EUROMEDICA  Hanover 29-30  Mai 2006	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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The usage of portative physiotherapy apparatus and methods in practice of GP-doctors was examined in 320 patients with cardiovascular pathology: ischaemic coronary disease (ICD), arterial hypertension (AH).

Simultaneously with the clinical findings the following factors were included into the examination: electrocardiography (ECG), echocardiography (EchoCG), veloergometry (VEM), Holter monitoring ECG and blood pressure (BP).

With the aim of determining the prevalent influence of one of the other physical treatment factors (PTF) on the function of cardiovascular sistem 168 ICD patients (with stable angina pectoris of the II-III-d functional class) and 152 men and women with AH have been examined within the 46-72 age group. The data of ECG, VEM, EchoCG, and Holter monitoring have been analized before and after the influence of several methods of magnitotherapy and electrotherapy.

It has been found antianginal effects of magnitotherapy (on precodial area and zones of pain irradiation, low dosage of magnite induction) combined with medicines in complex rehabilitation of ICD patiens. It has been noticed decreesing of episodes of stable angina (on 22%) and usage nitroglicerine (on 18%) per week in group used laserotherapy and atenolol compared with group of monotherapy of atenolol usage. It was found positive changes of repolarization by ECG, reducing S-T and T-vawe changes by VEM and Holter monitoring ECG in 122 (72,6%) ICD patients.

It was established more decreesing level of blood pressure (BP) in groop which combined atenolol with electrostimulation legs muscles (percutaneus sinusoidal modulated currents, portative apparatus) compared with atenolol monotherapy. Holter monitoring BP showed decreesing day and night levels of BP, persentage of non-dipper patients after rehabilitation course (53,5% before rehabilitation and 33,6% non-dipper patienrs after rehabilitation, P<0,05).

On the base of researches and literatures datas we discuss, that TPF are capable to change pharmacocinetics and pharmacodinamics of medicines; the electrotherapy promotes lengthening of the period of removing medicines from tissues and organs and prolongs action of medicines; many TPF can change the sensitivity of tissues and organs to medicines; TPF depending on a doze, time and the techniques of influence can strengthen or reduce therapeutic efficacy of medicines, reduce negative actions and toxical effects of medicines. On the other hand, some medicines can reduce of inadequate balneo- or physioreactions. And at last, the complex application of TPF and medicines promotes influence simultaneously on many pathogenetic parts of pathological process, that in a result is accompanied by lengthening of the period remission.

Despite of the positive clinical data on experiency of complex application of TPF and medicines, there are many important problems in conditions of general practice:

-The optimum combinations of various groups medicines and TPF at the patients with various cardiovascular pathology are not determined;

-With occurrence new physiotherapeutic equipment is not only careful experimental and clinical substantiation of the indications for its application at a various pathology, but also development of optimum techniques of complex application with medicines in general practice.

The development of research of optimum technologies of application TPF and medicines can essentially increase efficiency of treatment and rehabilitation of the patients with cardiovascular pathology in general practice.