Since the beginning of this century, this therapy has gradually developed in China, but there has been a lack of Chinese instruction or professional knowledge to learn. Therefore, domestic experts in ozone medicine organized and wrote "Expert Knowledge of Ozone Autologous Blood Therapy". For your reference.
After several revisions, this knowledge has been published in the Journal of Translational Medicine, the sixth issue of China Core Journal in June 20 18.
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Absolute contraindication
1. Glucose -6- phosphate dehydrogenase deficiency (silkworm disease)
2. Toxic diffuse goiter (Graves' disease)
3. Thrombocytopenia is less than 50X 109/L, and there is serious coagulation disorder.
4. Severe unstable cardiovascular disease and acute myocardial infarction.
5. Acute alcoholism
6. Massive blood loss, acute bleeding, anemia (
7, water electrolyte disorder
8. confiscation
9. Patients with hemochromatosis treated with copper or iron.
10, allergic to anticoagulant (sodium citrate)
1 1, pregnant
12, severe liver failure
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Relative contraindication
1. Female menstrual period.
2. It is not recommended for minors to do O3-AHT, and it is recommended to use trioxane rectal perfusion instead.
3. There is no strict age limit, and the elderly over 80 years old can choose ozone rectal perfusion instead.
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Effects of related drugs in ozone -AHT process
1. Oral vitamins or antioxidants are not recommended during treatment, but can be taken before and after treatment.
2. Angiotensin inhibitors: This therapy may increase the antihypertensive effect of angiotensin inhibitors, leading to hypotension in patients.
3. Anticoagulant: O3-AHT is not recommended when using anticoagulant.
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Clinical application suggestion
According to the evidence of evidence-based medicine and the clinical experience of experts, the diseases treated by O3-AHT are classified according to indications, diseases with uncertain efficacy, diseases whose efficacy and safety are being studied, and diseases that are not recommended.
According to evidence-based medicine (EBM), referring to the method of establishing disease evidence grade by American Preventive Services Working Group and Oxford Evidence-based Medicine Center, the diseases treated by O3-AHT can be divided into four categories: 1, 2:
Grade A evidence: There is good scientific evidence that the clinical benefits of O3-AHT far outweigh the potential risks. Systematic review based on randomized controlled trials, homogeneous cohort studies or similar case-control studies.
Grade B evidence: At least fair scientific evidence shows that the clinical benefits of O3-AHT outweigh the potential risks. Small random confidence interval based on individual, cohort study or case-control study. Related literature can be found in PUBMED database.
Grade C evidence: At least fair scientific evidence shows that O3-AHT can provide clinical benefits, but the risk of benefits cannot be determined. Case reports based on expert opinions and no clear critical evaluation are based on physiology, laboratory research, or "basic principles" or descriptive epidemiology. Related literature can be found in PUBMED database.
D-level evidence: Mainly based on the clinical experience of experts in O3-AHT writing group, PUBMED database has no relevant literature support at present.
(1) indications
Class a evidence: none.
Class b evidence:
1. Chronic hepatitis 3-4
2. Lower extremity arterial ischemia 5-8
3. Sudden deafness 9- 10
4. Age-related macular degeneration (atrophy) 1 1
Class c evidence:
1. Asthma 12
2. Multiple sclerosis 13- 14
3. Headache 15
4. Gout 16- 17
5. Cerebral infarction 18- 19
6. Sacroiliitis 20
7. Postherpetic neuralgia 2 1
8. Adjuvant treatment of cancer [22-23]
D-level evidence:
1. Chronic ischemic heart disease
2. insomnia
3. rheumatism
(2) Diseases with uncertain effects
1. Respiratory failure: Case report O3-AHT can effectively improve the symptoms of respiratory failure, which needs more clinical research evidence to support.
2. Renal failure: It is reported that O3-AHT can increase glomerular filtration rate, which needs more clinical research evidence.
3. Psoriasis: In clinical practice, O3-AHT is effective for some psoriasis, but a few patients get worse.
4. Hyperlipidemia: O3-AHT is effective for some patients with hyperlipidemia.
(3) Diseases whose efficacy and safety are being studied.
1. Systemic lupus erythematosus, Sjogren's syndrome, dermatomyositis, scleroderma, ankylosing spondylitis and other immune diseases, it is inferred from the mechanism that O3-AHT is effective, and some patients are found to be effective clinically, but more clinical experience and evidence-based medical evidence are needed.
2. Neurodegenerative diseases, such as Parkinson's disease, Huntington's disease, Creutzfeldt-Jakob disease and cerebellar atrophy: O3-AHT has been proved to be effective for multiple sclerosis, but the efficacy for other neurodegenerative diseases is not clear.
3. Respiratory system (except for respiratory tumors): At present, there is only evidence that O3-AHT is effective for asthma, and the efficacy of other respiratory diseases needs to be studied.
4. Diseases of urinary system, digestive system and reproductive system: There is no evidence that O3-AHT is effective for these three common diseases.
(4) Disease is not recommended.
1. Blood system diseases.
2. Hypothyroidism.
3. Pulmonary embolism.
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Main risks
1. Anticoagulant: Too little anticoagulant will cause thrombosis, and too much will lead to coagulation dysfunction.
2. Gas embolism: Improper operation may cause gas to enter blood vessels and form gas embolism.
3. For the elderly and patients with cardiac insufficiency, too fast blood transfusion or transfusion may induce heart failure.
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Side effects and complications
1 and O3-AHT may aggravate the symptoms of psoriasis and cause skin edema. It has even been reported that O3-AHT led to 1 death of psoriasis patients. 24
2. Hypotension will occur during sulfur trioxide autotransfusion, especially in patients who take ACEI orally, and the incidence of hypotension will increase. The blood pressure of such patients should be monitored during ozone AHT.
3. May induce acute coronary syndrome and acute myocardial infarction. 25
4. In patients with chronic renal failure and diabetes, O3-AHT may lead to hyperkalemia. 26
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operating procedure
1. Before each course of treatment, we should check blood routine, coagulation, biochemistry, thyroid function, infectious diseases, etc.
2. It is suggested to drink _300ml water 1 hour before treatment, which is beneficial to blood dilution and blood drawing.
3. Check patient information, regularly monitor pulse oxygen saturation, and emergency facilities and medicines are on standby.
4. When the patient is sitting or supine, elbow vein, median vein and basilic vein are preferred.
5. It is suggested that the blood volume should be calculated from 1.2mL/kg to 1.3mL/kg. For the convenience of clinical application, 100ml blood is usually mixed with 25 ml anticoagulant, that is, anticoagulant and blood volume are mixed in the ratio of 1:4.
6. The recommended ozone concentration is 10-40ug/ml, which can start from low concentration and gradually increase with the increase of treatment times; Ozone is mixed with the mixed gas of blood volume in the ratio of 1: 1. After the gas is mixed with blood, shake it slowly for 3-5 minutes to avoid violent oscillation.
7. The blood transfusion speed of blood trioxide is 75- 150 drops/minute (5- 10 ml/minute). It is suggested that 100ml of blood trioxide be infused into the body within 20 minutes. The return speed is adjusted according to the principle of slow first and then fast.
8. It is recommended to press for more than 5 minutes after pulling out the trocar, and observe for about 15 minutes.
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Processing parameters and precautions
1. Treatment frequency: once a day, or 1-3 times a week.
2. Course of treatment: 10 times/course of treatment, more than two courses of treatment per year.
3. During the ozone -AHT period, all containers and pipelines in contact with ozone should be made of antioxidant materials or glassware.
4. It is forbidden to inject any gas directly into blood vessels.