RU2347576C1 - Method for correction of airway hyperreactivity in children - Google Patents

Abstract

FIELD: medicine; pulmonology and pediatrics.

SUBSTANCE: drug for elimination of airway hyperreactivity contains medication inhaled into breathing passages, at that Konstantinovskaya-1 mineral water is inhaled, which is related to mineralised (extent of mineralisation is 1.5-2.0 g/l) waters of chloride-sodium composition.

EFFECT: positive correction of airway hyperreactivity in children and prevention of complications related to medical correction of this pathology.

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Description

The invention relates to medicine, namely to pulmonology and pediatrics, can be used in children for the treatment of respiratory tract hyperresponsiveness.

There are drugs for treating airway hyperresponsiveness in children, which is manifested by bronchospasm, such as aminophylline [1, 2]. However, the use of aminophylline has a large number of serious disadvantages:

but. Eufillin has a small "therapeutic latitude" (the proximity of therapeutic and toxic concentrations), which requires its mandatory determination in blood plasma. This means daily blood sampling from a child, i.e. the injury is not only physical, but also mental.

b. With an increase in the concentration of aminophylline in the blood, complications of the digestive system such as nausea, vomiting, diarrhea develop; from the cardiovascular system, as a risk of arrhythmia; on the part of the central nervous system, like insomnia, hand tremor, agitation, convulsions.

at. In patients taking antibiotics, macrolides or undergoing acute respiratory infections, there is a slowdown in the clearance of aminophylline, which can cause the development of complications even with a standard dosage of the drug.

The purpose of the invention is to optimize the results of treatment of airway hyperresponsiveness in children without complications.

This goal is achieved in that for the treatment of airway hyperresponsiveness in children, mineral water of well No. 2990 was used in the village of Konstantinovka, Amur Region (Konstantinovskaya-1 mineral water) in the form of ultrasonic inhalations.

The tool to eliminate airway hyperresponsiveness in children is used as follows. Konstantinovskaya-1 mineral water in the amount of 30 ml is poured into an ultrasonic inhaler, for example, of the “Volcano” type, which has a heated inhaled mixture to + 37 ° C. The child breathes water suspension for 10 minutes 1 time per day. The course of treatment lasts 7 days.

Konstantinovskaya-1 mineral water [3] refers to low-saline (degree of mineralization of 1.5-2.0 g / l) sodium chloride water with a basic chemical composition (mg / l):

- bicarbonates - 50-100;

- sulfates - 50-100;

- chlorides - 750-1000;

- sodium + potassium - 400-700;

- calcium - 15-40;

- magnesium - less than 10.

Konstantinovskaya-1 mineral water is approved as medicinal-table water [4].

To diagnose bronchial hyperreactivity, before and after treatment, a provocative test in the form of 3-minute inhalations with distilled water was used [5]. The presence of airway hyperreactivity and the effectiveness of treatment were determined by clinical data and indicators of ventilation function of the lungs, which were measured by spirography on a Flowscreen apparatus (Erich Jaeger, Germany). The parameters of the forced vital capacity of the lungs (FVC), forced expiratory volume in 1 second (FEV ₁ ), peak expiratory flow rate (PSV), maximum expiratory flow rates at the level of 25% (MOS ₂₅ ), 50% (MOS ₅₀ ) were determined and the difference was calculated between their absolute values before and after the provocative test as a percentage of the initial value (Δ,%). A provocation test was considered positive with a decrease in FEV _{1 of} more than 10% of the initial value. The tolerance of the provocative test in children was good; when it was carried out, the most diagnostically significant were changes in the parameters of FVC, FEV ₁ , MOC ₅₀ , MOC ₂₅ (table 1).

Table 1 Changes in the parameters of indicators of the ventilation function of the lungs in children after inhalation with distilled water (in% of the initial value, M ± m, n-number of patients). Indicators The main group, n = 19 The control group, n = 15 Before treatment After treatment R Before treatment After treatment R Δ FVC -7.42 ± 1.05 -4.53 ± 0.83 <0.05 -7.61 ± 1.1 -4.56 ± 0.71 <0.05 Δ FEV ₁ -12.04 ± 1.37 -7.14 ± 0.72 <0.02 -12.41 ± 1.2 -7.21 ± 0.84 <0.02 Δ PSV -8.23 ± 1.14 -5.91 ± 0.89 > 0.05 -8.01 ± 1.23 -5.83 ± 0.91 > 0.05 Δ MOS ₅₀ -13.62 ± 1.13 -10.58 ± 0.85 <0.05 -13.81 ± 1.22 -10.36 ± 0.09 <0.05 Δ MOS ₂₅ -13.86 ± 1.16 -9.91 ± 0.89 <0.02 -14.11 ± 1.34 -10.16 ± 0.08 <0.02

Group statistical analysis of the obtained data was carried out on the basis of standard methods of variation statistics with the assessment of the significance of differences by the t-student criterion.

In the control group, 15 children aged 6 to 14 years old were treated with amufillin inhalations (at a dose of 0.5 ml of a 2.4% solution diluted with an isotonic 0.9% sodium chloride solution in a ratio of 1: 1 to treat the revealed respiratory tract hyperresponsiveness). for the year of the child’s life). After inhalation of aminophylline, 5 children developed tachycardia with a pulse rate of 140 per minute, 1 child was diagnosed with extrasystole (loss of pulse after 10 strokes), two children had nausea at the end of treatment, with loss of appetite, and tremor of the fingers.

Respiratory tract hyperreactivity was treated with Konstantinovskaya-1 inhalation with mineral water in 19 children of the main group aged 8 to 14 years with various respiratory pathologies (acute bronchitis with obstructive syndrome, recurrent bronchitis, mild to moderate bronchial asthma) against the background of traditional treatment of the main pathology.

All children tolerated Konstantinovskaya-1 inhalations with mineral water well. The treatment field, shortness of breath and shortness of breath disappeared, sputum began to pass away easily, auscultation - wheezing over the pulmonary fields disappeared, bronchial patency improved spirographically (table 1).

Comparative indicators of ventilation function of the lungs before and after treatment of airway hyperresponsiveness in children of the main and control groups are presented in table 1.

From table 1 it can be seen that by inhalation of Konstantinovskaya-1 with mineral water, airway hyperresponsiveness in children was eliminated in the same way as inhalation with a solution of aminophylline. However, in the treatment of airway hyperresponsiveness in children with Konstantinovskaya-1 mineral water, no complications occurred.

We give examples of the specific use of the drug for the correction of airway hyperresponsiveness in children.

Example 1. Patient K., 14 years old, was admitted to the hospital on 10/18/2006 with a diagnosis of chronic obstructive bronchitis in the acute stage. Upon admission, he presented the following complaints: cough with sputum that was difficult to separate, shortness of breath with little physical exertion, low-grade fever, weakness, sweating. Sick from the age of 6, when after hypothermia he fell ill with pneumonia, exacerbations occurred annually in the spring and autumn. Upon receipt, the child's condition is satisfactory. The skin is warm, moist, marked cyanosis of the lips.

During auscultation in the lungs, scattered dry wheezing is determined. The number of breaths is 22 per minute. The number of heart contractions is 90 per minute. For other organs - without pathological changes. A provocative test with distilled water showed a decrease in FEV ₁ by 13.14% from the initial level, which confirmed the presence of airway hyperresponsiveness in the patient.

Within 7 days, against the background of traditional therapy, the child was inhaled with Konstantinovskaya-1 mineral water. After the treatment, the patient lost cough, shortness of breath, sputum began to separate easily, auscultation - wheezing in the lungs disappeared. Spirographic indices after conducting a provocative test with distilled water: before treatment, ΔОФВ ₁ as a percentage of the initial value was 13.14%; after treatment - 6.96%.

As a result of the treatment, the phenomena of airway hyperreactivity were eliminated, the child was discharged home with recovery.

Example 2. Patient I., 10 years old, was admitted to the hospital on 12.04.2007 with a diagnosis of bronchial asthma, stage - persistent lung.

Upon receipt, she presented the following complaints: cough, more in the evening, with sputum difficult to separate, attacks of suffocation at night, developing after one day, weakness, poor sleep, and appetite. Sick from 4 years of age, when the diagnosis of chronic bronchitis was first diagnosed, from which the patient was treated annually with traditional methods. Bronchial asthma has been verified in the last 2 years. Upon admission, the child's condition is satisfactory. The skin is warm, dry, slight cyanosis of the lips is noted. On auscultation, scattered dry, buzzing and wheezing sounds are heard. The number of breaths is 20 per minute. The number of heart contractions is 84 per minute. For other organs - without pathology. A provocative test with distilled water showed a decrease in FEV ₁ by 12.63% from the initial level, which confirmed the presence of airway hyperresponsiveness in the patient.

Within 7 days, against the background of traditional basic therapy, the patient was inhaled with Konstantinovskaya-1 mineral water. After the treatment, the patient's cough decreased, asthma attacks disappeared, auscultation - wheezing in the lungs disappeared. Spirographic indicators after a provocative test with distilled water: before treatment, ΔОФВ ₁ as a percentage of the initial value was - 12.63%; after treatment - 7.82%.

The use of prescribed inhalations of Konstantinovskaya-1 with mineral water was well tolerated by the child and allowed to eliminate airway hyperreactivity and the main symptoms of bronchial asthma.

The proposed tool allows you to:

- positively affect the severity of respiratory tract hyperresponsiveness in children;

- get rid of the complications that are characteristic of drug correction of airway hyperresponsiveness in children.

Information sources

1. Zaitseva OV Bronchial obstructive syndrome in children // Pediatrics, 2005, No. 4, p.102-103.

2. Matveeva L.A., Osin A.Ya., Pashinsky V.G. Aerosol therapy for lung diseases in children // Tomsk, 1990, p. 73.

3. Certificate of the Russian Federation on the right to use the appellation of origin of goods No. 86/1 from April 12, 2006

4. Certificate of state registration of the Federal Service for Supervision of Consumer Rights Protection and Human Well-being No. 77.99.19.6. U.2416.3.06. March 21, 2006

Claims (1)

An agent for eliminating respiratory tract hyperresponsiveness containing a medication inhaled into the respiratory tract, characterized in that Konstantinovskaya-1 mineral water is inhaled, related to the mineralized (degree of mineralization 1.5-2.0 g / l) sodium chloride composition, having a basic chemical composition, mg / l:
bicarbonates 50-100 sulfates 50-100 chlorides 750-1000 sodium + potassium 400-700 calcium 15-40 less magnesium 10