Method for treating children for ecologically aggravated chronic cholecystitis accompanied with concomitant myocardial dystrophy

FIELD: medicine.

SUBSTANCE: method involves prescribing low mineralization water to drink and mud applications on liver and gallbladder area. The liver and gallbladder area is to be additionally exposed to extremely high frequency bandwidth electromagnetic field treatment as 4-6 s long pulses and pauses. Then, heart zones of Zakharyin-Gedda are treated within 5-10 min in nonmodulated mode. Then paired biologically active points of gallbladder meridian VB 24 (Ri-yue) are treated 3-5 min long per each biologically active point in modulation mode as 4-6 s long pulses and pauses. The total treatment course is 15 daily procedures long.

EFFECT: enhanced effectiveness of anti-inflammatory biliary excretion system treatment; improved blood microcirculation processes, lipid peroxidation processes; accelerated injured functions recovery.

3 tbl

 

The present invention relates to medicine, namely physiotherapy and gastroenterology, and is intended for the treatment of chronic cholecystitis with concomitant myocardial.

Allowoutgoing diseases are characterized by chronicity of, haste to medical appointments and frequent (seasonal) exacerbations. Diseases of the hepatobiliary system in children occupy the third position in the overall infant morbidity.

There is a method of treatment of chronic cholecystitis in children mud applications in the area of the liver, temperature 38-40°and With a duration of 15 minutes (Sapropels and their therapeutic use. Sverdlovsk. - 1994. - P.100-126). Limitations of application of this method is the presence of functional disorders of the cardiovascular system.

Closest to the present invention is a method of treatment of chronic cholecystitis in children by ingestion brackish water in a volume of 3-5 ml/kg of weight and mud applications temperature 38-40°and up to 15 minutes on the area of the liver (Methodical recommendations. The use of sapropelic mud and drinking mineral water in chronic inflammatory diseases of the biliary tract in children. Sverdlovsk. - 1979. - 8 S.). However, this method does not give sufficient effect in the treatment of EC is logoutresponse chronic cholecystitis with concomitant myocardial does not ensure sustainability of achieved positive results, does not activate properly choleretic and halucinations function of the biliary system, and moreover aggravates cardiac activity of cardiomyopathy.

The objective of the invention: improving treatment effectiveness by improving choleretic and halucinations functions of the hepatobiliary system, normalization of pigment metabolism, reduce the toxic load on the liver and improve metabolism in the myocardium through an electromagnetic field in the range of extremely high frequency (EHF - 7.1 mm) on the region of the liver and gall bladder, heart Zakharyin-Ged zone and paired biologically active points (BAP) gallbladder Meridian VB 24 (LM-task).

The method is as follows: brackish water (GOST - 13273-88) is given orally in a volume of 3-5 ml / kg/weight 3 times a day 30 minutes before meals in the form of hot, daily for 20 days; mud - in the right hypochondrium (the projection area of the liver and gall bladder), temperature 38-40°S, with a duration of 15-20 minutes a day, treatment - 8 procedures; electromagnetic field in the range of extremely high frequency (EHF - 7.1 mm) on the region of the liver and gallbladder for 5-10 minutes in hard slozhnoorganizovannoy mode in the form of packages breaks for 4-6 seconds, and then at the middle zone Zakharyin-Ged within 5-1 minutes in CW mode, and then on the steam BATH gallbladder Meridian VB 24 (LM-ye) for 3-5 minutes on each BAT in the modulation mode in the form of packages breaks for 4-6 seconds, in the course of 15 treatments, daily.

According to our data EHF-therapy on the background of the action of mud applications pronounced effect on the functional state of the biliary system, anti-inflammatory effect, improves microcirculation processes, processes of peroxidation of lipids, promotes more rapid recovery of impaired functions.

The proposed method has been tested in the clinic of children's diseases, Chelyabinsk. The study included 49 children with allowoutgoing chronic cholecystitis, living in ecologically unfavorable district (district of Chelyabinsk metallurgical plant, Chelyabinsk).

The diagnosis is confirmed by clinical examination and laboratory indicators methods. The treatment efficiency was 98% and was accompanied by positive dynamics of clinical symptoms, indicators of protein, pigment metabolism and lipid peroxidation.

Long-term outcomes tracked for 2002-2003 showed preservation of remission from 8 months to a year, 77% of children.

Dynamics of clinical and laboratory parameters, as well as the effectiveness of the treatment were assessed in points and are presented in the table is 1-3.

Table 1
Comparison of treatment results (based on the principle of scoring; * - significant differences between groups, p<0,05)
IndicatorsThe comparison group
Prototype

points (n=54)
The claimed method scores (n=49)
Clinical indicators+0,90+1,20
Common blood test+1,00+0,35
Alpha-2-globulins+0,12+0,14
Albumin-0,02+0,22*
Bilirubin (total)-0,20+0,18*
The integral indicator of duodenal intubation+0,07+0,15
The ECGThe flattening of the T waveNormalization of the T wave
Only+1,87+2,24*

Clinical example. Sick Tanya K-VA, 8 years. Case history No. 157-02. He admitted with a diagnosis of Allowoutgoing chronic cholecystitis. Myocardial.

When entering noted complaints: pain in the right hypochondrium, bitter taste in the mouth, nausea and a decrease in Appeti is a, occurs shortness of breath when walking fast and running.

Table 2
The duration of the preservation of a positive effect (data in %; * - significant differences between groups, p<0,05)
MethodsDuration
to 3xmonthsup to 8 monthsup to 12 months
The claimed method98%88%*77%*
The placeholder92%70%52%
Table 3
Dynamics of indicators of lipid peroxidation (n - number of observations; * - significant differences, p<0,05)
IndicatorsThe placeholderThe claimed method (n=31)
before the treatmentafter the treatmentbefore the treatmentafter the treatment
Malonic dialdehyde (DMA), mol/l --0,98±0,030,92±0,01
Antioxidant activity (AOA), % Decel.--78,3±1,554,7±2,5*

From the anamnesis of the disease - acute exacerbation of chronic cholecystitis in the last year occurred in 1.5-2 months. Remission lasted no more than 3-3,5 months.

From the anamnesis of life - patient living in ecologically unfavorable district, Chelyabinsk (district CHMP).

On physical examination: pain in the right hypochondrium, at the point C, in the course of the large intestine, positive symptoms Murphy, Ortner, Anowara and right phrenicus. The liver is palpated at the edge of the costal arch, the edge of its elastic consistency, moderately painful.

Laboratory data: analysis of blood and urine without features. Bilirubin serum (direct - 4.3 mmol/l, indirect - 19,10 mmol/l). Duodenal intubation: I faction - 25 minutes (the portion of the bile And 3 ml), separating its intermittent, during the breaks, duodenal juice; II faction - 8 minutes; III fraction is 35 minutes (the portion of the bile - 32 ml), after double injection xylitol obtained reflex with gall bladder, intermittent emptying, bile dark color, cloudy, with cereals, microscopy revealed bile scop is possible leukocytes to 20-40 in the field of view, crystals bilirubin, bacteria; IV - fraction - 15 minutes; fraction V - 20 minutes (the portion of the C - 7 ml), bile light yellow, transparent, microscopic examination of signs of inflammation were not found. In the ECG detected - reducing voltage peaks and isolated extrasystoles.

Given the clinical picture and ecological place of stay, discharge diagnosis: Allowoutgoing chronic cholecystitis in the acute phase. Myocardial.

The treatment according to the claimed method: internal reception brackish water Obukhovskaya warmed for 30 minutes before a meal from the calculation of 3-5 ml / kg/weight, 3 times a day for 21 days; mud on the region of the liver and gall bladder, temperature 38-40°With, a course of 8 treatments assigned in a day; the electromagnetic field in the range grinevickij frequency (EHF - 7.1 mm) in the region of the liver and gallbladder for 5-10 minutes in hard slozhnoorganizovannoy mode in the form of packages breaks for 4-6 seconds and then on the middle zone Zakharyin-Ged for 5-10 minutes in CW mode, and then on the steam BATH gallbladder Meridian VB 24 (LM-ye) for 3-5 minutes on each BAT in the modulation mode in the form of packages breaks for 4-6 seconds, in the course of 15 treatments, daily.

The treatment was well tolerated, baldereschi not marked. During therapy complaints cropped, disappeared bolezn is held in the right upper quadrant at the point Kera, negative gallbladder symptoms - Murphy, Ortner, Anowara and right phrenicus that occurred before treatment. Improved overall health, appetite, and increased physical activity.

Laboratory tests: blood and urine without significant changes. Bilirubin direct 0 indirect - 9,23 mmol/L. Protein fractions in normal. Duodenal intubation: I faction - 20 minutes (the portion of the bile And 23 ml), Department of smooth, there is an admixture of mucus; II fraction - 6 minutes; (III fraction is 22 minutes (the portion of the bile - 25 ml)obtained after a single injection of xylitol emptying simultaneous, uniform and complete, bile dark olive color, transparent, microscopic examination of bile revealed no signs of inflammation; IV - fraction - 15 minutes; fraction V - 20 minutes (the portion With a 10 ml), bile light yellow, transparent, with microscopy signs of inflammation are not detected, there melkochristalliceski epithelium of the bile ducts. On ECG normal sinus rhythm, the increase of the voltage peaks.

Discharged with significant improvement. Remission - 9 months.

Sources of information

1. Salad ZH.N. The use of sapropelic mud and drinking mineral water in chronic inflammatory diseases of the biliary tract in children. //Methodical recommendations. Sverdlovsk. - 1979. - 8 S.

2. Sapropels and their treatment is applied. Sverdlovsk. - 1994. - 135 C.

The method of treatment allowoutgoing chronic cholecystitis with concomitant myocardial in children, including the use of inside brackish water, mud packs on the area of the liver and gall bladder, characterized in that it further influence of the electromagnetic field in the range grinevickij frequency 7.1 mm in the region of the liver and gallbladder for 5-10 min in hard slozhnoorganizovannoy mode in the form of packages breaks 4-6, and then on the middle zone Zakharyin-Ged for 5-10 min in CW mode, and then the pair of biologically active points (BAP) gallbladder Meridian VB 24 (LM-ye) 3-5 minutes on each BAT in the modulation mode in the form of packages pauses 4-6, in the course of 15 treatments daily.



 

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