New approaches in the treatment and rehabilitation of bronchial asthma patients

Professor Dr. med. Olga V. Balakireva , I. V. Netschay* , Moscow

INTRODUCTION

Chronic obstructive bronchitis (COB) and bronchial asthma (BA) today represent a considerable problem for modern medicine (1). Relevant publications reveal that, in the last 10 years, the incidence of chronic obstructive pulmonary disease (COPD) has grown steadily. Treatment with drugs is not always effective and is frequently accompanied by complications. Complications associated with COPD, such as obstructive emphysema and respiratory insufficiency, are caused, not least, by dysfunction of the inspiratory muscles and the vertebral column (2, 3, 4). Observations revealed that the vertebral column was deformed in 76 % of bronchial asthma patients (fig. 1). Inspiratory muscle fatigue develops as the muscle system responsible for breathing is overstrained through bronchial obstruction and emphysema (5, 6, 7). When treating bronchial asthma, therapy is gradually intensified. Patients, whose asthma cannot be controlled adequately with bronchodilators, are given corticosteroids to inhale as well as receiving basic therapy (8). Due to the likelihood that patients do not correctly master the technique of inhaling and do not adhere strictly to the instructions, the dose actually received by the patient does not always equate to the dose required to control the asthma symptoms (9). Complication such as candidosis of the oral cavity and dysphonia occur if excessive quantities of corticosteroids are inhaled in a single dose. If inhalational therapy with corticosteroids proves ineffective, peroral glucocorticoids, which have a systemic effect, are included in the treatment programme. There has long been a need in this connection to develop new methods of treatment aimed at restoring the functional performance of the body (10, 11, 12). Bioresonance therapy (BRT) combined with Detensor therapy – two new trends in healing and preventive medicine – currently represent just such an attractive and promising method for treating bronchial asthma and its accompanying complication of inspiratory muscle fatigue (13, 14, 15, 16). BRT devices work with the human body’s oscillations based on the principle of induction. As oscillations emitted by the patient take the form of electromagnetic oscillations, they can be transmitted by leads. Oscillations are picked up from the patient using applicators, from where they are fed into the device via a lead. They are converted into oscillations with reverse polarity in an electronic precision module and fed back to the patient as amplified information via a second lead. As a result, the pathological information is eliminated or partially suppressed (17, 18). In our investigations BRT was carried out using the BICOM device developed by the Regumed Institute in Germany. Treatment was based on an oscillation model of the patient in the BICOM device. The device inverts the pathological oscillation model and transmits it back to the patient in this inverted form. This process is repeated at fractions of a second with the pathological oscillations being suppressed and obliterated so that gradually physiological dynamic balance is restored. The BICOM device does not employ any artificially generated frequencies or currents. BRT is particularly effective in those cases where traditional methods are unable to achieve a therapeutic result. It brings together treatment methods such as acupuncture, Voll’s electro-acupuncture, homeopathy, nosode therapy, isotherapy without actually replacing any one of them (19). To correct inspiratory muscle fatigue we employed Prof K. L. Kienlein’s Detensor method (Germany, 1978), which is based on the physiological relief and sustained straightening of the spinal column. Tab. 1 shows the effectiveness of the Detensor system in restoring the functional capacity of the inspiratory muscles in patients with inspiratory muscle fatigue, determined using physical methods.

The dynamics of the functional capacity of the inspiratory muscles in patients with inspiratory muscle fatigue is shown in tab. 2.

OBJECTIVE AND APPROACH

The aim of our investigation was to prove the effectiveness of the complex method by which BRT and Detensor therapy are combined to treat patients with moderately severe bronchial asthma and inspiratory muscle fatigue.

The following tasks were formulated to achieve our desired goal:

1. investigation of the effectiveness of the treatment complex (BRT and Detensor therapy) on patients with moderately severe bronchial asthma and inspiratory muscle fatigue based on clinical symptoms.
2. research into the way the treatment complex works on the functional state of bronchial permeability.

To complete these tasks 296 outpatients with moderately severe bronchial asthma were investigated. They had previously received medium-sized doses of inhalant corticosteroids combined with various classes of broncholytics and short-acting powerful beta2 agonists. Tab. 3 indicates the clinical characteristics of the groups.

The patients were divided into 2 groups: 280 people formed the test group and 16 the control group, in which the BRT + Detensor therapy treatment complex was not used, but the customary course of drug treatment for bronchial asthma exacerbation was administered. When external respiratory function was examined, all patients displayed a high degree of obstruction and air overload. Further criteria for inclusion in the study were daily symptoms, night-time symptoms occurring more than once a week, values for forced expiratory volume in 1 second (FEV1) and peak expiratory flow between 60 % and 80 % of that required, with over 30 % variability and over 15 % reversibility. Documentary evidence of the diagnosis of bronchial asthma was provided and the severity of the disorder was assessed in line with the recommendations of the Global Strategy (19). The course of treatment consisted of a total of 10 twice weekly BRT sessions and 30 daily Detensor therapy sessions. At the same time, patients also received additional basic therapy. Patients in the control group were also in the exacerbation phase of their disorder and were therefore offered a short course of glucocorticoid therapy in view of the fact that high single doses of glucocorticoids could not bring the patients’ bronchial permeability under control.

The efficacy of the treatment complex (10 BRT sessions and 30 Detensor therapy sessions) was determined based on the results of a clinical functional examination of the patients before and after complex treatment (BRT and Detensor therapy), measuring peak flow, recording values of the flow volume curve with forced expiration and daily beta2 agonist requirement. Self-assessment forms were used to record patients’ symptoms, daily requirement of short-acting powerful beta2 agonists as well as the dynamics of the symptoms occurring during the day and of nightly waking due to an asthma attack. An improvement in the clinical values of all the parameters was observed in 89 % of bronchial asthma patients upon completion of the treatment complex. An analysis of peak flow measurements and patients’ diary entries, in which the number of urgent Ventolin inhalations during the day and night were recorded, revealed that the treatment complex was able to bring night-time symptoms under control and reduce the number of inhalations of short-acting powerful beta2 agonists. (In practice, towards the end of treatment, patients required, on average, no more than one or two inhalations of Berotek in a 24 hour period). By the second week, the Berotek requirement had already dropped by half (fig. 2).

From the third week the average number of inhalations for patients in the test group was 1–0.5 per day, which matched the results of the patients in the control group. Towards the end of the fourth week the number of inhalations in the test group fell virtually to zero while that of the control group remained unchanged. Moreover, a positive longterm effect was observed within the ten weeks following completion of the treatment (fig. 3).

Fig. 4 shows the variability of the parameters for bronchial permeability, measured by the average daily coefficient of variation of the peak expiratory rate.

The respiratory mechanism was monitored using a Flowscreen device (Erich Jäger, Germany). Peak values for inspiratory and expiratory flow were obtained by examining the flow volume curves for forced expiration and inhalation. The 12 second standard manoeuvre was used to determine the MVV value. The results obtained were expressed as a percentage of the normal value. The results were analysed statistically based on Wilcoxon’s non-parametric criteria and according to the variational statistical method using Student’s tcriteria. The dynamics of external respiratory function in bronchial asthma patients is displayed in table 4.

As can be seen from the table, the patients in the test group and the control group were initially in a functionally adverse condition which had developed as a result of severe obstruction combined with air overload, i. e. in an exacerbation phase of bronchial asthma. A significant increase in the parameters of the flow volume curve was observed after 10 treatment sessions with the complex.

External respiratory function values were compared with the data from the control group in which the patients had undergone a short 5-week course of glucocorticoids with the preparation gradually being eliminated. When lung vital capacity, peak inspiratory and expiratory flow, forced expiratory volume in 1 second and permeability of the large, intermediate and small bronchi were examined, a significant increase in values was observed in the patients in the control group [Translator’s note: sic], similar to those of the control group, but with the virtual suspension of drug treatment. Thus the value for forced expiratory volume in 1 second rose from 48 % at the start of treatment to 72 % within the first two weeks and to 92 % within the following two weeks. The increase amounted to 20 % for the large bronchi and 17 % for the small. The effect was significant, positive and sustained, i. e. it lasted 8 months.

The overall assessment of the effectiveness of combined treatment with BRT and the Detensor system was carried out both by the patients themselves and the attending doctor (fig. 5).

CONCLUSIONS

The results of the investigation enable the following conclusions to be drawn:

1. The treatment complex based on BRT and the Detensor system is an ideal treatment method for bronchial asthma patients from the point of view of efficacy and reliability.
2. BRT allows the body’s intoxication to be reduced. It increases the body’s reserves and immunity by acting on the inflammatory process.
3. Detensor therapy allows the mobile sections of the spinal column to be released easily and without complications, the shape of the spinal column to be restored, and the strength and reserves of the inspiratory muscles to be regenerated.
4. Use of the treatment complex ensures bronchial permeability and daily variability is controlled in a stable manner.
5. The healing process associated with the treatment complex has no side effects.

LITERATURE

1. Отчет о международном соглашении по ди- агностике и лечению бронхиальной астмы. Национальный институт кардиологии, пульмонологии и гематологии. Национальные институты здравоохранения – Бетеса, Мериленд, 1992.

2. Александрова Н. П., Голубева Е. В., Миняев В. П., «Взаимодействие наружных межреберных мышц и диафрагмы при развитии утомления дыхательной мускулатуры» – Актуальные вопросы медицины-М., 1993. – p. 114-122.

3. Туранова З. П., Утомление диафрагмальной мышцы-диагностика и лечение. – Tер. Aрхив – 1994. – № 8. – p. 77- 80.

4. Poussos C., Macklem P. T., Inspiratory muscle fatigue – Handbook of Physiology. The Respiratory System. – Washington, 1986. – Vol. 3, Pt. 2. – p. 511-527.

5. Айсанов З. Р., Утомление дыхательных мышц: Вопросы диагностики и лечения: Дис. … канд. мед. наук. – М., 1987.

6. Бичев А. А., Чучалин А. Г., Механизмы утомления дыхательной мускулатуры – Пульмонология – 1992ю – № 4 – p. 82-89.

7. Чучалин А. Г., Айсанов З. П., Нарушение функции дыхательных мышц при хрони- ческих обструктивных заболеваниях лег- ких – Тер. Aрх. – 1988 – № 8 – p. 126-132.

8. International consensus report on the diagnosis and treatment of asthma – Eur. Respir. J. – 1992 – Vol. 5 – p. 601-642.

9. Haahtela T. et al., Effects of reducing or discontinuing inhaled budisonide in patients with mild asthma – N. Engl. J. Med. – 1994 – Vol. 331, # 11 – p. 700-705.

10. Чучалин А. Г., Симпозиум «Новый подход к лечению бронхиальной астмы», Тезисы докладов – М., 1997 – p. 6

11. Овчаренко С. И., Шеянов М. В., Маколкин В. И., Факторы риска и пути предотвраще- ния ранних неблагоприятных исходов бронхиальной астмы – Тер. Арх. – 1998 – № 3 – p. 18-22.

12. Дуков Л. Г., Борохов А. И., Диагностика и лечение болезней органов дыхания – Смо- ленск, Русич, 1996.

13. Биорезонансная и мультирезонансная тера- пия, Сборник трудов «Имедис», М. 1996 С. 9-27. (8) И. Л. Блинков, Ю. В. Готовский Структурно-резонансная терапия, М. – 1998.

14. Лихарев В. А., Основы биорезонансной те- рапии (Методические рекомендации), М. – 1996.

15. Кинляйн К. Л., Штраус Й., Романов А. И., Балакирева О. В., Лечение заболеваний позвоночника с применением многоцелевой системы «ДЕТЕНЗОР» – Клин. Bести. – 1996. – № 1 – p. 64

16. Kienlein K. L., Die Detensor-Methode. [The Detensor method]. Published privately. – Roethenbach, 1990. – p. 3-20.

17. Франц Морелль, Mora-терапия, Германия – 1994.

18. BICOM Computer-Therapie-Handbuch [BICOM computer therapy manual] – Brügemann GmbH, 1994.

19. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, NHLB/WHO Workshop Report. 1993 – Bethesda, 1995 – p. 1-175.

20. Balakirewa Olga V., Aktiv und gesund: frei von Rückenschmerzen durch die DetensorMethode. [Active and healthy: free from back pain through the Detensor method] Olga V. Balakirewa, Alexej V. Kapustin. – 1 st Ed. – Baunach: Deutscher Spurbuchverlag, 1999, ISBN 3-88778-229-1

21. Kapustin, A. V., Balakirewa, O. V., Rückenschmerzen. Ein neues Verfahren zur Behandlung und Prophylaxe bei Erwachsenen und Kindern. [Back pain. A new method of treatment and prevention for adults and children]. To be published.

Physical methods of investigating inspiratory muscle fatigue

Dynamics of external respiratory function

Clinical description of patient groups

Dynamics of external respiratory function

Detensor therapy

Dynamics of inhalations

Adrenergic free days

Variability of peak expiratory rate

Assessment of the clinical effect of the treatment complex

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