Medication management of autonomic nervous system disorders in adolescents with tuberculosis
https://doi.org/10.21292/2075-1230-2020-98-7-44-50
Abstract
To manage autonomic disorders in adolescents with tuberculosis, 100 people from 12 to 15 years old were examined and randomly divided into two groups: Group 1 received standard anti-tuberculosis therapy, and in Group 2, additionally to standard therapy, comprehensive treatment with Magne B6 was used for 2 months, and then Valerian extract was used for another 2 months. For comparison, 50 healthy adolescents were examined. Before treatment, all adolescents with tuberculosis experienced a decrease in heart rate variability, a pronounced autonomic imbalance with the prevalence of sympathicotonia and overexertion of compensatory mechanisms. In Group 1, during the comprehensive treatment there were an increase in SDNN and Mo and decrease in AMo and tension index at rest. Active orthostatic test (AOT) was accompanied by a significant increase in SDNN, Mo and a decrease in AMo, which indicated an increase in the activity of the parasympathetic autonomic nervous system and decreased activity of the sympathetic autonomic nervous system. In the group receiving standard therapy, hypersympathycotonia persisted and manifested through significant (p < 0.05) reduction in such parameters as SDNN, increased heart rate, AMo, and Mo shift to short intervals. Medication management resulted in the vegetative balance by increasing heart rate variability, reducing hypersympathicotonia, improving the autonomic support of the cardiovascular system at rest and during AOT.
About the Authors
L. А. ShovkunRussian Federation
Lyudmila A. Shovkun, Doctor of Medical Sciences, Professor, Head of Tuberculosis Department
29, Nakhichevansky Lane, Rostov-on-Don, 344022
Phone: +7 (863) 250-42-00
N. Yu. Klimenko
Russian Federation
Natalya Yu. Klimenko, Candidate of Medical Sciences, Assistant of Infectious Diseases Department no. 2
29, Nakhichevansky Lane, Rostov-on-Don, 344022
Phone: +7 (863) 250-42-00
V. А. Аksenova
Russian Federation
Valentina A. Аksenova, Doctor of Medical Sciences, Professor,
Academician of RANS, Head of Department of Tuberculosis in Children and Adolescents, Chief External Pediatric TB Doctor
Build. 2, 4, Dostoevskiy St., Moscow, 127473
Phone: +7 (495) 681-92-36
D. А. Kudlay
Russian Federation
Dmitry A. Kudlay, Doctor of Medical Sciences, Professor of Pharmacology Department
8, Bd. 2, Trubetskaya St., Moscow, 119991
Phone: +7 (499) 248-05-53
N. Yu. Nikolenko
Russian Federation
Nikolay Yu. Nikolenko, Researcher
10, Stromynka St., Moscow, 107014
E. D. Kampos
Russian Federation
Elena D. Kampos, Candidate of Medical Sciences, Associate Professor of Tuberculosis Department
29, Nakhichevansky Lane, Rostov-on-Don, 344022
Phone: +7 (863) 250-42-00
References
1. Аksenova V.А., Levi D.T., Аleksandrova N.V., Kudlay D.А. Current tuberculosis incidence in children, agents for the infection prevention and diagnostics. Biopreparaty. Profilaktika, Diagnostika, Lechenie, 2017, vol. 17, no. 3, pp. 145-151. (In Russ.)
2. Analiz serdechnogo ritma. [Analysis of the heart rhythm]. D. Zhemaytite, P. Telksnis, eds., Vilnius, Kokslal, 1982, pp. 5-31.
3. Baevskiy R.M., Ivanov G.G. Heart rate variability: theoretical aspects and possibilities of clinical use. Ultrazvukovaya i Funktsionalnaya Diagnostika, 2001, no. 3, pp. 108-127. (In Russ.)
4. Bastrykina O.V. About the psychological types of the attitude to the disease in tuberculosis patients. Russkiy Meditsinskiy Journal, Pulmonologiya, Ftiziatriya, 2001, no. 21, pp. 56-63. (In Russ.)
5. Berezny E.А., Rubin А.M. Prakticheskaya kardioritmografiya. [Practical cardiorhythmography]. St. Peterburg, Neo Publ., 1997, 143 p.
6. Boltach А.V., Gorvenko I.I., Schebetko D.А., Silivanovich M.V., Gayduk А.R., Kurganskaya Yu.I. Assessment of the effect of magnesium drugs on heart rate variability and the functional state of endothelial in the adaptive syndrome. Lechebnoe Delo: Nauchno-Prakticheskiy Terapevticheskiy Journal, 2019, no. 3 (67), pp. 19-20. (In Russ.)
7. Vorobieva O.V., Аkarachkova E.S. Magne B6: experience of 5 years of clinical use in neurological and therapeutic practice. Pharmateka. 2008, no. 20 (174), pp. 73-81. (In Russ.)
8. Gromova O.А., Kalacheva А.G., Torshin I.Yu., Rudakov K.V., Grustlivaya U.E., Yudina N.V. et al. Magnesium deficiency is a significant risk factor for comorbidities: the results of massive magnesium screening in regions of Russia. Pharmateka. 2013, no. 6 (259), pp. 116-129. (In Russ.)
9. Zakharova I.N., Tvorogova T.M., Pshenichnikova I.I. Modern recommendations for the diagnosis and treatment of vegetative dystonia in children and adolescents. Meditsinsky Soviet, 2016, no. 16, pp. 116-123. (In Russ.)
10. Kazimirova N.E., Zlotarev А.M. Rate of heart rhythm variations in the evaluation of vegetative hemostasis in TB/HIV patients. Tuberculosis and Lung Diseases, 2014, no. 9, pp. 27-28. (In Russ.)
11. Karkashadze G.А., Namazova-Baranova L.S., Mamedyarov А.M., Konstantinidi T.А., Sergienko N.S. Magnesium deficiency in pediatric neurology: what should a pediatrician know? Voprosy Sovremennoy Pediatrii, 2014, vol. 13, no. 5, pp. 17-25. (In Russ.)
12. Kuleshova E.S., Karpova D.S. The role of magnesium in the human body. Periodic table of chemical elements: theory and practice of teaching. Materialy mezhvuzovskogo nauchno-prakticheskogo seminara. [Abst. book of Inter-University of Scientific Practical Seminar]. 2019, pp. 53-58. (In Russ.)
13. Loschakova А.I., Brazhenko O.N., Brazhenko N.А., Zheleznyak S.G., Tsygan N.V. The functional state of the autonomic nervous system, adaptation, homeostasis and reactivity of the host in the clinical signs of tuberculosis and sarcoidosis. Vestnik Rossiyskoy Voenno-Meditsinskoy Akademii, 2018, no. 2 (62), pp. 244-248. (In Russ.)
14. Mikhaylov V.M. Variabelnost ritma serdtsa: opyt prakticheskogo primeneniya. [The variability of the heart rhythm: the experience of practical application]. Ivanovo, 2002, 288 p.
15. Musazhanova R.А. Specific parameters of vegetative manifestations in chronic inflammatory bronchopulmonary diseases in children. Mezhdunarodny Nevrologicheskiy Journal, 2014, no. 8 (70), pp. 138-142. (In Russ.)
16. Pogotskaya А.А., Pogotskiy А.K. Valerian forte is a sedative medication based on herbs. Retsept, 2014, no. 2 (94), pp. 150-154. (In Russ.)
17. Slogotskaya L.V., Sinitsyn M.V., Kudlay D.А. Possibilities of immunological tests in the diagnosis of latent tuberculosis infection and tuberculosis. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 11, pp. 46-59. (In Russ.)
18. Starshinova А.А., Kudlay D.А., Dovgalyuk I.F., Basantsova N.Yu., Zinchenko Yu.S., Yablonskiy P.K. Efficacy of new methods of immunodiagnostics of tuberculous infection in the Russian Federation. Pediatriya, 2019, vol. 98, no. 4, pp. 229-235. (In Russ.) doi: 10.24110/0031-403X-2019-98-4-229-235.
19. Timofeeva E.P., Ryabichenko T.I., Skosyreva G.А., Kartseva T.V. The state of the autonomic nervous system in adolescents 15-17 years. Rossiyskiy Vestnik Perinatologii i Pediatrii, 2016, no. 4, pp. 82-87. (In Russ.)
20. Shilov А.M., Osiya А.O.Magnesium deficiency and cardiovascular diseases: pathophysiology and treatment in primary health care. Russkiy Meditsinskiy Journal, 2014, no. 2, pp. 156-161. (In Russ.)
21. Barrios-Payán J. et al. The contribution of the sympathetic nervous system to the immunopathology of experimental pulmonary tuberculosis. J. Neuroimmunology, 298, 2016, pp. 98-105.
22. Fitzgerald P.J. Serious infection may systemically increase noradrenergic signaling and produce psychological effects. Med. Hypotheses, 139, 2020, 109692.
23. Raimondia G., Contini S., Legramante J.M., Bocchino M. et al. Autonomic nervous system dysfunction in the course of active pulmonary tuberculosis. Respir. Med., 2007, vol. 101, is. 8, pp. 1804-1808.
24. Slogotskaya L.V., Litvinov V., Kudlay D.A., Ovsyankina E., Seltsovsky P., Ivanova D., Nikolenko N. New skin test with recombinant protein CFP10-ESAT6 in patients (children and adults) with tuberculosis, non-tuberculosis disease and latent TB infection. Eur. Respir. J., 2012, vol. 40 (S56), pp. 416.
25. Slogotskaya L.V., Litvinov V., Ovsyankina E., Seltsovsky P., Kudlay D. Results of QuantiFERON-TB Gold in-tube and skin testing with recombinant proteins CFP-10-ESAT-6 in children and adolescents with TB or latent TB infection. Paediatric Respir. Rev., 2013, vol. 14, no. 2, pp. S65.
26. Williams D.P., Koenig J., Carnevali L., Sgoifo F., Jarczok M.N., Sternberg E.M., Thayer J.F. Heart rate variability and inflammation: A meta-analysis of human studies. Brain Behav. Immun., 2019, Aug. no. 80, pp. 219-226.
Review
For citations:
Shovkun L.А., Klimenko N.Yu., Аksenova V.А., Kudlay D.А., Nikolenko N.Yu., Kampos E.D. Medication management of autonomic nervous system disorders in adolescents with tuberculosis. Tuberculosis and Lung Diseases. 2020;98(7):44-50. (In Russ.) https://doi.org/10.21292/2075-1230-2020-98-7-44-50