the clinical characteristic of groups

Research was spent on base gastroenterologicheskogo units of the advisory-diagnostic centre for children, a children's out-patient department № 43, a children's out-patient department № 27, medical centre "XXI-st century" of St.-Petersburg.

Among examined on reception at pediatrists and gastroenterologists of 268 children from 1 month to 6 months 62 children with clinical implications of functional disorders of a gastroenteric tract (FRZHKT) which completely corresponded to the Roman criteria III with reference to children of this age (G) have been selected. 40 healthy children from 1 to 6 months, without symptoms FRZHKT selected by an age principle, have made control group. Thus, 102 children who have been parted on 2 groups have been included in research: the basic (OG) and control (KG).

Criteria of including in the basic group (OG) were:

- Age from 1 till 6 months;

- Presence of the clinical implications FRZHKT corresponding to following Roman criteria III:

1. G1 - Infantile regurgitations (frequency of 2 and more times in day throughout 3 and more weeks, absence of vomitings, blood impurity in vomitive masses, aspirations, apnoe, arrests of development, difficulties at proglatyvanii nutrition and the feeding, unusual poses);

2. G4 - Infantile intestinal gripes (attacks of anxiety and crying which arise and disappear without any reason, episodes proceed 3 and more hours per day and 3 days in a week on an extent at least 1 weeks repeat not less often, there is no backlog in development);

3. G7 - functional constipations (less than 6 defecations in a week; dense character of a chair).

According to the Roman criteria III, at the age from 1 to 6 months following FRZHKT is inherent to children: G1 - infantile regurgitations (MS), G4 - infantile intestinal gripes (MKK), G7 - functional constipations (FZ). Others FRZHKT, concerning early age, have a little excellent age range: G2 - infantile ruminatsija, is more inherent to children 6 months are more senior, G3 - cyclic vomiting - to children is more senior 2 years, G5 - a functional diarrhoeia, can be established only at children from 6 months till 1,5 years, G6 - infantile dishezija, is characteristic for newborns. Thus, implications FRZHKT at the patients included in research completely corresponded to age criteria.

Criteria of an exception of research were:

- The age is more senior 6 months;

- Presence of an acute and chronic pathology GASTROINTESTINAL TRACT (developmental anomalies, chronic inflammatory diseases, infectious diseases, a sprue);

- Presence of an accompanying acute or chronic pathology of other organs and systems;

- Presence of signs of a food allergy (atopichesky a dermatitis).

Control group children at the age from 1 till 6 months with similar OG distribution on months and a kind have made the feedings which do not have symptoms of any pathology. In table 2 distribution of children of investigated groups on a floor is shown.

Table 2. Distribution of children in the basic and control group on a floor (n=102)

Group Girls Boys X2 R
abs. % abs. %
The basic group (n=62) 36 58,1 26 41,9 1,09 > 0,10
Control group (n=40) 19 47,5 21 52,5

In the basic group the age has averaged 3,44±0,20 month (Me=3,0 month, 50 % of children were at the age from 2 to 5 months), in control - 3,68±0,21 month (Me=4,0 month, 50 % of children were at the age from 2 to 4 months).

Average value of age of children in both groups do not differ (t=0,80; p> 0,10; U=1117,00; p> 0,10), dispersions of this indicator also are identical in both groups (F=1,43; p> 0,10), at use of h2-criterion Pirsona standardly applied to such purposes it is not taped differences of age distribution of patients (х2=4,00; p> 0,10).

In a drawing 1 are presented (in a graphic kind) results of the ridit-analysis. On an axis of abscisses - age of children, on an axis of ordinates - relative quantity (in percentage, an accruing result, from total of children in groups) the surveyed, reached age noted on an axis of abscisses.

Drawing 1. Distribution of children of the basic and control groups (by results of the ridit-analysis)

The value establishment laktaznoj failures (LN) in occurrence of symptoms FR was one of problems of our research. On the basis of results of the spent inspection among patients OG the subgroup of children has been allocated with
LN. In this connection OG it has been sectioned into 2 subgroups: 1) FR with LN (LN, n=23), 2) FR without LN (FR, n=39).

Selection of optimum therapy for correction FR depending on presence or absence LN was one of problems of our research. Therefore children from subgroup LN, being on thoracal feeding (n=22), within 28 days received a preparation Lactase Beby (subgroup). A fermental preparation Lactase Bebi, 7 mg (700 units), made by firm National Enzyme Company, the USA, has the registration certificate № У.6124.6.05 from Ekomarket the Alpha (Russia), capsules of 220 mg. (BUD) concerns group of alimentary biologically active additives. Is an additional source of enzyme v-galaktozidazy. Mothers before feeding entered a preparation independently into the decanted milk (1/3 from feeding volume) then left milk for 10-15 minutes at a room temperature for a fermentation. Feeding of the child began with this portion of milk and continued feeding by a breast without interruption.

Children from group FR depending on character of feeding within 28 days received probiotichesky strain Lactobacillus reuteri: children who were on natural feeding (n=20), accepted preparation Rela Lajf (subgroup). Rela Lajf (drops, the vial of 5 ml) is registered in territory of the Russian Federation (№ Е.013562.05.11; 2011-05-10. In 5 drops of a preparation contains 108 WHICH live Lactobacillus reuteri Protectis.Рела Lajf prescribed on 5 drops once a day, adding drops in thoracal milk. Children who were on artificial feeding (n=20), received as therapy within 28 days admixture Nan Comfort (Nestle, Switzerland), containing moderately hydrolyzed fiber Opti - pro and the lowered level lactoses (subgroup). Into admixture structure enter live laktobakterii Lactobacillus reuteri.

The control clinico-laboratory estimation of a condition of patients was spent in 28 days.

In a drawing 2 distribution of surveyed children on groups and a choice of a method of treatment depending on presence at them pathological symptoms is shown.

Drawing 2. Distribution of children on groups and on treatment methods

The general data on patients and the used methods are presented in table 3.

Table 3. Data on patients and the used methods

Research methods Quantity of researches
History of development of children (f. 112/at) 268
Metabolic card of the newborn (f. 113/at) 268
The anamnesis collecting, survey 268
Questioning 102
Conducting a diary of dynamic observation 102
The hydrogen respiratory test with lactose 164
Feces crops on a dysbacteriosis 164
PTSR a feces 164
Definition kalprotektina in a feces 164


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Scientific source KUBALOVA Saida Sultanovna. CLINICAL VALUE LAKTAZNOJ of INSUFFICIENCY And MICROBIC DISTURBANCES AT FUNCTIONAL DISORDERS of the GASTROENTERIC TRACT At CHILDREN of EARLY AGE. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 2014. 2014

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