Abstract
Few decades away a problem of throwing of acidic gastric content into an esophagus was reduced to the concept of reflux-esophagitis. In-depth study of pathogenesis of a disease resulted in “gastroesophageal reflux disease” (GERD) term which is acknowledged as leading disease of digestive system in terms of frequency and dangerous complications. GERD formation is determined by influence of numerous factors, however, it is generally accepted, that it is mainly related to insufficiency of lower esophageal sphincter (LES). Also, role of vasoactive intestinal peptide (VIP) in regulation of functional state of LES is determined. In spite of success in field of pharmacology, number of GERD patients has no downward trend which mainstreams search for non-medicine treatment methods. Physical factors affecting pathological processes by influencing regulatory processes are among these methods. Goal of this study is elaboration, scientific justification and clinical implementation of natural and preformed physical factors and acupuncture in treatment of patients with gastroesophageal reflux disease. Materials and Investigation methods: Randomized placebo-controlled study included 137 patients with gastroesophageal reflux disease, 63 (46%) men and 74 (54%) women, at the age of 18 to 65. Investigation included patients with no contraindications for physiotherapy. Patients with Barrett’s esophagus, stricture of esophagus, esophagus ulcer have also been excluded from investigation. Patients were divided into 3 groups: Ist group – 40 GERD patients, including high-frequency electromagnetic field effect and general iodine bromine bathes. II nd group - 67 GERD patients passing acupuncture treatment course. Control group was comprised of 30 GERD patients, receiving placebo MEF therapy. Treatment was carried out without medicines. Therapeutic effectiveness of complex influence of microwave electromagnetic field therapy (MEF-therapy) applied to collar area alternated with general iodine-bromine bathes on clinical manifestations of GERD is determined. Treatment course contributed to reliable decrease of increased count of VIP – a neurotransmitter, regulating LES tonus. In term, it contributed to improve of functional state of LES, reliable decrease of reflux index, and, as a result, improvement of clinical and functional indicators. Estimation of clinical manifestations of a disease among patients of 2nd group displayed positive dynamics of clinical and functional indicators. Round-clock pH-monitoring of stomach and esophageal content shows reliable decreaseof transitory relaxations of LES during single acupuncture procedure and increase of pH of gastric content. Acupuncture course also resulted in decrease of elevated VIP numbers.
Highlights
Gastroesophageal reflux disease (GERD) holds leading position in a structure of gastroenterologic incidences
That microwave electromagnetic field (MEF-therapy) impulses are being transmitted into central nervous system, reply reactions being formed are being further transmitted to executive organs by reflectory and neurohumoral ways which results in alterations of functional condition of gastrointestinal tract
Results obtained show that single MEF exposures with capacity of 25-30 W directed on collar area decrease volume of gastric secretion, which may indirectly point to oppression of gastric secretion as well as stimulation of gastric evacuation function; these factors are both favourable for GERD patients
Summary
Gastroesophageal reflux disease (GERD) holds leading position in a structure of gastroenterologic incidences. Leading role among non-medicine methods of treatment is played by physical factors, affecting main elements of pathogenesis of diseases, capable of affecting functional disorders and pathological processes by influencing regulatory systems of organism. One of important points in treatment of GERD is impact on neurohumoral regulation of LES, disturbed motor skills of esophagus and stomach, factor of aggression – acid and alkali refluxes It is known, that microwave electromagnetic field (MEF-therapy) impulses are being transmitted into central nervous system, reply reactions being formed are being further transmitted to executive organs by reflectory and neurohumoral ways which results in alterations of functional condition of gastrointestinal tract. Goal of this study is elaboration, scientific justification and clinical implementation of natural and preformed physical factors and acupuncture in treatment of patients with gastroesophageal reflux disease
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