Treatment of children with functional cardiopathy

 

(57) Abstract:

The invention relates to medicine, and is intended for the treatment of children with functional cardiopathy. The interference therapy spend apparatus of the "AIT" fronto-occipital technique in the adaptation period of two days in a row, then a day, and 1 procedure release when the frequency of the pulses 90-100 Hz - 3 minutes, followed by frequency of 50-100 Hz - 3 min; 2 procedure - frequency amplitude modulations 0-10 Hz to 3 minutes with a further switch handle frequencies of 50-100 Hz to 4 minutes; 3 procedure set the frequencies of 50-100 Hz to 4 minutes with the transition to the mode 0-100 Hz to 5 minutes; 4-10 procedure release when the frequency range 0-100 Hz to 10 minutes hydrogen sulfide baths spend days free from interference therapy girls when hydrogen sulfide concentration of 25-50 mg/l, boys 50-100 mg/l over the course of 10 physiotherapy and 8 hydrotherapy. The method allows to increase the effectiveness of treatment of children with functional cardiopathy. 3 table.

The invention relates to medicine, namely Pediatrics, and can be used in the treatment of children (boys and girls) aged 12-14 years with functional cardiopathy, on the basis of the syndrome, neurocirculatory dystonia.

Currently, the first of Menza (functional cardiopathy), the prevalence of which according to Y. M. Belozerova is 13.7%.

Functional cardiopathy is a disease neurogenic nature, based adaptation failure or disorders of the neuroendocrine regulation of the cardiovascular system, which is manifested multiple cardiovascular symptoms (cardialgia, tachycardia, vascular dystonia and other) in the absence of pathological changes in the heart.

The underlying functional cardiopathy violations kortiko-visceral interactions taking place via the hypothalamic-pituitary system, lead to disorder of homeostasis, i.e., suffers the security and reliability of all systems, primarily cardiovascular. Most often, the primary adaptation failure occurs at the level of the cerebral cortex (psychogenic) or at the level of the hypothalamus (nonspecific stress, infections, hormonal reorganization). However, further leads to dysfunction at the level of the peripheral autonomic system, mainly sympathoadrenal. The close relationship of all parts of the nervous system performs a variety of clinical symptoms and complicates the identification of "primary level p is water-electrolyte metabolism, acid-base balance. The result is a reduction obsesiones reserves portability various influences of the external environment, the lack of resistance to stressful situations, reduced physical and mental performance.

Vegetative dystonia in children and adolescents often acts not only as a transitional state between normal and disease, but also is an independent risk factor for atherosclerosis and coronary heart disease at a young age, so the development of effective methods of prevention and treatment remains a problem of practical Pediatrics.

Recently there has been an increase in the sensitivity of the population to various medicinal substances. In this regard, the use pathogenetic methods of physiotherapy has become an integral part of a comprehensive treatment and rehabilitation of patients with various diseases.

In modern physiotherapy special attention is given pulse effects, allowing to reduce the energy load on the child's body, to have a selective effect, to get a more pronounced reaction in comparison with a continuous g the rhythm of the organ or system.

A new perspective in Pediatrics has been the impact of interference currents.

When assigning interference therapy (it) creates conditions for direct stimulation of interrelation with, in neurophysiological concepts, polymodal afferentation properties with a wide range of responses of the body.

Currently, proven active influence of interference therapy on the autonomic nervous system, travelinformation, trophic tissues, muscle tone.

The diversity and versatility of the actions it has led to their use in medical therapy in adults with hypertension, discirculatory encephalopathy, gallbladder dyskinesia on hypertonic type. In pediatric practice, there are only a few reports of the use of it.

Small energy load on the child's body, soft effect, a large range of dosing options determine the current perspective it use in Pediatrics.

Whereas pathogenetic features of the development and progression of functional cardiopathy, justified the inclusion of the complex Spa therapy the action of hydrosulphuric baths, which is released when the concentration of hydrogen sulfide 25-50-100 mg/l, with a duration of 8-12 minutes, when the water temperature is 36-37oWith in a day, or two days in a row with a day break in the course of 12-15 baths regardless of gender.

However, the known method does not give the desired result, the treatment extended to 45 days, without regard to the sex of the baby.

Scientific research of the previous years in the children's Department of the Sochi SIC balneology and rehabilitation in the study of the influence of hydrogen sulfide water (shared baths) in different modes according to the concentration of hydrogen sulfide in the organism of children of different sex with functional cardiopathy, installed unequal influence on the processes of lipid peroxidation. Girls were more resistant to low concentrations that may be associated with several early hormonal changes, and therefore the girls was the recommended course of hydrogen sulfide baths with a concentration of hydrogen sulfide 25-50 mg/l In boys as the use of dilute hydrogen sulfide water balneotherapy caused an increase in the activity of processes of lipid peroxidation, resulting in them recommended to use high 50-100 mg/l of hydrogen sulfide concentrations PR is clonally cardiopathy on the basis of the syndrome, neurocirculatory dystonia, and the study of clinical effectiveness of it, development of method for combined use of interference therapy and shortened course mos balneotherapy with concentration, depending on the sex of the baby, the reduction of treatment time up to 26 days, increase the adaptive properties of the body by improving the neurovegetative regulation of the cardiovascular system, increases tolerance to physical activity.

This object is achieved in that the interference therapy spend apparatus of the "AIT" fronto-occipital technique in the adaptation period of two days in a row, then a day, and 1 procedure release when the frequency of the pulses 90-100 Hz - 3 minutes, followed by frequency of 50-100 Hz - 3 min; 2 procedure - frequency amplitude modulations 0-10 Hz to 3 minutes with a further switch handle frequencies of 50-100 Hz to 4 minutes; 3 procedure set the frequencies of 50-100 Hz to 4 minutes with the transition to the mode 0-100 Hz - 5 minutes; 4 through 10 procedures released in the frequency range 0 - 100 Hz to 10 minutes. And hydrosulphuric baths spend days free from interference therapy girls when hydrogen sulfide concentration 25 - 50 mg/l, boys 50-100 mg/l over the course of 10 physiotherapy and 8 hydrotherapy. Parameters transcranial effects on fronto-occipital technique interferentsionnyiy girls when hydrogen sulfide concentration of 25-50 mg/l, and boys 50-100 mg/l duration from 4 to 10 minutes with the increase in each subsequent procedure for 1 minute. Course 10 physio - and 8 hydrotherapy.

The vacation scheme procedures are presented in table.2.

The method is as follows.

In the period of adaptation of the child to the resort, after clinical examination, spend two days in a row, the interference therapy for fronto-occipital technique, then every other day (table. 2). In the days free from interference therapy spend mos balneotherapy at the concentration of hydrogen sulfide boys 50-100 mg/l, girls 25-50 mg/l as total baths when water temperature is 36-37oWith, lasting from 4 to 10 minutes, increasing follow-up procedures for 1 minute.

In the course of 10 physiotherapy and 8 hydrotherapy.

Advantages of the proposed method is the simplicity of construction, low energy load on the child's body, soft effect, the use of transcranial methodology facilitates rapid adaptation of the child to the resort, as well as the gradual adaptation of the child to powerful factor - mos balneotherapy, which helps to reduce the duration of stay of 22 days.

P the family with 23.08 - 19.09.1999 year. Was admitted to our Department with a diagnosis of Neurocirculatory dystonia. Cardiopathy. Chronic pharyngitis.

At the time of admission complained of stabbing pain in the heart when emotional stress, headache, fatigue, instability of mood.

History of present illness: there is a pediatrician, kardeorevmatologii within 3 years. Received outpatient treatment for neurocirculatory dystonia in the spring and autumn period: sedative herbs, restorative therapy cardiotropic. In 1998, has been treated in local motels with little effect.

Data of objective examination: satisfactory condition. The shape is correct, adynamic. Skin and visible mucous clean, pale pink color. Pocono-fatty tissue moderately developed. The Quetelet index equal 19,0. Tonsil gipertrofirovannyy to I, Art. II, no raids. The lymph nodes are not enlarged, b/painful to palpation. Borders of relative heart dullness within the age norm. Heart sounds are clear, rhythmic, heard the average intensity of the systolic murmur at the apex and V point. HELL 100/60 mm RT. Art., pulse 100 beats per 1 minute is detected. Mensis 12 years, has been established, b/painful load and with poor 5-6 days.

Survey data (before treatment):

Complete blood count: b - 125 g/l, L - 4.0109/l e - 4% P - 3%, 64%, L - 21%, M - 8%, ESR - 11 mm/h, the adoption rate of 0.33 (p-tion workout).

ECG: sinus arrhythmia, the vertical position of the electrical axis of the heart. Breath - rhythm is correct.

Biochemical blood test: weight peptides - 0,248 srvc. units , catalase serum 37.6 ľkat/l, tseruplazmina - 0,291 g/l, total lipids 2,42 g/l, diene conjugates in plasma lipids blood - 2,67 Rel. units, malonic dialdehyde erythrocytes is 48.6 nmol/ml, malonic dialdehyde erythrocytes is 20.1 nmol/mg

Clinorotation sample - binarycoalescence variant samples.

Veloergometry: achieved 75 watt (450 KGM/min), the work is done 2700 KGM/min, the work is done per kg/weight of 72.9, consumption O2- 1.55V, double work - 252,8.

The survey diagnosed with Functional cardiopathy. Neurocirculatory dystonia puberty. Chronic compensated tonsillitis. Chronic pharyngitis.

The girl assigned to the treatment by the proposed method:
the PAP by p I;

- interference therapy with 4 days of adaptation two days in a row, follow-up procedures through the day, a course of 10 treatments;

- General hydrosulphuric baths at a concentration of hydrogen sulfide 25-50 mg/l at a water temperature of 36oWith duration from 4 to 10 minutes with the increase in each subsequent procedure for 1 minute, a day, a course of 8 baths. The treatment scheme is shown in table.2.

During treatment, the girl was examined by 12 times, was well tolerated as a first procedure, interference therapy, and follow-up. On the first, fifth and tenth interference therapy procedures were carried out measurement of blood pressure and heart rate as before the procedure and after. Significant fluctuations in blood pressure and heart rate were not observed. The first procedure, interference therapy, the girl moved well. No complaints or side effects, which allowed to connect to therapeutic complex of hydrogen sulfide baths. During treatment the child received the full course of treatment. Discharged with significant improvement, which resulted in the disappearance of pain in the heart, the head, increased efficiency, improved mood. Interquantile diseases did not hurt.

Survey data after treatment:

Complete blood count: b - 130 g/l, L - 4,5109/l e - 1%, L is Noah blood increased hemoglobin, white - improved formula blood, decreased the percentage of eosinophils, increased adoption rate.

According to the self-assessment questionnaires - from moderately vigorous turned into a lively, which resulted in improving the mood, the disappearance of fears.

On the ECG is normal.

Clinorotation sample - normostenichesky option.

The purpose is achieved capacity 91,7 W (550 KGM/min), the work performed is increased to 3900 KGM/min per kg/body mass 102,6 KGM/min/kg, Consumption OF2increased to 1.67, double product increased to 290,4. The measure of the work done has increased tolerance to physical load has increased.

Biochemical blood test: weight peptides - 0.185 services. units, catalase serum - 22.6 ľkat/l, tseruplazmina - 0,201 g/l, total lipids 4,56 g/l, diene conjugates in plasma lipids blood - 5,11 Rel. units, malonic dialdehyde erythrocytes was 59.9 nmol/ml, malonic dialdehyde erythrocytes of 13.1 nmol/mg

Thus, during the treatment by the proposed method the girl had recovered their health, well-rested, improved mood, increased physical performance, discharged with considerable ului and rehabilitation 22/08-18/09.99, with a diagnosis of autonomic neuropathy, PMK posture.

At the time of inspection complained of pain in the heart, a feeling of "awe", on a periodic headaches after school, fatigue, irritability, anxiety, fear, gloomy thoughts.

Went along with clinical methods of examination special: electrocardiography, clinorotation test, graded exercise test (at step increasing the load test PWC 170), and lipid peroxidation. Examined was an ENT doctor, dentist.

The survey diagnosed with Functional cardiopathy. Neurocirculatory dystonia vacatoncustom type. Chronic pharyngitis. The posture.

ECG: sinus arrhythmia.

The vertical position of the electrical axis of the heart. Signs of vagotonia. Clinorotation sample - simpaticotonici option. He was assigned to the treatment by the proposed method:

- adaptation 5 days;

- diet 15;

- climatotherapy at p I-II;

- Physical therapy, cardiovascular group p II;

- interference therapy with a 4-day adaptation two days in a row, the subsequent procedures were released after a day on the course 10 procedres procedure from 4 to 10 minutes with the increase in each subsequent procedure for 1 minute, one day later, at the rate of 8 baths.

After treatment clinorotation sample normostenichesky option.

Biochemical study of lipid peroxidation and antioxidant defense: decreased diene conjugates with 2,84 to 2.54, malondialdehyde erythrocyte mass 46,8 to 44.8 nmol/ml, malondialdehyde with 12.7% and 12.4 nmol/mg of catalase from 27.1 to 26.4 ľkat/l, tseruplazmina of 0.333 to 0,322 g/L.

After treatment has come a positive change in the reaction of the cardiovascular system to physical activity. Accelerated recovery period. Positive changes in the response of the cardiovascular system to physical activity in the treatment process physical factors contributed to the improvement of muscle endurance work, resulting in increased power of the performed work. Increased physical performance (table. 3).

During treatment, the boy was examined by 12 times, was well tolerated procedures as interference therapy, and total hydrogen sulfide baths. Discharged with significant improvement, which resulted in the disappearance of complaints increased efficiency.

To assess the effectiveness of pre-Christ. - 40 children, 20 girls and 20 boys with functional cardiopathy received interference therapy for fronto-occipital technique, through the day, a course of 10 treatments.

Group II - 40 children (20 girls and 20 boys) received interference therapy by the same method on a course of 10 treatments, every other day in combination with hydrogen sulfide baths concentration of hydrogen sulfide for boys 50 - 100 mg/l for girls, 25 - 50 mg/l after day, at the rate of 8 baths.

All groups are identical disease, age (children puberty 12-14 years old).

In table.3 shows the dynamics of indicators of physical health in groups.

Thus, after treatment occurred, positive changes in the indicators of the functioning of the cardiovascular system and its response to physical activity: established favorable type her responses, increased physical performance. As can be seen from the table.3, the most reliable indicators were in group II patients.

Sources of information

1. Bogolyubov C. M., Ponomarenko, N. General physiotherapy. - M.-St. Petersburg. 1997.

2. Bogolyubov C. M. Handbook of sanatorium-resort selection. -M - 1986. - 342 S.

3. Bykov, M. C., Bogolyubov Century children patients with bronchial asthma // Matters. balneology, physiotherapy and physical education. - 1996. - 2. - S. 15-18.

4. Dovganyuk A. P. , Vukcevic D. L. Interference Therapy // Matters. a resort., physiotherapy and physical education. - 1992. - 2. - S. 62-67.

5. Yezhov centuries the Effectiveness of electrotherapy pulse currents of different frequencies, with the combined forms of cerebrovascular and vertebral pathology // Matters. a resort., physiotherapy and physical. culture. - 1995. - 4. - S. 17-19.

6. Recalls M,, Tyurin N. A., Ibragimov, F. and other connective tissue Dysplasia and level protivougonnykh antibodies in children with arrhythmias // Pediatrics. - 1998. - 6. - S. 26-29.

7. Kurochkin A. A. Application of low-intensity laser radiation in the treatment of children and adolescents with vegetative dystonia // Actual problems of sanatorium care for children: proc. report of the scientific-practical conference. - M., 1999. - S. 159-160.

8. Makolkin Century. And. with co-workers. Functional cardiopathy / Method. recommendations. - M - 1979. - 16 S.

9. Ulaschyk B. C. New methods and techniques of physical therapy. -Minsk: Belarus. - 1996. - S. 31-34.

10. Ushakov A. A. Interference Therapy. - M.: ANMI, 1996. - S. 28-29.

11. KHAN M. A., Bykov, M. R., Balabolkin And anatomo-resort assistance to children: proc. report of the scientific and practical use. proc. - M., 1999. - S. 185-188.

Treatment of children with functional cardiopathy by the total hydrogen sulfide baths and interference therapy, characterized in that the interference therapy spend apparatus of the "AIT" fronto-occipital technique in the adaptation period of two days in a row, then a day, and 1 procedure release when the frequency of the pulses 90-100 Hz - 3 min, followed by frequency of 50-100 Hz - 3 min; 2 procedure - frequency amplitude modulations 0-10 Hz to 3 minutes with a further switch handle frequencies of 50-100 Hz to 4 minutes; 3 procedure set the frequencies of 50-100 Hz to 4 minutes with the transition to the mode 0-100 Hz - 5 min; 4-10 procedure release when the frequency range 0-100 Hz to 10 min, and hydrogen sulfide baths spend days free from interference therapy girls when hydrogen sulfide concentration of 25-50 mg/l, boys 50-100 mg/l over the course of 10 physiotherapy and 8 hydrotherapy.

 

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