effect, the resumption of pain was not observed, clinical and biochemical parameters returned to normal.

 Explain observation 3.

 Patient Skladenkova A.A. 27 years old 82, the duration of treatment is 7.04. 04/27/92. DZ rheumatoid arthritis 1, act. 1, NSF 1 tbsp. Received with complaints of pain in the wrist and shoulder joints, minifangal fingers and toes, stiffness. For more than 4 years, after the flu, the small joints of the arms and legs swelled, was treated in a hospital where rheumatoid arthritis was diagnosed with antirheumatic drugs.

Objectively: HB 118 g / l, ESR 21 mm / h, "C" react. ⁺ , sialic acids 210, rheumatoid factor is positive, gamma globulins 24.1 g / l. In the joints of the fingers of the hands proliferative phenomena, pain on palpation.

 She took 8 procedures, after which the reduction and disappearance of pain during palpation, the disappearance of all clinical symptoms, all laboratory parameters returned to normal. After 8 procedures, the patient did not take laser therapy, but the achieved effect did not disappear, ESR 5 mm / h, gamma globulins 18.9 g / l, "C" react. negative, sialic acid 0.190. Thus, already 8 procedures caused a lasting effect.

 Treatment by the proposed method was carried out in 31 patients (the main group), in the control there were 18 patients treated by the prototype method (see table. 1).

 As follows from the above table. 1, both groups of patients by gender, severity, activity and prescription of the process were equivalent. Thus, among the observed patients, young women were predominant, mostly ill for no more than 4-6 years.

 An analysis of the treatment results (see Table 2) by the known and proposed method showed the following: in the main group, pain decreased in 90% in the control group in 70%, proliferative changes in 89% in the main group and 64% in the control group, stiffness in 100% in the main group and 76% in the control group. During treatment with the proposed method, joint dysfunction became less pronounced in 97% in the main and 80% in the control group, and blood counts improved in 59% in the main and 33% of the control, the advantage was statistically significant (P <0.05).

 Thus, the elimination of the main clinical signs of pain is expressed when using the above methodology. The dynamics of laboratory parameters was compiled: ESR in both groups decreased significantly in the main group from 21.5 ± 2.0 to 15.5 ± 1.9, in the control 23.7 ± 2.1 to 16.8 ± 2.4, as regards gamma globulins and sialic acids, then, according to these parameters, significant shifts are registered only in the main group. This was manifested in assessing the dynamics of the process activity; its decrease in the main group at 64% in the control 39% (P <0.05).

The normalizing effect of laser therapy on autonomic functions was manifested in ECG changes; myocardial metabolism improved in 75% of men; conductivity
43% rhythm 57%
In the control group, the ECG dynamics were not significant, which, apparently, is associated with a large number of procedures, positive shifts of 42, 12 and 16%, respectively
The overall treatment efficacy in the groups was: significant improvement 3% improvement 78% and slight 19% in the control improvement 52% slight improvement 37% and no change 1% Thus, there is a tendency to the advantage of the main group. This superiority of the proposed method becomes reliable (P <0.05).

 When analyzing long-term results, after a year the achieved efficiency in the main group was 67% and in the control group 47%. Thus, the effect of laser therapy at an exposure of 32 s, a frequency of 3000 Hz on the acupuncture points responsible for the pathogenesis and the most inflamed joint provides a better result in comparison with the known method, in addition, the therapeutic effect is achieved faster and lasts longer. This is manifested in the advantage of an analgesic and anti-inflammatory effect, a decrease in the objective signs of the disease and is confirmed by the presence of more persistent results in the long term (after a year).

 In this case, the claimed method of treatment may be applicable in addition to sanatoriums in polyclinics and hospitals.

Claims (1)

 A method of treating patients with rheumatoid arthritis, including laser irradiation of the affected joints, characterized in that the effect is exerted on three acupuncture symmetrical points of general action and the most affected joint with a frequency of 3000 Hz at an exposure of 32 s daily, 8 10 procedures are prescribed for the course.

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