• Корекція Psycho-emotional disorders and stress conditions correction in children with functional gastrointestinal disorders

Корекція Psycho-emotional disorders and stress conditions correction in children with functional gastrointestinal disorders

SOVREMENNAYA PEDIATRIYA.2017.2(82):76-84; doi 10.15574/SP.2017.82.76

Berezhniy V., Mamenko M., Drokh H., Boyarska K., Kozhyna H., Boholey O., Horbatova L.
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
Kyiv City Children's Clinical Hospital No. 1, Ukraine

И to evaluate the efficacy and safety of γ-phenyl-β-aminobutyric acid in treatment of functional dyspepsia (FD) in primary school children.

Materials and methods. The study involved 80 children aged 6-12 years with FD. Children were distributed into two groups: the main group — 40 patients, who received basic therapy along with γ-phenyl-β-aminobutyric acid (Noophen®100) and control group — 40 children who received only basic scheme of treatment. Methods of examination: clinical, instrumental, psychological testing, ELISA (adrenocorticotropic hormone (ACTH), cortisol, norepinephrine in blood serum and urine, insulin), biochemical markers (glucose, bilirubin, ALT, AST), statistics.

Results. Children with FD demonstrated clinical performance of autonomic dysfunction complaints (93%), high levels of depression (42%), anxiety (61%), sleep disorders (85%), reduced cognitive function (86%). High levels of stress condition were manifested by the increased levels of cortisol (597.6 nmol/L), norepinephrine in plasma (14.3 pg/ml) and in urine (111.4 mcg/day), high glucose levels (5.1 mmol/ml) and relatively low content of insulin (8.2 mcMO/ml) and ACTH (15.8 pg/mL). After the treatment with γ-phenyl-β-aminobutyric acid it was detected a significant decrease of FD symptoms (p=0.017), decreased levels of anxiety (p=0.050) and depression (p=0.033), lower manifestations of autonomic disorders (p=0.003), rare sleep disturbances (p=0.023), improved attention (p=0.041) and memory (p=0.007). Reduction of sympathoadrenal system activity was detected that was demonstrated by lower levels of cortisol (p=0.031), norepinephrine in urine (p=0.037) and plasma (p=0.041), higher levels of ACTH (p=0.042).

Conclusions. The γ-phenyl-β-aminobutyric acid usage in treatment of functional dyspepsia (FD) in primary school children may be recommended as effective and safe method.

Key words: functional gastrointestinal disorders, functional dyspepsia, stress, treatment.

References

1. Voznyak AV. 2015. Efficacy Noofen in treatment of autonomic dysfunction in children. International Journal of Pediatrics, Obstetrics and Gynecology. 1(8): 117-123.

2. Kozlyakovsʹkyi PA. 2004. General Psychology: Tutorial. Mykolaiv: 130.

3. Maidannyk VG. 2007. Rome criteria III (2006) in diagnostics of Functional gastrointestinal disorders in children. Pediatrics, Obstetrics and Gynecology. 3: 5-13.

4. Maidannyk VG. 2016. Rome IV (2016) criteria: What is new? International Journal of Pediatrics, Obstetrics and Gynecology. 10(1): 8-18.

5. Nagorna GV, Dubova V, Bordyugova YeV. 2012. Psychovegetative syndrome in children and possible ways to actionn. Sovremennaya pediatriya. 7(47): 47-51.

6. Nakaz MOZ Ukrayiny vid 29.01.2013 No.59 Pro zatverdzhennya unifikovanykh klinichnykh protokoliv medychnoyi dopomohy dityam iz zakhvoryuvannyamy orhaniv travlennya: 16-11.

7. Sednev VV, Zbarskyy ZH, Burtsev AK. 1997. Detskyy oprosnyk nevrozov (DON) (metodycheskye ukazanyya). Donetsk. 8.

8. Serhiyenko OI. 2011 Znachennya psykholohichnoho faktora u rozvytku funktsionalʹnykh rozladiv hastroduodenalʹnoyi zon. «Novosty medytsyny y farmatsyy» hastroenterolohyya (tematycheskyy nomer). 382.

9. Stepanov YuM. 2008. Psykhosomatycheskye aspekty y funktsyonalʹnye zabolevanyya zheludochno-kyshechnoho trakta. Zdorovya Ukrayiny: 32-33.

10. Khaytovych MV. 2002. Porushenn kohnityvnykh funktsiy u ditey z vehetatyvnymy dysfunktsiyamy ta yikh korektsiya Noofenom. Pediatrics, Obstetrics and Gynecology. 5: 84-86.

11. Sheptulin AA, Kurbatova AA. 2016. New Rome-IV criteria of the functional dyspepsia. Review. National college of gastroenterologists, hepatologists. 26(4): 124-128.

12. Creemens PA, Creemens J, Eiser C, Blades M. 2006. Factors influencing agreement between child self-report and parent proxyreports on the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scale. Health Qual. Life Outcomes. 4: 58. https://doi.org/10.1186/1477-7525-4-58; PMid:16942613 PMCid:PMC1564004

13. Drossman DA, Hasler WL. 2016. Rome IV – Functional GI disorders: disorders of gut-brain interaction. Gastroenterology. 150(6): 1257-61. https://doi.org/10.1053/j.gastro.2016.03.035; PMid:27147121

14. Drossman DA. 2006. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 130(5): 1377­1390. https://doi.org/10.1053/j.gastro.2006.03.008; PMid:16678553

15. Drossman DA, Creed FH, Olden KW, Svedlund J, Toner BB, Whitehead WE. 1999. Psychosocial aspects of the functional gastrointestinal disorders. Gut. 45; suppl 2: 25–30. https://doi.org/10.1136/gut.45.2008.ii25; https://doi.org/10.1136/gut.45.2008.ii1

16. Drossman DA, Corazziari E, Talley NJ, Thompson WG, Whitehead WE. 2000. Rome II. The functional gastrointestinal disorders. Diagnosis, pathophysiology and treatment: a multinational consensus. 2nd ed. McLean, VA: Degnon Associates;. 1–764.

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