Method for producing health resort treatment result prognosis estimation in treating children for ecological adaptation syndrome

FIELD: medicine.

SUBSTANCE: method involves determining blood insulin I and thyroxin T content and phagocytic leukocyte activity (PLA). Activity coefficient is calculated on the basis of formula KA=IxPLA/T. KA value being found greater than 2.8 units, considerable amelioration treatment effect is predicted. The value being from 1.4 to 2.8 units, amelioration is predicted. KA being less than 1.4 units, lower treatment efficiency is predicted.

EFFECT: high reliability of prognosis.

 

The invention relates to medicine, namely, balneology.

There is a method of prediction of treatment efficacy by regression-correlation analysis of the relationship of the series of selected indicators at the beginning and end of treatment and the availability of reliable pair correlation build linear regression predictive model of this relationship (Ngubo, Umesi "Mathematical prediction results of Spa therapy" in Proc. "Application of mathematical methods and computational techniques in balneology", Pyatigorsk, 1978, P.37-41).

This method has several disadvantages, narrowing its application. First, it allows us to predict only one option of treatment efficiency, not overall performance. Secondly, the lack of veracity of the above correlative connection makes such a prediction is impossible.

The proposed method does not have these disadvantages. It is that before the treatment is determined in blood insulin And thyroxine (T)and phagocytic activity of leukocytes (FAL), and then determine the activity coefficient according to the formula:

KA=AND×FAL/So

The method is as follows. Before treatment, the patient using radioimmunoassay or enzyme immunoassay is determined blood levels of insulin And thyroxine (T)method And the ANOVA and Chukhlovina (Ivanov A.I., Chuchalin B.A. TO the method of determining the absorptive and digestive ability of neutrophils. - Lab. case, 1967. No. 10. - S-613.) - phagocytic activity of leukocytes (FAL). Calculated activity coefficient according to the formula:

COP=×FAL/So

When the value of KA of greater than or 2.8%, expected therapeutic effect in the form of significant improvements, if the value is in the range from 2.8 to 1.4% improvement.

The value of KA, the smaller 1,4 units, characterized by a lower therapeutic effects. In this case, having a poor prognosis, the doctor is able to provide potentiation of the effect of natural physical factors through an additional purpose sorbents, biologically active substances, and, if necessary, medication. This situation often occurs when the rehabilitation of children with the syndrome of environmental maladjustment and particularly in the human thyroid system in children, arrived at the resort from areas of high background radiation.

The method can be illustrated by the following examples:

1. Patient Balagurov Il - 13 years old, live in the Orel region, PowerGUI. Was in Zheleznovodsk children's sanatorium named After N.K. from 3 June to 5 July 2000. Case history No. 639.

At admission she complained of fatigue and anxiety, persistent headaches, golovokrugenie is, disturbed sleep (hard to fall asleep), increased sweating, lack of attention, poor memory, nausea, abdominal pain when improper diet, constipation.

Objective: Weight - 31 kg Tongue coated thick white coating. Abdomen slightly swollen, palpation tenderness in the right hypochondrium. Gallbladder symptoms positive.

Muffled heart sounds. ECG - violation of myocardial metabolism. Ultrasound examination of the thyroid gland revealed the presence of signs of hyperplasia of I-II degree.

Psychological tests detected signs of impaired memory and attention.

Method radioimmunoassay analysis of the content of insulin (9 a/ml), thyroxine (88 nmol/l), and a method of Ivanov and Chukhlovina - phagocytic activity of leukocytes (56%). When these indicators activity coefficient was equal to 5.7%

Given the presence of functional disorders of the nervous, emotional, cardiovascular, digestive, immune and endocrine systems, diagnosed with the syndrome environmental maladjustment.

The medical complex included: sparing regimen, diet, morning hygienic and remedial exercises (daily), massage (10 procedures), mineral baths (t 36-37°C, 10 minutes, 10 treatments per course). Internal intake of mineral water assistless the rate of 5 ml per 1 kg of body weight of the child, ie, 150 ml, 3 times a day, 45 minutes before a meal.

In the Spa treatment the girl disappeared complaints about fatigue and anxiety, headaches, dizziness, increased sweating, nausea, and abdominal pain. Normalized sleep and chair, disappeared a white coating on the tongue, was not determined gallbladder symptoms and palpation tenderness in the right hypochondrium. Heart sounds are clear and loud. When psychological testing revealed an updated picture with a clear focus and increased productivity memorization. The girl gained weight 2 kg

The laboratory analysis revealed positive dynamics of indicators: insulin (12 a/ml), thyroxine (128 nmol/l), phagocytic activity of leukocytes (81%).

Given the normalization of clinical and paraclinical signs on the back of good General condition of the child, the Spa treatment is regarded as a significant improvement. Therefore, we confirmed the prognostic value of the activity coefficient before treatment.

2. Patient Jigulina Ira - 14 years old, live in the Ryazan region, the village of Pronsk. Was in Zheleznovodsk children's sanatorium named After N.K. from 8 January to 20 February 2000. Case history No. 125.

At admission she complained of fatigue and anxiety, persistent headaches, goloworez the tion, disturbed sleep (hard to fall asleep), increased sweating, impaired attention, poor appetite, nausea, abdominal pain when improper diet, constipation.

Objective: Weight 57 kg Tongue coated white bloom. Abdomen slightly swollen, palpation tenderness in the right hypochondrium. Gallbladder symptoms positive.

Special testing confirmed the deterioration in the quality of attention.

Method radioimmunoassay analysis of the content of insulin (8,1 the ua/ml), thyroxine (130 mol/l), and a method of Ivanov and Chukhlovina - phagocytic activity of leukocytes (42%). When these indicators activity coefficient was equal to 2.6%

Given the presence of functional disorders of emotional, nervous, digestive, immune and endocrine systems, diagnosed with the syndrome environmental maladjustment.

The medical complex included: sparing regimen, diet, morning hygienic and remedial exercises (daily), massage (10 procedures), mineral baths (t 36-37°C, 10 minutes, 10 treatments per course). Internal intake of mineral water was carried out at a rate of 5 ml per 1 kg of body weight of the child, that is, 200 ml, 3 times a day, 45 minutes before a meal.

In the Spa treatment the girl disappeared complaints about fatigue and anxiety, headaches, golovokruzhen is e, increased sweating, decreased appetite, nausea, and abdominal pain. Normalized sleep and chair, disappeared a white coating on the tongue, was not determined gallbladder symptoms and palpation tenderness in the right hypochondrium. But this only marginally improved the ability to concentration of attention. The girl gained weight 0.5 kg

The laboratory analysis revealed positive dynamics of indicators: insulin (8,5 the ua/ml), thyroxine (144,42 nmol/l), phagocytic activity of leukocytes (45%).

Since when expressed favorable dynamics of all clinical signs (except productivity remember), there was a normalization of indices of insulin, thyroxine and phagocytic activity of leukocytes, the treatment outcome was defined as improvement. Thus, the effect corresponds prognostic factor activity before treatment.

3. Patient Pashchenko Sasha - 8 years old, live in the Bryansk region, the village Pogar. Was in Zheleznovodsk children's sanatorium named After N.K. from 30 September to 2 November 2000. Case history No. 321.

At admission she complained of fatigue and anxiety, persistent headaches, dizziness, disturbed sleep (hard to fall asleep), segoviana, increased sweating, impaired memory and attention, the symptoms of disinhibited the spine, reduced appetite, belching, nausea, abdominal pain when improper diet, constipation.

Objective: Weight 29 lbs. Tongue coated white bloom. Abdomen slightly swollen, palpation tenderness in the right hypochondrium. Gallbladder symptoms positive.

Psychological testing revealed noticeable changes in the quality of memorization and sosredotachivanie.

Method radioimmunoassay analysis of the content of insulin (3,31 the ua/ml), thyroxine (311,26 nmol/l), and a method of Ivanov and Chukhlovina - phagocytic activity of leukocytes (56%). When these indicators activity coefficient was equal to 0,59%

Given the presence of functional disorders of the nervous, emotional, digestive, immune and endocrine systems, diagnosed with the syndrome environmental maladjustment.

The medical complex included: sparing regimen, diet, morning hygienic and remedial exercises (daily), massage (10 procedures), mineral baths (t 36-37°C, 10 minutes, 10 treatments per course). Internal intake of mineral water was carried out at a rate of 5 ml per 1 kg of body weight of the child, that is, 100 ml, 3 times a day, 45 minutes before a meal.

In the Spa treatment, the boy did not eliminate complaints about fatigue and anxiety, headaches, dizziness, increased sweating,decreased appetite, belching, nausea, and abdominal pain. Not normalized sleep and chair, preserved white coating on the tongue, gallbladder symptoms and palpation tenderness in the right hypochondrium. Has not changed indicators of psychological testing. The boy had not gained weight.

The laboratory analysis revealed no positive dynamics of indicators of insulin (5,57 the ua/ml), thyroxine (362,22 nmol/l) and phagocytic activity of leukocytes (68%).

Because after resort of course there were no changes in the overall health of the child, as well as laboratory parameters, treatment outcome was defined as no improvement, which is fully consistent prognostic factor activity before treatment.

The activity coefficient can theoretically be justified as follows. Insulin is the only one in the body anabolic hormone, thyroxine, a hormone catabolic, phagocytic activity of leukocytes, a process that ensured an active metabolism, so the formula KA=AND×FAL/T characterizes the activity of the metabolism, which determines the effect of treatment.

Was studied 55 children with radiation history of 7-14 years of age, were treated in the sanatorium them. Krupskaya (greatnews). Analyzed values of KA in children discharged with significant improvement (I-group I, 20 patients), improved the eat (II-I group, 20 patients) and without improvement (III-I group, 5 patients).

Significant improvement is the effect of sanatorium-resort treatment with complete disappearance of all objective and subjective symptoms of the disease and normalization of laboratory parameters improved - positive clinical effect in incomplete normalization of laboratory parameters, without improvement - no change in the child's General condition and laboratory parameters.

The value of KA to treatment in the first group consisted of 3.75±0,83%, the second - 1,37±0,19% (P<0,01). The scatter option in the control (group II) was equal to σ=0,61. Confidence interval M±tσ this was equal to 1.37±1,37 units, i.e. 0-2,8 units of KA Values, large 2,8%, can be attributed to the group's "significant improvement", the KA values in the range of 2.8-1,4 units to a group of "improvement", and that at lower values - "no improvement".

In the dynamics of treatment determined a clear parallelism between the treatment effect and the degree of positive dynamics of clinical effect. So, in the group of children discharged with significant improvement, the value of CA increased with 3.75±0,83 to 11.6±1,41% (P<0.00004)improvement - from 1.37±0,19 up to 3.92+0,88% (P<0,02). Therefore, the activity coefficient calculated initially, makes it possible to predict the clinical effect of Spa therapy of the above is contingent on the sick.

The way prognostic evaluation of the results of the Spa treatment of children with the syndrome environmental maladjustment, characterized in that before the treatment to determine blood levels of insulin, thyroxine (T) and phagocytic activity of leukocytes (FAL), on the basis of these indicators, calculate the activity coefficient according to the formula KS=And·FAL/T and the value of KA of greater than or 2.8%, predict therapeutic effect in the form of significant improvements, if the value is in the range of 2.8 to 1.4% - improvement, the value of KA is less than 1,4 units characterized by a lower therapeutic effect.



 

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