the technologies of extracorporeal hemocorrection
with the treatment of the painful syndromes of inflammatory genesis
Pain is sensation, well familiar to each person. Practically there are no people, which repeatedly in the course of their life did not survive a feeling of pain.
Chronic painful syndromes are more frequently than factors themselves, which cause them, are basic reason the losses of ability to work. This means that the solution of the problem of pain acquires extremely great economic and social importance. In 1987 at the world total conference on the state of the service of the protection of health, conducted by the National institute of the health of the USA, on the level with the prospect for the solution of the problems of cardiovascular and cancerous diseases, were determined to the next decade and the directions of further studies in the region of diagnostics and therapy of pain.
What such is pain? Which its physiological function?
From an objective point of view – pain this is simple signal about some serious damage to tissue or significant disturbance of the function of one or other organ or another. The information about the place and the dimensions of the damaged tissue enters with the aid of the painful sensitivity into the central nervous system. I.e., the sharply emergent pain plays positive role. It is analogous to the signal «SOS», supplied some with the structure of our organism, which requires so that we would undertake some special measures for its rescuing. For example, they jerked back hand from the fire, or they ended the action of the physical load, incommensurable with our possibilities.
However, its physiological value to a considerable degree loses upon transfer of pain into the chronic form, and it becomes dangerous and even threatening for the life. Chronic pain is characterized, in particular, by development in the organism of the specific neurophysiological reactions, directed toward the progression of pathologic process and by an increase in the stability of patient toward the treatment. For example, the prolongedly existing pain with osteochondrosis, which appears as a result of the compression of the conducting nervous ways, in turn causes the spastic traction of muscles of back and an even larger compression of spinal roots. Thus, it is obvious, that it is necessary to somehow fight with the chronic pain.
The complex protocols of the therapy of chronic painful syndromes are at present developed, of the directed to the correction basic it is sectional the pathogenesis of chronic painful syndrome. The usual protocol of therapeutic-rehabilitative program with the chronic painful syndrome, for example, as a result of osteochondrosis - includes the following basic components:
- treatment by position and/or immobilization
- analgesia, anti-edematous and anti-inflammatory therapy
- the restoration of blood circulation, an improvement in microcirculation and metabolism in the lethal area, immunocorrection
At an inefficiency of conservative therapy carrying out of decompressive operation is shown.
By up to now one of the basic components of the therapy of the inflammatory diseases, which are accompanied by painful syndrome, remain nonsteroid antiinflammatory drugs (NSAID). These preparations possess the powerful analgesic and antiinflammatory action.
However, these preparations possess the very expressed negative side effects. Their application leads to the development of ulcers in the gastrointestinal tract, the disturbance of the blood coagulation. All these preparations possess toxic action with respect to the kidneys and the liver (nefro- and hepatotoxicity).
It is known that in 10 last years of 18 preparations from the group NSAID they were forbidden because of the unacceptable complications.
In connection with this urgent the search for the new methods of treating of chronic painful syndromes, ways of increasing in effectiveness and reduction in the negative side action of traditional medicines remains. This search is conducted according to the following basic directions:
- Reduction in the duration of treatment and course dose NSAID.
- The search for the new methods of the introduction of analgesics.
- The search for the methods of strengthening the action of analgesics.
For the solution of these problems is at present developed The method of treating the painful syndrome with the inflammatory diseases of supporting-motor apparatus and internal organs, that is consisted in the introduction NSAID by incubation with the cellular mass, obtained as a result of plasmapheresis. Method is based on the special features of pharmacokinetics of the preparations of incubative technologies introduced into the organism with the use. These special features consist in the fact that the molecules of preparation are sorbed on the membranes of erythrocytes, which prevents their rapid inactivation and removal from the organism. It is known that with the usual courses of introduction to 99% of preparation with the entering into the organism the plasma of the blood are connected with the proteins and to 50% of active preparation it is inactivated with the first passage through the liver. The application of incubative technologies makes it possible to prolong the action of preparation, will increase its pharmacological effectiveness and, at the same time, to decrease the toxic load on the organism of patient. The analogous procedures of the introduction of medicines (antibiotics, glucocorticoids, antis-convulsant) proved their advantages over the traditional methods of introduction both on time and manifestation of the offensive of clinical effect and on the economic effect during their application.
So the results of studies of Russian researchers (Vlasov S.V., the Eremiuses V.B., 1999), which used these technologies of treatment in patients with the diagnosis: osteochondrosis of spine, the herniation of intervertebral disk, the syndrome of the compression of spinal roots, show that:
- the intensity of painful syndrome decreased doubly, whereas in comparison with the initial, after conducting of the first session of treatment
- conducting the subsequent procedures allowed toward the end of the course (the 6ths - 7th day) either completely to dilute painful syndrome or to reduce its intensity to the minimum value
An average stay of patients in the hospital in the group being investigated did not exceed 17 accommodation-days, and it was reliably less than in the control group. In this case the complete stopping of painful syndrome was achieved on the average on 5 days earlier and it is considerable (approximately 7 times) by smaller doses NSAID. Effective analgesic and antiinflammatory action led also to an increase of the volume of motions in the struck division of spine almost 2 times larger than in the control group. 97% patients are discharged with the distinct improvement.
The comparison of the results of traditional drug therapy and treating this category of patients with the use of methods of extracorporeal hemocorrection is shown in figure 1.
Fig. 1. Dynamics of painful syndrome (in the marks) with the traditional drug therapy and the treatment with the use of methods of extracorporeal hemocorrection. - a statistically reliable difference in the results.
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