RU2177775C2 - Method for treating children suffering from functional cardiopathy - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves administering general purpose baths every second day. Hydrogen sulfide concentration is equal to 25-100 mg/l. Magnetophoresis is carried out with 2% Dibasol solution. Inductor is set on segmental interscapular space in the C6-Th4 zone on the left side in continuous mode. The treatment is carried out at 12.5-17 Hz frequency, magnetic intensity is equal to 10,20 mTesla units. Hydrogen sulfide balneologic therapy is administered every second day at days free from magnetophoresis. EFFECT: accelerated treatment course. 5 tbl

Description

 The invention relates to medicine, namely pediatrics, and can be used in the treatment of children (boys and girls) aged 12-14 years with cardiac syndrome of psychogenic genesis of the lung.

 Functional cardiopathy is a disease of a neurogenic nature, which is based on a failure of adaptation or a disorder of the neuroendocrine regulation of the cardiovascular system, which is manifested by multiple cardiovascular symptoms (cardialgia, tachycardia, vascular dystonia, etc.) in the absence of a visible pathology in the heart.

 Disorders of cortico-visceral interactions underlying functional cardiopathy that occur through the hypothalamic-pituitary system lead to a disorder of homeostasis, i.e., the functioning and reliability of all systems, and especially the cardiovascular system, are affected. Most often, the primary failure of adaptation occurs at the level of the cerebral cortex (psychogeny) or at the level of the hypothalamus (with nonspecific stress effects, infections, hormonal changes). However, in the future, dysfunction occurs at the level of the peripheral autonomic system, mainly sympathoadrenal. The close interconnection of all parts of the nervous system provides a variety of clinical symptoms and makes it difficult to identify the "primary level of damage" (1; 6). Violation of homeostasis is manifested by multiple disorders of hormonal and mediator systems, water-electrolyte metabolism, acid-base balance. The result of this is a decrease in the general physiological reserves of tolerance for various environmental influences, insufficient resistance to stressful situations, and a decrease in physical and mental performance (1; 9).

Known methods for treating children with functional cardiopathy by exposure to hydrogen sulfide baths (2), which are released at a concentration of hydrogen sulfide 25-50-100 mg / l, lasting 8-12 minutes, at a water temperature of 35-37 ^o C every other day, or two days in a row with a break day, for a course of 12-15 baths, regardless of the gender of the child.

 However, the known method does not give the desired result, the treatment is long up to 45 days, excluding the gender of the child.

 Scientific studies of previous years in the children's department of the Sochi Scientific Research Institute of Balneology and Physiotherapy, when studying the effect of hydrogen sulfide water (in the form of shared baths) in various modes of hydrogen sulfide concentration on the body of children of different sexes with functional cardiopathy, revealed an unequal effect on lipid peroxidation processes. At the same time, the girls were more resistant to low concentrations. What may be associated with their somewhat early hormonal restructuring, in connection with which the girls were recommended a course of hydrogen sulfide baths with a concentration of hydrogen sulfide 25-50 mg / l. In boys, the use of low-concentrated hydrogen sulfide water during balneotherapy caused an increase in the activity of lipid peroxidation processes, as a result of which it is advisable to prescribe high 50-100 mg / l of hydrogen sulfide concentrations during the release of common baths.

 The purpose of the invention is the reduction of treatment time to 22-28 days due to the combined use of magnetophoresis of a 2% solution of dibazole (adaptogen) and a shortened course of hydrogen sulfide balneotherapy with a concentration depending on the sex of the child, increasing therapeutic efficiency by increasing the body's resistance to stressful situations, physical and mental performance, in reducing the phenomena of cardiopathy, lengthening remission.

This goal is achieved by the fact that during the adaptation period two days in a row they carry out magnetophoresis from the apparatus of the low-frequency alternating magnetic field "Pole-3" with a 2% solution of dibazole with pre-treatment of the skin area with a 30% aqueous solution of dimexide with the inductor located on the segmental interscapular region C ₆ - Th ₄ on the left in continuous mode, the first and tenth procedures being released upon induction of a magnetic field of 10 mT, the repetition rate is 12.5 Hz. With a duration of 10 minutes; the second and ninth - with the induction of a magnetic field - 20 mT of the same frequency and exposure time; the third and eighth - with magnetic field induction - 20 mT, frequency - 17 Hz and exposure duration - 15 minutes; the fourth, fifth, sixth and seventh procedures — with magnetic field induction — 30 mT, the frequency of the fourth procedure — 17 Hz, the fifth, sixth and seventh — 25 Hz — the duration of the fourth and fifth procedures — 15 minutes, the sixth and seventh — 20 minutes .

 The parameters of the effects of magnetophoresis of 2% dibazole solution by days are presented in table 1.

 Hydrogen sulfide balneotherapy is carried out on days free of magnetophoresis for girls at a concentration of hydrogen sulfide 25-50 mg / l, and for boys 50-100 mg / l lasting from 4 to 10 minutes with an increase in each subsequent procedure by 1 minute, a course of 10 physiotherapy and 8 balneotherapy .

 Scheme vacation procedures are presented in table 2.

 The method is as follows.

During the period of adaptation of the child in the resort, after a general clinical examination, spend two days in a row magnetophoresis of 2% dibazole solution, then every other day (T. 1). On days free from magnetophoresis, hydrogen sulfide balneotherapy is carried out at a concentration of hydrogen sulfide for boys 50-100 mg / l, girls 25-50 mg / l in the form of shared baths at a water temperature of 36-37 ^o C. Duration from 4 to 10 minutes, increasing the subsequent procedure for 1 minute.

 10 physical and 8 balneotherapy procedures are conducted for the course.

 The purpose of magnetophoresis of a 2% solution of dibazole for children with functional cardiopathy is pathogenetically justified, since an alternating magnetic field of low frequency has a mild sedative effect, gives a small energy load on the body, increases the body's resistance to hypoxia, physical activity due to adaptive restructuring of the body.

 The autonomic nervous system is highly sensitive to magnetic fields, which affect the sympathetic ganglia, the higher parts of the nervous system (7). The most pronounced effect of the magnetic field is to increase the blood circulation of tissues at the level of microcirculation, the intensity of oxidative processes, immunological reactivity, and the increase in inhibition in nervous processes. Due to this, compensatory-adaptive processes are activated and adaptive reactions of the body are formed, its resistance increases (10).

 It should be noted that not only a vasodilator effect is inherent in dibazole, but also the ability to increase the protective and adaptive capabilities of the body by stimulating the function of the pituitary-adrenal system.

 Therefore, in the treatment of children with functional cardiopathy, it is justified to use magnetophoresis of drugs with the directed action of adaptogens under psychoemotional stress to improve the body's adaptation to physical activity, while there are favorable dynamics of subjective manifestations, cardiohemodynamics.

 Moreover, taking into account the adaptogenic effect of magnetophoresis of 2% dibazole, it can be prescribed from the first days of a child's stay in the resort in order to exclude pathological balneoreaction.

 A 30% solution of dimexide is in this case as a penetrant, which promotes better penetration of drugs through the epithelial barrier, thereby increasing the effectiveness of drug phoresis.

 The advantages of the proposed method is accessibility, ease of execution, non-invasiveness and increased therapeutic effect by gradually adapting the child's body to a powerful factor - hydrogen sulfide balneotherapy.

 Example.

 Patient Katya V., 13 years old, was in the children's department of the center of balneology and rehabilitation since 22.08. - September 18, 1998. Was admitted to the department with a diagnosis of functional cardiopathy. Astheno-neurotic syndrome. Chronic compensated tonsillitis.

 At the time of admission, she complained of stitching pains in the heart during emotional and physical exertion, headache, fatigue, emotional lability.

 The history of this disease: it has been observed by a cardiorematologist since 1997, when, after suffering a trauma (brother's death), the above complaints appeared. Received outpatient treatment for functional cardiopathy; sedative herbs, vitamin and fortifying therapy. Spa treatment for the first time.

Objective examination data: satisfactory condition. The physique is correct, average, skin and visible mucous membranes are clean, pink. Subcutaneous fat is moderately developed. The Quetelet index is 17.5. Tonsils hypertrophied to I-II art. There are no raids. Lymph nodes nodes are not enlarged, b / painful on palpation. The boundaries of relative cardiac dullness within the age norm. Heart sounds are clear, rhythmic, a short systolic murmur is heard on V _T and the apex. Hell 110/60 mtr Art. , pulse 100 beats. per minute, satisfactory filling, tension. On the part of the respiratory system, digestion, allocation of pathology was not revealed, there were no monarchies.

 Data of applied examination methods (before treatment).

Complete blood count: HB - 125 g / l, L - 5.0 • 10 ⁹ / l, E - 3%, C - 66%, L - 21%, M - 7%, ESR - 5 mm / hour.

 Biochemical blood tests: medium molecular peptides - 0,300 srvc. units serum catalase - 41.6 μkat / l, ceruloylazmin - 0.402 g / l, total lipids - 3.04 g / l, diene conjugates of blood plasma lipids - 1.8, malonic dialydehyde of red blood cells - 73.9 nmol / ml, malonic lipid dialdehyde - 24.3 nmol / mg.

 ECG: sinus rhythm, semi-vertical position of the electrical axis of the heart. Violation of intraventricular conduction.

 Clinoorthostatic test: asymptatic test version.

 During the examination, the diagnosis was established: functional cardiopathy with cardialgic syndrome, psychogenic genesis, mild course. Chronic compensated tonsillitis.

The girl was prescribed treatment according to the proposed method:
-climatological procedures for a gentle, gentle-training regimen;
-mode of physical activity - gentle training;
-adaptation 5 days;
diet 15;
-therapeutic gymnastics for diseases of the cardiovascular system in a gentle-training mode;
- magnetophoresis of a 2% solution of dibazole from the 4th day of adaptation two days in a row, the following procedures were released every other day, for a course of 10 procedures;
-total hydrogen sulfide baths at a concentration of hydrogen sulfide 25-50 mg / l, water temperature 36-37 ^o C, the duration of the procedures from 4 to 10 minutes with an increase in each subsequent procedure by 1 minute, every other day, a course of 8 baths. The treatment regimen is shown in table 2.

 During treatment, the girl was examined by a doctor 12 times, good tolerance of both the first magnetophoresis procedure of a 2% solution of dibazole and subsequent ones was noted. In the first, fifth, and tenth magnetophoresis procedures, blood pressure and heart rate were measured both before and after the procedure. Significant fluctuations in blood pressure and heart rate are not registered. Adaptation of the body to the effects of physical factors went well, without side effects, which allowed us to connect hydrogen sulfide baths to the treatment complex. In the process of treatment, the child received a full planned course, consisting of 10 physiotherapy and 8 balneotherapy. It was discharged with a significant improvement, which resulted in the disappearance of pain in the heart, head, increased performance, improved mood.

 Examination data after treatment.

General blood test: HB - 135 g / l, L - 4.7 • 10 ⁹ / l, E - 1, P - 2, C - 64, L - 27, M-6, ESR-4 mm / hour.

 After treatment, there was an increase in hemoglobin from the red blood, and from the white, the blood formula improved.

 Biochemical blood test: medium molecular peptides - 0.218 srvc. units serum catalase - 51.8 μkat / l, cerulonplasmin - 0.308 g / l, total lipids - 5.53 g / l, diene conjugates of blood plasma lipids - 1.52, erythrocyte malondialdehyde - 63.4 nmol / ml, malonic lipid dialdehyde - 11.4 nmol / mg. After the treatment, the content of diene conjugates of blood plasma lipids significantly decreased, there was a tendency to a decrease in malondialdehyde lipids, the activity of catalase increased.

 There were no changes on the ECG. Clinoorthostatic test - normotonic option.

 After the treatment, positive changes occurred in the reaction of the cardiovascular system to physical activity, the recovery period of heart rate accelerated by an average of 3.9 ± 1.5 per minute, which indicates an increase in exercise tolerance.

 Positive changes in the response of the cardiovascular system to physical activity during treatment with physical factors contributed to an improvement in the tolerance of muscle work, as a result of which the power of the work performed increased, physical performance increased, up to treatment 108.7 ± 6.37. After treatment, 135.7 ± 5.06 (p <0.001).

 Thus, during the treatment according to the proposed method, the child improved his health, had a good rest, and was discharged with significant improvement. According to long-term results, for 6 months the girl did not seek help at the clinic about cardiopathy.

 Example.

 Patient Sasha T., 14 years old, was in the children's department of the center of balneology and rehabilitation since 22.08. -18.09.98g. He entered the department with a diagnosis of VVD on the cardiac type.

 At the time of the examination, he complained of pain in the heart, a feeling of "fading", periodic headaches, fatigue, irritability.

 He underwent a general clinical examination, as well as a biochemical blood test for lipid peroxidation, a clinostatic test, bicycle ergometry were performed. Examined by an ENT doctor, dentist.

 During the examination, the diagnosis was established: functional cardiopathy, cardialgic form, mild course. Chronic hypertrophic pharyngitis. Chronic hypertrophic ringitis.

 On the ECG: sinus rhythm. Semi-vertical position of the axis of the heart. ECG voltage reduction in standard leads.

 Clinoorthostatic test is a hyperdiastolic test.

The boy was prescribed treatment by the proposed method:
-climatological procedures for a gentle-training regimen;
-mode of physical activity - gentle training;
-adaptation 5 days;
diet 15;
-therapeutic gymnastics according to the gentle-training regimen in the group of cardiovascular diseases;
- magnetophoresis of a 2% solution of dibazole from 4 days of the adaptation period two days in a row, the following procedures were released every other day, for a course of 10 procedures;
-total hydrogen sulfide baths at a concentration of hydrogen sulfide for boys - 50-100 mg / l, water temperature 36-37 ^o C, duration of the procedure from 4 to 10 minutes with an increase in each subsequent procedure by 1 minute, every other day, a course of 8 baths.

 After treatment, a clino-orthostatic test is a normotonic option.

 Biochemical blood test: there was a decrease in diene conjugates of 2.62 to 0.80, malondialdehyde from 32.3 to 16.6 nmol / mg of lipids, catalase did not change, amounted to 45.8 μkat / l, ceruloplaslin decreased from 0.346 to 0.296 g / l

 During treatment, the boy was examined 12 times; good tolerability of both magnetophoresis and general hydrogen sulfide baths was noted. Discharged with significant improvement, which resulted in the disappearance of complaints, increased efficiency.

 To assess the effectiveness of the proposed method of treatment, a comparative characteristic was performed in two groups of patients.

 Group I - 40 children (control). 20 girls and 20 boys with functional cardiopathy received total hydrogen sulfide baths of 25-50-100 mg / l, depending on age, for a course of 10 procedures every other day.

 Group II - 40 children (20 girls and 20 boys) received magnetophoresis of a 2% solution of dibazole for a course of 10 procedures in combination with hydrogen sulfide baths with a concentration of hydrogen sulfide for boys of 50-100 mg / l. For girls, 25-50 mg / l, every other day, on a course of 8 baths.

 All groups are identical in disease, age (children of the puberty period of 12-14 years).

 Table 3 presents the dynamics of lipid peroxidation and antioxidant protection in groups.

 From the table it can be concluded that under the influence of the proposed method of treatment in group II there was a significant decrease in diene conjugates in blood lipids and malondialdehyde in the stroma of red blood cells. Thus, the use of hydrogen sulfide baths in combination with magnetophoresis in patients reduces the formation of diene conjugates, probably due to the gradual intake of hydrogen sulfide, which, accumulating in the depot, has a constant therapeutic effect, reducing the intensity of peroxidation at the initial stage, apparently by neutralizing the resulting hydrogen peroxide.

 Table 4 presents the dynamics of indicators of physical performance under the influence of medical complexes.

 Thus, after the treatment, positive changes occurred in the indicators of the functioning of the cardiovascular system and its response to physical activity: a favorable type of its reaction was established, and physical performance increased. As can be seen from table 5, the most reliable indicators were in group II patients.

 As can be seen from the table, there is a high efficiency of all medical complexes. A slightly high percentage of treatment improvement in the II group of patients is explained by the stimulating effect of the proposed complex, which improves adaptive processes.

 Thus, the proposed method for the treatment of children with functional cardiopathy aged 12-14 years using magnetophoresis of a 2% solution of dibazole (adaptogen) in combination with hydrogen sulfide balneotherapy with a concentration of hydrogen sulfide for boys 50-100 mg / l, for girls 25-50 mg / l has a pronounced therapeutic effect: the number of complaints is significantly reduced, physical performance is increased due to adaptive restructuring of the body. The proposed method of treatment can reduce the treatment of children from 45 to 22-28 days.

Sources of information
1. Functional cardiopathy, - Method. recommendations. - 1979, - compiled by V.I. Makolkin et al.

 2. Sanatorium-resort treatment of functional cardiopathies in children. - Method. recommendations. - Odessa. - 1980.

 3. Guide to sanatorium-resort selection edited by prof. V. M. Bogolyubova. - 1986.- S. 342.

 4. Mikhno L. E. Experience in the use of balneotherapy in the complex treatment of patients with functional cardiopathies. - Yalta. - 1978.

 5. Bogolyubov V. M., Ponomarenko G. N. General physiotherapy. -Moscow. - St. Petersburg, 1997.

 6. Groshev V. N., Krivoshchanov N. A. et al. Neurocirculatory dystonia in adolescence. // Pediatrics. - 1995. - 6. - S. 33-35.

 7. Konova OM, Khan M. A. Effect of a low-frequency alternating field on the autonomic nervous system of children with primary arterial hypertension. // Q. balneology, physiotherapy and physiotherapy, - 1996. - 2. - S. 8-10.

 8. Clerk B. C. New methods and techniques of physical therapy. - Minsk "Belarus", 1996. - S. 31-34.

 9. Tsaregorodtseva L.V. et al. Characterization of the psycho-vegetative syndrome in children with heart pain. // Pediatrics. - 1995. - 6. - S. 30-33.

 10. Sorokina E. I. Physical treatment methods in cardiology. - M., 1989 .-- S. 39-45.

Claims (1)

A method of treating children with functional cardiopathy by means of hydrogen sulfide balneotherapy in the form of shared baths, carried out every other day with a concentration of hydrogen sulfide 25-50-100 mg / l, characterized in that during the adaptation period two days in a row they carry out magnetophoresis from a low-frequency variable magnetic field apparatus "Pole - 3 "2% solution of dibazole with pre-treatment of the skin with a 30% solution of dimexide with the location of the inductor on the segmental interscapular region C ₆ -Th ₄ on the left in continuous mode, and the first and tenth procedures accelerate by induction of a magnetic field of 10 mT, a repetition rate of 12.5 Hz at a duration of 10 minutes; the second and ninth - with the induction of a magnetic field of 20 mT of the same frequency and exposure time; the third and eighth - with the induction of a magnetic field of 20 mT, with a frequency of 17 Hz and a duration of exposure of 15 minutes; the fourth, fifth, sixth and seventh procedures - with the induction of a magnetic field of 30 mT, the repetition rate of the fourth procedure is 17 Hz, the fifth, sixth and seventh - 25 Hz for the duration of the fourth and fifth procedures 15 minutes, the sixth and seventh - 20 minutes, and hydrogen sulfide balneotherapy is carried out on days free of magnetophoresis for girls at a concentration of hydrogen sulfide 25 - 50 mg / l, for boys 50-100 mg / l, for a course of 10 physiotherapy and 8 balneotherapy.

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