A method of treating immunopathy in iron deficiency anemia in frequently ill children, living in a large industrial city with a developed chemical and petrochemical industry

 

(57) Abstract:

The invention relates to medicine, namely to Pediatrics, and for the treatment of immunopathy in iron deficiency anemia in children residing in a large industrial city with a developed chemical and petrochemical industry. First by reorganization of the foci of infection and detoxification by assigning smecta or activated charcoal within 7-10 days, choleretic herbs, Mezim-Forte and hilak-Forte in 2-3 weeks. Then carry out metabolic correction using cocarboxylase daily 10, Pantothenate calcium and lipoic acid for 20 days. In the subsequent replace them pyridoxalphosphate daily 10, methyluracil, trivet within 3-4 weeks. After metabolic correction are immunomodulation by branhamella and nukleinat sodium. In remission inwardly ribomunyl and tincture of Siberian ginseng or a ginseng. The method allows to restore immune homeostasis, indicators of hematopoiesis and iron metabolism. This increases the effectiveness of the treatment and reduces Zhelezobeton.

The invention relates to medicine, namely to Pediatrics.

Famous traditional ways the Oia child Kiev, 1989). This method provides mild anemia by means of reception of iron preparations. The traditional method of treatment is a significant duration. Maximum therapeutic effect when it is achieved through 6-15 months, which is associated with extremely low absorption of iron preparations.

However, prolonged use of Zhelezobeton often accompanied by the development of side effects and complications, because iron supplements have a high toxicity (L. I. Idelson, 1981; A. J. Mandelbaum, 1987; M. M. Kulikova et al, 1989; J. G. Reonold, 1989, C. Hershko, 1989). This is due to the ability of iron preparations easily dissociate with the release of free iron ions, which leads to excessive accumulation of toxic ions of iron in the body, capable of denaturing the protein of the mucous membrane of the digestive tract and cause inflammation. Clinically it is manifested by discomfort, nausea, vomiting, diarrhea.

In addition, excess ferrous iron is capable of initiating the processes of free-radical peroxide oxidation of lipids, causing damage to membrane structures of cells, release of lysosomal enzymes from them with subsequent tissue damage and organogenetic time limits of their application.

Along with that there is a prolonged and refractory of sideropenia resistant to traditional Gelateria (Y. S. Sukhanov, 1982; J. H. Khakimov, 1988; C. I. Nikulicheva, 1996; S. Hercberg, 90). Often such anemia is accompanied by depletion of the reserves of the protection systems of the body, frequent incidence and worse prognosis of anemia (bpts Terenganu, 1987; C. G. Savchenko et al., 1996; A. N. Butler, 1997; L. M. Kazakov, 1997; Y. E. Ultidev, 1997).

Violation of immune homeostasis is most pronounced in frequently ill children (FIC), the components in separate regions of the country, two-thirds of the pediatric population (M. L. Ogneva et al., 1986; B. K. Ovcharov, 1995; E. I. Andreeva et al., 1996; Mutchelles et al., 1989). Significant growth sideropenia States among them testify about the lack of effective methods for their treatment.

The impact of toxicants chemical and petrochemical nature leads to endogenous intoxication, development ismetabolites processes and immunopathologia. Immune imbalance supports the violation of homeostasis, causing relapsing form of anemia and haste to traditional therapy (I. P. Danilov, L. I., Krylov, 1991; L. P. Mochalova et al., 1996).

The above determines the relevance and importance of the invention is a method of staged rehabilitation of children - residents of the industrial city with impaired iron metabolism, proposed F., Sadykova, L. F. Latypov, V. I. Nikulicheva et al. in the book "Actual problems of balneology and physiotherapy" (Ufa, 1997, S. 140-141). However, this method involves the reduction of iron deficiency only in children with chronic disorders of the digestive tract and eliminates the possibility of the treatment of anemia in children with frequent diseases of the respiratory system. So PermaCrete at the specified prototype is brought by the intensity of the organs of digestion and their characteristic abnormalities of the immune system. The main components of treatment are drugs that attack affecting motor and enzymatic functions of the digestive tract. Treatment in the prototype does not provide immune deviation bronchopulmonary apparatus does not include the preparatory phase (exception antigenic load, sanitation foci of infection) and detoxification. Metabolic correction also does not include the consistent application of complex metabolizantov, contributing to the restoration of the function of the respiratory system, in the composition of the drugs recommended in the proposed method. Among ispolzuemaya frequently ill children with respiratory pathology. In addition, the prototype is widely promoted stationary and specialized medical treatment, requiring long-term use of adequate causal pharmacokineti and stage applications hardware physiotherapy that, in General, significantly lengthens the time correction of iron deficiency. While the treatment of frequently ill children with respiratory disorders on an outpatient basis and involves the background of Ferrocarril only the restorative phase of treatment with the inclusion of the entire Arsenal of therapeutic procedures that significantly shortens the treatment of anemia.

The novelty of the proposed method lies in the use of, along with the traditional Gelateria, complex immunomodulation, aimed at restoring immune homeostasis, indicators of hemopoiesis and exchange funds of iron that enhance the body's resistance to infections and the degree of protection against adverse environmental influences. This increases the efficiency of ferreteria, and reduced time of reception of iron preparations, which significantly limits their toxic effects on the body and prevents the development of complications.

The technical immunopathy at IDA in CDB as follows: sick children prescribe a comprehensive treatment, providing for the removal of antigenic load (separation of the child from children's groups, limiting the influence of adverse medical and social factors, rehabilitation centers infections in the family), detoxification, metabolic correction, immunomodulation and ferreteria.

Recommended: health-protective mode, balanced diet, balanced on the basic food ingredients. Is sanitation foci of infection and restore drainage function of bronchial tree traditional methods.

At the initial stage of treatment prescribed smectite (up to year - 1 sachet per day, with 1 to 2 years - 2, over 2 years - 2-3 bags a day) or activated charcoal (preschoolers - 0.5-1.0 g, schoolchildren - 1.0-1.5 g 2-3 times a day) for 7-10 days depending on the severity of endotoxemia, the cholagogue collecting herbs (calendula officinalis, corn silk, dandelion, immortelle sandy, dill vegetable), prepared according to the standard technique for 50-150 ml three times a day; Mezim-Forte (from 3 to 6 years: 1-2 tablets, over 6 years - 2-3 pills a day) and hilak-Forte (infants 15 to 30 drops, the older 20-40 drops three times a day) for 2-3 weeks.

The next stage involves Corr is Arsim) children/m daily N 10; Pantothenate calcium for children under 3 years of 0,005 grams, from 3 to 14 years 0,1-0,2 g reception, 2 times a day and lipoic acid - children up to 7 years - 0,012 g over 7 years - 0,012-0,024 g 3 times a day for 20 days, after receipt of which designate the pyridoxal phosphate 0,005-0,01 g/m daily N 10 in combination with methyluracil (from 3 to 8 years - 0.25 g, over 8 years of 0.25-0.5 g three times daily) and trivita (preschool - 1 capsule, students 1-2 capsules per day) or WETROOM (from 1 year to 6 years - 0.3 ml, over 6 years of 0.45 ml daily) for 3-4 weeks.

After metabolic correction to the treatment of attach immunotropic tools: broncho-munal 1 capsule 1 time a day for 10-30 days in the acute period and then 10 days for 3 months and sodium nukleinat 0.01-0.05 g children under 5 years, 0.05 g - 6 to 12 years and 0.1-0.2 g - over 12 years to 2-3 times a day for 10-30 days.

In remission appoint ribomunyl in the first month 3 1 pill once a day, in the morning, on an empty stomach for 4 days the first 3 weeks of the month and then within 2-6 months 3 tablets 1 per day in the first 4 days of the month; adaptogens (tincture of Siberian ginseng - 1-2 drops per year of life or a ginseng - 1 drop per year of life 2-3 times a day) for 30-40 days. Lej, Physical therapy, aerosol therapy), herbal medicine (collection part 2-3 plants with immunomodulatory action: licorice root, violet, dandelion, grass and thyme, prepared according to the standard technique) within 2-3 weeks. Telezapper (veraplex, activeren, tardyferon, geotechnological, ferro-gradumet and others) apply during the entire period of treatment in a therapeutic dose (children age 5-8 mg/kg body weight, 1 to 3 years - 100 mg per day, 4-6 years 100-150 mg, 7-14 years of 150-200 mg) up to 1-1,5 months and supportive (in half-therapeutic dose) up to 1-1,5 months. Telestereo complement taking blood infusion from the leaves of nettle, Bidens tripartite, strawberry and rose fruit (collection prepared by the method of C. J. Shustov et al., 1985) 50-100 ml on an empty stomach 3-4 times a day for 1-1 .5 months.

Example 1. Sick,, 3 years old (case history N 184) was observed with a diagnosis of iron-deficiency anemia is severe. SOP.: CDB (immunopathy with a predominance of infectious syndrome).

Complaints of weakness, loss of appetite, sleep disorders, predisposition to prolonged and recurrent infections.

Objective: expressed trophic changes in the skin and mucous membranes. Increased time is to palpation. Muffled heart sounds, systolic murmur, heart rate reduction of 120 per minute. Tongue dry. Abdomen soft, liver at the edge of the costal arch, the spleen is not enlarged. The chair is unstable.

Laboratory studies: hemoglobin 75 g/l, erythrocytes - 3,01012/l, leukocytes 5,1109/l, eosinophils - 3%, stab - 2%. Segmented neutrophils - 62%, lymphocytes 30%, monocytes - 3%, ESR - 10 mm/h Total protein blood - 54 g/l, serum iron - 3.6 µmol/l, TIBC - 83,9 µmol/l, CST - 4,2%, ferritin - 1.5 ng/ml Immunoglobulin serum: IgA - 0,48 g/l, IgG and 9.1 g/l, IgM - 0,76 g/l; T-lymphocytes - 55%, phagocytosis - 54%.

Treatment: medical-protective mode, nutrition, sanitation nasopharynx and restore drainage function of bronchi traditional methods.

Ferropleks - 1 pill three times a day for 1 month, then a maintenance dose of 1 pill twice a day for 1.5 months, Antianemic infusion of 50 ml three times a day for 1 month.

At the same time was appointed smecta 1 service 2 times a day for 10 days, hilak-Forte 20 drops 3 times a day and Mezim-Forte - on 1 tablet 2 times a day; choleretic herbs 1 teaspoon 3 times a day for 3 weeks.

After metabolic correction was used bronchosan 1 capsule 1 time a day for 10 days and then 10 days for 3 months. In the period of remission was prescribed tincture of Siberian ginseng three drops twice a day for months, conducted medical treatment (air baths, swimming, massage, exercise therapy) according to standard techniques.

As a result of treatment installed the improvement of blood: hemoglobin - 125 g/l, erythrocytes - 41012/l, leucocytes - 6,0109/l, serum iron - 28.6 μmol/l, ferritin -31,7 ng/ml, IgA - 1.01 g/l, IgG - 8,9 g/l, IgM -1,21 g/l, T-lymphocytes - 60,33%, phagocytosis - 62,36%. Improved appetite, sleep, mood. Decreased frequency of colds up to 3-4 times per year, significantly reduced the number of complications.

Thus, the result of complex therapy is to increase the efficiency and reduce the time of gelaterie reducing morbidity of children. Restoration of immunological reactivity and stability of the child's body to infection contributes to scene 2-3 months that is, reduced to 2-3 times the duration of treatment, which significantly limited the toxic effects of iron supplements on the child's body and prevents the development of side effects and complications.

Comprehensive PermaCrete increases the efficiency of traditional ferreteria and provides disease-free for anemia in children - residents of the industrial city with a developed chemical and petrochemical industry. Timely correction of immune homeostasis in the FIC with sideropenia reduces the risk of formation of foci of infection, recurrence and chronic, as well as increases the degree of protection of an organism to adverse environmental influences.

Seems to be a promising application of this scheme of treatment in frequently ill children who are residents of ecologically unfavorable regions, anemia have different relapsing course and resistance to traditional ferreteria.

This method is applied in the treatment of anemia in 373 FIC in age from 3 to 14 years old, living in an industrial city with a developed chemical and petrochemical industry and can be used by pediatricians together with pulmonologists, immunologists and other Rogovaya in a large industrial city with a developed chemical and petrochemical industry, by ingestion of iron-containing medications, metabolic correction, immunomodulation, characterized in that the first conducting the remediation of foci of infection traditional methods and detoxification by assigning smecta or activated charcoal within 7 - 10 days, choleretic herbs, Mezim-Forte and hilak-Forte for 2 to 3 weeks, then carry out metabolic correction using cocarboxylase daily N 10, calcium Pantothenate, a-lipoic acid for 20 days, then replace them on the pyridoxal phosphate daily N 10 and methyluracil, trivet within 3 - 4 weeks after metabolic correction are immunomodulation by branhamella and sodium nukleinat; in remission inwardly ribomunyl and tincture of Siberian ginseng or a ginseng.

 

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