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PEDIATRICS
INVENTION
Patent of the Russian Federation RU2195250

METHOD OF TREATMENT OF BRONCHIAL ASTHMA IN CHILDREN

METHOD OF TREATMENT OF BRONCHIAL ASTHMA IN CHILDREN

The name of the inventor: Zhilnikov DV; Barybin V.F .; Tarasova ON; Bychenkov OA
The name of the patent holder: Moscow Regional Scientific Research Clinical Institute
Address for correspondence: 129110, Moscow, ul. Shchepkina, 61/2, MONIKI, patr.group
The effective date of the patent: 2001.03.22

The invention relates to medicine, pediatrics. The laser is applied to the points of acupuncture, to the area of ​​projection of the left cubital vein, to the projection of the bronchial tubes of the main and middle caliber in both paravertebral lines at the levels of the second, fourth and sixth thoracic vertebrae. On the course of 5-7 procedures, conducted daily. The method shortens the treatment time.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, in particular to pediatrics, and can be used to treat bronchial asthma in children.

A method for treating bronchial asthma in children is known by laser irradiation of the "ULF-01" generator with a wavelength of 0.63 μm of acupuncture points and reflexogenic zones ("Laser therapy in the practice of a doctor" ./ Under the editorship of Yu. V. Kaninsky et al. - Vladivostok, "Dalnauka", 1994, - pp. 143-151).

The objects of influence of LILS are the outer surfaces of the nose wings, the mesopharyngeal area, the projection of the sinus in the jugular fossa, the paravertebral region at the C6-Th4 level at 5-6 symmetrical points and the reflexogenic region of the adrenals. The total surface energy density is 4.9-13.1 J / cm 2 , the course of laser therapy is 10-12 procedures.

The disadvantage of this method is its low efficiency.

The method closest to the proposed method is the treatment of bronchial asthma in children, including drug therapy and laser treatment of acupuncture points (Methodological recommendations. "The use of laser radiation in the treatment and rehabilitation of patients with allergic diseases." Kislovodsk, 1994, Moscow, ed. VN Pokrovsky, pp. 9-11). In this case, laser therapy is carried out as follows.

When relieving an attack of bronchial asthma, the following BATs are used: P7 (above the styloid process of the radial bone at 1.5 tsunia), VG14 (between the spinous processes of the C1-D1 vertebrae), G14 (at the rear of the hand, in the corner formed by the proximal ends of the first and second metacarpal Bones), R27 (on the first lateral line of the breast, in the subclavian fossa, at the lower edge of the clavicle), VC22 (in the center of the jugular notch, about 0.7 cm above it), VC17 (on the front line, at the horizontal line of the nipples, Or at the 5th rib level), R24 (in the third intercostal space, on the first lateral line of the chest), R5 (in the center of the fold of the ulnar fold, near the ray margin of the biceps tendon of the shoulder), RP6 (above the upper edge of the inner ankle for 3 tsun) . In the interstitial and postoperative periods the following points are used: E13 (at the point of convergence of the clavicle and the first rib, 4 tsunya outside the midline), V13 (outside the interval between the spinous processes of D3-D4 at 1.5 tsun), V40 (in the popliteal center Fossa). The course of treatment is 12-15 procedures. The exposure time for 1 point is 15 seconds.

The drawbacks of this method of treatment are that the effectiveness of this method is very low, so the treatment course is long (up to 15 procedures). This increases the risk of unwanted side effects from laser therapy, which is especially dangerous for children.

In a known method, a large amount of BAP is effected. However, the response from exposure to certain BATs is not always predictable and can lead to a negative result in children whose body reacts very quickly and strongly to any physical effect.

The task is to eliminate the above-mentioned drawbacks and increase the effectiveness of treatment through a targeted and individualized effect on the projection of the bronchi, reducing the duration of treatment and thus eliminating the negative effects of laser exposure.

This task is achieved by the fact that in the method of treating bronchial asthma in children, which includes drug therapy and laser treatment of acupuncture points, affect the general stimulating points, and additionally to the projection zone of the left cubital vein in the ulnar fossa and the projection field of the bronchial tubes of the main and middle caliber, according to Both paravertebral lines at the levels of the second, fourth and sixth thoracic vertebrae, with a single dose of exposure to the projection zone of the left cubital vein is 0.00005-0.00015 J / cm 2 , on the bronchi projection fields 0.0018-0.007 J / cm 2 , The total time of exposure to the session is 14-16 minutes, for a course of 5-7 procedures performed daily.

The method is carried out as follows. Before the procedure, determine the therapeutic dose of exposure to one field of projection of the bronchi according to the formula



Where D is the therapeutic dose (J / cm 2 ),

P - output power of the generator (W),

E - H is the absorption coefficient of radiation by a biological tissue at a depth h, where - linear absorption coefficient for soft tissues and is equal to 1.84,

T - time of irradiation (sec),

S - the area of ​​the pathological focus (cm 2 ),

H - height of pathological focus (cm),

- reflection coefficient,

S is the scattering area of ​​the beam (cm 2 ),

H is the depth of the pathological focus (cm).

This dose is 0.0018-0.007 J / cm 2 , depending on the depth of the bronchi and their area, which are determined from the reference data (depending on the age of the child and the physical structure).

The patient is then placed on a couch and the acupuncture points (BAP) are irradiated: E36 "three gaps on the leg" (4 divisions below the knee cap, lateral tuberosity of the tibia), G14 (at the rear of the hand, in the corner formed by the proximal ends of the first and Second metacarpal bones), F13 "seated gates" (near the lower edge of the free end of the 11th rib, on the 4 lateral line of the abdomen). Exposure time per 1 BAT T = 20 sec. Further, the blood is irradiated by the intimate contact of the light guide with the projection of the left cubital vein in the ulnar fossa. Exposure time T = 100-120 sec. After that, the defocused beam irradiates the projection of the bronchi of the main and middle caliber, along both paravertebral lines, at the level of Th2, Th4, Th6. Exposure time per irradiation field T = 100-120 sec. The laser radiation source used is serial, helium-neon with a wavelength of (= 0.63 μm, a generator of the "ULF-01" type, the radiation regime is continuous, the output power is 20-25 mW.The total exposure time for the session is 14-16 min, For a course of 5-7 procedures, conducted daily.

Clinical and laboratory studies were conducted in 89 children aged 6 months to 15 years (62 boys and 27 girls), patients with severe (52 patients) and moderate (37 patients) with bronchial asthma receiving laser therapy with helium-neon generator "ULF -01 "(with a wavelength of -0.63 μm), a continuous mode of radiation and an output power of 22-25 mW The therapy was carried out by a method including sequential irradiation: 1. Acupuncture points E36, G14 and F13. Of the left cubital vein in the ulnar fossa, contacting the light guide to the skin with a light guide tool 3. The projection fields of the bronchial tubes of the main and middle caliber, on both paravertebral lines at the Th2, Th4, Th6 level, only 6 irradiation fields (defocused ray) .

The overwhelming majority of patients (81%) were at the time of the onset of laser therapy in the interictal period of the disease, usually not long enough (the interval between asthma attacks was no more than 1-2 weeks).

Analysis of clinical results obtained at the end of the course of treatment showed the presence of a direct positive effect (absence of seizures and satisfactory state of health) against the background of treatment in all patients. To confirm the effect of laser therapy, a study was made of the functions of external respiration before and after the course of laser therapy, in the analysis of which statistically significant (P <0.001) the residual lung volume decreased from 193.6 (4.6% to 150.2 (4.8%)) The peak exhalation rate, on average, increased from 30 to 105 liters per minute, and it is necessary to note that in 15% of patients the aerodynamic drag of exhalation in hyperventilation decreased significantly.In a third of patients, a decrease or decrease in hypersensitivity to household allergens and histamine was found. Positive dynamics in laser therapy was observed in a study of the restoration of lymphocytic-monocytic protection (skin screen test) increase in succinate dehydrogenase of lymphocytes (SDG from 71.4 (9.7 to 108.7 (6.4 units Keploi), monocytogram Manifested itself by a decrease in the "old" forms (from 36.26 (0.6 to 28.3 (5.8%), an increase in promyelocytes (from 18.4 (0.2 to 26.1 (2.5%), significantly The eosinophilic lymphocyte index decreased (from 0.16 (0.002 to 0.08 (0.001)). The follow-up data (mean catamnesis 6, 8 months) showed the presence of positive dynamics in 72.5% of children, which was expressed in a significant decrease in the frequency and severity of seizures and a significant increase in exercise tolerance. The average period of treatment by conventional traditional methods (pharmacological agents, chest massage, etc.) according to the archive archive was 23.4 days. In the group of children receiving laser therapy, the treatment period was 11.1 days. The term "bed-day" in the hospital has decreased by 50%, which gives a certain economic effect.

Example 1

Ill X., eight years old. Diagnosis: bronchial asthma, moderate severity, interictal period. Has been suffering from bronchial asthma since 3 years. In occasion of disease the boy repeatedly received courses интала, preparations teofillina, selective beta-2-adrenomimetiki. There was no remission of the response from the therapy, the seizures were repeated up to 2-3 times a month. The boy received a course of laser therapy 7 procedures according to the proposed method. According to which, the laser action on the BAT (E36, G14, F13), T = 20 seconds per 1 acupuncture point, on the projection area of ​​the left cubital vein in the ulnar fossa was carried out, contacting the lightguide tightly to the skin, exposure time T = 120 sec, in 6 regions of the projection of the bronchial tubes of the main and middle caliber, on both paravertebral lines, at the level of Th2, Th4, Th6, defocused ray, distantly, nested, exposure time T = 120 sec. The calculation of the therapeutic dose was carried out according to the above formula and is 0.0018 J / cm 2 .

The obtained clinical and laboratory data, after the course of laser therapy, showed the disappearance of skin sensitization to library dust and a decrease in sensitivity to histamine.

Before

After

Histamine

++

+ -

Library dust

+

-

In the immunological analysis of blood, the level of JgM decreased from 0.64 g / l to 0.35 g / l. The maximum volumetric expiratory flow rate from 275 l / min to 305 l / min increased. The state of health improved, the boy noted a significant relief of breathing. A catamnical observation showed no asthma attacks for more than 1 year.

Example 2

Patient N., 13 years old. Diagnosis: bronchial asthma, severe form, seizure period. A boy with a one-year-old age had severe manifestations of atopic dermatitis. Since the age of 8, bronchial asthma, pollinosis has been taking place, since 10 years expressed changes on the part of the digestive organs, apparently associated with prolonged massive medical therapy of bronchial asthma (at 12 years old, erosive gastritis was diagnosed). In occasion of a bronchial asthma the boy repeatedly received courses zaditena, intala, 1 course of a bekotid, various preparations of tefillin, beta-2-agonists were often appointed. Despite the ongoing therapy, frequent asthma attacks (at least once a week) were observed. The boy received a course of laser therapy for the GLS "ULF-01" 7 procedures: 1. 6 BAT (E36, G14, F13), T = 20 seconds per 1 acupuncture point, lightguide, generator output P = 25 mW. 2. On the projection area of ​​the left cubital vein in the ulnar fossa, contacting the light guide to the skin tightly, the exposure time T = 120 sec, the output power of the generator P = 25 mW. 3. 6 regions of the projection of the bronchial tubes of the main and middle caliber, on both paravertebral lines, at the level of Th2, Th4, Th6, defocused ray, distantly, nested, exposure time T = 120 s, generator output power P = 20 mW. The calculation of the therapeutic dose was carried out according to the above formula and is 0.0041 J / cm 2 . During the first course of laser therapy, supplemented to the course of intala, attacks of bronchial asthma stopped, and disappeared manifestations of latent bronchospasm (breathing in the lungs was carried out well). After the second course of laser therapy, the interictal period was about six months, and the manifestations of neurodermatitis decreased significantly. The third course was conducted in parallel with the appointment of the drug "tayled." For more than 4 months after the end of the last course of laser therapy, there was only one slight attack of bronchial asthma, self-stopping. The child stopped limiting the disruption in physical activity.

Example 3

Patient K., 14 years. Diagnosis: bronchial asthma, severe form, seizure period. In the anamnesis from an early age frequent bronhoobstructive bronchitis were noted. The diagnosis of bronchial asthma is set at 10 years. The last 1.5 years, bouts of shortness of breath are repeated every day or every other day. Laser therapy in the clinic received simultaneously with the course of the drug "tayled", according to the above method. She received a course of laser therapy for the GLS "ULF-01" 7 procedures: 1. 6 BAT (E36, G14, F13), T = 20 seconds per acupuncture point, lightguide, generator output P = 25 mW. 2. On the projection area of ​​the left cubital vein in the ulnar fossa, contacting the light guide to the skin tightly, the exposure time T = 120 sec, the output power of the generator P = 25 mW. 3. 6 regions of the projection of the bronchial tubes of the main and middle caliber, on both paravertebral lines, at the level of Th2, Th4, Th6, defocused ray, distantly, nested, exposure time T = 120 s, generator output power P = 20 mW. The calculation of the therapeutic dose was carried out according to the above formula and is 0.006 J / cm 2 . Objectively - the phenomena of bronchospasm (expiratory dyspnea, auscultatory dry "wheezing" rales over the entire surface of the lungs) were stopped after the first session of laser therapy and were no longer repeated during the entire inpatient treatment. According to laboratory data, a decrease in JgM from 1.20% to 0.80% was noted, an increase in the JgA content from 1.22% to 1.35%, an increase in T-lymphocyte count from 36% to 51%, a decrease toward the decrease in the NAB- 6 to 3 units. The performed studies of the function of external respiration before and after the course of laser therapy showed a decrease in the total aerodynamic drag by 46.7% and aerodynamic drag of exhalation during hyperventilation by 14.3%, an increase in peak expiratory flow rate was 114 l / min (481 l / min before and 595 l / Min after the course of laser therapy). Follow-up showed no bouts of bronchial asthma for 5 months.

The use of this method will increase the effectiveness of treatment through targeted, individualized laser exposure, which will shorten the duration of treatment and eliminate the negative effects of laser exposure.

CLAIM

A method of treating bronchial asthma in children, including drug therapy and laser treatment of acupuncture points, characterized by acting on the general stimulating points, the projection zone of the left cubital vein in the ulnar fossa and the projection field of the bronchial tubes of the main and middle caliber, along both paravertebral lines at levels Second, fourth and sixth thoracic vertebrae, with a single dose of exposure to the projection zone of the left cubital vein is 0.00005-0.00015 J / cm 2 , the projection of the bronchi is 0.0018-0.007 J / cm 2 , the total exposure time For a session of 14-16 minutes, for a course of 5-7 procedures performed daily.

print version
Date of publication 06.01.2007gg