RU2391960C1 - Method of sickly children sanitation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention belongs to medicine, notably to balneotherapeutics and pediatrics. Method includes training schedule, dietotherapy, remedial gymnastics, thorax massage, inhalations of mineral water aerosol every other day, radon baths and ingestion of mineral water. Additionally, method includes applications of Tambukan silt-sulphide mud on neck-collar zone. Remedial gymnastics with breathing exercises predominance is performed during 15 days. Thorax massage is performed every other day, 10-12 procedures per course. Inhalation of mineral water aerosol is performed every other day, 10-12 procedures per course. Ingestion of mineral water of Pyatigorsk mineral well #24 at the rate of 3-5 ml/kg of the child body mass 3 times a day, 30 minutes before meal. Radon bath is performed at 37°C temperature, for primary schoolchildren radon concentration is 20 nCi/l, duration of the bath 5-8 min, 6-8 baths per course; for senior schoolchildren radon concentration 40 nCi/l, duration of the bath 8-10 min, 8-10 baths per course. Applications on neck-collar zone of primary schoolchildren are performed at the temperature of mud 39°C during 6-8 min, 8 applications per course; for senior schoolchildren temperature of mud is 40°C, duration of application - 8-10 min, 10 applications per course.

EFFECT: method reduces quantity of aggravations in focal points of persistent infection, such as chronic tonsillitis, pharyngitis, adenoiditis, sinusitis.

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Description

The invention relates to medicine, in particular to pediatrics, and for the treatment of frequently ill children. According to WHO recommendations, this group of patients includes children with an acute respiratory illness rate of 4 or more times a year.

Practice has shown that prolonged use of medications provides often sick children with short-term and unstable results, and in addition, inevitably leads to the development of adverse reactions and depression of the immune system.

Since reducing the “drug load” becomes an urgent task in this situation, an alternative direction is the use of natural healing factors, the rehabilitation capabilities of which under these conditions are very advisable and effective.

The proof is a well-known method for the treatment of frequently ill children (patent No. 2322225 dated 04/20/08. "Method of healing often ill children"), which is the closest in technical essence to the proposed one. This method involves spa treatment, including a training regimen, daily therapeutic exercises with a predominance of breathing exercises for 15 days, chest massage every other day, 10-12 procedures, inhalation with mineral water every other day, 10-12 procedures per course and daily internal intake of mineral water from Pyatigorsk spring No. 24 (carbonic sulphate-chloride-bicarbonate calcium-sodium low-saline water), at the rate of 3-5 ml per 1 kg of a child’s body weight, 3 times a day, 30 minutes before meals.

Against this background, radon baths are prescribed at a temperature of 37 ° C, and for younger students (7-10 years), the bath concentration is 20 nCi / l, the duration of the procedure is 5-8 minutes, 6-8 baths per course, and for older students (11- 14 years) the concentration of the bath is 40 nCi / l, the duration of the procedure is 8-10 minutes, for the course of 8-10 baths.

The specified treatment complex provides positive dynamics of initially altered clinical and laboratory parameters, reduces the frequency and duration of respiratory diseases in the post-resort period. At the same time, as a two-year observation showed, the disadvantage of this method of healing often sick children is the lack of positive changes during concomitant respiratory diseases. Meanwhile, as a rule, often ill children have various chronic foci of infection in the form of tonsillitis, pharyngitis, adenoiditis, sinusitis, etc. (G.A.Samsygina, 2007). In this regard, the search and development of new, more effective ways of rehabilitating frequently ill children is justified. Very promising in this situation is the use of therapeutic mud.

As you know, peloid therapy is traditionally prescribed for chronic inflammatory processes in remission. It has been proved (G.P. Peklina, K.D. Babov, 2002) that this natural substrate is an active factor in not only local, but also general effects. It activates the sympathetic adrenal system, the production of glucocorticoids and catecholamines by the adrenal glands, followed by stimulation of the parasympathetic and antioxidant systems.

It has been established that the chemical components of peloids, penetrating through the skin, have a beneficial effect on the course of metabolic processes, the immunological reactivity of the body, provide enhanced protective and development of compensatory processes, significantly affect the regulation and restoration of impaired body functions that underlie recovery (I.P. Antonov , E.S. Kalipitsky, 1979).

Morphological and biochemical studies carried out by employees of the Pyatigorsk State Research Institute of Balneology (A.V. Shchelkunov et al., 1979) showed that Tambukan silt-sulphide mud has a stimulating effect on the processes of epithelization, maturation of connective tissue, reduces inflammatory infiltration and has a biostimulating effect.

The high biological activity of the mud and the peculiarities of its influence on the most important physiological systems, the general reactivity of the body and metabolic processes, as well as the ability to exert antimicrobial, bactericidal and bacteriostatic actions, are the basis for its use in order to improve the health of frequently ill children.

The technical result of the proposed method is to increase the efficiency of rehabilitation of frequently ill children by reducing the incidence of exacerbation of chronic foci of respiratory infection.

The specified technical result is achieved by the fact that against the background of a training regimen, therapeutic nutrition, therapeutic exercises with a predominance of breathing exercises for 15 days, chest massage every other day, 10-12 procedures, inhalations with mineral water every other day, 10-12 procedures as well as 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) and radon baths (temperature 37 ° C, for primary school children (7 -10 years)) the concentration of the bath is 20 nCi / l, longitudinal the duration of the procedure is 5-8 minutes, for a course of 6-8 baths, and for older schoolchildren (11-14 years) the bath concentration is 40 nCi / l, the duration of the procedure is 8-10 minutes, for the course of 8-10 baths) tambucan mud applications are prescribed for the cervical-collar zone: for younger schoolchildren - the temperature is 39 ° C, the duration of the procedure is 6-8 minutes, 8 applications per course, and for older schoolchildren - the temperature is 40 ° C, the duration of the procedure is 8-10 minutes, 10 applications per course.

Method description

The proposed method is as follows. The course of balneotherapy is 30 days and is prescribed in the conditions of a training regimen and medical 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 of Pyatigorsk spring No. 24 is 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 are prescribed at a temperature of 37 ° C: for younger students (7-10 years), the bath concentration is 20 nCi / l, the duration of the procedure is 5-8 minutes, 6-8 baths per course, and for older students (11-14 years), the concentration the bath is 40 nCi / l, the duration of the procedure is 8-10 minutes, for a course of 8-10 baths.

Mud applications of healing mud are applied to the child’s neck in the form of a collar: for younger students - at a temperature of 39 ° C, lasting 6-8 minutes, 8 applications per course, and for older students - at a temperature of 40 ° C, lasting 8-10 minutes, 10 applications per course.

The method is illustrated by the following example:

Dasha K., 9 years old, lives in Vladikavkaz, North Ossetia. Case history No. 412. The girl entered the pediatric department of the Pyatigorsk State Research Institute of Balneology March 11, 2007 with complaints of almost monthly colds that occur with hyperthermia, wet cough, runny nose, decreased appetite and impaired overall well-being. As a rule, respiratory infections are accompanied by exacerbation of chronic tonsillitis. Outpatient treatment caused a short-term therapeutic effect. The girl did not receive spa treatment.

Objectively: a girl of the correct physique, but the thoracic spine is scoliotic curved. The skin is pale, "shadow" under the eyes. The pharynx is calm, but the tonsils are loose, hypertrophied. Nasal breathing is not impaired. In the lungs - vesicular breathing.

The study of autonomic regulation of the heart according to cardiointervalography revealed a predominance of sympathicotonia (stress index - 469.04 units), which was accompanied by an overstrain of regulatory mechanisms.

The study of hematological parameters according to the method of L.Kh. Garkavi et al. (1979) revealed increased activation of adaptive reactions of the body, as evidenced by the content of lymphocytes (34%).

An analysis of the immune defense indices revealed a decrease in the quantitative characteristics of phagocytosis: leukocyte phagocytic activity - 52%; leukocyte phagocytic index - 0.75 units; the leukocyte completion rate is 37.1%.

A comprehensive spa treatment was carried out according to the proposed method: training regimen, therapeutic nutrition, daily therapeutic exercises with breathing exercises for 15 days, 10 chest massage procedures (every other day), inhalation with mineral water - 10 procedures (every other day), internal intake of mineral water of the Pyatigorsk spring No. 24, 100 ml, 30 minutes before meals, 3 times a day, radon baths with a temperature of 37 ° C, a concentration of 20 nCi / l, 8 minutes, 8 procedures per course. Mud applications with a temperature of 39 ° C, for 8 minutes, 8 procedures per course.

As a result of the comprehensive treatment, the girl became more active, her general health improved, her appetite was restored, the “shadows” under her eyes disappeared, her complexion improved. During the treatment period, no respiratory diseases and exacerbations of chronic tonsillitis were observed.

Cardiointervalography data showed a marked decrease in the sympathicotonic effect, which was confirmed by the value of the stress index (121.1 units). As a result, the state of overvoltage of regulatory mechanisms was replaced by a slight functional voltage.

The analysis of hematological parameters found a replacement for increased activation of the adaptive reactions of the child's body with a favorable state of training (lymphocyte content - 21%). At the same time, there has been a clear trend towards normalization of phagocytosis.

A study of the results of treatment after a year showed that the frequency of colds fell from a monthly to 3 times a year, their duration decreased from 10 to 5 days, and most importantly, the need for antibiotics disappeared. In addition, no exacerbation of chronic tonsillitis was observed.

The proposed method for improving the health of children was tested in the children's clinic of the Federal State Institution Pyatigorsk State Research Institute of Health and Social Development of Roszdrav on the main group of patients aged 6-14 years (30 people) with frequent respiratory diseases and various chronic foci of infection of the respiratory system.

The control was children (20 people), who were identical by sex, age, and nosological characteristics, by the duration of the disease, and clinical signs.

The main group of patients under the training regime received medical nutrition, daily therapeutic exercises with a predominance of breathing exercises for 15 days, 10-12 chest massage procedures, every other day and 10-12 inhalations with mineral water, every other day. The internal intake of mineral water of 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: for younger students, the bath concentration 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 was 40 nCi / l, the duration of the procedure was 8-10 minutes, for a course of 8-10 procedures.

Mud applications of therapeutic mud were prescribed for the cervical-collar zone: for younger schoolchildren - at a temperature of 39 ° C, lasting 6-8 minutes, 8 applications per course, and for older schoolchildren - at a temperature of 40 ° C, lasting 8-10 minutes, 10 applications for the course. The control group of patients received a similar treatment complex, but without mud applications.

Table 1 The dynamics of clinical indicators in frequently ill children under the influence of spa treatment Signs The number of patients with this symptom in groups: primary (n-30) control (n-20) before treatment after treatment before treatment after treatment abs. % abs. % abs. % abs. % Hyperemia of the pharynx 27 90 - - 19 95 - - Cough 16 53 - - 10 fifty - - Runny nose 9 thirty - - 7 35 - - Pallor of the skin 22 73 16 53 16 80 12 60 Decreased appetite eighteen 60 3 10 eleven 55 2 10 Headache 16 53 - - 12 60 - - Fatigue 27 90 3 10 17 85 3 fifteen Increased irritability 25 83 one 3 eighteen 90 2 10 Sleep disturbance 13 43 one 3 8 40 2 10 Hyperhidrosis 12 40 3 10 7 35 3 fifteen Heartache 6 twenty - - four twenty - -

After the treatment by the proposed method (table 1), a significant improvement in the general condition was noted in all observed patients of the main group: there was a complete elimination of such clinical signs as hyperemia of the throat, headache, cough, runny nose and heart pain. Against this background, there was a pronounced favorable dynamics on the part of most of the symptoms - increased irritability and fatigue, decreased appetite and sleep disturbances. In addition, although to a lesser extent, the number of children with manifestations of hyperhidrosis and pallor of the skin decreased.

The analysis showed that in the control group there were equivalent shifts: the same signs disappeared after treatment, and the revealed differences relative to the dynamics of other indicators were statistically unreliable. So, if in the main group the number of children with increased fatigue decreased by 80%, then in the control group - by 70%, with reduced nutrition in the first case - by 50%, in the second - by 45%.

A similar picture was also recorded regarding cases of sleep disturbance (decreased by 40% and 30%, respectively) and signs of hyperhidrosis (30% and 20%, respectively). In addition, in both compared groups, exactly the same dynamics was observed from the manifestations of increased irritability (decreased by 80%) and pallor of the skin (decreased by 20%).

In contrast to clinical signs, the dynamics of the functional indicators of the child's body testified to the advantage of the proposed method for the treatment of frequently ill children. This was primarily revealed in the study of autonomic regulation of the heart according to cardiointervalography.

table 2 The dynamics of vegetative tone in often ill children under the influence of spa treatment The state of vegetative tone The number of patients with this condition in the groups: primary (n-30) control (n-20) before treatment after treatment before treatment after treatment abs. % abs. % abs. % abs. % Aytonia one 3 fourteen 47 - - 6 thirty Vagotonia 3 10 16 53 3 fifteen 10 fifty Sympathicotonia 26 87 - - 17 85 four twenty

As can be seen from table 2, under the influence of spa treatment, the optimal variant of vegetative tone (eutonia) in the main group began to register more often by 44%, and in the control group - by 30%. As a result of the shifts that occurred, with almost the same number of patients with manifestations of vagotonia (53% and 50%, respectively), adverse signs of sympathicotonia in the first case completely disappeared, and in the second they continued to persist in 20% of patients. Consequently, the spa treatment carried out according to the proposed method provided an improvement in the functional state of the regulatory systems of the child's body to a greater extent than with the known method.

In order to determine the level of reactivity, and therefore the resistance of the child's body to various pathological factors, the state of general non-specific adaptation processes was studied.

Since the most complex neuroendocrine changes are reflected in the morphological composition of white blood, the type of adaptive reaction (stress, training, quiet activation, increased activation, and reactivation) was determined by the percentage of lymphocytes in the leukocyte formula (L.Kh. Garkavi et al., 1979).

These simple criteria for evaluating adaptive reactions were used to monitor the adequacy and effectiveness of the spa treatment. It is known that balneotherapy, increasing the adaptive reserves of the body, helps to increase the body's resistance to adverse environmental factors. Therefore, the use of selected indicators of adaptive reactions allows for monitoring therapy and control the body's resistance (L.Kh. Garkavi et al., 1979).

A normal variant of the state of the organism from the position of the theory of general non-specific adaptive reactions is activation and training reactions. Therefore, to achieve a positive therapeutic effect, it is necessary to obtain and maintain these reactions. Especially prognostically favorable is the development of a calm activation reaction, usually preceding recovery.

Table 3 Dynamics of indicators of adaptive reactions in frequently ill children under the influence of spa treatment Type of adaptive reaction (according to the content of lymphocytes-L) The number of patients with this adaptive reaction in the groups: primary (n = 30) control (n = 20) before treatment after treatment before treatment after treatment Stress (L = 20% or less) 4 (13%) 17.2 ± 1.4 - 2 (10%) 14.0 ± 0.3 - Training Area (L = 21-28%) 2 (7%) 28.0 ± 0.6 4 (13%) 25.2 ± 2.3 1 (5%) 23.1 ± 0.5 2 (10%) 27.0 ± 0.1 Zone of quiet activation (L = 29-33%) 3 (10%) 31.7 ± 0.6 11 (37%) 30.6 ± 0.6 1 (5%) 30.3 ± 0.2 3 (15%) 33.2 ± 0.4 Zone of increased activation (L = 34-44%) 15 (50%) 37.7 ± 1.1 15 (50%) 36.7 ± 0.9 11 (55%) 40.1 ± 0.5 13 (65%) 43.1 ± 0.2 Reactivation Zone (L = 45% or more) 6 (20%) 46.5 ± 0.5 - 5 (25%) 46.0 ± 0.3 2 (10%) 45.3 ± 0.1

As can be seen from table 3, the reaction of training in both compared groups began to be recorded more often in almost the same measure (by 6% and 5%). But at the same time, the most prognostically important reaction of calm activation in the main group recovered in 27% of children, and in the control group - only in 10%. As a result of the shifts, a decrease in adverse adaptive reactions was observed: in the main group, the number of patients with a reaction of increased activation did not change, but the hematological signs of reactivation and stress were completely eliminated, and in the control group, the manifestations of stress disappeared, but cases of increased activation increased by 10%, and the reactivation reaction persisted in 10% of children.

Thus, on the basis of the data presented, it can be concluded that the positive changes from the functional and laboratory parameters under the influence of the proposed method predominate in comparison with the well-known spa treatment of often ill children.

Analysis of the state of immunological parameters revealed a significant dynamics of the initially altered cellular and humoral factors of immune defense, which ensured the normalization of phagocytosis and the level of immunoglobulins of classes A, M and G in both groups.

Table 4 The effectiveness of spa treatment of often ill children Treatment result The number of children with this result in groups: primary (n = 30) control (n = 20) abs. % abs. % Significant improvement 5 17 2 10 Improvement 25 83 fifteen 75 Slight improvement - - 3 fifteen No change - - - - Total twenty one hundred twenty one hundred

As can be seen from table 4, the results of complex spa treatment in the compared groups had certain differences. Although in both cases a positive result was achieved in all patients, only in the control group 15% of the children were discharged with slight improvement. In addition, with the integrated use of radon baths and therapeutic muds, the results of “significant improvement” and “improvement” were more often recorded, respectively, in 17% versus 10% and in 83% versus 75% of patients.

It is important to note that in the post-resort period, exacerbation of chronic foci of nasopharyngeal infection occurred only in children of the control group (23%) who received spa treatment without mud applications.

The presented results of the study indicate the advantage of the proposed method of spa treatment during the phased rehabilitation of children with frequent respiratory diseases.

Claims (1)

A method of healing frequently ill children, including a training regimen, medical nutrition, therapeutic exercises with a predominance of breathing exercises for 15 days, chest massage every other day, 10-12 procedures, inhalation with mineral water every other day, 10-12 procedures, internal intake of mineral water from Pyatigorsk spring No. 24 at a rate of 3-5 ml per 1 kg of the child’s body weight, 3 times a day 30 minutes before meals and radon baths: temperature 37 ° C, concentration for younger students 20 nCi / l, duration of procedure 5 -8 min, for a course of 6-8 baths; for older students, the concentration is 40 nCi / l, the duration of the procedure is 8-10 minutes, for a course of 8-10 baths, characterized in that the applications of tambucan silt-sulphide mud are prescribed for the cervical-collar zone: for younger students, the temperature is 39 ° C, the duration of the procedure 6-8 minutes, 8 applications per course, and for high school students the temperature is 40 ° C, the duration of the procedure is 8-10 minutes, 10 applications per course.