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41МЕДИЦИНСКИЕ НАУКИ (MEDICINE)
УДК 616-053.2:616.233+616.24-008.41
Khalmatova B.T. Efficiency usage of inspiron (fenspiride) at
exacerbation of asthma in children
Khalmatova Barno Turdixodjaevna PhD, professor, head of department of Children's diseases of Tashkent medical academy, Uzbekistan
Abstract: The objective of the present study was to estimate the efficacy and safety of combination of anti-inflammatory treatment of bronchial asthma (BA) and therapy with Inspiron. A total of 47 children aged from 6 to 15 years were available for the observation. They presented with mild intermittent (n=27), mild persisting (n=20) forms of the disease. The traditional treatment of all the patients was supplemented by daily intake of inspiron syrup at a dose of 4 mg/kg b.w. from the first day after admission to the hospital.
Keywords: children, anti-inflammatory therapy, bronchial asthma, inspiron
Bronchial asthma (BA) in children — one of the important problems of pediatrics due to the high prevalence in the world. Last 20-30 years have been achieved considerable progress in the development of a variety of dosage of asthma medication, but the results of treatment, which can last in a child for many years, do not always satisfy the physician, the patient and his parents. There is an increasing frequency of allergic and adverse drug reactions, the development of resistance to different drugs.
Epidemiological studies in recent years indicate that between 4 and 8% of the population suffer from asthma. In the pediatric population, this figure is higher (5 — 12%) than in adults (5%) [1, ^143, 2, ^103, 4, ^6-10, 6, ^ 53-58]. Today, medicine has many groups of medicines used in the treatment of asthma: anti-inflammatory, bronchial spasmolytic, expectorants, antileukotrinic [3, ^106].
However, they are not devoid of side effects (dysfunction of the gastrointestinal tract, liver, lipid metabolism, tachycardia, increased blood pressure, and others.). Currently asthma in children is considered as a heterogeneous disease, which is based on a chronic allergic inflammation of the airways (GINA, 2014).
Chronic allergic inflammation leads to increased bronchial hyper reactivity,
bronchi spasm, and the appearance of the typical symptoms of crepitation, shortness of breath and cough after exposure to allergens and triggers. Some patients with asthma, airway tract only partially reversible because of violations of the structure of the bronchi (hypertrophy and hyperplasia of smooth muscle, subepithelial fibrosis), which is more typical for patients who did not receive basic anti-inflammatory therapy [4, c.6-10, 5, c.78-79].
The goal of treatment of asthma in children is to prevent disturbing the patient and his relatives symptoms, maintaining normal or near-normal lung function, physical activity, prevention of asthma exacerbations, minimizing the need for treatment and hospitalization in specialized departments, carrying out optimal pharmacotherapy with minimal side effects, meeting the expectations of parents and family in the treatment of asthma.
An important element of pathogenic therapy of asthma is the use of antiinflammatory drugs. For drugs with anti-inflammatory properties and affinity for the mucosa of the respiratory tract include Inspiron.
Anti-inflammatory effect of aspirin is due to the mechanisms that lead to a decrease in exudation, edema of the bronchial mucosa, and resulting viscosity of sputum. In addition, it is able to prevent the development of bronchial obstruction, which is especially important in young children. These properties of the drug provides its high efficiency in the treatment of inflammatory diseases of the respiratory tract, including asthma, in particular the main (after asthma attacks) their clinical symptom — wet and dry cough [3, c.106, 6, c. 53-58].
The purpose of research — to evaluate the clinical efficacy and safety of the combination of the traditional anti-inflammatory asthma therapy with the drug Inspiron.
Materials and methods. Have been examined 47 children aged 6 to 15 years with mild intermittent (n = 27) and mild persistent (n = 20) B A. The control group included 19 children of similar age with asthma. Children in the control group received conventional treatment of asthma based on severity. To babies of further study group was assigned Inspiron in the form of syrup in a dose of 4 mg / kg body weight per day from day hospital stay. One of the criteria for inclusion of children in the main group was the absence of conditions that required intensive care. The duration of treatment was 7-10 days.
In the study, criteria for evaluating the effectiveness of treatment of asthma were selected: 1) the duration of intensive cough; 2) duration of hearing crepitation on auscultation of the lungs; 3) the terms of normalization of peak expiratory flow rate (PSV); 4) saturation of the blood in the oximetry.
Results and discussion. Duration of intensive cough in children with asthma were: 1) under light intermittently course in the study group (n = 27) — 3 days in the control (n = 10) — 4 days; 2) with mild persistent during the study group (n = 20) — 4
days, in control group (n = 9) — 5 days (p <0.05). It should be emphasized that at the time of inclusion in the study, 95% of children have an intense nonproductive cough. 5% of children cough although it was wet, but sputum at the same coughs difficult.
It was found that the children of the main group (68.5%) by the 3rd day of the study medication was noted slowing cough and decrease its intensity, which was accompanied by an improvement in general condition, normalization of sleep and a tendency to improve appetite. In addition, the positive dynamics of the nature of cough in 71% manifested itself in the form of a transformation into a productive cough. The appearance of a moist, well sputum facilitated easier rehabilitation of tracheobronchial tree.
The duration of auscultation of crepitation on auscultation of the lungs in children with asthma were as follows: 1) for mild intermittent during the study group — 3 days in the control group — 4 days (p> 0.05); 2) with mild persistent course in the study group — 4 days in the control group — 5 days (p> 0.05). From these results, it is evident that the duration of auscultation of crepitation coincides with the duration of cough.
Terms normalization of PSV in children with asthma were:
1) in mild intermittent during the study group — 3.8 days in the control group — 7 days (p> 0.05); 2) with mild persistent course in the study group — 4.2 days in the control group — 7 days (p> 0.05). From these results it is clear that the timing of normalization of PSV in children with asthma are significantly reduced in the study group.
Indicators of blood oxygen saturation in children with asthma on the 8th day of therapy are as follows: 1) for mild intermittent during the study group — 98.2% in the control group — 97.2% (p> 0.05); 2) with mild persistent course in the study group — 98% in the control group — 97.3% (p> 0.05). From these results it is clear that the performance of blood oxygen saturation in children with asthma in the study group for the 8th day of treatment higher than those of children in the control group.
It should also be noted that during the study, all patients treated by Inspiron syrup, was identified as a good tolerability evaluation by doctors and from the viewpoint of patients or their parents. Emphasizing that side and adverse events during treatment in children has not been observed.
Our studies on the identification of clinical efficacy in the treatment of asthma with Inspiron in children led to the following conclusions:
1. Adding the drug of Inspiron in traditional treatment of asthma in children can reduce the duration of the clinical manifestations of the disease, such as cough and changes in pulmonary auscultation picture.
2. Inspiron in children with asthma can reduce recovery times of bronchial obstruction.
3. Using the Inspiron in the treatment of children with asthma can accelerate the process of oxygen saturation of arterial blood.
4. Inspiron syrup does not contain coloring E110, the so-called «sunset», therefore does not cause allergic reactions and does not cause bronchoconstriction, which makes it safer for use in children.
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