Clinical Pharmacia
? : CyriX2003@mail.ru
 

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. 1985 , . - 15 (, ), 7 - . ,   . . . - (). , .

BRONCHIAL ASTHMA AS PSYCHOSOMATICO-IMMUNOLOGY A DISTRESS-SYNDROME RESEARCH (KLINIKO-EXPERIMENTAL)

Summury The work urgency is dictated by the big percent of occurrence of an asthma psychogenic genezs - 30 % from the general number of occurrence of an asthma of others genezes. This large quantity of people to which emergency medical aid often is required. Disease is considered chronic, but at competent diagnostics and treatment can be completely is cured.

Abstract The author's psychological diagnostics based on early signs of occurrence this nozology, the competent complex individualised treatment taking into account weak organs from a birth - yields good results of treatment under condition of convertibility of processes and their prescription. But to facilitate a condition it is possible always.

    At psychosomatic components of illness methods of psychotherapy, an aromatherapy and natural medicine - vegetative energizers which, both activate well help, and displays of vegetative nervous system brake. The allergic and infectious component often joins psychogenic forms of an asthma, as secondary process which demands appointment mucolitics, expectorants, vegetative antibiotics, vegetative hormones of a bark of adrenal glands, antioxidants.

    The bronchial asthma psychogenic genezs is psychosomatic inflammatory not infectious process in 2 parties, going from mentality to somatic and from somatic and mentality, closing a vicious circle nozology, having the characteristic lines of the display, always accompanied oxidant stress on peroxid to a variant.

Introduction To pubertat the bronchial asthma arises at boys in 2 times, in an adult condition - more often at women of mature age is more often. In my rich practice there are many cases without recidive currents of illness with full recover with inclusion in standards of treatment of medicinal grasses and various extracts from them (an author's technique - not published data of the author).

    At elderly - emotional reactions can be less expressed, and here somatic - more. Every time when emotions choke, excluded from a consciousness field, lose an adequate discharge, they become a source of chronic pressure. Influence is carried out through cortico-talamical and vegetative spending ways since the peripheral vegetative system is not connected with thought processes.

    Thus, it is necessary to allocate psychiatric, psychosomatic, psychological, somato-psychological (1) and to correct it is necessary to each kind of the diagnosis with the approaches, considering, a sex, age, organism power since it already there will be different approaches just as prophilactical and to treat a human body it is necessary during the different periods and differently.

    In the conditions of set stressogenal factors complex methods of influence on a human body for preventive maintenance and treatment of diseases are necessary.

    Specific psychodynamic formulations should be reconsidered. There are also transitions from somatic to mentality. Them it is necessary to learn to differentiate as except psychosomatology the new branch - somato-psychology appears also. The psychosomatic method assumes group work, but the author recognises individual work, as at all different weak organs from a birth (not published data of the author).

Hypothesis At psychological level - illness start gives irritation of certain zones limbical systems. It leads to fits of anger or, on the contrary, to braking of inclinations and affects. At stimulation of certain sites of this system there is an uncertain fear or the fear directed on certain object, mood swings towards despondency or grief and, at last, impulsive sexual behaviour  (P. McLean, 1952).

     In modern medicine limbical system name visceral or power a brain. She answers; for sense of smell, emotions - fear and anger, salivation, slime formation in bronchial tubes, sexual behaviour, frequency of warm reductions, sizes the arterial pressure, secretion adrenokorticotrop hormons, katecholamins, other hormones and mediators. The system works cyclic character of movement of processes of excitation on the closed network of structures - circle Peipsa. At an asthma there is a closed vicious circle, which is necessary for breaking off.

     Nevertheless, despite plurality of localisation of functions, it was possible to establish key, or peismeker the mechanisms, which deenergizing conducts to full loss of function that is traced at an asthma.

     Limbical structures, which concern an olfactory brain, paragyppokamp a crinkle, temporal and frontal departments of a bark, at the expense of internal interrelations and wide influence on other formations of a brain also promote it generalization to excitation. Activating influences form a physiological basis of occurrence of motivational excitation of a brain. At occurrence of internal requirements of an organism there is an excitation motivationgenal the centres hypotalamuss, limbical and reticular formations, which at the expense of the activating influences will organise processes in a brain that leads to formation of purposeful behaviour. Along with activating ascending influences in a brain there are descending, mainly kortiko-fugal, influences on subcrustal structures. Interaction of ascending and descending influences causes a two-way communication between the brain structures, especially expressed between a bark of the big brain and subcrustal formations. Similar reverberation excitation can promote preservation of the centres of long excitation that underlies mechanisms of short-term memory or long emotional conditions.

     The higher centre of regulation of vegetative functions is limbical the system. From  limbical systems excitation impulses go - to the vegetative centres hipotalamusis, through it to a hypophysis and kernels of sympathetic and parasympathetic departments of vegetative nervous system. Thanks to the communications with bazal ganglis, forward departments talamus and reticular a formation, limbical the system can influence a functional condition of skeletal muscles. Some areas of a bark of the big brain, especially frontal and parietal departments, participate in regulation of vegetative functions. The irritation of these areas causes change of warm activity, level of arterial pressure and a breath rhythm, salivation, intestines movements, vomiting.

     Sympathetic influences on cages, especially on skeletal muscles, always adaptacion-trophic also are carried out at the expense of allocated mediators noradrenalins. Adaptacion-trophic influence of sympathetic nervous system can be and indirect at the expense of allocation noradrenalins  in liquid environments of an organism (blood, cerebrospinal a liquid, a lymph) or to be carried out through hypotalamus and glands of internal secretion. The majority of researchers consider any influence of nervous system as trophic, which is carried out with impuls to the form and has similarity to processes neurosecretion. Such substances formed in nervous cages, as mediators, peptids, amino acids, enzymes, are delivered to executive powers by means of acsonal transport and influence their exchange.

     The Limbic system participates in formation of emotional conditions of the person. The emotional conditions accompanied by positive or negative subjective experiences, are objectively shown impellent (laughter, crying, aggression) and vegetative (changes of breath, a blood pressure, sweat branch) by reactions. At formation of emotions there is a functional association of kortiko-subcrustal formations, when excitation is capable to circulate on various structures. Similar circulation excitations can form a basis of long emotional conditions and even to have pathological character - occurrence of a bronchial asthma.

There are following directions of research of psychological preconditions of occurrence of a bronchial asthma:

 

1. One direction in psychotherapy of a bronchial asthma is increase of a role of the right hemisphere of a brain, deficiency, which is distinctly traced at children with a bronchial asthma. Change of activity of the central nervous system promotes accumulation of affective excitation (alarm) and pressure of vegetative activity. Neurodinamical shifts can be primary, arising in connection with damage of structures, or secondary - at functional frustration central neuronal sistems. These shifts can be also a consequence of the amplifying or painfully changed signals from internal bodies. At the same time at defeat of the right hemisphere, arising emotional frustration, are combined with viscer-vegetative infringements.

    Displays of the basic disease in reply to psychogenic situations can be explained as follows: the psychotrauma, strengthening alarm, through the right hemisphere (in genezs disturbing frustration the leading part belongs to the right hemisphere and unformation

between a floor a sphere interactions) negatively influences on dienchephal the area, that in turn leads to infringement in regulation of a condition of internal bodies. Thus it is necessary to consider, that the most ordinary from the narrow-minded point of view a situation as owing to specificity of the brain organisation such child simply is always ready to answer with alarm can become the psychoinjuring even. At the same time raised functional conditions of the left hemisphere, providing high enough level of randomness and good memory, allows much of these children successfully to be trained at school, despite available deviations in a condition of the higher mental functions. Medical actions, besides traditional methods, should include those forms of the psychotherapeutic influence, which purpose is decrease in level of uneasiness. Use of methods of the impellent correction promoting formation bet of spherae of interaction is useful.

2.Research of personal features: it is possible to find such personal features, which it is the most frequent in different combinations meet at all psychosomatic frustration. Isolation, restraint, distrustfulness, uneasiness, sensitivity, propensity to easy occurrence concern them frustration, to prevalence of negative emotions over positive, low level of intellectual functioning in a combination with expressed the specification  and installation on achievement of high results. As a result of the spent researches it is found out, that such psychosomatic factors as alexitymiya, the raised level of animosities, personal uneasiness, depression and imunitive reaction type on frustration take part, probably, play the important role in the psychosomatic mechanism of development of a bronchial asthma. For patients with a bronchial asthma protective mental mechanisms are characteristic: negation, replacement and regress. At a bronchial asthma a leading emotional condition is the pathological alarm (stably raised level of personal uneasiness). And as for these patients other protective mental mechanism replacement, at which there is a partial unconscious replacement of a disturbing material is described, the alarm part can be shown. However the superseded part, probably, creates constant pressure, to similarly chronic uncontrollable stress, with corresponding shifts in noradranergical neuromediatoral to system that conducts to certain changes in the immune system, contributing to development of a bronchial asthma. For patients with a bronchial asthma in psychotherapy the accent should be put on the methods reducing alarm, the psychotherapeutic methods reducing internal pressure are used.

     Among personal lines suffering the bronchial asthma, observed prior to the beginning of illness, most often marked unusual sensitivity, uneasiness, excitability, emotional variability, propensity to development of the lowered mood, sensitivity, an impressionability. At the teenagers, suffering a bronchial asthma, allocate the following clinically expressed mental frustration, significant for psychotherapeutic intervention: , alarm and secondary hypotimiya, emotional instability.

     There is no uniform universal structure of the person, characteristic for all asthmatics. At research by method MMPI (the multipurpose psychological test) such indicators, as depression, a hysteria, a morbid depression appear the most considerable. The low self-estimation, decrease in level of social contacts, the emotional difficulties including problems of energy and self-confidence are characteristic also. In behaviour and lines of the person of patients reactions with protection emotional, first of all aggressive, promptings, and also the latent desire of tenderness and affinity are often found out. Behind aggressive behaviour the strong requirement for love and support can disappear. As all researchers mark such lines, as excessive or denied fear.

     In other research following personal features are established: asthmatics very strongly worry aggression, but do not show it; they are mistrustful and suspicious and consequently are not inclined to self-sacrifice. At patients the aggressive behaviour directed outside chokes; formation of imaginations and their verbalisation is worried, as dangerous and consequently go inside and are transferred to corporal sphere.

3.By the third direction of researchers it is underlined, that at a bronchial asthma bodies are amazed, smooth muscles which do not relax strong-willed effort and does not strain. The smooth muscles spazm or relax at the expense of our emotional condition.      Means, what hormones take root into a circulating channel so it and conducts herself. From this position any spasm is a reaction which was necessary to the ancient person adequately to react on an event: intercepts breath for fear. To conceal breath - the reaction of the defenceless person peculiar and for the child, which cannot attack the object causing fear. Occurrence of a bronchial asthma connect with an interdiction for freedom of expression of the emotions, suppressing displays of feelings.

4.One more psychotherapeutic direction pays attention that at an asthma there is a ressure

of certain muscles. The person starts to choke because while it is necessary to make a

breath or an exhalation, muscles spazm. The person physically simply cannot make a

 

breath.

 

    And, there is such loop of a feedback further: the person cannot inhale, it has an alarm, the spasm amplifies, even more cannot inhale, there comes a panic. This mechanism can be destroyed if to remove this muscular clip, to weaken muscles, it is literally to knead their hands, to warm up, pay attention of the person, to what muscles at it are strained. The person is meaningly capable to supervise many the muscles. But it is real in a life supervises 3-5 %. It is necessary, that the person has learnt to operate necessary muscles of a throat, throats, a thorax.

5. In a psychoanalytic direction of researches a bronchial asthma understand, how the illness determined by aspiration, a passionate impulse is cryid to mother. Degree of expressiveness of affect, feebleness, hopelessness and fear and as forces of psychosomatic reaction are defined by experience of early dialogue with other persons and, first of all with mother and the father. The stressful situation is created by loss or threat of loss of object of attachment therefore can arise as mental so psychosomatic frustration. The cause of psychosomatic frustration in occurrence of infringements of physiological functions of separate bodies and systems in reply to various stresses in the early childhood, as defines specificity of defeats.

     Disease development is preceded by conditions of refusal, leaving, capitulation reflecting feelings of hopelessness and feebleness. The condition of the child can appear an indicator of relations of his parents, painful displays at the child can be unique expression of family disorganisation. All changes of family mutual relations interfering development of individuality of the child, not allowing it openly to show the emotions, do its vulnerable concerning emotional stresses. The broken intrafamily contacts at early age, especially between mother and the child, increase further risk of development of psychosomatic diseases. The bronchial asthma speaks, how the suppressed shout against mother.

Supporters of psychoanalytic orientation postulate a pathogenic role of the suppressed emotions at an asthma, and expression of emotions in the course of psychotherapy, their comprehension and verbalisation contact improvement of a somatic and mental condition.

      The raised personal uneasiness often worried by the patient as causeless, is a consequence not realised intrapsychical of the conflict between desire of love and tenderness, on the one hand, and fear, the outcasted them, with another.

The asthma attack often appears as an equivalent of suppressed crying. It compare to shout and we cry the child protesting against loss of security. An explanation to crying suppression find in reproaches and refusals to which were exposed in the childhood if wished to call mother we cry or shout.

Early infringements of relations with mother operate at the patient, as confrontation of desire of tenderness and fear presence before tenderness. The fear remains hidden. V.    Broitigam writes: At an asthmatic short wind simultaneously with air can be late and emotions (12).

     Specify as the conflict of patients as infringement of psychological functions to give - to accept and tendency to identify in dialogue with other persons, to be alloyed with them.

Strong and often ambivalent experiences of disgust and tenderness underlie protection and replacement at sick of a bronchial asthma. Mothers of asthmatics often show ambivalent behaviour which simultaneously expresses aspiration to possession and a management and at the same time refusal of it. Patients are in a conflict condition between their desire to gain trust and fear before it. According to results of psychological researches of relatives in patients the bronchial asthma finds out obvious prevalence of supercareful and severe mothers.

6. And, naturally, hereditary predisposition to psychosomatic frustration. In the family anamnesis of 65, 5-85 % of children a bronchial asthma there are allergic reactions. Heredity - constitution  features, presence of a place of the least resistance.

7. A stress role during last periods of pregnancy and in infancy. At the heart of an etiology of somatic diseases lays uniform kortiko-visceral the mechanism: owing to emotional stress a primary overstrain and an exhaustion crustal cages, creation of the subcrustal centres of the stagnant centre of excitation, disharmony of vegetative nervous system, development  visceral frustration. A number of researchers gives great value of a role of formation of conditions of selectivity of psycho-vegetative influences, including development of psychosomatic diseases, late prenatal and early postnatal to the development periods as during these periods of existence ability of an organism to disposable training with formation of especially strong communication (Imprinting) is high, providing biologically expedient proof communication of a cub with parents or other factors of an environment. At sharply or the emotional overstrain is long also an inevitable situation conducts to expressed cerebro- visceral to infringements.

     PSYCHOSOMATIC CORRELATIONS IN BRONCHIAL ASTHMA.  Combination of somatic symptoms with neurotic manifestations and personalitys disturbances. In clinical picture of bronchial asthma was established during clinical and psychological observation of 89 patients with bronchial asthma. It was shown that increase of the number of frustrating situations (when psychical vulnerability was elevated), strengthening of both anxiety and emotional tension, as well as rigidity of negative emotions, hypochondriac and anxious-depressive tendencies composed the whole correlational system with alterations in functions of external respiration, changes in blood immunoglobulins levels just as with clinical indices of bronchial asthma. This system represented different levels of psychosomatic correlations regulation. The complex psychophysiological factor of frustration and emotional tension was described, moreover the increase of its value was accompanied by strengthening of both psychical alterations and somatic disorders which were quite characteristic for prevalence of either trophotropic activation or ergotropic one when β-adrenoceptors were blocked (2).

Data - On the basis of clinic Vita Avis and a medical unit Ivtecmash of Ivanovo (Russia) had been spent inspection and treatment of 38 patients at the age from 8 till 40 years. Patients have been divided into 2 groups. 19 patients are included in comparison group with an obstructive bronchitis and 12 patients with asthma which besides traditional treatment from the first symptoms kataral inflammations received preparations antidepressant Gelarium on 1-2 capsulis on night its influence on psychosomatics. The patients received preparations Gelomyrtol (Myrtle essence)  on 2 capsulis to meal, Olexin on 2 capsulis for adults and drops Olexin at children to 10 drops on reception ummunokorrektor. Aromaterapy Limon, Tangerine Essence. They remove bronchial obstruction. Psychological diagnostics (author's), the analysis immunogramms.  The calculations data it is made by means of the statistical analysis.

    The bronchial asthma at adult daughters arises from cruel treatment of mother, instead of as Alexander (3) about the psychosomatic cause of a bronchial asthma (a call for help to mother) writes. It not the true statement. And instructions of mother on its unreasonable cruelty, hyperguardianship and revision of its behaviour in relation to the daughter. At an asthma the most specific psychological conflict concentrates round dialogue with key figures of a life. For example, initial communication mother - the child is broken. This infringement at the small child is expressed in suppression of an impulse of crying. Later the child cannot come into frank, confidential verbal contact to mother or the person, its replacing. Often mothers to daughters happen are severe, because they identify the daughter with themselves. They can by itself be dissatisfied, and also are dissatisfied with the life and rage vent on daughters. Often at such mothers the is difficult-combined psychotypes of characters - shizoid-epileptoid-isteroid. It is the heaviest combination. Children have an education in a family on type - the persecutor-victim, hyperguardianship. And such mothers cannot be trusted to bring up the daughters.

     In full families - plays a role mutual relation type between spouses-parents. If in a family there is love, with breath always no problem. On insult, insults - the asthma and leaving in illness is a psychological conversion.

Plays a role and hormonal disbalanse, if the child full chances to have a problem with breath - are obvious. And, the asthma which has arisen in the childhood, at adult 20-year-old age is aggravated at the expense of deep changes of the immune status.

     Changes cellular and gumoral immunity heterogeneity. At a part of patients it is marked immunological insufficiency secondary; some have a communication between degree of infringements of immunity and weight of disease and improvement as a result immunocorregial therapies is observed.

     At sick the diversified changes, for example meet a bronchial asthma of average weight: activation gumoral a link of system of immunity at a bacterial infection, infringement phagocytar activity of leukocytes after virus diseases and others.

      Deposits of immunoglobulins G4, the M and component immunoglobulins complemant systems in bazal to a membrane (come to light not constantly), cellular infiltrat (mainly eozimophynal) two kinds (the containing plasmatic cages synthesising immunoglobulin and  immunoglobulin G).

     Who has deep changes G4, M, C3 - systems complemants, for those and a current of an asthma heavier. For such patients are necessary immunocorrectors. 

      Functional activity T-limfocites changes according to phases process with emission IL4 and IL-5. To easy severity level of disease there corresponds certain decrease, both total T-limfocites, and teofillin-resistant fraction. In process of increase in weight of disease the quantity of these populations increases and, at a heavy asthma, can exceed normal amounts considerably. It is considered, what exactly T-helpers 2nd type, play a key role in the organisation of inflammatory process in bronchial tubes at a bronchial asthma. Such condition is connected and with oppression of other subpopulations T-limfocites which provide the immune answer at healthy faces that serves as the precondition of heavy disease and appears already at sick of an easy bronchial asthma, earlier, than quantity T-helpers of 2nd type increases.

     Quantity T-helpers of protective subpopulations is lowered, but size T-helpers of 2nd type big enough. As a result the general maintenance active T-helpers appears within normal values, therefore more precisely activity of an inflammation at a bronchial asthma reflects an index of an allergic inflammation.

     In the immune status after an effective course of therapy in this group authentic decrease in a parity teofillin-resistant and teofillin-sensitive T-limfocites, an index of an allergic inflammation, and also phagocytar numbers, an index of activity of phagocytes (p <0.05) is received. Values of an index of an allergic inflammation before treatment have made accordingly 0.2430.49 and 0.1040.022 (p <0.05). Average sizes of other criteria of an inflammatory syndrome had no authentic dynamics by criterion t Siudents. By means of nonparametric criterion T Vilcocsons reliability of decrease in quantity eozinophyls in peripheral blood, quantities monocyts, maintenances limfocites in venous blood is established. If the size of teofillin-resistant fraction T-limfocites decreased after course of treatment the size of teofillin-sensitive fraction T-limfocites increased (p> 0.2). At the same time the increase in spontaneous aggregation trombocites after a course glucocorticoid therapies and decrease in time Hageman-dependent liziss a fibrinous clot (4) is noted. It means that therapy by steroids is dangerous development aterogenes nd also inflammation relapses at treatment by hormones (the note of the author). 

      Thus the index of an allergic inflammation was equal to value 0.291 (indicator size in group practically healthy faces 0.1210.014).

      Quantity CD3 and CD4-limfocites below a minimum level (accordingly 0, 8/ml and 0, 6/ml) them at healthy faces (5).

     Concentration Ig G and Ig A can decrease at patients with a bronchial asthma.

In T.A. Zadorozhnaya's work (6) it is shown, that at patients with an easy current of a bronchial asthma at studying of a condition of function of a thyroid gland and adrenal glands oppression of function of one of glands of internal secretion and hyperfunction another is characteristic. In attack the period of disease hypofunction tyreoid systems is observed against low level kortizols in blood whey. Similar infringements are established in other numerous researches.

   Concentration in blood plasma kortikotropin-rilizing the factor and adrenocorticotropic a hormone in remission of a bronchial asthma basically within norm or is raised. In an aggravation the expressed increase, both kortikotropin-rilizing the factor, and adreno-kortikotropical a hormone is observed. However the maintenance Kortizols fluctuates and, as a rule, remains glucocorticoid insufficiency. It is traced positive correlative communication between the maintenance of immunoglobulin G and Kortizols and negative between kortizols and innunoglobulins M, spent by J.S. Landyshevs and at all. (7) have allowed to establish certain laws in change of a functional condition gipofizar- adrenal glands systems, which had distinct is cyclic-phase character at sick of a bronchial asthma. At an easy current in attack the period was observed stressful type of reaction of a bark of adrenal glands with increase of level total 11-oksikortikosteroids in plasma of blood and qualitative change steroidgenezs and a metabolism glucocorticoid hormones. At patients with a heavy progressing current of a bronchial asthma sharp oppression androgen and glucocorticoid activity of a bark of adrenal glands is noted. In attack the period of disease the adrenaline maintenance increased almost in 3.5 times, adrenaline - in 1.9 times in comparison with control group. After treatment in remission of disease indicators had the distinct tendency to normalisation. It has been shown, that during asthma attacks production tireoid hormones amplifies. At long hypoxia decrease in function of a thyroid gland was observed. In attack the disease period have been revealed hypoinsulinemia and hyperglucagonemia. At women of reproductive age were marked hypoprogesteronemia, hyperestrogenemia and hyperprolactinemia. Hyperestrogenemia and hypoprogesteronemia influence mainly on an alpha - and beta - adrenoreceptors, raising activity an alpha - receptors and reducing activity beta receptors, that promotes asthma attacks.

    The physiological reasons - from the return - from somatic to mentality and from mentality to somatic. At askaridozs - often there is a bronchial asthma at children-boys.

At infection Staphylococcus aureus - the bronchial asthma infectious-allergic genezs, as Staphylococcus aureus the strongest allergen often develops. And approaches to treatment others (not published data of the author). And, the author observed at children migration Staphylococcus aureus from a pharynx in a nose at treatment. At children at fast involution timuss till 10 years and occurrence of a secondary immunodeficiency - the asthma proceeds especially hard (the note of the author). When adaptive mechanisms are exhausted (8) again there is a psychopathology - uneasiness, depression, a morbid depression. Such negative emotions, as insult and the anger, accompanied insult prevail.

    The constrained anger in unusual way influences cardiovascular system (Cannon; Fahrenkamp; Hill; Menninger, W. Menninger; Wolfe; Dunbar; Draper; Saul; Alexander; Dunbar, 1957). The conflict resulting stress, has specific influence on functions of breath (9).

    The stress-induced an asthma - arises on the strongest other-wordly stress. For example, on unpleasant news for the expert that close its office. There is a first attack of an asthma.

At men the bronchial asthma has other roots. Here plays a role asymmetry psycho-somatic (it is similar between hemispheres to asymmetry) - internal (the type and character constitution) - bidominant, divide complete, total, stable psycho-somatic into 2 subjects (between hemispheres  asymmetry). Integration between 2 hemispheres carries out (corpus collozium). This structure works for women better. For men works badly, they are easier for entering or programming on illness, therefore along with the treatment of a psychogenic asthma offered by me and asthmas - diagnostics of the psychologist on functioning between hemispheres asymmetries and special exercises on its development in boys is necessary and important. This medical psychological program works. Besides, these exercises like boys.     

    More than 20 % of children-asthmatics in process of a growing cease to test illness signs. Most often it occurs among boys. By 19 years at 21 % of children remission, at 41 % - a periodic asthma was observed. At boys remission was marked more often (26 % of cases in comparison with 14 % of cases among girls), but it with combination the heavy form of an asthma and an allergy on a wool of animals in 18 % of cases outgrow illness.

There is no uniform universal structure of the person, characteristic for all asthmatics. At research by method MMPI (the multipurpose psychological test) such indicators, as depression, a hysteria, a morbid depression appear the most considerable. The low self-estimation, decrease in level of social contacts, the emotional difficulties including problems of energy and self-confidence are characteristic also. In behaviour and lines of the person of patients reactions with protection emotional, first of all aggressive, promptings, and also the latent desire of tenderness and affinity are often found out. Behind aggressive behaviour the strong requirement for love and support can disappear. Subjective symptoms have made 5 groups: a panic-fear, irritability (excitability), hyperventilation-gipercapnia, bronchial obstruction, fatigue (asthenia).

     Asthenia quite often happens, a so-called, rod or leading syndrome at a psycho-somatic pathology. Sharp it is characterised by that flows as an asthenic syndrome with fluctuation of a condition and infringements (obscurings) of consciousness.

    It is established, that at 62, 5 % the obstacle-prepotent type of reaction to various situations in a combination with impunitive a behavioural orientation prevailed.    Domination of reactions impunitive directions means aspiration to settle the conflict, to hush up an awkward situation that to do it is not necessary. The conflict should be resolved. A discharge of affect in the form of flight from a psychotrauma situation: sudden leaving from a family from difficult parents (10). Teenagers often resort to such behaviour with labile mentality.

     All bodies work from the expressed intensity systems. Thus, at the majority of patients reactions peculiar obstacle-prepotent type to various situations in a combination with  impunitive an orientation - such personal lines as softness, compliance,

konformism, emotional restraint, the indicator frustration is raised come to light.

     These data can be used at psychotherapeutic correction of patients. At persons with prevalence of a sympathetic tone (it is women more often), disease is accompanied most by dependence on psychogenic factors, such patients have propensity to formation of disturbing-depressive frustration, for them the pressure condition regularor organism systems is characteristic. If alarm level - boundary, depression level - always clinically expressed. For such patients vegetative energizers (Gelarium) well approach.

     As a whole, at patients with a bronchial asthma prevalence of two types of protection has been revealed: Negation and Jet formations. By means of the mechanism of protection Negation the person denies circumstances causing alarm, or imperfection of the personal qualities. Usually such patients have isteroid a personal radical. At persons with the expressed mechanism of psychological protection Negation decrease in the general variability of a warm rhythm is marked. On an electrocardiogram increase of teeth - comes to light, there can be a depression of segment ST.

     At researches by means of the questionnaire and a series of tests A. Jores and Kerekjarto (11) have established following signs: asthmatics very strongly worry aggression, but do not show it; they are mistrustful and suspicious and consequently are not inclined to self-sacrifice. They differ strong I and same strong super-I.

     Asthmatics do not have lowered physiological and-or psychological threshold concerning all smells. Unpleasant smells proceed, first of all, from the subjects connected with a sewage and a dirt in the broad sense of the word. The same supersensitivity to similar smells extends for dirty ways of behaviour of associates, but, first of all, on own dirty thoughts. By this way of protection the excessive aspiration of some women concerns cleanliness in the house. The women sick of a bronchial asthma, happen frigid is more often, and men have infringements of a potentiality (12) is more often. Is not unexpected these infringements at persons with is persuasive-neurotic structure which are compelled to suppress sexual and aggressive promptings.

     Already from the very beginning of illness certain lines which amplify throughout

illness are shown: insufficient abilities, the aggression directed on associates, and self-

charges in  this aggression. Asthmatics are inclined to refuse aggression as it have shown

 A. Mayer  and . Weitermeyer (12).

    In behaviour and lines of the person of patients reactions with protection emotional, first of all aggressive, promptings, and also the latent desire of tenderness and affinity are often found out. For pseudo-indifferent or even aggressive behaviour the strong requirement for love and support (13) can disappear. Breath is an important component of speech, a breath - feeling of despair, expiration - crying (14). A combination of unconscious seduction by mother (at boys) and open aversion (at girls) - one of the most widespread models of asthmatics. An asthma attack (E. Weiss, 1922, Challidey, 1937) represents the suppressed crying turned to mother, arises a spasm of bronchial tubes, which arises at crying.

    The aleksitimic behaviour at defined psychosomatic patients is more clearly found out in an interview situation, when two talk. In empirical supervision to the speech analysis at which estimate statements of neurotics and psychosomatic sick interviews in a situation and compare them, appreciable and characteristic distinctions are found out. Speech of the psychosomatic patient is poorer on volume and under the maintenance and is less expressive (. Rad, 1983). At projective test researches, for example by means of test Rorschacha, psychosomatic patients in comparison with neurotics find out a syndrome of a lack of imagination (R. Vogt and at all, 1979). That fact, that speech can go about distinctions in intellectual level of the researcher and the patient creating difficulties in dialogue, today is not considered any more. According to it there is a necessity to develop special strategy of treatment  psychosomatic patients (W. Bmutigam, 1974).

The chronic current is characterised by presence of a long asthenic syndrome at which characteristic dynamics (condition deterioration by the evening) is observed.

    At somatic diseases with the chronic current, accompanied by long infringement of an exchange, an intoxication there come heavier and long changes of type psycho-patoanalogical, which are characterised:

1.Presence  proof frustration of mood, namely disforia with prevalence of weariness, weariness, enmity to all surrounding;

2.Feeling the discontent, deaf anxiety;

3.Decrease  efficiency of thinking;

4.Surface  judgements;

5.Decrease energy and activity;

6. Development  an egocentrism and narrowing of a circle of interests;

7.A monotony behaviour, importunity and persistence;

8.Confusion condition at the slightest vital difficulties.

   Character changes adrenoregulation in connection with formation of phase adaptive reactions are possible at hypoxia (experimental data): level increase c-AMF (cycle adeninmonofosfat) in an initial stage sharp hypoxia, prevalence c-GMF (cycle guaninmonofosfat) at late stages in process of adaptation formation. Decrease in c-AMF dependent regulation can have rather compensator character at a bronchial asthma owing to development chronic hypoxia and specifying in hyperfunction an alpha-adrenoreceptors. Infringement of vegetative regulation (influence increase acetylcholin, adrenergical disbalans: strengthening of activity an alpha-adrenoreceptors, function decrease beta 2-adrenoreceptors) and increase in sensitivity of bronchial tubes to stimulators bronchial-constriction, initial narrowing of air-spending ways.

    The syndrome of bronchial obstruction at an attack is accompanied by characteristic changes of pulmonary volumes: increase L (residual volume of lungs) and its shares in L (the general capacity of lungs), and also sharp increase of bronchial resistance on an exhalation, falling Functional Life Volume Lungs (FLVL) VL and index Tiffno. In a sharp stage of not complicated bronchial asthma are marked - obstructions hypoxemia, respiratory alkaloz, decrease parcial pressure and oxygen transport, at a part of patients - respiratory acidoz. These infringements are especially expressed at the asthmatic status.

Changes in peripheral blood are not characteristic at a psychogenic asthma, only at joining of a secondary infection.

    During attacks the quantity eritrocytes and haemoglobin raises; the number of leukocytes depends on activity of an inflammation; are marked eozinofilia (it is more expressed and constant marrowy eozinofilia), limfocytoz. Leukocytoz and eozinofilia are estimated with care after introduction of adrenaline and glucocorticoid preparations. SE (speed of subsidence eritrocytes) and biochemical indicators of activity of an inflammation depend on a phase of inflammatory process. Diagnostic value have proteinogramma, the S-reactive protein, glicoproteids whey, an alpha 2-globulinemia, hypergammaglobulinemia.

    In secret of bronchial tubes comes to light eozinofilia, there can be spirals Kurscmans, crystals Sharko-Leidena (can be absent in fresh allocation secret of bronchial tubes  and appear at its upholding); hyperactivity sour fosfatazs (in tens times above, than in whey), that specifies in deep damage lizosomal membranes neutrofiles and macrophages. At histologic research are found out not mucoid and degenerating cellular elements, and also eozinofile detrit.

The analysis of all parametres allows to carry out differential diagnostics genezs asthmas to influence its cause. Such diagnostic, and then medical approaches are as much as possible effective.  

    Characteristic - an early symptom before development of attacks of an asthma - sensation of compression of a thorax. At a part sick a unique first symptom of a bronchial asthma can be heavy night parosizmal cough, and in the afternoon of displays of illness is not present.

    Asthma biorhythms - the highest frequency of attacks is noted with 21 to 24 o'clock, the least - with 12 to 15. And, physiologically there is an increase of sympathetic nervous system, then the tone of parasympathetic nervous system (the asthma attack is aggravated) at the expense of increase of this tone raises, therefore all attacks of an asthma (asthma biorhythms) occur between 21-24 o'clock in the morning at children and in 4 mornings at adult and elderly (supervision of the author). 

   Additional differential diagnostics - deficiency of microcells at a bronchial asthma (not published data of the author).

   The author defines individually at everyone (author's diagnostics). But there is a general tendency - zinc fall - 0, 71 (norm of 0, 6-1, 2 mg/l) on the bottom borders of norm and more low.

    At stress there is a direct action on a cellular metabolism (S. Long, 1947).

FGE (dehydroepiandrosteron) - concentration below norm at persons about stress the-induced bronchial asthma - less - 95, 8 mkg/dl (p <0, 005).    

    Beta and an alpha-adrenergical stimulation, raising or reducing level c-AMF, reduces or increases allocation mediators. At a bronchial asthma often plays a role substance , causing strengthening paroxizmal cough. According to laws Pharmacodinamic it is necessary to apply blocators tachicinin receptors. But they exist only in experiment, unfortunately.

    It is expedient to do and other analyses - an acid alpha-neuromin acid, serotonins, gistamins, acethylcholins, kininogens in 2-3 times (increase at the moment of an attack).

Activity cholinesterazs decreases at the infectious-allergic form of a bronchial asthma.

Definition fibrinolitic is shown activity, maintenances free heparins and activity lipoproteidlipazs (increase during an attack), level decrease katecholamines in blood whey (depending on weight of an attack).

    At the psychosomatic diagnosis - there is an inflammation, but it not the infectious. There is hyperproduction secret of bronchial tubes, therefore there is a sense to appoint antioxidants and expectorants (dilute and delete secret of bronchial tubes) and ingibitors adhesions (not published data of the author).

  Graphics In the conditions of stress at illness under the blood count the functional condition was defined for Asthma. Basically all investigated were in a condition of activation of stress.

Table 1. Dependence of uniform elements and parameters of blood on a condition of reactions of activation of stress

Uniform
  elements of blood
 
Quiet
  activation
 
The
  raised activation
 
         Lymphocytes
 
28-33,5%
 
33,5-45%
 
 
         Leukocytes
                      9  
4 - 5  10
 
                              9
7  8  10
       
  Gemoglobin
                  130 g/l 
                  170 g/l
 
         Blood sugar
 
 
             Hyperglikemia 8 mmol/l
 
                 Hypoglikemia  3-4
mmol/l

 

\s

   It is established, that by 4th days of spent therapy in group of comparison expressiveness of a painful syndrome has decreased on the average for 36, 2 %, in control group - only on 18, 4 % ( <0,05). Expressiveness of inflammatory changes, hyperemia and infiltration palatal handles in comparison group also has decreased in comparison with the disease beginning for 44, 5 %. Thus also the maintenance of a pathological secret in lacunas essentially decreased, breath improved, easily departed slime of bronchial tubes.

    Positive dynamics remained and by 7th days of therapy - inflammatory changes have decreased in control group and comparison group accordingly for 43, 2 % and 45, 7 % in comparison with 4th day of illness. Introduction in complex therapy Helomirtol promoted improvement of the general condition of patients and simplification of a pain a little bit earlier, than at carrying out of traditional therapy that is the important factor for the patients conducting an active way of life and labour activity.

     Efficiency of spent therapy in comparison group was estimated by patients as excellent at 8 (42, 1 %), as good - 8 (42, 1 %), as satisfactory - 2 (10, 5 %) and 1 (5, 2 %) the patient as unsatisfactory. In control group excellent and good results are received at 5 (25 %) and 10 (50 %) patients; satisfactory and unsatisfactory - at 3 (15 %) and 2 (10 %) accordingly.

     Allergic reactions to components of a preparation at one of observed patients it is noted, on the contrary, myrtle connections treat allergy displays.

      At patients against treatment level g A was authentically restored, both at traditional therapy, and at combined application Helomirtols. Thus level g A at the patients receiving in complex therapy Helomirtol, has appeared statistically authentically higher not only in comparison with indicators before treatment, but also in comparison with the patients receiving the traditional scheme of therapy. Introduction in traditional scheme Helomirtol also promoted more active stabilisation of the maintenance in mouthlarynx a secret of the monomeasured form g, that apparently is connected with additional anti-inflammatory properties of the given phytocomposition.

The maintenance of antibodies in mouthlarynx a secret and in whey of blood at the investigated groups of patients, /

Yg A - 0, 27-0, 48 in mouthlarynx a secret.

Yg A in blood - IgA - 0, 9 (norm 1, 1 - 4, 5 /)

The control - 0, 44+ 0, 06

More precisely to define - S Yg A (secretor) and monomeasured (YgA) on O.F. Melnikovs, D.I. Zabolotnyas (15), but not all laboratories of clinic can execute all kinds of analyses.

The note: <0,05 in comparison with indicators before treatment.

                 <0,05 in comparison with control group.

        It is established, that use of the given phytopreparation improves a clinical picture and raises efficiency and safety of traditional schemes of treatment of inflammatory diseases of the top respiratory ways.

    Definition of fraction of antibodies of 1 level is enough for differential statement of the psychosomatic diagnosis. Immunogramms 2 and 3 levels it is necessary to do at others genezs asthmas. 

Conclusion  - Herbal preparation of choice for complex treatment of upper airways inflammatory diseases. The purpose of researches was clinical rating of effectiveness of use of herbal preparations Helomyrtol, Olexin, for complex treatment of upper airways inflammatory diseases. It is established, that the use of this herbal preparation improves a clinical picture and raises effectiveness and safety of traditional schemes of treatment of upper airways inflammatory diseases.

    Direct correlation between aggregation degree Trombocyts and expressiveness of bronchial obstruction, and also increase in level blood tromboxan, causing bronchoconstriction and connected with hyperfunction trombocyts  is found out. Activity change Trombocyts aside Trombocyts at sick of a bronchial asthma exist, therefore some it was appointed in complex treatment of a drop Eskuzan in average therapeutic doses.

PHARMACOLOGICAL PROPERTIES: Helomirtol Forte contains as active substance phytogenesis essence - Mirtol standardised.

Mirtol the standardised possesses secretmotor and secretolitic effect which leads goes slime of bronchial tubes, activation mucociliar epitelii and, as result, to intensive allocation slime of bronchial tubes. At application in high doses Mirtol standardised action.

Reception: capsules Helomirtol Forte are recommended for accepting for 30 mines to meal, washing down with a considerable quantity of cold water or other drinks.

At a clinical picture of sharp inflammatory disease it is recommended to accept on 1 capsule of preparation Helomirtol Forte 3-4 times a day. For the purpose of creation of conditions for dream improvement last dose needs to be accepted before a dream. At chronic inflammatory process appoint on 1 capsule Helomirtol Forte 2 times a day. The same mode of dispensing is recommended at long therapy.

For simplification morning goes slime of bronchial tubes at a chronic bronchitis it is recommended to accept in addition 1 capsule Helomirtol Forte in the evening before a dream.

To children about 10 years (appoint to children when they can independently swallow a capsule), on 1 capsule 2 times a day are elderly. A preparation accept in displays of symptoms of disease and throughout 2-4 days after their disappearance.

CONTRA-INDICATIONS: a hypersensibility to preparation components, is bilious-stone and urine-stone illness. The medicinal form of preparation Helomirtol Forte appoint to children at the age from 6 years.

BY-EFFECTS: in single instances there can be painful sensations and discomfort in intestines, a current aggravation bile a stone nozology and urolithic illness. Very seldom - allergic reactions (an itch, hyperemia).

SPECIAL INSTRUCTIONS: though the information confirming negative influence

Helomirtol Forte on a fruit is not present, application of a preparation in pregnancy is possible only under the control of the doctor (especially in the first trimester).

Pharmacological action Ambroxols.

Reduces viscosity slime of bronchial tubes. Raises impellent activity lashes tubes

vibrating epitelii, increases mucociliar transport slime of bronchial tubes.

After intake action comes in 30 minutes and proceeds during 6-12 .

Contra-indications

Hypersensibility to preparation components, pregnancy (I trimester).

With care - the Preparation should be applied with care at patients with a stomach ulcer of a stomach and a duodenal gut as there can come a stomach ulcer aggravation, and also at patients with nephritic and hepatic insufficiency.

Way of application and dose

Intake (1 ml = 20 drops).

Children aged are more senior 12 years and adults: the first 2-3 days - 3 times on 4 ml (30 mg Ambroxols hydrochlorid) a day, then - 2 times on 4 ml.

To children at the age of 5-12 years: 2-3 times a day on 2 ml (on 15 mg Ambroxols hydrochlorid).

Ambroxol follows accepted after meal in the diluted kind with water.

During treatment examinees used a lot of liquid (juice, tea, water, a berry juice) for strengthening mucolitic effect of a preparation.

Application for inhalations

To adults and children aged is more senior 5 years it is recommended to inhalate 1-2 times a day on 2-3 ml (40-60 drops that there correspond 15-22, 5 mg Ambroxols hydrochlorid).

To children aged is more younger 5 years it is recommended to inhalate 1-2 times a day on 2 ml (40 drops that there correspond 15 mg Ambroxols hydrochlorid). 

For inhalation it is necessary to use the suitable device with observance of instructions for use.

Duration of therapy depends on weight of disease and is defined by the attending physician. Without the recommendation of the doctor it is not necessary to accept Ambrogexal longer 4-5 days.

Collateral action in the appointed doses was not shown.

Interaction with other medical products

At application with contra tussi preparations probably difficulty goes slime of bronchial tubes as a result of suppression tussi a reflex. At simultaneous application with Amoxicillin, Cefuroxim, Erythromycin, Doxycycline - Ambroxol increases their concentration in a bronchial secret. This positive action has been used at the combined treatment.

Special instructions

Ambroxol it is necessary to apply with care at patients with weakened tussi a reflex or broken mucociliar transport because of congestion possibility slime of bronchial tubes.

The patients accepting Ambroxol should not recommend performance of respiratory gymnastics; at seriously ill patients it is necessary to carry out aspiration goes slime of bronchial tubes.

At patients with a bronchial asthma Ambroxol can strengthen cough.

It is not necessary to accept Ambroxol directly ahead of a dream.

Ambroxol it is not necessary to accept simultaneously with contra tussi preparations which can brake tussi a reflex, for example, with Codeins since it can complicate removal slime of bronchial tubes from a bronchial tree.

Bronchial with a plantain, Thymus serpilum and vitamin C - a choice phytopreparation in complex treatment of inflammatory diseases of the top respiratory ways.

Amdroxol + Helomirtol = action strengthening on deducing accumulated slime of bronchial tubes!

Helomirtol + Augmentin = a rational combination! Combination is nivelired collateral action Augmentins.

Helomirtol + Bronchial = a rational combination!

Helomirtol, Broncial choice phytopreparations in complex treatment of inflammatory diseases of the top respiratory ways.

   The similar combination of vegetative extracts and essence in the given preparation potentially could strengthen efficiency of traditional pharmacotherapy of inflammatory diseases of the top respiratory ways, as became a subject of our researches.

   Treatment - a miscellaneous, individual. On Z. Freid the author uses a psychoanalysis method, as a method of diagnostics of an original cause of an illness to influence it. Then there will be always positive results of treatment.

If in an organism at the person a lack of own steroids it is necessary to increase at first their concentration that the organism itself has started to include mechanisms of adaptation and protection against stress (innoculation stress). The author of article with success applies such techniques. All of them are based on good knowledge of natural therapy.

The Russian scientists L.H. Garkavi and E.V. Kvakina (16) have developed a technique activation therapies adaptogens (1998). The author of article modified this technique (not published data of the author). The technique is very effective, but it needs to be applied skilfully.

    The technique of construction of the new person on Assadzchioli too is modified by me (not published data of the author). It successfully works.

At a bronchial asthma only one medicine treatment seldom brings permanent simplification. If the emotional stress from unresolved conflicts remains, the patient will inevitably receive relapse. A psychosomatic portrait (Habitus) the person, age and a social status of the person - it is conventional. The author adds to it - weak bodies from a birth. Then treatment helps without resistance to it (not published data of the author).

Appointments of synthetic glucocorticoids only aggravate adaptation process. Considering, that patients often become lecomans - dependence on hormonal therapy, therefore it is necessary to apply pulse therapy by hormones of a bark of adrenal glands for levelling

collateral action of preparations. Glucocorticoids do not suit at all at infectious forms of an asthma, it only aggravates inflammatory process, promoting relapses.

   Often on hormonal therapy the medicinal metabolic syndrome develops.

The states with unsatisfied external political ambitions often worry social shocks, equally, and the persons deprived of social well-being (3 phase of health), worry psychosomatic problems. These tendencies are characteristic for all age with a low standard of living, therefore this situation should be changed. Thus, conditions of soul, a body and society unite in a single whole in the course of work on health of the person.

  The psychosomatic approach is most, than art , it is based on knowledge of the emotional factors operating in each case individually, and those physiological mechanisms with which help, emotional factors influence an illness course. Only on the basis of this knowledge possible effective psychotherapy, for it time should be successfully chosen. The first step to it is statement of the psychosomatic diagnosis (Felix Daich, 1939, Dunbar, 1943, Phenischal, 1945).

     It is necessary to give special attention to chronological sequence of development of symptoms, and also an external vital situation and an emotional condition of the patient. Emotional conflicts also prevail in psychosomatic diagnoses so, usual standard therapy will not help. It opens a key to different approaches in the therapy, all people cannot be contained in one template of diagnostics and treatment standards.

    Diagnosis example - a bronchial asthma of 2 severity levels, psychosomatic genezs (strict mother), complicated by an allergy on a house dust.

  For this purpose it is necessary to store records of the children's psychologists working with children to have possibility to take advantage of them when it is required. To store records it is necessary, as all medical documents - 75 years. For example, in an old age for the analysis of an emotional condition of the patient the conflict situation during which flash, the typical pattern of the patient is established is necessary. For this purpose the thorough knowledge of psychodynamics whereas the somatic diagnosis demands exact knowledge of anatomy, is necessary for physiology and a pathology of the person.

    The skilled psychotherapist will spend the sessions gradually, checking ability of the Ego to deal with the conflict as imprudence and illiteracy aggravates somatic symptoms. In a human body all is interconnected, it is impossible to separate mentality from somatic, and somatic from mentality. Here interaction of the psychotherapist with doctors - experts, only effective interaction for the blessing of the patient is necessary. The superficial, supporting psychotherapy without deep therapy since organic symptoms can rescue the patient from development of more serious symptoms at psychological level, and leaving in small and big psychiatry is necessary. Preventive maintenance of mental diseases of the person is here again traced.

    Double aspect of disease - suffering and satisfaction of requirement for dependence when from the point of view of the therapist, the patient is considered cured, and that from the point of view of the psychologist - the psychotherapist the patient. Here a dilemma which should to be able be solved in the course of interaction of experts.

    If it is possible to find ligitimic an exit for passive desires of the patient (to take holiday) to help it is possible to such patient.

    It is necessary in more thin way to give exit dependent desires, in such a way is a situation of carrying over with the analysis of feeling of fault and own advantage which are the emotional factors responsible for suppression of passive dependent desires or aggressive installations.

The phytotherapist - the person from the very beginning perceived by the patient as Mana - the person (K.G. Ung) (17), the Person of Force.

At such arrangement of psychological accents, quite clear there is, that a patient who was not quite successfully treated before by means of classical medicine, resorts to treat of plants, as to last hope that should influence creation of the certain relation to the phytotherapist - to the objective carrier of a method.

In such situation much depends on that, the expert how much reliably can fix attention of the patient, how much clearly he imagines the purposes, problems of treatment and a way of their achievement, and also how much accurately and distinctly he can state all it to the patient.

    Suggestive fastening of certain medical installations becomes frequent a success basis.

Since olden days, especially in east herbal medicine, there is a technique approved on Pashinsky V.G. (18) and named it a swing of biological rhythms. The technique essence is simple: in the morning to the patient give stimulating plants, and for the night the sedative. So do until will be restored own cyrkad the rhythms of an organism broken by illness. Besides, in the same way shake rhythmics and internal bodies.

   Lungs and bronchial tubes poorly work with 15 to 17 o'clock in the afternoon, therefore it is better to carry out reception of preparations at 13-14 o'clock in the afternoon to receive the greatest efficiency of treatment. Also smaller doses for this purpose be required to reach the expressed clinical effect. Another words - illness should be treated in acrophase pathological process then the picked up preparation will be effective as much as possible in ½ to its dose.  

    Special group among psychotropic and neurotropical plants occupy psycho - vegetative grasses. This name is meant as plants, owing to the biochemical structure influencing not only on psycho - emotional sphere, but also on peripheral and, that is more important, on the central link of regulation of vegetative functions what is hypotalamus.

    Hypotalamus there is a crossroads of three of major of four possible mechanisms of adaptation. The understanding of the given fact automatically appropriates enormous value to the vegetative means, capable to eliminate hypotalamical dysfunction.

    Degree of mental infringements, their development, current and outcome appreciably depends on features and weight of somatic disease. However correlation is not absolute. Mentality infringements can disappear or considerably will worsen, not looking at long development of somatic disease. The return relation is observed also: mentality change can exist or remain some time proof at the come improvement, or full disappearance of somatic disease.

    At recognition of somatogenic psychoses it is necessary to mean possibility of coexistence of mental and somatic disease. Reference such etiological psychoses independent of somatic disease to somatogenic - an error.

    At a bronchial asthma - mental infringements at this disease are as though a component of a clinical picture of disease. They are patients with a psychosomatic pathology, along with the expressed symptoms of internal illnesses it is observed neurotic and pato-characterological reactions.

    The big role belongs to psychotherapy in all its variants: rational and behavioural; individual and group, including work not only with the patient, but also with his family.

It and development sanogenic thinking and introspection (reflexion) directed in, is carried out against deep internal rest therefore, the stressful situations which have been gone through against relaxation (relaxation) are lost. The one, who knows, how its insult is arranged, can make its object and sanogenic thinking.

    At many conditions of infringement of mentality herbs since they have few by-effects

well help, level (clean) collateral actions of synthetic medical products (pharmacotherapy).

    The asthmatic feels fear before such object of transferring as the doctor-psychotherapist, being afraid most affinity, rallying, representation, that it will result in suppression of its person as earlier it already was with its supervigorous mother. In it the cause of frequent relapses of illness is covered.

    Unfortunately, psychological tests have the generalised character, and I to use them I do not love, at me the author's diagnostics. Besides, play a role; the person of the adviser, its ability to get into soul to the patient, its ability to carry away, feel, ability to empathy (empathy), charm, absence of pedantry, the moderate ambition, healthy and moderate hedonistic function to be able to keep the patient at arm's length and to avoid emotional rapprochement with it, not to go down on level of a court of the patient, to respect and estimate the patient, to live the present, to trust in people, the maximum goodwill, absence of indignation to be able to use a role if see the latent motive, not to exaggerate danger, readiness to be engaged in any case to use auto-suggestion possibility.

Conclusion:

1.It is necessary to include in standards of diagnostics of a psychogenic asthma - psychological techniques of the author in addition to conventional.

2.In treatment of a psychogenic asthma it is necessary to lean against psychotherapeutic methods with the individualised selection of a diet, exercises, an aromatherapy and other methods.

3. For stress diagnostics it is necessary to include technique Garkavi-Kvakina on normogramm blood in updatings of the author (not published data of the author). 

4. For stress diagnostics - it is possible to use an additional method - the hormonal analysis on FGEA (dehydroepiandroateron) at stress-induced of the form of an asthma.

5. For diagnostics of any form of an asthma it is necessary to develop the diagnostic markers entering into the diagnostic legalised standard, guaranteed to any person. For example, tymus stromal lymfopoetine (TSLP), metalloproteinkinaza (in Russia it is possible only in Moscow).

6. For statement of the correct diagnosis and competent treatment - it is necessary to define Yg A, Yg G, Yg M, and Yg E - immunogramma 1 level of complexity.

At atopic and infectious forms of asthma Yg A will be always lowered, at the psychogenic form - can be within norm. At joining to the psychogenic form of an asthma of an infectious-allergic component always Yg A will be lowered without treatment. 

Fall Yg A and increase Yg E - is characteristic for atopic asthma forms. And to treat it is necessary to begin with increase Yg A - Chilak forte (at a combination with disbiozs intestines), vegetative Adaptogens (at propensity to infection to diseases) to raise the general and nonspecific resistance of an organism that the organism could resist to any bacterial infection - Sangviritrin (the preparation possesses threefold action - antibacterially, antifungally, immumokorrectorly), sensibilization - antiallergic therapy (Olexin), in the presence of fungi from pollen of plants - antifyngal therapy (Sangviritrin and others).      

7. For the infectious form of an asthma it is characteristic - increase Yg G. For the pure psychogenic form of an asthma indicators innunogramm can be within norm.

8. At initial forms of intolerance of chemical substances the diagnosis - a syndrome lowdoses chemical sensitivity is pertinent.

9.Plants to a thicket are not allergens, allergens are the fungi breeding on pollen of plants, therefore diagnostics on fungi - is pertinent.  

10.For treatment of any form of an asthma it is necessary to develop medical standards, they should be legalised and guaranteed to any person. 

11.The treatment standard at the psychogenic form of an asthma - psychology methods, psychotherapy, an aromatherapy, vegetative energizers (Gelarium), Mucolitics.

12.The treatment standard at the psychogenic form of an asthma in a combination with atopic the form - the treatment standard at the psychogenic form of an asthma with joining - antiallergenic therapy - Olexin.

13.The treatment standard at atopic to the asthma form - antiallergic therapy, sensibilization therapy.

14.The treatment standard at the bacterial form of an asthma - Sangviritrin, Ambroxol, Bronchial, Augmentin + Gelomirtol, Expectorants.   

15.Definitive working out ingibitors is necessary to adhesion at all forms of an asthma not to allow some slime to stick together and cork bronchial tubes of average-large calibre (in bronchial tubes of small calibre of slime is not present) - at this stage - Gelomirtol - a choice preparation.

16.Gelomirtol - a phytopreparation consisting of essence of a myrtle with double purposeful action - antiallergik and Expectorant.  

17.The psychosomatic approach to asthma treatment - a true way to its treatment. Construction of the new person on Assadzchioli in updating of the author preferably (not published data of the author).

18.The combined treatment of any forms of an asthma - the keystone to success in their treatment.

19.Revision of psychoanalysis of Z. Freida on diagnostic criterion is a revealing of an original cause of an illness with purposeful influence on it.

20. Inclusion chronopharmacological a method in treatment of any form of an asthma - is preferable from the point of view of efficiency. 

21.At treatment of an asthma of any form very high requirements should be shown to experts. 

22.Especially I wish to allocate asthma risk factors - preparations Serotoninergic actions - provoke attacks of a bronchial asthma, reception of aspirin,

Frequent infections, a bronchitis, a pneumonia with presence staphylococcal and pneuvmocist an infection, nodular periarteriit, immunodeficit conditions, the esarean section on 80 % raises risk of an asthma at babies, children who transfer a strong shock in the childhood (death of one of parents or someone from relatives, the risk of occurrence of an asthma at adult age) is increased. Play a role in asthma development - aspartam (sugar substitute) and the paracetamol accepted by women during pregnancy - at 27 % of children arises an asthma. These are not steroid anti-inflammatory preparations - they are counter-indicative to asthmatics and the persons having an asthmatic bronchitis. High parent levels of folic acid at pregnancy associate with an asthma in 3 years. Grapes kish-mish - a grade golden too process chemicals - alkalis, therefore on such especially golden grade of grapes - there can be an allergy passing in an asthma in the future. The childs - the low weight at a birth is less 2, 5 kg, artificial feeding, smoking active and passive.

23. It is necessary to develop new standards of treatment as collateral action of out-of-date standards is fraught - 2-agonists cause - a tremor and paradoxical action (provocation of attacks of an asthma), glucocorticoids - development of a secondary medicinal metabolic syndrome.

24.Definition IL-8 should be included in diagnostics standards at the above-named diseases (the author, 2011). Secret of bronchial tubes - the increase matriks metalloproteinkinaza, is necessary definition of its concentration. While it is possible only in Moscow.

25. It is necessary working out ingibitors for adhesion for knocking over of initial signs of an asthma (not published workings out of the author).

The used literature:

1. Schneider Kurt. A classical management Clinical psychopathology (1931; 8 The

edition, 1967). (In English).

 

2. Berezin F.B., Kulikova E.M., Shatalov N.N.psihosomatical parities at a bronchial asthma

/F.B.Berezin, E.M.Kulikova, N.N.Shatalov, N.A.Charova//Neuropathology and Psychiatry

Magazine, 1997. - 4. - s. 35-38. (In Russian).

3.Alexander Frants. Psychosomatic medicine. Its principles and application, 1950. (In

English).

4.A.V.Tuev, V.J. Mishlanov a bronchial asthma (immunity, a hemostasis, treatment) Perm,

 

2000. (In Russian).

 

5. Gogyeva, M.N. Features of clinic and aetiologies of a bronchial asthma at inhabitants of of Stavropol / M.N. Gogueva, I.I. Voronenko, A.V. Fedurchenko//XII total (interuniversity) scientific conference of students and young scientists / the Stavropol state medical academy. - Stavropol, 2004. - s. 71. (In Russian).

6.Zadorozchaya, Tatyana Aleksandrovna. Application of a microclimate of hydrochloric mines and its analogue in treatment of children sick of a bronchial asthma: autoreferat dissertation cand. Medical sciences: 14.00.34, 14.00.09 / T.A. Zadorozhnaja, 1986. s.24.

(In Russian).

7. Landyshev J. S, Miscuk V.P. Cirkad rhythms of level G, kortizols and 17-oksikortikosteroid at sick of a bronchial asthma. Rubbed. . 1994; 3:12-5. (In Russian).

8.Selye G. Sketches about an adaptable syndrome - : Medgiz, 1960. (In Russian).

9. Alexander F. Psychosomatic medicine. New York; Norton. 1950. (In English).

     10. A.E. Lichko. A management Teenage psychiatry, 2, L. Medicina, 1985. (In Russian).

     11.Jores, A., M V. Kerekjarto: Der Asthmatiker. Ätiologie und Therapie des Asthma

     bronchiale aus psychologischer Sicht. Huber, Bern 1967. (In German).

      12.Broitigam ., Christian P., M. Psihosomatic medicine is glad:  The short textbook/ the   

      Lane with it. G.A. Obuhova, A.V. Bruenka;  The foreword V.G. Ostroglazova. - :      

      GEOTAR MEDICINE, 1999. - 376 s.

      13.Groen, J., Bastiaans, J.: Psychotherapy van inwen-dige ziekten. Ned. T. Geneesk., 95.

1951, 2831. (In German).

14. Alexander F.Psihosomatic medicine. Principles and practical application. The/lane from English S. Mogilevskys. - : Publishing house the EKSMO-PRESS, 2002. - 352 s. (A Series Psychology without borders).

15.Milnikovs O.F, Zabolotniy D.I. Diagnostika of immunodeficiencies at a pathology of a mucous membrane on the basis of definition of antibodies in secrets - the concept of diagnostics of antibodies in mucous membranes. - Kiev, 2003. - .3. (In Russian).

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