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INVENTION
Patent of the Russian Federation RU2234956
METHOD FOR TREATMENT OF LIVERNOUS GASTRIC DISEASE
The name of the inventor: Cheyda Alexander Andreevich
The name of the patent owner: Cheyda Alexander Andreevich
Address for correspondence: 153000, Ivanovo, ul. Nozdrina, 17, ap. 21, A.A. Chade
The effective date of the patent: 2002.07.19
The invention relates to medicine, namely, to gastroenterology. Transcutaneously, low-intensity infrared laser radiation of arsenide-gallium nature is applied to the area of the projection of the ulcer on the anterior abdominal wall. If the patient has first-degree protein deficiency and pain syndrome, this zone is irradiated at a frequency of 150 Hz, then at a frequency of 1500 Hz during the session. If there is no pain syndrome, irradiate at a frequency of 80 Hz. The exposure dose for irradiation with each frequency is 0.1 mJ / cm 2 . If the patient has a protein deficiency of the third degree and pain syndrome, this zone is irradiated at a frequency of 150 Hz, then at a frequency of 1500 Hz during the session. If there is no pain syndrome, irradiate at a frequency of 80 Hz. The exposure dose for irradiation with each frequency is 0.01 mJ / cm 2 . The duration of irradiation with each frequency is calculated by the formula: 
, Where D is the exposure dose of irradiation with each frequency, J / cm 2 ; P is the average pulse power of the radiation beam, W; T is the pulse duration, s; F - pulse repetition frequency, Hz; T is the irradiation time, s; S is the irradiation area, cm 2 . The method provides dosage of laser radiation depending on the reserve capabilities of the body, which increases efficiency and shortens the duration of treatment.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely to gastroenterology and physiotherapy, to the treatment of peptic ulcer (IB) of the stomach.
For the prototype of the invention, a method for treating gastric ulcer is taken by repeated transient exposure to low-intensity infrared laser radiation of arsenide-gallium nature using a laser therapeutic device on the area of projection of the ulcer on the anterior abdominal wall and paravertebral regions; Irradiation of the area of projection of the ulcer is carried out for 8 minutes with a pulse frequency of 80 Hz (with a mild pain syndrome) or at a frequency of 1500 Hz (with severe pain syndrome), paravertebral areas are irradiated at a level of Th 7-9 for 2 min at a frequency of 300 Hz (VP Kharchenko et al. Treatment of gastroduodenal ulcers with laser semiconductor device "Uzor" // Sovetskaya meditsina 1990. P.54-57).
The disadvantage of the prototype is the lack of dosage of laser radiation, depending on the reserve capabilities of the patient's body, which makes it impossible to differentiate the therapy according to the duration of exposure, at the exposure dose and reduces the effectiveness of treatment of stomach ulcers.
The technical result is aimed at increasing the effectiveness of treatment of stomach ulcers.
The technical result is achieved by the fact that, including multiple session-transcutaneous exposure by low-intensity infrared laser radiation of arsenide-gallium nature by means of a laser therapeutic device on the area of the projection of the ulcer on the anterior abdominal wall, the method of treatment of ND involves irradiation, in addition to the projection, gastroduodenal ulcer, during which the irradiator is constantly Move without detachment from the skin so that the duration of irradiation of one point does not exceed 2 seconds, the duration of the irradiation session is determined by the severity of the protein deficiency, taking into account the clinical picture of the disease.
If the patient has a pain syndrome, the gastroduodenal zone is irradiated first with a frequency of 150 Hz, then at a frequency of 1500 Hz.
If the patient does not have pain syndrome, the gastroduodenal zone is irradiated at a frequency of 80 Hz.
The duration of irradiation (t) of the gastroduodenal zone is calculated by the formula
Where D is the exposure dose, J / cm 2 ;
P is the average pulse power of the radiation beam, W;
T is the pulse duration, s;
F - pulse repetition frequency, Hz;
T is the irradiation time, s;
S is the irradiation area, cm 2 .
The duration of irradiation is calculated on the basis that if the patient has a protein deficiency of the first-second degree, the exposure dose for irradiation with each frequency should be 0.1 mJ / cm 2 . Thus, if the patient has a pain syndrome, the exposure dose for the session is 0.2 mJ / cm 2 , in the absence of pain syndrome 0.1 mJ / cm 2 .
If the patient has a protein deficiency of the third degree, the exposure dose for irradiation with each frequency should be 0.01 mJ / cm 2 . Thus, if the patient has pain syndrome, the exposure dose for the session is 0.02 mJ / cm 2 , in the absence of pain syndrome 0.01 mJ / cm 2 .
It is known that low-intensity infrared laser radiation with a frequency of 50-100 Hz is most effective for stimulating regenerative processes, the frequencies of the interval 150-600 Hz have the highest anti-inflammatory activity, the frequencies of the interval 1000-1500 Hz have an analgesic effect and influence the flow of reflex processes.
At the same time, it is known that an active inflammatory process with YaB without marked disorders of nervous regulation and pain sensitivity is accompanied by pain syndrome, the severity of which is directly determined by the severity of the exacerbation of the disease. Stihanie pain syndrome and its absence is usually observed in the epithelization of ulcers. In addition, YaB is characterized by chronic persistent inflammation. Consequently, the choice of the interval ensures correction of the leading pathogenetic links of the ND, which allows one to take into account the individual features of the YaB flow.
The reserve capacity of the organism of a patient with peptic ulcer of the stomach reflects the degree of protein deficiency (Cheaida AA Protein deficiency and its correction in determining indications for surgical treatment of patients with peptic ulcer: diss ... cms, Ivanovo, 1985. - C . 108).
Therefore, the choice of the duration of irradiation, corresponding to the severity of protein deficiency in the patient, provides a dosage of laser radiation, depending on the reserve capacity of the organism.
Examples of practical implementation of the method
1. Patient S., 34 years old. Has been hospitalized in occasion of an exacerbation of a stomach ulcer. Complains of severe epigastric pain. In fibroesophagogastroduodenoscopy (PHEGS): marked hyperemia of the gastric mucosa, gastric ulcer 0.7 cm in diameter, 0.2 cm deep, at the bottom of which - plaque fibrin.
The total protein is 70.5 g / l, the albumin of the blood is 37.7 g / l, the albumin-globulin coefficient is 1.45, the volume of the circulating blood is 68.9 ml / kg, the volume of the circulating plasma is 39.2 ml / kg , The volume of extracellular fluid is 156.5 ml / kg, the intercellular fluid is 87.4 ml / kg, i.е. Protein deficiency of the patient C. corresponds to the first degree.
Therefore, in accordance with the proposed method, the patient S., in accordance with the proposed method, is assigned daily session transcutaneous exposure by low-intensity infrared laser radiation of arsenide-gallium nature with the help of the laser therapeutic apparatus "Spectrum" to the region of the epigastric zone with an area of 120 cm 2 in series with a repetition rate of 150 Hz for 3 min 20 S, then at a frequency of 1500 Hz for 20 s with a constant movement of the irradiator within the zone without detachment from the skin so that the duration of irradiation of one point does not exceed 2 seconds. The course of treatment is 10 sessions.
On the control of PHAGS after treatment: cicatrization of the ulcer.
2. Patient F., 54 years old. Has been hospitalized in occasion of an exacerbation of a stomach ulcer. There is no pain, the ulcer is detected in fibroesophagogastroduodenoscopy (PHEGS): 1.8 cm in diameter, 0.3 cm in depth.
The total protein is 70.0 g / l, the albumin of the blood is 36.4 g / l, the albumin-globulin coefficient is 1.08, the volume of the circulating blood is 56.1 ml / kg, the volume of the circulating plasma is 28.05 ml / kg , The volume of extracellular fluid is 181.2 ml / kg, the intercellular fluid is 125.1 ml / kg, i.e. The protein deficiency of the patient F. corresponds to the third degree.
Therefore, in accordance with the proposed method, the patient F., according to the proposed method, has daily daily transcutaneous exposure to low-intensity infrared laser radiation of arsenide-gallium nature using a laser therapeutic device "Spectrum" to the region of the epigastric zone 120 cm 2 in series with a repetition rate of 80 Hz for 6 min 15 S with a constant movement of the irradiator within the zone without detachment from the skin so that the duration of irradiation of one point does not exceed 2 seconds. The course of treatment is 10 sessions. On control of PHEGS: reduction of ulcer size to 0.7 mm.
The results of treatment of other patients with stomach ulcers showed that in the treatment according to the method of the prototype (91 people) complete scarring by 10 sessions was obtained in 40 patients (43.96%), and in the treatment according to the proposed method (94 people) in 82 patients (87.23%), i.e. "Additionally" to the prototype method 43.27%. In addition, 7.69% of patients treated with the prototype method and 1.06% of patients treated with the proposed method had a "no change" condition. The average duration of healing of the ulcerative defect (according to the parameters of fibro-esophagogastroduodenoscopy) was 21.8 ± 1.63 days in the group treated by the prototype method and 14.3 ± 0.96 days according to the proposed method. Therefore, in the treatment according to the proposed method, the number of patients with complete cicatrization of the ulcerative defect by the 10th day of treatment increases with simultaneous reduction of the treatment period.
Thus, the proposed method, which presupposes the dosage of laser radiation depending on the reserve capacity of the organism for the duration of the session and the exposure dose, increases the efficiency of treatment of the stomach ulcer due to faster scarring of the ulcerative defect in a larger number of patients.
Advantage of the invention in relation to the prototype is an increase in the effectiveness of treatment of gastric ulcer.
The use of the invention will help reduce the duration of temporary disability, improve the quality of rehabilitation of patients.
CLAIM
A method for treating gastric ulcer, comprising a transcutaneous action of low-intensity infrared laser radiation of arsenide-gallium nature on the area of the projection of an ulcer on the anterior abdominal wall, characterized in that in the presence of a protein deficiency of the first and second degree and pain syndrome, this zone is irradiated at a frequency of 150 Hz , Then at a frequency of 1500 Hz during the session, in the absence of pain syndrome - irradiate at a frequency of 80 Hz so that the exposure dose at irradiation with each frequency is 0.1 mJ / cm 2 , and in the presence of a patient's protein deficiency of the third degree and pain Of the syndrome, this zone is irradiated at a frequency of 150 Hz, then at a frequency of 1500 Hz during the session, in the absence of pain syndrome, it is irradiated at a frequency of 80 Hz so that the exposure dose at irradiation with each frequency is 0.01 mJ / cm 2 , Irradiation with each frequency is calculated by the formula
Where D is the exposure dose of irradiation with each frequency, J / cm 2 ;
P is the average pulse power of the radiation beam, W;
T is the pulse duration, s;
F - pulse repetition frequency, Hz;
T is the irradiation time, s;
S is the irradiation area, cm 2 .
print version
Date of publication 29.03.2007gg
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