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3.3. Efficiency of acupuncture in complex treatment of children with a chronic constipation.

Now in treatment of a constipation besides medicamental therapy various methods of apparatus physiotherapy, reflexotherapy are widely applied, is barefooted-THERAPY, however efficiency, an application and indication technique to use of most accessible of the listed methods - acupunctures (IRT) in treatment HZ at children till now are insufficiently studied.

For today it is known, that IRT with success it is applied in applied medicine at various diseases of organs of breath, nervous and cardiovascular systems [28, 55, 120].

On the basis of the above-stated, we have made an attempt to estimate efficiency IRT in complex treatment of a chronic constipation at children and to develop indications to its use. All children observed by us with HZ (139 children) have been parted on 5 groups depending on character of the spent treatment.

The first group 32 children (23 %) at the age from 6 till 17 years 5 months (have made middle age 9,6 yo 2,8), received basic treatment (BL) - a diet, medicinal preparations, massage and medical gymnastics.

The second group 40 children (28,8 %) at the age from 6 till 17 years 2 months (have made middle age 8,9, yo 3,1), received basic treatment in a combination to physiotherapy (БЛ+ФТ).

The third group 19 children (13,7 %) at the age from 6 till 16 years 6 months (have made middle age 11,4 yo 3,2), received as treatment basic treatment and IRT (БЛ+ИРТ).

The fourth group consisted of 37 children (26,6 %) at the age from 6 till 16 years 11 months (average возраст10,4 yo 2,7), received basic treatment, physiotherapy and IRT (БЛ+ФТ+ИРТ).

The fifth group was made by 11 children (7,9 %) at the age from 6 till 16 years 5 months (11,2 yo 2,6), received only IRT. Course of treatment has made 3 weeks.

Distribution of children with HZ on age and a floor depending on the spent treatment is presented in table 3.3.1.

Table 3.3.1

Distribution of children with HZ on a floor and age depending on the spent treatment (n=139).

Groups of children 6 years 7 - 11 years 12 years also are more senior In total
M D M D M D M D
1st group Abs 1 2 13 9 5 2 19 13
% 0,7 % 1,4 % 9,3 % 6,5 % 3,6 % 1,4 % 13,7 % 9,3 %
2nd group Abs 1 22 10 4 3 27 13
% 0,7 % 15,8 % 7,2 % 2,9 % 2,2 % 19,4 % 9,3 %
3rd group Abs - 6 4 5 4 11 8
% - 4,3 % 2,9 % 3,6 % 2,9 % 7,9 % 5,7 %
4th group Abs - 16 6 8 7 24 13
% - 11,5 % 4,3 % 5,7 % 5,0 % 17,3 % 9,3 %
5th group Abs 1 4 2 3 1 8 3
% 0,7 % 2,9 % 1,4 % 2,2 % 0,7 % 5,7 % 2,2 %

Apparently from table 3.3.1 peak of appealability of children with HZ in all groups

Fell to age 7 - 11 years, thus in each group boys prevailed.

The carried out analysis of data of the anamnesis of disease of children observed by us has shown, that 111 of them (79,9 %) received treatment earlier, including in a hospital - 26 children (18,7 %), in out-patient conditions - 40 children (28,8 %), and 27 children (19,4 %) - both in a hospital, and in an out-patient department. It is necessary to notice, that 18 children with HZ (12,9 %) before entering in a hospital did not address for medical aid in the given occasion and were treated independently, and at 28 children (20,1 %) the given hospitalisation has followed after the first reference to the pediatrist or the doctor-gastroenterologu.

Character of complaints on groups before spent treatment it is presented in table 3.3.2.

Table 3.3.2

Spectrum of complaints at children of investigated groups before treatment (n=139).

Complaints, % BL БЛ+ФТ БЛ+ИРТ БЛ+ФТ+ИРТ IRT IN TOTAL
Chair 1 r in 5 and more days 13 23 7 15 4 62
9,4 % 16,5 % 5 % 10,8 % 2,9 % 44,6 %
Chair 1р in 3-4 d 16 15 6 14 5 56
11,5 % 10,8 % 4,3 % 10,1 % 3,6 % 40,3 %
Chair 1р in 2 d 3 2 6 8 2 21
2,2 % 1,4 % 4,3 % 5,6 % 1,4 % 15,1 %
Chair of the big diameter 8 14 5 12 3 42
5,6 % 10,1 % 3,6 % 8,6 % 2,1 % 30,2 %
The "sheep" chair 15 21 4 15 8 63
10,8 % 15,1 % 2,9 % 10,8 % 5,6 % 45,3 %
The chair is not changed 12 5 10 10 0 37
8,6 % 3,6 % 7,2 % 7,2 % 0 % 26,6 %
Abdominal pains 29 35 19 36 11 130
20,9 % 25,2 % 13,7 % 25,9 % 7,9 % 93,5 %
Incomplete oporozhnenie 12 17 9 20 9 67
8,6 % 12,2 % 6,5 % 14,4 % 6,5 % 48,2 %
Long natuzhivanie 11 16 10 16 8 61
7,9 % 11,5 % 7,2 % 11,5 % 5,6 % 43,9 %
Meteorism 13 19 9 13 6 60
9,4 % 13,7 % 6,5 % 9,4 % 4,3 % 43,2 %
Kalomazanie 16 29 6 19 6 76
11,5 % 20,9 % 4,3 % 13,7 % 4,3 % 54,7 %

It is necessary to notice, that in one of investigated groups there were no children with a daily defecation while complaints to absence of an independent chair till 2 days showed 15,1 % of children, to 3 - 4 days - 40,3 % and on absence of a chair till 5 and more days complained 44,6 % of children. Among children with HZ the complaint second for frequency there were abdominal pains (93,5 % of children). Complaints on kalomazanie showed 54,7 % of children, on incomplete oporozhnenie an intestine - 48,2 %, on long natuzhivanie during the defecation certificate - 43,9 % and on a meteorism - 43,2 % of children. Pathological character of a chair took place at 109 children (78,4 %), from them at 45,3 % - the chair was "sheep", and at 30,2 % - the big diameter. On the average on each child it was necessary on 5 complaints (an abdominal pain, absence daily
Independent chair, kalomazanie, incomplete oporozhnenie an intestine, the sheep chair).

For an estimation of efficiency of various schemes of therapy of a chronic constipation at children we have analysed complaints before treatment in each investigated group.

In the first group (n = 32) before reception of basic treatment (BL) complaints to absence of an independent chair till 5 and more days the delay of a chair to 3 - - at 16 children (50 %) became perceptible 4 days at 13 children (40,6 %), and at 3 children (9,4 %) the chair was 1 time in 2 days.

After the spent course of basic treatment at the majority of children positive dynamics in the form of reduction of intervals between certificates of a defecation (tab. 3.3.3) became perceptible.

Table 3.3.3

Duration of intervals between certificates of a defecation at children with HZ on

Basic therapy before treatment (n=32)

Treatment Quantity of children
Duration of intervals between defecations
Daily 1 time in 2 days 3-4 days 5 and more days
Before basic treatment abs 3 16 13
% - 9,4 % 50 % 40,6 %
After basic treatment abs 7 19 5 1
% 21,8 % 59,4 % 15,6 % 3,1 %

Apparently from the table, after appointment BL duration of intervals between defecation certificates was authentically reduced: daily the chair became at 7 children (21,8 %), and at 19 children (59,4 %) 1 time in 2 days (the river 0.01).

The analysis of character of a chair at children with HZ in the first group before appointment BL has shown, that at 8 children (25 %) it was the big diameter, at 15 children (46,9 %) - "sheep", at 9 children (28,1 %) - is not changed, however at them complaints on long intensive natuzhivanie during a defecation became perceptible. Complaints to abdominal pains showed 29 children (90,6 %), incomplete oporozhnenie an intestine - 12 children (37,5 %), long natuzhivanie during a defecation - 11 (34,4 %), a meteorism-13 (40,6 %) and kalomazanie - 16 children (50 %).

In a drawing 3.3.1 the spectrum of complaints at children of I th group with HZ before basic treatment in percentage (%) is presented.

Fig. 3.3.1 Spectrum of complaints at children with HZ before treatment BL in percentage (%).

Apparently on the chart 3.3.1 against reception of medicamental therapy at children with HZ positive dynamics in a kind became perceptible: normalisation of character of a chair (r 0.01), decreases of complaints by the "sheep" chair (r 0.05) and a chair of the big diameter (r 0.05). Against basic therapy the quantity of complaints to abdominal pains (56,3 %), kalomazanie (37,5 %), a meteorism also has decreased
(25 %), complaints concerning incomplete oporozhnenija an intestine (18,8 %), long natuzhivanija during a defecation (21,9 %), however the received differences were not statistically significant.

At children in the second group (n = 40) prior to the beginning of reception of basic treatment simultaneously with physiotherapy (БЛ+ФТ) complaints to absence of an independent chair till 5 and more days - at 23 children (57,5 %), a delay of a chair to 3 - 4 days took place - at 15 children (37,5 %), at 2 children (5 %) the chair was 1 time in 2 days and was accompanied by difficulty at the certificate of a defecation and sensation incomplete oporozhnenija an intestine (tab. 3.3.4).

Table 3.3.4

Duration of intervals between certificates of a defecation at children with HZ before treatment BL + FT (n = 40)

Treatment Quantity of children
Duration of intervals between defecations
Daily 1 time in 2 days 3-4 days 5 and more days
To БЛ+ФТ abs 2 15 23
% 5 % 37,5 % 57,5 %
After БЛ+ФТ abs 13 21 5 1
% 32,5 % 52,5 % 21 % 2,5 %

Apparently from the table, after appointment БЛ+ФТ at 13 children (32,5 %) a chair daily, and at 21 children (52,5 %) duration of intervals between defecation certificates became no more than 1 time in 2 days (r 0.01).

The analysis of character of a chair at children in the second group has shown, that at 14 children (35 %) the chair was the big diameter, at 21 children (52,5 %) - "sheep", at 5 children (12,5 %) the chair has not been changed, however at them complaints on long intensive natuzhivanie during a defecation or feeling incomplete oporozhnenija an intestine became perceptible. Complaints to abdominal pains showed 35 children
(87,5 %), incomplete oporozhnenie an intestine - 17 children (17,5 %), long natuzhivanie during a defecation - 16 (40 %), a meteorism - 19 (47,5 %) and on kalomazanie complained 29 children (72,5 %).

After appointment БЛ+ФТ at children positive dynamics in a kind became perceptible: cuppings of a painful syndrome (r 0.01), depressions of quantity of complaints on incomplete oporozhnenie an intestine (р0.05) and long natuzhivanie during a defecation (r 0.05), decreases of complaints by a meteorism (р0.05) and kalomazanie (r 0.05).

Against BL and FT appreciable improvement of character of a chair became perceptible also. Children observed by us from the second group authentically the "sheep" chair (р0.01) and a chair of the big diameter (less often disturbed the river 0.05) while the quantity of children with a normal consistence and the chair form was authentically enlarged (r ' 0.01).

In a drawing 3.3.2 the spectrum of complaints before basic treatment simultaneously with physiotherapy in percentage (%) is resulted.

Fig. 3.3.2 Spectrum of complaints at children with HZ before treatment БЛ+ФТ in percentage (%).

In the third group (n=19) before reception of basic treatment simultaneously with acupuncture (БЛ+ИРТ) complaints to absence of an independent chair till 5 and more days became perceptible at 7 children (36,8 %), a delay of a chair to 3 - 4 days and to 1 time in 1 - 2 days were taped at identical quantity of children and have made on 31,6 % in each group (tab. 3.3.5).

Table 3.3.5

Duration of intervals between certificates of a defecation at children with HZ to and

After treatment БЛ+ИРТ (n=19)

Treatment Quantity of children
Duration of intervals between defecations
Daily 1 time in 2 days 3-4 days 5 and more days
To BL +

IRT

abs 6 6 7
% 31,6 % 31,6 % 36,8 %
After BL +ИРТ abs 8 10 1
% 42,1 % 52,6 % 5,3 % -

Against БЛ+ИРТ also as well as against treatment BL and БЛ+ФТ at the majority of children duration of intervals between defecation certificates it was authentically reduced: the chair of 1 times in 2 days has appeared at 10 children (52,6 %), and at 8 children (42,1 %) the chair became daily (p-0.01).

The analysis of character of a chair at children in the third group has shown, that at 5 children (26,3 %) the chair was the big diameter, at 4 children (21,1 %) - "sheep". At 10 children (52,6 %) the chair was a normal consistence, however these children showed complaints on long intensive natuzhivanie during a defecation and-or feeling incomplete oporozhnenija an intestine. Complaints to abdominal pains were shown by all children in investigated group (100 %), incomplete oporozhnenie an intestine it became perceptible at 9 children (47,4 %), long natuzhivanie during time
Defecations - at 10 (52,6 %), a meteorism - at 9 (47,4 %) and kalomazanie - at 6 children (31,6 %).

After appointment БЛ+ИРТ of children in investigated group authentically disturbed abdominal pains (r 0.01) and a meteorism (the river 0.05) less often. The quantity of complaints on incomplete oporozhnenie an intestine (10,5 %) has decreased, long natuzhivanie during a defecation (15,8 %) and kalomazanie (15,8 %), however the received differences were not statistically significant.

Against simultaneous therapy BL and IRT only 2 children still had complaints to pathological character of a chair: at 1 child - on the "sheep" chair (5,3 %), at another - on a feces of the big diameter. The quantity of children with a normal consistence and the chair form was authentically enlarged (r 0.05).

In a drawing 3.3.3 the spectrum of complaints before basic treatment simultaneously with physiotherapy in percentage (%) is resulted.

Fig. 3.3.3 Spectrum of complaints at children with HZ before treatment БЛ+ИРТ in percentage (%).

In 4 group (n = 37) before reception of the complex therapy, including basic, physiotherapy and acupuncture (БЛ+ФТ+ИРТ), complaints to absence of an independent chair till 5 and more days became perceptible at 15 children (40,5 %), a delay of a chair to 3 - 4 days - at 14 children (37,8 %) and at 8 children (21,6 %) the chair was 1 time in 1 - 2 days (tab. 3.3.6).

Table 3.3.6

Duration of intervals between certificates of a defecation at children with HZ before treatment БЛ+ФТ+ИРТ

Treatment Quantity of children
Duration of intervals between defecations
Daily 1 time in 2 days 3-4 days 5 and more days
To BL + ФТ+ИРТ abs - 8 14 15
% 21,6 37,8 % 40,5 %
After BL + ФТ+ИРТ abs 25 11 1
% 67,6 % 29,7 % 2,7 % -

Against БЛ+ФТ+ИРТ also as well as against treatment BL and БЛ+ФТ duration of intervals between defecation certificates was authentically reduced to 1 time in 2 days at 11 children (29,7 %), daily the chair became at 25 children (67,6 %) (the river 0.01).

The analysis of character of a chair at children in the fourth group has shown, that at 12 children (32,4 %) the chair was the big diameter, and 15 children (40,5 %) - were disturbed by"the"sheep"chair. The chair of a normal consistence became perceptible only at 10 children (27,1 %), however at them complaints on long intensive natuzhivanie during a defecation became perceptible. Complaints to abdominal pains were shown by all children except for 1 child (97,3 %), incomplete oporozhnenie an intestine it became perceptible at 20 children (54,1 %), long natuzhivanie during a defecation - at 16 (43,2 %), a meteorism - at 13 (35,1 %) and kalomazanie - at 19 children (51,3 %) (the chart 3.3.4).

After appointment of complex therapy (БЛ+ФТ+ИРТ) at children positive dynamics in the form of cupping of a painful syndrome (r 0.01), decreases of complaints by the sheep chair (r 0.01) and a chair of the big diameter (r 0.05) became perceptible. Also against complex therapy the quantity of complaints concerning incomplete oporozhnenija an intestine (r 0.01), long natuzhivanija during a defecation (r 0.01) has decreased, a meteorism (r 0.01), Only one child against BL, IRT and FT continued to disturb kalomazanie, at other children the given symptom was stopped (r 0.01) (fig. 3.3.4).

Fig. 3.3.4 Spectrum of complaints at children with HZ before treatment БЛ+ФТ+ИРТ in percentage (%).

All children in the fifth investigated group (n=11) received only acupuncture (IRT). Before appointment IRT at 4 (36,4 %) children became perceptible complaints to absence independent till 5 and more days, at 5 children (45,5 %) the chair delay was to 3 - 4 days and at 2 children (18,2 %) the chair was 1 time in 2 days (tab. 3.3.7).

Table 3.3.7

Duration of intervals between certificates of a defecation at children with HZ before treatment IRT

Treatment Quantity of children
Duration of intervals between defecations
Daily 1 time in 2 days 3-4 days 5 and more days
To IRT abs - 1 6 4
% - 9,1 % 54,5 % 36,4 %
After IRT abs 6 3 2
% 54,5 % 27,3 % 18,2 % -

Against IRT also as well as against treatment BT and БТ+ФТ at 6 children (54,5 %) the chair became daily, and at 3 children (27,3 %) duration of intervals between certificates did not exceed 1 time in 2 days (p0.05).

The analysis of character of a chair at children in the fifth group has shown, that at 3 children (27,3 %) the chair was the big diameter, at 8 children (72,7 %) - "sheep". With the normal characteristic of a chair there was no child. Complaints to abdominal pains were shown by all children in investigated group, incomplete oporozhnenie an intestine it became perceptible at 9 children (81,8 %), long natuzhivanie during a defecation - at 8 (72,7 %), a meteorism - at 6 children (54,5 %) and kalomazanie disturbed 6 patients.

After appointment IRT at children in investigated group positive dynamics in the form of cupping of a painful syndrome (r 0.01), decreases of complaints on incomplete oporozhnenie an intestine (r 0.01), long natuzhivanie during a defecation (r 0.05), the "sheep" chair (r 0.05) became perceptible. Also against acupuncture the quantity of complaints concerning a chair of the big diameter (9,1 %) has decreased, kalomazanija (18,2 %), a meteorism (9,1 %), however the received differences were not statistically significant (fig. 3.3.5).

Fig. 3.3.5 Spectrum of complaints at children with HZ before treatment IRT in percentage (%).

Character of complaints on groups after treatment it is presented in table 3.3.8.

Table 3.3.8

Spectrum of complaints at children of investigated groups after treatment (n=139).

Complaints, % BL БЛ+ФТ БЛ+ИРТ БЛ+ФТ+ИРТ IRT IN TOTAL
Chair 1 r in 5 and more days 1 1 0 0 0 2
3,1 % 2,5 % 0 % 0 % 0 % 1,4 %
Chair 1р in 3-4д 5 5 1 1 2 14
15,6 % 12,5 % 5,26 % 2,7 % 18,2 % 10,1 %
Chair 1р in 2д 19 21 10 11 3 64
59,4 % 52,5 % 52,6 % 29,7 % 27,3 % 46 %
Daily chair 7 13 8 25 6 59
21,9 % 32,5 % 42,1 % 67,6 54,5 42,5 %
Chair of the big diameter 3 5 1 2 1 12
9,4 % 12,5 % 5,3 % 5,4 % 9,1 % 8,6 %
The "sheep" chair 6 8 1 1 1 17
18,8 % 20 % 5,3 % 2,7 % 9,1 % 12,2 %
The chair is not changed 23 27 17 34 9 110
71,9 % 67,5 % 89,5 % 91,9 % 81,8 % 79,1 %
Abdominal pains 18 16 5 5 1 45
56,3 % 40 % 26,3 % 13,5 % 9,1 % 32,4 %
Incomplete oporozhnenie 6 7 2 3 1 19
18,8 % 17,5 % 10,5 % 8,1 % 9,1 % 13,7 %
Long natuzhivanie 7 8 3 4 3 25
21,9 % 20 % 15,8 % 10,8 % 27,3 % 18 %
Meteorism 8 7 2 1 1 19
25 % 17,5 % 10,5 % 2,7 % 9,1 % 13,7 %
Kalomazanie 12 17 3 1 2 35
37,5 % 42,5 % 15,8 % 2,7 % 18,2 % 25,2 %

We have compared efficiency in the form of reduction of quantity of complaints by abdominal pains, a meteorism, kalomazanie, reduction of intervals between defecation certificates, sensation incomplete oporozhnenija an intestine, long natuzhivanie during a defecation and normalisation of character of a chair. On the basis of the received results of research we have decided to compare efficiency of various schemes of therapy of children with HZ, having analysed complaints before treatment between investigated groups.

We have compared efficiency of various methods of treatment on normalisation of frequency of a chair at children with HZ.

Fig. 3.3.6 Comparative results of duration of intervals between defecations at children of survey samples after treatment in %.

Apparently from a drawing 3.3.6 daily chair authentically became perceptible against complex treatment БЛ+ФТ+ИРТ in comparison with BL (p

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Scientific source IPATOV ANDREY ALEKSANDROVICH. EFFICIENCY of ACUPUNCTURE In COMPLEX TREATMENT of CHILDREN With the CONSTIPATION SYNDROME. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

Other medical related information 3.3. Efficiency of acupuncture in complex treatment of children with a chronic constipation.:

  1. 6.2 Results of application of a preparation of system enzymotherapy (Vobenzim) as an agent strengthening action of a causal treatment at children with OSL (croup)
  2. IPATOV ANDREY ALEKSANDROVICH. EFFICIENCY of ACUPUNCTURE In COMPLEX TREATMENT of CHILDREN With the CONSTIPATION SYNDROME. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014, 2014
  3. THE TABLE OF CONTENTS
  4. INTRODUCTION
  5. 3.2 Efficiency of acupuncture in complex treatment of children with an acute constipation.
  6. 3.3. Efficiency of acupuncture in complex treatment of children with a chronic constipation.
  7. CONCLUSIONS
  8. the CHAPTER I. MODERN TECHNOLOGIES of REGENERATIVE TREATMENT of CHILDREN With PERINTALNYM the LESION of NERVOUS SYSTEM. The LITERATURE REVIEW.
  9. IVANOV ALEVTINA OLEGOVNA. the IMPULSIVE LOW-FREQUENCY ELECTROMAGNETIC FIELD In COMPLEX TREATMENT of CHILDREN With SOCHETANNYMI the DISEASES UNITED by the UNDIFFERENTIATED DYSPLASIA of the CONNECTING TISSUE. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014, 2014
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  11. treatment of children sick of a tuberculosis, sochetannym from a HIV - an infection
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  13. studying of clinical efficiency of bacterination BTSZH in group of children of sick HIV-infections (В23)
  14. CHAPTER 8. FEATURES OF TREATMENT OF CHILDREN SICK OF THE TUBERCULOSIS AND A HIV BY A-INFECTION
  15. CHAPTER 7. THE PATHOGENETIC SUBSTANTIATION AND TREATMENT OF CHILDREN WITH THE LONG SUBFEBRILE CONDITION
  16. Chapter 3.1. Efficiency and safety infliksimaba at children with JUIA.
  17. Chapter 3.2. Efficiency and safety etanertsepta at children with JUIA.
  18. Chapter 3.3. Efficiency and safety abatatsepta at children with JUIA.