Endarteritis (the most common synonym for “obliterating endarteritis”) is a serious, steadily progressing disease of the arteries, leading to complete closure of their lumen, impaired circulation in the affected organ and the development of gangrene. Most often, endarteritis affects the vessels of the legs. Symptoms of endarteritis most often appear in middle-aged and young men who abuse smoking. Treatment of endarteritis is quite effective only in the early stages of the disease; with deep tissue damage and the development of gangrene, amputation of the limbs is indicated.
The nature of obliterating endarteritis has not been fully established. Most doctors believe that autoimmune antibodies are to blame for the development of endarteritis of the lower extremities, causing inflammatory damage to the arterial wall, as a result of which connective tissue develops and the lumen of the vessel narrows. Inflammation and sclerosis affect the fatty tissue surrounding the vessels. The connective tissue compresses the arteries from the outside, which further aggravates the situation.
In addition, a connection has been established between the development of obliterating endarteritis and chronic poisoning of the body with nicotine and other poisons, neuropsychic stress and regular hypothermia of the legs.
Patients with endarteritis of the lower extremities pay attention to the following symptoms:
- periodic feeling of cold feet
- feeling of “crawling goosebumps”
- increased sweating of the lower extremities
- pale and dry skin of the legs
- brittleness and blueness of toenails
- fatigue when walking
- cramps and pain when walking, and later at rest
- reduction of pulsation in the artery of the dorsum of the foot
- the appearance of edema of the lower extremities
- formation of ulcers on the legs
A patient with obliterating endarteritis can be recognized on the street by his specific gait. These patients walk, stopping after a few steps. This is explained by the fact that due to a lack of oxygen supply to the tissues through the narrowed vessels, a spasm develops in the calf muscles and severe pain occurs.
After stopping, the muscles' need for oxygen decreases somewhat, blood supply improves, spasm disappears and pain goes away. But as soon as a person suffering from endarteritis begins to move, everything repeats itself all over again.
Obliterating endarteritis is characterized by a progressive cyclic course with alternating periods of exacerbation and remission. There are several phases in its development.
In the later stages of the disease, characteristic vascular changes can be found in all internal organs, including the heart and brain.
As soon as symptoms of endarteritis appear, you need to consult a surgeon. With the help of modern research methods, the doctor will be able to make the correct diagnosis and prescribe treatment. To establish the diagnosis of endarteritis, volumetric sphygmography (pulsation measurement), Doppler ultrasound, rheovasography and X-ray contrast examination of the vessels of the lower extremities are used.
Obliterating endarteritis is a disease for which modern medicine does not have enough means and methods. At the moment, it is impossible to reverse the development of connective tissue; you can only slow down the process of its formation and alleviate the patient’s condition.
A prerequisite for the treatment of endarteritis is the patient’s complete cessation of smoking and drinking alcohol, since these substances contribute to prolonged vasospasm and aggravate the condition.
A special diet is not indicated for a patient with endarteritis; however, one should not overeat, since excess body weight creates additional stress on the lower limbs. Overweight patients are advised to lose weight, and to do this, reduce the daily caloric content of food and eliminate flour, fatty and sweet foods.
With endarteritis of the lower extremities, it is useful to move a lot; you need to walk for at least an hour a day, despite attacks of intermittent claudication. If pain occurs, you need to stop and wait until it subsides completely. Cycling and swimming in water with a temperature of at least 22-24 degrees will be beneficial.
A patient with endarteritis needs to take care of the hygienic condition of his feet - before going to bed, wash them with warm water and soap, wipe them dry and lubricate them with a rich cream.
If these methods do not help, the symptoms of endarteritis increase, and the patient’s condition worsens, it is necessary to resort to surgical methods of treating endarteritis:
— Sympathectomy – removal of the second and third lumbar ganglia in the border sympathetic trunk, which leads to paretic expansion of collateral vessels and improved blood supply to the limb.
— Bypass surgery is the creation of a vascular anastomosis bypassing the affected area of the artery. This is one of the most effective methods of treating endarteritis.
— Thrombinthymectomy – removal of a blood clot blocking the lumen of a vessel affected by endarteritis, along with pathologically overgrown intima (inner lining of the artery).
- Amputation of a limb - this extreme measure is carried out in cases where necrosis of soft tissues and gangrene of the limb develop as a result of obliterating endarteritis, and the patient is constantly tormented by unbearable pain.
In order to prevent this sad outcome, it is necessary to consult a doctor in a timely manner, carefully follow all his recommendations and maintain a healthy lifestyle.
Among men, the problem of prostatitis is acute. Pharmacies offer a wide range of options to combat the disease. Therefore, you need to understand all the diversity.
The doctor will choose the most effective treatment for prostatitis
Types of medications for prostatitis:
Suppositories for prostatitis
Antibiotics are the first choice of any doctor when treating prostate inflammation. Divided into three groups:
Sulfa-P is of Israeli origin. Effective on all gram-positive and gram-negative bacteria. The effectiveness of the medicine is observed after a week of use. The dosage regimen depends on the severity of the disease (it is chosen by the doctor) and looks like this:
The course of therapy is three weeks. While taking the drug, it is necessary to have regular sex life.
Contraindications: renal and liver failure, blood diseases, thyroid pathology and individual intolerance to one of the components. Its disadvantages include its high cost - from $180 per package.
Afala in the treatment of prostatitis
Oxacillin. Included in the penicillin group. When taking it, the following contraindications should be taken into account:
Prostamol uno capsules
Prostamol uno. Take one capsule per day, after eating. Included in the list of medications for the prevention of prostatitis.
Adrenergic blockers for prostatitis
Adrenergic blockers. Their advantage is that they relax the smooth muscles of the gland tissue, thereby facilitating the outflow of urine.
Prazosin. The advantage is rapid absorption from the gastrointestinal tract. Excretion occurs along with bile. After taking it, the patient’s blood vessels dilate, thereby facilitating the outflow of urine. The downside is that sometimes when taking the first dose, the patient’s blood pressure drops sharply. Therefore, self-administration is not recommended.
Alfuzosin - relieves spasms and reduces pain during urination, thereby bringing this process to normal. Doctors recommend starting the course of treatment in the evening. Its duration, frequency of taking tablets and their dosage are determined by the doctor.
Doxazosin improves urination, the overall urodynamic indicator returns to normal. An additional advantage is that the patient's total cholesterol level increases.
Drugs in this group act specifically - they stop the action of the sympathetic nervous system only on the prostate gland.
The fastest-acting injections for prostatitis are injections.
Ceftriaxone - neutralizes pathological bacteria. It is administered intramuscularly twice a day for a week. The dosage is selected by the attending physician individually for each patient.
Prostatilen is made from the prostate tissue of cattle. Eliminates swelling of the male gland and prevents its occurrence as a prophylactic agent.
Prostacor - prescribed for the treatment of chronic prostatitis. It is based on natural gland tissue from cattle. It is prescribed for low bladder muscle tone and reduces the likelihood of thrombosis. The course of treatment is 5-10 days, one injection per day. Of the contraindications, only one is noted - hypersensitivity to one of the components. A side effect is the possibility of allergies.
Suppositories with propolis (Prostamin, Tambuil and Propolis DN) are the most effective. Thanks to propolis, which contains a set of amino acids, resins, microelements, these medicines for prostatitis have several effects on the affected organ - anti-inflammatory, antibacterial, regenerating and analgesic. Contraindications include individual intolerance and allergy to propolis.
Indomethacin is the best suppository for pain relief due to the content of promedol. And the ability to relieve inflammation speeds up treatment.
But suppositories with diclofenac as the main healing component are more effective against inflammation. These are suppositories such as “Diclofenac”, “Voltaren”. In addition to prostatitis, it will also help a man with hemorrhoids.
Ichthyol suppositories can be used as anesthetics, disinfectants and antiseptics. Improves blood circulation in the pelvic organs. Contraindications: individual intolerance to the components.
This country has the largest number of men. Therefore, the issue of combating the disease has always been relevant. The glory of Chinese medicine is so great that people from all over the world come here for treatment. And local medications for prostatitis in men have very good reviews.
Furongbao is a Chinese herbal pill that strengthens a man's potency and improves the secretory activity of the male gland. Ingredients: ginseng root, lingzhi mushroom, horny weed and medicinal alpania. Recommended as a restorative drug after a course of treatment. Do not take if you have high blood pressure, insomnia or nervous excitability.
What other medications should I take for prostatitis in men? Chinese medicine recommends a patch for prostatitis. The advantage is that it has no side effects and contains no chemicals. Non-toxic.
The list is extensive and the most popular ones are presented here. We hope men that now you know what medications to take for prostatitis.
consultative, outpatient, polyclinic.
mash for rubbing into the skin of the upper and lower extremities (chlorophyll, propolis tincture, herbal tincture, minerals, pharmaceutical derivatives); powders for internal use (microelements, herbal extracts, vitamins, pharmaceutical derivatives); drops for internal use (herbal extracts); herbal infusions for internal use (for outpatient treatment patients); vitamin therapy (factory forms of natural oral and parenteral medications); gel for rubbing into the skin of the upper and lower extremities (oil extracts from herbs, chlorophyll, natural essential oils, trace elements, microorganics, vitamins, propolis tincture, herbal tinctures, vegetable fats); angioprotectors (factory forms of natural parenteral medications); emulsion for rubbing into the skin of the upper and lower extremities (herbal pigments, vegetable aromatic oils, oily herbal extracts, herbal tinctures, vegetable fats, macroelements, vitamins, propolis tincture); cream for rubbing into the skin of the upper and lower extremities (natural aromatic oils, oily extracts from herbs, plant pigment, herbal tinctures, vegetable fats, vitamins, propolis tincture, macroorganics); liquid for rubbing into the skin of the upper and lower extremities (oil extracts from herbs, natural essential oils, chlorophyll, herbal tinctures, vitamins, propolis tincture, microelements); improved lactotherapy (extracts from whole cow's milk and stimulated aloe vera for intramuscular use); original apipuncture (for outpatient treatment patients); hardware physiotherapy (darsonvalization, ultrasound, electrophoresis, DDT, APT, magnetic laser therapy, laser therapy, magnetotherapy. For outpatient treatment patients).
hypocholesterolemic, utilizing triglycerides and lipids, vasodilating, anti-inflammatory, antibacterial, antifungal, antiviral, desensitizing, strengthening the walls of blood vessels, enhancing hemocirculation in the lower extremities, increasing redox processes, activating tissue respiration, regenerating, enhancing plastic and trophic functions, eliminating ischemic and hypotrophic changes in tissues, resolving, anti-adhesive, dehydrating, general and local immunocorrective, restorative, general healing.
5 times a day, 30-90 minutes before meals, the patient takes herbal infusions orally. The course of treatment is 1 month; 3 times a day, 15 minutes before meals, the patient takes 3 drops of herbal extracts in 1 tablespoon of corn oil orally. The course of treatment is 1-2 months; 2 times a day, after meals, 1.5 hours later, the patient takes 1 powder orally. The course of treatment is 1-2.5 months; 3 times a day, 30 minutes after meals, the patient takes 1 tablet of multivitamins orally. The course of treatment is 1-2 months; In the morning, at noon, after lunch, in the evening and at night, the patient alternately rubs liquid, gel, cream, mash and emulsion into the skin of the upper and lower extremities. The course of treatment is 1-2 months; The patient receives subcutaneous injections of monovitamins several times a day. The course of treatment is 10 injections of each; Once every 3 days, the patient receives intramuscular injections of improved lactotherapy. Course of treatment - 5 injections; The patient receives subcutaneous injections of angioprotectors several times a day. The course of treatment is 10 injections of each; Once every 1-2 days, the patient comes to the clinic to receive signature apipuncture. The duration of 1 session is 30 minutes. Number of procedures - 30; Every day the patient receives physiotherapy sessions using four standard methods of treatment for obliterating endarteritis from our full physiotherapy arsenal. The duration of a session with one device is 10-20 minutes. The course of treatment is 12 procedures.
prescriptions (for one or several items, or for small quantities of all drugs that make up the author’s treatment complex), or exclusively by existing standards of chemotherapy treatment, but with the risk of obtaining an incomplete and/or unstable effect.
endarteritis for up to 4 days with some medicinal prescriptions and/or original apipuncture, laser therapy and physiotherapy.
the primary subjective result is already available after 2-4 days of treatment, the final objective result is after 20-30 days, but will significantly depend on the initial characteristics (what form, stage and features of the course of endarteritis, what the nature of complications and concomitant pathology is, what age of the patient, dietary habits, the patient’s attitude towards the prescribed treatment, etc.).
The complexity of the causes and mechanisms of thromboangiitis obliterans makes effective treatment difficult, however, in recent years, information has appeared on the pathogenesis of vascular damage in endarteritis obliterans, and new methods of influencing Buerger's disease have appeared. Technological advances in endovascular and microsurgery have opened up new treatment prospects.
1. Relief of the inflammatory process. Achieved by pulse therapy with hormonal drugs. If a short course of methylprednisolone does not relieve pain and critical ischemia, exchange plasmapheresis is performed.
2. We are trying to achieve improved blood circulation in obliterating endarteritis using minimally invasive methods. Angioplasty uses a special drug-coated balloon. This medicine blocks the inflammatory and proliferative process in the vascular wall, and angioplasty provides blood access to the foot and toes.
3. If angioplasty is ineffective and critical ischemia persists, microsurgical operations on blood vessels are performed. The combination of reconstructive surgery with vascular therapy significantly improves treatment results. Among the indirect methods of improving blood flow, free transplantation of muscle or fasciocutaneous flaps on a vascular pedicle is used in the presence of significant tissue defects. It is designed to form a new vascular network in the muscles of the leg, growing from the graft.
Based on the autoimmune inflammatory theory of endarteritis, anti-inflammatory therapy is important, since during exacerbation of the disease there is a pronounced inflammatory autoimmune reaction. For these purposes, adrenal hormones are prescribed in large doses, due to which the inflammation is stopped.
An important direction of treatment should be the reduction of increased blood clotting (fraxiparine and similar drugs). To treat circulatory disorders, prostaglandin e preparations (alprostan or vazaprostan) and oxygen therapy (hyperbaric oxygenation) are used. It is necessary to exclude unfavorable factors, primarily smoking, hypothermia, vibrations, and psycho-emotional stimuli. The basis of treatment is anti-inflammatory therapy and suppression of increased immune reactions during exacerbation (adrenal hormones and immunosuppressants are used in large doses).
Hormonal pulse therapy with methylprednisolone is carried out for 3 days. After this, the cytostatic chemotherapy drug cyclophosphamide is administered. This therapy allows you to quickly relieve pain in patients with endarteritis and stop the active process of autoimmune inflammation. At the same time, pain relief is carried out using prolonged epidural anesthesia.
This is a new approach in the treatment of lower limb ischemia. The indication for its use is chronic ischemia of the lower extremities of atherosclerotic origin. Angiogenesis is the process of growth and development of new blood vessels. Therapeutic angiogenesis is a treatment strategy based on drug stimulation of the natural angiogenesis process. In other words, therapeutic angiogenesis is the application of the evolutionarily programmed process of formation and growth of blood vessels to treat chronic lower extremity ischemia. The appearance and growth of new vessels in patients with chronic ischemia of the lower extremities occurs in the area of greatest vascular occlusion. The functioning of new vessels occurs according to the principle of shunts. The process of angiogenesis lasts about three months, after which the structure of the new vessels stabilizes and the patient feels an improvement in his condition (for example, the distance walked without pain may increase, there is no chilliness in the legs, the condition of the skin is normalized), the process of blood supply and oxygen utilization in the tissues of the limb improves. Therapeutic angiogenesis improves the condition within two years.
High-volume plasmapheresis allows you to completely replace the patient’s plasma in 3-4 sessions. This removes active antibodies to one’s own blood vessels. Removing antibodies helps relieve inflammation and increases the chances of saving the leg in patients with severe Buerger's disease.
After these methods, it is possible to perform microsurgical operations on blood vessels and remove dead tissue.
In the early postoperative period, restorative treatment and the use of anabolic steroids are necessary for the healing of postoperative wounds, since hormonal pulse therapy reduces the possibilities of repair and scar formation after removal of necrosis on the foot.
Treatment of active thromboangiitis is carried out in an intensive care unit with the participation of a resuscitator.
Symptoms of thromboangiitis obliterans are associated with chronic arterial insufficiency of the lower extremities. Patients complain of increased sensitivity to low temperatures, fatigue in the legs, numbness, cramps, pain when walking or at rest, trophic disorders in the form of ulcers in the fingers and toes, necrosis or gangrene. Differential diagnosis should be carried out, first of all, with obliterating atherosclerosis and vascular damage in diabetes. Buerger's disease is indicated by the young age of the patients, the characteristic clinical picture and the results of additional studies.
The clinical course of the disease is characterized by waves, in which periods of exacerbation are replaced by more or less persistent improvement. Painful trophic ulcers and even gangrene often develop, requiring amputation.
The diagnosis of thromboangiitis obliterans (endarteritis) is made on the basis of the patient’s young age, the clinical picture (warm leg and severe pain at rest) and the characteristic picture on vascular ultrasound: mosaic staining of the blood flow around the arteries with a sharply thickened wall. The central blood flow in the arteries of the leg during the period of exacerbation is not determined. In soft tissues it is possible to identify a large number of small collaterals with high blood flow rates.
Angiography reveals occlusion of the arteries of the leg with the development of characteristic corkscrew-shaped collaterals. Despite the fact that the collaterals are very developed, the level of microcirculation in the tissues of the foot is low, which contributes to the development of trophic changes.
The exact cause of obliterating endarteritis has not been established to date. Currently, most researchers are inclined to favor the autoimmune nature of the disease. These patients often exhibit changes in the immune system, which are expressed in the appearance of antivascular antibodies, an increase in the concentration of circulating immunoglobulins, and a decrease in the level of lymphocytes.
The development of the disease can be represented as follows: under the influence of various factors (smoking, infection, nutrition, etc.), antibodies accumulate in the vascular wall and the formation of immune complexes occurs. As a result, inflammation of all layers of the artery develops, which subsequently leads to sclerosis of the wall and blockage (obliteration) of the lumen. This process ultimately leads to the development of circulatory failure in the fingers and feet.
Smoking significantly increases the risk of Buerger's disease. Heavy cigarette smokers (people who smoke one and a half packs a day or more) have a high risk of developing endarteritis obliterans, although it can also occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled tobacco products have the greatest risk of developing Buerger's disease and leg amputation. (Data from the Mayo Clinic)
Obliterating endarteritis is a slowly developing vascular disease with primary involvement of the arteries of the lower extremities in this pathological process. As the disease progresses, the lumen of the artery slowly decreases, leading over time to complete closure. In this case, the tissues of the organ involved in the process begin to suffer from a lack of blood supply, which leads to gangrene (spontaneous death).
Obliterating endarteritis is a disease of a systemic nature, with a predominant lesion of the legs. This disease in medical circles was called “smoker’s disease”, and for good reason - there really is a connection between the addiction and this pathological condition.
Obliterating endarteritis is characterized by a cyclic course, that is, phases of exacerbation and well-being alternate with each other. Most often, obliterating endarteritis occurs in a chronic form, but occasionally there are also variants of acute development. At the very beginning of the development of the disease, no organic changes are noted in the vascular wall; in this phase, only vasospasm can be observed.
As obliterating endarteritis progresses, the supply of biological tissues to the affected area rapidly deteriorates, which causes the formation of ulcers on the legs or gangrene (usually the fingers). The development of obliterating endarteritis of the legs occurs in five stages.
¦ Stage one – degeneration of nerve endings. At this stage, the vessel (usually an artery, but sometimes veins are also damaged) narrows slightly. Due to the formation of collaterals, the blood supply is practically not affected. This stage does not have any characteristic symptoms or pronounced clinical signs, however, obliterating endarteritis is already rapidly progressing.
¦ Stage two – spasm of large-caliber arteries. The collaterals formed at the first stage of obliterating endarteritis can no longer cope with the rapidly increasing load, so the first alarming symptoms appear: rapidly increasing fatigue, a feeling of coldness in the legs, and later lameness joins. Already at the second stage, treatment should be started immediately.
¦ Stage three – rapid growth of connective tissue. At this stage, connective tissue cells of absolutely all layers of the wall of blood vessels in the legs begin to actively grow. This process leads to the fact that painful sensations disturb a person with obliterating endarteritis not only when moving, but also at rest. The pulsation in the arteries of the legs is significantly reduced. This condition is already considered an advanced phase of disease of the arteries of the lower extremities.
¦ Stage four – total blockage or thrombosis of the vessels of the limb. In this phase, irreversible processes develop: necrosis and gangrene.
¦ Stage five - similar changes begin to occur not only in the vessels of the legs, but also in many organs. At this stage, the vessels of the brain and heart suffer.
Obliterating endarteritis of the upper extremities occurs in patients much less frequently than in the lower extremities. In most manifestations, its clinical picture is the same as that of obliterating endarteritis of the legs. The stages that the pathological process goes through are exactly the same. At first, the sick person does not notice any changes in his well-being, although the disease is already progressing at this time. Later, the first signs begin to appear, which should alert you and become a reason to go to the doctor. This is a feeling of coldness in the hands, an unpleasant tingling sensation, weakness, and rapid fatigue. After some time, pain of varying intensity and nature is added to the above manifestations.
Often, aching pain appears while performing any activity (housework, lifting heavy objects, etc.), and as obliterating endarteritis of the hands progresses, the pain becomes an almost constant symptom, bothering a person even at night. If the disease is not treated at these already quite advanced stages, ulcers and areas of tissue necrosis appear on the skin. Later, the disease becomes systemic.
Obliterating endarteritis has not yet been fully studied by specialists, so the nature of its occurrence has not yet been established. Most doctors believe that autoimmune antibodies stimulate the development of this disease. They cause damage to the walls of the arteries and trigger the process of proliferation of connective tissue, which causes the vessel to narrow. Many scientists are confident that obliterating endarteritis occurs due to regular self-poisoning with nicotine, frequent hypothermia or emotional shock.
Factors predisposing to the disease: smoking, regular hypothermia leading to prolonged vascular spasms, a history of frostbite of the extremities. In addition to the above factors that increase the risk of this disease, traumatic injury, chronic infectious processes, and various neuritis can provoke the development of pathology.
In the course of a large number of studies, doctors and scientists have concluded that there are four theories for the development of obliterating endarteritis. The first place is given to atherosclerotic effects (that is, the development of atherosclerosis at a young age). In second place are infectious and toxic agents (various infections, including mycoses). Third place was taken by pathological changes in the blood coagulation system. The last reason is tobacco allergy (increased sensitivity to components of tobacco smoke, which a person may not even be aware of).
The very first sign that should attract attention is weakness in the limbs and rapid fatigue. A patient with obliterating endarteritis begins to notice that he is increasingly tired after prolonged walking or standing, and it seems that his legs are “humming.” The skin on your feet becomes colder and drier over time. At first, cold snaps are episodic, but later this feeling does not go away even in warm socks or under a blanket.
A person develops increased chilliness in their feet, which forces them to wear warm shoes even in the warm season. From time to time, a person begins to be bothered by numbness of the injured limbs, a feeling of slight tingling or crawling.
Over time, when the process has already become protracted, and the vessels have undergone significant changes, and hemodynamics have suffered, the temperature of the legs begins to differ sharply from body temperature. Reduced blood flow causes the feet to become pale and cold, with the toes being a distinctly different color from the rest of the foot. They take on a bluish or even blue-red hue. Increased sweating on injured limbs should also alert the patient.
In the later stages of the disease, a person feels quite intense pain in the foot and leg. Unpleasant sensations force the patient to take a break while walking and wait until the pain subsides. This symptom is called intermittent claudication. The vessels of the calf muscles narrow greatly, which makes it difficult to supply the tissues with oxygen. The result of this is a spasm, which causes pain. During rest (when stopping), the leg muscles require less oxygen, blood supply increases, spasm disappears and pain disappears.
As obliterating endarteritis develops, walking distance and speed decrease. Nails also undergo changes - they become blue, brittle, and subject to deformation due to poor nutrition of the nail bed. If a person progresses obliterating endarteritis, the clinic is complemented by a strong decrease in the intensity of pulsation of the arteries of the dorsum of the foot. At this stage, cramps begin to appear when walking, and later they bother you even in a calm state. If obliterating endarteritis is not treated at this stage, swelling and then ulcers on the skin begin to form. The most severe and dangerous manifestation is tissue necrosis.
If, based on extensive manifestations, obliterating endarteritis is suspected in a person, diagnosis will not be difficult. Nowadays, doctors are helped to verify the disease by the latest instrumental diagnostic methods, which make it possible to determine the degree of damage to the vessel wall.
Dopplerography (a diagnostic method using ultrasound) has become quite popular in our time. In addition to this method, volumetric sphygmography, capillaroscopy, rheovasography, plethysmography, and duplex scanning of blood vessels are widely used. All these methods are quite informative, inexpensive and simple. Also a big plus is their non-traumatic nature and the ability to conduct research not only in a hospital, but also in an outpatient setting. X-ray contrast angiography is performed exclusively in hospital settings. If the doctor has any doubts, he prescribes additional tests. Among additional studies, such methods as Voll diagnosis and vegetative resonance diagnostic study are common.
A doctor may prescribe a series of tests to a person suspected of having obliterating endarteritis. If the main goal is to find out when the process began to develop and what changes the tissues have already undergone, ultrasound diagnostics are prescribed in combination with digital radiography. If you need to find out everything about the state of energy channels, pulse diagnostics will always come to the aid of a specialist. This method will help to correctly prescribe therapy for each patient individually and in accordance with the degree and severity of obliterating endarteritis that has developed.
If a person who is attentive to his health and changes in well-being turns to him at the very beginning of the development of this disease, a very sensitive and informative method - vegetative resonance diagnostics - will help to verify the diagnosis in the first stages. It will help detect insufficiency or, conversely, redundancy of the leading meridian. Thermography will help you find out in detail what processes are occurring in a certain area of the body.
Diagnostics using the Voll method helps to establish the cause and effect of the appearance of a pathological condition, to find the causative agents of the disease (determines the presence of viral, bacterial agents, as well as fungi). This method is electropuncture. If the doctor needs to find out what changes other organs have undergone during the illness, he will prescribe clinical and biochemical tests.
Treatment of obliterating endarteritis should begin at the first manifestations, since it is impossible to achieve recovery in the later stages. As soon as the first signs appear (coldness, tingling, fatigue of the limbs), measures must be taken.
The first step is to get rid of the factors that provoke the development of obliterating endarteritis: smoking, hypothermia, drinking alcohol, as all this causes vasospasm. It is necessary to take care of the affected limbs: avoid damage, injury, wear shoes a size larger than usual (they should not squeeze the foot and be dry). You should also start wearing socks even in the summer and carefully observe foot hygiene. Extremities with obliterating endarteritis should be washed twice a day in warm water and soap. If sweating of the feet begins to bother you, which quite often happens with this disease, after using the hygienic toilet you should wipe your feet with a cotton ball soaked in 70% alcohol.
After the adverse factors have stopped influencing, drugs that eliminate spasms begin to act: antispasmodics and ganglion blockers. Among the antispasmodics, Halidor, No-shpa, and Vazodilan are used, and among the ganglion blockers, Hexonium and Diprofen are used. Halidor is usually administered orally; in exceptionally severe cases, it is injected into a vein, artery, or muscle. The standard dosage is one hundred milligrams after meals every six to eight hours. It is prescribed in a course of 14-21 days. The course is repeated at the doctor's discretion. No-shpu for obliterating endarteritis is most often prescribed orally twice a day, 0.04-0.08 grams. In the later stages of the disease, the doctor may prescribe intra-arterial administration of this drug into the body. For injection, take a two percent solution of No-shpa in the amount of two to four milliliters per injection. It is important to know that No-shpa is strictly prohibited for use in patients with concomitant glaucoma and prostatic hypertrophy.
Hexonium is administered either orally or under the skin or into a muscle. It is prescribed orally in the form of a solution or powder (0.1-0.25 grams). Two percent Hexonium is administered parenterally at 0.01-0.03 grams. After introducing the drug into the body, a person should lie down for at least an hour. Usually the drug is prescribed in courses of 7-21 days, then they take a break for a month and repeat treatment with the drug again.
Diprofen is a remedy that can help reduce pain and stabilize blood circulation. Take it orally twice a day. The dosage is chosen taking into account the characteristics of the development of obliterating endarteritis; usually one to four tablets of the drug are needed per dose. Relief occurs already at the end of the first week of therapy with this drug. The duration of one course is no more than twenty days. The patient should be warned that when treated with Diprofen, some unpleasant symptoms may appear: numbness of the mouth, slight dizziness, nausea in the morning. These effects do not require additional treatment and go away on their own.
For intense pain accompanying obliterating endarteritis, the introduction of painkillers into the treatment regimen is indicated. If the pain is very severe, intra-arterial administration of one percent Novocaine and epidural blockade are performed.
Desensitizing drugs must be used in the treatment of obliterating endarteritis. The most commonly used are Tavegil, Pipolfen, and Suprastin. Usually the daily amount of Tavegil is two milligrams. The daily dose is divided into two times. If the need arises, the dosage can be increased to six milligrams. If the drug is administered by injection, two milligrams are prescribed twice a day. It is important to know: when treating with Tavegil, you should not drink alcohol or alcohol-based drugs (tinctures, syrups). Pipolfen should be prescribed in the minimum dosage that gives the desired effect. The drug is prescribed orally at a dose of twenty-five milligrams once a day. If there is no effect, you can take a double dose, divided into two doses with an interval of twelve hours. Pipolfen is administered into a vein in a dose of 12.5 milligrams to 25 milligrams. You should start with the smallest dose, administer once every six hours, and only if ineffective, increase the amount of the drug per injection and reduce the time between injections to four hours. The patient should be warned that during treatment of obliterating endarteritis with this medicine, drowsiness, blurred vision, and some psychomotor agitation may occur. If the side effects are too severe, treatment should be stopped and the drug replaced with another one. The daily dose of Suprastin can reach one hundred milligrams. Usually the drug is taken three to four times a day, one tablet. Suprastin is administered intravenously only in severe cases. One or two injections of one milliliter of the drug are given per day. This medicine is prescribed especially carefully to elderly people, people with a history of liver and kidney diseases.
In order to improve blood rheology, Polyglucin, Nicotinic or Acetylsalicylic acid, Reopoliglucin are introduced into treatment. Reopoliglyukin and Poliglyukin are used taking into account the individual characteristics of the course of obliterating endarteritis in a particular patient. Before placing an IV with these drugs, a person needs to do a skin test, as allergies may develop. The predominant route of administration of Nicotinic acid is intravenous, since injections into the muscle and under the skin are extremely painful. To treat this pathology, one percent acid is used, one milliliter is administered once a day. Before giving the first injection, the person should be warned that he may experience a feeling of heat. This reaction to the drug is completely normal and goes away over time without requiring any treatment. Instead of the above medications, due to budget limitations, Acetylsalicylic acid may be prescribed as a drug that improves blood rheology. It is not a drug of choice due to multiple side effects with long-term use. This drug can cause the development of epigastric pain, the formation of ulcers, stool disorders, anorexia, decreased platelet fraction, liver and kidney dysfunction. They take one tablet every day for a long period of time.
In addition to the above drugs, the patient must be given drugs that act on microcirculation: Angiotrophin, Depo-Padutin. Angiotrophin obliterating endarteritis is treated for no more than ten days, one or two milliliters of the drug are administered every day. Depo-Padutin acts in the same way as Angiotrophin, but longer. It is injected into the muscle every day or every other day. Forty units of drug action are required per injection. Patients with hypersensitivity are administered twenty units of action every other day. The duration of therapy with this drug is four to six weeks. If the disease began to be treated in an advanced form, the duration of the injections is several months (the regimen is every other day). Depo-Padutin cannot be stopped abruptly - the daily dose must be reduced slowly.
Anticoagulation treatment is also of great importance. Fibrinolysin, Heparin, Streptolyase are prescribed for obliterating endarteritis. Fibrinolysin and Heparin are injected into a vein together. Twenty to forty thousand action units of Fibrinolysin are added to a sodium chloride solution (isotonic!), then Heparin is introduced into the mixture in a dose half as much as Fibrinolysin. The dropper is adjusted to a speed of ten to twelve drops per sixty seconds, and with normal conductivity the infusion rate is increased to twenty drops. The duration of treatment is determined by the doctor. If during the infusion of the mixture a person experiences side effects (fever, abdominal pain, urticaria, pain in the affected veins), the rate of administration is reduced and antihistamines are given to drink. If the side effects are severe, the administration is stopped.
For obliterating endarteritis, taking vitamins (B, E, C) is mandatory. The doctor determines which vitamins are needed and in what doses. In addition to drug therapy, obliterating endarteritis is treated using quantum hemotherapy. Now a widely used procedure involves irradiating the blood with ultraviolet rays and intravascular irradiation using a laser. These methods reduce the ability of red blood cells to aggregate, reduce ESR, viscosity, increase oxygen supply to tissues and, as a result, eliminate hypoxia. A rather expensive but effective method of treating this pathology is plasma sorption with plasmapheresis. During the procedure, cholesterol and lipoproteins are removed from the blood, which leads to such positive effects as improved microcirculation and hemodynamics.
If all conservative methods have been tried, but the desired effect is not achieved, surgical intervention is resorted to. During the operation, surgeons act on the sympathetic ganglia, adrenal glands, or directly on the affected vessel.
The prognosis for life in everything depends on the diligence and responsibility of the sick person. If he follows all the recommendations and prescriptions of his doctor, regularly undergoes medical examination four times a year, takes anti-relapse therapy, this allows him to achieve a long period of remission and maintain satisfactory functioning of the limb affected by obliterating endarteritis.
Cardiology is a field of medicine that studies the vital system of the human body - the cardiovascular system: the structural features and functions of the heart and blood vessels, the causes and mechanisms of pathology; develops and improves methods for diagnosing, preventing and treating cardiovascular diseases. Considerable attention in cardiology is paid to the rehabilitation of patients with cardiovascular pathology. Unfortunately, heart and vascular diseases have an increasing tendency to affect young people and represent one of the most important problems of modern health care.
Surgical cardiology surgically eliminates congenital and acquired heart defects and other lesions of the heart and blood vessels, and performs prosthetics of heart valves and vessels.
Cardiovascular diseases are currently considered the most common cause of disability and early mortality in economically prosperous Western countries. According to statistics, the mortality rate due to cardiovascular diseases is 40-60% annually of the total number of deaths.
The main symptoms that allow one to suspect the development of cardiovascular diseases are pain arising behind the sternum and radiating to the left shoulder or scapula, shortness of breath, persistently elevated blood pressure (BP over 140/90 mm Hg), tachycardia (heart rate more than 100 beats per minute) or bradycardia (pulse less than 50 beats per minute), interruptions in heart rhythm, edema. When the first signs of heart and vascular diseases appear, in order to avoid the development of persistent disorders and complications, you must immediately contact a cardiologist. In the initial period of disease development, restoration of functions is achieved more easily and with smaller doses of drugs.
Currently, cardiology has reached a new level in terms of being equipped with the most modern equipment for quick and early diagnosis and timely treatment of cardiovascular pathology. The main diagnostic methods in cardiology are: phonocardiography, electrocardiography (ECG), echocardiography (ultrasound of the heart), daily ECG monitoring. They allow you to assess the contractile function and condition of the heart muscle, cavities, valves and blood vessels of the heart. Over the past few decades, new methods for examining patients with cardiac pathology have been actively developed: probing of the heart cavities and angiocardiography, which allow diagnosing and planning operations on the heart and coronary vessels.
Modern technologies and methods of treating cardiac pathology make it possible to cope with heart diseases that were considered incurable just yesterday. With the help of heart transplantation, cardiology today saves the lives of many desperate patients.
The main directions in the complex of preventive measures to prevent heart disease are optimal physical activity, giving up bad habits, eliminating nervous overload and stress, healthy eating and proper rest.