Methods of treating hypertension: medicinal and non-medicinal methods of combating the disease. Non-drug treatment of arterial hypertension

They are: bloodletting, cauterization, compresses, baths, massage. Non-drug treatment methods also include methods of physical and mental training that are not described in detail in the “Four Tantras,” such as relaxation, yantra yoga, and contemplative transformation of the body-speech-thought complex.

Bleeding.

“Diseases for which bloodletting is prescribed: widespread fever, confused fever, fever from infection, tumors and edema, surya disease, herpes zoster, lymph diseases, leprosy, and in the absence of these - diseases of the liver, spleen, mouth, eyes, head and so on. In short, bloodletting is prescribed for the most part for fever diseases arising [from] blood and bile. But bloodletting is not allowed in case of undivided blood [see. below], immature infectious diseases, empty heat, with untreated intoxication, dangerous infectious heat, exhaustion of bodily strength, although this is the essence of a disease with the genesis of heat. In addition, bloodletting is not allowed during pregnancy in women, after childbirth, in diseases of edema due to metabolic disorders, decreased fiery warmth of the stomach, indigestion of food, in short, in diseases arising [based on] mucus and wind, [but even] the absence of such - in children under 16 years of age and in persons who have reached old age."

Time sequence. “Separation bloodletting must be carried out immediately in cases of swirling blood in internal dense and hollow organs, in case of extensive fever, infectious diseases, and in the absence of such - in cases of continuous bleeding from the mouth, nose, etc. classified as mature diseases...” .

There are a number of other indications and contraindications, however, due to the complexity of preparing for bloodletting and the bloodletting procedure itself, I consider it inappropriate to present this topic in detail in this book. I just want to briefly outline the main points related to bloodletting.

First. To carry out bloodletting, special instruments were used, the material of manufacture, shape, and quality of which were subject to very serious requirements. The secrets of making such instruments were passed on from master to master.

Second. It is necessary to learn to clearly distinguish between diseases for which bloodletting is used and those diseases for which it is unacceptable. To do this, the doctor must be fluent in the art of making a diagnosis and have a good knowledge of nosology. The same requirements are also important for the third point - knowledge of the time sequence of development of diseases, since the use of bloodletting for an immature disease, as a rule, is not allowed.

Fourth. It is necessary to properly prepare the patient's body for bloodletting. Using special methods, it is necessary to bring the immature disease to maturity, using special medicinal compounds to separate bad blood from good blood at the sites of bloodletting, then, again, use medicines, separate the blood and the wind. As a result, when bleeding, a little bubbling blood with large gas bubbles first comes out of the cut area, then a little black bad blood comes out, and then the blood stops. But this is the simplest case. Fifth. A good knowledge of bloodletting techniques, especially practical, is necessary. This technique varies depending on which vessel the phlebotomy is being drawn from. Note that what is called bloodletting includes bleeding from veins, arteries, as well as the removal of lymph from lymphatic vessels.

Sixth. A good knowledge of the topography of the points of the body at which bloodletting is performed for specific diseases is necessary. In total, there are 77 main and 13 additional blood, bile and lymph channels, from which diseased blood, bile and lymph are released from the body. There are also 112 main and a number of secondary channels and places in which bloodletting is unacceptable; these are “vulnerable structures of the body channels.”

Seventh. It is necessary to know the measure, the amount of blood or lymph released in each specific case.

Eighth. Knowledge and skills in caring for the patient after the procedure are required.

Ninth. You should be aware that excessive, insufficient and unskilled bloodletting can be harmful. The doctor must be extremely careful to avoid mistakes, and if one is made, he must be able to protect the patient from its consequences.

Tenth. The doctor should be aware of the signs of the beneficial effects of the bloodletting procedure on the patient’s body.

Cauterization.

The topic of moxibustion is considered, as a rule, on seven points: indications for the use of moxibustion, contraindications, cones for moxibustion, places in which moxibustion is performed, moxibustion technique, rehabilitation, the effect of moxibustion or the benefits of moxibustion.

Indications and contraindications. Cauterization is recommended in the presence of “a decrease in the warmth of the stomach, the formation of edema [tumors], gout, swirling of the lymph in the bones and joints of the extremities, external edema, pain, dizziness due to wind diseases, confusion, insanity, pain leading to fainting, disorders of movement of the limbs due to illness channels, lymphatic vessels and veins. In the absence of such [diseases], it is very useful for diseases of the wind and cold classes, which very often arise after abscesses [ulcers], empty fever and other hot diseases, and in addition - for diseases of the lymph. However, not Cauterization should be performed for diseases of hot bile, heat of the blood, for [diseases] of the inputs of the sense organs, the channel of being in the perineum in men."

Collection and processing of edelweiss, making cones. Cauterization is carried out using special cones of different sizes, made from edelweiss and a certain amount of nettle. For various diseases, the size of the cauterization cone varies depending on the size of the “upper phalanx” thumb"and up to the size of a dry pea. To make cones, the inflorescence of depleted edelweiss and palibin edelweiss is used.

The places where cauterization is performed are called "sang dmigs" in Tibetan. They come in two types: “sanmmg”, in which pain is felt, i.e. tied to the disease itself, and additionally known to the doctor as “sanmig”.

The first are places of arthritic turbulence of lymph in the joints of bones, external tumors, edema; places in which pain is felt when pressure is applied, and relief is felt when pressure is removed; around swelling, growths, malignant wounds.

The second are places associated with the circulation channels of wind, bile, mucus, blood, and lymph.

Let's give an example. “The first vertebra is the “sunwink of the wind.” When the neck is bent, round projections become visible; cauterization is performed on the first such round bone. [This is VII cervical vertebra.] Main indications: due to wind entering the channel of life, confusion, madness, severe cardiac arrhythmia, trembling in the body, wind-induced muteness, insomnia, deafness, inability to turn the neck are observed; [cauterization of this vertebra] is also useful for other diseases of the wind group.”

Cauterization technique. First, the poison should be removed from the patient’s body. “Poisons is a term for denoting substances harmful to the body and life that enter [the body] with food.” Then the edelweiss cone is placed on the “sanmig” place of the back chosen by the doctor, having previously prepared this place. Rules have been developed for cauterization with one cone, several cones , the rules that determine the duration of cauterization. Moreover, if, for example, cauterization is performed at the “sunlight,” the heat should be felt from the front, and vice versa. The absence of pain at the cauterization site after the procedure is a sign that cauterization has brought great benefit."

Rehabilitation. After cauterization, the remaining ash is not cleaned off, but is smeared on top with a mixture of butter and salt; it is not recommended to drink cold water and wine, etc. at night. .

Benefits of cauterization. “If moxibustion is carried out in accordance with the method, it has a beneficial effect on the flow of wind and blood, “closing the mouth” of the channels, relieving pain, suppressing the wind, strengthening memory and mind, generating warmth in the stomach and body, digesting food, removing dead tissue from tumors, abscesses, old wounds, relieving swelling, drawing out lymph, drying it out, etc.” .

Compresses.

There are cold and hot compresses, but doctors believe that special compresses are necessary for children in some cases.

Cold compresses.

For swelling from bruises and fractures, widespread and confused fever, if they are accompanied by pain, apply a heating pad filled with cold water, a cloth moistened with cold water, a cold cobblestone pulled out of the water, or other cold objects to the sore spots. This compress relieves pain and eliminates fever.

For continuous nosebleeds, it is recommended to apply a bottle of cold water, collected early in the morning, when the stars have not yet gone out, or mud mixed with water from the bottom of a well or spring to the space between the eyebrows, to the hollow at the back of the head.

For toothaches due to the heat of the blood and to areas swollen due to wind disorders, cold mud is also applied.

For gouty heat, apply a cold compress of crushed Sophora yellowish root mixed with an equal amount of cow dung.

In case of widespread fever due to disorders of the blood and bile, apply a cloth moistened with cold water or a cobblestone pulled out of cold water under the armpits and on the forehead.

Hot compresses. For pain from indigestion or due to acute diseases of the abdominal organs, apply a hot compress of salt wrapped in a cloth and heated in a frying pan or in a cast iron pot.

If the warmth of the kidneys decreases and urinary retention is applied to the lower back, it is recommended to apply a hot compress of dried stillage preheated over a fire and wrapped in a cloth.

For postpartum pain in the lower intestine, in the buttocks, kidneys, and lumbar region, it is recommended to apply warm compresses from soil wrapped in cloth, thrown back with a mouse when digging a mink, after heating the soil over a fire in good wine.

For dark red mucus, intoxication and other diseases that cause stomach pain, it is recommended to apply hot compresses from bergenia, sorrel and medlar leaves boiled in water and then wrapped in cloth.

For cold stomach tumors due to indigestion, it is recommended to apply hot compresses from pigeon droppings heated over a fire and wrapped in cloth.

In case of acute diseases of the abdominal organs of helminthic origin, it is recommended to apply hot compresses from the roots and leaves of Angelica Dahurian heated over a fire and wrapped in cloth.

If lymph gets into the joint vagina, it is recommended to boil ground pebble or sand mixed with a small amount of salt in beer or water, wrap it in cloth and apply a hot compress.

In case of urinary retention due to cold, it is recommended to apply a hot compress from the sediment of ghee and pigeon droppings to the lower abdomen.

For pain in the limbs due to lymphatic diseases, it is recommended to apply a hot compress of sheep droppings boiled in wine.

Compresses are contraindicated in diseases of mucous edema, when bile juice stains meat and skin dark yellow, in case of leprosy, intoxication, dropsy, obesity, contagious disease "ball", smallpox, rashes on the skin, after eating.

Compresses applied to the liver in children are used in cases of liver enlargement. The child is undressed and placed on his back. A piece of natural silk is dipped in cold water, then placed on the child’s belly on the right, cleaned, barringonia leaves are placed on the liver area, a mirror, crystal, ladle, vessel with water, an old vomer or any cold, round and smooth object is placed on top of the lower part of the liver. thing and move it to the upper part of the liver 10 to 15 times, then clean the stomach again, moisten a piece of silk with water and place it on the liver area, tying it with ribbons, as if wrapping the stomach in silk. According to the degree of the disease - small, large, dangerous - this compress should be worn for 3 to 5 days.

Baths.

There are hot baths from natural springs and artificial baths.

Baths are prescribed for gouty, rheumatoid, contraction of the limbs caused by swelling of the legs due to coarsening of the veins and the formation of articular tumors and edema; for lameness caused by improper functioning of the white canals; with flabbiness of muscles; when knots form in channels due to a decrease in their heat; with curvature of the lumbar canals; for “meat variegation” disease and other diseases of the skin and lymph; for old wounds; with suppuration of wounds; for “surya” disease of dense and hollow organs; in case of intoxication; for tumors and edema due to wind disorders; with deterioration of skin pigmentation, roughening of the skin; for chronic, difficult-to-treat diseases.

Baths are contraindicated in case of fever from infection, confused fever, extensive fever, pregnancy, high blood pressure, heart disease.

The waters of natural springs in Buryatia and the Chita Autonomous Soviet Socialist Republic were once studied by lamas and classified according to classes of diseases. Already in the 70s, the traditional doctor G.L. Lenkhoboev and Candidate of Philosophical Sciences N.Ts. Zhambaldagbaev jointly examined a large number of natural sources in Buryatia and the Chita region. The sources were examined using traditional methods: the water was determined by taste, by strength (predominant value), by the soil through which it passes, by the characteristics of the flora growing at the source, etc. It turned out that many natural springs retained their strength, but in those places where deep wells were drilled and torpedoed for mass use of water, these waters largely lost their healing properties. In the same area, different sources, even those located in close proximity, could be used to treat diseases of completely different etiologies - they passed through different soils, enriched with different microelements and, therefore, powers. When such waters are mixed, their characteristics are lost. When using water from natural sources and specially prepared water for baths using various medicinal ingredients, it is necessary to adhere to fairly strict rules, which partially vary in each specific case. The experience of practical balneology is not easily conveyed, and it would be inappropriate to describe the rules for using healing baths in this book - if they are used incorrectly, the consequences can be very disastrous.

Massage.

Massage in Tibetan medicine refers to the use of rubbing, kneading and tapping techniques after anointing the skin with old butter, sesame oil, animal fat and medicinal substances. This is one of the ways to treat painful underlying conditions.

Anointing with fats.

For insanity, fainting, memory loss and other groups of wind diseases, butter from a year ago is rubbed into the area of ​​the I vertebra (this is the VII cervical vertebra) and, starting from it, VI and VII, as well as into the point between the nipples on the chest. After rubbing and kneading, these places are wiped with toasted barley flour. A similar procedure is performed in the cases described below.

For itching due to lymphatic disorders, it is recommended to rub horse, onager, and donkey fat into the skin.

When the strength of the kidneys is depleted and the semen is expired, it is recommended to rub beaver fat [or otter fat] and marmot fat into the lumbar vertebrae.

If a whitish discharge appears between the eyelid and the eyeball, the consistency of which resembles a paste, it is recommended to rub yak oil with cumin into the soles of the feet. Rubbing in mixtures.

For abscesses, abscesses, and ulcers, it is recommended to rub a mixture of yellow sulfur, salt, wine (beer) starter, soot on old oil prepared in the form of a paste into the sore spots and bask in the sun.

In old festering wounds and old wounds with difficult-to-remove pus, it is recommended to rub a mixture of ash from burnt hollow stems of astragalus or astragalus in mare's or donkey's milk.

For gouty pain, you should rub in white or black sesame flour boiled in cheese whey.

If acne, pimples, or ulcers from lichen appear on the face, it is recommended to rub a liquid mixture of white mustard powder, calamus, purified salt and dry leaves of Japanese medlar on cow urine.

For colic due to blood diseases, skin diseases, infectious edema, herpes zoster and eczema, it is recommended to rub a mixture of red sandalwood powder, gentian large-leaved flowers and Baikal skullcap roots on snow water.

For skin rashes due to scabies, it is recommended to rub in a mixture of soot, the roots of Saussurea burdock, sorrel, the ash of the roots of Stellera dwarf, salt, wine [beer] starter in rancid oil (on the oil that collects on the walls of the vessel with sour milk).

For diseases of “skin spotting”, lichen, “cow licking” (see) and other skin diseases, it is recommended to rub a mixture from the skin of a black snake, burned in a vessel without escaping smoke, in pork fat.

Contraindications.

Massage is contraindicated in case of indigestion (non-digestion of food taken), stiffness in the thighs due to wind disorders, lack of appetite, poisoning from poisons made from precious stones, dropsy, diseases of mucus and dark red mucus of the stomach, etc. In total, five main non-drug treatment methods of Tibetan medicine are described.

As for the additional corrective methods available in Tibetan medicine, a special study should be devoted to studying them. Let's name some of them.

Acupuncture It is considered the final corrective procedure, closing the entrances of the canals after removing diseases from them with the help of medicinal and non-medicinal therapy. Carrying out an acupuncture procedure at the very beginning of treatment is compared to the situation when, having discovered thieves in a house, they close the doors without driving them out.

Yoga methods. There are many yoga systems, individual elements of which can serve to preserve and restore health. In general, we can say that the practice of yoga includes exercises to control the mind, speech and body, aimed at achieving a balance in the functions of the body systems, energetically provided by the activity of the “lunar” wind La-lana, the “solar” wind Rasana and the “wind of wisdom” Avadhuti, as well as the regime of pulsations of “solar”, “lunar” and “equal” origin.

Phytotherapy. It is symptomatic. They use infusions and decoctions of nettle, shepherd's purse, water pepper, yarrow, and lagochilus. You can also use pure extracts from water pepper, red viburnum, lagochilus (25-40 drops 3-4 times a day).

Most commonly applied fees:

• Collection I. Nettle grass - 10.0, yarrow grass - 10.0. Pour 400 ml of boiling water over the collection, leave for 20 minutes, take 50 ml. 3 times a day.
• Collection 2. Horsetail grass - 5.0, shepherd's purse grass - 5.0. Pour 300 ml of the mixture. boiling water, leave for 20 minutes, take 50 ml 3 times a day.
• Collection 3. Liquid burnet extract - 50.0 ml. Sterilize. Inject intrauterinely 3-5 ml. daily until bleeding stops.
• Collection 4. Oak bark - 2.0, shepherd's purse grass - 3.0, yarrow grass - 3.0, cinquefoil erect root - 3.0. Mix, boil for 5 minutes in 500 ml. boiling water, leave for 20 minutes, take 50 ml. 3-4 times a day.

Gynecological massage

This is one of the components of complex therapy for DUB.

Indications:

• DUB in combination with general and genital infantilism, uterine hypoplasia, adhesions, uterine prolapse and genital hypotrophy;
• DUB in combination with a chronic inflammatory process (residual effects).
• Anovulatory DUB with hypoestrogenism.
• Ovulatory DMC with insufficiency of both phases of the cycle.

In the absence of bleeding, it is advisable to combine gynecological massage with thermal procedures and balneotherapy.

Purpose of massage: stretching and resorption of scars and adhesions, improving blood supply to the hypoplastic uterus.

Conditions:

• technical training of personnel;
• separate room with a gynecological chair, rubber gloves;
• normal body temperature;
• blood parameters: leukocytosis no more than 6.0x109 g/l, ESR no more than 15 mm/h;
• III degree of vaginal cleanliness;
• bowel and bladder emptying.

The duration of the massage session is from 3 to 10 minutes, the course of treatment is 30-40 days.

Hardware physiotherapy

Impact on the central mechanisms of regulation of the menstrual cycle. Most often used:

1. Cervicofacial galvanization(according to G. A. Kellat) through a 1% solution of zinc chloride, 2-3% solution of sodium bromide or 2-3% solution of magnesium sulfate; procedures are carried out daily or every other day, a total of 12-15 sessions with an exposure of 8-12 minutes.

2. Endonasal galvanization or endonasal electrophoresis:

• with a 10% solution of calcium chloride - for bleeding due to inflammatory processes;
• with vitamin B1 - for anovulatory hypoestrogenic bleeding;
• with a 0.25-0.5% solution of novocaine - for anovulatory hyperestrogenic bleeding, a total of 12-15 procedures per course daily or every other day;

3. Indirect electrical stimulation of the hypothalamic-pituitary region(according to S.N. Davydov) begin with ongoing uterine bleeding - the first three days of the procedure are performed daily for 10 minutes, then three sessions every other day. If after 6 procedures hemostasis does not occur, other methods of therapy are indicated, namely:

• longitudinal diathermy of the head and ionogalvanization (according to A.E. Shcherbak) - the location of the electrodes is frontoccipital, exposure is 20 minutes, the galvanic collar is carried out through a 1% sodium bromide solution, alternating with diathermy, the number of procedures is 6, the course of treatment is 2 weeks;
• impact on the area of ​​the cervical superior sympathetic ganglia (procaine blockade - 10-15 ml of 0.5% novocaine solution; electrophoresis - with 1% novocaine solution on the supracervical area, exposure - 15 minutes, course - 8-10 sessions).

The effect of electrical stimulation on the pelvic organs.

Electrical stimulation of the uterus with diadynamic currents. Indications:

• hemostasis with recurrent bleeding after multiple curettages in the past, after uterine curettage and insufficient hemostasis;
• with heavy blood loss after hormonal hemostasis;
• with juvenile bleeding.

The total duration of the procedure is 8 minutes, the course of treatment is 2-5 days.

Thermal effects on the cervix are carried out by douching with hot water - 35 ° C and above at intervals of 1-2 hours or irrigation with chlorethyl.

Vacuum stimulation of the cervix - created by an electric pump in the form of negative pressure at the cervix. Exposure - 5-10 minutes, course of treatment - 5-6 procedures).

Electrical stimulation of the cervix (according to S. N. Davydov) (carried out with pulsed currents, course - 6 sessions). Most often used for dysfunctional uterine bleeding. For recurrent bleeding, it is used for prophylactic purposes from the 14th day after curettage, and in subsequent cycles - from the 14th day after the next menstruation for three days. Exposure - 10 minutes.

Inductothermy (15-20 sessions every other day).

Ultraton - from the 5th day of the menstrual cycle daily or every other day, up to 20 sessions in total.

4. Ultrasound.

Electrophoresis with galvanic or pulsed current through various medicinal substances, taking into account the existing concomitant gynecological pathology.

5. Laser therapy(use helium-neon laser, wavelength - 632.8 nm, power density - up to 200 mW/cm2). The area of ​​influence is the cervix, vaginal vaults, reflexogenic zones of Zakharyin-Ged, projectionally connected with the ovaries, active points of the meridians of the kidneys, urinary and gall bladder, liver, pancreas, spleen, anterior median meridian. Method of influence: remote, contact (through a light guide). The course of treatment is 8-9 procedures.

Effect on menstrual function through the mammary gland. The automammification method is based on an indirect (through the mammary gland) reduction in the estrogen-producing function of the ovaries.

The following methods of automammification are distinguished:

• diathermy (inductothermy) of the right mammary gland (procedures - every other day, duration - 15-20 minutes);
• electrophoresis with a 5-10% solution of calcium chloride on the area of ​​the mammary glands (exposure - 20 minutes, sessions - daily or every other day, 10-12 sessions in total), an exposure option of 5 to 20 minutes is possible, gradually increasing;
• darsonvalization of the area of ​​the right breast (exposure - 5 minutes, sessions - daily, 10 in total).

Hardware physiotherapy is indicated in the second phase of the menstrual cycle or on the eve of menstruation in the form of:

• electrophoresis on the lower abdomen, solar plexus area: 0.25% solution of novocaine, 1% solution of trimecaine, 1-2% solution of magnesium sulfate, antipyrine;
• cervicofacial galvanization - galvanic collar (according to A.E. Shcherbak) with calcium, bromine, nicotinic acid.

When treating girls, they widely use:

• ultrasound in pulsed mode;
• low-frequency pulse currents (LCT, SMT) from the 5-7th day of the menstrual cycle with the end of the course after the next menstruation;
• short-wave diathermy;
• central electroanalgesia;
• ozokerite;
• paraffin;
• mud;
• transcutaneous neuroelectric stimulation (TNES);
• playing sports.

With the vagotonic form, heating pads on the lower abdomen and pine baths are indicated.

Hardware physiotherapy is the leading method of treating patients with chronic endometritis.

Before performing hardware physiotherapy, you must consider:

• Premorbid background, the patient’s age, the nature of menstrual dysfunction and the age of their onset.
• Previous therapy and its effectiveness.
• Functional state of the reproductive system.
• The reaction of the body and reproductive system to treatment, starting from the first days of its implementation.
• Dynamics of changes in general condition, the effect of treatment on pathological processes, the reproductive system.
• Presence of hay fever, tolerance of therapeutic effects.

The main types of hardware physiotherapy for menopausal syndrome:

• galvanization of the cervicofacial area;
• anodic galvanization of the brain;
• electrophoresis of novocaine on the area of ​​the superior cervical sympathetic ganglia;
• combined endonasal electrophoresis of 10% magnesium sulfate solution and 5% lithium carbonate solution or 5% lithium carbonate solution + 1% amitriptyline solution + 10% sodium bromide solution or 10% sodium bromide solution + 10% GHB solution + 10% magnesium sulfate solution;
• darsonvalization of the “collar” area (2-3 courses at intervals of 2-3 months);
• electrophoresis of a 10% general magnesium sulfate solution (according to S. B. Vermeule) or in the “collar” area.

Reflexology

It is carried out in several options (acupuncture, laser puncture, etc.).

Acupuncture:

For dysfunctional uterine bleeding, the inhibitory method of acupuncture is used. First, irritation is applied to the points of general strengthening action, then after 2-3 sessions special action points are connected, 3-5 TA per procedure. The most commonly used corporate points: V 2 2, V 31, V 33, V 47, T 4, T 19, V 23, V 32, V 34, V 10, T 20, T 21, VB 20, J 4, RP 10, R 7, V 43, RP 6, J 6, E 27, R 9, R 3, E 36, G 14. Auricular points: endocrine glands - 22MV, sympathetic - 51 NNP3, pituitary gland - 28PC, Uterus - 58TY .

For hypermenorrhea, treatment is carried out during the menstrual cycle. The procedures begin with the legs, then move to the lower abdomen or lower back. An approximate version of an acupuncture prescription: 1st session: TA T 20, V 43 (symmetrical, calming method); 2nd session: VB 20, G 14 (symmetrical); 3rd session: T 19, RP 6, E 36 (calming method).

For polymenorrhea, treatment begins 2-3 days before the start of menstruation. The course of treatment is 10 days. The method of influence is inhibitory. Approximate combination of points: 1st session: R 9, RP 6, J 4, V 23; 2nd session: R 6, T 4, V 32, V 34 (symmetrical); 3rd session: RP 6 (symmetrical); 4th session: T 4, V 23, V 22 (symmetrical, calming method 1-2 hours after acupressure of medium strength); 5th session: RP 6, V 47 (symmetrically, acupressure of medium strength with light vibration; after 15 minutes of rest, continue acupressure in TA J 6, J 4, E 27, RP 10); 6th session: VB 20, T 19, VG 21, V 32, V 10 (symmetrical, braking method).

Laser puncture:

Carry out using fiberglass optics and a helium-neon laser at therapeutic power densities (10-100 mW/cm2).

Currently, a differentiated approach is used in the use of reflexology for endogenous stimulation of the gonads.

In the first phase of the menstrual cycle, the effect is aimed at stimulating the function of the parasympathetic nervous system. To do this, starting from the 5th day of the menstrual cycle, a helium-neon laser is applied to the meridian points of the pericardium, heart, kidneys, liver, and anterior median meridian.

In the second phase of the cycle, laser or other reflexology is aimed at stimulating the function of the sympathetic nervous system. To do this, starting from the day of ovulation, they influence the acupuncture points of the meridians of the bladder, colon, and posterior median meridian.

Reflexotherapy for algodismenorrhea is carried out using two methods:

3-4 days before menstruation, acupuncture (IRT) is used according to the inhibitory method or sedation, depending on the severity of the pain. Main TA: J 6, R 14, RP 6, J Z, G 14, J 4. Additional TA: T 26, E 26, RP 8, RP 10, J 1, R 12, RP 9, T4, R 6, F 1 1.

IRT is started 1-2 days before menstruation, needle exposure is 20-30 minutes. The most effective points are located in D10-S4 dermatometers, which have a common source of innervation with genitourinary organs. For algomenorrhea caused by genital pathology, the lumbar and sacral points T2, 4, V 31-V 32 are effective; the inhibitory method is used. For heavy and painful periods, the toning method is applied to RP 3, RP 10, E 30, F 3, R 12, R 1 Z, R 14; braking method - on J 3, J 5, J 6, V 23, V 26. 5-6 TA are used in one session. In case of intense pain with the onset of menstruation, micro-acupuncture (2 - 3 days) is added to the corporal points on the AT of the uterus, stomach, kidney, and sympathetic point.

The given options for acupuncture are used in the acute period of salpingo-oophoritis and are carried out using traditional methods of acupuncture or in combination with electroacupuncture (ELAP). Course - 11-14 sessions daily.

Treatment is carried out in two versions.

Option 1:

on the 1st day, auricular AT 55, AT 23, AT 58 and corporal points are used: E 36, G 14, GI 11, RP 6 (bilaterally according to the second version of the inhibitory method with needle exposure for 20 minutes);

on the 2nd day (in case of intoxication) - TA of the second pair of “miraculous meridians” - TR 5 on the right, VB 41 on the left and AT 55, AT 58 on the right (in case of vegetative disorders, the third pair of “miraculous meridians” is affected - P7, R 6) ;

on the 3rd day TR 5 on the left, B41 on the right, AT 55, AT 58 on the left;

on the 4th day - TR 5 on the right, VB 41 on the left, VB 25 - bilateral;

on the 5th day - TR 5 on the left, VB 41 - on the right, VB 26 - bilateral;

on the 6th day they act on RP 6, VC 4;

on the 7th day - AT 23, AT 97, AT 58 (from severe inflammation), V 60, V 23, V 32;

on the 8th day - R 6, R 12, R 14 (bilateral or on the side of inflammation);

on the 9th day - VG 14, V 1 1, J 14 or GI 15;

on the 10th day - E 30, E 36;

on the 11th day - V 31, V 32, V 33 (select painful points), V 60;

on the 12th day - G 14, P 7.

Option 2: use TA of the lumbosacral region (V 23, V 25-V 34, T2-T4), abdomen (J 2 - J 4, R 11 - R 13) and lower limbs(RP 6, RP 9- RP 10, E 36, E 37, R 7); The formulation of each procedure includes points of general influence (GI 11, G 14, E 36, RP 6, MC6), as well as AT (uterus, endocrine glands, ovary, pelvic cavity, abdomen, external genitalia).

Other methods

Hyperbaric oxygen therapy (HBO):

Carry out in the complex treatment of dysfunctional uterine bleeding from the moment the patient is admitted to the hospital, in the absence of heavy bleeding.

A single pressure chamber "OKA-MT" with hyperbaric oxygenation is used at a pressure mode of 2 atm and exposure time of 40-60 minutes.

The course of treatment is 6-10 procedures.

Bleeding usually stops after the third session

Electrical stimulation of the cervix in combination with dosed local hyperthermia.

The technique is most indicated for anovulation after suffering from chronic inflammatory processes of the uterus and appendages, and for rehabilitation in case of infertility.

Treatment begins immediately after the end of menstruation and continues until the next one. It includes 16-18 sessions of dosed local hyperthermia. The temperature increases from 38ºС (daily by 1°С) to 43°С with a maximum on the 11-12th day of the cycle. After this, it is maintained at the same level until day 24-25 and decreases to 39°C by day 28. Temperature conditions may vary depending on the length of the menstrual cycle.

During the period of expected ovulation (taking into account functional diagnostic tests), against the background of dosed local hyperthermia, electrical stimulation of the cervix is ​​carried out for 4-6 days.

Central electroanalgesia.

Central electroanalgesia is carried out using the Lenar and Elektronarkon apparatus. The location of the electrodes is frontomastoid. Number of procedures: mild form - 7-8, moderate form - 10-12.

If there is no effect (partial), central electroanalgesia after the 8-9th session is supplemented with microdoses of monophasic combined contraceptives (bisecurin, rigevidon) - 1/5-1/8 tablets per day for 4 weeks. In the future, the frequency of courses of monophasic combined contraceptives is determined by clinical symptoms.

Aerotherapy (air treatment).

It is carried out in several variants: walking in the fresh air with increasing duration and load (walks); dosed running (health path); light-air baths at an air temperature of no lower than 18°C ​​and a wind speed of no more than 5 m/s with ever increasing duration.

Heliotherapy (sun treatment).

First of all, contraindications (diseases of the cardiovascular system, thyrotoxicosis, etc.) should be strictly taken into account. Initial doses are 5-7 minutes, gradually increased to 45-60 minutes; Time: morning and evening.

Balneotherapy and spa treatment.

Venue: home conditions, local physio-hydrotherapy clinics, sanatoriums and health centers of the usual climate zone, or direction to the southern coast of Crimea.

Main varieties: dousing; washing; shower; baths (pine, sage, valerian, hot foot, pearl, carbon dioxide, oxygen, foam, radon, iodine-bromine); vaginal irrigation with mineral and radon waters. The resorts of Gagra, Tskaltubo (not in the hot season), and the Baltic region (in summer) are recommended.

Cryotherapy is mainly used in the acute period of salpinoophoritis.

Performed in two versions:

vaginal hypothermia;

external abdominal hypothermia with the ALG-2 apparatus, procedure duration from 2 to 3.5 hours per day; or cold on the hypogastric region for 2 hours with breaks of 30-60 minutes.

The duration of the cryotherapy course is from 1 to 5 days.

Hyperbaric oxygen therapy is mainly used in the acute period of salpinoophoritis.

It has a multifaceted effect on purulent infections. Most optimal mode- pressure 1.5-3 at (147.1-294.3 kPa), session duration 1-1.5 hours every other day. The course of treatment is 6-7 procedures.

Sanatorium-resort treatment is used in recovery period after acute salpingo-oophoritis or with chronic salpingo-oophoritis.

Climatic factors include:

• aerotherapy (general and local air baths);
• thalassotherapy (treatment by bathing in the sea and seaside climate);
• heliotherapy (solar energy treatment).
• balneotherapy, treatment using natural physical factors, is carried out in a resort or sanatorium.

The main therapeutic factors are hydrotherapy and peloid therapy (mud therapy).

General and local (sitz) fresh baths, vibration baths, general aromatized baths (pine, sage, turpentine) are widely used; general gas baths - pearl, oxygen, foam. Sulfide, carbon dioxide, radon, salt, and iodine-bromine waters are used in the form of baths, vaginal irrigations, and microenemas. Salt, carbon dioxide, sulfide waters, peloids, peloid-like substances are contraindicated in case of relative hyperestrogenism, and treatment with radon, iodine, bromine is contraindicated in case of ovarian hypofunction.

Phytotherapy

Herbal medicine is used to regulate contraction of the uterus, bladder, and increase diuresis: roots of various types of angelica - 50 drops per day for 2 months; various fees.

Collection 1. Buckthorn bark - 1, blackberry leaf - 1, peppermint leaf - 1, birch leaf - 1, yarrow herb - 1, valerian root - 1 part. Pour 1 tablespoon of the mixture into 200 ml of boiling water. Drink the infusion in small sips throughout the day for 3-4 months.

Collection 2. Buckthorn bark - 1, viburnum bark - 1, wheatgrass rhizomes - 1 part. Pour 1 tablespoon of the mixture into 200 ml of boiling water and leave for 2-5 hours. Drink 75 ml. 3 times a day for 2 months.

Collection 3. Buckthorn bark - 1, lemon balm leaves - 1, valerian root - 1, cinquefoil goose grass - 1 part. Pour 1 tablespoon of the mixture into 200 ml. boiling water Leave for 5 hours, take 200 ml orally. 4 times a day for 5 days 3-5 days before menstruation.

Collection 4. Calendula flower - 1, valerian root - 1, Aralia Manchurian rhizome - 1, calamus rhizome - 1, caraway fruit - 3, chamomile flower - 2 parts. Pour 2 tablespoons of the mixture into 400 ml. boiling water, boil for 3 minutes. Drink 75 ml. 3 times a day for 2-3 months.

Collection 5. Knotweed grass - 1, centaury grass - 3, horsetail grass - 1, cinquefoil - 5 parts. Pour 1 tablespoon of the mixture into 200 ml. boiling water Drink in sips throughout the day of painful periods.

Collection 6. Melissa leaf - 1, peppermint leaf - 1, chamomile flowers - 1, valerian root - 1, nettle flowers - 1, rue grass - 1, buckthorn bark - 1 part. Pour 4 tablespoons of the mixture into 1 liter of boiling water and leave for 10-12 hours. Drink 75 ml. 3 times a day for 2-3 months.

Herbal medicine is indicated in complex treatment or at the rehabilitation stage.

Collection 1. Walnut leaf - 20.0, hop flower - 40.0, sage leaf - 40.0. 1 teaspoon of the mixture is poured into 200 ml of boiling water, boil for 5 minutes. Take 1 glass of infusion (200 ml) 2-3 times a day to reduce and suppress lactation.

Collection 1. Calendula flower - 2 g, violet tricolor herb - 2, buckthorn bark - 3, black elderberry flower - 3, licorice root - 3 g. 4 tablespoons of the mixture are poured into 1 liter of boiling water and left for 30 minutes. Take 200 ml. sips morning and evening.

Collection 2. Celandine grass - 1 g, yarrow grass - 1, chamomile flower - 1, cinquefoil grass - 1 g. 1 tablespoon of the mixture is poured into 200 ml. boiling water Take 200 ml. infusion 2 times a day.

Collection 3. Peppermint herb - 1 g, wormwood herb - 1, fennel fruit - 2, buckthorn bark - 3 g. 1 tablespoon of the mixture is poured into 200 ml. boiling water and leave for 20 minutes. Take 200 ml. in the morning and in the evening.

Collection 4. Hawthorn flower - 4 g, St. John's wort grass - 2, calendula flower - 2, buckthorn bark - 4, motherwort grass - 5, chamomile flower - 2, dry grass - 3, yarrow grass - 1, sage grass - 2, rosehip fruit - 3, hop fruit - 1, fennel fruit - 1 g. 2 tablespoons of the mixture are poured into 1 liter of boiling water, boiled for 1 minute, left for 20 minutes, filtered. Take 50-100 ml. 3 times a day in courses of 2 months at 10-day intervals.

Collection 5. Valerian root - 3 g, peppermint herb - 3, chamomile flower - 4. 2 tablespoons of the mixture are poured into 400 ml. boiling water, boil for 3 minutes. Take 200 ml. decoction 2 times a day.

Herbal medicine is more often used in the subacute period or during the recovery period. It involves the use of douching preparations, vaginal tampons and baths. The main medicinal plants: chamomile, cinquefoil, nettle, sage, knotweed, yarrow, sweet clover, calendula, mallow, oak bark, willow, linden flowers, black elderberry, tricolor violet, eucalyptus leaf.

The most commonly used fees are:

Collection 1. Chamomile flowers - 1 hour, sweet clover grass - 1 hour. 2 tablespoons of the mixture are poured into 200 ml of boiling water. The steamed herb mixture is wrapped in cloth and inserted hot into the vagina for 12-10 hours (at night).

Collection 2. Marshmallow root - 1 tsp, chamomile flowers - 1, mallow flowers - 1, sweet clover grass - 1, flax seed - 3 tsp. 1 tablespoon of the mixture is poured into 200 ml of boiling water, inserted as a tampon into the vagina overnight.

Collection 3. Calendula tincture, eucalyptus tincture - 20.0 g each, dimexide solution 50% - 10.0, lanolin - 50.0 g. Mix and use as an ointment for vaginal tampons.

Collection 4. Aloe extract - 10.0 g, Kalanchoe juice - 30.0, dimexide 50% - 10.0, lanolin - 50.0 g. Mix and use as an ointment for vaginal tampons.

Collection 5. Sage herb - 1 tsp, lagochilus leaf - 1, calendula flower - 1, nettle herb - 1, St. John's wort herb - 1, yarrow herb - 1 tsp. 3 tablespoons of the mixture are poured into 1 liter of boiling water, left for 2 hours, filtered. Take 100 ml orally 3 times a day for 2 months.

Collection 6. Sweet clover flowers - 1 tsp, coltsfoot leaf - 1, centaury herb - 1, nettle herb - 1, yarrow herb - 2 tsp. 1 tablespoon of the mixture is poured into 500 ml of boiling water, drink 100 ml 3 times a day day.

Indications: vulvitis, colpitis, cervicitis.

Fees medicinal herbs used for douching, baths, vaginal tampons.

Collection 1. Lavender herb - 1 tsp, bird cherry flower - 1, calendula herb - 2, oak bark - 2, dried grass - 2, birch leaf - 2, sage herb - 2, chamomile herb - 3 tsp. Pour 1 tablespoon of the mixture 1 liter of boiling water, leave for 2 hours, filter. The warm solution is used for douching at night for 2 weeks.

Collection 2. Oak bark - 1 tsp, chamomile flower - 1, nettle leaf - 3, knotweed grass - 5 tsp. 2 tablespoons of the mixture are poured with 1 liter of boiling water. They insist and filter.

Collection 3. Mallow flower - 1 tsp, oak bark - 1, sage leaf - 1.5, chamomile flower - 1.5, walnut leaf - 2.5 tsp. 2 tablespoons of the mixture are poured with 1 liter of boiling water; used identically to collections 1 and 2.

Collection 4. Immortelle basket - 2 parts, birch leaf - 2, strawberry leaf - 2, corn silk - 2, coltsfoot leaf - 2, peppermint herb - 2, yarrow herb - 2, leaf beans - 2, knotweed grass - 3, nettle leaf - 3, string grass - 3, rosehip fruits - 3, rowan fruits - 1 teaspoon. 2 tablespoons of the mixture are poured into 500 ml of boiling water, left for 10 hours, filtered. Take 100 ml of infusion 3 times a day.

Collection 5. Black elderberry flower - 1 tsp, oak bark - 2, strawberry leaf - 2, linden flower - 1, rowan fruit - 1, tricolor violet flower - 1, rose hip fruit - 3 tsp. 2 tablespoons of the mixture are poured into 500 ml . boiling water, leave for 10 hours, filter. Take 100 ml of infusion 3 times a day.

Herbal medicine is carried out to reduce menstrual blood loss and to treat associated extragenital diseases.

Collection 1. Shepherd's purse grass - 1, knotweed grass - 1, mistletoe grass - 1; Pour 1 tablespoon of the mixture into 200 ml of water, boil for 5 minutes, take 200 ml of the decoction in the morning and evening, starting from the 3rd day of menstruation.

Collection 2. Lagochilus leaf - 2, shepherd's purse grass - 2, cinquefoil root - 1, nettle leaf - 2, yarrow grass - 1; 2 tablespoons of the mixture are poured into 500 ml of boiling water, take 100 ml of infusion 3 times a day until the bleeding stops.

Collection 3. Corn silk - 1, celandine grass - 1, St. John's wort grass - 1, immortelle grass - 1; 3 tablespoons of the mixture are poured into 600 ml of boiling water, take 200 ml of decoction 3 times a day to improve the function of the hepato-biliary system.

Collection 4. Immortelle basket - 1, corn silk - 1, chamomile flowers - 1, dandelion root - 1, fennel fruits - 1, wormwood herb - 1, calendula flowers - 1, peppermint herb - 1, tansy flowers - 1, celandine grass - 1; 2 tablespoons of the mixture pour 500 ml of boiling water, infusion

Acupuncture

Used as monotherapy or in combination with other treatments.

Carry out 3 courses of treatment, 10-12 daily in each course. The interval between them is 10-12 days (1st-2nd course), 1 month (2nd-3rd course).

Main TA: J 6, MS6, RP 6, T 14, MS7, GI 11, E 36, E 44.

Additional TAs are determined by clinical symptoms.

For vegetative-vascular disorders and tachycardia, they affect MC6, M C7, C5, C7, RP 6, GI 11; for hyperhidrosis - on R 7, IG 3, G 14; for depression - at T 20, V 15, V 16 using the toning method; for asthenia, a tonic method is indicated affecting E 36, IG 3, C9, VB 34, T4, Y 13, T 16; for insomnia, an inhibitory effect is used on T 20, MC6, MC7, V 15, V 60, RP 5, TR 10, Tr 17.

Preventive acupuncture is performed once a month in TA MC6, RP 6.

Acupuncture acts as a symptomatic remedy for hemostasis and analgesia.

Hemostasis is carried out by placing push-button needles for 5-7 days in AT 58, AT 23, AT 22. At the same time, the needles are applied to the TA according to the following scheme:

1st day - toning GI 11, E 29, E 30;

2nd - RP 2, RP 4, RP 12;

3rd - RP 9, VC 3, F 8;

4th - V C7, V 58, V 27 (toning);

5th - on R 7 (toning), R 3, R 12;

Day 6 - RP 6, VC2.

According to indications, in the future it is possible to use the meridian points R, F, VB, RP, E for up to 10-12 sessions.

In case of severe pain syndrome, one-time acupuncture is performed in AT 58, AT 56, AT 23 with an effect on the TA according to the following scheme:

1st day - VC 5, TR 5;

2nd - F 9, F 12;

3rd - F 2, F 28;

4th - P 7, VC 4, R 6;

5th - V C4, V 23, V 32;

6th - V 31, V ZZ, V 60;

7th - G 14, E 36, RP 6;

8th - VG 14, V 11;

9th - R 11, R 2;

Day 10 – MC 6, MC7, RP 4.

Method of exposure - dispersion, exposure - 20-30 minutes.

Acupuncture is indicated as a component of complex treatment. Permanent push-button needles are used for 5 days on AT 71, AT 58, AT 56 in combination with exposure to corporal TA according to the scheme:

1st day use G 14, E 36, RP 6;

2nd – V 53, V 58;

3rd - R 4, R 10, V 55;

4th - VB 28, VB 29, F 2;

5th - E 10, F 11, VC 1 (removing button needles from AT);

6th - VC2, F12, VB27, and AT 13, AT 22, AT 34;

7th - E36, RP6, GI10;

8th – R 7, R 6;

9th –R3, R12;

10th - TR 5, VB 39, VB 41.

Method of exposure - dispersion, needle exposure - 20-40 minutes.

With the predominance of vegetative-vascular changes.

Mild form of menopausal syndrome.

The most commonly used treatments are: aerotherapy and hydrotherapy (douches, washes, rain showers, baths at home - pine, sage, contrasting foot baths). For angina pectoris - hot hand baths. If ineffective, use a fan and circular shower, jet shower or Scottish shower for obesity.

Balneotherapy: carbon dioxide, pearl, oxygen, foam, radon, iodine-bromine baths (for uterine fibroids, endometriosis, mastopathy, thyrotoxicosis).

From hardware physiotherapy - anodic galvanization of the brain, galvanization of the cervical-facial region, a two-stage scheme of hardware physiotherapy for menopausal syndrome, acupuncture as ionotherapy or in combination with pharmacological influences locally in the TA using diphenhydramine, analgin.

Moderate severity of menopausal syndrome.

Shown:

carbon dioxide (atherosclerosis) and radon (hyperthyroidism) baths;

central electroanalgesia or electrosleep through a 10% GHB solution.

If this is not possible, anodic galvanization of the brain and (or) galvanization of the cervicofacial region; electrophoresis of novocaine in the area of ​​the upper cervical sympathetic nodes; classic manual massage of the collar area; Spa treatment.

Severe form of menopausal syndrome.

Indicated in the treatment complex are aerotherapy, hydrotherapy, and classic manual massage of the “collar” area.

With a predominance of emotional-neurotic disorders

Most shown:

aero- and hydrotherapy; aero-iono- or hydroaeroionotherapy;

general franklinization;

galvanization (anodic, endonasal, “collar” zone);

After 6-8 weeks, a course of general calcium electrophoresis (according to S. B. Vermeule), balneotherapy (pearl, oxygen, foam, nitrogen, radon baths), and sanatorium treatment are used.

Diet, work and rest schedule

Therapy of neurometabolic-endocrine syndrome is a complex and lengthy process of a stage-by-stage nature. It involves an obstetrician-gynecologist, endocrinologist, therapist, ophthalmologist, neurologist and other specialists.

Treatment of neurometabolic-endocrine syndrome includes the implementation of the following recommendations, taking into account the purpose of therapy and the assigned tasks - work, rest, and nutrition. The regimen must be strictly observed for at least 4-10 months after the patient’s first visit to the doctor.

rational psychotherapy - about the need to follow the doctor’s advice, the goals of treatment; inadmissibility of mental and physical overload, sports, physical education, participation in health groups;

maintaining sufficient (at least 8 hours) sleep (sedation therapy as indicated);

prohibition of fasting for therapeutic purposes (danger of aggravating hyperglycemia); maintaining a balanced diet.

Power mode includes:

• total number of calories - no more than 1200-1800,
• 5-6 meals a day,
• replacing animal fats with vegetable ones,
• limiting rapidly absorbed sugars and insulinogenic substances (sugar, jam, honey, flour products),
• mainly dairy, fruit and vegetable nutrition (to cover the required calorie content),
• individually selected fasting days (1-3 times a week),
• normalization of gastrointestinal tract function.

Pharmacotherapy is carried out simultaneously with dietary and regimen measures.

Non-drug treatment of gynecological diseases

Not drug treatment includes:

• general massage,
• massage of the “collar zone”,
• underwater hydromassage,
• balneotherapy.

Instrumental physiotherapy includes endonasal electrophoresis with vitamin B1, central electroanalgesia from the 5-6th day of the menstrual cycle (8-10 procedures).

Acupuncture sessions are carried out every 1-2 days according to the following scheme:

1st session - impact on AT 51, 23, 28, 56 (permanent push-button needles for 8-10 days) or on TA daily for the same time - G 14, TR 5, GI 1 1, E 36 (toning up to 5 minutes);

2nd session: VG 1 1, V 11, V 43 (toning up to 5 min);

3rd session: VG 4, V 2 3 (toning up to 5 min);

4th session: V 25, V 31, V 33 (toning up to 5 min);

5th session: VG 2, VG ​​4, F 12, RP 9 (toning up to 5 minutes);

6th session: RPA, MC 6;

7th session: RP 6, VC 4;

8th session: R 5, R 6, R 12 (dispersion up to 30-40 min);

9th session: G 14, E 36, C I 10 (dispersion up to 40 min);

10th session: R 7, V 23, V 32 (toning z up to 5 min).

Treatment depending on the severity of premenstrual syndrome

For mild forms of the disease, the sequence of therapeutic effects is as follows:

• aerotherapy;
• balneotherapy (coniferous, iodine-bromine, valerian, sage baths);
• hydroaeroionotherapy;
• general franklinization;
• central electroanalgesia, electrosleep;
• galvanization (anodic, endonasal).

After 6-8 weeks (break) - a course of general calcium electrophoresis (according to S. B. Vermeule), balneotherapy (pearl, foam, oxygen, nitrogen, radon baths), sanatorium treatment.

In severe cases of premenstrual syndrome, treatment is carried out in two stages:

• Stage 1 - exposure to the adrenal gland area with microwaves in the deci-, centimeter range, inductothermy, general quartz;
• Stage 2 - carrying out three therapeutic courses of physiotherapy identical to the mild form of premenstrual syndrome.

Physiobalneotherapy

Physiobalneotherapy includes therapeutic mud, ozokerite, paraffin (“panties”, vaginal tampons), sulfide baths, irrigation.

Laser therapy on the lower abdomen is carried out using an infrared laser, “Uzor” and AFDL-2 devices, scanning technique, frequency - 300 imp/min, exposure - 128 s, course - 10 sessions. A helium-neon laser (wavelength 0.63 microns, power density up to 100 mW/cm2) is used in the form of a scattered beam on reflexogenic zones (exposure - 5-10 minutes) or a focused beam through a light guide using an intrauterine technique.

With concomitant ovarian hypofunction, it is more advisable to use only a helium-neon laser.

Non-drug detoxification

Modern methods of non-drug detoxification are integral part complex therapy carried out in the acute period of salpinoophoritis.

Exchange plasmapheresis:

Can be performed using discrete and continuous methods. Reinfusion of exfused erythrocytes is carried out using native plasma or its components, fresh frozen plasma, dextrans, and Ringer's solution as plasma replacement solutions. The PF-05 apparatus is used for blood exfusion. Number of sessions - 3-4 per course. It is advisable to combine the method with UVOC; Contraindicated in case of cardiovascular, pulmonary insufficiency, severe hypotension, anemia, hypoproteinemia, impaired hemostasis.

Ultraviolet blood irradiation (UFOI):

It is performed using the Isolda MD73M device, which allows you to select the UV spectrum, dose irradiation, and ensure the sterility of blood collection and return. For photomodification of blood, it is possible to use the FMK-1 device.

Method of extracorporeal UVOC followed by autotransfusion: take 50 ml of isotonic sodium chloride solution and 5000 units of heparin into a 500 ml bottle; Blood is taken from a vein at the rate of 2-3.5 ml per 1 kg of patient weight. Glugitsir or citroglucophosphate can be used as a preservative - 50 ml per standard bottle. The amount of heparin administered once intravenously before surgery is also 5000 units. Blood is collected using a peristaltic pump; passing through the system through a quartz cell, it is exposed to irradiation. Having collected the required volume upon return (speed 30-40 drops/min), the blood is again irradiated and returned to the vein. Irradiation time is 15-20 minutes, the number of UVOC sessions is from 2 to 10 (on average 3.0+0.4) with an interval of 3-5 days. More frequent procedures are undesirable due to short-term immunosuppression, previous immunostimulation and possible accumulation of suppressive effects during photomodification of autologous blood.

Extracorporeal hemosorption (HMS):

It is carried out using a special portable hemoperfusion system. The technique includes hemodilution in the presorption period, pharmacological stimulation of transcapillary metabolism during hemosorption itself, hemodilution in combination with pathogenetic therapy in the immediate postsorption period. The duration of GMS is from 40 to 90 minutes, the volumetric speed is 60-120 ml/min, the total volume of sorbed blood in one session is 4000-18000 ml. Access to the patient's vascular system is achieved by catheterization of large venous trunks. Various brands of nitrogen-containing activated carbon SKN (spherical carbonite) are used as hemosorbents. The course of treatment is 2-4 sessions of GMS.

The best results are observed after removal of the source of purulent infection. The method improves hematological parameters and eliminates endogenous intoxication.

Laser therapy:

Intravenous laser blood irradiation (ILBI) is used as an immunostimulant in the body with a variety of clinical effects.

Methodology: use any laser device that generates a helium-neon laser (wavelength 0.63 microns) with a fiberglass microlight guide (diameter 200-400 microns) inserted into the patient’s vein. Power flux density - from 0.15 to 16 mW/cm2; ILBI exposure is 30-60 minutes, procedures are carried out daily, the course is 3-5 days. For acute salpingitis and exacerbation of chronic salpingitis with intoxication, the use of a helium-cadmium laser (GCL) is indicated: wavelength - 444.6 nm, power density - 130-150 mW/cm2. Irradiation is carried out in parallel with intensive therapy by affecting both groin areas (scattered beam), lateral vaginal vaults, external pharynx (focused beam). Irradiation exposure of one field is 30-90 seconds. Total time procedures - up to 20-30 minutes (depending on the beam divergence), course - 15-20 sessions daily. When performing dynamic laparoscopy in some patients, a good effect is observed when using an ultraviolet laser (wavelength 0.337 µm/with irradiation of directly affected appendages and uterus).

Laser therapy

The most commonly used is a helium-neon laser (wavelength 0.63 microns). Method of exposure - remote scattered beam, power density up to 100 mW/cm2, exposure 10 minutes. Improves local hemodynamics, trophism, has an anti-inflammatory effect, normalizes the biocenosis of the vagina.

It is permissible to use UV laser radiation (wavelength 0.337 microns, LGI-505 apparatus). Scanning technique, power density 6-7 mW/cm2, exposure 5-10 minutes, number of procedures 2-3.

An infrared laser (wavelength 0.89 microns) is used using a set of special attachments according to the vaginal technique, pulse frequency 300 pulses/min, exposure 128-256 seconds, course - 7-10 procedures.

The goal of treating arterial hypertension is to prevent the long-term consequences of this pathological condition. Most patients require lifelong antihypertensive therapy, but it is first advisable to monitor blood pressure for 4 to 6 months to assess the possibility of its spontaneous decrease, except in cases where immediate drug treatment is necessary (for target organ damage: kidneys, brain, heart , blood vessels, as well as when non-drug treatment is ineffective).

Non-drug treatment involves lifestyle change. The main non-drug measures for arterial hypertension are diet, reduction of excess body weight, sufficient physical activity, refusal bad habits. In 40 - 60% of patients with the initial stage of arterial hypertension and low blood pressure, it is possible to achieve its reduction using only non-drug treatment.

Non-drug treatments for hypertension

Treatment of hypertension should be accompanied by a decisive change in lifestyle: first of all, the mandatory introduction of regular feasible physical activity (this can be walking, jogging, gentle swimming, cycling and other activities that you like). And of course, you can’t do this without a special diet.

In many patients with stage I and even stage II hypertension, with the help of therapeutic nutrition, it is possible to achieve a significant reduction in blood pressure while simultaneously reducing doses medicines, which will increase the effectiveness of drug treatment and prevent its complications. Limiting the consumption of table salt to 4-5 g per day allows you to reduce blood pressure by 4-6 mm Hg within a week. Art., and then, as you follow such a diet for 2-3 weeks or more, sometimes up to normal. Salt restriction is especially effective in old age and obesity. To improve the taste of food, you can use dried seaweed, herbs, onions, garlic, spices, tomato juice, citric acid, vinegar, and various salt substitutes.

However, moderation should be observed in everything, since the sodium and chlorine contained in table salt are essential microelements for our body. Therefore, if symptoms of their deficiency occur (muscle weakness, loss of taste, appetite suppression, etc.), you need to increase your salt intake. How to ensure that it does not linger in the body?
  There is a solution: eating foods rich in potassium, which helps remove fluid from the body!

For your information

Healthy laughter relieves stress and relaxes muscles, and also improves immunity, which helps treat hypertension. According to studies conducted in the USA, each burst of laughter relieves tension in the cardiovascular system for 45 minutes. This improves vascular elasticity and blood circulation.

Be sure to include cucumbers, dried fruits, nuts, beans, seaweed, peas, and potatoes in your diet. Consuming enough potassium is also important to prevent potassium deficiency, which occurs when using certain diuretics (for example, furosemide).

These medications should be taken strictly according to doctor's orders! They are usually prescribed accompanied by potassium supplements (panangin, asparkam and others). And be sure to get tested! After all, if the increase in blood pressure is secondary and associated with kidney disease, you can harm yourself by consuming potassium-containing foods.

It is advisable to enrich the diet with multivitamin preparations - no more than 1-2 tablets per day, especially in the winter and spring. Reducing body weight by at least 4-5 kg ​​almost always helps reduce blood pressure. Therefore, in case of hypertension and obesity, it is recommended first of all to adhere to low-calorie diets.

Drug treatment of hypertension

Treatment of arterial hypertension is carried out taking into account the stage of the disease, its clinical manifestations and complications. In complex therapy of hypertension, antihypertensive, sedative, diuretic and other drugs are used.

As initial therapy for stages I and II of hypertension (mild and moderate hypertension), one of the first-line drugs is usually prescribed (diuretic, angiotensin-converting enzyme inhibitor, beta-blocker, calcium antagonist, angiotensin II receptor antagonist or alpha-blocker) followed by increasing the dose if the effect is insufficient.
  However, today there is no doubt that essential hypertension is a heterogeneous disease caused by the presence of a large number of factors that contribute to the development of vasoconstriction and the maintenance of elevated blood pressure. And monotherapy, aimed at correcting only one of the many pathogenetic links, does not allow achieving the desired level of blood pressure reduction: without increasing the dose, the effectiveness of treatment with one drug is only 50-60%.
  And therefore, more and more often, experts recommend for adequate blood pressure correction combination therapy- a combination of antihypertensive drugs of different groups. Combination therapy with diuretics and ACE inhibitors has noticeable advantages, since with the combined use of drugs from these groups, a decrease in blood pressure is more often achieved due to complementary effects.

It is also advisable to use light sedatives that relieve increased excitability (valerian, motherwort, Corvalol). In the early stages of hypertension, they resort to drugs that expand the lumen of blood vessels (papaverine, no-spa, dibazol).

For your information!

  If you are taking antihypertensive and diuretic drugs, you must remember: when you quickly change from horizontal to vertical body position, blood pressure drops rapidly; this is fraught with loss of consciousness.
  Therefore, you should not get up and sit down suddenly in bed, and even more so, you should not get up suddenly after a night's sleep or a long period of lying down. This must be done slowly, step by step, so that the heart and blood vessels can compensate for the change in position.

If a patient suffering from hypertension does not have coronary heart disease, as a result of the above measures it is possible to bring the pressure back to normal. However, in the presence of coronary disease, it is impossible to significantly reduce the indicators so as not to cause deterioration of blood circulation in the heart muscle.

At the same time, for the prevention of heart attack and other complications, lower pressure is of fundamental importance: we must strive to reduce it to normal, that is, to 80 mm Hg. Art.
The rate of blood pressure reduction is very important. In the absence of emergency indications (worsening of cardiac asthma, angina attack, pre-stroke condition), the pressure reduction to the desired level must be carried out gradually, over several weeks.

And even if the emergency conditions listed above occur, it is still better to reduce the pressure not immediately, but within 24 hours. A sharp decrease in blood pressure can cause acute circulatory disorders in the brain and heart, which creates a risk of developing an ischemic stroke or heart attack.

Attention! the information on the site does not constitute a medical diagnosis or a guide to action and is intended for informational purposes only.

The basis of non-drug treatment of hypertension is changing the patient’s lifestyle. This means:

• reducing the consumption of table salt. The recommended norm is 5-6 grams per day. The contribution of salt (sodium chloride) to the development of hypertension is quite large, since salt retains fluid in the vessels, hence the increase in pressure.
• complete cessation of smoking. Nicotine has been shown to inhibit the effectiveness of some antihypertensive drugs. Moreover, smoking itself increases the risk of cardiovascular complications and other pathologies, including cancer.
• reducing alcohol consumption. It is important to understand that alcohol is not so terrible as dependence on it. Alcoholism leads to liver pathology, and its role in blood pressure regulation can hardly be overestimated. The daily alcohol intake for men is 20-30 g of pure ethanol (50-60 g of vodka, 200-250 ml of wine, 0.5 liters of beer), for women - half as much. Drinking more alcohol is accompanied by an increase in blood pressure; at the same time, the effectiveness of antihypertensive therapy also decreases, which is especially fraught for hypertensive patients. It’s best to completely eliminate alcohol from your diet.
• reduction of excess body weight. As you know, excess weight contributes to the development of diabetes. an increase in cholesterol in the blood and the deposition of plaques in blood vessels, leading to an increase in heart size - all of these are risk factors for hypertension. It has been noted that a decrease in body weight by 10 kg reduces the “upper” pressure by 5-20 mmHg. Maintaining a body mass index between 19 and 25 is considered ideal.
• review of diet. A person prone to high blood pressure should have more vegetables, fruits, cereals, wholemeal products, fiber, natural products, unsaturated fatty acids (olive, flaxseed oil, northern sea fish), and dairy products on the menu. You need to reduce the consumption of carbohydrates (sugar, confectionery products made from premium flour), animal fats, and foods containing large amounts of cholesterol. Particular attention should be paid to drinking water, which should be of medium hardness. Water that is too soft contains little calcium and magnesium salts, which are necessary for normal heart function. The heart also needs potassium, its sources are potatoes, natural juices, as well as fresh vegetables and fruits.
• increasing physical activity. Regular physical training enhances the hypotensive effect of diet and other non-drug methods of lowering blood pressure. It is recommended to carry out systematic aerobic physical exercise, especially for people with a sedentary lifestyle (office workers, drivers). The loads must correspond to the person’s abilities: it is unacceptable to overexert yourself, since in this case the pressure will, on the contrary, increase. The best thing is walking (up to 5-6 km daily), light running (up to 45 minutes a day, 3-4 times a week). Swimming effectively helps reduce blood pressure. If the blood pressure level is very high, then physical activity is allowed only after achieving optimal blood pressure with the help of medications.
• reducing emotional stress, eliminating stressful situations from your life. It is clear, of course, that it is almost impossible to completely avoid stress in our lives, but we must strive to reduce their number and the overall level of emotional stress in everyday life.

ALL ABOUT HYPERTENSION

Non-drug treatment

Treatment of arterial hypertension. Non-pharmacological measures. Prevention of arterial hypertension

All measures for the treatment of arterial hypertension can be divided into two groups: non-drug measures (recommendations on nutrition, physical activity, etc.) and medicinal (hypertensive drugs). The word “conditionally” is very important, because non-drug measures aimed at correcting risk factors for cardiovascular disease vascular complications, despite their apparent simplicity, are very important. Their fairly strict and constant observance in some cases makes it possible to prevent the onset of arterial hypertension, slow down its progression, and in some patients (unfortunately, not many) they are enough to completely correct high blood pressure. We should not forget that even if the doctor prescribed you an antihypertensive drug, compliance with non-drug recommendations is very important for the same reasons. Refusal of non-drug measures in the presence of drug therapy is a wrong step.

NON-DRUG MEASURES

The goal of non-drug treatment is to develop a healthy lifestyle, which helps reduce the overall risk of such serious cardiovascular diseases as stroke, coronary heart disease and myocardial infarction, heart and kidney failure. Basic principles of non-drug treatment include:

• reducing salt intake (no more than 5 g per day, or 1 level teaspoon);
• sufficient intake of potassium and magnesium (3.5 g per day) from vegetables and fruits;
• reducing the amount of saturated fat;
• reduction of excess body weight;
• increased physical activity;
• limiting excess alcohol consumption (no more than 30 g per day for men and 15 g per day for women in terms of pure alcohol);
• to give up smoking; ability to relax.

Along with this, it is advisable for women of childbearing age to cancel hormonal contraceptives, since they increase blood pressure, and also discuss another method of contraception with the gynecologist. In addition, if there are concomitant problems with the joints and spine, you should discuss with your doctor the possibility of discontinuing non-steroidal anti-inflammatory drugs (ortofen, diclofenac, ibuprofen and others), the use of which can cause arterial hypertension (increase in diastolic blood pressure by an average of 5 mm Hg .).

TO GIVE UP SMOKING

A complete and immediate cessation of smoking is necessary!

Stopping smoking leads to the fact that after 5 years the risk of developing heart and vascular diseases and their complications becomes the same as for non-smokers. At the same time, people who continue to smoke remain at increased risk of developing coronary heart disease even after their blood pressure has returned to normal. In addition, smoking may reduce the effectiveness of some antihypertensive drugs (eg, propranolol).

At the same time, with prolonged smoking, physical and psychological dependence develops, so you may experience considerable difficulties when trying to quit smoking, and to resolve them you will need to consult a specialist. You need to quit smoking immediately, at once, since experience shows that attempts to quit smoking are gradually doomed to failure. In the first days and weeks of quitting smoking, avoid tense situations, informal communication with heavy smokers, boredom, try to occupy your head and hands with something.

Dieting has been proven to lower blood pressure. Moreover, the effectiveness of dieting in many patients is comparable even to the effect of antihypertensive medications. Following a diet reduces systolic blood pressure by 4.4-14 mmHg. Art. and diastolic - 2.5-5.5 mm Hg. Art. Special studies conducted among large populations have shown that following a diet leads to a reduction in the incidence of heart disease by 15% and stroke by 27%.

People who follow a vegetarian diet have lower blood pressure than people who do not eat meat. Apparently, this is due to the exclusion of foods containing saturated animal fats from the diet. This leads to a decrease in blood viscosity. In addition, plant-based foods contain less sodium and fat with virtually no cholesterol. Vegetables and fruits are also rich in potassium and magnesium, which also help lower blood pressure.

There are 10 rules healthy eating.

1. Eat a varied and tasty diet.

2. Pay attention to fats in your food. Try to cook without animal fats.

3. Eat enough bran bread and potatoes.

4. Use 200 g of vegetables and 2 1 servings of fruit every day.

5. Don't increase your weight! Don't eat "for company"! Don’t be afraid to leave something uneaten on your plate! Don't buy food when you're hungry!

6. Save salt!

7. Drink enough (but not alcohol). Everyone should drink at least 1 - 1.5 liters of liquid per day (water, tea, milk, juice, yogurt, soup, etc.) A glass of still water half an hour before meals reduces appetite.

8. Don't snack all day. Start from the main methods of poverty and one additional one. Don't skip breakfast or lunch.

9. Maintain good hygiene. Give yourself enough time, do not rush to swallow food,

10. Read information on food packages. Don’t trust the words “diet”, “low-calorie”, pay attention to the numbers.

Our ideas about what we eat and how much it corresponds to the concept of healthy eating are strikingly different from reality. This is illustrated by a study conducted in one of the prosperous countries of the European Union - the Netherlands:

- only 2 in 10 Dutch people think they eat too much fatty food. In fact, 6 out of 10 do this;

only 1 in 10 think they eat too few vegetables. In practice, this occurs in 8 out of 10;

- only 3 out of 10 think they eat too little fruit. In fact, 6 out of 10 experience this.

Low-fat or reduced-fat dairy products, grains, fruits, vegetables, nuts, beans, and fish are recommended. Preference should be given to foods rich in protein and containing microelements - potassium, calcium, magnesium (these microelements have a hypotensive effect). It is recommended to include garlic in the daily diet, which has a beneficial effect on people with high blood pressure and cholesterol levels in the blood. You can start with 1 clove of garlic per day or 1.5-6 g of garlic; in tablets. At the same time, you don’t need to count on lowering blood cholesterol levels. It has been proven that this requires a daily intake of 7-28 cloves of garlic!

Foods rich in saturated fats, which increase cholesterol levels, are not recommended. in the blood, as well as by cholesterol itself: fatty meats, including goose and duck meat, rich broths, beef, pork, lamb fat, meat by-products (liver, kidneys, brains, heart), minced meat, bacon, lard, loin, carbonate, hamburgers, salami servelata, sausages, frankfurters, pates, butter, margarine in packs, coconut and palm oil, mayonnaise, egg yolks, caviar, shrimp, squid, eel, cream, full-fat sour cream, concentrated milk, goat milk, cheeses (fat content more than 40%), cream or cheese sauces, puddings, cream, pastries, cream cakes, fatty snacks, cocoa, chocolate (especially milk), toffee, fudge, coconut bars, butter and soy ice cream, hot chocolate, Irish coffee. Remember that “a cake remains for a minute in the mouth, an hour in the stomach and a lifetime in the waist.” An extra 100 g of carbohydrates leads to the deposition of 30 g of fat in the body.

Try to eat fish, especially sea fish, at least 1-2 days a week (with a ratio of 2/3 white and 1/3 fatty). Replace most animal fats with vegetable oils: sunflower, olive ("Extga virgen"), corn, soybean, peanut, nut, grape seed (1 tablespoon per day). They are unsaturated (“healthy”) fats that lower blood cholesterol. When it comes to margarines, choose only soft varieties that contain less than 17 g of saturated fat per 100 g (in jars, not in packs). Please note: the minimum content of unsaturated fats should be 75%, while polyunsaturated fats should be 50%. Use products that include the word "light" in the name. The latter means they contain 1/3 less calories, fat, sugar and salt than a comparable "regular" product. French fries and potato croquettes cooked in lard and rendered animal fat are not recommended. They can be prepared in vegetable oil and eaten no more than once a week. Recommended mashed potatoes using vegetable oil and without adding egg yolks. Cool the meat broth and skim off the layer of congealed fat. Eggs are allowed to be consumed only boiled and no more than twice a week. If you love baking, replace eggs in recipes with egg whites (one whole equals 2 whites or 1 white with 2 teaspoons of vegetable oil. Avoid baked goods with a high fat content (cakes, biscuits, croissants, coffee cookies). Choose low-calorie sweets with low fat content. fat ( oat cookies or whole grain crackers). Prefer fruit desserts without cream and sugar, fruit jellies, sorbet ice cream, and ripe fruit sorbet.

Use non-stick cookware that does not require adding fat when cooking, as well as a grill. A microwave oven is well suited for preparing dishes from potatoes, vegetables or fish, as well as heating dishes.

Products containing licorice (licorice) (sweets with antitussive effects, etc.) should be excluded from the diet. The maximum caffeine intake per day should not exceed 400 mg (drink no more than 2 cups of coffee or strong tea per day, actively use decaffeinated coffee). Coffee beans contain substances that increase blood cholesterol levels. However, when brewing coffee in coffee makers by filtering, they remain on the filter. On the contrary, when preparing coffee in a cezve or French press, these substances directly enter the cup, so do not use these methods of brewing coffee every day. Instant coffee has no effect on cholesterol levels. The use of Coca-Cola and Pepsi-Cola, drugs containing caffeine, is not recommended. It should be remembered that 1 teaspoon of instant coffee or 3 teaspoons of ground coffee contains 100-150 mg of caffeine, 1 glass of tea or Coca-Cola - 14 mg, cocoa - 17 mg.

REDUCING SALT CONSUMPTION

Relatively simple dietary modifications (no salt on the table, avoiding salty foods) can reduce salt intake to 100 mmol/day. This leads to a decrease of 1 mmHg at 20-29 years of age. Art. diastolic blood pressure. In contrast, the same reduction in dietary salt at age 60–69 years could result in a 7 mmHg drop in diastolic blood pressure. Art. which is comparable to the reduction achieved with diuretics or beta blockers. Therefore, older people with hypertension need to reduce their salt intake. This can be achieved without discomfort, and patients are likely to benefit from this measure, as it will reduce diastolic blood pressure and reduce the need for drug therapy with all its associated side effects.

Excessive salt intake causes fluid retention in the body, which leads to increased blood pressure. It is recommended to limit salt intake to 2 g per day.

Adhere to the following rules:

- do not add salt to food cooking process,

- remove the salt shaker from the table,

- replace salt seasonings with salt-free spices,

- When buying products, read about the sodium content in them.

Gradually reduce the amount of salt. Eliminate salty snacks from your diet (potato chips, salted nuts, olives, capers, sauerkraut, cheese crackers, etc.), products in fast food restaurants, salted butter and cheese, ham, smoked meats, sausages, including in cans, herring, anchovies, smoked eel, salmon and sardines, canned vegetables and mushrooms and soups instant cooking from cans or bags, bouillon cubes, tomato juice. Ready-made herbal mixtures, Maggi seasonings, sauces from bags, mayonnaise, ketchup, ready-made mustard, salted tomato paste, and soy sauce are not recommended. Use fresh or deep-frozen vegetables, which are naturally low in sodium. Read food labels carefully for sodium content.

If you are accustomed to a certain taste of food, use special substitutes for table salt - "Sanasol", "Losalt", etc. (sea salt contains a lot of sodium and is therefore not recommended), onions, garlic, pepper, paprika, horseradish, mustard seeds , lemon juice, ginger, cranberries, cumin, Thai fish and Chinese oyster sauces, fresh and dried herbs (basil, dill, tarragon, rosemary, oregano, watercress, parsley, mint, thyme), as well as spices (bay leaf, anise, cloves, curry, nutmeg, cayenne red pepper, cinnamon, juniper).

ALCOHOL

Excessive alcohol consumption not only raises blood pressure within 1-2 weeks, increasing the risk of stroke, but also is a source of large amounts of calories, which worsens the problem of excess weight. Excessive alcohol intake may cause low effectiveness of antihypertensive (blood pressure-lowering) drugs. Limiting alcohol reduces systolic blood pressure by 2-4 mmHg. Art.

Experts from the World Health Organization (WHO) recommend limiting alcohol consumption (no more than 30 g of pure alcohol per day for men, this is: 30-60 ml of vodka, cognac, gin, rum or tequila, 120-240 ml of wine, 350 ml of beer; and 15 g of pure alcohol per day for women or low weight men). Still, preference should be given not to strong alcoholic drinks, but to wine. The latter is due to the fact that it contains natural antioxidants (vitamins A, C, E), as well as substances that reduce cholesterol levels in the blood, thin the blood, and protect against the development of tumors (polyphenols). Polyphenol levels are twice as high in red than white wine. It should be noted that the beneficial effect of wine is manifested if it is drunk slowly during meals. Don’t think that if you haven’t had a drink today, then tomorrow you can safely add the saved glass to your daily one!

BX

Basal metabolism is the minimum energy expenditure required to maintain the life of the body in a state of complete rest, with the exception of all internal and external influences, 12 hours after eating.

Basal metabolism is expressed as the amount of energy in kilocalories (kcal) or kilojoules (kJ) released by the entire body (or per 1 kg of its mass) per unit of time (minute, hour or day).

Calories are outdated and non-standard, but familiar and generally accepted units of measurement of energy (heat, amount of work): one calorie heats one gram of water by one degree. One kilocalorie is a thousand calories.

The basal metabolism of an adult is approximately 1 kcal per 1 kg of body weight per 1 hour. Thus, the daily basal metabolic rate for a 30-year-old man weighing 80 kg will be equal to 1920 kcal (1 kcal x 80 kg x 24 hours).

The amount of basal metabolism depends on age, body weight, gender and many other factors. The basal metabolism of the same person on different days can vary by ±10%.

Age. After 20-30 years, the basal metabolism begins to decline. On average, per year in adult men, the daily basal metabolism decreases by 7 kcal, in women - by 2 or 3 kcal.

The basal metabolism in adults decreases by 7-10% every 10 years and by old age reaches the minimum values ​​for each person.

The daily energy requirement for basal metabolism for people aged 60 years is calculated as follows:

for men: weight (kg) x 13.5 + 487;

length for women: weight (kg) x 10.5 + 596.

Body mass. There is a clear connection between the development of muscle tissue and basal metabolism: with the same weight and height, a lean and muscular person spends 10-15% more energy on basal metabolism than a plump and loose “non-athlete.”

The intensity of metabolism and energy in adipose tissue is three times lower than in the rest of the cellular mass of the body.

Each gram of adipose tissue “burns” 25-30% less energy than the “average” gram of so-called lean mass spends in the same time. Energy expenditure per kilogram of weight in class II obesity is 20-25% less than in healthy people, and in class III obesity it is 30%. Therefore, in obesity, the total mass of the basal metabolic rate increases much more slowly than body weight.

Floor. Metabolic processes in women are less intense than in men. With the same height, women have less body weight, the muscular system is less developed, and adipose tissue is stronger. All this leads to the fact that the basal metabolism per kg of weight in women is less compared to men. Accordingly, a woman needs less energy to maintain her basal metabolism than a man of the same weight. Normally, these differences are 5-6%.

Nutrition. The level of basal metabolism depends on a person’s diet. Prolonged dietary restriction or excess food consumption significantly affects basal metabolism. Significantly affects the metabolism and quality of food, in particular, increased or insufficient content of certain nutrients in the diet, i.e. unbalanced diet.

When food is limited, the basal metabolism decreases. Body weight may remain unchanged or decrease, depending on individual characteristics and the quantity and quality of food consumed.

Excessive food consumption can lead to both an increase and a decrease in basal metabolism. The decrease in metabolism is explained by the accumulation of inactive adipose tissue in the body, and the increase is explained by the increased load on the internal organs associated with excess body weight.

The basal metabolism also depends on the quality of food; excessive and predominant protein nutrition increases the basal metabolism, and, on the contrary, decreases with carbohydrate nutrition.

Muscle activity. Tense muscle work helps increase basal metabolism. Physical inactivity leads to a decrease in basal metabolism.

Ambient temperature. Most researchers point to an increase in basal metabolism with low temperatures and decrease - at high levels.

Diseases. In healthy people, basal metabolism largely depends on the individual characteristics of the thyroid gland. With increased function of the thyroid glands (hyperthyroidism), the basal metabolism increases by 150% or more, and with a significant decrease in its function (severe hypothyroidism), it decreases by 35-40%.

Basal metabolism increases during feverish conditions. An increase in temperature by 1 degree leads to an increase in basal metabolism by 13% due to an increase in heat production, increased ventilation of the lungs and an increase in heart rate.

Nutrition and metabolism. There is a theory of ideal energy expenditure. Its essence is that with constant weight in healthy people, energy expenditure does not depend on changes in the amount of incoming food. In case of deviations from the ideal body weight, energy expenditure decreases with a decrease in food intake and increases with overeating. Intense physical activity causes a natural increase in food consumption while maintaining body weight at a constant level.

With obesity, there is a more economical expenditure of nutrients and energy during work. To maintain a stable weight, fat people need only 65% ​​of the “average” diet, and thin people need 135%.

Maintaining body weight is an indicator of energy adequacy of nutrition.

Appetite and eating behavior. People prone to obesity spend less energy on normal physiological functions. However, excess nutrition compared to energy expenditure is the main reason for deviation of body weight from ideal.

Appetite is not a necessary part of the feeling of hunger. It can occur on its own: sometimes during a meal, and often in anticipation of a favorite dish. Appetite is caused by a deficiency of a certain substance in the body. Often it reflects individual inclinations towards a particular dish that are innate or acquired as a result of upbringing.

Eating behavior is formed in childhood. Older children often compensate for their loneliness and abandonment with food. Parents often use food as a reward. If the child behaves well, then he is given something “tasty” - food in this case becomes a reward. If the baby does not behave the way the parents want, then he is deprived of sweets, that is, food is used as punishment. As a result, the child begins to perceive refusal of poverty as deprivation of his only joy. Subsequently, it will be difficult for him to teach him to perceive refusal to eat as a reward, and overeating as a punishment.

Pathological eating behavior often develops in adulthood. At the first stage, psychological dependence develops, and at the second stage, physiological dependence. Imagine that you really like some product, for example a cake, and you want to eat it again - this is a psychological addiction. You buy it again and again, and then you feel that without this cake the evening will be ruined, and again you go to the store - This is already a psychological addiction. Cake has ceased to be a source of pleasure, but becomes a need that must be satisfied. The habit of drinking sweet tea and using a lot of salt is also formed.

Eating behavior can be significantly disrupted in cases of psychosis and neuroses. Both excess food consumption and refusal of it can be a manifestation of protest when difficulties arise in other areas of life. It has long been known that many widows begin to gain excess weight. 30% of people experience an increase in appetite as a reaction to stress. In overweight people, this phenomenon occurs 1.5 times more often. The feeling of anxiety prompts you to go to the refrigerator more often, and even in those occasional cases the anxiety is not justified. Depression and disruption of the usual lifestyle can cause a desire to relieve stress and get rid of anxiety. This is where the danger of deviating from the ideal weight lurks - either due to overeating, or due to a complete refusal to eat. Often the cause of overeating is boring work, monotonous life, lack of new experiences and joys.

This process is accompanied by the development of physical inactivity, laziness, and reluctance to do anything. Overeating and physical inactivity contribute to weight gain. If a person was once “overweight”, then psychological reasons will return him to his previous state.

Food causes the brain to release endorphins, hormones similar to drugs. This creates a feeling of calm, relaxation, and comfort. This happens especially often to those people who in childhood developed a conditioned reflex of “eating anxiety.” Often there is a need to “eat up” anxiety with carbohydrate foods - sweets, chocolate. A so-called carbohydrate thirst develops—some nutritionists call it “carbohydrate addiction.” Cravings for sweets often accompany depression and anxiety.

If you are used to eating more than you need, if you are used to eating to reward yourself, if you are used to eating when your soul is “scratching cats,” then you can no longer rely on your body’s signals.

People get fat from tedious work. Department public health The University of Helsinki published the work “Psychological working conditions and weight gain in employees” as part of the ongoing Helsinki Heart Study, which involved 7 thousand women and 2 thousand men aged 40 to 60 years. It turned out that those who are very tired at work especially often gain weight: among women - those who found it difficult to combine work and family, among men - those who are subject to high demands at work.

Alcohol and excess weight. Excessive alcohol consumption is without a doubt the most common, although not the only, cause of weight gain.

Alcohol stimulates appetite. Even mild intoxication reduces control over food intake. A person who regularly drinks alcohol gains weight quite quickly. If it develops alcohol addiction, then over time the appetite and need for food decrease, and patients gradually become exhausted.

Any alcoholic drink is a high-calorie product, which is also very easily absorbed into the blood and is absorbed very quickly (for example, a glass of beer (200 ml) contains approximately 53.2 kcal, a glass of table wine (90 ml) - 57.4 kcal , in a glass of fortified wine (60 ml) - 61.6 kcal, and in a shot of vodka (30 ml) - 64.4 kcal).

Thus, constant use alcoholic drinks, even in small quantities, can lead to overweight and obesity.

WEIGHT CONTROL

There is a close relationship between excess body weight and increased blood pressure. Excessive fat deposition in the abdominal area is especially unfavorable. Weight loss lowers blood pressure, normalizes fat and carbohydrate metabolism, and reduces the risk of cardiovascular complications.

The problem of achieving and controlling ideal body weight is very difficult, since there is no panacea for this, therefore, you will need the help of an appropriate specialist. There is a common belief that to lose weight you need to eat less. However, this is not quite true. To maintain normal body weight, it is necessary to adhere to a diet that will ensure a realistic level of energy expenditure. So, if you find that you are gaining weight, then you have two options: the first is to reduce the caloric content of the food you consume; the second is to increase the level of energy expenditure through physical activity. The results will be best if you combine both methods. A balanced diet is a matter of discipline, moderation and sanity, not living from hand to mouth! Remember to avoid all fad and exotic dietary recommendations, as they tend to be nutritionally deficient and the weight loss they provide is usually short-term and quickly reversible.

PHYSICAL EXERCISE

Regular exercise has many health benefits. They normalize body weight, help reduce low-density lipoprotein cholesterol and blood pressure, keep the cardiovascular system in good shape, stimulate metabolic processes, reduce exposure to stress, etc.

Regular exercise for 30 minutes reduces systolic blood pressure by 3-9 mm Hg. Art. and diastolic - by 3 mm Hg. Art. Overall, they reduce the risk of developing cardiovascular complications.

Entering the physical activity regime should be done gradually - the less physically active you are, the slower you should increase the load.

ABILITY TO RELAX

It is extremely difficult to get rid of the various stresses that our life brings to us. The founder of the doctrine of stress, Hans Selye, said: “Stress can cause both a passionate kiss, and a kick in the ass!". What can you oppose to this? Smile! Think about pleasant things! It is very important to create a calm psychological climate at home and at work, to be optimistic and friendly. Avoid a state of chronic overfatigue, alternate between mental and physical work. Organize your life: keep a diary, set up an effective system for storing bills, receipts, letters and documents.

Try to get at least 7-8 hours of sleep a day. To improve falling asleep, it is useful to take a quiet walk in the fresh air before going to bed, take a warm foot or general bath, drink warm tea with soothing herbs, and give up a heavy dinner in the evening and television programs. Your doctor may recommend so-called periods of relaxation or relaxation in addition to exercise. This could be reading, listening to music, extra naps during the day, deep breathing exercises, autogenic training (breathing training, volitional mouse relaxation, changing body position, concentration, yoga, meditation, hypnosis and anything else that really relaxes you) . Using these techniques once or twice a week will reduce the levels of substances that increase blood pressure, which can ultimately lead to a decrease in systolic blood pressure by 6 mm Hg and diastolic blood pressure by 4 mmHg. Art. But it does not at all follow from this that you have reason to consider yourself disabled and relax unlimitedly. If something hurts you, don’t store up your tears inside, don’t be afraid to cry in front of your loved ones or alone. Control your feelings of guilt, learn to differentiate between the justified expectations of your loved ones and their unrealistic demands. Learn to be a little selfish: you should love yourself more, think about yourself, be able to appreciate your good qualities.

Non-drug treatment of arterial hypertension

Arterial hypertension 20-30% of the adult population suffers. The prevalence increases with age and reaches 50–65% in people over 65 years of age. Among all the forms arterial hypertension Mild and moderate cases account for about 70-80%; in other cases, severe arterial hypertension is observed.

To diagnose increased blood pressure it is enough to record at least three times higher blood pressure figures obtained at different times against the background of a calm environment; the patient should not take drugs that change blood pressure that day. Failure to comply with the last condition can lead to an increase in blood pressure: after drinking coffee by 11/5 mm Hg. Art. alcohol - by 8/8 mm Hg. Art. after smoking - by 6/5 mm Hg. Art. with a full bladder - by 15/10 mm Hg. Art. in the absence of support for the arm - by 7/11 mm Hg. Art.

Goal of treatment arterial hypertension- prevention of long-term consequences of this pathological condition. Most patients require lifelong antihypertensive therapy, but it is first advisable to monitor blood pressure for 4 to 6 months to assess the possibility of its spontaneous decrease, except in cases where immediate drug treatment is necessary (for target organ damage: kidneys, brain, heart , blood vessels, as well as when non-drug treatment is ineffective).

Non-drug treatment implies a change in lifestyle. The main non-drug measures for arterial hypertension are diet, reducing excess body weight, sufficient physical activity, and giving up bad habits. In 40 - 60% of patients with the initial stage of arterial hypertension and low blood pressure, it is possible to achieve its reduction using only non-drug treatment.

For patients with high blood pressure, a special diet number 10. which implies limiting table salt to 6 - 8 g / day (3 - 4 g in products and 3 - 4 g added to food), free liquid to 1.2 l (including soups, jelly, etc.), animal fats , replacing them with plant-based ones, including in the diet foods rich in cell membranes (vegetables, fruits, grains), vitamins, potassium, calcium, magnesium ions. The energy value should not exceed 2600 kcal/day. Anyone suffering from this should follow a diet like this. arterial hypertension. Additional difficulties arise in patients with increased body weight. As a rule, hypertensive patients are obese. It is now generally accepted that if the weight begins to exceed 15% of the ideal, there is a much greater chance of coronary heart disease occurring due to high blood pressure, diabetes. vascular atherosclerosis.

All patients with arterial hypertension whose body weight exceeds 15% of ideal weight loss are indicated. It is believed that a decrease in excess body weight by 1 kg leads to a decrease in blood pressure by an average of 2 mmHg. Art.

In order to reduce the amount of energy stored in the body as fat, it is necessary to consume less energy than the body uses. You can lose weight in three ways: reduce the amount of food you eat, increase physical activity, or combine these 2 methods. It is necessary to ensure that the body expends more energy than it receives from food.

For an obese person whose energy needs reach 2000 kcal per day, even a fairly gentle diet of 1500 kcal will lead to a decrease in energy intake by 500 kcal per day, or 3500 kcal per week, which corresponds to 450 g of weight. Hippocrates also said: “Medicine should be food, and food should be medicine.” Following this rule, when choosing a diet, it is necessary to take into account the individual characteristics of the body, lifestyle, work and rest schedule. The diet should also be complete, i.e. contain all necessary nutrients in sufficient quantities.

As an independent method of non-drug therapy arterial hypertension. and in addition to diet, sufficient cyclic physical activity (walking, light jogging, skiing) in the absence of contraindications can help normalize blood pressure. For example, jogging for 30 minutes helps burn 300 kcal or 40 g of weight, swimming - 175 kcal in 30 minutes, skating - 200 kcal in 30 minutes. But the simplest and most accessible way is regular walking. When 4 thousand doctors from 20 countries were asked the easiest way to improve their health, they answered: walking. Walking improves blood circulation, stimulates the heart and lungs, relaxes joints and helps you lose weight.

American scientists have proven that repeated moderately intense dynamic loads cause a significant decrease in blood pressure, regardless of weight loss or changes in sodium excretion.

Other treatment methods have also retained their importance arterial hypertension. psychotherapy, acupuncture, physiotherapeutic methods (electrosleep, diadynamic currents), water procedures, herbal medicine (chokeberry, tincture of hawthorn, motherwort, infusions with cudweed, hawthorn, sweet clover).