16.12.2017, 15:59 MedGizmo
Clinical application of complex dynamically variable low-intensity magnetic fields generated by “Multimag” hardware-software device for treatment of bronchial asthma
Vladimirsky E.V., Doctor of Medicine, professor, Kirianova T. V., Institute of Rehabilitating Medicine, Physiotherapy and Balneology GOU VPO PMGA named after E. A. Vagner, Kriakov V. G., PhD, Kasimovsky Instrument Plant
Bronchial asthma (BA) is a widespread human disease which occupies one of the first places in invalidization and mortality rate. The treatment of BA remains a matter of arguments because existing therapeutic regimens are not always efficient, and medicaments prescribed in BA have many side effects. For this reason, non medicamental treatment methods, such as physiotherapy, are those of interest. Magnetic field (MF) has been successfully applied in pulmonology practice since many years, because it exerts influence upon key factors of BA pathogenesis.
The objective of the present study was to investigate dynamics of clinical and laboratory indices in patients with BA in response to complex treatment by means of low-intensity dynamically variable MF generated by “Multimag” hardware-software device.
“Multimag” hardware-software device is a new generation magnetotherapy complex. It forms therapeutic magnetic environment around the patient’s body. The feature of the environment is that it creates magnetic field with evident space-time inhomogeneity, it generates an extensive ensemble of low-intensity dynamically variable magnetic fields of almost any form and it is possible to synchronize the effect with the main patient’s biorhythms. The device is provided with a user interface permitting to create intended treatment methods. 3-dimensional visualization of generated magnetic field in real time allows displaying field variation dynamics, time-and-frequency parameters and magnetic field gradient and vector alteration during the exposure. A bank of methods on different nosologies simplifies the work of operators. In order to facilitate the user’s work the device has the option to enter and to store any data about the patient (“registration” mode). Besides, it is possible to monitor in feedback mode parameters of variation pulsometry and to process mathematically obtained parameters.
During the reporting period 62 patients with BA of medium and high severity, aged on average 52,3 ± 7,7 and 53,1 ± 8,3 respectively, were examined. BA diagnostics and classification was realized in accordance with GINA criteria (2002, 2006). Patients with insular diabetes and internal diseases in acute condition were excluded. All the patients were subjects to investigations of immunograms, of pro-inflammatory interleukins (PIIL) such as alpha tumor necrosis factor (α TNF), 1 beta interleukin (1β IL) and interleukin 6 (IL 6) by immune-enzyme method; as well as to common blood analysis (CBA) for 200 cells with adaptive response determination by L. Kh. Garkavi.
Two observation groups were formed: the first group included the patients with BA aggravation (23) who were treated in a pulmonology department and who were receiving standard therapeutic treatment supplemented by a cure of 10 procedures by low-intensity dynamically variable magnetic field generated by “Multimag” hardware-software device. The comparison group included inpatients who were receiving standard therapeutic treatment only. A group of 31 ambulatory patients with stabile remission of BA was also formed. The remission was determined in accordance with GINA criteria (2002, 2006). All the patients received bronchodilating and anti-inflammatory therapy as per GINA recommendations. The treatment of patients of the observation group (22) was supplemented by magnetotherapy in compliance with the described above method. All the patients were subjects to investigation of laboratory inflammatory markers before and after the treatment. In the comparison group these parameters were also determined twice with an interval of several weeks.
The results of the study were treated by means of Statistica 6 software packet with the use of Mann-Whitney nonparametric test.
Results and discussion. The results of CBA did not present significant difference in patients of the experimental and of the control groups before the treatment.
Before the discharge from the hospital, lymphocytes level in the patients whose treatment had been supplemented by “Multimag” magnetotherapy was lower than lymphocytes level in the patients who had received standard therapeutic treatment only – 25,1±6,4 and 32,7±9,2 respectively, (p=0,041). Initially, in the experimental group exercise reactions (ER) – 33,5% and stress reactions (SR) – 26,6% cases prevailed; there were 20% of balanced activation reactions (BAR) cases and 20% of raised activation reactions (RAR). In the comparison group 37,5% of patients presented with ER, 25% of patients presented with BAR and RAR, SR was observed in 12,5% of patients only. After the treatment the correlation changed – in the treatment group 55,5% of patients presented with ER, 22,2% with BAR and RAR. In the comparison group BAR prevailed (50%); 12,5% and 37,5% of patients presented with ER and RAR respectively. L. Kh. Garkavi and co-authors (2002) proved that ER is optimal by energy usage. In this case vital functions are well balanced; the body can exist a long time without compensatory reserves exhaustion risk. BAR occurs in response to week stimuli which are not life threatening; neurohumoral adaptive systems are activated without overexertion. RAR is observed in case of stronger stimuli affect, it is characterized by maximum tension of all the compensatory systems. SR occurs in case of adaptation mechanisms exhaustion.
It is remarked that the patients of the treatment group presented, generally, with less compensatory systems tension than in the comparison group. It seems optimal for patients of mature age with chronic pathology, because a long activation stage may lead to adaptation mechanism disturbance.
The investigation of PIIL before the treatment no significant differences were detected between the observation and the comparison groups. Before the discharge form the hospital IL 1 blood level in the patients treated by “Multimag” device was lower than in the comparison group – 1,78±1,2 pg/ml (median 2,0) and 6,1±4,5 pg/ml (median 6,8) respectively, p=0,020. It is known that IL 1 activates a cascade of cytochemical reactions and it is one of the key inflammatory mediators. Consequently, laboratory remission was more complete in the patients who underwent a magnetotherapy cure. In the immunograms before the treatment immunoglobulin A (Ig A) level variation was observed. Its concentration was higher in the patients of the experimental group – 2,7±0,8 against 1,7±0,11 in the control group (р=0,009). After the treatment the assay for T-activin presented with better effect in the patients of the observation group than in the patients treated by standard therapy only – 56,4±13,5% and 42,5±4,6% respectively, p=0,030.
The assay for Т-activin gives evidence of immunicompetent cells procreation and differentiation activity, and primarily, it is question of T-suppressors. Consequently,
a higher value of this assay shows sanogenesis mechanisms efficiency, because BA is a disease primarily due to immune system dysfunction. Besides, in the observation group immunoglobulin M level (Ig M) varied within normal range (1,23±0,34); in the comparison group it was below the normal level (0,95±0,08), the difference is significant, р=0,045. Ig M serum level represents insipient immune response, exceeding of normal values means that inflammation persists and remission is incomplete, but, at the same time, diminution of its concentration is undesirable, because it is indicative of immune system insufficiency.
Immunodeficiency may be observed after a systemic glucocorticoid therapy, which is the case of patients with BA. On the basis of the fact that in the observation group Ig M level was normal, it is possible to suppose that MF “attenuates” the side effects of glucocorticoid therapy by retaining immunogram indices within normal range.
There were no significant differences of CBA in the patients with stabile remission before and after the treatment. There were no significant differences from the
comparison group. However, lymphocytes level tended to diminish in the patients after MF exposure – 32,5±11,5% against 39,7±7,2% in the control group, р=0,079. Attention should be paid to the fact that in the both groups during the first and the second investigations of peripheral blood adaptation systems tension was detected: in the observation group before the treatment 9,5% of patients presented with ER, 28,6% BAR, 57,1% RAR and 4,8% SR. After the treatment the patients with RAR prevailed too – 38,0%, but the part of the patients with SR and BAR increased – 19,0% and 42,9% respectively. In the comparison group, during the first and the second investigations, 44,4% of patients presented with RAR, the part of ER did not change (22,2%), but the number of patients with BAR increased up to 33,3% (22,2% initially). This confirms the fact that compensatory reserves in patients with chronic diseases remain constantly tense. In order to avoid adaptation mechanism exhaustion and disturbance, it is necessary
to apply modulating actions such as general physiotherapeutic procedures. To increase their efficiency it is desirable to combine them with other factors which produce beneficial effect on general resistibility of the body, such as exercise therapy, tempering, adaptogens. Initially, in the immunogram there was a difference in Ig A level – 2,59±0,67 g/l in the observation group and 1,68±0,02 g/l in the comparison group, р=0,0079. After the reinvestigation in the patients exposed to MF Ig A level was 2,49±0,5 g/l against 2,19±0,33 g/l in the comparison group, the difference is statistically unreliable. This confirms bibliography data about normalizing effect of low-intensity MF exposure on the integrative systems of the body. There were no significant changes of PIIL level after the double investigation in the both groups of patients. It may mean that in case of not only clinical but also laboratory remission, the application of MF does not produce any supplementary changes.
The results of the executed study provide strong evidence that the application of dynamic low-intensity complex structure MF generated by “Multimag” hardware-
software device for treatment of bronchial asthma optimizes the body integrative systems condition and converts them into a more energy saving and secure
functional mode. These changes are more remarkable in patients with acute stage of the disease; besides, MF diminishes side effects risk of hormonal therapy in this kind of patients.
“Kurortnye vedomosti” Journal No.2, 2008
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16.12.2017, 15:59 MedGizmo
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