RU2103033C1 - Method for treating hypertension disease - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing the region of superficial cardiac dullness to infrared radiation. The region of neurovascular fascicle is additionally subjected to laser radiation with semiconductor laser power being not greater than 3.5 mW and infrared radiation of light-emitting diodes being not greater than 60 mW, magnetic field density of 43 ± 3 mT for 13-16 min daily with 10-15 sessions per course. EFFECT: achieved hypotensive reflex responses; improved trophicity of cardiac muscle.

Description

 The invention relates to medicine, namely to cardiology, and can be used in the treatment of hypertension (GB).

 Known methods of treating hypertension with the help of physiotherapeutic factors, such as Shcherbak galvanic collar, variable and "traveling" pulsed magnetic fields, etc. However, these procedures require specially adapted rooms in a hospital and clinic and do not always allow achieving an effect, especially in patients with stable hypertension [1].

 The closest technical solution to the proposed method is a method of treating GB using a helium-neon laser with a wavelength of 0.630 μm, emitting in the red range, by exposing the defocused beam to reflexogenic zones, including the area of the projection of the heart; irradiation is carried out daily with a beam defocused to 1.5 cm, with a power density of 0.5 - 0.6 mW / cm, an exposure of 60 s for six reflexogenic zones, a course of treatment of 10 to 12 procedures [2].

 However, this treatment method allows you to affect only reflexogenic zones, mainly causing reactions of the body according to the type of skin-visceral reflex and does not allow to achieve a stable effect, does not affect the pathogenetic mechanisms of the course of hypertension, due to the low penetration depth of the red laser radiation.

 The technical result of the proposed method is the impact on the myocardium, receptor apparatus of the heart and blood without the use of invasive techniques.

 The technical result is achieved by the fact that in the method of treating hypertension by exposure to physiotherapeutic factors, the effect is performed on absolute cardiac dullness and, additionally, on the neurovascular bundle of the left supraclavicular region, which allows, due to the large diameter of the vessel, to affect large volumes of blood per unit time.

 In this case, the vascular bundle, reflexogenic zone and directly on the heart are affected by infrared radiation from a semiconductor laser with a wavelength of 0.85 ± 0.03 μm and a radiation power of not more than 3.5 mW; infrared radiation of LEDs with a wavelength of 0.95 ± 0.03 μm, a radiation power of not more than 60 mW and a magnetic field with induction of 43 ± 3 mT, carrying out procedures for 13 - 16 minutes daily, course - 10 - 15 sessions.

 The diameter of the used fiber is selected in accordance with the area of absolute cardiac dullness in this particular patient, which allows in each case to use the same exposure parameters. When exposed to the neurovascular bundle, this requirement is achieved by the fact that in an adult, its diameter is known.

 The method is carried out using the Izel magneto-optical laser exposure apparatus by applying the emitter head to the patient's skin.

 The proposed method for the treatment of GB is based on a number of theoretical, practical, and experimental prerequisites. Firstly, the infrared radiation of a semiconductor laser has the ability to penetrate through the integumentary tissues of the body to a depth of more than 6 cm, which allows it to be used to affect the heart muscle and heart receptors in order to achieve a hypotensive response and improve trophic processes in the heart muscle that are disturbed during development GB

 Secondly, the magnetic field is able to penetrate to the same depth and, based on the mechanisms of magneto-laser therapy, interact synergistically with laser radiation, providing a stronger effect on the heart.

 Thirdly, the analysis of literature data indicates that in patients with GB there are regular violations of the rheological properties of blood, a decrease in the deformability of red blood cells, an increase in their aggregation, a change in the lipoprotein composition of blood serum and erythrocyte membrane lipids. These disorders correlate with the severity of the disease, affect the level of total peripheral vascular resistance (OPSS). In addition, there are a number of studies that note the positive effect of laser radiation on hemorheological disorders in various pathological conditions. We found the corrective effect of magneto-laser therapy on initially elevated blood viscosity, erythrocyte and platelet aggregation in patients with hypertension, which correlated with general peripheral vascular resistance and clinical efficacy. Based on this, it is advisable to use magneto-laser exposure to the vascular bundle with the aim of direct irradiation of the blood to correct hemorheological parameters.

 The authors deliberately did not use irradiation of the synocarotid zone, the benefits of exposure to which, at first glance, seem obvious (the presence of a large number of chemo- and baroreceptors, the effect of which can give a significant hypotensive reaction). This was done on the basis of their danger of direct and intense irritation of the sinocarotid zone, which has a powerful receptor apparatus, which can cause undesirable consequences, which was confirmed by a number of authors for other physical factors (collaptoid reactions, impaired regulation of the brain vessels).

 Indications for the appointment of magneto-optical laser therapy were the ineffectiveness of antihypertensive medication, poor tolerance of drugs in the form of drug allergies, or other side effects. Contraindications were traditional, generally accepted contraindications for physiotherapeutic procedures: benign and malignant neoplasms, fever, pregnancy, mental disorders, etc.

 A course of magneto-laser therapy was conducted in 40 patients, of which 10 men and 30 women aged 23 to 60 years (average 49 ± 1.6 g), with a disease duration of 3 to 20 years (average 11.2 ± 1.4 g). Three patients were diagnosed with stage 1 hypertension, 37 - stage II hypertension. Of the concomitant diseases, chronic cholecystitis, chronic pancreatitis, chronic bronchitis were noted. Before and after the course of magneto-laser therapy, a clinical examination of patients was carried out, which included a survey, physical examination, traditional laboratory and instrumental studies (general blood test, general urine analysis, biochemical parameters, ECG) and additional, specific laboratory and instrumental studies (bicycle ergometry, tetrapolar rheography, study of the rheological properties of blood).

 Measurement of blood pressure was carried out using a mercury sphygmomanometer (according to Korotkov) before and after each session and during the day. Electrocardiographic examination was performed using a 6-NEK apparatus in 12 standard leads. The state of central hemodynamics was evaluated by the results of tetrapolar rheography at rest and with additional physical activity. The following indicators were determined: stroke volume (UO), stroke index (UI), cardiac index (SI), total peripheral vascular resistance (OPSS). Tolerance to physical activity was assessed by the results of a VEM test, the level of maximum tolerated load, the amount of work performed, and the type of pressor reaction to the load were determined. Blood rheology indicators were studied on a rotational viscometer of the V.N.Zakharchenko system and included the determination of yield strength, apparent viscosity, and erythrocyte aggregation coefficient.

 Evaluation of the effectiveness of the course application of magneto-optical laser therapy was carried out in three degrees. The effect was assessed as good if, as a result of the course of treatment, it was possible to achieve stabilization of blood pressure on the usual, normal numbers with a significant improvement in the subjective state of the patient and the complete abolition of antihypertensive drugs. The effect was assessed as satisfactory if it was possible to achieve an improvement in the subjective state and a decrease in blood pressure, which did not reach normal numbers and additional administration of antihypertensive drugs was required. An unsatisfactory effect was observed in the absence of stabilization of blood pressure and improvement of the subjective state.

 A good and satisfactory clinical effect was recorded in 31 patients (77.5%), unsatisfactory in 9 patients (22.5%).

 The dynamics of blood pressure during the course of treatment was as follows: before treatment - SBP - 178.7 ± 3.4 mm Hg, DBP - 102.3 ± 3.2 mm Hg; after treatment - GARDEN - 137.3 ± 3.4 mm Hg, DBP - 86.6 ± 2.8 mm Hg

 When studying the effect of magneto-laser therapy on the state of central hemodynamics, the corrective effect of this method of treating hypertension on hemodynamic parameters was noted. So, with the initial hyperkinetic type of blood circulation under the influence of therapy, there was a significant decrease in stroke volume, stroke and cardiac indices with an unreliable increase in OPSS. With the initial hypokinetic type of blood circulation, there was a significant decrease in OPSS and an increase in UI and SI.

 After the course of treatment, there was a significant increase in the power of the threshold load (more than one step), the amount of work performed in 29 patients. In 27 patients, the hypertonic type of response to physical activity turned into normotonic; in the rest, the degree of hypertensive pressor reaction decreased.

 Interesting data were obtained in the study of hemorheological parameters in the course of the course application of magneto-optical laser therapy. 21 patients showed an increase in baseline blood viscosity (erythrocyte aggregation coefficient was increased by 84%, yield strength - by 80%, apparent viscosity - by 54%). As a result of treatment, a decrease in initially elevated hemorheological parameters to normal was noted, which correlated with clinical efficacy. Significant changes in the initially normal blood viscosity were not observed.

 Clinical example 1.

 Patient T., 60 years old, medical history N 3044.

 Diagnosis: Hypertension stage II, exacerbation. Received in GKB N 11 2.10.92 g with complaints of headaches, dizziness, stitching pains in the heart area, not associated with physical activity, sleep disturbances. Notes an increase in blood pressure over 12 years. The maximum blood pressure is up to 200/110 mm Hg, the usual blood pressure is 150/90 mm Hg. The last worsening within a month, hypertensive crises up to three times a week on the background of antihypertensive therapy. On examination, an expansion of the boundaries of relative cardiac dullness to the left by 1.5 cm was noted, the emphasis was on II tone on the aorta, blood pressure - 180/100 mm Hg, heart rate - 72 per minute.

 ECG: Sinus rhythm. Heart rate - 76 per minute. Hypertrophy of the left ventricle with systolic overload.

When registering indicators of central hemodynamics, the patient revealed a hypokinetic variant: UI amounted to 28 ml / m ² , SI - 1.9 l / min / m ² , OPSS - 2972 dyne / sec / cm ^-5 . According to the results of the VEM test, the patient performed a load of 50 W, a pressor reaction to a load of a hypertonic type was recorded, the amount of work performed was 450 kg / m.

In the study of hemorheological parameters, an increase in all the studied parameters was recorded (the erythrocyte aggregation coefficient was 1.47 dyne / cm ² • 10 ^-6 , the yield strength was 0.054 dyne / cm ² , and the apparent viscosity was 23.6 cps).

A course of magneto-optical laser therapy according to the proposed method in the amount of 12 sessions. Improving health came after five treatments. Blood pressure stabilized at 145 - 150/85 - 90 mm Hg, the subjective state improved - headaches, dizziness disappeared, sleep normalized. During the VEM test, the performed load increased by one step (75 W), the amount of work performed increased by 450 kg / m, the degree of hypertonic reaction to the load decreased. According to tetrapolar rheography, a decrease in SPS to 2566 dyne / s / cm ^-5 and an increase in UI to 30.5 ml / m ² , SI to 2.1 l / min / m ^{2 were} noted. Thus, the hypokinetic type of blood circulation closer to eukinetic. Hemorheological indicators also returned to normal and amounted to: erythrocyte aggregation coefficient - 0.67 dyn / cm ² • 10 ^-6 , yield strength - 0.034 dyn / cm ² , apparent viscosity - 15.1 cps.

 Clinical example 2.

 Patient K., 48 years old, medical history N 3202. Diagnosis: Hypertension II stage, exacerbation. Received in Clinical Hospital N11 10/20/92 g with complaints of intense headaches, sleep disturbance, emotional lability, palpitations. Notes an increase in blood pressure over 8 years. The maximum blood pressure is up to 200/90 mm Hg, the usual - 130/80 mm Hg Hypertensive crises with a frequency of up to three times a month, associates with emotional overstrain. Crisis is accompanied by a headache, psychomotor agitation, palpitations. Last worsening in two weeks. After emotional stress, blood pressure increased to 170 - 180/90 mm Hg, taking antihypertensive drugs was not accompanied by stabilization of blood pressure. When examining the border of relative cardiac dullness within normal limits, with auscultation, tones are clear, rhythmic, no noise, heart rate - 92 per minute, blood pressure - 170/85 mm Hg.

 ECG: Sinus rhythm. Intermediate position of the electrical axis of the heart. Amplitude signs of left ventricular hypertrophy.

When registering indicators of central hemodynamics, the patient revealed a hyperkinetic type of blood circulation: UI amounted to 37 ml / m ² , SI - 2.95 l / min / m ² , OPSS - 1720 dyne / sec / cm ^-5 . VEM test: 75 W load performed, hypertensive pressure response to the load. In the study of hemorheology, all indicators did not deviate from normal values. A course of therapy was carried out according to the proposed method in the amount of 10 sessions. Improving health came after the fifth procedure. Blood pressure stabilized at the level of 120 - 130/80 mm Hg, the subjective state improved (headaches decreased, sleep normalized, heartbeats disappeared). According to bicycle ergometry, the hypertonic type of reaction to physical activity turned into normotonic, the performed load increased by one step and amounted to 100 watts. In the study of central hemodynamics, an increase in SPS to 2175 dyne / sec / cm ^-5 , a decrease in UI to 32.5 ml / m ² and SI to 2.45 l / min / m ^{2 were} noted. Thus, the hyperkinetic type of hemodynamics turned into eukinetic.

 Hemorheological indicators remained within normal limits.

 Clinical example 3.

 Patient A., 52 years old, medical history N 3162. Diagnosis: Hypertension II stage, exacerbation. Received in Clinical Hospital N11 10/15/92 with complaints of headaches, tinnitus, memory loss, mental performance, sleep disturbance. Notes an increase in blood pressure over 12 years. The maximum numbers of blood pressure up to 210/120 mm Hg, the usual - 145 - 150/90 mm Hg The last exacerbation within 1.5 months, blood pressure is constantly kept at the level of 170 - 180/100 - 110 mm RT. Art. while taking antihypertensive drugs. On examination, pastility of the legs, the boundaries of relative cardiac dullness extended to the left by 2 cm, the emphasis of the II tone on the aorta, blood pressure - 185/105 mm Hg, heart rate - 68 per min.

ECG: Sinus rhythm. Heart rate - 80 per minute. The horizontal position of the electrical axis of the heart. Left ventricular hypertrophy with signs of systolic overload. When registering indicators of central hemodynamics, the patient revealed a hypokinetic type of blood circulation: UI amounted to 27.4 ml / m ² , SI - 1.77 l / min / m ² , OPSS - 3014 dyne / sec / cm ^-5 . According to the results of the VEM test, a load of 50 W was performed, a hypertonic reaction to the load was recorded.

In the study of hemorheological parameters, an increase in all parameters was recorded: the erythrocyte aggregation coefficient was 1.54 dyne / cm ² • 10 ^-6 , the yield strength was 0.065 dyne / cm ² , and the apparent viscosity was 27.1 cps.

 A course of treatment according to the proposed method in the amount of 15 sessions. Improvement of well-being came on the 10th procedure. Headaches, noise in the head decreased, blood pressure stabilized at 150/90 mm Hg. The dose of antihypertensive drugs was reduced three times.

When carrying out bicycle ergometry, the performed load increased by one step. According to tetrapolar rheography, a decrease in SPS to 2876 dyne / s / cm ^-5 , an increase in SI to 29.3 ml / m ² and SI to 1.95 l / min / m ^{2 were} noted. Hemorheological indices decreased, but did not come to normal (erythrocyte aggregation coefficient - 1.07 dyn / cm ² • 10 ^-6 , yield strength - 0.059 dyn / cm ² , apparent viscosity - 18.3 cps). Thus, in this case of stable hypertension, a satisfactory clinical effect was observed on a significantly reduced dose of antihypertensive drugs.

 All the above patients underwent a control study a month after the end of the course of magnetic laser therapy - there was no deterioration.

 Thus, the effect on the vascular bundle of the left supraclavicular region, on the cardiac muscle and receptor apparatus of the heart, as well as on the reflexogenic zone in the area of the projection of the heart onto the anterior chest wall (radiation power of a semiconductor laser not more than 3.5 mW, LED radiation power not more than 60 mW, magnetic field induction 43 ± 3 mW) creates optimal conditions for the treatment of hypertension.

 The proposed method allows you to combine various mechanisms of action on the course of hypertension, such as a reflex hypotensive reaction when acting on the reflexogenic zone and heart receptors, normalization of hemorheological disorders, which have recently been given a leading role in the pathogenesis of hypertension, and improvement of trophic processes in the heart muscle. \\ 2 As a result of using this method of treatment, improvement of clinical data, correction of hemodynamic parameters depending on the initial type of blood circulation, improvement of physical performance (increase in the volume of work performed, increase in threshold load, decrease in the degree of hypertensive reaction to physical activity), normalization of initially elevated hemorheological indicators.

 In addition, the proposed method for the treatment of hypertension is quite simple in technical execution, does not require special facilities, special security measures. The magneto-optical laser apparatus is miniature and can be used in the ward, on an outpatient basis, at home.

Bibliography
1. EI Sorokina // Physical methods of treatment in cardiology, M., 1989, p. 226 - 239.

 2. A. A. Shatrov, B. A. Sokolov, S. R. Danilenko // The use of laser therapy in the complex spa treatment of patients with hypertension, Thes. doc. to scientific and practical conf., Odessa, 1989, p. 174 - 175.

Claims (1)

 A method of treating hypertension, including the action of low-intensity laser radiation on the area of the projection of the heart onto the chest wall, characterized in that the effect is carried out by infrared laser radiation on the area of absolute cardiac dullness, additionally affecting the projection area of the neurovascular bundle of the left supraclavicular region, using infrared radiation of a semiconductor laser with a radiation power of not more than 3.5 mW, infrared radiation of LEDs with a radiation power of n more than 60 mW, the magnetic field of induction 43 mT ±, procedure 16 to 13 minutes daily, a course of 10 15 sessions.