A method for the treatment of children with primary arterial hypertension

 

(57) Abstract:

The invention relates to medicine, namely Pediatrics. After a five-day adaptation carry out ultrasonic inhalations brackish alkaline sodium bicarbonate, boric, with high concentration of fluoride mineral water at a flow rate of aerosol 5 l/min with a duration of 3 minutes followed by inhalation olive or stone fruit oil. Inhalation spend a day with a total hydrogen sulfide baths when water temperature is 36°With that let boys when hydrogen sulfide concentration of 50-100 mg/l, the girls 25-50 mg/l of hydrogen sulfide at the rate of 8 balneo - and 10 physical therapy. The method allows to increase the adaptive capacity of the organism and its tolerance to physical load. 3 table.

The invention relates to medicine, namely Pediatrics, and can be used in the treatment of children (boys and girls) aged 12-15 years with primary arterial hypertension syndrome of vegetative-vascular dystonia.

Cardiovascular disease is called the disease of the century because of their wide distribution and social significance. Such pathologies include hypertension in childhood. Posay adaptation in the face, challenging, it correlates with emotional status, anxiety, individual reactions to frustrating, causing tension, personality characteristics, and current mental status.

Due to the fact that in recent years a marked increase in cardiovascular diseases in childhood, including hypertension, it becomes extremely urgent problem of identifying high-risk groups and to study the factors contributing to the development of this disease. The risk factors for hypertension are: personality, changes in lipid metabolism, vascular embryopathy, pathology receptors of the vascular wall and endothelium, features ReninAngiotensin system, nutrition, environmental conditions, etc. extensively studied the role of heredity in the development of primary hypertension (PAG) in children.

Vegetative-dystonic cardiovascular disorders in children occur relatively late, which is associated with the maturation cardio-vascular system, usually on the background of pubertal body changes, combined with other, previously arisen or almost simultaneously with them, psychotomimetic prevention of cardiovascular disease in children and improving the efficiency of sanatorium rehabilitation and treatment of children with primary hypertension. In this sense the value of new highly effective methods with the use of non-standard combinations, including the use of mineral waters. When developing adaptive compensatory abilities of the body, any mineral water, including fluoride, have complex effects on the body due to its chemical composition.

It is noted that the internal use of fluorine-containing mineral waters (“Belly”) contributes to the activation of tissue enzymes liver, while normalizing the lipid metabolism.

In the mineral water “Bellies” discovered a number of biologically active components, such as fluorine, iodine, bromine, silicon and boron (in the form of the corresponding acids). Bor refers to biologically active trace elements and showed its high efficiency in the regulation regarding recovery and metabolic processes of the body, shows the most pronounced effect of this trace element in the process of reparative regeneration of the gastric mucosa.

It should be noted that in this mineral water is present in elevated concentrations of fluoride. In internal administration promotes the excretion from the human body for the s cell metabolism, that is really essential in the treatment of cardiovascular diseases, has a positive influence on calcium metabolism, has anti-arrhythmic action. The composition of water in addition to fluorine and boron are other components with distinct pharmacological properties: iodine, bromine, silicon, magnesium, calcium, etc. that have on the body is a complex action.

However, the unique chemical composition and physico-chemical properties of mineral waters require further in-depth research with a view to their differentiated medicinal use not only in the quality of drinking water, but in physiotherapy practice, in particular for transpulmonary the way of introduction in the form of an ultrasonic aerosol.

Given that an important place among the actuators PAG children play a violation of the processes of adaptation, justified the development of medical facilities for children with PAH, including the use of balneotherapy and ultrasonic inhalations using brackish alkaline sodium bicarbonate, boric fluoride mineral water, providing training, improves metabolic processes, restorative effect. The presence estadistas activity especially in the processes of excitation and contraction of the cardiac muscle, increase resistance it to oxygen starvation in the hemostatic system, immune status, improving adactive of the body, rapid excretion of toxic products of metabolism.

In the course of research in the development of the method of transpulmonary route of administration brackish alkaline sodium bicarbonate, boric with high concentration of fluoride mineral water in the body in the form of ultrasound (vysokodisperstnogo) aerosol was detected sufficiently high therapeutic effect. It is known that the dispersion of the drug increases the pharmacokinetics, pharmacodynamics, pharmacokinetic aerosol. Among the advantages of such a method of use of mineral waters - small volume flow of mineral water(1 patient up to 10 ml per procedure), which increases the throughput of physiotherapeutic treatments.

In the resort in rehabilitation at PAG in children is important and balneotherapy (mos baths), providing a clear cardiotonic, sedative, antioxidant effect.

There is a method of treatment of children with PAH pozitia from 5 to 10 min at a rate of 8-10 baths every other day ("Methods of treatment of natural and preformed physical factors in children with primary hypertension ". Methodical recommendations. - Sochi. - 1991).

However, the known method does not give the desired result, is not taken into account the concentration of hydrogen sulfide on the sex of the baby and when using this method, stable hemodynamic does not occur.

The technical result of the invention is to improve therapeutic efficacy and the development of new economically meaningful method of complex treatment of children with primary hypertension by enhancing the adaptive capacity of the organism and its tolerance to physical activity.

The technical result is achieved by the fact that after the five-day adaptation carry out ultrasonic inhalations brackish alkaline sodium bicarbonate, boric with high concentration of fluoride mineral water (“Belly”) at a flow rate of aerosol 5 l/min with a duration of 3 min followed by the inhalation of peach and stone fruit oil through the day with a total hydrogen sulfide baths, which released the boys at a concentration of water of 50 mg/l, the next - 100 ml/l of hydrogen sulfide and girls, respectively, 25-50 mg/l of hydrogen sulfide at the rate of 10 physiotherapy and 8 hydrotherapy (see tab. 1) the ora THOMEX L-2 (range drops of 0.5 to 8 microns, the effectiveness of mist 2.5 ml/min, the ability to regulate air flowed from 0 to 20 l/min, which allows you to properly dispense the amount entered in the respiratory tract medical substances). Procedure release in a separate room with permanent ventilation by model rules for ultrasonic inhalers. To obtain vysokodispersnyh aerosols using brackish alkaline sodium bicarbonate boron with high concentration of fluoride mineral water: content of orthoboric acid - 33,2 mg/DM3, metasilicic - 30.0 mg/DM3, fluoride - 4,8 mg/DM3, iodide 0.1 mg/DM3,(“Belly”).

Set the following parameters for the ULTRASONIC inhalations:

- the flow rate of aerosol 5 l/min;

the consumption of mineral water 5 cm3;

- duration inhalation aerosol 3 minutes

The course consists of 10 sessions over a day.

During the procedure, ULTRASONIC inhalations rhythm, frequency and depth of breathing normal and must comply with the conditions in the measurement of basal metabolic rate. Inhalation vysokodisperstnogo aerosol mineral water can be observed phenomena razdrazhenii olive or stone fruit oil.

The total hydrogen sulfide baths appointed with a 7-day stay of the child in the clinic at a water temperature of 36°C, with a duration of 5-10 min (increasing vacation each subsequent procedure for 1 minute) in a day with ULTRASONIC inhalations with mineral water “Bellies” when hydrogen sulfide concentration of 50-100 mg/l for mineral water “Bellies” when hydrogen sulfide concentration of 50-100 mg/l for boys, 25-50 mg/l of hydrogen sulfide for girls on the course 8 baths (table 1).

Example 1. Patient Maxim B., 13 years of age, was treated at the pediatric clinic Nicker with 04.01. - 28.01.2002, with a diagnosis of primary hypertension syndrome of vegetative-vascular dystonia.

Child 1 of pregnancy toxemia and nephropathy 1 degree, delivery on time, in the occipital previa. At birth, the body weight 3100,0. The neonatal period without features. Psihoticescoy development according to age. In 1999, after suffering a sore throat and began to complain of headaches, increased blood pressure to 130-140/80-90 mm RT.article Examined by a cardiologist, ophthalmologist, diagnosis: transient arterial hypertension. PMK 1 degree.

Received treatment: vascular neotrope, sedatives, vitamins, metabolites, physical. Dynamics is negligible. Ultrasonography pachistopelma in the centre clinic complained of headaches, weakness, fatigue, pain in the heart, segoviana, dizziness.

Objectively: height 173 cm, weight 65,5 kg Skin and visible mucous net. Muscle tone and subcutaneous fat developed satisfactorily. Tonsil loose, no raids. Peripheral lymph nodes are not palpable. Respiratory, digestive and musculoskeletal systems without pathology. Borders of relative heart dullness within normal limits. Apical impulse - Y m/p, the tones are muffled, rhythmic, short systolic murmur over the apex, V so the Pulse 84 beats/min blood pressure (right hand) 140/90 mm RT.article AD (left hand) 140/90 mm RT.article The results of the survey before the treatment: the blood - HB 150 g/l, L - 6,2·109/l e/3 P/1/66, L/26 M/3, ESR - 4 mm/h

Clinical analysis of urine within normal limits.

Biochemical blood test: weight peptides - 0,242.E., kata-Laza serum 34.9 µkat/l ceruloplasmin - 0,289 mg/l, diene conjugates, LIPI Dov plasma - 3, 53. units, malonic dialdehyde erythrocytes of 27.3 nmol/ml

The results of the ECG: rhythm 80 beats/min, RR-0,75", PQ-0,16" QRS-0,06", QT-0,34". Sinus rhythm. Vertical axis. Violation of intraventricular conduction.

Ultrasound of the kidneys without PA 105 BPM AD - 140/100 mm RT.art., 3 min II load - HR 111 beats/min, BP is 150/100 mm RT.art., 3 min III load - HR - 122 beats/min, BP is 160/100 mm RT.art., 3 min IV load - HR 127 BPM, AD - 170/100 mm RT.article During the recovery period (4 min) heart rate 86 beats./min, BP 130/80 mm RT.art., index DP (GARDEN×HR/100) - 216. Physical capacity - 650 kg·m/min. during Bicycle ergometry, III load 3 minutes began to complain of shortness of breath, headache, fatigue.

After the examination, on day 6 after adaptation to a child receiving treatment by the proposed method (table 1): ultrasonic inhalations brackish alkaline sodium bicarbonate, boric with high concentration of fluoride mineral water (“Belly”)at a flow rate of aerosol 5 l/min, with a duration of 3 minutes through the day No. 10 with subsequent inhalation peach oil in combination with hydrogen sulfide baths concentration of hydrogen sulfide 100 mg/l (introductory tub 50 mg/l) at a water temperature of 36°C duration from 5 to 10 minutes (exposure time of each of the following procedure increases by 1 min) No. 8, which released in the days free from the BONDAGE of inhalation.

After 4 treatments, the child disappeared complaints of fatigue, headaches, pain in the ser is all right. During exercise had no complaints. During treatment stabilized blood pressure within 110-120/80 mm RT.article Improved lipid oxidation and antioxidant protection: reduced the number of diene conjugates, decreased serum catalase and reduced ceruloplasmin. Came positive changes in the reaction of the cardiovascular system to physical activity. Improved portability of muscular work, resulting in increased power and work performed.

Survey data after treatment:

The purpose: the initial heart rate of 75 beats/min, BP 110/80 mm RT.art., for 3 minutes I load - HR 107 beats/min, BP is 130/90 mm RT.art., 3 min II load - heart rate of 125 beats/min, BP is 130/90 mm RT.art., 3 min III load - HR - 133 BPM, HELL -140/90 mm RT.art., 3 min IV load - heart rate is 150 beats/min, BP is 150/90 mm RT.art., 3 min V load - HR 158 beats/min, BP 160/80 mm RT.article.

During the recovery period (4 min) heart rate 95 beats/min, BP -120/80 mm RT.art., index DP - 253. Physical capacity - 850 kg·m/min.

Clinorotation sample - normostenichesky option. The treatment results in marked positive dynamics of clinical data: there are no complaints, active, sleep, calm, and treatment are shown in table 2.

Example 2. Patient Tatiana H., 14 years of age, was treated at the children's hospital center from November 2 - November 27, 2001 with a diagnosis of primary hypertension. Right thoracic scoliosis 1 tbsp. Girl 1 normal pregnancy, urgent delivery of mass 3400,0. Was rarely sick. Grew and developed accordingly. Since may 1999, for the first time began to disturb pains in the heart, dizziness, headaches, palpitations. It became quickly tired, emotionally labile, tearful. When examination revealed hypertension, BP - 140/90 mm RT.article Was treated in hospital, the diagnosis of primary hypertension. Scoliosis of the thoracic spine 1 tbsp.

Routine treatment is not received. Dynamics is negligible. Upon admission to the hospital center complaints on headache, increased irritability, tearfulness, pain in the heart, fatigue, palpitations, irritability.

Data of objective examination: height 157 cm, right physique, satisfactory power. Skin and visible mucous net. The asymmetry of the shoulders, shoulder blades. Tonsil loose. Palpable submandibular lymph nodes, a single, flexible, movable, bezbolesnie is rdca slightly muffled, on top and in so Botkin heard a short systolic murmur. Pulse 86 beats/min blood pressure (right hand) - 130/90 mm RT.art., AD (left hand) - 130/80 mm RT.article With the respiratory, digestive, excretory system revealed no pathology. Mensis 13 years, regular, load and with poor 5-6 days, slightly painful.

Survey data before treatment.

Complete blood count: HB-140 g/l, L-7·0×109/l, P/3, p/66, e/3, L/20, M/8, erythrocyte sedimentation rate of 12 mm/h

ECG - sinus arrhythmia. The normal position of the axis. Violation of intraventricular conduction.

Clinical analysis of urine within normal limits.

Ultrasound of the kidney - without a pathology.

ECG - moderate sinus tachycardia, heart rate 96 beats/min Normal position of the axis. Violation of intraventricular conduction.

Biochemical blood test: weight peptides - 0,270 srvc.ed., catalase serum - 35.9 µkat/l, 52,56 nmol/ml

The results of Bicycle ergometry: initial heart rate is 86 beats/min, BP - 130/80 mm RT.art., for 3 minutes I load heart rate of 115 beats/min, BP 140/80 beats/min for 3 min II load-HR 122 beats/min, BP 140/70 mm RT.art., 3 min III load - HR 143 beats/min, BP 150/70 mm RT.article 3 min IV load - HR 158 beats/min, BP 160/80. During the recovery period (4 min) - HR 97 BPM, HELL Nota power 100 watts). During Bicycle ergometry at 2 load have shortness of breath, fatigue at the end of IV load - dizziness.

Clinorotation sample - giperkatolichesky option.

After examination on day 6 of adaptation to a child receiving treatment by the proposed method (table 1):

ULTRASONIC inhalations brackish alkaline sodium bicarbonate, boric with high concentration of fluoride mineral water (“Belly”) in combination with hydrogen sulfide baths concentration of hydrogen sulfide 50 mg/l (introductory tub 25 mg/l) at a water temperature of 36°C, duration 5 to 10 minutes (exposure time of each of the following procedure increases by 1 minute), No. 8, which released in the days free from the BONDAGE of inhalation.

After 4-5 treatments disappeared complained of headache, dizziness, fatigue, palpitations. Improved emotional tone. HELL dropped to 120/80 mm RT.article General medical complex on the proposed method moved well. During treatment stabilized the HELL up to 110-120/80 mm RT.art, improved peripheral blood, antioxidant defense system, blood and lipid peroxidation in the form of lower levels of diene conjugates and malonic diaye shifts in the reaction of the cardiovascular system to physical activity.

Veloergometry after treatment: initial heart rate 80 beats/min, BP-110/70 mm RT.art., for 3 minutes I load - HR 109 beats/min, BP 120/80 mm RT.art., 3 min 2 load - heart rate of 125 beats/min, BP - 130/80 mm RT.art., 3 min III load - HR 139 beats/min, BP - 130/80 mm RT.art., 3 min - heart rate of 160 beats/min, BP is 140/80 mm RT.article 3 min IV load - HR 169 BPM, BP is 140/80 mm RT.article index DT - 237. The physical capacity of 750 kg·m/min (achieved power 125 W).

Clinorotation sample - normostenichesky option. The treatment results in marked positive dynamics of clinical data: there are no complaints, improved mood, increased efficiency, HELL decreased to 110-120/70-80 mm RT.art., heart sounds become zvuchanie. The girl was discharged with significant improvement. Evaluation of the effectiveness of treatment are shown in table 3.

A comprehensive evaluation of effectiveness was based on counting the number of signs (indicators) with favorable dynamics. When this is installed the following categories of assessments: a significant improvement - 11 signs with positive dynamics, improved - 6-10 signs of a slight improvement - 1-5 signs of deterioration - adverse changes.

To evaluate the effectiveness of the proposed method of treatment provedoria 12-15 years with primary arterial hypertension were treated by hydrogen sulfide balneotherapy in the form of hydrogen sulfide total baths with hydrogen sulfide concentration of 50 mg/l No. 8 in a day when the water temperature is 36°C duration of 5-10 min on the background of physical therapy, dosed walking, using sports games (prototype).

Group II - 30 children (boys and girls) aged 12-15 years with primary arterial hypertension were treated by the proposed method according to the scheme of leave procedures (table 1).

The treatment in both groups contributed to the favorable changes in subjective status. After treatment by the proposed method subjective complaints was stopped in both boys and girls, while in the treatment method prototype the number of complaints significantly reduced.

The formation of the PAG in children depends on the type of hemodynamics, i.e., the coordinated relationship between cardiac output and peripheral resistance to blood flow. In the group of children treated in the prototype, therapeutic effect identified in the hyperkinetic type of blood circulation by reducing stroke volume. In the group of children treated by the proposed method, accurate shifts marked with hyperkinetic type of circulatory and eugenetics and marked activation system antioxid and MDA both in the stroma of erythrocytes, and lipids.

Thus, the pronounced hypotensive effect, increased tolerance to physical load and consequently the improvement of the General condition and clinical benefits in the treatment by the proposed method observed in 83.3% of cases, the treatment according to the method-prototype - in 72.2% of cases.

Evaluation of the treatment effectiveness of the proposed method in example 1 are presented in table 2.

Evaluation of the treatment effectiveness of the proposed method in example 2 are shown in table 3.

Thus, the proposed method of treatment can improve therapeutic efficacy of sanatorium-resort treatment of children with primary hypertension on 11,10% by increasing the adaptive capacities of the organism and its tolerance to physical activity.

Literature used

1. Belokon N. A., Koberger M. B. heart Disease and blood vessels in children. - Moscow. - Medicine. - 1987. - T. 2. - S. 136-190.

2. Karachevtseva T. C. Therapy of various diseases in childhood. - Moscow. - Medicine. - 1988. - C. 802.

3. Ulaschyk B. C. New methods and techniques of physical therapy. - Minsk. - Belarus. - 1 lakticheskoj cardiology. J. Cardiology. - 1987. - №9.

5. Bogolyubov C. M., Ponomarenko, N. General physiotherapy. - Moscow. - Saint-Petersburg. - 1997.

6. Therapeutic mineral water “Bellies” guidelines. - Sochi. - 1997

7. Ivanov centuries the Main criteria for the evaluation of the chemical composition of mineral waters. - M, Centrometric. - 1982: GOST 13273-88. Drinking mineral water and curative - table.

8. Garkavi L. H., Cucina E. B. and other Adaptive response and resistance of organism. - Rostov-on-don. - 1990. - c.222.

9. Garkavi L. H., Cucina E. B. and other Signal indicators anti-stress reactions and stress in children. - Pediatrics. - 1996. No. 5. - S. 107-109.

A method for the treatment of children with primary hypertension by common hydrogen sulfide baths, over-against the background of physical therapy, dosed walking, using sports games through the day at a water temperature of 36°With a duration of 5-10 min, characterized in that after the five-day adaptation carry out ultrasonic inhalations brackish alkaline sodium bicarbonate, boric with high concentration of fluoride mineral water at a flow rate of aerosol 5 l/min duration of 3 nor free from inhalation boys when hydrogen sulfide concentration of 50-100 mg/l, girls - 25-50 mg/l, at a rate of 8 balneo - and 10 physical therapy.



 

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