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DOI: http://dx.doi.org/10.20534/ESR-17-5.6-42-44
Salaeva Muborak Saidabdullayevn, Tashkent Medical Academy, Uzbekistan associate professor of the Department of Internal Medicine No. 2
of the Faculty of Medicine. E-mail: muborak.salaeva@tma.uz Tagaeva Mavjuda Khalmatovna, Tashkent Medical Academy, Uzbekistan associate professor of the Department of Internal Medicine No. 2
of the Faculty of Medicine E-mail: tagaeva0808@mail.ru Xaydarov Farurukh Sidakhmetovich, Tashkent Medical Academy, Uzbekistan assistant of the Department of Internal Medicine No. 3 of the Medical Pedagogical Faculty.
E-mail: dr.farrux@gmail.com Salimova Nargiza Djurabayevna, Tashkent Medical Academy, Uzbekistan senior lecturer of the Department of Internal Medicine No. 2
of the Faculty of Medicine.
E-mail: muzaffar.salimov5696@mail.ru Khalimova Kholida Khakimbyevna, Tashkent Medical Academy, Uzbekistan assistant of the Department of Internal Medicine No. 2
of the Faculty of Medicine E-mail: Holida80@mail.ru
INTERRELATIONSHIP BETWEEN LIFE QUALITY AND VEGETATIVE NERVOUS SYSTEM IN PATIENTS WITH ASTHMA
Abstract: The purpose of this work was to study interrelation shipbet ween quality of life parameters and vegetative nervous system in patients with bronchial asthma (BA). In the pulmonological department 62 patients with asthma were studied. The Quality life was assessed by Seattle Questionnaire. In the patients with asthma there was noted tension and damage of adaptation-compensatory body capacity and reductionof the life quality parameters. In thepatients with asthma defined relationship is more pronounced reduction in QoL physical and emotional state of hypersympathicotonic and vagotonics. The expansion of rehabilitation measures aimed at restoring the adaptive-compensatory abilities of the body, can help to restore and improve the quality of life of patients with asthma.
Keywords: bronchial asthma, vegetative nervous system, quality of life.
Bronchial asthma (BA), is not only medical, social and eco- degree of comfort within themselves and within their society. QL nomic, but also the general humanitarian problem [3]. related to health, — a set of parameters describing the various as-
Clinician's interest is increased in study of the functional state pects ofhuman functioning: physical and psychological state, social ofthe vegetative nervous system (VNS) currently. VNS mediates its relations, the functionality of the period of his illness [1; 8; 9]. effect on the functional state of the bronchial tubes through the sym- Found that in AD is a significant decline in the quality of life of
pathetic and parasympathetic regulation mechanisms. Influences patients [4; 5; 6; 7]. Interconnection between subjective feelings of are transmitted via vagus, causing contraction of bronchial smooth the patient and objective parameters that characterize the vegetative-muscle, through the pulmonary sympathetic plexus — adrenergic nervous system has not been studied.
effects, relaxing smooth muscle [2]. The aim of this work is researching the interconnection of pa-
Assessment of quality of life (QL) of a person takes the major rameters of quality of life and the vegetativenervous system in pa-place in the clinical and socio-medical researches, assessment the tients with asthma.
INTERRELATIONSHIP BETWEEN LIFE QUALITY AND VEGETATIVE NERVOUS SYSTEM IN PATIENTS WITH ASTHMA
Materials and methods:
Clinical and functional studies of 62 patients with asthma on the basis of Pulmonology Institute of TB and Pulmonologist Ministry of Health of Uzbekistan Republic were conducted. Quality of life was determined by the Seattle questionnaire comprising 29 questions that assess physical condition, emotional state, the state of professional competence and satisfaction with treatment.
State of the vegetativenervous system was assessed by Cardio-intergraphic (CIG) on Bayes (1976). The obtained data were processed statistically using Student's t test.
Results and discussion.
According to the study the initial vegetativetonus that characterizes the adaptive ability of the organism to the disease, in patients with asthma noted that only 30% remains adaptability, manifested Ayton (ET), at 20,9% shows the state sympathic (ST), which determines the voltage adaptation possibilities, at 45,3% — hypersym-pathicotonia (HST) and 4,8% — vagotonia (VT), reflecting the failure of the state of adaptation options.
Comparing the state of autonomic tone with the original parameters QL of patients with asthma found that the stress and frustration of adaptive capacity had significantly marked reduction of QL parameters for the physical and emotional state (table 1). Specifications QL in patients with asthma with various conditions vegetative tonus (in basis points).
The parameters of the physical condition of patients with asthma hypersympathicotonic were reduced — by 23%, and in patients with asthma vagotony — by 31% compared to tonicity and respectively — 54% and 59% of the maximum possible points. Parameters of the emotional state of patients with asthma sympathicotonic reduced — by 26,4%, from hypersympathicotonic — by 32,3% and vagotony — by 43,8%, compared with patients with asthma and tonicity — by 57,7%, 61,1% and 67,7% of the maximum possible points. QL parameters fit and satisfaction with treatment in patients with asthma have been reduced to 55,8% and 50% respectively of the maximum possible values. However, without a significant decrease in these parameters depending on the initial vegetativetone.
Table 1.
Pairmetres Max. possible ET (n = 18) ST (n = 13) HST (n = 28) VT (n = 3) P
1-2 1-3 1-4
Physical condition 5,2 3,09 ± 0,20 2,18 ± 0,24 2,38 ± 0,09 2,14 ± 0,21 < 0,01 < 0,001 < 0,001
Emotionalcondition 7,0 4,02 ± 0,37 2,96 ± 0,36 2,72 ± 0,20 2,26 ± 0,14 < 0,05 < 0,001 < 0,001
Professionalfitness 7,0 4,09 ± 0,32 3,32 ± 0,44 3,09 ± 0,19 3,91 ± 0,25 > 0,5 < 0,01 > 0,5
Complacencybytreatment 5,0 2,58 ± 0,19 2,69 ± 0,12 2,55 ± 0,09 2,5 ± 0,10 > 0,5 > 0,5 > 0,5
The study of the compensatory capacity of the organism of patients with asthma, estimated by vegetativereactivity, showed that only 30.6% of patients with asthma recorded normal vegetativereactivity (NVR), reflecting preservation of compensatory abilities, in 54.8% of patients — hypersympathicotonicvegetativereactivity (HSR) reflecting voltage compensation abilities and 14,6% — asym-pathicotonic autonomic reactivity (ASVR) — failure mechanisms of compensation.
Comparing the form of the vegetativereactivity ofpatients with asthma with the parameters of quality of life was observed a significant reduction of the maximum possible values (table 2).
Specifications the patients QL with various conditions of asthma autonomic reactivity (in basis points).
Patients with asthma with normal vegetativereactivity parameter QL physical condition reduced — by 53,5% of the maximum possible, on the emotional — by 57,7%, as a professional fitness — by 54%, and treatment satisfaction — by 50,6% of the maximum possible score. Among patients with asthma and SSR ASVR quality of life parameters were also significantly reduced. However, we have not established communication with derating QL compensatory abilities of the body.
Table 2.
Pairmetres Max. possible NVR (n = 16) HSR (n = 34) ASVR (n = 7) P
Physical condition 5,2 2,42 ± 0,20 2,66 ± 0,11 2,30 ± 0,22 >0,5 >0,5
Emotionalcondition 7,0 2,96 ± 0,32 3,21 ± 0,20 3,08 ± 0,45 >0,5 >0,5
Professionalfitness 7,0 3,22 ± 0,26 3,61 ± 0,19 3,53 ± 0,42 <0,2 >0,5
Complacencybytreatment 5,0 2,47 ± 0,09 2,60 ± 0,12 2,77 ± 0,17 >0,5 <0,2
Conclusions
1. Patients with asthma often marked stress and disruption of adaptive-compensatory abilities of the body and reduced quality of life parameters. Patients with asthma defined relationship is more pronounced reduction in QL parameters in physical and emotional state of hypersympathicotonic and vagotonys.
2. Reducing of QL parameters in patients with asthma is not established due of reducing these parameters on the state of the veg-etativereactivity
3. The expansion of rehabilitation measures aimed at restoring the adaptive-compensatory abilities of the body, can help to restore and improve the quality of life of patients with asthma.
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