RU2535161C1 - Method for improving psychoemotional characteristics in frequently ill primary school-aged children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: children referred to a follow-up group of frequently ill children are prescribed with Multitabs Junior 1 tablet once a day for 30 days within three therapeutic courses every second month and glucosaminyl muramyl dipeptide 1 tablet once a day sublingually for 10 days within three therapeutic courses every 2 months.

EFFECT: method enables lowering a rate of respiratory infections in the frequently ill children by increasing the body resistance to infectious agents and filling the deficiency of vitamins and microelements.

1 tbl, 2 ex

Description

The invention relates to medicine, in particular to pediatrics, allergology, immunology, and can be used to improve psycho-emotional indicators and also to reduce the incidence of respiratory infections in children of primary school age.

A known method for the prevention of respiratory infections in children, consisting in vaccinating children with anti-hippo vaccines (Grippol, Vaksigripp) [1], which provides the creation of active immunity in vaccinated only against influenza pathogens. At the same time, up to 400 different pathogens, as well as their associations, can act as an etiological factor in frequent infections of the respiratory tract in children [2; 3].

Therefore, the prophylactic effect of influenza vaccines is insufficient. Also, this method does not improve the psycho-emotional indicators of children receiving vaccination.

Also known is a method for the prevention of respiratory infections in children, which consists in vaccinating children with drugs containing antigens of pneumococcal infection (Pneumo 23 vaccine) [1].

This analogue method has similar disadvantages. The introduction of the Pneumo 23 vaccine provides the creation of active immunity in vaccines only against the pathogen Streptococcus pneumoniae, while the cause of infectious diseases in children from the dispensary group who are often ill are both bacterial and viral pathogens. This method also does not improve the psycho-emotional performance of children receiving vaccination.

As the closest analogue (prototype), the method of using the drug glucosaminylmuramyl dipeptide (lycopid) for the treatment of chronic infections of the respiratory tract in children, consisting in taking the drug 1 mg orally 1 time per day for 10 days, was selected [4]. The disadvantages of the closest analogue (prototype) include the effect only on the frequency of respiratory infections and the absence of a positive effect on the psycho-emotional indicators of children.

The objective of the invention is to improve psycho-emotional indicators and reduce the frequency of respiratory infections in children of primary school age.

The problem is solved due to the fact that children of primary school age are prescribed preventive treatment, which includes a complex of multivitamins and minerals (Multi-Tabs Junior), 1 tablet 1 time per day for 30 days - 3 courses with an interval of 1 month and glucosaminylmuramyl dipeptide (tablets 1 mg) according to the scheme - 1 tablet 1 time per day sublingually for 10 days. The course of the drug glucosaminylmuramyl dipeptide is repeated three times at intervals of 2 months.

Using this method allows you to reduce the frequency of respiratory infections and improve psycho-emotional indicators: reduce high levels of anxiety in the classroom (p <0.05) and extracurricular time (p <0.05), as well as high levels of negative emotions in the classroom (p <0.05) and after school hours (p <0.05). In addition, the use of this method leads to an increase in the number of children with an “average” level that is most favorable for normal personality development [5], the level of negative experiences in the classroom (p <0.05) and extracurricular time (p <0.05), as well as the level of anxiety both during classes (p <0.05) and extracurricular hours (p <0.05)

Description of concepts

Often sick children is a dispensary observation group that includes children with frequent respiratory diseases arising from transient, correctable deviations in the body’s defense systems and without persistent organic disorders [6; 7; 8]. The group of often sick includes children suffering 4 or more infectious diseases of the upper respiratory tract per year [6].

Therapy begins at the beginning of the school year - before the seasonal rise in infectious diseases.

The purpose of multivitamins and minerals is due to the fact that at present, in most regions of Russia, a significant deficiency of vitamins and minerals remains in the diet [9; 10], which may be a factor that reduces the body's resistance to infectious pathogens.

Three times the use of the drug lycopid provides a longer lasting effect of the preventive effect and improvement of psychoemotional indicators.

Psycho-emotional state was assessed using the questionnaire Ch.D. Spielberger in the modification of L.D. Andreeva [5] in terms of anxiety, cognitive activity and the level of negative experiences both in the classroom and in extracurricular time.

Between the set of essential features of the claimed object and the achieved technical result there is a causal relationship, namely:

1) a number of authors consider it appropriate to consider the interaction of the immune and nervous systems as a single functional barrier that adapts the body to environmental changes [11; 12; 13; fourteen]. For example, the ability of cytokines (IL-1, IL-2, IFN-α, IFN-γ, TNF-α produced by immunocompetent cells to influence the isolation and exchange of norepinephrine and serotonin in the brain, especially in the hypothalamus and hippocampus, has been revealed while both stimulating and inhibitory effects on preaminergic, serotonergic, acetylcholinergic and neurotransmitter systems [15; 16]. Such an effect can lead to neurobiological and psychotropic effects in connection with changes in the functions of the limbic system, causing the modules emotional state and activation of cognitive functions [17; 18; 19]. This suggests the effectiveness of the use of some immunocorrectors to restore not only immune, but also psycho-emotional indicators;

2) the appointment of the drug glucosaminylmuramyl dipeptide increases anti-infective immunity in children taking it;

3) the appointment of multivitamins and minerals restores their deficiency and increases the body's resistance to infectious pathogens in children receiving them.

The technical result is an improvement in psycho-emotional indicators and a decrease in the frequency of respiratory infections in frequently ill children of primary school age.

The possibility of carrying out the claimed invention is shown by the following examples.

Clinical example No. 1

Between 09.2010 and 10.2011, prophylactic immunocorrection was performed in 31 children of primary school age enrolled in school number 7 in Torzhok. All children belonged to the dispensary group of often sick. The average age is 8.5 ± 0.4 years. Distribution by gender: boys - 16 (51.6%), girls - 15 (48.4%).

Preventive immunocorrection included a complex of multivitamins and minerals (Multi-Tab Junior drug) 1 tablet 1 time per day for 30 days - 3 courses with an interval of 1 month and glucosaminylmuramyl dipeptide (lycopide in 1 mg tablets) according to the scheme - 1 tablet 1 time per day sublingually for 10 days. The course of the drug lycopid was repeated three times at intervals of 2 months.

30 schoolchildren who studied at the same school and are often sick in the dispensary group, made up the control group that did not receive immunomodulating therapy. The average age is 8.4 ± 0.4 years. Distribution by gender: boys - 15 (50%), girls - 15 (50%). There were no statistically significant differences in age and sex between children in the selected groups.

In all children, the frequency of respiratory infections and the psychoemotional state were determined, which was assessed using the Ch.D. Spielberger in the modification of L.D. Andreeva in terms of anxiety, cognitive activity and the level of negative experiences both in the classroom and outside of class. The first examination was carried out at the beginning of the study, from September 15 to September 20, the second - 12 months after the first.

For statistical data processing, Statistica 10 software packages were used. For processing the obtained results, non-parametric methods for assessing quantitative attributes were used: the Man-Whitney test and the Wilcoxon test. The studied quantitative indicators in the work are presented in the form M ± m, where M is the average value, and m is the standard deviation.

Children of the main and control groups were randomly selected for the prevention program.

Indicators of the psychoemotional state before and after the therapy are shown in table No. 1, indicators of the incidence of respiratory infections in table No. 2.

A comparison of mental indicators obtained during the 1st and 2nd examinations of frequently ill children who received prophylactic treatment revealed statistically significant differences: the number of children with both high levels of anxiety in the classroom (p <0.05) and extracurricular time (p < 0.05), as well as high levels of negative emotions in the classroom (p <0.05) and extracurricular hours (p <0.05).

In addition, in this group the number of children with an “average” level most favorable for normal personality development [5], the level of negative experiences in the classroom (p <0.05) and extracurricular time (p <0.05), as well as the level of anxiety, increased during classes (p <0.05), and extracurricular time (p <0.05) (see table).

Also, as a result of preventive measures, there is a decrease in the frequency of respiratory infections in frequently ill children who received prophylactic immunocorrection.

In the control group, there was no statistically significant change in the number of respiratory infections and indicators of the psychoemotional state.

Clinical example No. 2

In the period from 09.2010 to 10.2011, prophylactic immunocorrection was performed in 30 children of primary school age enrolled in school No. 22 in Tver. All children belonged to the dispensary group of often sick. The average age is 9.6 ± 0.3 years. Distribution by gender: boys - 15 (50%), girls - 15 (50%).

Preventive immunocorrection included a complex of multivitamins and minerals (Multi-Tab Junior drug) 1 tablet 1 time per day for 30 days - 3 courses with an interval of 1 month and glucosaminylmuramyl dipeptide (lycopide in 1 mg tablets) according to the scheme - 1 tablet 1 time per day sublingually for 10 days. The course of the drug lycopid was repeated three times at intervals of 2 months.

30 schoolchildren who studied at the same school and are often sick in the dispensary group, made up the control group that did not receive immunomodulating therapy. The average age is 9.3 ± 0.5 years. Distribution by gender: boys - 15 (50%), girls - 15 (50%). There were no statistically significant differences in age and sex between children in the selected groups.

In all children, the frequency of respiratory infections and the psychoemotional state were determined, which was assessed using the Ch.D. Spielberger in the modification of A.D. Andreeva in terms of anxiety, cognitive activity and the level of negative experiences both in the classroom and outside of class. The first examination was carried out at the beginning of the study, from September 15 to September 20, the second - 12 months after the first.

For statistical data processing, Statistica 10 software packages were used. For processing the obtained results, non-parametric methods for assessing quantitative attributes were used: the Man-Whitney test and the Wilcoxon test. The studied quantitative indicators in the work are presented in the form M ± m, where M is the average value, and m is the standard deviation.

Children of the main and control groups were randomly selected for the prevention program.

The indicators of the psycho-emotional state before and after the therapy are shown in table No. 3, the incidence of respiratory infections in table No. 4.

A comparison of mental indicators obtained during the 1st and 2nd examinations of frequently ill children who received prophylactic treatment revealed statistically significant differences: the number of children with both high levels of anxiety in the classroom (p <0.05) and extracurricular time (p < 0.05), as well as high levels of negative emotions in the classroom (p <0.05) and extracurricular hours (p <0.05).

In addition, in this group the number of children with an “average” level most favorable for normal personality development [5], the level of negative experiences in the classroom (p <0.05) and extracurricular time (p <0.05), as well as the level of anxiety, increased during classes (p <0.05), and extracurricular time (p <0.05) (see table).

In addition, as a result of preventive measures, there is a decrease in the frequency of respiratory infections in frequently ill children who received prophylactic immunocorrection.

In the control group, there was no statistically significant change in the number of respiratory infections and indicators of the psychoemotional state.

Bibliography

1) Acute respiratory infections in children: treatment and prevention. A manual for doctors.- M., 2002. - 70 p.

2) Korovina P.A., Zaplatnikov A.L., Cheburkin et al. Frequently and long-term sick children: modern possibilities of immunorehabilitation: a guide for doctors. - M., 2001 .-- 79 s.

3) Kladova O.V., Fomina V.L., Feldfix L.I. Bacterial lysates in frequently ill children during the rise in the incidence of acute respiratory infections. Children's infections. - 2009 - No. 3 - p. 48-53.

4) The register of medicines of Russia. Encyclopedia of drugs, ed. G.L. Vyshkovsky. M.: Radar-Media, 2012 .-- 1368 p.

5) Dermanova I.B. Diagnosis of emotional and moral development. St. Petersburg: Speech, 2002 .-- 176 p.

6) Albitsky V.Yu., Kamaev I.A., Ogneva M.L. Often sick children. N. Novgorod: NGMA, 2003 .-- 180 p.

7) Romantsev M.G., Ershov F.I. Often sick children: modern pharmacotherapy. Moscow: Geotar Media, 2006 .-- 190 p.

8) Samsygina G.A. Frequently ill children: problems of pathogenesis, diagnosis and therapy. Pediatrics. - 2005. - No. 1. - S.66-74.

9) Ruleva A.A. Spring hypovitaminosis in children. Questions of modern pediatrics, 2011. - V. 10. No. 2. - S.155-161.

10) Tutelyan V.A., Spirichev V.V., Shatnyuk L.N. Correction of micronutrient deficiency is the most important aspect of the concept of healthy nutrition of the population of Russia. Nutrition issues. - 1999. - No. 1. - C.3-11.

11) Ivanova N.A. Often sick children: are immunomodulators needed? Pulmonology and allergology. - 2006. - No. 4. - S.18-20.

12) Vetlugina T.P. Clinical psychoneuroimmunology: results and prospects. Siberian Bulletin of Psychiatry and Addiction. - 2008. - No. 1. - S.12-17.

13) Khaitov P.M., Ignatieva G.A., Sidorovich I.G. Physiology of the immune system. - M .: Medicine, 2001 .-- 223 p.

14) Kvetnoy I.M. Neuroimmunoendocrinology: where is the field for study? Neuro Endocrinol. Lett. - 2002. - V. 2. - P.119-120.

15) Akmaev I.G., Grinevich V.V. From neuroendocrinology to neuroimmunoendocrinology. Bulletin of Experimental Biology and Medicine. - 2001. - No. 1. - S. 22-32.

16) Hiramoto R.N., Rogers C.F. Psychoneuroendocrine immunology: site of recognition, learning and memory in the immune system and the brain. Int. J. Neurosci. - 1997. - V. 3-4. - P. 259-285.

17) Dantzer R., Konsman J.P. et al. Neural and humoral pathways of communication from the immune system to the brain: parallel or convergent? J. Auton. Neurosci. - 2000. - V. 85 (1-3). - P. 60-65.

18) Kiess W. Stress related immune regulation. J. Pediatr. Pathol. - 1992. - V. 27 (5). - P. 113-117.

19) Blalock J.E. The syntax of immune-neuroendocrine communication // Immunol. Today. - 1994. - Vol.15, N 11. - P.504-511.

 Table number 1 Psycho-emotional parameters of often ill children in% Indicator Emotion level Experimental group, n = 31 The control group, n = 30 1st study 2nd study 1st study 2nd study Extracurricular anxiety low twenty fourteen 16 fourteen average 42 46 42 64 * tall 38 40 42 22 * Anxiety in the lesson low 24 24 fourteen 12 average 40 42 44 68 * tall 36 34 42 twenty* Negative emotional experiences outside the classroom low four four 8 6 average 46 44 44 70 * tall fifty 52 48 24 * low 12 12 8 8 average 44 42 44 70 * experience in the lesson tall 44 46 48 22 * Extracurricular cognitive activity low four four 12 10 average 52 fifty 42 40 tall 44 46 46 fifty Cognitive activity in the lesson low 12 12 10 8 average 36 38 44 44 tall 52 fifty 46 48 Note. * p <0.05 in relation to the result of 1 study of the same group; n is the number of observations in each group

Table number 2 Respiratory morbidity rates Indicator Experimental group, n = 31 The control group, n = 30 1st study 2nd study 1st study 2nd study Number of respiratory infections 7.28 ± 0.4 4 ± 0.4 * 6.78 ± 0.3 6.63 ± 0.5 Note * p <0.001 with respect to result 1 of the study of the same group; n is the number of observations.

Table number 3 Psycho-emotional parameters of often ill children in% Indicator Emotion level Experimental group, n = 30 The control group, n = 30 1st study 2nd study 1st study 2nd study Extracurricular anxiety low twenty twenty 16 16 average 40 44 38 58 * tall 40 36 46 26 * Anxiety in the lesson low 24 22 twenty eighteen average 40 42 40 62 * tall 36 36 40 twenty* Negative emotional experiences outside the classroom low 6 6 6 four average 46 fifty 44 74 * tall 48 44 fifty 22 * Negative emotional experiences in the lesson. low 10 10 10 8 average 44 42 42 70 * tall 46 48 48 22 *

Extracurricular cognitive activity low 12 10 12 10 average 36 38 40 44 tall 52 52 48 46 Cognitive activity in the lesson low 12 12 12 12 average 40 42 38 42 tall 48 46 fifty 46 Note. * p <0.05; in relation to the result of 1 study of the same group; n is the number of observations in each group.

Table number 4 Respiratory morbidity rates Indicator Experimental group, n = 30 The control group, n = 30 1st study 2nd study 1st study 2nd study Number of respiratory infections 7.13 ± 0.4 4.1 ± 0.5 * 6.9 ± 0.4 6.5 ± 0.5 Note. * p <0.001 in relation to the result of 1 study of the same group; n is the number of observations.

Claims (1)

A way to improve psycho-emotional indicators in often ill children of primary school age, which consists in the fact that children in the dispensary group are often ill, treatment is carried out, including taking Multi-Tab Junior 1 tablet 1 time per day for 30 days - 3 course with an interval of 1 month and glucosaminylmuramyl dipeptide 1 tablet 1 time per day sublingually for 10 days - 3 courses with an interval of 2 months.