RU2195334C2 - Method for treating children with functional cardiopathy from controlled territories after emergency in chernobyl nuclear power station - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: it is suggested to take iodobromine baths in a day. Also, during adaptation period for 2 running, then in a day a magnetophoresis is conducted of 2%-dibasol solution from "Polus No.3" apparatus for a collar area at preliminary treatment of skin section with 30-% dimexide aqueous solution at a constant mode, moreover, the 1st, the 2nd, the 9th, the 10th procedures are given at induction of magnetic field of 18 mTl at frequency of sendings of 10 Hz and duration - 10 min, the 3d, the 4th and the 8th procedures - at the same induction, frequency of sendings of 17 Hz and procedure duration of 15 min, the 5th, the 6th and the 7th procedures at induction of magnetic field of 36 mTl, frequency of sendings of 25 Hz and duration for 20 min in combination with artificial iodobromine baths prescribed since the 6th day of treatment, at 8 balneoprocedures and 10 physioprocedures per a course. EFFECT: higher efficiency of therapy. 2 tbl

Description

 The invention relates to medicine, namely pediatrics and can be used in the treatment of children aged 13-15 years with functional cardiology, living in controlled areas as a result of the Chernobyl accident.

 The accident at the Chernobyl nuclear power plant changed the already unstable economic situation in several regions of Russia, caused psychological stress and created a real danger of deterioration in the health of the population, especially children, whose body is most sensitive to environmental dysfunction and stress.

 The multicomponent effect of the adverse factors of the Chernobyl accident on the child’s body contributed to the formation of a peculiar symptom complex, characterized by the presence of various shifts on the part of many organs and systems, accompanied by an increase in the level of free radical processes, signs of destabilization of cell membranes, activation of blood cell metabolism, suppression of the T-cell immunity to background of psychological disorders of the cardiovascular system.

 An undoubted role in their occurrence was played by the stress factor. However, a number of metabolic disorders, primarily at the level of cell membranes, does not preclude the participation of the radiation factor in the onset and formation of the Chernobyl syndrome in children. In this regard, the possible collapse of the central nervous system, autonomic and cardiovascular systems. This leads to an increase in the incidence among children, limits their social adaptation, worsens physical development, and increases the occurrence of chronic pathology.

 Despite the effectiveness of recreational activities, the system of rehabilitation of children requires correction and further improvement.

 It is known that resort factors, including mineral waters, have a corrective effect on the functional state of the cardiovascular system, indicators of vegetative, endocrine status, the violation of which plays a large role in the medical consequences of the Chernobyl accident.

 Actual is the search for new methods of directed physiotherapeutic correction. In children's practice, a relatively new physical factor is an alternating magnetic field of low frequency, which has a mild sedative effect, giving a small energy load on the child's body. The use of magnetophoresis of adaptagens (dibazole) and antioxidants provides for the combined action of a magnetic field and medications directed action.

 Dibazole is not only a psychotropic, spasmolytic agent, but has become known as an adaptagen.

 The administration of dibazole with galvanic current provides interstitial transport of drugs through the cell membrane and, most importantly, creates a skin depot of dibazole, in which the drug is held for 1-2 days, slowly entering the bloodstream.

 Under the influence of a magnetic field, certain physiological compensatory mechanisms are actively mobilized without the development of negative metabolic effects, with the inclusion of dibazole, adaptive reactions of the body are formed, and its resistance increases. In this regard, it seems reasonable to study iodine-bromine baths that have an active effect on the nervous cardiovascular, endocrine systems, due to the temperature, hydrodynamic and specific influence of the microcomponents of mineral baths - iodine and bromine.

 There is no data in the literature on the use of iodine-bromine baths for functional cardiopathy in children from controlled territories; the possibility of the combined use of iodine-bromine baths and dibazole magnetophoresis has not been studied. Studies in the children's clinic in Sochi SRC & R have shown that dibazole magnetophoresis is an effective treatment for coronary artery disease.

 It is proved that the cause of many psychosamotic diseases, including functional cardiopathy, is autonomic dysfunction, the nature of which is determined by the initial autonomic tone and autonomic reactivity. Autonomic dystonia in children and adolescents often acts not only as a transition state between the norm and the disease, but also is an independent risk factor for the development of atherosclerosis and coronary heart disease at a young age, so the development of effective methods for its prevention and treatment remains an urgent problem in practical pediatrics.

 A known method of treating children by exposure to iodine-bromine baths (1).

 However, the known method does not give the desired result.

 The objective of the invention is to reduce treatment time to 22-26 days instead of 45 days due to the combined use of magnetophoresis of a 2% solution of dibazole in the collar area and a shortened course of iodine-bromine baths, increasing therapeutic efficiency by increasing the body's resistance to stressful situations, physical and mental performance, reduction of cardiopathy, lengthening remission.

 The task is achieved by the fact that during the adaptation period two days in a row then magnetophoresis of a 2% solution of dibazole from the Polyus-3 apparatus is carried out with preliminary treatment of the skin area with a 30% aqueous solution of dimexide with the location of the inductors on both sides of the collar zone in a continuous mode moreover, the first, second, ninth and tenth procedures are released with an induction of a magnetic field of 18 mT, a repetition rate of 10 Hz, with a duration of 10 minutes, a third, fourth and eighth with the same magnetic field induction, h the repetition rate of 17 Hz parcels and the duration of the procedures is 15 min, the fifth, sixth, seventh - with a magnetic field induction of 36 mT, the parcel repetition rate is 25 Hz, the duration is 20 min in combination with artificial iodine-bromine baths dispensed every other day, starting from 6- the first day of treatment for a course of 10 physiotherapy and 8 balneotherapy.

Artificial iodine-bromine baths are released at a water temperature of 36-37 ^o C, lasting from 5 to 10 minutes with an increase in each subsequent bath by 1 minute. The concentration of components in one bath is: sodium bromide - 43 mg / l, potassium iodide - 21 mg / l, sodium chloride 1.0 g / l. The concentration of the components was taken in accordance with the approved guidelines (2).

 Scheme vacation procedures are presented in table 1.

Example. Sasha K., 14 years old, was in the clinic of the institute from 1.02-26.02.2000. He was admitted with a diagnosis of vegetovascular dystonia
PMK I Art. Chronic tonsillitis.

 At the time of admission, he complained of stabbing heart pains, periodic headaches after school, joint pains, fatigue, irritability, and mood instability.

 History of the present disease: Observed by a cardiologist with 1 cl. receives periodic seasonal prophylaxis, cardiotrophics, multivitamins, sedative herbs. Spa treatment in 1998

 Objective examination data: satisfactory condition. Emotionally labile. The physique is correct, average. The skin and visible mucous membranes are clean, pink in color. Subcutaneous fat is moderately developed. The Quetelet index is 21.5. Tonsils are hypertrophied to the I-II degree, loose, no raids. Lymph nodes are not enlarged, painless on palpation. The boundaries of relative cardiac dullness within the age norm. Heart sounds are muffled, rhythmic, a systolic murmur is heard at the apex and in t. Botkin. HELL 105/70 mm Hg, Ps - 100 bpm satisfactory filling, voltage. On the part of the respiratory system, digestion, excretion - no pathology was detected.

 Data of applied research methods (before treatment).

Complete blood count: HB - 140 g / l, L - 6.0x10 ⁹ / l, E - 1%, P - 2%, C - 68%, L - 25%, M - 4%, ESR - 5 mm / hour.

 Blood biochemistry: medium molecular peptides - 0.238 conv. units, serum catalase - 39.0 μkat / l, ceruloplasmin - 0.228 g / l, total lipids - 3.3 g / l, diene conjugates of blood plasma lipids - 2.28; erythrocyte malondialdehyde - 73.1 nmol / ml, lipid malondialdehyde - 22.2 nmol / mg.

 ECG: sinus arrhythmia. The vertical position of the electrical axis of the heart.

 Clinoorthostatic test: asymptatic test version.

Immune status: the total number of leukocytes - 8.1 thousand / μl, L - 37%, M - 6%, the absolute number of lymphocytes - 2997 / μl, the relative number of lymphocytes: T-lymphocytes - 50%, B-lymphocytes -11%, the absolute number of T-lymphocytes - 1498.5 μl, B-lymphocytes - 329.7 μl. IgM - 1.36 g / l, IgG - 13.0 IgA - 2.5 g / l, T _x - 32% - 479.5 T _s - 18% - 269.7, zero lymphocytes 39%, CRP - 1 .

 Bicycle ergometry: achieved power = 108.9 W-650 kgm / min. Work performed = 4800 kgm / min, double product 244.9 physical exercise tolerance 82.4% - high, negative test. The type of hemodynamics is hypertonic.

 During the examination, the diagnosis was established: functional cardiopathy. The mixed vegetative vascular dystonia of the puberty period. PMK I Art. Chronic tonsillitis.

The patient was prescribed a course of treatment by the proposed method:
- climatotherapy in a gentle-training mode;
- mode of physical activity according to RP;
- adaptation of 5 days;
- diet 15;
- therapeutic exercises for the disease s / s, according to RP;
- magnetophoresis of a 2% solution of dibazole to the collar zone from the 3rd day of adaptation two days in a row, then every other day, at a rate of 10 percent., - general artificial baths iodine-bromine, at a water temperature of 37 ^o C, lasting from 5 to 10 minutes with an increase each subsequent procedure in time for 1 min, every other day, for a course of 8 baths.

 During treatment, the boy was examined 12 times; good tolerance was noted both for the first magnetophoresis procedure and the subsequent ones. After 1, 5, 10 magnetophoresis procedures, blood pressure and heart rate were measured (before and after the procedure). Significant fluctuations are not registered. The adaptation period proceeded without complaints and catarrhal phenomena, without adverse reactions, which made it possible to connect iodine-bromine baths to the treatment complex. During treatment, the child received a full planned course of treatment, consisting of 10 physiotherapy and 8 balneotherapy. Discharged with significant improvement, which was expressed in the disappearance of pain in the heart and head. The boy became calm, increased efficiency, increased exercise tolerance, improved mood.

Examination data after treatment:
General blood test: HB - 140 g / l, L - 7.0x10 ⁹ / l, ESR - 5 mm / hour.

 After treatment, changes in red and white blood were not detected.

Biochemical blood test:
molecular weight peptides - 0.190 srvc. units, serum catalase - 30.3 μkat / l, ceruloplasmin - 0.332 g / l, total lipids - 2.3 g / l diene conjugates - 3.17; erythrocyte malondialdehyde - 48.4 nmol / ml, lipid malondialdehyde - 21.0 nmol / mg.

 After the treatment, serum catalase, erythrocyte malondialdehyde significantly decreased, and there is a tendency to decrease lipid malondialdehyde.

 There were no significant changes on the immunogram; the C-reactive protein became negative.

 Clinoorthostatic test - normotonic option.

 Bicycle ergometry: the work performed increased to 5550 kgm / min, exercise tolerance increased to 90.0%.

 Thus, during the treatment according to the proposed method, the boy improved his health, had a good rest and was discharged with a significant improvement.

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

 Group I - 35 children with functional cardiopathy living in controlled territories as a result of the Chernobyl accident at the age of 13-15 received iodine-bromine baths 8 every other day.

 II group - 35 children the same contingent and age as in group I; received treatment according to the proposed method - magnetophoresis of 2% solution of dibazole on the collar region in combination with iodine-bromine baths (artificial).

 Both groups are identical in disease and age.

 Table 2 presents the dynamics of lipid peroxidation and antioxidant protection in groups.

 From table 2 it is seen that under the influence of the proposed method in the II group of patients there was a significant decrease in diene conjugates in blood lipids and malondialdehyde in the erythrocyte stroma. Thus, when iodine-bromine baths are used in combination with magnetophoresis of a 2% solution of dibazole to the collar zone, the formation of diene conjugates, malondialdehyde in the stroma of red blood cells and lipids is reduced, thereby reducing lipid oxidation. The proposed method 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 duration of treatment 22-26 days instead of 45 days.

Claims (1)

 A method of treating children with functional cardiopathy from controlled territories as a result of the Chernobyl accident by iodine-bromine baths conducted every other day, characterized in that during the adaptation period two days in a row, then magnetophoresis of a 2% dibazole solution from the Polyus apparatus is carried out every other day 3 "to the collar zone with pre-treatment of the skin area with a 30% aqueous solution of dimexide in continuous mode, with 1, 2, 9, 10 procedures being released with a magnetic field induction of 18 mT, the repetition rate of 10 Hz and for a long time 10 minutes, 3, 4, 8 procedures - with the same induction, a repetition rate of 17 Hz and a duration of 15 minutes; 5, 6, 7 procedures - with a magnetic field of 36 mT, a repetition rate of 25 Hz and a duration of 20 min in combination with artificial iodine-bromine baths dispensed from the 6th day of treatment for a course of 10 physiotherapy and 8 balneotherapy.

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