Prevention of recurrent respiratory infections in preschoolers
Objective: to evaluate tolerability and efficacy of a complex of sanative measures in preschoolers with recurrent respiratory infections (RRIs). Materials and methods. This study included 63 preschool children aged between 4 and 7 years from Seversk. Children with RRIs (n = 44) were randomized into 2 groups. The experimental group comprised 22 children who received a complex of sanative measures (including thermotherapy, cold massage of the nasal vestibule, and breathing exercises), whereas the control group included 22 children with RRIs who received a similar complex of sanative measures, but without cold massage. We also examined 19 healthy children. During 9 months, we had been monitoring clinical efficacy of this complex by evaluating the frequency and duration of acute respiratory infections, calculating the epidemic efficiency index (EEI) and epidemic efficiency coefficient (EEC), and assessing morphofunctional characteristics of the nasal mucosa using the method developed by L.A. Matveeva. Results. The highest treatment efficacy was observed in the experimental group (EEI=1.39; EEC=28.2%). The assessment of morphofunctional characteristics of the nasal mucosa demonstrated a significant decrease in the mean level of neutrophil destruction and squamous epithelium destruction among children from the experimental group by the end of the third month (р < 0.001 and р = 0.031 respectively); these changes were stable and were still observed by the end of the 9<sup>th</sup> month (р = 0.001 and р = 0.030 respectively). We also registered a significant decrease in the neutrophil cytolysis index and squamous epithelium cytolysis index by the end of the 3<sup>rd</sup> month (p = 0.024 and р = 0.037 respectively). Comparative analysis showed a more pronounced reduction of the mean destruction rates of neutrophils and squamous epithelium along with cell cytolysis indices (for neutrophils and squamous epithelium) in the experimental group during 9 month of rehabilitation compared to the control group. Conclusion. The proposed complex of measures is well tolerated by patients, decrease the number of RRI episodes, and restore the components of the local immunity in the nasal mucosa; therefore, it can be used for the rehabilitation of preschoolers with RRIs.