2016
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Документ Застосування елементів літотерапії в комплексному лікуванні пацієнтів з невропатіями лицевого нерва(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2016) Мельник, Владислав Леонідович; Шевченко, Василь Кирилович; Шевченко, Євген Васильович; Мельник, Ірина Василівна; Melnik, V. L.; Shevchenko, V. K.; Shevchenko, E. V.; Melnik, I. V.Традиційне медикаментозне лікування пацієнтів із невропатією лицевого нерва зазвичай складне та малоефективне, тому авторами для лікування невропатій запропоновано використання елементів літо- терапії (сердоліку) і голкотерапії (техніки пекінської школи). Методика мала ефективність у 91,2% пацієн- тів основної групи. У результаті лікування на боці ураження була відновлена до норми функція мімічних м’язів обличчя, що виражалось у природній симетрії при посмішці, надуванні щік, примружуванні очей; повернена чутливість шкіри та досягнута довготривала ремісія захворювання в пацієнтів.; Традиционное медикаментозное лечение пациентов с невропатией лицевого нерва, как правило, сложное и малоэффективное. Поэтому авторами для лечения невропатий предложено использование элементов литотерапии (сердолик) и иглотерапии (по технике пекинской школы). Методика была эффек- тивной в 91,2% пациентов основной группы. В результате лечения на стороне поражения была восста- новлена к норме функция мимических мышц лица, что выражалось в природной симметрии при улыбке, надувании щёк, прищуривании глаз; возобновлена чувствительность кожи и достигнута длительная ре- миссия заболевания у пациентов. ; Introduction. Neuropathy of facial nerve occurs in 38% of all cases of mononeuropathy. Traditional medical treatment of patients with this disease is usually complicated and inefficient, so we proposed a specific treat- ment that included the use of elements of lithotherapy (carnelian), acupuncture (Beijing engineering school) and qigong therapy. Materials and Methods. To evaluate the effectiveness of treatment of patients for neuropathy facial nerve using lithotherapy and acupuncture compared to traditional treatment we created 2 groups of patients. The first (basic) 12 patients have already conducted preliminary traditional medication which didn’t bring the results nor had any complications. The second (comparison) group consisted of 10 patients. They conducted a traditional medication. The first group was of 12 female patients, aged 24 to 56 years who have addressed with complaints of defects of the configuration of the face, speech and vision functions. From history we know that the first pa- tient became ill about two years ago and hospital treatment was not made. One of the patients underwent a course of acupuncture for 1 month. Functional tests showed that all patients had facial asymmetry with a smile, blowing cheeks, closing eyes. This was the motivating factor for the use of alternative therapies – acupuncture complex with application ele- ments, and lithotherapy qigong-therapy. We proposed treatment, which included: application elements of lithotherapy – cornelian treatment; use of unconventional methods of Eastern medicine: reflexology Beijing school with the use of acupuncture and blots applicator. To achieve stabilization process the individual rehabili- tation program developed for each patient was taken into account – Chinese Tuyna facial massage, techniques qigong therapy, exercise of wellness gymnastics. For each of the 12 patients of the main group on the affected side applications of carnelian stone of elliptical form 25x15 mm diameter were applied, water was heated to 600C, followed by application to the damage area of exposure of 3 to 5 minutes. The total number of sessions was from 20 to 30. Microneedles and needles-buttons were used on the affected area of the face with an expo- sure of 45 minutes. Needles with length of working part 1,5-2,5 cm. were used in areas of palmar surfaces by methodologies of Beijing school. At the same time in treatment applicator blots (roller and mat) with step needle 3,8-4,2 mm. were used for cervical part, face, palms. The comparison group included 10 patients (8 women and 2 men) aged 37 to 62 with similar symptoms, which for 2-3 months were treated by traditional methods of physi- cian and neurologist which included dehydration therapy (furasemid 40 mg); neksametylentetramin (10 ml of 40% solution of 5 ml. of 40% glucose solution); B12, B1, C; corticosteroids (hydrocortisone 125 mg – 5 in num- ber gradually reducing the dose); dimexide baths at night; mannitol 15% – 200-400ml. nicotinic acid 1% of 1 ml to 10 ml, then vice versa; analgesics for pain; cortisone acetate 100-300 mg per day; tranquilizers (diazepam); neuroleptics (etakerazyn); antihistamines (diphenhydramine); physiotherapy (UHF, ultrasound, iontophoresis 10% solution of trilon, paraffin, ozocerite baths). In the subacute period physiotherapy and massage mimic muscles were prescribed. Each patient got symptomatic therapy of accompanying illnesses. Results and discussion. In 8 patients of the main group after 20 complex medical procedures (1 month) pain on the affected side disappeared, facial feature of facial muscles became normal, smile became symmet- ric, and there were no blowing cheeks. In 4 patients similar results appeared after 30 sessions of treatment (1, 5 months). After treatment in 11 patients sensitivity of the skin was completely restored, appeared the natural symmetry of a smile. As a result of the treatment algorithm applied to the first group of 11 patients (91,2%) re- ceived long-term remission of the disease. In the comparison group in 4 patients out of 10 (40%), regardless of internists doctors, who conducted medical therapy, pain and facial asymmetry was partially remained; in 6 pa- tients out of 10 (60%) natural-looking face on the affected side was observed. It should be note that an inte- grated approach in the treatment of facial nerve was effective enough not only for eliminating the asymmetry of the face and returning of muscle tone, but also for future rehabilitation period. Further study is planned to con- tinue the proposed treatment efficiency in patients with facial nerve neuritis. Conclusions Comprehensive treatment with elements of lithotherapy (carnelian) and acupuncture (Beijing engineering school) had 91,2% effectiveness for patients of the main group. As a result of the treatment facial asymmetry was eliminated. Patients of the main group achieved remission of the disease when viewed up to 1,5-2 years.Документ Міждисциплінарний підхід у лікуванні пацієнтів із больовою дисфункцією скронево-нижньощелепного суглоба на фоні остеохондрозу шийного відділу хребта(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2016) Мельник, Владислав Леонідович; Шевченко, Василь Кирилович; Melnik, V.; Shevchenko, V.Алгоритм лікування хворих із больовою дисфункцією СНЩС на фоні остеохондрозу шийного відділу хребта складався із застосування мануальної терапії, ЦИГУН-терапії, рефлексоаналгезії, світлолікування, виготовлення індивідуальної суглобової капи, профілактики ускладнень з урахуванням виконання індиві- дуальної програми реабілітації. Одержані позитивні результати застосування запропонованого алгоритму лікування 14 пацієнтів у терміни від 2 до 4,5 місяців, які підтверджені клінічними і параклінічними дослі- дженнями. ; Алгоритм лечения больных с болевой дисфункцией височно-нижнечелюстного сустава на фоне ос- теохондроза шейного отдела позвоночника состоял из применения мануальной терапии, ЦИГУН- терапии, рефлексоаналгезии, светолечения, изготовления индивидуальной суставной каппы, профилак- тики осложнений с учетом выполнения индивидуальной программы реабилитации. Получены положите- льные результаты применения предложенного алгоритма лечения 14 пациентов в сроки от 2 до 4,5 ме- сяцев, которые подтверджены клиническими и параклиническими исследованиями. ; According to the literature in present Ukraine, 80% of young people aged 18 to 39 years diagnosed osteochondrosis. This is primarily manifested by dizziness, headache in the occipital region, tinnitus. With head- turning set of symptoms may increase and sharp movement often leads to loss of consciousness. Such symptoms manifested by temporo-mandibular pain-dysfunction syndrome, which is characterized by the presence of trigger points of muscles of the head, headache different nature and location of pain in the neck, ears, in the joints, tooth-ache, cracking and crunching during opening or closing the mouth. This condition conducive to long monotonous working at the computer, the same type of movements of the head and neck associated with the profession. In these cases, there are destructive changes of cartilage with subsequent salt deposits, deteriorating shock absorbing properties of intervertebral discs having pain and discomfort. Concomitant factors that accelerate the development of disease is dynamic and static overloading, back injury, vibration. Therefore, the aim of our study was to: 1.Create a new algorithm for the treatment of patients with temporomandibular pain-dysfunction syndrome against the backdrop of cervical osteochondrosis; 2.Verify the effectiveness of methods of anesthesia in patients with temporo-mandibular pain-dysfunction against the backdrop of cervical osteochondrosis in applying acupuncture and light therapy; 3.Estimate the effectiveness of the proposed algorithm for treatment. Clinical observations were carried out in 14 patients (7 men and 7 women aged 20 to 37 years). Diagnosis and treatment of these patients was carried out jointly with the osteopath, and prosthodontist. The specificity of the treatment effect was in pain components in patients in problem areas right and left temporo-mandibular joint and cervical spine using non-traditional methods (methods for acupuncture analgesia Peking school, phototherapy - blue light (B2 mode) apparatus LuxDent «UFL 122» use applicator Lyapko, methods of Chi Kung therapy). We proposed treatment algorithm included: 1.Eliminating pain component in the region of the right and left temporo-mandibular joint and cervical spine (osteopaths , Chi Kung Therapy , acupuncture analgesia, blue light (B2) apparatus LuxDent «UFL 122». 2.Prevention complications of occlusion (making an orthopedic mouthguards for temporary fixation of prosthetic occlusion followed if it is necessary). 3.Fixing the outcome of the central bite central occlusion. 4.Prevention of complications (patients individual work at home Chi Kung - therapy, massage , exercises of recreational gymnastics). 5.Consummation and stabilization the process based on the performance of individual rehabilitation program prepared for each patient. As a result of applying our proposed algorithm of treatment in this group of patients over a period of 2 to 4.5 months of positive results to help you believe this algorithm is effective when used in integrated the multidisciplinary approach to treating patients with temporo-mandibular pain-dysfunction against the backdrop of cervical osteochondrosis. The feasibility of using our proposed treatment of clinical and paraclinical research results were conducted.