Recommended application technology for "Rista-EPD" complex used for diagnostic of autonomic nervous system (ANS) state and localization of treatment zones on skin surface for neuroadaptive electrostimulation.
The hardware-software reflexodiagnostic complex “Rista-EPD” is intended for picking up and estimating of electro conductivity of the biologically active points (BAP) according to the Nakatani’s method, R. Voll’s method and auricular diagnostics.
A combination of these methods within one device gives wide opportunities not only for investigating of acupuncture point’s state and functional state of meridians, but it also gives an opportunity to realize new approaches in estimation of functional state of autonomic nervous system (ANS).
Besides the common functions specific for most types of electro-diagnostics devices, the complex carries out a specialized data processing, which allows:
- to detect any disordered organs and systems, which regulate the vital body functions from the side of ANS and also estimate a functional state of human body,
- to create the optimal treatment scheme of skin zones of patient by means of neuroadaptiv electrostimulation.
- to calculated the main parameters of the cardiovascular system by measuring pulse and pressure in order to assess its initial state and response to therapy (pulse and blood pressure are measured by conventional methods, and entered into the program manually).
The built-in expert system assesses of the ANS state and makes the scheme of treatment zones according to several techniques, chosen with the help of Level option in the Option menu. This option allows you to adjust the software to the user’s level of training. In total, there are 3 levels. The higher the level, the more knowledge and experience in acupuncture point’s examination must have a user.
In Section 2 of this appendix, there will be considered basic requirements for user training, specified the level selection criteria and recommended schemes of patient examination for each of the levels.
In Section 3 of this appendix there will be given a procedure of cardiovascular system functional state indices calculation
2.The recommended scheme of examination to assess the status and location of ANS reflex zones.
2.1 Selection criteria and choosing the Level of the expert system
The complex can be adapted to the user’s level of training and user can control it through the Option menu (configurations). User can set one of three performance levels of expert system
à b c
If you set up software, you automatically install the first level.
The first level considers minimum requirements to user’s training and it can be applied even in everyday life. For the first level the user must have practical skills in measuring of electro conductivity of the biologically active points (BAP) according to the Nakatani’s method, measuring of blood pressure and pulse rate. A set of functions for the first level is specified in the menu:
If you install the second level of the program, the user must have not only skills and knowledge required for the first level of the program, but he must be able to find out and estimate not less than 5 points on the ear auricle such as: ÀÒ-37 – Cervical vertebrae, ÀÒ-38 – Sacrum and a tailbone, ÀÒ-39 – Thoracic vertebrae and ÀÒ-40 – Lumbar vertebrae, and also ÀÒ-82 – diaphragm, so called the Zero point. The second level requires from the user an acquirement of auricular techniques.
If you set up the second level you must open the Option menu and click the Level 2. A set of functions for the second level is specified in the menu:
If you set up the first and second levels of the program, the option “Tonus VNS clinical” is disabled. If this option is disabled, the expert system estimates the level of ANS functional activity, based on the tonus estimation according to the measured blood pressure and pulse rate. To view the Medical Conclusion document, the user must click the mouse on the button shape:
If you set up the third level, it provides the user with the most accurate estimation of the ANS. To use the third level the user must have practical skills in application of three research methods of BAP diagnostic - the Nakatani’s method, R. Voll’s method and auricular diagnostics.
To setup the level you should click Level 3, in this case the option “Tonus VNS clinical” will be switched on automatically. A set of functions for the third level is specified in the menu:
If the option “Tonus VNS clinical” is switched on, in order to estimate functional activity of ANS user must explicitly specify the form of estimation of VNS tonus for the expert system by clicking on the one of the buttons :
The option “Tonus VNS clinical” can be used when you switch on the first or the second level. Then the assessment of functional activity of VNS will be formed independently of blood pressure and pulse rate.
In many cases, the assessment of the ANS and the schemes of treatment zones obtained with the help of 1st, 2nd and 3rd levels are the same. However if you examine people with cardiovascular diseases, children, elderly people and athletes the test results can be different.
It will be more reasonable to use the third level for examination for these categories of people, the third level of examination is intended to get an assessment of balanced tonus according to R. Voll method or clinically.
Below you can find the recommended procedures for applying this complex for each of three levels of users However, this does not exclude the possibility of creating by the user his original scheme of the examination using a methodological support of the complex, as well as making schemes of general treatment zones.
2.2 Technique of research at the first level.
The first level is installed automatically when you install the software. In the Settings menu you must choose the following settings: option “Tonus VNS clinical” - "off", Level 1 - "on".
A patient card must be created before the procedure.
To carry out the research it is necessary:
Place the patient on the couch and prepare him for examination according to Nakatani method (bare hands and feet).
You need to double click the surname in the list of patients, to choose the appropriate patient..
In the menu choose the item "Document/New" and select Nakatani, make the calibration and measure the electrical conductivity of 24 points representted on the hands and feet.
Measure blood pressure and heart rate of patient in prone position and type the data into appropriate fields and close the window. Document with the examination data according to the Nakatani method, dated by the time of the examination, will be added in the Documents list window, after closing the window.
You need to double click Nakatani
Documents to open them. On screen you can view a riodoraku map:
Take a look at its contents and click the button
. You will see the Conclusion
. Take a look at its contents and if it is necessary to print it, click the Print
After analyzing of conclusion click on the button Prescription
and close the Conclusion
. In this case, the Prescription document will be displayed on the screen
If necessary you can print Prescription and close the window.
After closing of a window Prescription, a new Prescription document , dated time of its creation will appear in the folder of documents.
It is the finishing of patient assessment for functional ANS state estimation and receptions of the optimum scheme of influence zones.
2.3 Technique of research at installation of the second level.
The user has to set up the second level of program before the beginning of research. In the menu option “Tonus VNS clinical” is switched off, Level 2 is included. This installation is set up unitary, is remembered and is saved at next program starts unless and until the user will change it.
You have to create the patient card before procedure.
- Then follow in items 1-5, the same as at installation of level 1.
- If you use the level 2 in cases when at installation of the first level the Prescription «6 face points and three pathways» was formed, by choosing Prescription there is formed the message on necessity of additional research of a condition of a backbone according to auricular technique.
- If you get the recommendation that it is necessary to make research on auricular technique (choose OK), and also close documents Conclusion and Nakatani
- Enter into the menu Document / New and choose Auricular diagnostic.
- If you choose Auricular diagnostic on the monitor screen Choice window for setting the list of investigated points is displayed. Choose for point research: ÀÒ-37 – cervical vertebra, ÀÒ-38 – the Sacrum and a tailbone, ÀÒ-39 – Thoracic vertebrae and ÀÒ-40 – Lumbar vertebra and then click OK.
- After OK the window Measurement will be displayed. In this window measure auricular points settled earlier. Measure it by dry auricular probes. If it is not specified, measure on a leading ear. After measurement of all points close a window Measurement. A new document will appear, dated time of research after closing of window Measurement in the folder Documents.
- Open the document.. Analyze it and select button Expert-Prescription, and the description of the necessary treatment scheme will be displayed.
- Take a look at description of the treatment scheme, if it is necessary print and close all documents opened earlier. After that in the folder Documents there will be a document Prescription,
dated time of its creation and containing the description of treatment scheme.
2.4 Technique of research at installation of the third level.
The user has to install the third level as well as the second by the beginning of research. In the menu option “Tonus VNS clinical” is switched on, Level 3 is switched on too. This installation is set one time, is kept and is stored at next program starts until it will be changed by the user.
For research it is necessary to do following:
- Clear items 1-4 as well as at installation of level 1.
- Make a research according to the Voll’s method in a horizontal position. For this purpose enter into the menu Document / New and choose Voll.
- At a choice of Voll on the monitor screen the window Choice f will be displayedor the task of the treatment points list. Click the mouse on By Meridians, click in the left window on Triple warmer meridians (endocrine system), in the right window choose a point 1 – cervical region of the sympathetic chain, in left view the list of meridians and click by Nervous degeneration meridian, in left window choose a point of the 3rd test point of head parasympathetic ganglion and then OK. After that the window Measurement will be displayed.
- Measure chosen points and close a window Measurement. After closing of Measurement in folder documents the new document "Voll" will appear, dated time of research.
- Open this document, have a look at document content, remember VNS tonus estimation and close the document:
- Open the document "Nakatani" and after the analysis of document content click by which name will correspond to the tonus estimation received at research according to the Voll’s method. Conclusion will be displayed. Analyze its content and if it is necessary print it.
- After Conclusion analysis click by Prescription and close the document. Thus document Prescription or the recommendation about necessity of additional researches will be displayed.
- If the prescription is received use it for treatment and finish research.
- If you get the recommendation about necessity of additional researches close the document Conclusion, the document Nakatani and leave in the primary window of the program.
- Conduct research according to auricular technique in horizontal position as it is described in section 2.5, items 4-8.
3. Calculation of cardiovascular system functional state indices
Characteristics of the complex let us to estimate the basic indices of cardiovascular system functional state using means of calculation.
A patient's card must be created preliminarily. All required fields of the card must be completed. Calculation techniques will give consistent index assessments for men from 21 years old and for women from 20 years old.
For carrying out investigation, it is necessary to:
- Measure arterial tension and pulse rate in horizontal position. All measurement must be made with the help of standard methods of diagnostic in 3-5 minutes after a patient takes a horizontal position.
- Enter the menu Document/New and selected item Hemodynamic
- You will see form:
- Put mouse cursor in the systolic blood pressure input field (1) and type the setting value, then put mouse cursor in the diastolic blood pressure input field (2) and type the setting value, put mouse cursor in the pulse rate input field (3) and type the setting value.
- Press the button Recalculate. All settings will be recalculated and introduced in the form after pressing the button.
- If it is necessary to view data in the form of diagram click the button Show scheme. After that you will see the diagram on the screen of monitor.
- After closing all windows, a new document with the name Hemodynamic, dated by the time of its creation, will appear in the document field.