RU2322225C1 - Method for sanitizing frequently sick children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: at the background of training mode it is necessary to prescribe radon baths of 37°C per 2 baths/wk at therapeutic terms of 30 d. For younger schoolchildren the concentration of bath corresponds to 20 nOUF/l (OUF - oxygen utilization factor), the duration of procedure corresponds to 5-8 min, the quantity of procedures being 6-8. For older schoolchildren the concentration of bath corresponds to 40 nOUF/l, the duration of procedure is 8-10 min, the quantity of procedures being 8-10. Training mode includes curative gymnastics at predominance of respiratory exercises for the period of 15 min, massage of thorax, every other day per 10-12 procedures, inhalations with mineral water every other day per 10-12 procedures in the intake of mineral water of Pyatigorsk well №24 at about 3-5 ml/kg body weight thrice daily, 30 min before meals. The innovation enables to improve humoral and cellular immunity, optimize the processes of tissue blood supply and provide normalization of autonomic regulatory mechanisms.

EFFECT: higher efficiency.

2 ex, 4 tbl

Description

The invention relates to medicine and for the treatment of children with frequent respiratory diseases.

Currently, this group of patients is one of the most common and its timely recovery is the most important socio-medical problem in terms of preventing chronic respiratory diseases.

There is a method of treating often and long-term sick children (N.A. Korovina. Experience of using ribomunil in Russian pediatric practice. - M .: 2002. - P.7-16). This method involves conducting immuno-corrective therapy by prescribing an immunomodulator of bacterial origin - ribomunyl. This drug is taken orally on an empty stomach. Daily dose: 3 tablets of 0.25 or 1 tablet of 0.75. In the first month of treatment, ribomunil is taken for the first 4 days of each week for 3 weeks; in the next 2-5 months - the first 4 days of each month.

The appointment of ribomunyl provides stimulation of the immune system, facilitates the course of the disease and accelerates recovery (O.A. Borisova, T.V. Pariyskaya, A.E. Polovinko, 2004). However, a differentiated approach to the use of immunostimulants is difficult due to the limited ability to take into account the individual characteristics of the body's reactivity and the polymorphism of pathogenetic factors leading to frequent respiratory diseases (A.V. Cheburkin, A.A. Cheburkin, 1994). In addition, long-term use of immunostimulants can lead to suppression of the function of the immune system and therefore requires constant immunological monitoring (D.V. Stefanie, Yu.E. Veltishchev, 1996).

Since often ill children with abnormalities in the protective systems of the body exhibit a violation of the function of external respiration, as well as signs of intoxication and autonomic dysfunction, it is justified to use natural healing factors, the rehabilitation capabilities of which under these conditions can be very useful and effective.

The technical result of the proposed method is the optimal method of sanatorium treatment of frequently ill children using radon therapy, which provides high efficiency without side effects on the children's body.

The specified technical result is achieved by the fact that against the background of the training regimen, therapeutic exercises with a predominance of breathing exercises for 15 days, chest massage, every other day for 10-12 procedures, and inhalations with mineral water, every other day for 10-12 procedures and with internal intake of mineral water from Pyatigorsk spring No. 24 at the rate of 3-5 ml per 1 kg of the child’s body weight 3 times a day, 30 minutes before meals, radon baths with a temperature of 37 ° C are prescribed for 2 baths per week with a treatment period of 30 days, moreover for primary school children concentration bath was 20 nCi / l, treatment time 5-8 minutes 6-8 of procedures and for older students bath concentration was 40 nCi / liter, treatment time of 8-10 minutes, a course of 8-10 treatments.

The proposed method is as follows. The course of balneotherapy is 30 days and is prescribed under the conditions of a training regimen in combination with therapeutic nutrition. Therapeutic exercises with a predominance of breathing exercises are carried out daily for 15 days. Massage of the chest is prescribed every other day, for 10-12 procedures. Inhalations with mineral water are taken every other day, for a course of 10-12 procedures. The internal intake of mineral water from Pyatigorsk spring No. 24 is carried out at a rate of 3-5 ml per 1 kg of the child’s body weight (that is, up to 100 ml per dose for children 7-10 years old and up to 200 ml for 11-14 years old), 3 times a day, 30 minutes before meals. Radon baths with a temperature of 37 ° C, 2 baths per week for a treatment period of 30 days, and for younger students the bath concentration is 20 nCi / L, the duration of the procedure is 5-8 minutes, the number of procedures is 6-8, and for older students the bath concentration is 40 nCi / l, the duration of the procedure is 8-10 minutes, per course of 8-10 procedures.

The method is illustrated by the following examples.

Soslan K., 12 years old, lives in Vladikavkaz, North Ossetia, medical history No. 838. The boy entered the pediatric department of the Pyatigorsk State Research Institute of Balneology on May 28, 2006 with complaints of frequent (up to 5 times a year) colds, which occur with severe hyperemia, cough, runny nose, impaired general health, headaches, decreased appetite, and irritability.

Objectively: pallor of the skin, “shadow” under the eyes, lack of body weight (3 kg). The mucous pharynx is hyperemic, the tonsils are hypertrophic. In the lungs - vesicular breathing, no wheezing.

The study of autonomic tone according to cardiointervalography revealed a sympathetic type of regulation of heart activity (voltage index - more than 80 conventional units).

The study of hematological parameters according to the method of L.Kh. Garkavi et al. (1979) revealed a calm activation of the body, since the lymphocyte content was 30%.

Determination of indicators of humoral immunity showed a significant decrease in the level of class A immunoglobulins (1.20 ± 0.05). At the same time, phagocytosis indices were of normal value.

A comprehensive spa treatment was carried out according to the proposed methodology: training regimen, medical nutrition, daily therapeutic exercises with breathing exercises, for 15 days, 12 chest massage procedures (every other day); alkaline inhalations - 12 procedures (every other day); internal intake of mineral water of Pyatigorsk spring No. 24, 150 ml, 30 minutes before meals, 3 times a day; radon baths at a concentration of 40 nCi / l, temperature 37 ° C, 10 minutes, 10 procedures.

As a result of the treatment, the general well-being of the boy improved, blood hemoglobin increased from 120 to 130 g / l, the “shadows” under the eyes disappeared, and his body weight increased by 1500 g. Hyperemia of the pharynx disappeared. The optimal variant of autonomic tone - vagotonia (stress index - less than 40 conventional units) was restored. The state of calm activation of the body was replaced by increased activation (lymphocyte content of 40%). The level of class A immunoglobulins increased (1.39 ± 0.20), although this did not ensure its normalization.

The result of treatment is improvement

Sofya K., 8 years old, lives in Vladikavkaz, North Ossetia, medical history No. 837. The girl was admitted to the pediatric department of the clinic of the Pyatigorsky State Research Institute of Cancer on May 28, 2006 with complaints of frequent colds (4-5 times a year), accompanied by hyperthermia, cough, sore throat, weakness, loss of appetite, sleep disturbance, headaches.

Objectively: lack of body weight (2 kg), pallor of the skin. The pharynx is hyperemic, the tonsils are hypertrophic. In the lungs, vesicular breathing, no wheezing.

The study of vegetative tone revealed a predominance of sympathetic influence (sympathicotonia), since the index of stress during cardiointervalography was more than 80 conventional units.

The study of hematological parameters according to the method of L.Kh. Garkavi et al. (1979) found calm activation of the body, as evidenced by the content of lymphocytes (32%).

The state of indicators of cellular immunity indicated a decrease in the quantitative characteristics of phagocytosis: phagocytic activity of leukocytes - 72.01 ± 2.07%; leukocyte phagocytic index - 2.04 ± 0.1 units; leukocyte completion rate - 41.03 ± 2.15%. On the part of humoral immunity, a tendency toward a decrease in the level of class A immunoglobulin (1.49 ± 0.13 g / l) was revealed.

A comprehensive spa treatment was carried out according to the proposed methodology: training regimen, therapeutic nutrition, daily therapeutic exercises with breathing exercises, for 15 days, 10 chest massage procedures (every other day), alkaline inhalations - 10 procedures (every other day); internal intake of mineral water of Pyatigorsk spring No. 24, 100 ml, 30 minutes before meals, 3 times a day; radon baths with a concentration of 20 nCi / l, temperature 37 ° С, for 8 minutes, 8 procedures.

As a result of complex spa therapy, the girl added 1200 g in body weight. Her general well-being improved, she became more active. Blood hemoglobin increased from 110 to 120 g / l. All indicators of phagocytosis and the level of class A immunoglobulin were normalized. At the same time, the optimal variant of the vegetative tone, vagotonia (stress index, less than 40 conventional units) was restored. The state of calm activation of the body was replaced by increased activation (lymphocyte content of 44%). The result of treatment is a significant improvement.

The proposed method using radon therapy was tested on the main (30 people) group of children with frequent respiratory diseases. The control was children (10 people), which were identical in sex, age, and nosological characteristics, in the duration of the disease, and clinical manifestations.

The main group of patients under the training regimen received medical nutrition, daily therapeutic exercises with a predominance of breathing exercises for 15 days, 10-12 chest massage procedures and 10-12 mineral water inhalations.

The internal intake of mineral water from Pyatigorsk spring No. 24 was carried out at the rate of 3-5 ml per 1 kg of the child’s body weight (that is, up to 100 ml per dose for children 7-10 years old and up to 200 ml for 11-14 years old), 3 times a day, 30 minutes before meals.

Radon baths were prescribed at a temperature of 37 ° C, 2 baths per week with a treatment period of 30 days, and for younger students the concentration of the bath was 20 nCi / l, the duration of the procedure was 5-8 minutes, the number of procedures was 6-8, and for older students the bath concentration amounted to 40 nCi / l, the duration of the procedure was 8-10 minutes, per course of 8-10 procedures.

A control group of patients in an outpatient setting, against the background of daily therapeutic exercises with breathing exercises, received a ribomunil immunomodulator for 10 days, 10 chest massage procedures and 10 alkaline inhalations. The drug was administered orally on an empty stomach, 1 tablet (0.75). In the first month, ribomunil was taken for the first 4 days of each week, for 3 weeks, and for the next 2 months, the first 4 days of each month.

After the treatment by the proposed method (table 1), a significant improvement in the general condition was noted: in all the observed children of the main group, such clinical manifestations as headache, hyperemia of the throat, cough, runny nose and heart pain were completely eliminated. At the same time, complaints of increased fatigue and irritability, decreased appetite and sleep disturbance were clearly reduced. In addition, the number of children with signs of hyperhidrosis and pallor of the skin decreased.

Table 1 The dynamics of clinical indicators in children with frequent respiratory diseases under the influence of treatment Signs The number of patients with this symptom in groups: primary (n = 30) control (n = 10) before treatment after treatment before treatment after treatment abs. % abs. % abs. % abs. % Hyperemia of the pharynx 29th 97 - - 9 90 - - Cough fifteen fifty - - 5 fifty - - Runny nose eleven 37 - - four 40 - - Pallor 25 83 eighteen 60 8 80 7 70 Decreased appetite 17 57 3 10 6 60 3 thirty Headache 19 63 - - 6 60 2 twenty Fatigue 26 87 four 13 9 90 four 40 Increased irritability 27 90 3 10 9 90 3 thirty Sleep disturbance 12 40 2 7 3 thirty one 10 Hyperhidrosis eleven 37 5 17 3 thirty one 10 Heartache 6 twenty - - 2 twenty one 10

The control group also showed significant positive changes, but they turned out to be less pronounced. So, if in the main group the number of children with increased irritability decreased by 80%, then in the control group - by 60%, with increased fatigue in the first case - by 74%, and in the second - by 50%. The difference in dynamics was also recorded in cases of headache (decreased by 63% and 40%, respectively), decreased appetite (by 47% and 30%), sleep disturbances (by 33% and 20%), pallor of the skin (by 23% and 10%), as well as hyperhidrosis and pain in the heart (by 20% and 10%).

Confirmed the advantage of the proposed method, the results of the study of autonomic tone according to cardiointervalography.

table 2 The dynamics of vegetative tone in children with frequent respiratory diseases under the influence of treatment The state of vegetative tone The number of patients with this condition in the groups: primary (n = 30) control (n = 10) before treatment after treatment before treatment after treatment abs. % abs. % abs. % abs. % Aytonia - - 9 thirty - - one 10 Vagotonia four 13 fifteen fifty one 10 3 thirty Sympathicotonia 26 87 6 twenty 9 90 6 60

The analysis showed (Table 2) that after the completion of the treatment course, the optimal variant of vegetative tone (eutonia) in the main group was restored in 30% of children, and in the control group - only in 10% of patients. A similar predominance was revealed in relation to signs of vagotonia (50% versus 30%), that is, 37% more often this condition began to be detected after balneotherapy and 20% when ribomunyl was prescribed. As a result of the shifts, the adverse signs of sympathicotonic regulation in the main group decreased by 67%, and in the compared group - by 30%.

As you know, an increase in the body's resistance to various pathological factors can be caused by the development of general non-specific adaptive reactions. In this case, the most complex neuroendocrine changes that characterize each of the adaptive reactions receive a certain reflection in the morphological composition of white blood. This makes it possible to use simple indicators for each of the reactions and, therefore, carry out controlled non-specific therapy and manage the body's resistance (L.Kh. Garkavi, 1978).

Table 3 The dynamics of adaptive reactions under the influence of treatment in children with frequent respiratory diseases Type of adaptive reaction (according to the content of lymphocytes - L) The number of patients with this adaptation reaction in the groups: primary (n = 30) control (n = 10) before treatment after treatment before treatment after treatment Stress (L - less than 20%) 3 (10%) (14.0 ± 0.3) - 1 (10%) (16.1 ± 0.2) - Training Area (L = 21-28%) 2 (7%) (23.1 ± 0.5) 3 (10%) (27.0 ± 0.1) 1 (10%) (25.5 ± 0.1) 3 (30%) (24.8 ± 0.3) Zone of quiet activation (L = 28-33%) 1 (10%) (30.3 ± 0.2) 5 (17%) (33.2 ± 0.4) 1 (10%) (32.7 ± 0.5) 1 (10%) (32.5 ± 0.2) Zone of increased activation (L = 34-44%) 16 (53%) (40.1 ± 0.5) 20 (67%) (43.1 ± 0.2) 4 (40%) (43.5 ± 0.2) 4 (40%) (43.8 ± 0.1) Reactivation Zone (L = 45% or more) 8 (27%) (46.0 ± 0.3) 2 (7%) (45.3 ± 0.1) 3 (30%) (46.2 ± 0.1) 2 (20%) (47.0 ± 0.5)

In our case, the proposed simple criteria for assessing adaptive reactions (according to the content of lymphocytes) were used to monitor the adequacy and effectiveness of the spa course.

To achieve a therapeutic effect, it is necessary to obtain and maintain a training or activation reaction. The most favorable in the prognostic respect are the development of an activation reaction, usually preceding recovery.

As can be seen from table 3, the dynamics of the adaptive reactions of the body under the influence of the treatment was mixed. In both compared groups, the hematological signs of stress that occurred before treatment in 10% of the subjects disappeared. The training reaction began to be recorded in the main group in 10% of children (instead of the initial 7%), and in the control group in 30% (instead of 10%).

At the same time, the fact that an increase in the number of patients with a favorable activation reaction occurred only in the case of balneotherapy was prescribed: quiet activation was now observed in 17% (instead of 10%), and increased activation in 67% (instead of 53%). At the same time, the children who received ribomunyl maintained their baseline values, that is, the number of children with signs of calm and increased activation remained the same.

In addition, the advantage of complex spa treatment was manifested in the fact that it provided a decrease in the cases of reactivation reaction from 27 to 7%, and in the compared group only from 30 to 20%. Saving this state of adaptation processes is fraught with the possibility of depletion of the glucocorticoid function of the adrenal cortex.

Thus, based on the observed decrease in cases of reactivation of the body and a simultaneous increase in the number of children with signs of persistence and increased activation, it can be concluded that the spa treatment has a beneficial effect on the adaptation processes of the child’s body.

The analysis of the state of immunological parameters revealed the advantage of the control complex with respect to cellular and humoral defense factors, causing a more significant dynamics of phagocytosis and level of class A immunoglobulins. But at the same time, despite the varying degree of positive shifts, normalization of the initially altered immunity indicators occurred in both compared groups.

As can be seen from table 4, treatment with the proposed method, that is, using radon baths, was more effective: 13% were prescribed with a significant improvement, with an improvement of 77%, with a slight improvement - 10% of the observed patients.

Under the influence of the treatment complex using ribomunil, significant improvement was achieved in 10% of children, improvement was noted in 60%, slight improvement was observed in 20%, and the condition remained unchanged in 10%.

Table 4 The effectiveness of spa treatment for children with frequent respiratory diseases Treatment result The number of children with this result in groups: primary (n = 30) control (n = 10) abs. % abs. % Significant improvement four 13 one 10 Improvement 23 77 6 60 Slight improvement 3 10 2 twenty No change - - one 10 Total thirty one hundred 10 one hundred

Higher treatment results by the proposed method are explained by the ability of radon baths to “awaken the protective and adaptive forces of the body” (I.I. Gusarov, 2000), improve humoral and cellular immunity, optimize tissue blood supply processes (S.M. Miletenko, 1985), and in addition to In addition, to ensure the normalization of autonomic regulatory mechanisms (S.V. Yurchenko, 2003), to provide anti-inflammatory and sedative effects (V.M. Dorogina, 1987, A.A. Barashkova, 2001).

An equally important factor in favor of radon therapy is the fact that, firstly, it (unlike ribomunyl) does not cause side effects. Secondly, a significantly shorter treatment period (1 month instead of the required according to the instructions, 2-5 months when ribomunyl is prescribed) takes on economic significance.

The results obtained allow us to argue about the advantage of the proposed method of complex spa treatment for the rehabilitation of children with frequent respiratory diseases.

Claims (1)

A method of healing often sick children, characterized in that against the background of a training regimen, therapeutic exercises with a predominance of breathing exercises for 15 days, chest massage, every other day 10-12 procedures, and inhalations with mineral water every other day 10-12 procedures and internal intake of mineral water of Pyatigorsk spring No. 24 at the rate of 3-5 ml per 1 kg of the child’s body weight 3 times a day, 30 minutes before meals, radon baths are prescribed at a temperature of 37 ° C for 2 baths per week with a treatment period of 30 days , and for younger schoolchildren conc ntratsiya bath was 20 nCi / l, treatment time 5-8 minutes 6-8 of procedures and for older students bath concentration was 40 nCi / liter, treatment time of 8-10 minutes course 8-10 procedures.