RU2294227C1 - Method for treating degenerative-dystrophic diseases of vertebral column and large articulations - Google Patents

Abstract

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: it is necessary to irradiate affected area with low-intensity He-Ne laser at wave length of 0.63 mcm and density of radiation power being 10 mW/sq. cm, impact exposure - 10 min. Quantity of seances corresponds to 10. Before irradiation one should apply a single-layer filter cloth impregnated with 1%-carypazim solution onto the skin of affected area. The innovation enables to quickly remove pain syndrome, reconstruct the volume of movements in affected area and achieve prolonged remission of the disease mentioned.

EFFECT: higher efficiency of therapy.

2 dwg, 2 ex, 1 tbl

Description

The invention relates to medicine, in particular to traumatology and orthopedics, and is intended for the treatment of degenerative diseases of the spine and large joints

Many methods have been proposed for the treatment of DDD, each of which has both positive and negative properties.

The basic therapy of DDD consists of the immobilization of the affected segment, the appointment of non-steroidal anti-inflammatory drugs, novocaine blockade, physiotherapy. Recently, low-energy laser therapy has been included in the range of therapeutic measures for DD.

Low-intensity laser therapy is successfully used both for the treatment of osteochondrosis of the spine and for the treatment of deforming osteoarthrosis.

A method for the treatment of discogenic neurological manifestations of osteochondrosis of the spine (AC 2180830 C2) Miryutova NF, 1999. The method consists in irradiating myogenic triggers with a low-intensity infrared laser with a wavelength of 0.63 and 0.89 microns to treat spinal osteochondrosis.

A method for the conservative treatment of deforming osteoarthrosis of the knee joints (AC 2182832 C1) Dubrovin GM, 2001. The method consists in laser exposure of the joint to treat deforming osteoarthrosis.

A method of treating the initial stages of deforming arthrosis (AC 2239468 C2) Kotelnikov GP, 2002. The method consists in simultaneously irradiating the knee joint with a laser beam of a wavelength of 0.63 microns and intra-articular oxygen insufflation.

In the treatment of degenerative-dystrophic diseases of the spine and joints, electrophoresis with karipazim has been successfully used recently. Closest to the proposed method is a method for the treatment of neurological and orthopedic-traumatological pathologies (AS 2141359, Naydin V.L., Bobkov Yu.G., Yurishchev P.E.). The method consists in electrophoresis of a solution of caripazim. The introduction is carried out for 15-20 minutes The current strength is 10-15 μA. Spend three courses of 20-30 procedures.

However, not all patients are shown electrophoresis. An important disadvantage of electrophoresis, as well as other methods of electrotherapy, is the need to include the patient's body in the electrical circuit of the device. Contraindications to electrophoresis are cardiovascular failure, the presence of an artificial pacemaker, chronic renal failure, pustular and systemic skin diseases, as well as cancer.

In recent years, interest has increased in improving the methods of administering drugs by various physical factors. One of the little-studied problems of quantum medicine is the interaction of the laser beam and pharmaceuticals. On the basis of the MONIKI laser laboratory, the change in the diffusion coefficient of various ointments under the influence of low-intensity irradiation with a helium-neon laser was studied (Barybin V.F., Skovorodko S.N., Gerasimenko M.Yu. Features of photophoresis in the experiment // Successes in Physical Sciences. - 1991 . - T.128, issue 1. - S.135-160.). The authors found that the phenomenon of drug photophoresis is based on the combined effect of light pressure and thermophoretic forces on particles of a drug substance. The predominance of one of these factors determines the type of photophoresis. For the particles of the drug solution, the main factor is light pressure, which determines the positive photophoresis of the pharmaceutical product.

We were the first to propose a method for treating degenerative-dystrophic diseases by photophoresis of the Karipazim preparation using a low-intensity helium-neon laser with a wavelength of 0.63 microns.

The method consists in non-contact laser irradiation of the affected joint and / or paravertebral region with a helium-neon laser beam with a wavelength of 0.63 μm after preliminary application of a single-layer gauze cloth moistened with a 1% solution of caripazime on the skin. Laser irradiation was carried out with a radiation power density of 10 mW / cm ² , exposure time 10 minutes, the number of sessions - 10.

The proposed method of laser photophoresis was successfully applied in 46 patients with osteochondrosis of the lumbar and cervical spine, shoulder-scapular periarthritis, as well as deforming osteoarthritis of the knee joints, which constituted the main group. The age of patients ranged from 23 to 75 years. 32 men were treated, 14 women. Patients received basic therapy, including limiting physical activity, immobilizing the affected segment, taking anti-inflammatory drugs, performing novocaine blockades, and also laser irradiating the affected joint and (or) paravertebral region with a helium-neon laser with a wavelength of 0.63 microns after preliminary application to the skin of a single-layer gauze cloth moistened with a 1% solution of karipazim. Laser irradiation was carried out with a radiation power density of 10 mW / cm ² , exposure time 10 minutes, the number of 10 sessions. Inpatient treatment was continued until relief of pain, restoration of range of motion in the affected joint and spine. After discharge to outpatient treatment recommended massage, physical therapy. The first comparison group consisted of 35 patients with DDD who received basic therapy and caripazim electrophoresis to the affected joint area and paravertebrally, the second group - 28 patients who received basic treatment and low-energy laser therapy. Electrophoresis was carried out for 15-20 minutes. With a current strength of 10-15 μA. Used 10 sessions daily. In the 2nd comparison group, helium-neon laser was irradiated with a wavelength of 0.63 μm to the area of the affected joint and paravertebrally with a radiation power density of 10 mW / cm ² , exposure time of 10 minutes, the number of sessions was 10. The groups were homogeneous by age and gender. The clinical results of treatment of patients of the main group and comparison groups are presented in table 1.

Table 1 Clinical results of low-intensity laser therapy for degenerative-dystrophic diseases of the spine and large joints Parameters for assessing the clinical effect of laser therapy Laser photophoresis of caripazim Laser therapy helium-neon laser 0.63 microns Caripazim Electrophoresis Number of patients 46 28 35 The term for the relief of pain, days four 7 5 The term recovery volume of movement, days 10 16 fourteen The duration of the hospital phase of treatment, bed-day 10 16 fourteen Period of temporary disability, days twenty 30-35 thirty

An analysis of the indicators presented in Table 1 shows the advantages of using photophoresis of karypasim by a helium-neon laser with a wavelength of 0.63 μm over traditional laser therapy and electrophoresis of karypasim. Due to the combination of the anti-inflammatory and rheological effects of the helium-neon laser with the proteolytic effect of caripazim, microcirculation improved, muscle spasm was relieved, periarthritis was eliminated, scars and adhesions resolved in the affected segment. At the same time, the pain syndrome was stopped faster, the range of movements in the segment of the spine and joint increased; due to the restoration of anatomical relationships in the joint, a long-term remission of the disease was achieved.

We present two clinical observations.

Clinical observation No. 1: patient B., 56 years old, was hospitalized in the laser department of MMU "City Clinical Hospital No. 6 named after Acad. VNKosheleva "January 28, 2005 with a clinic of vertebrogenic lumbalgia against the background of osteochondrosis of the lumbar spine in the presence of a herniated disc L4-L5. Low back pain has been bothering for the past 3 years. Deterioration during the last week, which is associated with hypothermia and physical activity. Not sleeping because of pain. Cannot raise leg above 90 degrees (tension symptoms). Passive and active movements in the lumbar region are limited and sharply painful. Muscle tension of the lumbar region is noted, palpation of the paravertebral points L3-L5 is sharply painful. The axial load on the shoulders radiates to the lower back. A low-intensity laser therapy with a helium-neon laser has been prescribed. After the 4th session, the pain syndrome was stopped. After the 10th session, the range of movements in the lumbar region was completely restored. Discharged in satisfactory condition for work.

Figure 1 presents the magnetic resonance imaging of the patient before treatment. In Fig.2 - after, where a reduction in disc herniation is clearly visible.

Clinical observation No. 2. Patient M., 71 years old, was undergoing treatment at the laser department of the Moscow City Medical University No. 6 named after Acad. V.N.Kosheleva "in 1998 with a clinic of a shoulder-scapular periarthritis. A previous history of the disease for 10 years. Repeatedly treated on an outpatient basis and in a neurological hospital without effect. The last two weeks before entering the laser department did not sleep because of pain. The patient took a forced position - held her right forearm with her healthy left hand. A course of low-intensity laser therapy with a helium-neon laser was carried out. The pain syndrome is completely stopped. The volume of movement in the shoulder joint has fully recovered. For 7 years observed in the laser department. There was no relapse of the disease.

During photophoresis of karypazim by a helium-neon laser, the anti-inflammatory effects of laser radiation and the metabolic effect of karypazim are mutually potentiated. This leads to the simultaneous effect on several pathogenetic links of DDZ: synovitis, myositis, neuralgia. As a result, the vicious circle of painful spasm of the periarticular muscles is broken, myogenic compression of the articular surfaces decreases, and a non-specific adaptogenic effect occurs.

The advantages of the proposed method for the treatment of DDD are more rapid relief of pain, restoration of range of motion, achieving long-term remission of the disease. Laser photophoresis, unlike electrophoresis, can be performed in patients with an artificial pacemaker, with severe concomitant pathology.

Claims (1)

A method for the treatment of degenerative dystrophic diseases of the spine and large joints, including irradiating the affected area with low-intensity laser radiation, characterized in that the irradiation is carried out with a helium-neon laser with a wavelength of 0.63 μm, a radiation power density of 10 mW / cm ² , exposure time 10 min , the number of sessions 10 after preliminary application to the skin of the affected area of a single-layer gauze cloth moistened with 1% solution of karipazim.

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