RU2551243C1 - Method for preventing rhinitis in preschool children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves cold water treatment by heat therapy by having a sauna bath at a temperature of +60…+70°C for 3-7 min depending on child's age and cold exposure on a nasal mucosa by massaging the nasal mucosa with a cotton tampon wetted with cold water and movable circularly clockwise and counterclockwise for 30 s with increasing an exposure time up to 3 min and decreasing to 30 s. That is followed by massaging wings of nose and doing a complex of respiratory exercises, wherein the first exercise involves inhaling through a right half of nose with the left blocked with a finger, with a pause of 5-10 s, exhaling through a left half of nose to be repeated 5-6 times. The second exercise represents inhaling through the left half of nose with the right one blocked with the finger with a pause of 5-10 s, exhaling through the right half of nose to be repeated 5-6 times. During the third exercise, the child inhales through both halves of nose with a pause of 5-10 s, and exhales through the right and left halves of nose alternatively. The fourth exercise provides inhaling through both halves of nose with a pause of 5-10 s and exhaling through both nostrils; the procedure is performed 2 times a day before noon; the therapeutic course is 16 procedures.

EFFECT: creating the conditions for local respiratory immune development in the children of the given group, improving mucociliary clearance, increasing activity of the central and peripheral blood flow, forming preschool children's body adaptation to acute respiratory diseases, and simplifying the method.

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Description

The invention relates to medicine, namely to pediatrics, and can be used to prevent relapse of rhinitis in preschool children.

Acute respiratory infections (ARI) to date remain one of the most pressing and unresolved health problems. In terms of prevalence, these are the most widespread infections. In children with reduced body resistance, these infections significantly affect the incidence rate, increasing the group of long-term and often ill children. Analysis of long-term dynamics shows that the incidence of respiratory infections tends to increase.

The system of children's health protection focuses on the treatment of patients, the provision of high-tech inpatient care. The analysis shows that medical care is mainly provided to children by referral, and preventive work is minimized. The results of the study in different regions of Russia allow us to talk about an ineffective system of preventive care and the need for its optimization. The solution to this problem can be implemented by an integrated approach: the joint organized work of teachers, doctors, psychologists, the creation of new forms of medical care for children [1].

It is known to use immunomodulators and antiviral drugs as a means of nonspecific prevention of respiratory infection. The main disadvantages of this method are the selectivity of the action, the presence of side effects, allergization of the body and short-term action.

Also, to maintain the health of local immunity, various methods of hardening are actively used, which can conditionally be divided into traditional and non-traditional. Traditional hardening uses solar, air and water treatments with moderate temperature and water load. However, it is proven that a weak temperature stimulus is not able to lead to hardening and can even cause overcooling while taking hardening procedures.

Known methods of healing frequently ill children using physical factors, such as ultraviolet radiation, inhalation of medicinal herbs or mineral water, mud applications on the chest area, shared baths from sea and mineral water. However, these methods have disadvantages in that ultraviolet irradiation has a photodynamic effect, can cause tissue damage in case of an overdose, requires special working skills; inhalation therapy has a predominantly local effect; the use of general and mud applications is not available for most medical institutions in view of the technical difficulties of dispensing procedures [2].

The closest to the achieved positive effect is the method of healing frequently ill children by aeroionotherapy, in which the child is exposed to a directed dosed stream of light negative aeroions moving from the aeroion generator in the direction of the electrode mounted on the child's body so that its metal plate is in contact with the skin, in a dose of ^{13 October} ions on procedure with a gradual increase until a dose of 3 10 ¹³ -6 10 ¹³ on procedure when a course of treatment is 10-15 percent fools. However, the method is complex and requires the use of complex and bulky equipment.

A new technical result is the creation of conditions for the formation of local immunity of the respiratory tract in preschool children, an improvement in mucociliary clearance, an increase in the activity of central and peripheral circulation, the formation of an adaptation of the organism of preschool children to various acute respiratory diseases, and a simplification of the method.

To achieve a new technical result, a method for the prevention of rhinitis in preschool children involves hardening by thermotherapy in the form of a sauna with a temperature of + 60 ... + 70 ° C for 3-7 minutes, depending on the age of the child and cold exposure to the nasal mucosa, by massage the nasal mucosa with a cotton swab moistened with cold water in circular movements clockwise and counterclockwise for a duration of 30 s, gradually increasing the exposure time to 3 minutes and again decreasing to 30 s, then mass n the wings of the nose and a complex of breathing exercises consisting of exercises: the first includes inhaling through the right half of the nose, the left is closed with a finger, pause 5-10 seconds, exhaling through the left half of the nose, repeat 5-6 times, the second includes inhaling through the left half of the nose, the right one is closed with a finger, pause 5-10 s, exhale through the right half of the nose, repeat 5-6 times, the third includes inhalation through both halves of the nose, pause 5-10 s, exhale alternately through the right and left halves of the nose, the fourth includes inhalation through both halves of the nose, pause 5-10 s, exhale through both nostrils, procedures u spend 2 times a week in the morning, on a course of 16 procedures.

According to the Research Institute of Hygiene and Health Protection of Children and Adolescents of the Russian Academy of Medical Sciences, monitoring of children's health indicates that at the preschool stage the number of practically healthy children does not exceed 10%, a significant part of the examined children (70%) have multiple functional disorders. Conducted in-depth studies in various regions of Russia prove that the real state of children's health is worse than that recorded by medical documents of educational institutions. Moreover, the older the child, the less reliable the information of official medical documentation [1].

In preschool institutions, this problem is of particular importance, based on the assertion that physical education should be an integral part of a child’s life from birth, and the task of promoting health is one of the priorities in the work of preschool educational institutions [3, 4, 5]. Over the past decade, the health status of preschool children has deteriorated sharply: the number of children of the first group of health has decreased from 23.2 to 15.1%; the number of children of group II (with various deviations) increased from 60.9 to 67.6% and children of group III (with chronic diseases) from 15.9 to 17.3% [4, 6].

An individual approach is necessary for the recovery and rehabilitation of children with health problems. It should help: restore the functional reserve of the body, socially and physically adapt to the loads, gradually bring the body of a long-term and often sick child to the level of fitness of a practically healthy child, prepare the child for school loads [7].

The mucous membrane of the nasal cavity is the first barrier to the protection of the respiratory tract, therefore, thousands of microorganisms are deposited on the mucous membrane of the nasal cavity every second. Most of them are representatives of saprophytic microflora and do not harm a person, while others are capable of provoking the development of an infectious disease. In addition to infectious diseases, in industrialized countries, 10-20% of the population suffer from acute allergic diseases. In addition, in the pathogenesis of inflammatory diseases of the upper respiratory tract, along with local and general exposure to the pathogen, sensitization of the body and immunological changes directly in the nasal mucosa and paranasal sinuses play a role.

The nasal mucosa is the area that is exposed to a wide variety of foreign particles. Allergen molecules extremely quickly cause an allergic reaction, as a result of which, after the penetration of allergens, sneezing, itching in the nasal cavity, and rhinorrhea occur [8]. In order to improve mucociliary clearance, blood and lymph circulation in the nasopharynx, nasal wings massage, breathing exercises, massage of the nasal mucosa are prescribed, which also have a pronounced positive effect on the formation of local immunity of the respiratory tract.

Currently, nasal theory and nasal reflexology are becoming more common. The French scientist P. Bonnier belongs to the discovery of the so-called nasobulbar sectors - certain areas located on the mucous membrane of the nose, which can be influenced by one or another internal organ, and the state of the body can be judged by the state of the mucosa. Moreover, it turned out that it is not at all necessary to know the exact location of the sectors on the nasal mucosa, since it is all covered with receptors. Therefore, a general effect on the entire nasal mucosa is sufficient - with the goal of healing the whole body and activating the brain.

The use of thermotherapy (adapted for the child's body) is especially closely combined with hardening, personal hygiene and positive emotions. In addition, the indisputable general healing effect of adequate thermal procedures creates the necessary prerequisites for optimizing the growth and development of the child.

As you know, this healing procedure affects the body multifaceted. Heat, water, steam, a sharp change in temperature, massage of the nasal mucosa - all these factors create a whole complex of irritants to which the body responds with appropriate reactions. In conditions of a preschool educational institution, a sauna in combination with a massage of the nasal mucosa can be considered as an integral part of the rehabilitation complex created for the prophylactic hardening of the child’s body, outdoor activities in order to restore vitality, adapt, neutralize the negative effects of progress, relieve physical and psychoemotional overwork [9].

Thermotherapy is a treatment with sufficiently high temperatures. When using a sauna, the skin and its pores are deeply cleansed, skin respiration improves. Inhalation of hot air enhances the blood supply to the mucous membranes of the upper respiratory tract, causes relaxation of the respiratory muscles of the bronchi and thereby facilitates breathing. Increased active blood circulation, strong skin warming when visiting the sauna entail an increase in sweating. Sweat carries away excess heat, removes toxins from the body.

The method allows to increase the nonspecific resistance of the body to damaging factors of the external and internal environment, has an anti-allergic effect and increases physical and mental performance. The use of the proposed method for the prevention of rhinitis in preschool children helps to achieve the correction of local immunity, increase the overall resistance of the body.

The method is as follows

1. Preparation: undressing, washing the body, rubbing the body to dryness - 12 minutes.

2. Heating. 1st entry into the sauna: it is necessary to lie down and sit, relaxing, the last minutes to sit straight - 3-5 minutes.

3. Rest 15-20 minutes. To maintain heat and to continue perspiration during rest, you can drink a glass of tea with honey or tea picking. Then carry out self-massage of the nasal mucosa for 10 minutes (the technique is described below).

4. The second entry into the sauna. Heating - 5-7 minutes.

5. Quenching thirst. Dressing.

Technique

It is recommended that children prescribe thermotherapy no more than 2-3 times a week every other day.

1. Before entering the sauna, the child should take a hygienic shower with a water temperature of 30-36 ° C for 2-3 minutes. After the water procedure, the child is thoroughly wiped and enters naked in the sauna, where it is located on the lowest shelf.

2. Inside the sauna, the child should be calm, moving and talking is not recommended. At the same time, several children take the procedure (5-6 children).

3. Through the window in the sauna, medical personnel monitor the condition of the children. If you experience a feeling of heat, dizziness, stop the procedure immediately.

4. After taking the procedure, the child should rest for 40-60 minutes.

Self-massage of the nasal mucosa

Material support: a glass of cold water with ice, cotton buds, a towel.

Technique:

Spend 2 times a week Tuesday, Thursday.

1st week

- Tue - 30 s for each half of the nose;

- th. - 30 s each;

2nd week

- Tue - 1 min each;

- th. - 1.5 minutes each;

3rd week

- Tue - 2 minutes each;

- th. - 2.5 minutes each;

4th week

- Tue - 3 minutes each;

- th. - 3 minutes each

Then in reverse order:

5th week

- Tue - 3 minutes each;

- th. - 3 minutes each;

6th week

- Tue - 2.5 minutes each;

- th. - 2 minutes each;

7th week

- Tue - 1.5 minutes each;

- th. - 1 min each;

8th week

- Tue.- 30 s each;

- Thu. - for 30 s.

Massage technique. The child is in a pose of relaxation. Massage the nose mucous membrane with a cotton swab dipped in cold water, first one half of the nose in circular movements clockwise and counterclockwise, then the other half of the nose, also in circular movements.

Then carry out a massage of the wings of the nose. Perform circular movements of the middle phalanges of the index fingers with a rotation speed of up to 100 revolutions per minute. Inhale through the mouth, exhale through the nose.

After the massage, the respiratory complex for the nasal mucosa is performed:

1. Inhale through the right half of the nose, the left is closed with a finger, pause 5-10 seconds, exhale through the left half of the nose. Repeat 5-6 times;

2. Inhale through the left half of the nose, the right is closed with a finger, pause 5-10 s, exhale through the right half of the nose. Repeat 5-6 times;

3. Inhale through both halves of the nose, pause 5-10 s, exhale alternately through the right and left halves of the nose;

4. Inhale through both halves of the nose, pause 5-10 s, exhale through both nostrils.

The mode of the proposed method is based on the results of the analysis of clinical observation data and cytological examination. A survey and rehabilitation of 44 frequently ill children and children with chronic foci of nasopharyngeal infection aged 4 to 7 years was carried out. All patients are randomized into 2 groups. In the main group there were 22 children who received the full complex in accordance with medical technology. The comparison group also included 22 children who were prescribed a similar method of thermotherapy, but without affecting the nasal mucosa.

In order to derive the norm criterion for the studied indicators and to identify age-related fluctuations, a control group was formed with a total of 19 children. All children belonged to I-IIA health groups. According to children's development stories, it was revealed that in the year preceding the observation, children had transferred no more than three acute respiratory infections. In most cases, the duration of the disease did not exceed five to seven days. All diseases proceeded without complications. At the time of the examination, all the children were healthy (no complaints), upon examination there were no signs of the disease. At least three months have passed since the last illness. The averaged indicators of nasocytograms of children of the control group are given in table.2.

Statistical processing of the results was carried out using the Statistica 6, Microsoft Exel 2007 packages. Each studied parameter in the observation groups was calculated by such statistical characteristics as the average value (M), the arithmetic mean error (t). The significance of differences between the studied values is T-student test, Fisher. Differences were considered significant at p <0.05.

The analysis of clinical status indicators showed greater protection against acute respiratory diseases in the main group than in the comparison group, which is confirmed by the epidemic efficiency index (IEE), epidemic efficiency coefficient (CEE), the number of cases of acute respiratory infections per child and the average duration of one disease, the data are presented in table 1. In the main group, the symptoms of respiratory diseases were slightly expressed, the temperature increase did not exceed subfebrile numbers (37-37.5 ° C), difficulty in nasal breathing was observed for 2-3 days. Respiratory diseases went smoothly, bacterial complications were not fixed, there was no need for hospitalization. In the comparison group, a greater severity of intoxication symptoms was noted: a rise in temperature to febrile values (38.5-39.0 ° C), lethargy, tearfulness, difficulty in nasal breathing for 3-5 days. In some cases, they were diagnosed with acute simple bronchitis, acute obstructive bronchitis, stenosing laryngotracheitis with laryngeal stenosis of the I-II degree, and also a complication in the form of acute catarrhal otitis media.

Thus, the thermotherapy complex used by children with self-massage of the nasal mucosa and elements of respiratory gymnastics is a combination of intense hardening and physical exercises, which are an effective means of increasing nonspecific resistance and the prevention of acute respiratory diseases in preschool children.

Based on the indicators of nasocytograms shown in table No. 2, it can be seen that the initial quantitative and qualitative composition of cells in both groups is not significantly different (p> 0.05). Further examination found that the application of the proposed method in preschool children caused a positive trend at the level of some local protection factors. A tendency toward normalization of the epithelial cover of the nasal mucosa was observed: the number of PE cells increased, destruction indicators (SPD PE, IDK PE) significantly decreased compared to the initial ones, DCD changed from type III to I, a significant increase in the adsorption capacity of PE was observed (p <0 , 05). The relative number of CE cells also significantly increased, and the degree of its destruction decreased, which was confirmed by a decrease in SPD and IDC of CE. The content of neutrophils in the nasal mucosa decreased, while maintaining their structure, as indicated by a decrease in granulocyte SPD. Among children in the comparison group with the same study time, no significant differences in nasocytogram indices were revealed.

The course favorably affects the nature of cellular factors of protection of the nasal mucosa, rises and approaches the level of physiological age standards. The positive dynamics of indicators shows a good mechanism of intercellular cooperation, which leads to the preservation of a natural level of natural resistance.

The presented research results indicate the advantage of the proposed method of medical technology for the prevention of acute respiratory diseases and often ill children in preschool age.

Thus, the proposed treatment complex, including thermotherapy with self-massage of the nasal mucosa and elements of respiratory gymnastics, has a local anti-inflammatory effect, helps to increase the body's natural resistance and can be used to prevent acute rhinitis of children with allergic diseases of the upper respiratory tract, as well as often ill children in preschool age , in the conditions of a kindergarten.

List of sources of information

1. Privalova T.E., Shadrin S.A., Shvets E.N. Medical and social aspects of the ineffectiveness of preventive care for preschool children // Pediatric Pharmacology. - 2008. - T. 5. - No. 4. - S. 65-69.

2. Razumov A.N., Khan M.A., Chervinskaya A.V., Ivanova L.V., Sotnikova E.N., Vakhova E.L. Patent No. 2229905 "Method for the recovery of frequently ill children", 2004

3. Andriyanova E.Yu. Correction of the physical condition of preschool children by means of physical education: author. dis ... cand. ped sciences / Andriyanova E.Yu. - M., 2001 .-- 25 p.

4. Astashina M.P. Modern approaches to the fitness activities of preschoolers: author. dis ... cand. ped Sciences / Astashina M.P. - Omsk, 2007 .-- 28 p.

5. Bannikova L.P. The program of rehabilitation of children in preschool educational institutions: method, manual / L.P. Bannikova. - M.: SC Sphere, 2007 .-- 48 p.

6. Approaches to creating a comprehensive program for the modernization of physical education of weakened and often ill preschool children / E.I. Krivitskaya et al. // Interaction of pedagogical science and practice in ensuring the effectiveness and quality of education: Sat. Materials Intern. scientific - prakt. conf. - M., Smolensk, 2007 .-- S. 296-304.

7. Krivonogova T.S., Mikhalev E.V., Babikova Yu.A. Wellness technologies in preschool children: method, recommended. / Krivonogova T.S. et al. - Tomsk: Publishing House "Printing Manufactory", 2011. - 48 p.

8. Makarov G.I. The transport function of the ciliated epithelium of the nasal mucosa in inflammatory diseases // Bulletin of otorhinolaryngology. - 1985. - No. 4. - S. 36-37.

9. Khromina I.I., Chernyaev V.G. The program "Thermotherapy in kindergarten" / Khromina I.I. et al. - Lipetsk, 2006. - 11 p.

Table 1

The dynamics of respiratory disease incidence rates in preschool children in the studied groups (M ± m).

p - significance of differences between the main group and the comparison group.

table 2

Dynamics of nasocytogram indices in preschool children in the studied groups (M ± m).

PE - squamous epithelium;

SPD PE - the average rate of destruction of squamous epithelium;

IDK PE - index of destruction of squamous epithelium;

APE - adsorption capacity of squamous epithelium;

CE - cylindrical epithelium;

SPD CE - the average rate of destruction of the cylindrical epithelium;

IDK CE - index destruction of the cylindrical epithelium;

H - neutrophils;

SPD N - average neutrophil destruction rate;

L - lymphocytes;

p - the significance of differences between the indicators after a course of medical technology.

Claims (1)

A method for the prevention of rhinitis in preschool children, characterized in that it includes hardening by thermotherapy in the form of a sauna with a temperature of + 60 ... + 70 ° C for 3-7 minutes, depending on the age of the child and cold exposure to the nasal mucosa, by massage the nasal mucosa with a cotton swab moistened with cold water, circular movements clockwise and counterclockwise for a duration of 30 s, gradually increasing the exposure time to 3 minutes and again decreasing to 30 s, then massage the wings of the nose and plex of respiratory gymnastics, consisting of exercises: the first includes inhalation through the right half of the nose, the left is closed with a finger, pause 5-10 seconds, exhale through the left half of the nose, repeat 5-6 times, the second includes inhalation through the left half of the nose, the right is closed with a finger, pause 5-10 s, exhale through the right half of the nose, repeat 5-6 times, the third includes inhalation through both halves of the nose, pause 5-10 s, exhale alternately through the right and left halves of the nose, the fourth includes inhalation through both halves of the nose, pause 5-10 s, exhale through both nostrils, the procedure is carried out 2 times in n divide in the first half of the day, a course of 16 treatments.