Abstract
Purpose . To study the effectiveness of laser therapy in patients with cardiovascular diseases using a diagnostic hardware-software complex. Material and methods . 120 patients with cardiovascular diseases (arterial hypertension – AH and ischemic heart disease – IHD) were taken into the study. Patients were divided into three groups depending on the rehabilitation program and prescribed basic medicamentous therapy: Group I – reflexotherapy (RT); Group II – RT and laser therapy (RT + LT); Group III (controls) – basic medicamentous treatment. At reflexotherapy sessions, biologically active points were electrostimulated with pointed pulses from «Lasper» device (Japan) having amplitude 0.8–2.5 V, pulse duration 1.5 ms, frequency 10 Hz and exposure 20 minutes. Infrared «Mlada» apparatus, generating in continuous mode with wavelength 0.85 μm, output power of two emitters 30 mW was used for laser therapy sessions. The effectiveness of treatment was assessed with diagnostic hardware and software complex (APK) «Physiocontrol-R» (Russia) which includes: analyzer of heart rate variability by cardiointervalogram, hemodynamic analyzer, psychological testing program (Spielberger, Beck, SAN test). The renin-angiotensin-aldosterone system (RAAS) and sympatho-adrenal system (SAS) were assessed with biochemical analyzer «Chemetrics' (USA). The developed calculation algorithms were used for assessing organism's functional reserves and risks of developing common diseases. Discriminant equations derived by us were used to assess the effectiveness of rehabilitation measures and to define groups of patients with varying level of effectiveness. Results . General mechanisms of RT and LT therapeutic effects in patients with cardiovascular diseases have been found out: correction of SAS and RAAS activity, limitation of excessive sympathetic impacts at heart and restoration of autonomic regulation function of the cardiovascular system, as a whole, which has been confirmed by the dynamics of biochemical parameters and SAS and RAAC decrease. Application of RT + LT complex for the rehabilitation of patients with hypertension and ischemic heart disease is more effective compared to RT monotherapy, which is confirmed by the largest increase in loading threshold (by 49.4%) when analyzing findings of the exercise test. Conclusion . 1. RT + LT complex applied in patients with cardiovascular diseases for rehabilitation is more effective modality in comparison with RT monotherapy. 2. The hardware-software complex «Physiocontrol-R» has been found to be a possible tool for evaluating the effectiveness of non-medicamentous therapy. 3. The developed diagnostic modality: algorithms for calculating a quantitative assessment of body's functional reserves and defining risks of common diseases as well as the discriminant equations for determining the level of effectiveness in different groups of patients – can be widely used for assessing the effectiveness of treatment.
Highlights
Отличительной особенностью восстановительной медицины является профилактическая направленность, реализуемая путем повышения адаптивных возможностей организма человека в целях увеличения функциональных резервов, профессиональной надежности, долголетия на основе преимущественного применения немедикаментозного лечения [1], что диктует необходимость инновационных разработок методологии оценки адаптационных и функциональных резервов организма с помощью аппаратно-программных комплексов (АПК)
Patients were divided into three groups depending on the rehabilitation program and prescribed basic medicamentous therapy: Group I – reflexotherapy (RT); Group II – RT and laser therapy (RT + LT); Group III – basic medicamentous treatment
Biologically active points were electrostimulated with pointed pulses from «Lasper» device (Japan) having amplitude 0.8–2.5 V, pulse duration 1.5 ms, frequency 10 Hz and exposure 20 minutes
Summary
Физические методы реабилитации на фоне базового медикаментозного лечения были применены у 120 пациентов с сердечно-сосудистыми заболеваниями: артериальной гипертонией (АГ) и ишемической болезнью сердца (ИБС) в возрасте от 21 года до 60 лет; женщин – 75 (62,5%), мужчин – 45 (37,5%). Для оценки функциональных резервов организма и расчета риска развития распространенных заболеваний, расчета предикторов и показателей эффективности проводимых лечебно-оздоровительных мероприятий применяли диагностический аппаратно-программный комплекс (АПК) «Физиоконтроль-Р» (Россия), который включает в свой состав: анализатор вариабельности сердечного ритма; анализатор гемодинамики; модуль анализа антропометрических данных; анкету на наличие вредных привычек, программу психологического тестирования. Для количественной оценки функциональных резервов организма и расчета риска развития. Для оценки эффективности реабилитационных мероприятий использовали выведенные нами дискриминантные уравнения по определению групп пациентов с различной степенью эффективности: 1-я – со значительным улучшением, 2-я – со средневыраженным улучшением, 3-я – с незначительно выраженным улучшением и пациенты с отсутствием динамики [7]. Статистическую обработку проводили c использованием компьютерного пакета прикладных программ SPSS-23
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