Saturday, 31 March 2012


Chronic Forms of Cerebrovascular Insufficiency
(Discirculatory Encephalopathy)
According to the up-to-date classification of cerebrospinal vascular diseases (E.V.Schmidt, 1985), discirculatory encephalopathy means slowly progressing cerebral circulatory disorders, which lead to gradually increasing diffuse structural changes associated with cerebral dysfunctions.
The main role in the etiology is assigned to atherosclerosis, arterial hypertension or their combination (G.A.Akimov, 1983; A.N.Baranenko, 1988; N.A.Borisova, 1995), angiocoagulopathies (E.M.Burtsev, 1978; O.N.Voskresenskaya et al, 1995), heart diseases (I.P.Gonzova, 1995; I.V.Damulin, 1995).
The insufficient oxygen brain supply and insufficient oxygen utilization characteristic of discirculatory encephalopathy are considered the main indications for including ozone therapy into the complex of therapeutic methods.
Recommended methods of ozone therapy:
·   Intravenous drop-by-drop infusions of ozonated saline solution or
·   Rectal ozone insufflations.
In order to select the patients for ozone therapy, along with disease duration it is necessary to evaluate the initial level of lipid peroxidation products and antioxidant system, their balance level as well as to control the patient's tolerance to trial single infusion of ozonated saline solution. The known contraindications should be also taken into consideration: hemorrhagic syndrome, hyperthyroidism, epilepsy, acute myocardial infarction. It is not recommended to use ozone therapy in combination with hyperbaric oxygenation to ensure neither hyperoxia nor intensified lipid peroxidation as well as with hypocoagulation preparations.
The feeling of well-being was observed practically in all patients after the first ozone treatments. This manifested in the feeling of "energy increase", "activity increase", "brain lucidity", a considerable decrease in the intensity and duration of headache, giddiness, sonitus and tiredness. After all, there were observed decreased emotional and dissomnic disturbances, absent-mindedness, increased interest in the environment (communication, books, TV programs), improved memory (A.A.Smirnov, 1996).
So, the use of ozonated saline drips as a component of multimodality therapy of patients with discirculatory encephalopathy associated with atherosclerosis of cerebral blood vessels or in combination with arterial hypertension has shown that along with clinical improvement it comes to positive shifts in the structure of lipid metabolism parameters. The investigation into the lipid peroxidation products and antioxidant system in dynamics before and after the treatment has shown a reliable decrease in diene and triene conjugates in patients at I and II stages, and in Schiff's bases - in patients at all stages of discirculatory encephalopathy. At the same time, it comes to a significant activation of the antioxidant system as an increase in blood enzymes: superoxidedismutase at all stages and catalase at I stage that points out a stimulation of the organism's defense potential in the conditions of chronic hypoxia associated with discirculatory disorders.
The analysis of immediate results of treatment including ozone therapy has established that the efficiency of treatment is higher in patients with discirculatory encephalopathy of I and II stages associated with atherosclerosis of cerebral blood vessels with disease duration less than 10 years. A good effect owing to the use of ozonated saline solution is received in patients at I stage associated with hypertensive disease. There is no direct relationship of the results of treatment with the course of discirculatory encephalopathy, age and associated diseases. Only insignificant improvement after the course of treatment including ozone therapy is found out in patients with discirculatory encephalopathy of II and III stages associated with atherosclerosis in combination with hypertensive disease of II-III degree. There are no deteriorations of the patient's state and side effects due to intravenous ozone therapy. The received results allow making a conclusion that the more expressed and stable clinical improvement in patients with discirculatory encephalopathy is connected with the use of ozonated saline drips which can be explained by its action on the main pathogenetic mechanisms of discirculatory encephalopathy.
So, the use of ozone facilitates to level the changed values of lipid metabolism, to activate the enzymatic link of antioxidant defense system by inducing a decrease in the level of initially increased lipid peroxidation products. After all, a decrease in the blood viscosity allows improving the rheological properties of blood and therefore decreasing hypoxia appearances in central nervous system that along with a decrease in angiospasm symptoms contributes to the improvement of cerebral haemodynamics parameters, according to REG.
Basing on the above-mentioned, the general mechanisms of action of ozone therapy in chronic ischemic disturbances of cerebral circulation can be demonstrated as follows:
The use of ozonated saline drips results in the production of the so-called ozonides in the patient's blood. These secondary compounds of ozone are transported through the whole body. In consideration of the intensity of cerebral blood flow, most of the ozonides penetrate through the   haematoencephalic barrier into the brain where producing a membrane-stabilizing effect through the improvement of structural-functional properties of neuronal membrane lipid biolayer. Cell membranes are the main targets of action of ozone on the body systems. This results in the improvement in the processes of transmission, processing and keeping of information in CNS (A.N.Erin, N.V.Gulyaeva, E.V.Nikushin, 1994).
On this basis the optimization of integrative activity of brain takes place that results in the more fast   development of compensative processes with improvement or restoration of sensorimotor, limbic-reticular functions and others.
So, the results of the conducted investigation allow recommending the given method of complex treatment with ozonated saline drips as a pathogenetically adequate method of treatment for patients with discirculatory encephalopathy associated with atherosclerosis and arterial hypertension.

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