Electroplated panties for Shcherbak. Medical procedure – medicinal electrophoresis. Ionic reflexes according to Shcherbak

Back in the second half of the 20th century. in the USSR, clinical scientists developed scientifically based galvanization techniques, while creating special devices different device. When galvanizing, direct current is used, generated by devices AGN-1, GAN-2 (wall-mounted); GVP-3, AGP-33 (portable); "Stream-1", GF.

In the listed devices, using a transformer, the AC voltage of a conventional electric lighting network is reduced from 220 V (or 127 V) to 30-60 V. At the same time, rectification occurs in these devices sinusoidal current, and then smoothing out the current ripple. The rectified and smoothed current is supplied to the adjustment potentiometer and to the terminals of the above devices. Then, a direct electric current is supplied from the terminals of the device used to the patient (in certain places) using flexible, well-insulated wires, at the ends of which clamps are attached to connect the wire to the electrodes. The current supplied to the electrodes is controlled by a milliammeter built into the device, which provides shunting of 5 mA and 50 mA. To supply direct current to the patient, electrodes are used, consisting of a lead plate with a thickness of 0.3-1 mm and a damp cloth pad with a thickness of at least 10 mm. These pads are made from 12-16 layers of white flannel. The purpose of the gasket is to create uniform density of contact between the electrode and the patient’s body while simultaneously reducing the high osmotic resistance of dry skin and eliminating the pressing effect of electrolysis products on the skin. To avoid the danger of the patient’s skin coming into contact with the metal plate, it is necessary that the gasket protrudes from all sides beyond the edges of the plate by 10-20 mm.

With electrophoresis, the intensity of the effect is expressed by the current density (constant) on the pad area and is used for medicinal purposes in the range from 0.01 to 0.1 mA/cm 2 depending on the sensitivity of the skin, individual tolerance, age, and gender. For children and adolescents, a current density of 0.01 to 0.05 mA/cm 2 is used.

First option. General impact with the arrangement of electrodes according to S.B. Vermeule: an electrode with an area of ​​300 cm 2 is installed in the interscapular region and connected to one of the terminals of the apparatus used. At the same time, two other electrodes, each with an area of ​​150 cm2, are placed on calf muscles ah and using a forked wire, connect it to the second terminal of the same device. In this version of galvanization, a current density of 0.05 to 0.1 mA/cm 2 is used, the duration of the procedure is from 20 to 40 minutes, daily or every other day, taking into account the individual characteristics of the patient. For a course of treatment using this galvanization technique, 12 to 20 procedures are prescribed (depending on the patient’s condition and type of disease), which is an important element intensive care. This technique is based on the fact that cell membranes with their protein substance, under the influence of direct current, change their permeability, while the processes of diffusion and osmosis are enhanced, as a result of galvanization, the metabolism in the human body and the flow of used substances become more intense. medicinal substances through the skin.

Special studies carried out in the Soviet Union in the 1970-1980s found that human skin is a complex organism that performs multiple functions aimed at adapting the body to a constantly changing external environment. During galvanization (or electrophoresis), intensive absorption of medicinal substances occurs through the pores of the skin, and they affect not only locally, but also on the body as a whole. When electrodes are connected to the patient’s body, H-ions move to the cathode and OH-ions move to the anode, which causes shifts in acid-base balance, while the pH of the environment changes, which affects the activity of enzymes and tissue respiration.

As clinical studies have shown, under the cathode when a direct current passes, the following are observed:

Bright hyperemia on the skin;

Increased permeability of cell membranes;

Gain metabolic processes in organism;

Increased nerve excitability.

All this occurs due to the light and mobile monovalent cadium and sodium ions contained in solutions of medicinal substances. The following phenomena were noted under the anode:

Mild hyperemia on the skin;

Compaction of cell membranes;

Reduced intensity of metabolic processes;

Decreased nerve excitability due to the relative predominance of slowly moving heavy divalent ions of calcium and magnesium.

In 1990 V.G. Yasnogorodsky reliably determined the medicinal substances used in electrophoresis, and established the concentrations of their solutions and polarity. For example, when administering heparin, the ion of which has negative polarity, heparin is used sodium salt, while 5000-1000 units are dissolved in 30 ml of distilled water. The negatively charged heparin ion in this example is introduced from the cathode. In the event that positively charged ions are introduced, such as potassium, calcium, magnesium, sodium, histamine, no-spa, novocaine, papaverine, dibazole, an anode is used. With the correct selection of medicinal substances for performing the electrophoresis procedure using the methods of the first option, the following were noted:

Improvement general condition;

Reducing lethargy and fatigue;

Increased performance and mood;

Activation of the immune and regenerative functions of the body;

Strengthening capillary blood circulation;

Suppression of inflammatory processes, etc.

Electrophoresis according to the method of S.B. Vermeule is used in the absence of contraindications (including abrasions, scratches, wounds, etc.) for the treatment of metabolic disorders and peripheral circulation, weakened immunity, diabetic angiopathy and other diseases identified during a medical examination by the attending physician. Many years of medical practice have established that with electrophoresis:

They conduct direct current well: blood, urine, lymph, cerebrospinal fluid, parenchymal organs, muscles;

Poor conduction of current: adipose tissue, tendons, nerves, bones;

They do not carry out electricity: stratum corneum, dry skin (hard skin), nails, hair.

At the same time, a number of contraindications were identified, such as:

Individual intolerance to electrical direct current;

Violation of the integrity of the skin;

Dermatitis;

Acute purulent inflammatory processes;

Second half of pregnancy;

Tendency to bleed;

Cardiovascular diseases with circulatory disorders of the third degree.

Second option: galvanic collar according to A.E. Shcherbak. When carrying out this electrophoresis procedure, an electrode with an area of ​​400-600 cm 2 in the shape of a collar is installed on the back in the area of ​​​​the shoulder girdle and in front in the area of ​​\u200b\u200bthe collarbones and connected to the positive terminal of the device. The second electrode is placed on the lumbosacral region and connected to the negative terminal of the device. When performing galvanization, direct current exposure begins at 6 mA (milliamps) for 6 minutes. After this, every two procedures, the duration of exposure is increased by 2 minutes, and the current strength is increased by 2 mA, and in subsequent days the duration is increased to 16 minutes at a current strength of 16 mA. Depending on the disease, 20 to 30 procedures are prescribed for a course of treatment. This electrophoresis technique is used for neuroses, hypertension, atherosclerosis.

Third option: galvanization of the panty area (galvanic panties according to A.E. Shcherbak). When performing this procedure, an electrode with an area of ​​400 cm2 is installed on the lumbosacral region and connected to the positive terminal of the device. Two other electrodes (with a total area of ​​200 cm2) are placed on the surface of the thighs and connected to the negative terminal of the device used. When performing the first procedure for 10 minutes, the current strength is set using the device regulator in the range from 10 to 15 mA. The duration of each subsequent electrophoresis procedure is increased by 2 minutes compared to the previous one, while the time of the procedure can be increased to 30 minutes (in the absence of unforeseen complications). Depending on the disease, 10 to 20 procedures are prescribed for the entire course of treatment. The described electrophoresis technique is used for diseases of the pelvic organs, blood vessels, limbs, chronic prostatitis, etc. in this case treatment should be pathogenetic, i.e. taking into account factors predisposing to the disease. In general, physiological methods are the second type of pathogenetic treatment for a disease such as chronic prostatitis, which occurs for various reasons in men over 40 years of age.

Fourth option Galvanization consists of a longitudinal arrangement of electrodes, the area of ​​which depends on the size of the areas of impact. In this case, they are placed longitudinally along the nerve trunk: one electrode is in the area of ​​the peripheral portion of the nerve, and the second is in the area nerve plexus or the corresponding segment of the spinal cord, along the spine, into paravertebral areas, along muscles, etc. When performing this electrophoresis procedure, one important condition must be observed - the distance between the edges of the electrodes (vertically) must be no less than the diameter of the electrode. When performing procedures prescribed by the attending physician, the current strength is set in the range from 0.05 mA to 0.1 mA, and the duration of exposure is from 10 to 30 minutes daily or every other day. Depending on the disease identified during a medical examination, 10 to 20 procedures are prescribed. The described electrophoresis technique is used for lesions peripheral nerves and muscles.

The fifth option of galvanization involves a transverse arrangement of electrodes, the area of ​​which depends on the location of the impact. In this case, they are installed on opposite surfaces of the patient’s body area. The horizontal distance between the edges of the electrodes must be no less than the diameter of the electrode. When performing the galvanization procedure, the current strength is set in the range of 0.03 to 0.1 mA/cm 2, and the duration of exposure is from 20 to 40 minutes daily or every other day. Depending on the identified disease, 12 to 15 procedures are prescribed for the course of treatment. Transverse installation of electrodes when performing electrophoresis procedures is most often used when affecting joints, chest, internal organs (in particular, on the stomach area with secretory and motor disorders in the digestive system, gastritis, colitis, with hyper- and hypomotor dyskinesia).

The sixth option of galvanization involves exposure to direct current with a force of 4 to 7 mA and from 10 to 15 mA on the cervico-facial area for neuroses, climacteric syndrome and other diseases. This technique was developed in the second half of the 1980s. M.D. Chernyakovskaya, Yu.F. Zmanovsky and G.A. Kellatom. It involves the use of bi-blade electrodes installed on the lateral surfaces of the upper third of the neck. In this case, the ears are located between the blades of the electrodes. The procedures are performed for 7-15 minutes daily. Depending on the disease, 10 to 20 procedures are prescribed per course of treatment.

In addition to the indicated, most commonly used galvanization techniques (options), numerous special techniques are used in medical practice (especially in specialized clinics):

Galvanization on the area of ​​the mammary glands with round electrodes with a diameter of 15 to 20 cm with holes in the center for the nipples and corolla;

Galvanization of the pelvic organs in women with the placement of electrodes in the vagina and above the pubic symphysis or on the sacrum;

Galvanization of cervical sympathetic nodes;

Galvanization of the nasal mucosa;

Galvanization of limbs (arms and legs) using a four-chamber galvanic bath, etc.

When performing galvanization using any method, the following are noted:

Specific local reactions, expressed in the sensation of tingling and burning under the electrodes, the appearance of hyperemia of the skin, irritation of sensitive nerve endings, contraction of the muscles under the electrodes when the current is briefly turned on or off (therefore, electrophoresis is carried out with a gradual increase in the current strength to the desired value);

Nonspecific reactions manifested in stimulation of the trophic function of the nervous system, metabolism, endocrine system, cardiovascular reactions, circulatory system, etc.

During electrophoresis, as a result of exposure to direct current in the areas where the autonomic ganglia are located (superior cervical sympathetic nodes, neck and shoulder area, collar zone, panty zone, paravertebral zones), the functions of the autonomic centers reflexively change, which helps to increase blood supply and metabolism in the brain, heart, lungs, organs abdominal cavity, pelvis, limbs. During special clinical studies, it was reliably established the following readings to electrophoresis (taking into account the physiological effects of direct current on the body) for:

Regulation of basic nervous processes in neuroses, peptic ulcers, hypertension stages I and II;

Regulation of autonomic functions in migraines, solarium, bronchial asthma, vasomotor rhinitis;

Stimulation of peripheral nerve regeneration;

Relieving and eliminating pain in neuralgia, neuritis, neuromyositis;

Restoration and reduction of secretory and motor disorders in the digestive system with gastritis, colitis, with hyper- and hypomotor dyskinesia, hyper- and hyposecretory disorders, gallbladder dyskinesia;

Resorption of inflammatory infiltrates in chronic inflammatory processes;

Improvement of trophic processes in case of muscle atrophy as a result of injuries of peripheral nerves, poliomyelitis, etc.

Note. When performing electrophoresis procedures of any kind, fabric flannel pads must be moistened in warm boiled tap water, which must be filtered through a shungite or other highly efficient filter to remove impurities harmful to health, such as phenol, salts heavy metals(lead, cadmium, mercury, arsenic, etc.). During electrophoresis, these substances can enter the patient’s body and cause unforeseen serious complications.

Examples of appointments for galvanization procedures

1. Neurasthenic form of neurosis. Galvanic collar according to Shcherbakov. Installation of electrodes: on the collar area - anode, on the lumbar region - cathode. DC current strength from 6 to 16 mA. The duration of exposure is from 6 to 16 minutes daily. The course of treatment is 25 procedures (in the absence of unforeseen complications).

2. Right-sided trigeminal neuralgia. Galvanization of the right half of the face. Electrodes used: Bergenier half mask on the right half of the face from the anode, electrode (second) with an area of ​​200 cm 2 on the left shoulder area from the cathode. DC current strength from 1 to 5 mA. The duration of exposure is from 10 to 40 minutes (in the absence of unforeseen complications) daily or every other day. The entire course of treatment consists of 12 procedures.

3. Traumatic injury ulnar nerve. Galvanization is performed along the ulnar nerve. Electrodes are installed: the first with an area of ​​150 cm2 - on the area of ​​the lower cervical and upper thoracic vertebrae (anode-cathode). Another electrode with an area of ​​150 cm2 is placed on the brush (cathode anode). Permissible direct current strength - up to 10 mA, duration of exposure - from 15 to 30 minutes daily or every other day; course of treatment 15 procedures (in the absence of unforeseen complications).

Electrophoresis is a physiotherapeutic procedure in which the human body is exposed to constant electrical impulses in order to provide a general and local therapeutic effect. Electrophoresis is also used to administer drugs through the skin and mucous membranes. This route of drug administration has a number of advantages over other methods of administration.

The following main routes of drug administration are distinguished:

• using electrophoresis;
• injection route ( intramuscularly, intravenously, intradermally, subcutaneously);
• oral route ( through the mouth).

History of electrophoresis

Subsequently, the Swedish biochemist Arne Tiselius published a paper in 1926 in which he described a U-shaped quartz tube designed for electrophoresis, then in 1930 the tube material was changed to silver chloride.

In 1936, thanks to a good base of research and experimental work, the first electrophoresis apparatus was developed. The shape of the previously proposed tubes was replaced by narrow cells and then by glass sections. These changes made it possible to increase optical susceptibility and more effectively eliminate the heat produced by the passage of electric current.

In practice, A. Tiselius first tested the device, thanks to the study of horse serum. After some time of exposure to electrophoresis, the scientist noticed four bands separated from each other. This was the migration of blood proteins, three globulins ( alpha, beta and gamma) and albumin ( globulin and albumin are plasma proteins). Subsequently, similar tests were carried out on human and rabbit serum, in which similar results were also observed.

This made it possible to establish that in a liquid medium, molecules with an electrical charge, under the influence electromagnetic field move to the area opposite to the charged electrode.

After some time, A. Tiselius, in addition to the electrophoresis apparatus, began to use an ultracentrifuge, which made it possible to more accurately differentiate the migration of proteins and calculate the conditional amount of proteins in the composition.

In 1950, a more modern method was described, which involved separating proteins on filter paper, which was subsequently cut into strips, to which dyes were added, and the protein content in these solutions was examined. It should also be noted that this method made it possible to record the migration of proteins, which was previously impossible to do, since after turning off the electrophoresis they merged together again.

The presented experimental works of A. Tiselius were later widely used in medicine.

For example, this research method allows you to identify protein abnormalities and is currently widely used in many countries for diagnosis:

• infectious inflammatory diseases;
• genetic and immune disorders;
• malignant tumors.

The mechanism of the therapeutic effect of electrophoresis

Note: This treatment method is prescribed only after consulting a doctor.

During the consultation, the doctor collects anamnesis ( medical history) of the patient and prescribes certain examinations to exclude the presence of contraindications to electrophoresis. After confirming the possibility of electrophoresis, the patient is allowed directly to the procedure itself.

Before the procedure, the medical worker examines those areas of the patient’s body on which pads with electrodes will subsequently be applied. In the places where the pads are applied, the patient’s skin should be clean, without any tumors or damage ( for example, pustular lesions, moles). The gaskets, in turn, are soaked in a solvent; as a rule, this is saline solution or water. Then the drug is prepared and applied to the pad.

Note: Hydrophilic material or gauze folded in several layers and wrapped in filter paper is used as a gasket.

For the upcoming procedure, it is necessary to dissolve the medicinal substance in saline solution ( water solution sodium chloride 0.9%). To do this, you need to warm the prepared solution to body temperature and fill a syringe with ten milliliters and insert it into a bottle with the required medication. Then shake the bottle slightly and add an anesthetic and anti-inflammatory agent, for example, 0.5 ml of Dimexide. The finished medicine is drawn into a syringe and distributed onto a pre-prepared pad.

Note: This gasket will be connected to the positive.

On the second gasket ( which will be connected to the negative) another medicinal substance is poured out, as a rule, Eufillin 2% is used. Eufillin helps improve blood circulation, which leads to saturation of organs and tissues. Moreover, this drug relaxes smooth muscles and combines analgesic properties, making it especially effective for muscle pain.

The pads are then placed on the affected parts of the patient's body and electrodes are attached to them. For diseases of the cervical or thoracic spine, a pad with a positive electrode is applied directly to the affected area of ​​the body, and a pad with a minus electrode is placed on the lumbar region. If electrophoresis needs to be carried out in the lumbar region, then a pad with a positive electrode is placed on the lumbar region, and a pad connected to the minus electrode is placed on the thighs of the legs. After application, the gaskets are fixed with a weight ( usually use special sandbags) and the patient is covered with a sheet.

There are also other methods of electrophoresis, in which the method of applying the drug, the procedure for applying electrodes and the type of electrical influence differ.

Highlight following methods use of electrophoresis:

• bath;
• interstitial;
• cavitary.

Interstitial method
Through other routes of administration ( for example, orally or intravenously) the patient is injected with a drug and electrodes are applied to the diseased area of ​​the body. The method is especially effective for diseases of the respiratory system ( e.g. laryngitis, bronchitis).

Cavity method
A solution containing a medicinal substance is injected into the patient’s vagina or rectum, and an electrode is also placed inside. An electrode of a different polarity is attached to the outer surface of the body. This method is used for diseases of the pelvic organs and large intestine.

During the procedure, the medical worker gradually increases the current, while simultaneously inquiring about the patient’s well-being. The current regulator is fixed when the patient feels slight tingling. If the patient feels a burning or itching during electrophoresis, the procedure should be stopped immediately.

The procedure usually takes ten to fifteen minutes. The duration of the course, as a rule, includes ten to twenty procedures daily or every other day.

The following devices are also available for electrophoresis:

• "Elfor";
• "Elfor Prof";
• "Stream-1" and others.

Under the influence of electrophoresis, the drug substance is converted into electrically charged particles ( ions), which, moving, penetrate the skin. The main part of the drug is retained here, providing a largely local therapeutic effect. The other part of the medicine enters the body tissues through certain areas of the skin and is carried throughout the body through the blood and lymph flow.

Penetration of drugs into the body occurs through the following components of the skin:

• excretory ducts of sweat glands;
• excretory ducts of the sebaceous glands;
• hair follicles;
• intercellular spaces.

The quality of drug absorption may be affected by the following factors:

• patient's age;
• place of impact;
• duration of the procedure;
• solvent properties;
• dose and concentration of the administered drug ( As a rule, the concentration of solutions used for the procedure ranges from one to five percent);
• electric current strength;
• ion charge and size;
• individual tolerance.

What drugs can be used for electrophoresis?

During electrophoresis, only those drugs are used that, under the influence of current, are able to penetrate the skin. Drugs can be administered either alone or in combination with other drugs to enhance the therapeutic effect.

The main medicinal substances that are administered through the positive pole ( anode)

The main medicinal substances that are administered through the negative pole ( cathode)

• aminophylline;
• humisol;
• histidine;
• lidase;
• trypsin and others.

Indications for electrophoresis

• patient's diagnosis;
• mechanism of action of the drug used;
• presence of contraindications.

• diseases of the respiratory system;
• ENT diseases ( ear, throat, nose);
• diseases of the gastrointestinal tract;
• diseases of the cardiovascular system;
• diseases of the genitourinary system;
• diseases of the nervous system;
• diseases of the musculoskeletal system;
• skin diseases;
• eye diseases;
• dental diseases.

osteochondrosis; osteoarthritis; arthritis; spondylosis dislocation; fracture; joint contracture.
Endocrine system diseases
Skin diseases	burn; acne; seborrhea; scarring; psoriasis; trophic ulcers; bedsores; dermatitis; folliculitis; furuncle; carbuncle; scabies.
Eye diseases	iridocyclitis; uveitis; iritis; conjunctivitis; blepharitis; keratitis; optic nerve atrophy.
Dental diseases microelements, hormones); stimulates the body's defenses; It should also be noted that electrophoresis has proven itself well when used in infants. Electrophoresis in infants can be used in the following cases: increased or decreased muscle tone; minor neurological disorders; diseases of the musculoskeletal system; diseases accompanied by painful sensations; diathesis; diseases of the ENT organs; burns. Contraindications for electrophoresis Like any other physiotherapeutic method, the procedure using electrophoresis has its contraindications. There are contraindications to electrophoresis: absolute; in the acute stage (for example, Side effects of electrophoresis Today, the occurrence of serious side effects not detected during electrophoresis. However, there is a possibility of allergic reactions on medications used during the procedure. Also, excessive or prolonged exposure to electric current on the patient's body can cause redness and irritation of the skin at the site where the pad is applied.

During menopause and menopause, to restore the regulatory and coordinating function of the nervous system, as well as to eliminate disorders that develop against the background of menopause (dysfunction endocrine glands, cardiovascular system, nervous system, etc.), physical methods of treatment are used.

For menopausal syndrome, the following methods are most often used.

Ultraviolet therapy in the form of local irradiation (“pants”). With the help of ultraviolet therapy, inhibition of the nervous system and gums and sibilization of the body is achieved, which results in a significant reduction, and in some cases, elimination of vegetoneurotic phenomena (I. B. Asaturov, A. A. Lebedev, N. Zhelokhovtsev, etc.).

Methodology. With ultraviolet erythema therapy (“panties”), the lower abdomen, lumbosacral region and the back surface of the upper third of the thighs are irradiated. The initial dose is 1-2 biodoses *, maximum 4-6 biodoses (the biodose is increased gradually), sessions every other day. After irradiation of the indicated areas, the second round begins, conducting it in the same sequence. The total number of exposures is 8-12.

Galvanic collar according to Shcherbak. The effect is achieved through the cervical-vegetative region (normalizes the trophic function of the nervous system). The beneficial effect of the galvanic collar in climacteric disorders has been confirmed by many clinical observations (A. V. Kashinsky, E. T. Vasilyeva, A. E. Zadorozhnikova, A. F. Makarchenko, V. F. Saenko-Lyubarskaya, etc.).

Methodology. The first electrode (in the form of a shawl collar) with a gasket wetted potassium iodide(or some other electrolyte) is placed on the shoulder girdle, and the second electrode (18X20 cm) with a pad moistened with calcium chloride (or some other medicinal solution) is placed on the lumbosacral region. The current strength is 6-16 mA, the duration of the procedure is 10-20 minutes, the frequency of sessions is daily or every other day; The total course of treatment is 15-20 procedures.

Cervicofacial ionogalvanization(according to Kellat). With this method, the skin is exposed to direct electric current. reflexogenic zones the upper third of the lateral surfaces of the neck and face, its right and left sides, as well as the nerve formations located in the corresponding metameres, which are connected with the subcortical sections, with the cerebral cortex, pituitary gland and thyroid gland. Afferent impulses arising under the influence of direct current, according to the author, change the functional state higher departments central nervous system, pituitary gland and endocrine glands.

Methodology. Two two-bladed aluminum electrodes (150-180 cm2) with hydrophilic gaskets, wetted saline solution, apply to the lateral surfaces of the skin of the neck and face so that the auricle is located between the blades of the electrode. The electrodes are fixed with rubber bandages and connected to the poles of the galvanic apparatus. The current strength is 2-8 mA, the duration of the procedure is 7-20 minutes, the frequency of sessions is daily or every other day; The general course of treatment is 12-15 sessions. Research by G. A. Kellat and Yu. F. Zmanovsky (Institute of Obstetrics and Gynecology of the Ministry of Health of the RSFSR) showed that cervicofacial ionogalvanization, improving the dynamics of nervous processes - dark adaptation (its speed is reduced by 2-3 times compared to the original) , is effective method treatment for menopausal disorders.

Transnasal electrophoresis. The method is based on the fact that a galvanic current with chemicals administered through the nose, irritating the endings of the centripetal nerves, causes a generalized reaction from the central and peripheral parts of the nervous system, which leads to a general therapeutic effect. The application of current to the nasal mucosa in close proximity to the base of the brain and repeated electrophoresis, causing stimulation of the higher parts of the nervous system and changing the tone of the central innervation devices, gives a great therapeutic effect. Of no small importance are the medicinal substances administered simultaneously with the galvanic current (novocaine, diphenhydramine, thiamine, etc.); According to A.E. Gilcher, transnasal electrophoresis, which he has used since 1946 in women with functional disorders during menopause, gave 82% a positive result - sleep improved, hot flashes stopped, sweating decreased. The results of treatment lasted for a long time in many patients.

Methodology (according to Cassil). Two cotton or gauze turundas (15-20 cm long) are moistened with an appropriate medicinal solution heated to body temperature. Using tweezers, the turunda is inserted into the nasal cavity until it comes into contact with the mucous membrane. The outer ends of the turunda are placed on the upper lip and nasal septum on top of the oilcloth, where an additional small cotton swab moistened with the same medicinal substance is applied. A lead electrode (2X3 cm) with a soldered wire is fixed on a cotton swab with two to three turns of the bandage around the head. The second gasket - flannel (3X12 cm) - with a lead electrode attached to it (8X10 cm) is placed on the back of the head, corresponding to the occipital foramen. This pad is fixed by the weight of the head, since the procedure is performed with the patient in a supine position. With this arrangement of electrodes, it is achieved best impact electrical power lines to the cortical and subcortical parts of the brain. Before the procedure, it is necessary to especially carefully follow the rules of nasal electrophoresis - rinsing the nose before the procedure, heating the solution, deep insertion of cotton wool into the nasal cavity, etc. The current strength is 0.3-0.5 mA, the duration of the procedure is 10-30 minutes, the frequency of sessions is daily , the general course of treatment is up to 30 procedures. The following are used: 2% solution of calcium chloride, 2% solution of thiamine bromide, 0.25-4% solution of novocaine, etc. Of the treatment regimens proposed by the author, the following can be recommended: the first 3-5 sessions lasting 10 minutes; in subsequent sessions, the current strength is increased to 0.5 mA, the duration of the procedure is up to 30 minutes.

Longitudinal diathermy of the head- impact on the pituitary gland and autonomic centers of the interstitial brain.

Methodology. One electrode (9X5.5 cm2) is applied to the forehead, the other (11X6 cm2) - to the occipital region. The current strength is 0.1-0.2 mA, the duration of the procedure is 8-15 minutes, the frequency of sessions is 10-12 every other day. According to S. N. Astakhov, Ya. A. Ratner, V. E. Dorfman and others, longitudinal diathermy of the head is an excellent method of treating menopausal disorders, the effectiveness of which increases when combined with a galvanic collar. In these cases, it is advisable to prescribe procedures every other day (data from S. N. Davydov).

Anodic galvanization of the brain helps normalize the body's reactivity.

Methodology. One electrode (6.5X3.5 cm 2) with a flannel pad moistened with 0.85% sodium chloride solution is applied to the forehead, another (9X7 cm) with the same pad is applied to the lumbosacral region. The current strength is 0.5-3.5 mA, the duration of the procedure is 5-12 minutes, the frequency of sessions is every other day; The general course of treatment is 6-8 procedures. It is advisable to combine with a galvanic collar. According to S. N. Davydov, electroencephalographic studies in women who have undergone anodic galvanization show long-term normalization of the electrical activity of the brain. Normalization was expressed by increased lability, decreased excitability and increased inhibition processes; clinically, patients experienced a significant weakening or cessation of the phenomena of menopausal disorders.

IN last years for the treatment of climacteric neurosis, a promising, from our point of view, method is increasingly being introduced hydroaeroionization. Hydroaeroionization treatment is based on inhalation of ionized air. This method consists of artificially reproducing the process observed in natural conditions when spraying water from mountain rivers and waterfalls. This process is accompanied by the release of positive and negative ions with a predominance of negative charges into the surrounding air. Aeroions formed during air atomization first enter the upper Airways(mouth, nose), from where they already penetrate into the lungs. Aeroionization has a beneficial effect on vegetative nervous system. Treatment is carried out in special rooms (hydroaeroionatoriums). Soft chairs are installed around the apparatus - the hydroaeroionizer - in which patients can sit comfortably and sleep, or special rooms are arranged where the hydroaeroionizer is installed. Patients receive treatment before bedtime or during the afternoon rest hour. Session duration is from 30 minutes to 1-1.2 hours. The course of treatment is 18-30 procedures. A second course of treatment is prescribed after 3-6 months. The concentration of ions in 1 cm 3 of air, duration, frequency and number of procedures during hydroaeroionization treatment are prescribed strictly individually. Hydroaeroionization has a beneficial effect on patients with climacteric neurosis: sleep improves, headaches, fatigue and fatigue disappear, vitality and performance increase.

For menopausal bleeding, an effective treatment method is thoraco-dorsal diathermy and especially ionogalvanization (automamminization), reflex-segmental irritation from the thoracic spinal cord.

Automamminoionization technique. Round electrodes (14-16 cm in diameter) with specially sewn gaskets (10-12 layers), moistened with 2% potassium iodide, are fixed in the form of a bra on the mammary glands (the nipples are insulated with a rubber gasket); a second plate electrode with a gasket (200-300 cm 2), moistened with a 2-3% calcium chloride solution, is applied to the area of ​​the upper thoracic vertebrae. Current strength is 15-20 mA, procedure duration is 20-30 minutes; frequency of sessions - daily or every other day; The total course of treatment is 15-20 procedures.

In recent years, for the treatment of menopausal bleeding, the following have been used: a) the method of electrical stimulation of the receptors of the cervical canal of the uterus - a method of reflex action on the central nervous system through the receptive zones of the genital apparatus (I. I. Yakovlev and S. N. Davydov) and b) ultra-high frequency therapy - according to a technique usually used for the treatment of gynecological inflammatory diseases (V.I. Konstantinov and R.S. Mirsagatova). Data on the use of the latter two methods are still insufficient to draw definitive conclusions about their effectiveness.

According to our observations, the use of physical methods of treatment for pathologically occurring menopause is especially effective for mildly expressed menopausal disorders. These methods, combined with the administration of vitamins and drug therapy, without hormone therapy, sometimes removed for long periods pathological manifestations menopause, and when applied after hormones have relieved severe pathological phenomena, they consolidate and maintain the balance that has established in the body. In case of severe menopausal disorders, physical methods of treatment enhance and prolong the effect of hormonal drugs, the doses of which in these cases can be significantly reduced.

* The biological dose (biodose) is the time required to obtain minimal erythema on the skin of a given patient at a certain distance from the burner. Biodose shows the sensitivity of the skin to ultraviolet rays.

Galvanization– the use for therapeutic and prophylactic purposes of a constant continuous electric current of low voltage (30-80 V) and low strength (up to 50 mA), called galvanic.

The method and type of such current were named after the Italian physiologist Luigi Galvani. It was first used for medicinal purposes after the invention of the galvanic cell in the 19th century. In Russia, Russian doctors and scientists studied this method - A. T. Bolotov, I. K. Gruzinov, A. A. Kabat, V. I. Vartanov (dissertation “Galvanic phenomena in the skin of a frog”) and many others.

Galvanic current- direct electric current of low voltage and low strength. Intact human skin has a high ohmic resistance and low electrical conductivity, so current penetrates into the body mainly through the excretory ducts of the sweat and sebaceous glands and intercellular gaps. Since their total area does not exceed 1/200 of the skin surface, most of the current energy is spent on overcoming the epidermis, which has the greatest electrical resistance. Therefore, the most pronounced physicochemical reactions to direct current exposure develop here, and irritation of nerve receptors is more pronounced. Having overcome the resistance of the skin, the current further spreads along the path of least ohmic resistance, mainly through the intercellular spaces, blood and lymph vessels, nerve sheaths and muscles.

The passage of current through biological tissue is accompanied by a number of primary physicochemical changes that underlie the physiological and therapeutic effect factor a.

Physiological and therapeutic effects

Under the influence of an external electromagnetic field applied to the tissues, a conduction current arises in them. Positively charged particles (cations) move towards the negative pole (cathode), and negatively charged particles (anions) move towards the positively charged pole (anode). Approaching the metal plate of the electrode, the ions restore their outer electron shell (lose their charge) and turn into atoms with high chemical activity (electrolysis) (Fig. 1). Interacting with water, these atoms form electrolysis products. An acid (HCI) is formed under the anode, and an alkali (KOH, NaOH) is formed under the cathode. One of the variants of such reactions is presented in the diagram

H2 + NaOH ← 2 H2O + Na - + → Na+ Cl- ← + 4CI + 2 H2O → 4HCI + O2

Electrolysis products are chemically active substances and in sufficient concentration can cause chemical burn underlying tissues. To prevent it, gaskets moistened with water are placed under the electrodes, which allows for sufficient dilution of chemically active compounds.

Fig.1. Electrolysis circuit

The conduction current density is determined by the electromagnetic field strength and depends on the electrical conductivity of the tissues. Due to the low electrical conductivity of the skin, the movement of charged particles into the underlying tissue occurs mainly through the excretory ducts of the sweat glands and hair follicles and, to a lesser extent, through the intercellular spaces of the epidermis and dermis. In deeper tissues, the maximum conduction current density is observed in body fluids: blood, urine, lymph, interstitium, perineural spaces. On the contrary, a thousandth of the conduction current passes through the plasmalemma, and the movements of ions in the cell are most often limited by the space of the compartment. It should be taken into account that the electrical conductivity of tissues increases with shifts in their acid-base balance resulting from inflammatory edema, hyperemia, etc.

Differences in the electrophoretic mobility of ions cause local changes in the content of ions of the same sign on different surfaces of cell membranes, as a result of which virtual (intermediate, short-term) poles are formed in the compartment (Fig. 2) and a local countercurrent of ions. As a result, an accumulation of ions of the opposite sign occurs on both sides of cell membranes, interstitial septa and fascia.

The movement of ions under the influence of direct electric current causes a change in their normal ratio in cells and intercellular space. Such dynamics of the ionic environment especially affects the plasmalemma of excitable tissues, changing their polarization.

Rice. 2. Formation of virtual poles on cell membranes in a constant electric field

Under the cathode, under the action of direct current, a decrease in the resting potential first occurs with a constant critical level of depolarization (CLD) of excitable membranes (Fig. 3A). It is caused by the inactivation of potential-dependent potassium ion channels and leads to partial depolarization of excitable membranes (physiological cathelectroton). At the same time, with prolonged exposure to current, inactivation of voltage-dependent sodium ion channels also occurs, which leads to a positive shift in the EAC and a decrease in tissue excitability. Under the anode, activation of voltage-gated potassium channels occurs.

As a result, the value of the resting potential increases with a constant ADC, which leads to partial hyperpolarization of excitable membranes (physiological anelectroton, Fig. 3B). Subsequently, due to a negative shift in the CUD associated with the elimination of stationary inactivation of a certain number of sodium channels, tissue excitability increases.

Rice. 3. Dynamics of the resting potential (RP) and critical level depolarization (CUD) with prolonged exposure to direct current.

A - under the cathode (with subthreshold depolarization),

B - under the anode (with subthreshold hyperpolarization).

FC - physiological catelectroton;

FA - physiological anelectrotonion channels.

Along with the movement of ions, electric current changes the permeability of biological membranes and increases the passive transport through them of large protein molecules (ampholytes) and other substances (the phenomenon of electrodiffusion). In addition, under the influence of an electric field in tissues, multidirectional movement of water molecules occurs, included in the hydration shells of the corresponding ions (mainly Na+, K+, SG). Due to the fact that the number of water molecules in the hydration shells of cations is greater than that of anions, the water content under the cathode increases and under the anode decreases (electroosmosis).

Thus, direct electric current calls in biological tissues the following physical and chemical effects: electrolysis, polarization, electrodiffusion and electroosmosis.

When galvanization is carried out in the underlying tissues, the local blood flow regulation systems are activated and the content of biologically active substances (bradykinin, kallikrein, prostaglandins) and vasoactive mediators (acetylcholine, histamine) increases, causing activation of vascular relaxation factors (nitric oxide and endothelins). As a result, the lumen of the skin vessels expands and its hyperemia occurs. In its genesis, a significant role is played by the local irritating effect on nerve fibers of electrolysis products, changing the ionic balance of tissues.

Expansion of capillaries and increased permeability of their walls due to local neurohumoral processes occurs not only at the site of application of the electrodes, but also in deeply located tissues through which a constant electric current passes. Along with increased blood and lymph circulation, increased tissue resorption capacity, muscle tone is weakened, the excretory function of the skin is increased and swelling in the area of ​​inflammation or injury is reduced. In addition, the compression of pain conductors is reduced, which is more pronounced under the anode due to electroosmosis. Direct electric current enhances the synthesis of macroergs in cells, stimulates metabolic-trophic and local neurohumoral processes in tissues. It increases the phagocytic activity of macrophages and polymorphonuclear leukocytes, accelerates the processes of regeneration of peripheral nerves, bone and connective tissue, epithelization of slow-healing wounds and trophic ulcers, and also enhances secretory function salivary glands, stomach and intestines.

Depending on the parameters of the current current, the functional state of the patient and the chosen galvanization technique, the patient experiences local, segmental-metameric or generalized reactions. Local responses are usually observed in the skin and partially in tissues and organs located in the interpolar zone. Higher order reactions occur during galvanization of reflexogenic and paravertebral zones, as well as corresponding segments and structures of the brain. Thus, an example of the emergence of predominantly general reaction the body in response to the influence of galvanic current is galvanization of the collar zone, in which the response through irritation of the cervical sympathetic nodes is involved the cardiovascular system, blood circulation in organs innervated from the corresponding segment of the spinal cord improves, metabolic processes improve.

When electrodes are placed in the head area, reactions may occur that are characteristic of irritation not only of the skin analyzer, but also of others: gustatory (sensation of a metallic taste in the mouth), visual (appearance of phosphenes), etc.

When the electrodes are placed transversely in the temple area, dizziness may occur as a result of irritation of the vestibular apparatus.

Direct current does not only act at the point of application. Its influence extends to other organs and tissues, primarily to those innervated by the corresponding segment of the spinal cord.

Galvanization stimulates the regulatory function of the nervous and endocrine systems, helps normalize the secretory and motor functions of the digestive organs, stimulates trophic and energy processes in the body, increases the body's reactivity, resistance to external influences, in particular, increases the protective functions of the skin.

With general galvanization, the number of leukocytes in the blood increases, the ESR increases slightly, hemodynamics improve, the number of heartbeats decreases, and metabolism increases (especially carbohydrate and protein).

Low-intensity direct current (at a density of up to 0.05 mA/cm2) helps accelerate coronary circulation, increase oxygen absorption and glycogen deposition in the myocardium. However, higher current strength causes the opposite effect.

Therapeutic effects: anti-inflammatory (drainage-dehydrating), analgesic, sedative (at the anode), vasodilator, muscle relaxant, metabolic, secretory (at the cathode).

Options

There is the concept of “current density” (CT). Current density is the current divided by the electrode area. The unit of current density is mA/cm2. 1 mA/cm2 is a current equal to 1 mA acting on an active electrode area equal to 1 cm2. Therapeutic current density - small values: from 0.01 to 0.1-0.2 mA/cm2. PT 0.5 mA/cm2 or more causes irreversible changes in tissues.

For energy dosage in medicine, a therapeutic current density corridor is used in 3 ranges:

I. Low therapeutic current density: from 0.01 to 0.04 mA/cm2 (current strength is from 1 to 4 mA). Used for acute processes, pain syndromes in children under 4 years of age.

II. Average therapeutic current density: from 0.04 to O.08 mA/cm2.

III. High therapeutic current density: from 0.08 to 0.1 (0.2) mA/cm2. Used for local effects: protracted and chronic diseases.

Galvanization procedures are dosed according to current density (or strength) and duration of exposure. For therapeutic purposes, direct current of low voltage (up to 80 V) and low power (up to 50 mA) is used. For general and segmental-reflex techniques, a current density of 0.01-0.05 is used, and for local ones - 0.02-0.08 mA/cm?. In this case, the maximum current is used when galvanizing the limbs (20-30 mA) and torso (15-20 mA). On the face its value usually does not exceed 3-5 mA, and on the mucous membranes of the mouth and nose - 2-3 mA. At the same time, be sure to focus on the patient’s sensations: the current should cause a feeling of “pins and needles” or a slight tingling sensation. The appearance of a burning sensation serves as a signal to reduce the density of the supplied current. The duration of the procedure can vary from 10-15 (for general and segmental-reflex effects) to 30-40 minutes (for local procedures).

A course of treatment usually includes 10-12 to 20 procedures, which can be performed daily or every other day. If necessary, a second course of galvanization is carried out after 1 month.

Methodology

The current from the device is supplied through wires to the patient, often through plate electrodes. To prevent burns from electrolysis products, a hydrophilic pad (flannel or special plastic) moistened with water is placed between the metal plate and the body. The intermediate medium between the metal electrode and the skin can also be water poured into baths. After fixing the electrodes, the current is turned on, and then it is gradually increased to the required value. At the end of the procedure, the current is also gradually reduced until it is completely turned off.

During procedures, current is supplied to the patient through electrodes along current-carrying wires. The electrodes consist of lead plates 0.3-1 mm thick, a wet hydrophilic fabric pad and a cord.

The pads are made from 12-16 layers of white flannel. They should be warm enough to open the skin pores. To avoid the danger of contact of the patient's skin with the metal plate, it is necessary that the gasket protrudes from all sides beyond the edges of the plate by 1.5-2 cm. The purpose of the gasket is to create uniform density of contact between the electrode and the patient's body, reducing high skin resistance.

Electrodes come in various shapes and sizes. Most often, rectangular electrodes are used, but sometimes a special form of electrode is needed, for example, a half mask for galvanizing the face, a “collar” for galvanizing the upper back and shoulder girdles, a funnel for galvanizing the ear area, a tray for galvanizing the eye area. IN gynecological practice special cavity electrodes are used - vaginal, in surgery (proctology) - rectal, etc. The area of ​​the electrodes is different, therefore the area of ​​the pads is also different.

Lead plates are used as electrodes, since they are very flexible and easily take the shape of the areas of the body on which they are applied. The plates must be smooth, without sharp corners, so that the current density is uniform.

The cathode and anode electrodes can be of the same area, or one of them can be smaller in size - the so-called active electrode. The current density per 1 cm2 of spacer at the active electrode turns out to be greater because the field lines become thicker. During the procedure, the active electrode is applied to the area where it is necessary to ensure the maximum effect of the current.

When prescribing galvanization, the permissible current strength is set according to the area of ​​the active electrode, taking into account the characteristics of the area of ​​the body exposed to the effect, and most importantly, taking into account the patient’s condition.

There are transverse and longitudinal arrangement of electrodes. With a transverse arrangement, the electrodes are placed opposite each other on opposite parts of the body (the effect is provided on deeper tissues). With a longitudinal arrangement, the electrodes are located on one side of the body (superficially located tissues are exposed).

Before applying electrodes, it is necessary to carefully examine the relevant areas of the skin. The skin should be clean. Areas with damaged epidermis are smeared with Vaseline and covered with pieces of cotton wool, thin rubber or oilcloth.

During the procedure, it is necessary to monitor the patient’s sensations and the device’s readings, ensuring that the specified current strength is not exceeded. Galvanization, carried out in compliance with the specified rules, usually causes a tingling sensation, “crawling goosebumps” on the areas of the skin under the electrodes. If you feel a sharp burning or pain, even in small areas of the skin, you need to smoothly turn off the device and determine the cause of the adverse reactions. They may depend both on technical conditions and on the state of the body.

During a course of galvanization, it is recommended to lubricate the skin with Vaseline to avoid peeling of the track and the appearance of cracks. After the procedure, the pads should be washed and boiled.

To remove addiction to the procedure, use degabitizing technique: turn off the device or change the polarity for 2 minutes.

It must be remembered that after 5-7 procedures, a slight exacerbation of the disease (worsening of the condition) may be observed in physiotherapeutic reactions, which indicates a positive therapeutic effect of the prescriptions.

Depending on the therapeutic problems being solved, methods are used local And general galvanization, as well as galvanization of reflex segmental zones.

At local galvanization Direct current is supplied to the patient's body area using two electrodes, each of which consists of a lead plate (or conductive carbon-graphite fabric) and a hydrophilic gasket. Electrodes of various shapes are used, with an area of ​​8-15 cm2; profile gaskets 1-1.5 cm thick (12-16 layers of flannel or calico) are moistened warm water, squeeze out and place on the appropriate area of ​​the body. With the help of gaskets, good contact of the electrode with the patient’s body is created, and his skin and mucous membranes are protected from the effects of electrolysis products (acids and alkalis). The shape of the hydrophilic gasket must match the shape metal plate electrode. To prevent contact of the metal part of the electrode with the patient’s skin, the hydrophilic gasket should protrude from all sides beyond the edges of the plate by 1-2 cm.

Along with rectangular electrodes, electrodes in the form of a half mask (for the face), a collar (for the upper back and shoulder girdles), glass trays (for the eyes) or special cavity electrodes (rectal, vaginal, etc.) are used for local galvanization. The wires (electrode cords) have a tip at one end for connection to one of the terminals of the device, and at the other - a spring screw clamp or a staniol plate (flag) for connection to the metal part of the electrode. To connect electrodes with sewn-in graphitized fabric, special carbon-graphite contacts are used.

When performing galvanization procedures, electrodes are placed on the patient’s body longitudinally or transversely When positioned longitudinally Electrodes are placed on one side of the body and exposed to superficial tissue. With a transverse arrangement electrodes are placed on opposite parts of the body and deeply located organs and tissues are exposed. In some cases, transverse diagonal placement of electrodes is used. When using electrodes of different areas, the smaller one is conventionally called active, and the one with a larger area is called indifferent. To carry out some procedures, 3 or 4 electrodes are used, and bifurcated wires are also used to simultaneously connect 2 electrodes to one of the device terminals of the corresponding polarity. The electrodes are fixed on the patient's body using elastic or gauze bandage, adhesive plaster or sandbags. Galvanization procedures are most often performed on patients in a lying position, sometimes sitting in a comfortable position.

For general galvanization - use a small therapeutic dose, for example, a four-chamber hydrogalvanic bath (Fig. 4).

Rice. 4. Four-chamber hydrogalvanic bath

During this procedure, the patient immerses the limbs in earthenware baths filled with warm (36-37°C) tap water. On the inner wall of each chamber there are two carbon electrodes, closed from direct contact with the patient’s body. The wires from the electrodes are connected to the corresponding poles of the galvanizing apparatus, equipped with a switch to change the direction of the electric current supplied to the patient. The current strength during this procedure reaches 30 mA

For galvanization reflex segmental zones Direct current is applied to the paravertebral zones of various parts of the spine and the corresponding metameres. Most often, galvanization of the collar and panty zones is used (galvanic collar and panties according to A.E. Shcherbak).

Rice. 5. Location of electrodes on the front (1) and back (2) surfaces of the body during galvanization of the collar (A) and panty (B) zones (according to A.E. Shcherbak)

In the first case, one electrode with an area of ​​1000-1200 cm2, made in the shape of a shawl collar, is placed on the back, shoulder girdle and collarbones of the patient (Fig. 5A) and connected to the positive pole. The second electrode (usually connected to the cathode) of a rectangular shape with an area of ​​400-600 cm2 is placed in the lumbosacral region. Procedures lasting 6 minutes begin with a current of 6 mA. After one procedure, the current strength is increased by 2 mA, the duration of exposure is increased by 2 minutes, and adjusted to 16 mA and 16 minutes, respectively.

When galvanizing the panty area, one rectangular electrode with an area of ​​300 cm2 is placed in the lumbosacral area and connected to the anode. Two other electrodes (each with an area of ​​150 cm2) are placed on the front surface of the upper half of the thighs and connected with a forked wire to the cathode (Fig. 5B). Current modes and duration of procedures are similar to the previous method.

Galvanization procedures are combined with high-frequency magnetotherapy (galvanoinductothermy), mud therapy (galvano-mud therapy), and acupuncture (galvanoacupuncture).

The use of direct current for therapeutic purposes for galvanization is currently gradually narrowing, giving way to electrophoresis- introduction of medicinal substances into the body through the skin or mucous membranes.

Some private galvanization techniques

Method No. 1. Longitudinal galvanization of the head area. One electrode with an area of ​​50 cm2 is placed on the forehead, the second, of the same area, is placed in the cervical-occipital region; if it is a positive electrode, then it can be placed higher - in the area of ​​the first cervical vertebra, but if it is negative, then it is placed lower.

Method No. 2. Orbital-occipital galvanization technique for the head area (Bourgignon technique). Two round metal plates, each 2 cm in diameter, are placed on gauze balls placed on the closed eyelids and connected to one clamp of the galvanizing apparatus. A second electrode with an area of ​​50 cm2 is placed under the occipital protuberance (if it is a negative electrode, it is placed lower); In this case, the hair should be well moistened with water.

Method No. 3. Galvanization of the facial area. A three-bladed electrode [Bergonie half mask] is placed on the affected half of the face so that the blades are adjacent to the forehead, cheek and chin, leaving the eye and corner of the mouth free. The second electrode with an area of ​​300 cm2 is placed in the interscapular region or on the opposite shoulder. Sometimes, with neuritis of the facial nerve, a tampon moistened with an appropriate medicinal solution will be inserted into the external auditory canal, bringing the free end of the tampon under the facial electrode gasket.

Method No. 4. Galvanization of the ear area. A gauze swab moistened with warm tap water is inserted into the ear canal, the end of which is brought out, placing it on the auricle; a regular electrode with an area of ​​50 cm2 is placed on the latter, connecting it to one clamp of the galvanizing apparatus. The so-called indifferent electrode with an area of ​​100 cm2 is placed on the opposite cheek in front of the auricle.

During electrophoresis, a rubber or ebonite funnel is inserted into the external auditory canal, into which a metal rod is inserted so that it does not come out of the lower end of the funnel. Pour the appropriate medicinal solution. The second electrode is applied as above.

It is possible to carry out galvanization of the ear area and through the outer integument. In this case, a kidney-shaped electrode with a cutout for the auricle is placed on the mastoid area; second electrode, as above.

When galvanizing both ears, the procedures are performed on each ear separately.

Method No. 5. Galvanization of the area of ​​the cervical sympathetic nodes. Two electrodes with an area of ​​20 cm2 each are placed on the neck along the anterior edge of both sternocleidomastial muscles, connecting them to various clamps of the galvanizing apparatus or to one of them. IN the latter case an additional electrode with an area of ​​40 cm2 is placed in the cervical-occipital region, connecting it to the second clamp of the device.

Method No. 6. Galvanic collar according to A.E. Shcherbak. One electrode in the form of a shawl collar (area 1000 cm2) is placed on the “collar” zone (upper back, supraclavicular areas, upper shoulders), the second, with an area of ​​400-600 cm2, is placed on the lumbosacral region. The collar electrode is usually connected to the positive pole of the device. Initial current 6 mA; it is increased with each procedure or every other procedure by 2 mA, bringing the current strength to 16 mA. The initial duration of the procedure is 2 minutes; with each subsequent procedure or every other procedure, it is increased by 2 minutes to 16 minutes. Procedures are carried out daily or every other day; for a course of treatment 25-30 procedures.

Method No. 7. Galvanic panties according to A.E. Shcherbak. An electrode with an area of ​​300 cm2 is placed in the lumbosacral region, connecting it to the positive pole of the galvanization apparatus. Two other electrodes with an area of ​​150 cm2 each are placed on the anterior surface of the upper third of the thighs, connecting them to the negative pole of the device. The current strength is gradually increased from 10 to 15 mA, and the duration of the procedure is extended from 10 to 20 minutes.

Method No. 8. Galvanic belt according to A.E. Shcherbak. This technique is a variation of the previous one. In this case, one electrode in the form of a belt (width 15 cm, length 75 cm) is placed around the lower part of the body, connecting it to one, two other electrodes with an area of ​​150 cm2 each are placed on the anterior surfaces of the upper third of the thighs, connecting them to the second clamp of the device. The rest is the same as method No. 7.

Method No. 9. Ion reflex according to A.E. Shcherbak. Two electrodes with an area of ​​60-100 cm2 each are placed opposite each other on the flexor and extension surfaces, usually of the left shoulder. The polarity of the electrodes depends on the polarity of the administered drug.

Initial current 10 mA; by the third procedure it is brought to 20 mA, without increasing it in subsequent procedures. The duration of the first procedure is 10 minutes with its extension for the third and subsequent procedures up to 20 minutes. During the procedure, the current is turned off 2 times (usually at the 8-11th and 18th minutes) for 1 minute, which, according to A.E. Shcherbak, promotes a deeper passage of ions of medicinal substances. Procedures are carried out daily; a total of 30-40 procedures per course of treatment.

Method No. 10. Galvanization for diseases and damage to the nerves of the upper extremities. One electrode with an area of ​​150 cm2 is applied to the area of ​​the lower cervical and upper thoracic vertebrae, the second with an area of ​​100 cm2 is applied to the forearm, depending on the topographic location of the affected nerve. So, if the radial nerve is damaged, it is placed on the extensor surface of the middle third of the forearm, if the median nerve is damaged - in the lower third of the forearm laterally, if the ulnar nerve is damaged - in the lower third of the forearm medially. This electrode can be replaced with a single-chamber bath by placing the second electrode in the area of ​​the shoulder girdle. For injuries nerve trunks This technique is alternated daily with the transverse technique of the injury site.

Method No. 11.. Galvanization for diseases and nerve damage lower limbs. If the sciatic nerve is damaged, one electrode with an area of ​​300 cm2 is placed in the lumbosacral region, the second with an area of ​​200 cm2 is placed in the area of ​​the calf muscles. In case of bilateral disease or damage to the sciatic nerve. va, in addition to the electrode in the lumbosacral region (area 400 cm2), two electrodes with an area of ​​200 cm2 each are placed in the area of ​​the calf muscles of both lower extremities, connecting them to one clamp of the galvanization apparatus.

If the peroneal nerve is damaged, one electrode with an area of ​​100 cm2 is placed in the upper third of the leg on the outside, and a second electrode of the same area is placed on the dorsum of the foot.

If the tibial nerve is damaged, one electrode with an area of ​​100 cm2 is placed in the upper third of the posterior surface of the leg, the second of the same area is placed on the plantar surface of the foot.

If the femoral nerve is damaged, one electrode with an area of ​​300 cm2 is placed in the lumbosacral region, the second with an area of ​​200 cm2 is placed in the upper third of the anterior surface of the thigh.

With the transverse method of galvanization of the sciatic nerve, proceed as follows: one electrode pad measuring 120X15 cm covers the area of ​​the sacrum, buttocks and the posterior surface of the corresponding lower limb to ankle joint, the second measuring 80-90 X 12 cm - the anterior surface of the lower limb from the inguinal fold to the ankle joint. It is more convenient to use the metal part of the electrode, consisting of separate small-area plates, applied in a tile-like manner. The electrodes are fixed with a bandage. In electrophoresis, the drug is administered from a back electrode connected to the terminal of the galvanizing machine that matches the polarity of the drug being used.

Method No. 12. General galvanization according to S. B. Vermeule. One electrode with an area of ​​300 cm2 is placed in the interscapular area, connecting it to one clamp of the galvanization apparatus, two other electrodes with an area of ​​150 cm2 each are placed on the area of ​​the calf muscles of both lower extremities, connecting them to the second clamp of the apparatus. This technique was proposed by the author for the purposes of electrophoresis. The electrode gasket located in the interscapular region is moistened with a solution of the medicinal substance, connecting the electrode to the clamp of the device that corresponds to the polarity of the injected medicinal substance.

Method No. 13. Galvanization of the spine area. One electrode with an area of ​​200 cm2 is placed in the area of ​​the lower cervical and upper thoracic spine, the second of the same area is placed in the area of ​​the lumbosacral spine.

Electrodes with an area of ​​200 cm2 each can be placed paravertebrally, according to the part of the spine that they want to expose.

During transverse galvanization of the spine, one electrode with a width of 4-6 cm and a length corresponding to the affected part of the spine is placed in the spinal region, a second of the same size is placed on the front surface of the body opposite the first. Sometimes the entire spine from the cervical region to the coccyx can be exposed using this method, using electrodes 4-6 cm wide and long in accordance with the length of the spine.

Method No. 14. Galvanization of the joint area. For diseases of many joints, especially the small joints of the fingers and toes, as well as the wrists and ankles, galvanization is carried out using chamber baths. The number of baths used and their polarity depend on the extent of the lesion.

In case of illness large joints Transverse galvanization of the affected joint area is used. Thus, when galvanizing a shoulder or hip joint, electrodes with an area of ​​100 cm2 each are placed on the front and back surfaces of the corresponding joint, and when galvanizing a knee or elbow, electrodes with an area of ​​100-50 cm2 each are placed on the lateral surfaces of the corresponding joint.

Method No. 15. Galvanization of the gastrointestinal tract area. An electrode with an area of ​​300 cm2 is placed in the abdomen, and a second electrode with an area of ​​400 cm2 is placed in the area of ​​the lower thoracic and upper lumbar spine.

Method No. 16. Galvanization of the area of ​​the internal female genital organs. In this case, the following galvanization methods are available:

a) abdominal-sacral, in which two electrodes of the same area of ​​200 cm2 are placed one above the pubic symphysis, the second in the sacrum;

b) abdominal-vaginal, in which one electrode with an area of ​​200 cm2 is placed above the pubic symphysis, the second, a special vaginal one (carbon or liquid), is inserted into the vagina;

c) sacrovaginal, in which one electrode with an area of ​​200 cm2 is placed in the sacral area, the second, a special vaginal electrode (carbon or liquid), is inserted into the vagina.

Method No. 17. Galvanization of the mammary gland area. A round electrode, each 15 cm in diameter, with a hole in the center for the nipple and isola, is placed on each mammary gland. Both electrodes are connected to one clamp of the galvanizing apparatus, and the so-called indifferent electrode with an area of ​​300-400 cm2 is placed on the back and connected to the second clamp of the apparatus. During electrophoresis, electrodes located in the area of ​​the mammary glands are connected to the clamp of the galvanization apparatus that corresponds to the polarity of the administered drug substance.

Method No. 18. Electrophoresis through the nasal mucosa. After rinsing the nose with water, gauze turundas moistened with a medicinal substance are inserted into both nostrils so that they fill the anterior pits of the wings of the nose and fit tightly to its mucosa. On upper lip Place a piece of oilcloth on which the extended ends of the turunda are laid, covering them with a metal electrode plate (size 2X3 cm) with a wire soldered to it. All this is secured with a bandage. The so-called indifferent electrode with an area of ​​100 cm2 is placed in the cervico-occipital region near the foramen magnum. The strength of the current, the duration of the procedure, and the number of procedures depend on the nature of the disease and the medicinal substance used. Thus, when using vitamin B1, the current strength is from 0.5 to 2 mA, the duration of procedures is from 10 to 30 minutes; only 20-25 procedures per course of treatment. When using calcium chloride or novocaine, the current strength is from 0.2 to 0.7 mA, the duration of the procedures and their number are the same.

Method No. 19. Chamber baths.

a) Four-chamber bath. Earthenware baths for the lower and upper extremities are filled with water (temperature 36-38°) so that the water level in them reaches the middle of the shins (in foot baths) and above elbow joints(in hand baths). The carbon electrodes located in the vessels are connected to a special switch, which is located on the galvanization apparatus (it can also be independent). Thanks to this, the direction of the current in the patient’s body can be made either downward (if the electrodes of the hand baths are connected to the positive pole, and the electrodes of the foot baths to the negative pole), or upward (if the electrodes of the baths are connected in reverse).

b) Two-chamber bath. Hand or foot baths (depending on which limbs are being treated) are filled with water as described above. The electrodes of one bath are connected to one, the electrodes of the second - to the second clamp of the galvanizing apparatus. It is possible to connect the electrodes of both baths with one clamp of the device, but then they also use a common electrode for galvanization with an area of ​​200 cm2, which is placed either on the lower back (for galvanization of the lower extremities) or in the area of ​​the lower cervical and upper thoracic vertebrae (for galvanization of the upper extremities ), connecting it to the second clamp of the device.

c) Three-chamber bath. Any 3 limbs are exposed, connecting the electrodes of two baths to one, the electrodes of the third bath to another clamp of the device.

d) Single-chamber bath. One limb is exposed. In this case, they also use a conventional electrode for galvanization, which is applied as indicated for a two-chamber bath (for galvanization upper limb This electrode can also be placed in the area of ​​the shoulder girdle).

If chamber baths are used for electrophoresis, the electrodes of the corresponding baths are connected to the clamps of the galvanizing apparatus, taking into account the polarity of the administered drug substance.

Method No. 20. Electrophoresis of antibiotics. An electrode consisting of a lead plate, an ordinary hydrophilic pad moistened with warm tap water, 2-3 layers of filter paper moistened with a 5% glucose solution or 1% glycol solution (to absorb electrolysis products), and an ordinary hydrophilic pad is used as the so-called active electrode. , moistened with warm tap water, and, finally, a layer of filter paper moistened with a solution of the appropriate antibiotic. The so-called indifferent electrode is no different from that used in conventional galvanization. The amount of antibiotic (penicillin, streptomycin) required for one procedure depends on the area of ​​the so-called active electrode (on average 600-1000 units per 1 cm2 of electrode area).

When electrophoresing penicillin, the so-called active electrode is connected to the negative, streptomycin - to the positive clamp of the galvanization apparatus.

Indications for galvanization

Consequences of traumatic lesions of the brain and spinal cord and their membranes, consequences of diseases of the central and peripheral nervous system (neuralgia, neuritis, plexitis, radiculitis, neuromyositis); functional diseases of the central nervous system with autonomic disorders and sleep disorders, autonomic dystonia, migraine, neurasthenia and other neurotic conditions; diseases of the digestive system (chronic gastritis, colitis, cholecystitis, pancreatitis, biliary dyskinesia, peptic ulcer of the stomach and duodenum); hyper- and hypotensive diseases, coronary heart disease, atherosclerosis in the initial stages; chronic inflammatory processes in various organs and tissues (bronchial asthma, COPD); skin diseases (almost all, except those described in contraindications); some dental diseases(periodontal disease, glossalgia, etc.); eye diseases (keratitis, glaucoma, etc.); diseases of the musculoskeletal system (joint diseases of various etiologies - chronic arthritis and periarthritis of various origins, spinal osteochondrosis, ankylosing spondylitis), bone fractures, chronic osteomyelitis, scleroderma; diseases of the female genital organs (almost all, except those described in contraindications).

Contraindications

Acute inflammatory and purulent processes;

Circulatory insufficiency 2-6-3 degrees;

Hypertension stage 3;

Systemic blood diseases;

Severe atherosclerosis;

Tendency to bleed;

Feverish state;

Dermatitis;

Violation of the integrity of the skin at the sites where the electrodes are applied;

Individual intolerance to current;

Malignant neoplasms;

Skin sensitivity disorders;

Fever;

Pregnancy;

Cachexia.

Bibliography:
1. Lisetskaya S. Yu. BMP-107;
2. Handbook of physical therapy practitioners. Edited by prof. Obrosova A. N. Medicine Publishing House, Leningrad, 1963
3. Types of rehabilitation: physiotherapy, physical therapy, massage: textbook. allowance / T.Yu. Bykovskaya [and others]; under general ed. B.V. Kabarukhina. - Rostov n/d: Phoenix, 2010. - 557, p.: ill. - (Medicine). pp. 34-40.

List of some dissertations on the topic Galvanization:

1. Airy Aliya Malikovna. Differentiated use of galvanic and low-frequency pulse currents for the correction of age-related changes in facial skin: dissertation... Candidate of Medical Sciences: 14.00.51 / Airi Aliya Malikovna; [Place of defense: State Educational Institution "Institute for Advanced Studies of the Federal Medical and Biological Agency"]. - Moscow, 2009. - 72 p.: ill.

2. Maslov Andrey Gennadievich “The use of transcardial galvanization in the treatment acute heart attack myocardium".

3. Losinskaya Natalya Evgenievna. The use of galvanization, magnesium electrophoresis, lidase with low current in children with perinatal lesion brain of hypoxic-ischemic origin. : dissertation... candidate of medical sciences: 14.00.51 Losinskaya Natalya Evgenevna. - St. Petersburg, 2009.

4. Ibadova Guli Dzhuraevna. Optimization of the medical rehabilitation system for patients with osteoarthritis at a balneological resort. : dissertation... candidate of medical sciences: 14.00.51. Ibadova Guli Dzhuraevna - Moscow, 2006.

5. Tagirov Nair Sabirovich. Combined use of magnesium and direct current drugs in the treatment and prevention of relapses in patients urolithiasis: dissertation... candidate of medical sciences: 14.00.51. Tagirov Nair Sabirovich - St. Petersburg, 2007.

6. Dostovalova Olga Vladimirovna. The influence of physiobalneotherapy on the adaptive capabilities of the body of participants in armed conflicts by disease: dissertation... Candidate of Medical Sciences: 14.00.51. Dostovalova Olga Vladimirovna - Tomsk, 2004.

7. Gorbacheva Kira Valerievna. The use of physiotherapy methods in the complex treatment of intestinal dysbiosis with increased proliferation of fungi of the genus Candida: dissertation... Candidate of Medical Sciences: 14.00.51. Gorbacheva Kira Valerievna - St. Petersburg, 2003.

8. Mogileva Elena Vladimirovna. The effectiveness of physiotherapy and hydrotherapy in the complex treatment of pre-ulcerative conditions and mild arterial hypertension among liquidators of the consequences of the accident at the Chernobyl nuclear power plant, dissertation... Candidate of Medical Sciences: 14.00.51. Mogileva, Elena Vladimirovna - Moscow, 2004.

9. Airy Aliya Malikovna. Differentiated use of galvanic and low-frequency pulse currents for the correction of age-related changes in facial skin: dissertation... Candidate of Medical Sciences: 14.00.51. Airy, Aliya Malikovna - Moscow, 2009.

Physiotherapy is a branch of medicine that uses various natural phenomena to treat diseases: magnetic waves, heat, cold, ultrasound radiation, etc. For example, electricity has the ability to move fine particles dispersed phase in a liquid medium. Based on this feature, electrophoresis according to Shcherbak was developed.

Modern physiotherapy allows you to gently influence the body, improving the processes of nervous regulation, normalizing vascular tone and stimulating immune system. Metabolic-trophic reactions are activated in tissues; under the influence of an electromagnetic field, reparative processes are accelerated, which accelerates the healing and restoration of tissues. Therefore, physiotherapy is widely used to help patients with chronic inflammation, disorders of the nervous system and insomnia.

Main advantages of electrophoresis

The main idea of ​​this technique is that when exposed to current, the molecules of the drug substance are ionized, as a result of which it becomes more active. Also, thanks to the electric field, the ions move in a certain direction, entering deeper areas of the skin, which distinguishes this method from the usual use of medications in the form of ointments or pastes.

The administration of drugs by electrophoresis has a number of advantages:

• you can get by with relatively small doses, since almost the entire volume active substance penetrates the skin;
• ions trapped in the tissue quickly form unique depots, which prolongs the effect of medications;
• under the influence of an electric field, the drug acquires additional activity, as it passes into the form of ions;
• this method of exposure makes it possible to create high local concentrations of the active substance, which is important in the treatment of focal processes;
• drugs do not enter the blood and lymphatic system, thereby reducing the risk and severity of side effects, because medications have almost no effect on other organs;
• during inflammatory reactions, local blood flow may be impaired, which makes it difficult to use oral medications; electrophoresis allows you to avoid this;
• With this route of administration, the medicine is not destroyed, unlike oral administration.

The electric current itself also has a beneficial effect on the body, activating the immune response and helping to improve the body's reactivity. There is a variant of the procedure in the form of galvanophoresis, in which ions of a substance are introduced into an electrically conductive medium by using electromotive forces (EMF).

This technique differs from conventional electrophoresis in that small portable current sources are used to create an emf rather than stationary ones.

Thanks to this, the device can be used for a long time, since it does not require the patient to be constantly in the physiotherapy room. During galvanization according to Shcherbak, in addition to the direct administration of drugs, irritation of the nerve endings in the collar area occurs. Next, excitation follows the pathways into the central nervous system, causing activation of autonomic regulatory centers.

Shcherbak's technique involves galvanization of external areas of the skin that are not directly related to the pathological focus.

However, their stimulation activates the corresponding reflexes, thereby influencing the disease. To enhance the effect, electrophoresis according to Shcherbak with bromine is used. It allows you to enhance the electrical sensitivity of the tissue, thereby enhancing the positive effect of galvanophoresis. At the same time, blood circulation and lymphatic drainage are enhanced.

Indications for the appointment of electrophoresis are the following conditions:

• Suffered traumatic brain injuries.
• Neuroses.
• Hypertonic disease.
• Insomnia or other sleep disorders.
• In dentistry for disinfection of dental canals.
• For the auxiliary treatment of gastritis, gastric and duodenal ulcers.

This procedure can also be prescribed to children to treat muscle tone disorders, neurotic conditions, diseases of the musculoskeletal system. It should be taken into account that depending on the age of the child, the procedure may be different. Therefore, you need to calm him down and explain in as much detail as possible how he should behave and what awaits him, so that he is not afraid and behaves calmly.

The procedure for galvanophoresis

During the procedure on the collar area of ​​the neck and top part A special pad soaked in a warm medicinal substance is placed on the breasts. A layer of protective fabric (for example, flannel) is placed on top of it. At the junction of the lumbar and sacral vertebrae, a second electrode is placed, under which a similar two-layer pad is placed. The difference is that in this case the fabric is moistened with ordinary distilled water, and not with medicines.

When the current is turned on, the device allows two ions with different charges to be delivered to their destination at once. Bromine will flow from the cathode, and potassium from the anode. You can also use novocaine, iodine and other medications. The current should be 4 mA, then it is increased to 6 mA. The duration of the procedure usually varies from 5 to 15 minutes. In some cases it can be 20 minutes.

Such procedures are contraindicated for patients suffering from skin diseases, as well as those with active infections. Also, galvanophoresis should not be performed by people with bronchial asthma, severe hypertension or heart failure.

In addition, the procedure is not recommended for people with pathologies thyroid gland and renal failure. The presence of neoplasms is considered a contraindication to the use of physiotherapy. Intolerance to medications used during electrophoresis should also be taken into account. Electrophoresis should not be prescribed during pregnancy.

Conclusion

Thus, physiotherapy combines many different techniques that affect reactivity and immune status body. Electrical and galvanic currents improve the penetration of topical medications, thereby increasing their effectiveness and prolonging their effect.

These methods are used for many diseases, however, it must be remembered that physical therapy is only one of the treatment methods. Any procedure should be prescribed after consultation with the attending physician, and they should be performed by specially trained medical personnel within the walls of the hospital.

Due to the fact that relatively small doses of medicinal substances are used during the procedure, which also do not enter the general bloodstream, the risk of side effects is extremely low. Sometimes after the procedure, patients may only complain of redness and a slight burning sensation in the area where the electrodes are applied. In such cases, the doctor may prescribe small doses of antihistamines that will quickly relieve unpleasant symptoms.