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INTRODUCTION

Problem of acute respiratory infections (SHOUT) in pediatric practice gets the greatest urgency as in structure of the general primary case rate of children on a share of respiratory diseases it is necessary more cases, than on all other illnesses together taken (50, 135, 165, 200).

C SHOUT it is bound about 90 % of references behind the out-patient pediatric help during the osenne-winter period (56, 117, 124).

In the Russian Federation on official statistical data annually it is on the average registered more than 30 million cases SHOUT, including in such largest megacity as Moscow, in different years from 3 million to 5 million cases (38, 110, 120, 204). Annually a case rate indicator these infections in the city of Moscow approximately in 1,5-1,8 times above, than value of the same indicator as a whole on the country. Annual total economic injury from SHOUT it is estimated in 40 billion rbl., making about 80 % of injury from all infectious diseases (5, 34, 95, 107, 115, 120).

It is bound to certain features of the given region, as the large megacity, differing the high population density developed by a transport network, intensive processes of population shift, including from endemichnyh districts (95).

Children living in large cities, concern group of especially high risk on prevalence of infections of a respiratory tract. Frequency of hospitalisation of children of younger age exceeds that among patients of adult age, and first of all from risk groups (120, 181) more often.

By data the CART, from SHOUT also their complications annually 4 million children aged till 5 years dies, and the share of children till 1 year among the died makes more than 66 %. In 75 % of cases the reason of a children's mortality from SHOUT is the acute pneumonia (96, 131, 140).

Despite enough big arsenal of medical products, therapy of repeated infections of ENTs-bodies and respiratory tracts not always it appears effective. Especially it concerns groups of often ill children (CHBD). In
Communications with it interest to working out of tactics of conducting children with repeated infections (100) is clear.

Perspective direction in preventive maintenance SHOUT is use safe malotoksichnyh, but the effective remedies of protection having a natural parentage (homoeopathic and phytotherapeutic preparations) (52, 142).

Perfection of medical aid CHBD will allow to carry out their improvement, will give real possibility to improve health indicators, to reduce a case rate and physical inability. The massive medicinal load at CHBD leads to change of reactance of an organism and weakening of the processes promoting formation of the high-grade immune answer (51, 54).

For this reason at often ill children expediently application of agents of a natural parentage, in particular, homoeopathic remedies which are effective, safe, do not frame an additional pharmacological load on an organism (55, 142).

Last years the sufficient material confirmed with clinico-laboratory data, by successful experience of use of homoeopathic preparations in improving programs of often ill children with diseases limfoglotochnogo rings and bronholegochnoj systems (26, 27, 51, 52, 127, 142) is saved up.

However, the works devoted to working out of preventive programs for often ill children (CHBD) with use of agents of a natural parentage (SPP) with carrying out of a long catamnesis and an estimation of efficiency of the spent preventive actions to us has not met.

Research objective

Optimisation of preventive programs at often ill children (CHBD) early age in establishments of a primary link from a position of a constitutional accessory and application of agents of a natural parentage was the purpose of the present research.

Research problems

1. To analyse the anamnesis and features of a current SHOUT at observable children.

2. To define shipping, safety of the complex

Homoeopathic preparation №1 (KGP № 1), a complex homoeopathic preparation №2 (KGP № 2) and the Phytopreparation in preventive maintenance of the acute

Infectious diseases of the top respiratory tracts at children at the age from 0 till 6 years.

3. To carry out katamnesticheskoe observation within 6 months for children receiving various kinds of preventive correction, with definition of efficiency of various ways of preventive maintenance.

4. To develop the preventive maintenance scheme SHOUT at often ill children with use of agents of a natural parentage.

5. To establish interrelation between constitutional features of the child and efficiency of spent therapy.

Novelty of research

For the first time the differentiated approach to appointment of preventive correction at often ill children from a position of a constitutional accessory and application of agents of a natural parentage is developed.

The author carries out a long catamnesis (180 days) often ill children in the conditions of a children's out-patient department after carrying out of preventive actions.

Application of complex homoeopathic preparations in the program of preventive maintenance of often ill children of 1st year of a life is proved

Necessity of carrying out of preventive actions for case rate depression is proved SHOUT at children not less than 3 times a year.

Introduction of results of research

The developed schemes of application of agents of a natural parentage for protection of children against acute respiratory diseases are recommended for
Uses in practical activities of doctors of out-patient departments, dispensaries, the aftertreatment centres.

Results of the given work are introduced in work of polyclinic unit DGKB №13 of N.F.Filatova, DGP №140 branch №1, and also №2 pediatric faculties GBOU VPO RNIMU of N.I.Pirogova MZ the Russian Federation are used in pedagogical process on chair of hospital pediatrics.

Expected mediko-social efficiency from introduction of offers

• depression of a case rate of children of early age;

• reduction of growth of a chronic pathology;

• improvement of quality of a life of children of early age;

• depression polipragmazii;

• economic feasibility.

The author personally defines the plan of carrying out of research, the observation card is developed, the set of children is carried out, types of observable children are allocated constitutional, the long catamnesis (6 months) is spent, statistical data processing with the subsequent writing of work is made.

Approbation of materials of dissertational work

Materials of dissertational work are reported on joint nauchnoyoprakticheskoj conferences of employees of chair of hospital pediatrics №2 RNIMU of N.I.Pirogova and employees of polyclinic unit DGKB13 of N.F.Filatova; at annual conference of pediatrists (Samara, 2012), annual conference of pediatrists (Nizhni Novgorod, 2013), conferences of pediatrists in Bashkiria (Ufa, 2014), scientifically-practical conference Quality and safety of rendering of medical aid to children within the limits of IV Inter-regional forum Healthy children - the future of Russia (Nizhni Novgorod, 2014); international scientifically - practical conference Information technologies in medicine and pharmacology (Rostov-on-Don, 2014), annual international homoeopathic conference (Moscow, 2015).

Publications in the scientific press

On a dissertation theme 5 printing works are published.

Volume and dissertation structure

The dissertation is stated on 129 p. of the typewritten text, 4 heads (the literary review, materials and research methods, own results, discussion of the received results), conclusions, practical references, the literature list consist of introduction. The bibliography contains 213 sources, from them 154 domestic, 59 foreign works. Work is illustrated by 36 tables, 21 schedules, 1 drawing and 3 extracts of case histories of children.

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Scientific source TISHKINA IRINA SERGEEVNA. Preventive programs at often ill children of early age in establishments of a primary link. The DISSERTATION ON COMPETITION of the SCIENTIFIC DEGREE of the CANDIDATE of MEDICAL SCIENCES. Moscow - 2015. 2015

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