RU2794433C1 - Method for treatment of patients with chronic fatigue syndrome - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely physiotherapy and balneology, and can be used to treat patients with chronic fatigue syndrome. In the period from 10.00 to 12.00 a. m., a high-amplitude pulsed bipolar current with biofeedback is applied to the collar area, the scalp and the liver area with a gradual increase in current strength until a distinct painless vibration appears under the electrode. At the same time, the frequency is 60 Hz with a duration of the procedure of 15-30 minutes daily, for a course of 10-12 procedures. After a session of electrical stimulation in the period from 14.00 to 18.00 p. m., balneotherapy is carried out with common iodine-bromine baths. At the same time, the concentration of substances is: sodium chloride 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, and the temperature is 36-37°C. At the same time, the duration of the procedure is 10-15 minutes, daily, for a course of 10-12 procedures.

EFFECT: method provides restorative treatment of patients with chronic fatigue syndrome by improving the indicators of the psychological status and adaptive capabilities of the patient’s body, due to the developed complex effect and a certain mode of this effect.

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Description

The invention relates to medicine, namely to physiotherapy and balneology, and can be used to treat patients with chronic fatigue syndrome.

Chronic fatigue syndrome (CFS), otherwise known as myalgic encephalomyelitis (ME), is a clinical condition characterized by persistent severe fatigue lasting more than 6 months despite sleep and rest. The etiology and pathogenesis of CFS is still not well understood (Rutherford G., Manning P., Newton JL J. Muscle Dysfunction in Chronic Fatigue Syndrome // J. Aging Res. - 2016: 2497348. doi: 10.1155/2016/2497348.) . CFS is a symptom complex of various clinical manifestations that characterize the development of fatigue in humans. Psychophysiological adaptation disorders observed in CFS are manifested by a decrease in the effectiveness of professional activity, emotional exhaustion, dysfunction of interpersonal contacts at work and in the family, and as a result lead to persistent disorders of mental and somatic health.

Pathogenetically substantiated methods of treating asthenic disorders are methods of balneotherapy, which allow to relieve stress and normalize the psycho-emotional state in a short time.

A known method for the treatment of chronic fatigue syndrome (CFS) by hemosorption and plasmapheresis in the form of alternating procedures, accompanied by exfusion of 5-7% of the volume of circulating blood. Alternate procedures according to the scheme: 1st day of the cycle - hemosorption, 6th day of the cycle - plasmapheresis, 12th day of the cycle - hemosorption, 18th day of the cycle - plasmapheresis. The invention allows to increase the effectiveness of treatment, reduce the frequency of relapses, improve the quality of life of patients due to the occurrence of compensatory mechanisms as a result of treatment, contributing to the return of the systemic regulation of the body to the physiological norm (Vedishchev S.V., Shempeleva L.A., Sula A.S., Gvozdikova E. A. Patent No. 2362590 Method for the treatment of chronic fatigue syndrome // Russia, publ. 27.07.2009). The disadvantage of this method is that the main effect of hemosorption is only its detoxification ability. The effects of plasmapheresis are much broader and include effects on immune function. However, the procedure has a large number of contraindications and side effects, in particular, during the procedure, an increase in blood pressure, dizziness, a feeling of heat, nausea, and local bleeding are possible. More complex and distant side effects include a violation of blood clotting in the form of thrombosis with various consequences, and a number of literary sources indicate a short-term effect of this procedure in the form that the concentration of pathological substances returns to its previous level after a few hours.

A known method for the treatment of patients with CFS, including the impact of EHF and acupuncture (IRT) (Liang V.N., Liang N.V., Votoropin S.D. Patent No. 98111449 Method for the treatment of chronic fatigue syndrome // Russia, publ. 10.04.2000 G.). The disadvantages of this method are the impossibility of individually dosing the effect, the difficulty of determining the localization of the effect, and the results of Nakatani diagnostics, with which it is proposed to control the treatment process, strongly depend on the qualifications of the doctor. An equally important point is the fact that EHF-therapy contributes to the mobilization of the body's reserves, which are continuously decreasing with age. Therefore, without adequate provision of the patient's body with vitamins, amino acids, antioxidants, these reserves can be depleted.

Closest to the present invention is a method for the treatment of CFS, which consists in the overall effect on the patient's body with the use of bath products "Biolong" (Davydova O.B., Uyanaeva A.I., Krikorova S.A. Manual for doctors, 2003) which was combined with sessions of psychotherapeutic influence. The disadvantages of the method are: the inaccessibility of the drug "Biolong" in wide medical practice due to the termination of its production, as well as the need for a psychotherapist in the staff of the medical institution.

A new technical result is an increase in the efficiency of restorative treatment of patients with chronic fatigue syndrome by improving the indicators of the psychological status and adaptive capabilities of the patient's body.

To achieve a new technical result in a method for treating patients with chronic fatigue syndrome by balneotherapy, moreover, in the period from 10.00 to 12.00 hours, high-amplitude pulsed bipolar current with biological feedback is applied to the collar region, scalp and liver region with a gradual increase in current strength to the appearance of a distinct painless vibration under the electrode, with a frequency of 60 Hz, with a procedure duration of 15-30 minutes, according to a labile method, daily, for a course of 10-12 procedures, after a session of electrical stimulation in the period from 14.00 to 18.00, balneotherapy is carried out with general iodine-bromine baths, with a concentration sodium chloride 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, temperature 36-37°C, procedure duration 10-15 minutes, daily, 10-12 procedures per course.

The method is carried out as follows. In the period from 10.00 to 12.00 hours, a high-amplitude pulsed bipolar current with biological feedback is applied to the collar region, scalp and liver area of the patient with a gradual increase in current strength until a distinct painless vibration appears under the electrode, with a frequency of 60 Hz, with a procedure duration of 15- 30 minutes, according to a labile method, daily, for a course of 10-12 procedures, after a session of electrical stimulation in the period from 14.00 to 18.00, balneotherapy is carried out with general iodine-bromine baths, with a concentration of sodium chloride 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, temperature 36-37°С, procedure duration 10-15 minutes, daily, 10-12 procedures per course.

The duration of the treatment course is determined taking into account the fact that the improvement of clinical symptoms in balneotherapy occurs after 5-7 procedures. Therefore, the lower limit of the duration of the course of treatment was 8 procedures. At 11-12 procedures, there was an increase in sympathetic-adrenal activity, an increase in the frequency of astheno-vegetative disorders, which determined the limitation of the course of treatment to 10 procedures (Golubova T.F., Lagunova N.V., Polenok I.A. The state of adaptive-compensatory mechanisms in children with diabetes mellitus and their changes under the influence of spa treatment // Bulletin of new medical technologies. Electronic edition. - 2014. - No. 1.)

The time of the balneotherapy procedure was chosen taking into account the circadian biorhythms of the activity of the sympathoadrenal system. The morning hours are characterized by an increase in the functions of homeostatic systems and the predominance of the activity of the sympathetic nervous system, the afternoon hours are characterized by the predominance of parasympathetic activity, therefore, the appointment of balneotherapy for patients with cardiovascular diseases is most indicated in the second half of the day. In the afternoon hours from 14.00 to 18.00 there is an increase in the processes of inhibition in the central and autonomic nervous systems, the appointment of balneotherapy at this time enhances the hypotensive effect of treatment by correcting the increased activity of the hypothalamic-pituitary-adrenal system (Razumov A.N. Natural therapeutic factors and biological rhythms in restorative chronomedicine / A.N. Razumov, I.E. Oransky. - M.: Medicine, 2004. - 296 p.; Borodin Y.I. Fundamentals of chronobiology and chronomedicine / Y.I. Borodin, V.A. Trufakin , A. V. Shurlygina. - Novosibirsk, 2000. - S. 61-64).

SCENAR-therapy was prescribed in the morning from 10.00 to 12.00, taking into account daily biorhythms, in order to stimulate metabolic processes aimed at correcting lipid metabolism, reducing lipid peroxidation, increasing the adaptive capacity of the body, and enhancing the hypotensive effect of treatment by reducing hypersympathicotonia. In the claimed method, the parameters of SCENAR-therapy are determined taking into account the clinical data obtained as a result of the study. The zones of influence are determined taking into account the pathogenesis of cardiovascular diseases and the need to influence both the reflexogenic zones of neurohumoral regulation (collar region, scalp) and the reflexogenic zone of lipid metabolism (liver region), with a frequency of 60 Hz determined as the most effective in terms of influencing activity of the sympathetic nervous system.

Immune imbalance is one of the important pathogenetic mechanisms for the development of CFS. The use of iodine-bromine baths in the claimed method is due to their ability to correct the functional state of the central and autonomic nervous system. Ions of iodine and bromine, being included in biochemical processes, stimulate the work of enzyme systems. Iodine-bromine baths have a sedative effect, as they help to enhance the processes of inhibition in the cerebral cortex, increase the threshold of pain and tactile sensitivity, normalize muscle tone, which is justified in patients with CFS (Mavraeva MA, Guseinov T.S. Influence of iodinebrominewater on the morpho-functional features of thethyroid gland // Natural and exact sciences - 2014. - Vol. 3, No. 28. - P. 62-65 Amila K., Samiha H., Dijana A. The effect of mineral radon water applied in the form of Shishko E.Yu., Bobrik Yu.V., Kolbasin P.N. full baths on blood pressure in patients with hypertension // Journal of Health Sciences - 2013. - Vol. ., Ponomarev V.A. Features of physical therapy of patients with hypertension at the sanatorium-resort stage of rehabilitation // Crimean Journal of Experimental and Classical Medicine. - 2017. - V. 7, No. 2. - P. 127-136). Strengthening the inhibitory processes in the cerebral cortex, iodine-bromine baths affect the neurotransmitters and releasing factors of the hypothalamus involved in the synthesis of pituitary hormones, which causes their immunocorrective effect (Khramova I.A., Slyusareva E.E., Antonyuk M.V. Influence of iodine-bromine baths on the cells of the macrophage system of women with menopausal syndrome // Pacific Medical Journal - 2014. - No. 2. P. 56-58).

The use of self-controlled energy neuroadaptive electrical stimulation (SCENAR-therapy) also seems to be a necessary factor of influence for the treatment of patients with this pathology. Experimental and clinical studies conducted by the authors confirm that the therapeutic effect of SCENAR therapy is based on multilevel reflex and neurochemical reactions that trigger a cascade of regulatory and adaptive mechanisms of the body that affect autonomic regulation, metabolic processes and other body systems (Krasovsky V.O., Kireeva N.V., Ryavkin A.Yu. Study of the mechanism of action of DENS-therapy devices by the method of "biotempo-measurements" // Med. Bulletin. - Ekaterinburg. - 2003. - No. 1. P. 14-15; Mizova O.V., Klushina O.D. Peculiarities of changes in the power of EEG rhythms during DENS-therapy in patients with cervical osteochondrosis // Proceedings of the International Symposium, devoted to the 6-year-old Corporation "BENAS MS", edited by Prof. V.V. Malakhov - 2004. - S. 61-64.).

Self-controlled energy-neuroadaptive electrical stimulation (SCENAR-therapy) in the claimed method is prescribed to correct autonomic imbalance and hypersympathicotonia, normalize lipid peroxidation and antioxidant protection, increase overall nonspecific reactivity and adaptive capabilities of the body. As a result, pain syndromes are eliminated, local and systemic blood circulation is improved, an anti-inflammatory effect is exerted, the formation of biologically active substances and metabolic processes in tissues are activated, which helps to remove metabolic products from pathological foci, and muscle and vascular tone is normalized. This type of treatment is manifested primarily by a rapid improvement in well-being, mood, normalization of sleep and appetite, increased efficiency (Konovalova N.I., Kargapolov A.A., Malakhov V.V., Ryavkin S.Yu. The use of electrodynamic reflexology in gastroenterological practice // Medical Bulletin - Ekaterinburg - 2004. - V. 3. No. 1. - P. 17-22).

Example 1. Patient B, 32 years old, was admitted for treatment to the therapeutic department of the Branch of TNIIKiF FGBU SibFNKTs FMBA of Russia on January 15, 2020 with a diagnosis of Chronic Fatigue Syndrome. Concomitant diseases: Hypertension I degree, risk 2. Dyslipoproteinemia. triglyceridemia. Cervicalgia syndrome, chronic relapsing course. Upon admission, he complained of increased fatigue, headaches, dizziness, daytime drowsiness and insomnia at night, emotional depression, muscle and joint pain after physical exertion, and a feeling of unreasonable anxiety.

From the anamnesis: These complaints appeared about 1.5 years ago against the background of excessive psycho-emotional stress and work-related workload. Objective status: General condition is satisfactory. Skin and mucous membranes are clean, skin moisture is increased. Lymph nodes - cervical lymph nodes are enlarged. Hyperemia of the posterior pharyngeal wall. Heart sounds are rhythmic, there are no loud murmurs. Heart rate 78 per minute. BP at admission 130/90 mm Hg. Breathing is vesicular, rales in the lungs are not heard. The abdomen is soft, painless on palpation.

Biochemical blood parameters before treatment: total cholesterol 4.93 mmol/l (at a rate of up to 5.17 mmol/l), high-density lipoprotein cholesterol 0.64 mmol/l (at a rate of more than 1.0 mmol/l in men) , low-density lipoprotein cholesterol 3.26 mmol / l (at a rate of up to 3.0 mmol / l), triglycerides 2.25 mmol / l (at a rate of up to 1.7 mmol / l), non-high-density lipoprotein cholesterol 4 .29 mmol / l (at a rate of up to 3.0 mmol / l), glucose 5.44 mmol / l (at a rate of up to 5.89 mmol / l), uric acid 270.9 μmol / l (at a rate of up to 420 μmol /l in men), fibrinogen 3.5 g/l (at a norm of up to 4 g/l), the total level of lipid peroxides 553.95 μmol/l (at a norm of up to 200 μmol/l), tumor necrosis factor (TNF-α ) 8.19 pg/ml (norm up to 6 pg/ml), interleukin 1β (IL-1β) 4.02 pg/ml (at a norm up to 11 pg/ml), endothelium-1 (ET-1) 2.26 pg/ml (norm up to 2.0 pg/ml), highly sensitive C-reactive protein (hsCRP) 5.39 IU/l (at a norm of up to 3 IU/l), stimulated phagocytic activity of lymphocytes 35.6% (at a norm of 40 -80%). The adaptive reaction was assessed as a reaction of calm activation of a high level of reactivity (the number of lymphocytes is 30% at a rate of up to 40%). Tolerance to physical activity by the method of bicycle ergometry is average - 100 W. During cardiointervalography, hypersympathicotonia was revealed as the initial vegetative tone (the norm is atonia or sympathicotonia). Psychological status was assessed using the MOPSY questionnaire to assess the depletion of vitality and threats of depression - before treatment - 14 points (0-4 points - normal, 5-9 points - overwork, 10-14 points - exhaustion).

The treatment was carried out in accordance with the claimed method. From the first day of stay in the clinic, SCENAR therapy was prescribed from 10.00 to 12.00, with a high-amplitude pulsed bipolar current with biofeedback (automatic shutdown when the impedance levels inside the device and in the skin are equalized), with a frequency of 60 Hz, with a procedure duration of 15 minutes, the impact is carried out on collar area, scalp and liver area (with a gradual increase in current strength until a distinct painless vibration appears under the electrode), according to a labile method, daily, for a course of 10 procedures; general iodine-bromine baths, sodium chloride concentration 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, temperature 36°C, procedure duration 10 minutes, daily, in the afternoon from 14.00 to 18.00, per course 10 procedures .

The patient tolerated the treatment well. Clinical manifestations of balneoreaction were not recorded. There were no sharp fluctuations in vegetative indices characterizing vegetative tone and reactivity. After treatment according to the claimed method, the patient disappeared all of the above complaints, significantly decreased emotional disturbances. An improvement in the blood lipid spectrum was noted: the concentration of total cholesterol decreased to 4.05 mmol / l, low-density lipoprotein cholesterol decreased to 2.17 mmol / l, high-density lipoprotein cholesterol increased to 1.21, triglycerides decreased to 1.48 mmol /l, non-high-density lipoprotein cholesterol decreased to 2.84 mmol/l, fibrinogen level decreased to 3.1 g/l, uric acid - to 193.2 µmol/l, total lipid peroxide level decreased to 309.9 µmol /l, tumor necrosis factor (TNF-α) decreased to 5.43 pg/ml, the concentration of interleukin 1β (IL-1β) decreased to 2.96 pg/ml, endothelin-1 (ET-1) to 1.94 pg /ml, highly sensitive C-reactive protein (hsCRP) decreased to 3.26 IU/l, stimulated phagocytic activity of lymphocytes increased to 54.1%. The adaptive response was assessed as a training response of a high level of reactivity. The exercise tolerance increased to 180 watts. Vegetative tone after treatment - sympathicotonia. According to the MOPSY test, the total score decreased to 4, which is normal.

The immediate results of treatment were generally rated as a significant improvement.

Example 2. Patient M, 54 years old, was admitted for treatment to the therapeutic department of the Branch of TNIIKiF FGBU SibFNKTs FMBA of Russia on February 17, 2020 with a diagnosis of Chronic Fatigue Syndrome. Concomitant diseases: Lumbalgia syndrome, chronic relapsing course. Chronic gastritis, remission. Upon admission, he complained of increased fatigue, headaches, dizziness, daytime drowsiness and insomnia at night, emotional depression, muscle and joint pain after exercise, a feeling of constant anxiety, sore throat when swallowing, fever up to 37 2°C on waking, while denying any viral infections.

From the anamnesis: These complaints appeared about 3 years ago. He associates his condition with constant stress and tension at work. Objective status: General condition is satisfactory. Skin and mucous membranes are clean. Lymph nodes - enlarged cervical lymph nodes, painless. Hyperemia of the posterior pharyngeal wall. Heart sounds are rhythmic, there are no loud murmurs. Heart rate 85 per minute. BP at admission 120/80 mm Hg. Breathing is vesicular, rales in the lungs are not heard. The abdomen is soft, painless on palpation. Liver on the edge of the costal arch. The kidneys are not palpable. Stool and urination are normal.

Biochemical blood parameters before treatment: total cholesterol 5.83 mmol/l (at a rate of up to 5.17 mmol/l), high-density lipoprotein cholesterol 0.92 mmol/l (at a rate of more than 1.0 mmol/l in men) , low-density lipoprotein cholesterol 4.02 mmol/l (at a rate of up to 3.0 mmol/l), triglycerides 1.95 mmol/l (at a rate of up to 1.7 mmol/l), high-density non-lipoprotein cholesterol 4 .91 mmol / l (at a rate of up to 3.0 mmol / l), glucose 6.01 mmol / l (at a rate of up to 5.89 mmol / l), uric acid 415.7 μmol / l (at a rate of up to 420 μmol /l in men), fibrinogen 3.2 g/l (at a rate of up to 4 g/l), the total level of lipid peroxides 625.84 μmol/l (at a rate of up to 200 μmol/l), tumor necrosis factor (TNF-α ) 7.47 pg / ml (norm up to 6 pg / ml), interleukin 1β (IL-1β) 6.25 pg / ml (at a norm up to 11 pg / ml), endothelium-1 (ET-1) 2.78 pg/ml (norm up to 2.0 pg/ml), highly sensitive C-reactive protein (hsCRP) 6.53 IU/l (at a norm of up to 3 IU/l), stimulated phagocytic activity of lymphocytes 48.4% (at a norm of 40 -80%). The adaptive response was assessed as a reactivation reaction of a low level of reactivity (the number of lymphocytes was 48% at a rate of up to 40%). Tolerance to physical activity by the method of bicycle ergometry is average - 95 W. When conducting cardiointervalography, hypersympathicotonia was revealed as the initial vegetative tone (normal - atonia or sympathicotonia). Psychological status was assessed using the MOPSY questionnaire to assess the depletion of vitality and threats of depression - before treatment - 14 points (0-4 points - normal, 5-9 points - overwork, 10-14 points - exhaustion).

The treatment was carried out in accordance with the claimed method. From the first day of stay in the clinic, SCENAR therapy was prescribed from 10.00 to 12.00, with a high-amplitude pulsed bipolar current with biological feedback (automatic shutdown when the impedance levels inside the device and in the skin are equalized), with a frequency of 60 Hz, with a procedure duration of 30 minutes, exposure is carried out on the collar region, scalp and liver region (with a gradual increase in current until a distinct painless vibration appears under the electrode), according to a labile method, daily, for a course of 12 procedures; general iodine-bromine baths, sodium chloride concentration 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, temperature 37°C, procedure duration 15 minutes, daily, from 14.00 to 18.00, for a course of 12 procedures .

The patient tolerated the treatment well. Clinical manifestations of balneoreaction were not recorded. There were no sharp fluctuations in vegetative indices characterizing vegetative tone and reactivity. After treatment according to the claimed method, the patient disappeared all of the above complaints, significantly decreased emotional disturbances. An improvement in the blood lipid spectrum was noted: the concentration of total cholesterol decreased to 5.12 mmol/l, low-density lipoprotein cholesterol decreased to 3.35 mmol/l, high-density lipoprotein cholesterol increased to 1.06, triglycerides decreased to 1.55 mmol /l, non-high-density lipoprotein cholesterol decreased to 4.06 mmol/l, fibrinogen level decreased to 3.0 g/l, uric acid - to 385.3 µmol/l, total lipid peroxide level decreased to 300.0 µmol /l, tumor necrosis factor (TNF-α) decreased to 6.39 pg/ml, the concentration of interleukin 1β (IL-1β) decreased to 3.52 pg/ml, endothelin-1 (ET-1) to 1.85 pg /ml, highly sensitive C-reactive protein (hsCRP) decreased to 4.05 IU/l, stimulated phagocytic activity of lymphocytes increased to 62.3%. The adaptive reaction was assessed as a reaction of calm activation of a high level of reactivity. Exercise tolerance increased to 155 watts. Vegetative tone after treatment - sympathicotonia. According to the MOPSY test, the score decreased to 3, which is normal.

The immediate results of treatment were generally rated as a significant improvement.

The proposed method is based on the analysis of the results of clinical trials.

Treatment according to the claimed method was received by 45 patients (group II). The control group consisted of 42 patients who received only general iodine-bromine baths according to the above method without prescribing SCENAR therapy (group I). The average age of the patients was 50.8±6.88 years, the average duration of the disease was 2.61±2.22 years. To verify the symptom complex of CFS, all patients underwent a comprehensive clinical and psychological study, including an analysis of the diagnostic criteria for CFS according to the developed algorithm. It was revealed that the majority of patients had the main diagnostic criteria for chronic fatigue syndrome, while all the examined patients did not have exacerbations of chronic diseases with a similar clinical picture. The main clinical characteristic of CFS in all examined patients was complaints of increased fatigue.

The criteria for the effectiveness of treatment were: relief of symptoms of CFS, increased physical performance in terms of exercise tolerance (ET), correction of antioxidant defense disorders, improvement of blood lipid spectrum, improvement of autonomic regulation of the cardiovascular system.

After a course of treatment with the use of natural and preformed therapeutic factors, anxiety persisted in 27 (64.3%) patients belonging to comparison group I, and only in 9 (20%) patients of the main group II who additionally received SCENAR therapy. Complaints of daytime sleepiness persisted only in 14 (33.3%) patients from comparison group I. Sore throat persisted only in 4 (9.5%) patients from the comparison group, symptoms of catarrhal pharyngitis in 8 (19.04%) ) patients.

After a course of sanatorium-and-spa rehabilitation with the inclusion of SCENAR-therapy, the frequency of registration of verified CFS decreased by 3 times (a combination of 2 "major" and more than 12 "minor" diagnostic criteria). The number of patients with a low risk of CFS increased after a course of sanatorium rehabilitation in both groups.

Thus, the degree of relief of clinical manifestations of CFS was most pronounced in the group of patients who additionally received SCENAR-therapy (p=0.006; χ2=7.619).

Against the background of treatment, it was possible to significantly improve the adaptive potential only in group II with the inclusion of neuroadaptive electrical stimulation. Thus, the frequency of occurrence of a pathological reactivation reaction decreased by more than 2 times, the stress reaction was completely stopped, and the number of patients with physiological training reactions increased by 4 times.

Evaluation of the adaptive potential according to the index of functional changes showed that after the treatment in patients of the I group of comparison, the incidence of unsatisfactory adaptive potential decreased by 71.4%. The number of patients with strained adaptation mechanisms increased by 61.5% (p=0.028), due to the fact that patients moved from the groups of unsatisfactory adaptation and failure of adaptation

The most pronounced results were obtained in patients of the main group II. The frequency of occurrence of a satisfactory adaptive potential increased by 73.3% (p=0.002). Conditions of unsatisfactory adaptation and failure of adaptation against the background of treatment were completely stopped.

All examined patients underwent the MOPSY test, which assesses the degree of exhaustion of vitality and the threat of depression, the results of which are used to verify the diagnosis of CFS. After a course of sanatorium-and-spa treatment, the states of pronounced vital exhaustion and intense stress load according to the MOPSY test were completely stopped in patients of both groups.

The indicators of heart rate variability before treatment in the whole sample of patients with CFS were mostly within normal values with a tendency to sympathotonia. According to the spectral analysis, a balanced ratio of high and low frequency components (HF and LF) was observed, with sufficient total spectrum power (TP).

After the course of treatment in group I, there were no statistically significant changes, all indicators remained within the reference values.

In the control group II, after the course of treatment, such indicators as the amplitude of the mode significantly increased (from 54.2 to 57.8, at p<0.017), there was also a tendency to reduce the spectrum of low LF frequencies (from 223 to 144, at p<0.065 ), while the spectrum of high frequencies increased significantly (from 23.6 to 103, at p<0.012), and the LF/HF ratio, on the contrary, decreased from 5.95 to 1.41, at p<0.003. The data obtained are more typical for an increase in the share of influence of the autonomic nervous system in the processes of heart rhythm regulation, while the balance between the sympathetic and parasympathetic divisions was restored.

After the course of treatment, a distinct positive dynamics of oxidative stress was noted only in the group with the additional appointment of neuroadaptive electrical stimulation (control group II), where the PerOx level decreased from 343.15 [296.9; 542.0] µmol/l to 254.73 [184.4; 369.9] µmol/l (p=0.004). In the comparison group, the indicator of the total content of peroxides as a marker of oxidative stress did not change.

Comprehensive sanatorium-resort rehabilitation in both groups had a pronounced positive effect on the activity of inflammation processes and endothelial dysfunction - the level of inflammation markers (hsCRP) significantly decreased (in comparison group I by 5.3% (p = 0.015), in control group II - by 4.46% (p=0.036)), MSR-1 (in comparison group I by 8.7% (p=0.049), in control group II - by 16.6% (p=0.045))), and markers of endothelial dysfunction (ET-1 (in comparison group I by 9.7% (p=0.014), in control group II - by 11.1% (p=0.037)), vWF:Ag (in comparison group I by 18 0.0% (p=0.003), in the control group II - by 20.0% (p=0.007))).

Studies have confirmed that exposure to high-amplitude pulsed bipolar current with biofeedback on the collar region, scalp and liver region with a gradual increase in current strength until a distinct painless vibration appears under the electrode, with a frequency of 60 Hz, with a procedure duration of 15-30 minutes, labile method, daily, for a course of 10-12 procedures, it turned out to be optimal for obtaining a therapeutic effect in combination with balneotherapy with general iodine-bromine baths, with a concentration of sodium chloride 10 g/l, potassium bromide 25 g/l, potassium iodide 10 g/l, temperature 36 -37°C, procedure duration 10-15 minutes, daily, 10-12 procedures per course.

Thus, the application of the proposed method increases the efficiency of restorative treatment of patients with chronic fatigue syndrome by improving autonomic regulation, increasing the adaptive capacity of the body, reduces the concentration of markers of inflammation and endothelial dysfunction. The complex use of the above natural and preformed physical factors helps to improve the psycho-emotional and adaptive status, the realization of the anti-inflammatory effect and improve the quality of life of patients with CFS. The inclusion of SCENAR-therapy in the treatment complex contributes to a significant reduction in the level of oxidative stress as one of the mechanisms of nonspecific inflammation in CFS.

Claims (1)

A method for treating patients with chronic fatigue syndrome by balneotherapy, characterized in that in the period from 10.00 to 12.00 hours high-amplitude pulsed bipolar current is applied to the collar area, scalp and liver area with a gradual increase in current strength until a distinct painless vibration appears under the electrode, with a frequency of 60 Hz, with a procedure duration of 15-30 minutes, according to a labile method with biological feedback, including automatic shutdown when the impedance levels inside the device and in the skin are equalized, daily, for a course of 10-12 procedures, after a session of electrical stimulation in the period from 14.00 to 18.00 carry out balneotherapy with general iodine-bromine baths, with a concentration of sodium chloride 10 g / l, potassium bromide 25 g / l, potassium iodide 10 g / l, temperature 36-37 ° C, procedure duration 10-15 minutes, daily, for a course of 10- 12 procedures.