Phototherapy

Light therapy ( or phototherapy) is one of the oldest and most natural methods of healing. It is known that sunlight was very often and widely used by physicians of Ancient Egypt and Ancient Greece for the treatment of various diseases. Even then, doctors noticed that sunlight is absolutely necessary to maintain human health at the proper level. With a lack of light, people not only violate natural physiological processes( for example, growth and development of the body), but also many serious diseases( rachitis, tuberculosis, various infectious diseases, skin lesions and even mental disorders).For hundreds of thousands of years of its evolution, man has always experienced the biological action of light, and his body has adapted to this effect and has learned to use it for his life. As shown by special scientific studies, sunlight can affect the functions of the cardiovascular, immune systems, the brain, and also stimulate in the human body the synthesis of vitamin D and the secretion of many important biologically active substances and hormones. In addition, it is the sunlight that determines the biological rhythms of the human body.

The development of light therapy, or phototherapy, began in the first half of the 20th century, when thanks to the success of physical science scientists were able to distinguish different types of light radiation, each of which had a special effect on the human body. The pioneer of phototherapy is the Danish scientist N. Finsen, who not only opened the very first institute of phototherapy, but also developed the first phototherapeutic devices and methods of treatment, for which he was awarded the Nobel Prize. Currently in phototherapy with a therapeutic purpose, a wide variety of devices are used that produce infrared, visible and ultraviolet radiation. Infrared radiation is characterized by a light wavelength of 400 microns( 1 micrometer = 1 millionth of a meter) to 760 nanometers( 1 nanometer = 1 billionth of a meter), visible radiation - from 760 to 400 nm, and ultraviolet from 400 to 2 nm. Together, these radiation are optical radiation. For therapeutic and prophylactic purposes, optical radiation is used in the range from 400 μm to 180 nm. Special studies have shown that 62% of the incident infrared and 13% of ultraviolet rays are reflected from the unpigmented human skin, while from the pigmented skin only 42% of infrared and only 8% of ultraviolet rays are reflected. This is due to the fact that a large amount of pigment appears in the skin - melanin, which has a good absorbing capacity and less reflects light rays. Ultraviolet radiation penetrates into the tissues of the human body to a small depth - up to 1 mm, and infrared and visible radiation penetrate into the tissues subcutaneously more deeply - up to 4-5 cm. Long-wave are absorbed well enough by the horny and malpighian layer of the skin, the short-wave part is most strongly absorbed by the stratum corneum. Absorption of infrared radiation by the tissues of any animal organism causes mainly rotational and vibrational motions of whole atoms and molecules, while the absorption of the ultraviolet part of the optical radiation is associated with the motion of electrons( the so-called photoelectric effect).In general, the absorbed energy of the light flux causes the appearance in the human body of complex biological reactions. The biological effect of light is extremely diverse and is closely related to the spectral composition of the light flux used to irradiate the pathological focus with the use of an instrument.

As a result of the absorption by the tissues of the human skin of infrared and visible energy radiation, molecular shifts occur such as an increase in the temperature of the irradiated part of the body, acceleration of physicochemical reactions in the body, stimulation of receptors and interoreceptors of vessels and tissues that perceive temperature fluctuations. The change in the functions of the corresponding nerve centers causes the appearance of physiological reactions in the human body, both local and general. Special studies have established that with light thermal irradiation of the skin in the lower thoracic and lumbar spine not only hyperemia( reddening of the skin), but also the expansion of the vessels of the kidneys, an increase in their urinary function is noted;and with the same irradiation of the stomach area, the motor and contractile functions of the stomach improve,

spastic phenomena decrease. Visible light radiation exerts on the human body not only thermal action, but also more complex under the influence of illumination on the eyes, in which nerve impulses enter the brain, reach the pituitary gland and other endocrine glands. The hormones of these glands ultimately influence the process, getting into the flow of blood, affect the vital activity of the whole organism. When carrying out special studies in the laboratory of an outstanding Russian psychiatrist and neuropathologist, V.M.Bechterew revealed the influence of different gradations of color illumination on the speed of the course of mental processes. At the same time, there was a soothing effect of blue in case of mental excitement, and with depression a positive effect on the mental state was rendered pink( red color excites the psyche to a large extent).

In light therapy, various installations and apparatus are used. To obtain infrared rays designed to affect heat on pathological foci, the simplest installations were previously used.

In phototherapy, three types of sollyx lamps were used:

• stationary on a tripod with a lamp of 500-1000 W;

• Portable with a lamp of 200-300 watts;

• desktop with a lamp of 200 watts. Infrared rays of such a lamp penetrate to a depth of 5 cm, while the warming of the lesion occurs.

1. "Lamp" infrared on a tripod, where the source of radiation was a nichrome thread wound on a ceramic base. The flow of infrared radiation in this lamp was directed to the area of ​​the pathological focus with the help of a reflector. The temperature of the hot filament in the "lamp" reached 500 ° C, so it was installed at a distance of 60-70 cm from the patient and adjusted by the degree of sensation of the patient's heat. The duration of irradiation was from 20 to 40 minutes, the procedures were performed daily or every other day, 15 to 20 procedures were prescribed for the entire course of treatment. This lamp was intended for surface heat exposure to the area of ​​the pathological focus.

2. Sollux lamp stationary on a tripod with an incandescent lamp with a power of 200 to 1000 W, in which the temperature reached 3600 ° C.The radiation from the Solux lamp contained 80 to 90% of the infrared rays and 12 to 10% of the visible radiation. Such a lamp had a parabolic reflector, mounted on a tripod. To the reflector, if necessary, attached removable tube-localizer, which limits the area of ​​irradiation in a small area of ​​the pathological focus. On it( the tube) the glass filters of red and blue glass were strengthened in a special cut, used for exposure to homogeneous light.

Depending on the power of the lamp, it was placed at a distance of 40-100 cm from the patient, the duration of the irradiation procedure was 15 to 30 minutes, daily or every other day. For the entire course of treatment, 20 to 25 procedures were prescribed.

At present, portable devices of the "Heska" series, which are a source of powerful monochromatic red and infrared radiation, which by their parameters are approaching the laser, began to be used for carrying out similar procedures of light therapy. The main active element in the apparatus of "Geska" are special LEDs of infrared radiation, which has the most pronounced biological effect on the human body, primarily on the pathological focus, while the effect extends to a depth of 5-7 cm, which means that it can actnot only directly on the skin, but also on deeper layers under the skin - muscle tissue, joints and nerve fibers. In addition, when exposed to infrared radiation apparatus "Geska" on the surface area of ​​large blood vessels, as well as subcutaneous lymph nodes( for example, in the armpit, ulnar and popliteal fossa);in the end, there is a general effect on the entire body through the activation of the universal functions of blood and lymph.

Special studies conducted in the 1990s showed that the energy of infrared radiation from the Heska device activates biologically active molecules and enzymes in different tissues of the body, resulting in the following reactions:

• general and local blood circulation of the

improvesthe activity of protein synthesis is increased, which means that processes and lymph circulation are accelerated;

regeneration and healing in a pathological focus;

• lowers blood pressure;

• reduces edema of tissues;

• increases the activity of the immune system;

• Muscle relaxation occurs;

• bactericidal action is provided.

• An analgesic effect is achieved;

The above-mentioned studies have scientifically proved the following indications for the use of phototherapy apparatuses of the "Heska" series:

• musculoskeletal disorders: arthrosis, arthritis, joint and bone injuries, spinal osteochondrosis, muscle trauma;

• Skin diseases: herpes, furunculosis, youthful acne, neurodermatitis, allergic dermatitis, eczema, lichen planus, shingles, psoriasis;

• surgical diseases: prevention of postoperative complications, treatment of wounds, burns, abrasions, bruises;

• cardiovascular diseases: coronary heart disease, hypertension, vegetovascular( neurocirculatory) dystonia, varicose veins, thrombophlebitis, obliterating atherosclerosis of the vessels of the extremities;

• Diseases of the bronchopulmonary system: acute respiratory infections, acute and chronic bronchitis, tracheitis, pneumonia, bronchial asthma;

• ENT diseases acute and chronic: sinusitis, rhinitis, otitis, tonsillitis;

• neurological diseases: neuritis and neuralgia, consequences of acute disorders of cerebral circulation, craniocerebral trauma and spinal cord injuries;

• urological diseases: chronic inflammatory diseases of the kidneys and urinary tract, chronic and acute prostatitis;

• gynecological diseases: inflammatory diseases of female genital organs, nipple cracks, mastitis;

• Dental diseases: treatment of complicated dental caries, stomatitis, gingivitis, periodontitis.

Simultaneously, during clinical trials, the following contraindications were identified:

• abdominal pain without a clearly established cause;

• pregnancy;

• Oncological diseases;

• acute thrombosis and thrombophlebitis;

• severe forms of cardiovascular diseases, diabetes, kidney and liver diseases, severe infectious diseases;

• purulent wounds, boils, abscesses prior to surgery.

A detailed description of the methods of using the Hesk Apparatus for specific diseases is contained in the insert attached to each device.

Since 2001, the Gesca-MAG devices have been used successfully in specialized clinics and sanatoriums for the treatment of various diseases using the combined phototherapy and magnetotherapy method. These advanced high-performance devices have a special magnetic attachment, which produces a slowly varying magnetic field. Such an original apparatus allows to further enhance the phototherapeutic effect during the procedures of phototherapeutic treatment. As a result of this combination treatment, the effectiveness of treatment procedures is increased, the terms of recovery are shortened.

Special investigations and clinical trials have established that the magnetic field significantly enhances the following effects of infrared radiation: analgesic and decongestant action, widening of blood vessels and stimulation of local blood circulation, acceleration of the healing and regeneration processes of the skin and muscle tissue. In addition, the magnetic field in combination with infrared radiation of the same apparatus has a number of additional effects, primarily a decrease in the viscosity of the blood( antithrombotic effect), and is also characterized by antiallergic action.

Indications and contraindications for the use of the apparatus "Gesca-MAG" in the procedures of phototherapy are the same as those of the "Geska" series. In any particular case, consultation of the attending physician is necessary.

For a long time, light therapy uses a Minin lamp, which has a 60 W incandescent bulb with a blue glass bulb. This lamp is portable, has a mirror reflector - a parabolic reflector and a wooden or plastic handle, the presence of which allows the patient himself to keep the lamp or hang it by the hook near the bed. If necessary, the blue light bulb is replaced with red light to produce infrared radiation. When irradiated with a Minin lamp, a distance of 15-20 cm from the bulb to the surface of the pathological focus is maintained, but usually the distance is set according to the patient's sensation. The duration of irradiation is from 15 to 20 minutes, while the procedures are performed daily 1-2 times a day. For the entire course of treatment, up to 15 irradiation procedures are prescribed.

The local light and heat bath is designed to irradiate the entire trunk or lower limbs. In the first case, 12 incandescent lamps with a power of 60-75 W are used, and in the second - 8 lamps of the same power. The construction of the light-thermal bath is a plastic or metal frame, on the inner surface of which there are incandescent lamps and mirror reflectors-plates, as a result of which the air is heated to 70 ° C.In such baths, the patient's body is exposed to infrared and visible radiation, as well as heated air. To ensure that the heated air does not leave the bath in the room, it is covered from above with a bikini blanket or sheet. There are two methods of phototherapy with the use of light-thermal procedures: local and general effects. In the method of local exposure, a small portion of the pathological focus is exposed to irradiation, and the clothes and objects that squeeze tissues and prevent the normalization of blood flow( for example, wristwatches or jewelry in the form of bracelets) are previously released from clothing. When performing phototherapy procedures, the patient must wear special sunglasses. The duration of exposure to light-thermal procedures is usually determined by the patient's sensation, but the existing norms range from 20 to 30 minutes when administered daily or every other day.

The scientifically substantiated indications for the application of light-thermal procedures are established:

• acute and chronic inflammatory processes( infiltrate);

• inflammatory pathological foci;

• painful sensations( myositis, myalgia, neuralgia);

• Sluggish wounds and ulcers;

• burns and frostbite;

• contractures;

• spikes;

• Splices of different origin.

There are some contraindications:

• neoplasms;

• circulatory failure of II-III degree;

• bleeding;

• acute inflammatory-purulent diseases.