RU2111737C1 - Method to treat children suffered with secondary pancreatitis - Google Patents

Abstract

FIELD: medicine, health resort treatment. SUBSTANCE: patients are prescribed to take radon baths at radon concentration of 40 for 10-15 minutes of impact duration in a day. Treatment course is 8-10 radon baths. EFFECT: higher efficiency to eliminate main manifestations of a disease due to an impact upon pathogenic links of a disease by normalizing functions of regulatory systems (autonomous nervous system, endocrine system) due to antiflogistic action. 3 tbl

Description

 The invention relates to medicine and relates to the treatment of children by physical methods.

Closest to the invention is a method for the complex treatment of secondary pancreatitis with mineral water, including drinking Slavyanovskaya water, diet, gentle treatment, exercise therapy, massage and mineral baths (Novozhilova L.I. Dis. Dr. med. Sciences, 1980, p. 48 ) According to the known method appoint mineral baths with a temperature of 37 ^o C for a duration of 15-20 minutes, every other day, only 8 - 10 baths per course.

 However, the known method does not ensure the achievement of stable remission.

 The essence of the invention is that they have an effect of radon baths with a concentration of radon of 40 nCi / l lasting 10 to 15 minutes, every other day, on a course of 8 to 10 baths.

 The method is as follows.

 The course of treatment is 30 days. Patients are prescribed drinking (low-carbonate chloride-bicarbonate-sulphate calcium-sodium water of average mineralization at an age dose), exercise therapy, abdominal massage during diet therapy and radon baths according to the method described above.

 The treatment method is illustrated by the following examples.

 I observation. Patient H., 9 years old, medical history N 309. She was admitted to the hospital on February 3, 94 with complaints of frequent abdominal pain, nausea, heartburn, belching, poor appetite, weakness, and fatigue. Sick for 2 years, 3 times examined in the RCCH.

 From the anamnesis: born from the 3rd pregnancy, 1 birth. Pregnancy proceeded with a threat in the I and II half. On breastfeeding was up to 4 months. Up to a year - diathesis. In the psychophysical development, she did not lag behind her peers. Past diseases: measles, chickenpox.

 At admission: satisfactory condition, increased nutrition. In the lungs and heart without features. The tongue is moderately coated with a white coating. The abdomen is soft, painful on palpation in the pyloroduodenal zone and in the area of the projection of the gallbladder.

 Functional research: EGDFs from 08/08/94 - antral gastritis, bulbitis, duodenitis. Ultrasound from 01.94, the liver is not enlarged, the walls of the vessels are sealed. The contours are even. Pancreas - 10 • 10 • 16 cm, parenchyma with small linear sections. The condensed gallbladder is of normal size, the walls are denser, in the gaps of the sediment.

 Paraclinical data: PAT in feces 1:40, 0; in the coprogram steatorrhea. Urine diastasis from 07.02 - 11.7 g / h; blood diastasis - 17.02 g / h • l.

 Exercise tests with sugars: with glucose - 5.5; 6.8; 5.1 mmol / l; with lactose - 5.1; 6.2; 5.5 mmol / l; with sucrose - 4.9; 5.85; 5.5 mmol / L.

 According to EGDFs, the child has gastroduodenitis, ultrasound - signs of chronic pancreatitis. The proteolytic activity of trypsin in feces is reduced. Flat curves loaded with sucrose and lactose.

 Clinical and paraclinical data gave reason to make a diagnosis: biliary dyskinesia, secondary malabsorption syndrome, disaccharidase deficiency; secondary chronic pancreatitis, chronic gastroduodenitis.

In the clinic, the child received: diet therapy (table 5) with the exception of milk, sweets; Exercise therapy, massage of the abdomen, mineral water chloride-bicarbonate-sulphate-sodium-calcium with a temperature of 40 ^o C before meals, for a month; radon baths with a radon concentration of 40 nCi / l with a temperature of 37 ^o C for 10 minutes, 8 baths per course.

 After the treatment, a positive dynamics of the clinical symptoms of the disease was noted: appetite improved, abdominal pain, dyspeptic symptoms, symptoms of chronic intoxication disappeared. The child gained 2 kg in weight in 1.5 months. The coprogram normalized, the proteolytic activity of trypsin in feces increased from 1:40 to 1: 160, and steatorrhea disappeared. In the blood, eosinophilia decreased, HB increased from 130 to 140 g / l. On ultrasound, the precipitate in the gall bladder disappeared, signs of inflammation decreased.

 Thus, a single treatment of the patient in the clinic with the use of diet therapy, internal intake of mineral water, radon baths contributed to the onset of complete remission. A year later, long-term results were studied (the child was called to the clinic again). During the year, the child was not sick, there was no exacerbation of the disease.

 II observation. Patient D., 10 years old, medical history N 173. Was admitted to the clinic 07/23/93, with complaints of unstable stool, delayed physical development.

 From the anamnesis: the girl from birth has plentiful loose stools up to 10 - 15 times a day, frothy, fetid, with mucus, flatulence. From 4 months milk is completely excluded from the diet, after which the condition of the child returned to normal. In 1 g, 7 months, she began to lose weight, and stool disorder appeared again. At the age of 2, she was treated at the RCCH, where she was diagnosed with celiac disease. I followed a diet up to 5 years (my condition improved), then I began to break the diet, poorly in weight, and stools - 1-3 times a day, voluminous.

 At admission: low nutrition, stunted, pale, polyadenitis is pronounced. In the heart, systolic murmur of a functional nature, the abdomen is enlarged, soft, painless. The liver protrudes 2 cm from the edge of the costal arch. The stool is voluminous with undigested food elements.

Paraclinical data: trypsin - 3.26 units; trypsin inhibitor 74.66. The absorption of the sample with D-xylose is impaired. Load tests: with lactose - 4.1; 3.6; 3.7; 4.0; 3.6; with sucrose - 4.15; 5.5; 4.35; with glucose - 5.5; 4.6; 4.15 mmol / L. Ultrasound - the liver is enlarged, the parenchyma is granular, the walls of blood vessels and bile ducts are compacted, slightly enlarged, of a normal structure, the gall bladder is of a normal shape, the wall is sealed. Lipase - 0.5 ml; general blood test: er. 4.7 • 10 ¹² / l, L - 4.7 • 10 ⁹ / l, HB - 122 g / l, e - 3, n - 2, s - 65, l - 26, m - 4. In urine analysis there is no pathology. PAK - 1:80.

 Based on clinical and paraclinical data, the diagnosis was made: celiac disease, incomplete remission, primary lactase deficiency, hypomotor biliary tract dyskinesia, secondary pancreatitis, incomplete remission.

The child received the following treatment in the clinic: mineral water for 30 days, diet therapy (table 4a, without cereal and fresh milk), mineral baths N 8 with a temperature of 37 ^o C for 10 minutes, every other day, 8 baths per treatment course.

 After the treatment, the girl's condition improved: her general condition improved; stool normalized; the liver was reduced to normal. Paraclinic data did not tend to normalize: the absorption in the small intestine remained impaired, the proteolytic activity of trypsin in the feces did not change, the ultrasound of the pancreas remained the same as at admission.

 In this case, the dynamics of the disease after treatment was less positive, and the paraclinical data remained practically unchanged.

 After a year, the girl felt fine, but she was stunted, she periodically has abdominal pain, and she continues to have periodic stool disorders, i.e. persistent remission is not received.

 Testing of the proposed method was carried out in the conditions of the Pyatigorsk clinic GNIIK. The tests were carried out on two groups of patients - the main (proposed method) and control (prototype method). In the main group there were 16, in the control - 31 people. The clinical characteristics of patients are presented in table. one.

 Patients of the main group were prescribed radon baths, the control - carbon dioxide-hydrogen sulfide. Patients of both groups received low-carbonic chloride-hydrogen carbonate-sulfate calcium-sodium water for 4 weeks, at an age-specific dosage.

 A statistical evaluation of two groups of patients was carried out, while it was found that according to all criteria of the initial clinical data, no significant differences between the groups were revealed. This allows us to justify the full clinical adequacy of these groups.

 In the table. 2 and 3 show the dynamics of clinical and paraclinical data. The data table. 2 show that the proposed method using radon baths is clearly more effective: in 90% of patients treated with the proposed method, abdominal pains have disappeared; 94% had symptoms of chronic intoxication, 76% of children had normal stools.

 Paraclinic data confirm the pronounced effectiveness of our chosen method. All patients under the influence of radon baths significantly improved not only clinical data, but also improved pancreatic function. This is confirmed by an increase in the activity of trypsin in feces, blood, and positive dynamics of ultrasound studies.

 In the group of patients who underwent treatment with carbon dioxide-hydrogen baths, the dynamics of paraclinical parameters was mostly unreliable.

Claims (1)

 A method of treating children with secondary pancreatitis, including drinking mineral water, physical therapy, diet therapy, massage and mineral baths, characterized in that radon baths with a concentration of radon of 40 nCi / l are carried out as a mineral bath for 10-15 minutes, course 8 - 10 baths.

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