{"title":"体位疗法治疗婴儿频繁肠绞痛的疗效观察","authors":"T. Sorokman, V. Ostapchuk","doi":"10.24061/2413-4260.xiii.1.47.2023.2","DOIUrl":null,"url":null,"abstract":"Infantile colic is a general term used to describe excessive crying, abdominal pain, and discomfort in the first months of life, and it causes stress for parents and concern for clinicians. Colic in babies is common all over the world. The Rome criteria offer diagnostic criteria for functional gastrointestinal symptoms but do not discuss their treatment. Manipulative treatments are considered effective interventions to reduce the severity of symptoms.The aim of the study. To evaluate the effectiveness of postural therapy in infants with intestinal colic.Methods. The current prospective cohort study used data from a mother-child cohort. 37 \"mother-child\" pairs (age of babies from 2 weeks to 4 months) were under observation. Two observation groups were created by the method of simple randomization: Group I - 17 infants who received traditional therapy (preparations based on simethicone, prokinetics, enzymes, antispasmodics, in case of significant flatulence, a gas removal tube or microenema was used), Group II - 20 infants who received postural therapy.To reveal the statistical difference between indicators in groups distributed normally, the Student's t-criterion of reliability was used, the degree of significance - r. The probability of the difference between relative values was determined by the Fisher's angular transformation method (Рφ).The research design and all the methods used in this study were reviewed and approved by the bioethics commission of the Bukovinian State Medical University (protocol No. 8, dated 02/17/2023).The study was carried out as part of the research work «Early diagnosis, treatment and prevention of combined pathology of the gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results of the study. In 81.1% of babies, colic started after the 2nd week of life, in 18.9% - after the 1st month of life. The average age of onset of symptoms was 1.1 ± 0.1 months. Initially, colic occurred less often (1-2 times a week) and lasted up to 15 minutes, with age, their frequency and duration increased. We identified the main risk factors for the development of colic in babies: younger age of parents (F = 0.529, p = 0.001), mother's smoking (F = 0.498, p = 0.01), hypodynamia of the mother during pregnancy (F = 0.511, p = 0 .02), positive history of the father regarding functional diseases of the gastrointestinal tract (F = 0.788, p= 0.004), positive history of the mother regarding functional diseases of the gastrointestinal tract (F = 0.489, p= 0.01), food allergy in the mother (Ф = 0.476, p = 0.02), food allergy in the father (F = 0.329, p = 0.05), early (up to 3 months) transfer of the child to mixed or artificial feeding (F = 0.324, p = 0.05), hypoxic-ischemic CNS damage (F = 0.467, p = 0.05), body weight at birth <2900 g (F = 0.531, p = 0.01). The dynamics of symptoms in children of both observation groups was almost the same, with the exception of such signs of colic as flatulence and grunting, which disappeared faster by 2.7±0.6 days in children who were on postural therapy. The frequency of colic attacks also decreased. Positive dynamics of body weight gain were noted in infants of both groups.Conclusions.1. The average age of onset of intestinal colic symptoms in infants was 1.1 ± 0.1 months.2. The relationship between the age of the parents, the mother's smoking and the mother's hypodynamia during pregnancy, a positive history of the parents regarding functional diseases of the gastrointestinal tract, hypoxic-ischemic lesions of the central nervous system and a birth weight of less than 2900 g and intestinal colic in infants was established.3. The use of postural therapy in infants with intestinal colic is an effective method of their treatment, which is confirmed by the positive dynamics of symptoms, a decrease in the frequency and duration of colic attacks, a sufficient increase in body weight and does not require the cost of medication.","PeriodicalId":162458,"journal":{"name":"Neonatology, surgery and perinatal medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"EFFECTIVENESS OF POSTURAL THERAPY IN INFANTS WITH FREQUENT INTESTINAL COLIC\",\"authors\":\"T. Sorokman, V. Ostapchuk\",\"doi\":\"10.24061/2413-4260.xiii.1.47.2023.2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Infantile colic is a general term used to describe excessive crying, abdominal pain, and discomfort in the first months of life, and it causes stress for parents and concern for clinicians. Colic in babies is common all over the world. The Rome criteria offer diagnostic criteria for functional gastrointestinal symptoms but do not discuss their treatment. Manipulative treatments are considered effective interventions to reduce the severity of symptoms.The aim of the study. To evaluate the effectiveness of postural therapy in infants with intestinal colic.Methods. The current prospective cohort study used data from a mother-child cohort. 37 \\\"mother-child\\\" pairs (age of babies from 2 weeks to 4 months) were under observation. Two observation groups were created by the method of simple randomization: Group I - 17 infants who received traditional therapy (preparations based on simethicone, prokinetics, enzymes, antispasmodics, in case of significant flatulence, a gas removal tube or microenema was used), Group II - 20 infants who received postural therapy.To reveal the statistical difference between indicators in groups distributed normally, the Student's t-criterion of reliability was used, the degree of significance - r. The probability of the difference between relative values was determined by the Fisher's angular transformation method (Рφ).The research design and all the methods used in this study were reviewed and approved by the bioethics commission of the Bukovinian State Medical University (protocol No. 8, dated 02/17/2023).The study was carried out as part of the research work «Early diagnosis, treatment and prevention of combined pathology of the gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results of the study. In 81.1% of babies, colic started after the 2nd week of life, in 18.9% - after the 1st month of life. The average age of onset of symptoms was 1.1 ± 0.1 months. Initially, colic occurred less often (1-2 times a week) and lasted up to 15 minutes, with age, their frequency and duration increased. We identified the main risk factors for the development of colic in babies: younger age of parents (F = 0.529, p = 0.001), mother's smoking (F = 0.498, p = 0.01), hypodynamia of the mother during pregnancy (F = 0.511, p = 0 .02), positive history of the father regarding functional diseases of the gastrointestinal tract (F = 0.788, p= 0.004), positive history of the mother regarding functional diseases of the gastrointestinal tract (F = 0.489, p= 0.01), food allergy in the mother (Ф = 0.476, p = 0.02), food allergy in the father (F = 0.329, p = 0.05), early (up to 3 months) transfer of the child to mixed or artificial feeding (F = 0.324, p = 0.05), hypoxic-ischemic CNS damage (F = 0.467, p = 0.05), body weight at birth <2900 g (F = 0.531, p = 0.01). The dynamics of symptoms in children of both observation groups was almost the same, with the exception of such signs of colic as flatulence and grunting, which disappeared faster by 2.7±0.6 days in children who were on postural therapy. The frequency of colic attacks also decreased. Positive dynamics of body weight gain were noted in infants of both groups.Conclusions.1. The average age of onset of intestinal colic symptoms in infants was 1.1 ± 0.1 months.2. The relationship between the age of the parents, the mother's smoking and the mother's hypodynamia during pregnancy, a positive history of the parents regarding functional diseases of the gastrointestinal tract, hypoxic-ischemic lesions of the central nervous system and a birth weight of less than 2900 g and intestinal colic in infants was established.3. The use of postural therapy in infants with intestinal colic is an effective method of their treatment, which is confirmed by the positive dynamics of symptoms, a decrease in the frequency and duration of colic attacks, a sufficient increase in body weight and does not require the cost of medication.\",\"PeriodicalId\":162458,\"journal\":{\"name\":\"Neonatology, surgery and perinatal medicine\",\"volume\":\"1 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-02-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neonatology, surgery and perinatal medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neonatology, surgery and perinatal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24061/2413-4260.xiii.1.47.2023.2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
婴儿绞痛是一个通用术语,用于描述出生后最初几个月的过度哭泣、腹痛和不适,它给父母带来压力,也给临床医生带来担忧。婴儿疝气在世界各地都很常见。Rome标准提供了功能性胃肠道症状的诊断标准,但没有讨论其治疗方法。手法治疗被认为是减轻症状严重程度的有效干预措施。研究的目的。目的:探讨体位疗法治疗婴幼儿肠绞痛的疗效。目前的前瞻性队列研究使用了来自母婴队列的数据。37对“母子”(婴儿年龄从2周至4个月)进行了观察。采用简单随机化的方法建立两个观察组:第一组- 17名婴儿接受传统治疗(以西甲硅氧烷、原动力学、酶制剂、抗痉挛药物为基础的制剂,如果出现明显的胀气,则使用排气管或微灌肠),第二组- 20名婴儿接受体位治疗。为了揭示正态分布组中指标之间的统计差异,采用Student's t信度判据,显著度- r。相对值之间差异的概率由Fisher角变换法确定(Рφ)。本研究的研究设计和使用的所有方法均经Bukovinian州立医科大学生物伦理委员会审查并批准(议定书第8号,日期为2023年2月17日)。该研究是“儿童胃肠道和甲状腺联合病理的早期诊断、治疗和预防”研究工作的一部分(国家注册号0116U002937,实施期02.2016-11.2022)。研究结果。在81.1%的婴儿中,绞痛在出生后2周开始,18.9%在出生后1个月。平均发病年龄1.1±0.1个月。最初,绞痛发生率较低(1-2次/周),持续时间可达15分钟,随着年龄的增长,发生频率和持续时间增加。我们确定了导致婴儿肠绞痛的主要危险因素:年轻的父母(F = 0.529, p = 0.001),母亲吸烟(F = 0.498, p = 0.01),体力不够的母亲在怀孕期间(F = 0.511, p = 0 .02点),积极的历史父亲关于功能性胃肠道疾病(F = 0.788, p = 0.004),积极的历史母亲关于功能性胃肠道疾病(F = 0.489, p = 0.01),食物过敏的母亲(Ф= 0.476,p = 0.02),食物过敏的父亲(F = 0.329, p = 0.05),早期(3个月前)改用混合或人工喂养(F = 0.324, p = 0.05),缺氧缺血性中枢神经系统损伤(F = 0.467, p = 0.05),出生时体重<2900 g (F = 0.531, p = 0.01)。两个观察组儿童的症状动态几乎相同,除了肠胃胀气和咕噜声等绞痛症状,在接受体位治疗的儿童中,这些症状消失得更快,为2.7±0.6天。绞痛发作的频率也有所下降。两组婴儿体重增加均呈积极动态变化。婴儿出现肠绞痛症状的平均年龄为1.1±0.1个月。2 .父母年龄、母亲吸烟与母亲妊娠期动力不足、父母有胃肠道功能性疾病、中枢神经系统缺氧缺血性病变、出生体重小于2900 g、婴儿肠绞痛的阳性病史之间建立关系。在肠绞痛婴儿中使用体位疗法是一种有效的治疗方法,这是由症状的积极动态,绞痛发作频率和持续时间的减少,体重的充分增加以及不需要药物费用所证实的。
EFFECTIVENESS OF POSTURAL THERAPY IN INFANTS WITH FREQUENT INTESTINAL COLIC
Infantile colic is a general term used to describe excessive crying, abdominal pain, and discomfort in the first months of life, and it causes stress for parents and concern for clinicians. Colic in babies is common all over the world. The Rome criteria offer diagnostic criteria for functional gastrointestinal symptoms but do not discuss their treatment. Manipulative treatments are considered effective interventions to reduce the severity of symptoms.The aim of the study. To evaluate the effectiveness of postural therapy in infants with intestinal colic.Methods. The current prospective cohort study used data from a mother-child cohort. 37 "mother-child" pairs (age of babies from 2 weeks to 4 months) were under observation. Two observation groups were created by the method of simple randomization: Group I - 17 infants who received traditional therapy (preparations based on simethicone, prokinetics, enzymes, antispasmodics, in case of significant flatulence, a gas removal tube or microenema was used), Group II - 20 infants who received postural therapy.To reveal the statistical difference between indicators in groups distributed normally, the Student's t-criterion of reliability was used, the degree of significance - r. The probability of the difference between relative values was determined by the Fisher's angular transformation method (Рφ).The research design and all the methods used in this study were reviewed and approved by the bioethics commission of the Bukovinian State Medical University (protocol No. 8, dated 02/17/2023).The study was carried out as part of the research work «Early diagnosis, treatment and prevention of combined pathology of the gastrointestinal tract and thyroid gland in children» (state registration number 0116U002937, implementation period 02.2016-11.2022).Results of the study. In 81.1% of babies, colic started after the 2nd week of life, in 18.9% - after the 1st month of life. The average age of onset of symptoms was 1.1 ± 0.1 months. Initially, colic occurred less often (1-2 times a week) and lasted up to 15 minutes, with age, their frequency and duration increased. We identified the main risk factors for the development of colic in babies: younger age of parents (F = 0.529, p = 0.001), mother's smoking (F = 0.498, p = 0.01), hypodynamia of the mother during pregnancy (F = 0.511, p = 0 .02), positive history of the father regarding functional diseases of the gastrointestinal tract (F = 0.788, p= 0.004), positive history of the mother regarding functional diseases of the gastrointestinal tract (F = 0.489, p= 0.01), food allergy in the mother (Ф = 0.476, p = 0.02), food allergy in the father (F = 0.329, p = 0.05), early (up to 3 months) transfer of the child to mixed or artificial feeding (F = 0.324, p = 0.05), hypoxic-ischemic CNS damage (F = 0.467, p = 0.05), body weight at birth <2900 g (F = 0.531, p = 0.01). The dynamics of symptoms in children of both observation groups was almost the same, with the exception of such signs of colic as flatulence and grunting, which disappeared faster by 2.7±0.6 days in children who were on postural therapy. The frequency of colic attacks also decreased. Positive dynamics of body weight gain were noted in infants of both groups.Conclusions.1. The average age of onset of intestinal colic symptoms in infants was 1.1 ± 0.1 months.2. The relationship between the age of the parents, the mother's smoking and the mother's hypodynamia during pregnancy, a positive history of the parents regarding functional diseases of the gastrointestinal tract, hypoxic-ischemic lesions of the central nervous system and a birth weight of less than 2900 g and intestinal colic in infants was established.3. The use of postural therapy in infants with intestinal colic is an effective method of their treatment, which is confirmed by the positive dynamics of symptoms, a decrease in the frequency and duration of colic attacks, a sufficient increase in body weight and does not require the cost of medication.