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GASTROENTEROLOGY
INVENTION
Patent of the Russian Federation RU2126280

METHOD FOR TREATMENT OF LIVERNOUS GASTROINTESTINAL DISEASE AND TWELFTH DIAGNOSTIC

METHOD FOR TREATMENT OF LIVERNOUS GASTROINTESTINAL DISEASE AND TWELFTH DIAGNOSTIC

The name of the inventor: Rusakov VI; Zaguskin S.L .; Bubnova VI; Chernogubova EA; Lazarev IA; Slyusarev S.L.
The name of the patent holder: Zaguskin Sergey Lvovich
Address for correspondence: 344022 Rostov-on-Don, PO Box 3408, Zaguskin S.L.
Date of commencement of the patent: 1995.03.02

The invention relates to medicine and is intended for the treatment of peptic ulcer of the stomach and duodenum. Irradiate with an infrared laser. Synchronize the radiation with the rhythm of pulse and respiration of the patient with increasing radiation power in the phases of systole and inspiration with a modulation depth of 30%. We are irradiated daily, percutaneously through the abdominal wall of the projection area of ​​the ulcerative defect. Use a matrix of at least 10 laser emitters in an area of ​​at least 12.5 s 2 . Pulse power not less than 60-80 W. Applied apparatus for biocontrolled chronofizioterapii type "Mustang-bio." The method allows to stabilize the therapeutic effect and shorten the treatment time.

DESCRIPTION OF THE INVENTION

The invention relates to medicine - to gastroenterology and can be used to treat exacerbations of peptic ulcer or to be used in the complex treatment of patients with chronic gastric and duodenal ulcers.

The aim of the invention is to reduce and individually optimize the timing of treatment.

Various methods for treating peptic ulcer with a laser beam in the red and infrared regions, in constant and pulsed regimes, percutaneously and through a light guide through an endoscope are known [1-18].

Summing up the experience of the majority of researchers, clinical observations and the most recent comparative studies using new semiconductor lasers with large pulsed power in the infrared range, the latest methodological recommendations give preference to the treatment of this disease by pulsed infrared lasers in noninvasive transdermal irradiation regimens.

However, a wide range of results in terms of treatment of specific patients and frequent relapses indicate the need for individual optimization of the laser irradiation regime and control of efficacy. This is not the case with existing methods. With percutaneous irradiation in the methods used, the insufficient pulsed power of the infrared lasers did not guarantee a direct effect on the ulcer area and the therapeutic effect was carried out through the Zakharyin-Geda zones and biologically active points.

The method closest to the claimed method is the method for treating the stomach and duodenum according to AS of the USSR 1736512 [19]. In this method, the infrared laser action is synchronized with the rhythm of the pulse and respiration of the patient, while increasing the maximum irradiation power in the systole and inspiratory phases with a modulation depth of 30%.

Disadvantages of this method are:

1. There is no control or criteria for individual effectiveness and sufficiency in the number of laser treatments to reduce the likelihood or exclusion of relapse.

2. Irradiation of the tissue around the ulcer is carried out through the gastroendoscopic probe, which is poorly perceived by many patients and allows for daily sessions, because of which the duration of treatment (stay in the hospital) increases by the number of days in which treatment is performed.

3. The area of ​​simultaneous irradiation through an optical fiber in the endoscope, especially for large ulcer defects, is insufficient for reconstructing the rhythms of blood microcirculation throughout the area of ​​the ulcerative defect and requires either an increase in the number of irradiation fields (which is not always possible in time during irradiation through an endoscope) or additional sessions .

The proposed method, while retaining the advantages of accelerating healing through individual synchronization of changes in the intensity of laser irradiation with changes in blood filling (rhythm of blood flow) of the prototype excludes the above disadvantages. The proposal is that laser pulsed infrared irradiation of the area of ​​the projection of the ulcerative defect through the abdominal wall is synchronized with the rhythms of fluctuations in the blood flow velocity with the help of the apparatus for the purpose of non-invasiveness and simplification of treatment, diagnosis and individual correction of the number of treatment sessions, increasing the stability of the therapeutic effect and reducing relapse of the disease For biocontrolled chronotherapy "Mustang-bio", and the result is controlled for individual correction of the number of sessions on the change in the level of activity of superoxide dismutase in the erythrocytes of the patient's blood. The final evaluation of the results of treatment is carried out additionally according to the generally accepted clinical diagnostic characteristics, the data of X-ray examination and gastroscopy.

The method is carried out as follows. Before the start of treatment in all patients, the level of activity of superoxide dismutase (SOD) of blood erythrocytes is determined. The determination is repeated after each laser therapy session a day before the next session. To do this, the patient is taken from the finger 0.1 ml of blood and determine the level of activity of SOD by the method of Rainer F. [20]. In the absolute majority of patients, this level is much lower than the norm (norm 206 4.03 U / ml. ). Normalization of this indicator is used as a control of the effectiveness of treatment. Complete normalization of the SOD level indicates the stability of the therapeutic effect, incomplete - about the possibility of a rapid relapse of the disease, despite the scarring of the ulcer. The sessions of laser therapy continue even after complete cicatrization of the ulcer up to the full normalization of the level of SOD or the cessation of its increase.

Laser therapy sessions are performed by the patient in the supine position with the help of a device or biocontrolled laser chronotherapy "Mustang-bio" (serially produced with the permission of the Ministry of Health of the Russian Federation by the firm "Technika" 105037, Moscow, PO Box 106). The pulse and breathing sensors of this apparatus are mounted on the patient's body, the apparatus is turned on, setting the power meter to measure the pulse power from 60 to 80 W in the pulse, depending on the degree of fatty deposits of the subcutaneous layer. A matrix of 10 semiconductor infrared (0.89 μm) lasers with a simultaneous irradiation area of ​​12.5 cm 2 is located in the projection of a pre-established localization of the stomach ulcer or duodenal ulcer. Irradiation is carried out non-invasively through the abdominal wall of the patient's stomach for 256 seconds (on a timer) daily in the afternoon. The electrical signals of the pulse and breath sensors of the Mustang-bio device allow modulating the intensity of laser irradiation with a depth of modulation for each signal of 30% with its increase in the systole and inspiration phases and a decrease in diastole and expiratory phases, thereby synchronizing the intensity of laser irradiation with the rhythms of the blood flow (Blood filling). The carrier frequency is 3 kHz and an additional modulation frequency in the rhythms of elongation and tremor is 10 Hz. The duration of rectangular pulses is 100 ns. Advantages of biocontrolled chronophysiotherapy in comparison with conventional laser therapy, the justification of these parameters and the device for bio-controlled laser chronotherapy are set forth in the works of S.L. Zaguskin, for example [21-23].

The average period of pain relief was 1-2 days (session), the average time of cicatrization of stomach ulcer and ulcer of duodenum - accordingly 3.5 ± 0.6 and 3 ± 0.2 sessions or 4 days of treatment, and the average number of sessions (Days) before the normalization or stabilization of the SOD level in blood erythrocytes of patients 10 ± 1.9 days. The level of activity of SOD in blood erythrocytes of healthy people is 206.5 ± 4.03 units. / Ml. ; In patients before treatment, 130.2 ± 6.87 U / ml; After scarring of ulcers in patients - 174,9 ± 4,15 (P <0,01). Of these, with subsequent relapses, 163 ± 5.45 U / ml (P <0.05 compared with the control and before treatment); After treatment in patients without relapses, at least 1 year - 198 ± 8.11 units / ml (P <0.01 compared to pre-treatment level and P <0.05 compared with the control). The level of activity of cerulplasm of blood plasma was normalized reliably in all patients (from 0.68 ± 0.07 to 1.12 ± 0.14 μm / l).

Examples of specific use of the method (extract from the case histories):

Example 1. Patient K.I.B. N 1208, 30 years old. Has arrived in clinic of surgical illnesses or diseases N 2 with DS: a peptic ulcer of 12 duodenal ulcer. Sick for 15 years, exacerbation at least 2 times a year. When you receive a complaint of pain in the epigastric region, nausea, vomiting. Two phase ulcers, localized in the bulb of the duodenum, were found in the GBS. The level of activity of superoxide dismutase (SOD) in erythrocytes is 157.4 U / ml. A conservative treatment using bio-controlled laser therapy with the Mustang-Bio No. 10 apparatus was performed. The pain syndrome, nausea and vomiting disappeared by 4-5 days from the start of treatment. At control FGD after a course of treatment ulcers were healed. The activity of SOD in erythrocytes after a complete course of treatment for 10 days was 199.3 U / ml. It is discharged in a satisfactory condition.

Example 2. Patient K. N 1016/80, 37 years old. Was in a surgical clinic with DS: peptic ulcer of duodenal ulcer, exacerbation. He is ill for 4 years, in the anamnesis bleeding. At receipt of the complaint on "hungry" pains in an epigastrium, delicacy, a nausea. With FGDS - ulcer bulb of duodenum 0.5 cm in diameter. The level of activity of SOD in erythrocytes - 148 units / ml. A course of conservative treatment with the use of bio-controlled laser therapy with the apparatus of Mustang-Bio No. 10 was conducted. The pain syndrome, nausea stopped at 4-5 days from the beginning of treatment. After the course of treatment with a control FGD, the ulcer was healed. The activity level of SOD is 168 units / ml.

The proposed method allowed:

- Compared with the prototype, reduce the duration of treatment due to daily procedures and non-invasive methods; Increase the stability of the therapeutic effect (the duration of remissions) through monitoring and individual optimization of the number of sessions to normalize the level of SOD activity in red blood cells and increase the area of ​​simultaneous irradiation; Simplify the way of laser treatment due to non-invasion;

- in comparison with non-invasive methods of laser therapy, reduce the duration of treatment and cicatrization of the ulcer by synchronizing the increase in the intensity of the laser exposure with the phases of strengthening the blood filling and blood flow (with the rhythms of the blood flow); Increase the stability of the therapeutic effect due to individual control of the normalization of the level of SOD activity.

USED ​​BOOKS

1. Balalykin AS, Avaliani MV, Lapshina SV Endoscopic phototherapy in the complex treatment of peptic ulcer of the stomach and duodenum / / Therapeutic. Arch-1987, N 10.C.66-68.

2. Barakaev S.B. Comparative evaluation of external and endoscopic laser therapy of duodenal ulcer 12 / Materials of the 4th All-Union Congress of Gastroenterologists. - M; L .; 1990, P.129 and 130.

3. Budantsev, SI, a comparative evaluation of the effect of laser radiation on the regeneration of chronic gastric ulcers, Sovrem. Methods of laser therapy. - Ryazan: 1988, P.66-69.

4. Brown AN, Leonov AN, Deineka S.V. And others. Clinical and morphological aspects of endoscopic laser therapy of gastric ulcers // Klinich. Surgery.- 1985 N 8, p. 23-25.

5. Gorban VV, Golovina TE Efficiency of treatment with low-energy pulsed semiconductor laser radiation of mediogastric ulcers. // 4th All-Union Congress of Gastroenterol. Materials: M.-L .: 1990, vol. 1, p. 206 and 207.

6. Dmitriev AE, Kashevarov SB, Arapov NA Laser therapy of ulcerative defects of the stomach and duodenum // Klin. Med.-1991, No. 4, p. 85-87.

7. Illarionov V.E. Fundamentals of laser therapy. - Moscow: 1992, 122 p.

8. Karu TI, Letokhov VS, Lobko VV Illumination of patients with gastric ulcer and duodenal ulcer on the basis of cell stimulation by low-intensity red light // Vopr. Health resort, physiotherapy and physiotherapy. - 1984, No. 1, p. 36-39.

9. Kerin VV, Gembitsky EV, Sinev Yu.V. And others. The use of low-energy laser radiation in the complex treatment of gastric ulcer and duodenal ulcer // Therapeutic. Arch. - 1984, v. 56, No. 2, p. 46-48.

10. Kozlov VI, Builin V.A. Laser therapy with ALT "Mustang". - Moscow: 1994, 124 p.

11. Authorship of the USSR N 1143429, 1985.

12. Loginov AS, Basov NG, Ambartsumian VV Et al. Efficiency of treatment of long-lasting non-healing gastric ulcers by a copper vapor laser. // Therapeutic. Arch. - 1989, No. 2, Vol. 1, p. 42-46.

13. Application of low-intensity lasers in medicine. Methodical recommendations .- Ryazan: 1992, 134 p.

14. Radbil OS, Evstigneev AR, Shpigelman S.D. Application of lasers in gastroenterology (Review of foreign literature). MLC, section XVII, - 1984, No. 9, p. 1-4.

15. Romanov G.A. Efficiency of a low-intensity helium-neon laser in the complex treatment of peptic ulcer of the stomach and duodenum // Klin. honey. - 1987, No. 10, p. 66-68.

16. Semendyaeva ME, Lebedev AV, Matveev GN Laser therapy of gastroduodenal ulcers. / / Wedge. honey. - 1990, No. 10, p. 72-74.

17. Fleisher D. Endoscopic Lazer therapy for gastrointestinal disease // V 3296 Arch. Intern. Med. - 1984, 144, 6, p. 1225-1230.

18. Greguss P. Low-Lewel lazer therapy - reality or myth? // Optics and Lazer Thechonologu. - 1984, v. 16, No. 2, p. 81-85.

19. Authorship of the USSR N 1736512, 17.05.91.

20. Rainer F. Enzymatic and non-enzymatic assay ob superoxid dismutase // Biochem. - 1975, v. 57, p. 657-660.

21. Zaguskin SL Chronobiology - Physiotherapy. / / Physician, 1994, N 2, p. 30-34.

22. Komarov FI, Zaguskin SL, Rapoport S.I. Chronobiological direction in medicine: biocontrolled chronophysiotherapy. // Therapeutic archive. - 1994, No. 8, p. 3-6.

23. Application No. 4733853 / 30-14, 31.08.90.

CLAIM

1. A method for treating gastric and duodenal ulcers by infrared laser irradiation synchronized with the pulse rhythms and respiration of the patient, with increasing irradiation power in the systole and inspiratory phases with a modulation depth of 30%, characterized in that the irradiation is daily percutaneously through the abdominal wall of the projection area Ulcer defect with a simultaneous matrix of at least 10 laser emitters on an area of ​​at least 12.5 cm 2 with a pulse power of at least 60 - 80 W using a device for biocontrolled chronophysiotherapy, such as Mustang-bio.

2. A method according to claim 1, characterized in that the number of sessions for stopping the increase (normalization compared to the initial lowered from the normal level before treatment) is optimized individually for the level of activity of superoxide dismutase in the blood erythrocytes of the patient

print version
Date of publication 29.03.2007gg