PHYSHOLEGETAL SYNDROM - This is a painful state characterized by cardiac illness (feeling of squeezing, rapid heartbeat), headaches, gravity in the stomach, impaired urinary, increased sensitivity to cold, sweating, nausea, dizziness, monthly cycle disorders. In addition, the depression, various phobias, inner concern, anxiety, irritability, insomnia and apathy are often noted. All these symptoms patients are characterized as pronounced. However, after a careful medical examination, it turns out that internal organs (heart, stomach, intestines and bladder) patients are completely healthy.

Symptoms

• Hearts.
• The severity in the stomach, disorders of urinary and emptying of the intestine.
• Nausea, dizziness, headaches, sweating.
• Depression, phobia, insomnia.

Causes of occurrence

At the heart of the psychohegetative syndrome is a violation of the functions of the autonomic nervous system of a person. The predisposition to this disorder is usually transmitted by inheritance, but its true reason is a large psychological burden.

Treatment

With pronounced symptoms, drug treatment is most often used. Some medicines have a soothing effect on the vegetative nervous system. Typically, the symptoms of the pillastic syndrome quickly disappear rather quickly, but the disease is not fully cured.

In uncomplicated cases, when psychoshegetative disorders appear only occasionally, it is necessary to simply relax. For example, you can take leave, leave the city or go strolling outdoors. With pronounced and long symptoms, it is necessary to think about the change of lifestyle. Often the disappearance of all symptoms of the disease contributes to the change of profession, the cessation of complex relations with a partner, the occupation of a completely new activity, deepening in religion, etc.

As a rule, people suffering from psychoshegetative disorders are not trying to fight with them. However, in case of somatic violations, it should be immediately applied to a qualified physician. Many people suffer from mental exhaustion, therefore it is recommended to go to a psychologist as early as possible and begin anti-stress therapy. In severe cases, certain mental disorders may be incurable.

Before diagnosing the psychowerhegetive syndrome, the doctor should find out if the patient does not suffer from any organic disease, for example, a stomach ulcer. After the diagnosis is prescribed medication. The doctor then will surely ask the patient about his lifestyle, perhaps advises something to change or send to a psychotherapist.

Course of the disease

This syndrome can flow differently. The symptoms and the degree of their severity are also distinguished by a variety. Most often, the ailment is manifested at the age of 40, as well as during periods of hormonal changes. Symptoms of the disease most often succumb to successful treatment. In order to avoid relapse, it is recommended to change the lifestyle or psychotherapy. However, the predisposition to this disorder (which is manifested by new and new symptoms) remains throughout life.

Our life flows in a mad rhythm, demanding permanent perception and understanding of continuously changing information flow. The modern life of the civilized world is, in the main manifestations, it is the information that interacts with a certain information base is the main part of the work of a large number of people of modern society. There is little time on physical activity. Thus, a person is constantly in a sitting, a larger state.

In addition, the crowded population and constantly high noise and vibration, changes in ecology, hereditary factors and nutritional features lead to the development of vegetative dystonia syndrome in many representatives of the young population of our country. Permanent shared weakness, irritability, violation of the rhythm of heart cuts, dizziness, fainting, disorders of the gastrointestinal tract, the so-called neurogenic impotence, depression, various chronic inflammatory diseases - permanent satellites of patients with vegetative dystonia. All this significantly reduces the quality of life, despite the fact that many doctors consider them almost simulants and patients do not receive a proper serious relationship and appropriate treatment. This occurs because the structural damage of the central and peripheral nervous system is not associated with neurocircular dystonia. There is no cases of a significant reduction in intelligence even with heavy forms. All the patient's complaints (for weakness, brunce, frequent headaches, pain in different parts of the body, the feeling of crawling goosebumps, obscure sensations in different parts of the body (sensenestopathy), learning problems) refer to "functional". However, according to authoritative pathophysiologists, such patients still have changes in the molecular and ultrastructural level of the organization of the nervous system. Due to the fact that under this disease, the performance is significantly reduced, physical, mental and social adaptation is disturbed, a serious attitude towards this disease is required, starting with infant and children's ages.

Special article in this problem - children. Among children suffering from vegetative-vascular dystonia, most part will include those who immediately after birth was diagnosed with chronic intrauterine hypoxia. Despite the common view that vegetative dystonia in children is a purely "functional" manifestation recently it was established that there are small pseudokists and the growth of neuroglia in such patients in the brain (neuroglia - these are cells that are part of the brain tissue, its growing indicates damage to the nervous system).

It should be noted that under the mask of vegetative dystonia, serious diseases are often hidden, for example, brain tumors, epilepsy, mental pathology, cardiac pathology, blood system.

For harmonious and healthy life, an alternate and dosage tension of the mental and physical spheres of the human body are needed. It is almost impossible to carry out this in modern conditions of the metropolis. Imagine a man who, working for a computer in the office, after 1-2 hours of work gets up and starts to do the charge, and then a jogging and a pair of clovers in the corridor. But it is precisely the combination of mental labor and physical activity that provides the most efficient and fruitful daily work and prevents the development of vegetative dystonia, and after it - and many other chronic diseases. The hereditary factor is of great importance, while the "vegetative portrait" is inherited by the maternal line. Mental features of the individual are of great importance. In general, vegetative dystonia are closely related to diseases such as neurosis and depression. This is due to the fact that the same structures are involved in the pathological activity process, and a starting point in their development is a situation that requires increased voltage of adaptive mechanisms. Masternally-conditioned or entered by raising the types of psychological response - for example, renal installations of the type "always and in all of all be better than all". For example, with alexitimia (from Greek. A - the absence, Lexis is a word, TYMOS - a sense) - the limited ability of the individual to the perception of their own emotions - the pikegetatic disorders are not uncommon. In suffering, alexithymia there are heavy affective breakdowns (pivothegetative paroxysms), and the sick often cannot explain their cause. But it may be connected, in addition to fearful heredity, also with socio-media factors of development, family education, blameing the expression of emotions and feelings. Such patients are extremely seriously amenable to psychotherapeutic effects.

What happens in the nervous system, if changes in its activity affect all the lives of such patients?

Levels of the vegetative nervous system

In autonomous, or vegetative, nervous system, two levels are distinguished: an apprental and segmental.

Neurons of the segmental vegetative nervous system are laid in the brain barrel and the side pillars of the spinal cord. They are divided into sympathetic and parasympathetic nervous systems.

The sympathetic department of the vegetative nervous system acts in situations requiring intensive physical and mental activities. For example, a person does not have time to work and need to run. When running there is a more frequent and intensive reduction in almost all skeletal muscle groups. For this, they need a large than usual delivery of oxygen and other substances. Delivery is carried out by blood, therefore, you need more intensive blood supply and blood saturation with oxygen in the lungs. The sympathetic nervous system ensures the increase in heart rate, the increase in respiration and increase the tone of the vessels, expands the pupil (as a result, the beam of light is increasing, which falls on the retina, the vision becomes clearer). As a result, a healthy person can quickly run for some time, while not experiencing any discomfort.

The parasympathetic department of the vegetative nervous system performs the opposite function. This happens during the rest - the tone of the vessels decreases, the heart rate is reduced, the muscle tone decreases, the processes of digestion decreases, the processes of the digestion are activated, the amount of insulin in the blood increases, therefore, glucose goes into tissues in which the synthesis processes are activated.

The functioning of the sympathetic and parasympathetic departments of the nervous system occurs in close and constant interaction. "Guide" activation of one or another needless structures.

Adventure vegetative structures are represented by a limbic-reticular complex, almond, hypothalamus and certain brain cores. Under the combination of "Limbico-Reticular" means two closely interacting structures in the central nervous system - a limbic system and a reticular formation. The reticular formation is, as follows from the name (from the Latin Rete - Network), a network formation, which is an integral part of many departments of the central nervous system. Its stem and the Talalamic departments are especially important, with their defeat, a person may have a coma or the so-called "locked man syndrome", when consciousness operates, but the person resembles a "live corpse." The cyclic change of sleep and wake is associated with the functions of the reticular formation, the activation of several brain areas in response to various irritation of the body.

The limbic nervous system is represented by a partition, a vault of the brain, a hippocampus (part of the brain externally similar to the sea skate), waist with winding and premium bodies. It is associated with such functions as memory and attention, emotional mood background.

The constant state of excitation in which these structures are due to the intensive mental work, the effects of irritants or emotional experiences creates in these structures constant of the excitation focus. But this focus is not limited to the central nervous system. The excitation switches to the segmental level of autonomous (vegetative) nervous system, and then - and peripheral nerves. As a result, the frequency and power of heartbreaks, the tone of the vessels (arteries and veins) changes, the work of endocrine glands changes (the emission of so-called stress stress hormones increases, the level of thyroid hormones increases), the concentration of insulin in the blood increases, the tone of the intestinal muscles and The bladder, the tone of the skeletal muscles (especially susceptible to these changes of the muscle tone of the collar neck), will change the sweating (enhanced or suppressed).

General information about psychohegetal disorders

Vegetative-vascular dystonia is widespread in the population and are detected according to Western authors from 10-26% of patients with a general network, more often found in young women.

Diagnosis of pikegetatic disorders

The clinical manifestations of vegetative dystonia are characterized by community extensions: memory violations, attention, irritability, sleep disorders, and phenomena reminiscent of a somatic disease; In this regard, one of the synonyms of vegetative-vascular dystonia is somatoform disorder. Somatoform disorders are a group of psychogenic diseases characterized by symptoms resembling a somatic disease, but no morphological manifestations are detected. Although there are often nonspecific functional disorders. Somatoform disorders in most cases are manifest aged 22-44 years and are characterized by violations of three levels - sensual, cognitive (i.e. related to learning) and behavioral. Patients are divided into two pathocharacterological groups: polymorphic and isomorphic type. In patients with polymorphic type, emotional lability is observed, an increased impressionability, a tendency to dramatize, anxiety, distractions, impatience, nonsense. In patients with SFR isomorphic type, the features of rigidity (non-dusty) are dominated: a tendency to stagnant affects and the formation of ultra-subject complexes, a trend towards jams on trifles and detail, monotonous activities.

Psychological disorders levels

These groups of patients can highlight the levels of disorders:

The somatic level is a variety of organ dysfunctions (irritable intestinal syndrome, arrhythmia, respiratory disorders, violation of the function of urinary organs).

Neurological - the revival of tendon reflexes, a slight tremor of the tongue, clonus stop (involuntary thick-shaped serial fitting feet in response to re-flexion. Clonus is the highest degree of increasing tendon reflex.)

Mental level is an inner anxiety, anxiety, sleep disorder, mood lability, increased depletion, attention disorders.

Treatment of psychohegetatic disorders

Preferred with pilovgetative disorders is an outpatient treatment, since hospitalization itself is extremely negatively affected by such patients. Therapeutic process is carried out by a neurologist and therapist in collaboration with a psychiatrist. Psychotherapy, which should be aimed at clarifying the sickness of the benignness of his symptoms. It is important to explain that there is no "breakdown" of the disease, but the "unbalance". Patients with psychoshegetive syndrome are good to keep the diary of symptoms.

It is important to teach the patient with simple techniques of autogenic training, aimed at a self-disabling, proper breathing at the time of Panic attacks - ("Once, two - inhale, once, two three - exhalation"), it will help to avoid the development of respiratory alkalosis and the possible loss of consciousness. In pivothegetative dysfunction, the relaxing effect of the cervical-collar zone massage is helping to achieve a relaxation effect (craniosacral technique is particularly effective - in a short time, a pronounced relaxing effect of almost all the muscles of the human body is achieved, the venous outflow is improved, the intracranial pressure is reduced). Methods of transcranial electrostations have proven well established.

Pharmacotherapy: The preparations of atypical benzodiazepines are well established - Grandaxin and Alprazolam, the nestrazodiazepine tranquilizer atrax. They can be assigned together with antidepressants - inhibitors of the inverse neural seizure of serotonin (SSRS). Effective drugs such as PAROKSETHIN (Capshil, Rextin), sertraline (gold, stimulus, astente), Lerivon (MIANSERIN), Fluoksetin, Fevarin, Tianeptin (Coaxil) from neuroleptics is particularly widely and efficiently used sulpirid (eglonyl). It is possible to use thiuridazine (Sonapaks). Under the phenomena of Vagotonia, belladonna preparations are prescribed (Bellataminal, Bellappon). With hyperactivation of the sympathetic nervous system - α- and β-blocker Pirroxan. Vitaminotherapy is effective - vitamins of B, vitamin E, ascorbic acid are used, calcium glycera phosphate is prescribed during Vagotonia, with sympathicotonia - potassium preparations. Nootropic preparations of adaptogenic action are prescribed, which are synthetic analogues of Coenzyme Q-10, IDeDeneon (Noben), Kudesan. These drugs are contraindicated at elevated convulsive readiness at the peak of sharp respiratory infections.

CATAD_TEMA Vegetative Dysfunction Syndrome (SVD) - Articles

Possibilities of treating pivothegetative syndrome

O.V.Kotova
Department of the pathology of the autonomic nervous system of the first MIMU. I.M. Suchenova

The principles of diagnosis and treatment of pivothegetative syndrome are considered. A comprehensive approach significantly improves the results of treatment: it is advisable to combine any psychotropic drugs with vegetotropic therapy.

Keywords:pHYSHOLEGETATIVA SYNDROM, PSYETOPY, NEETOTOTROPIC TREATMENTS, ENTIL-methyl hydroxypyridine succinate.

Possibilities of Treatment of Psychovegetative Syndrome
O.V.KOTOVA.
First Moscow Medical State University Named by I.M.Sechenov, Moscow
Principles of Diagnosis and Treatment of Psychovegetative Syndrome Are Considered. Complex Approach May Significantly Improve Results of Treatment: IT IS REASONABLE TO COMBINE Any Psychotropic Medications with Vegetotropic Therapy.
Key Words:psychovegetative Syndrome, Psychotropic Medications, Vegetotropic Therapy, Ethylmethylhydro-XypeRidine Succinate.

Vegetative dystonia syndrome (SVD) is a diagnosis that is made by the doctors of various specialties to a huge number of patients.
Unfortunately, the doctors often forget that SVD is a combination of several clinical units, namely:

PHYSHOLEGETATIVA SYNDROM (PVS) is the most frequent form of SVD;
peripheral vegetative failure syndrome;
Angiotropoalgic syndrome.

This article we will talk primarily about PVA.

In the middle of the last century, the German explorer W.Thiele was proposed by the term "psychoshegetive syndrome" to designate an oversegmental vegetative disorders. In the domestic literature, this term has consolidated thanks to the works of Academician A.M. Wain, and still it is used to designate SVD associated with psychogenic factors, and as a manifestation of emotional and affective disorders.

According to statistics, more than 25% of patients with the public network has a PVA. In the individual territories of Russia, the volume of the diagnosis of SVD is 20-30% of the total volume of recorded incidence data, and in the absence of the need to send a patient for consultation into specialized psychiatric institutions, it is encoded by doctors and statisticians of outpatient polyclinic institutions as a somatic diagnosis. More than 70% of cases of SVD are made to the primary diagnosis under the vulture of somatic nosology G90.9 - the frustration of the vegetative (autonomous) nervous system uncomfortable or G90.8 is other disorders of the nervous system. According to the results of a survey of 206 neurologists and therapists and therapists of Russia, participants in conferences conducted by the Department of Pathology of the Vegetative Nervous System of the NIC and the Department of Nervous Diseases of the FPPs of the First Moscow State Medical University them I.M. Schechenov for the period 2009-2010, 97% of respondents apply the diagnosis "SVD" in his practice, of which 64% use it constantly and often.

Despite the fact that the PVA is not an independent nosological unit, most doctors use this term for a syndromic description of psychogenic-determined polysystem vegetative violations. The latter include a variety of occurrence and manifestations of disorders of somatic (vegetative) functions associated with the disorder of their neurogenic regulation. Therefore, the terms "neurocirculatory dystonia" or "Vegeta dystonia" are a special occasion of PVA and indicate vegetative disorders with an emphasis on violations in the cardiovascular system.

Most often, patients with such pathology are characterized by a high probability of re-visiting specialists associated with dissatisfaction with prescribed treatment.

At the reception at a doctor, patients make complaints, first of all, on somateptative disorders: stubborn cardialgia, long-term and "inexplicable" hyperthermia, a permanent shortness of breath, an impassive feeling of nausea, exhausting sweating, dizziness, dramatic for patients with vegetative paroxysms or, on modern terminology, "Panic attacks "(PA), etc.

SVD can develop as a result of many reasons and have different nosological affiliation.

SVD may have a hereditary constitutional nature. In this case, vegetative violations debut in childhood, often family, hereditary character. With age, vegetative instability can be compensated, however, this compensation happens, as a rule, non-stress and violates with any loads (stressful situations, physical exertion, changing climatic conditions, professional harm, and a large number of internal factors - hormonal restructuring, somatic diseases, etc. ).

SVD may occur within the framework of psycho-physiological reactions in healthy people under the influence of emergency, extreme events and in an acute stressful situation.

SVD may occur during periods of hormonal rearrangements (Pubertat, Prelimax and Climax, pregnancy, lactation), as well as when taking hormonal drugs.

SVD is found at different occupational diseases, organic somatic and neurological diseases. Treatment of the underlying disease leads to a decrease or complete disappearance of signs of SVD.

In the overwhelming majority of cases, the cause of the PVA is mental disorders of anxious or anxious-depressive nature in the framework of neurotic, associated with stress, disorders, less often an endogenous disease. Mental disorders - anxiety and depression, along with mental symptoms, in their clinical picture have somatic or vegetative violations. In some patients, vegetative symptoms are leading diseases in the clinical picture, in the first place there are mental disorders, which are accompanied by bright vegetative impairments, but such patients consider them a natural response to the existing "severe somatic disease". For this reason, patients pay for help to a doctor, a cardiologist, a gastroenterologist or a neurologist, which makes the problem of PVA interdisciplinary, and doctors of different specialties need not only to be able to diagnose the disease, but also to be able to help the patient get rid of his suffering.

Analysis of the peculiarities of subjective and objective somatic or vegetative manifestations helps to assume their psychosomatic or psychegetal character.

One of the most important features of the PVA is the polysystem of vegetative disorders. The ability of the doctor to see, in addition to the leading complaint, naturally accompanying its disorders of other systems, allows for the clinical stage to understand the pathogenetic essence of these violations. For example, cardialgia with PVED is most often associated with muscle tension of breast muscles and is closely related to breathing enhancement and hyperventilation.

Sine tachycardia from 90 to 130-140 UD / min is a frequent manifestation of PVA. Subjectively patients feel not only a rapid heartbeat, but also the fact that the heart "hits the chest", interruptions, jackets, fading (extrasystoles). In addition to these cardiorahythmic disorders, patients experience overall weakness, dizziness, lack of air, paresthesia.

The disorders of the gastrointestinal tract (gastrointestinal tract) of psychogenic nature are detected in 30-60% of patients in the gastroenterology department. The most serious manifestation is abdomalgia. The peculiarity of Abdomalgius at PVA is their tendency to paroxysm, as well as bright pillastic support (hyperventilation, increasing the nervous excitability, strengthening the Motoric gastrointestinal tract).

The presence of a certain connection between the subjective experiences of the patient, the dynamics of a psychogenic situation and the emergence or aggravation of certain somatic symptoms is one of the PVA criteria. The reduction of somatic complaints usually occurs under the influence of sedatives - Validol, Corvalol, Valerians, benzodiazapines, etc.

With a careful abrasion of the patient, you can identify the unusualness of clinical manifestations and dissimilar to the well-known somatic suffering. If there are complaints for the presence of painful syndrome - cardiagia or abdomalgia, the nature of pain can vary widely. The pain can wear a stitching, pressing, compressing, burning or pulsating character. It may also be sensations that are far from their characteristics from pain (discomfort, an unpleasant feeling of the "feeling of the heart"). They can wear atypical localization for organic pain and wider irradiation. For example, when cardialgia, pain irradiates to the left hand, the left shoulder, the left hypochondrium, under the blade, in the axillary region, in some cases can be spread to the right half of the chest; It is longer than when angina. With abdomalgia, pain is localized, as a rule, in the middle line of the abdomen.

The ratio of the presentations of the patient about his disease (in patients with PVS the inner picture of the disease "developed" is distinguished by fantasticity) and the degree of their implementation in behavior allows to determine the role of mental disorders in their pathogenesis.

When examining a patient with PVA, there are no objective clinical and paraclinic signs indicating the presence of organic pathology in a particular system.

The differential diagnosis of SVD should be carried out with thyrotoxicosis, since, with an increase in the function of the thyroid gland, secondary disturbing violations may appear, having the necessary objective and subjective manifestations.

The most responsible is the differential diagnosis of cardiac and cardiac syndromes with angina, especially atypical options, and arrhythmias. A patient in such cases should pass a specialized cardiology examination. This is the necessary stage of negative diagnostics of SVD. At the same time, during the examination of this category of patients, it is necessary to avoid minimally-informative numerous studies, since their conduct and inevitable instrumental findings can support the catastrophic presentation of the patient about their disease.

It is also important to remember that the manifestations of SVD in some cases can be associated with the side effects of drugs: amphetamines, bronchodilators, caffeine, ephedrine, levodopa, levotheroxin, antidepressants with a pronounced activating effect. If they are canceled, regressing vegetative disorders occurs.

In most cases, vegetative violations are secondary and arise against mental background. It must be remembered that the pillagety syndrome is the first stage of the doctor's diagnostic reflection, which can be completed by the formulation of the nosological diagnosis. In this case, an invaluable help of a general practice doctor or a neurologist will give a psychiatrist, determining the type of mental disorder.

Currently, the following groups of drugs are used in the treatment of psychohegetative syndrome:

Vegetterotropic agents;
antidepressants;
Tranquilizers (benzodiazepines typical and atypical);
Small neuroleptics.

In the treatment of PVA, given its psychogenic origin mainly, psychotropic therapy has priority. It is not necessary to treat a symptom or syndrome, but a disease. In the case of PVA, these are alarming and depressive violations.

It should be noted that the use of any psychotropic agents is advisable to combine with vegetotropic therapy, since the complex approach significantly improves the results of treatment. Among the means widely used for these targets - ethylmethylhydroxypyridine succinate (2-ethyl-6-methyl-3-hydroxypyridine succinate) (ES) is an inhibitor of free radical processes. The spectrum of action includes membrantecture, antihypoxic, stressoprotective, nootropic, anti-epileptic, anxiolytic effects. Ethylmethylhydroxypyridine succinate modulates the activity of membrane-bound enzymes, receptor complexes (benzodiazepine, gamke, acetylcholine), which contributes to their binding to ligands, preserving the structural and functional organization Biomembrane, the transport of neurotransmitters and the improvement of synaptic transmission. ES Although it is not a gamke, but increases the amount of this neurotransmitter in the brain and / or improves its binding to the gamke-receptors.

ES increases the concentration in the brain of dopamine through an increase in the activity of dopamine neurons in the central nervous system, and the level of dopamine is important for emotions such as satisfaction, joy, etc. .

ES enhances the body's resistance to the effects of various damaging factors in pathological conditions (shock, hypoxia and ischemia, brain circulation disorders, ethanol intoxication and antipsychotic drugs).

ES has cerebroprotective, anti-alcohol, nootropic, anti-hypoxic, tranquilizing, anticonvulsant, anti-parkinsonic, anti-storage, vegetotropic effect. What is followed by testimony to use: treatment of acute violations of cerebral circulation, discirculatory encephalopathy, psychegetative syndrome, neurotic and neurosis-like disorders with alarm manifestation, treatment of acute intoxication with neuroleptics and a number of other diseases.

If we talk about PVA therapy, then ethylmethylhydroxypyridine succinate has a pronounced tranquilizing and anti-storage effect, the ability to eliminate the alarm, fear, tension, anxiety. ES has a potentiary effect on the effects of other neuropsychotropic drugs, under its influence the effect of tranquilizing, neuroleptic, antidepressant, sleeping pills and anticonvulsants, which reduces their doses and reduce side effects.

According to the spectrum of operation, the ES can be attributed to daytime tranquilizers, which is effective both in the hospital, and in an outpatient practice, while there are no sedative, muscle relaxant and amnesia effects.

Another equally valuable drug for the treatment of PVA, which is used as a vegetoprotector - pyridoxine (vitamin B 6) is the predecessor of glutamate and gamke - the main neurotransmitters in the central nervous system.

The pronounced deficit of pyridoxine may be accompanied by the development of seizures, which are usually not treated with ordinary means. In addition, there is an increased irritability, such symptoms like dermatitis, as well as Haleosis, Glossite and Stomatitis. Psychiatry describes a state in 6-dependent anxiety.

The doctor in his practice always tries to choose effective preparations with a combined effect, having different points of the application to the pathogenesis of the disease, as it increases the patient's commitment to treatment. Among such drugs - Mexing 6. This is a combined drug, which is available in tablets (No. 30), contains 125 mg of ethylmethylhydroxypyridine succinate and 10 mg of pyridoxine, and due to such a unique composition. What makes it possible to effectively normalize the patient's psycho-emotional background.

In addition to pharmacological treatment, it is extremely important to explain the patient the essence of the disease, while it is necessary to convince the patient that it is curable; explain the origin of symptoms, especially somatic, their relationship with mental disorders; To convince that there is no organic illness (after a thorough examination). In addition, it is necessary to recommend regular exercise, cessation of smoking, reducing the use of coffee and alcohol.

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It will shine a truly affectionate spring sun, and in the ability of a neurologist one after another, frowning people appear with an afflicted expression of the face ...

There are many symptoms, no disease

To the doctor of these people usually lead vegetative symptoms, which with all the diversity constitute a completely characteristic set in the patient's card:

• the cardiovascular system:rapid heartbeat, tachycardia, extrasystolia, unpleasant sensations or chest pain, fluctuations in blood pressure, pre-corporate states, stuffing heat or cold, sweating, cold and wet palms;
• respiratory system:feeling coma in the throat, "non-aromance" or lack of air, shortness of breath, non-uniformity of breathing, dissatisfaction with breath;
• nervous system(pseudoneurological symptoms): dizziness, headaches, pre-corrupt state, tremor, muscle twitching, shudding, paresthesia (discomfort in the skin), stress and pain in muscles, sleep disorders; chills and unfortunate subfebelitets (minor temperature increase);
• gastrointestinal system: nausea, dry mouth, dyspepsia, diarrhea or constipation, abdominal pain, meteorism, disorders of appetite;
• gilitary system:student urination, reduced libido, impotence.

And all this against the background of a common bad condition:

• the patient is tired and tired, irritable and weak at the same time, suffers from weakness in combination with motor concerns and fussiness, inability to relax, stiffness in muscles and tension in the body;
• tormented by the impatience and loss of self-control, the nonsense and inability to concentrate physically and mentally, the memory deteriorates, and the new one does not work out;
• broken sleep, there are difficulties with falling asleep and awakening;
• the mood is reduced, torments depression, tearlessness, and fiscalness, disruption of appetite, concern or feeling of guilt, sense of hopelessness;
• alarms and fears are exacerbated.

Surprisingly, with such an abundance of symptomatics to make the diagnosis turns out to be at all ...

Elusive diagnosis

In the diagnosis of the therapist (which thoroughly searched at least a specific disease in this subject, but did not find) you can see such scary words as "asthenic syndrome", "neurocirculatory" or "vegetative dystonia", "chronic fatigue syndrome" ...

And usually the patients themselves see these words not for the first time, because the problems described are described by them since childhood. Concerned about the health of their weak and pale chad, parents are dragging them to "the luminaries of medicine" and make a bunch of surveys. Doctors call it a "diagnostic panic".

Immirementary diagnosis flows into the infinite process of "treatment", and the outpatient map of the child is shot by mutually exclusive appointments of drugs and non-drug methods, ranging from physiotherapy, ending with "folk" techniques. Sometimes a tandem "Parents + Little Student" is lucky - and it comes to relief, but usually it is time after all returns to the circles - the nightmare continues.

Then the pediatrician takes the verdict "with age will pass" - and everyone is waiting and hoping.

But these are often not justified. And in adulthood, the same patients often go to the hospital, cause a doctor to the house, make health inspections, research and carefully study medical literature. It is they who are regulars of the clinic and private medical centers, where financially interested doctors are fully capable of finding a menitious citizen a lot of interesting "sores", which, with varying success, can also be treated for years and decades.

It happens that these patients (not to find assistance from doctors) "disappointed" in medicine and live alone with their "illness" or fall to psychiatrists (or to psychotherapists) and they are observed with such disorders as somatoform vegetative dysfunction, masked depression, Anxiety disorder.

Others become "pets" therapist: treat irritable bowel syndrome, hypertension, voltage headache, discirculatory encephalopathy, etc. Well, women are treated for the gynecologists "premenstrual syndrome".

The trouble is that without the correct understanding of the nature of the disease therapy, it turns out to be useless at best.

What is really happening?

All these patients unites one general feature - the high sensitivity of the body to the "disturbing" factors of the internal environment and to external environmental factors. That is, due to the congenital weakness of the nervous system, it does not cope with the exercise of the environment, which for others is considered a daily relative norm.

The name of this phenomenon is pHYSHSHEGETATIVA SYNDROM..

At the same time, the dependence of the symptoms from the dynamics of the actual psychogenic situation is striking. The appearance or exacerbation of the intensity of patient complaints is often associated with a conflict situation or a stress event. The stronger stress - the worse the patient feels.

Often, doctors note in patients a gradual replacement of some symptoms on the other - "mobility", and the appearance of a new, incomprehensible symptom for a patient is always an additional stress and can lead to a deterioration. Therefore, such patients doctors do not like. I looked at him not so - and the exacerbation.

The mass of exacerbations of the doctors learned to write off on "bad weather" and "geomagnetic storms" (very convenient, do not find?) However, in the directions of Dr. District Polyclinic, three "terrible" letters of the PND flashes. Doctors of private medical centers, initially hospitably opening the doors of their cabinets, constantly write in the directions "Recommended the consultation of a psychologist / psychotherapist" ...

This is not a "conspiracy" and not the desire to get rid of an incomprehensible patient. Whyer before the condition of which in medicine and the name is no uniform, the psychotherapist will take place (as an option is a neurologist), the better. Believe that with age, problems are only growing. And do not be afraid of drugs and doctors - with them you need to competently cooperate.

What can I do yourself?

If in the picture described above, you learned ourselves or loved ones, and the visit to the psychotherapist and the neurologist is postponed indefinitely, here you have several proven recommendations.

Treatment of psychological syndrome is advisable to start with psycho-generic events. General Tips for Patients Such:

• optimize operation and rest mode;
• enter tonic physical exertion;
• diverse diet.

Moreover:

1. Believe that your condition is treated. But it is also important to believe and realize that the symptoms are directly connected to the mental state.
2. Make sure that the organic illness is really not.
3. Throw smoking and drinking coffee (and alcohol, of course, too).
4. The respiratory gymnastics with the regulation of the depth and frequency of breathing helps well.
5. Use autogenic workout and trainings to relax.
6. Treatment at the psychotherapist - helps.
7. Biological feedback (BOS) is applied from instrumental non-good methods - a process in which people learn to improve their health and psychological state, observing their own body signals registered with special devices.

And what kind of medicine, you ask? As for drug therapy, the only preparation, the positive effect of which was confirmed by a double-blind randominized slave-controlled study, is magnesium sulfate. However, its use is limited due to the methods of administration and pronounced side effects.

It must be remembered that in some cases, specific psychotropic pharmacotherapy may be required, which includes drugs of three groups: antidepressants, tranquilizers and neuroleptics. But only the doctor can appoint them, and the self-recognition here is contraindicated here.

Valentina Saratovskaya

Photo Thinkstockphotos.com.

PHYSHSHEGETATIVA SYNDROM. (vegetative dystonia, psychiatric decline et al.) is a syndrome in which human has violations of vegetative functions, different on manifestations and origin.

The reasons

Psychegetative disorders are often diagnosed in children of the older age group, as well as in adolescents and young people. In more rare cases, the disease is manifested in people after 40 years. Cardiopsychoneurosis Most often develops in young people. This is primarily due to the slow focus of the neuroendocrine system in the young organism, as well as with the inconsistency of the physical development and the work of the endocrine system.

PHYSHOLEGETAL SYNDROM is manifested under the influence of hereditary factors, constitutional features, damage to the nervous system of organic nature, disorders of a somatic and mental type. The symptoms of the disease are also manifested by the hormonal rearrangements of the body, psycho-physiological shifts (we are talking about stress - acute and chronic), psychosomatic diseases (heart disease, hypertension, bronchial asthma, etc.), diseases of the nervous system, some occupational diseases, mental disorders and.

All described factors contribute to the manifestation of vegetative dystonia. If the treatment of the disease is not carried out in a timely manner, it may be complicated by manifestation.

Vegetative dysfunction often occurs as the consequence of organic brain ailments, as well as in the presence. But one of the most common causes of the manifestation of vegetative disorders is the process of endocrine restructuring of the human body in the adolescence, as well as in women during menopause. A separate form is psycho-physiological vegetative dystonia, which manifests itself in humans as a consequence of stress, strong physical stresses, neurotic disorders.

Symptoms

Vegetative dystonia syndrome Can be expressed by different symptoms that are affected by etiological factors. The symptoms of vegetative dystonia are manifested by a number of diverse syndromes, the treatment of which should be carried out only comprehensively.

Cardiovascular syndrome the patient is manifested by changes in the rhythm of the heart, (both and bradycardia ), lifting, (pallor,), tides, manifestation of ultray limbs.

Cardialgic syndrome - This is the occurrence of pain of a variety of or discomfort in the precordial area. The pain is sometimes taken for manifestations, but it is not connected with physical exertion, continues longer and does not pass after the reception. Sometimes changes can be detected on the ECG.

Also in pain, a person suffers from hyperventilation (Frequent breathing, sensation of lack of air), having a psychogenic character, as well as from cough. With rapid breathing from the body, too much carbon dioxide is removed. As a result, the body occurs in the body leading to the manifestation of muscle spasms and paresthesia in the distal limbs and the perioreral region. Hyperventilation can cause pre-corrupt phenomena in a patient - he darkens in his eyes, the weakness is manifested. But most often, hyperventilation is manifested by pain in the heart, as well as pains in the stomach, in which there is a violation of the gastrointestinal motorcycle.

With the disorders of the gastrointestinal tract functions, the patient disrupts the appetite, it may be disturbed by an irritable bowel syndrome. Sometimes vomiting, heaviness in epigastria, chair disorder.

In vegetative dystonia can manifest sexy dysfunction In which men observed disorders of erection or ejaculation, and in women - vaginism or. Another symptom - cystalgia (rapid painful urination).

Psychegetative violations are also expressed by the presence of violations of thermoregulation. They are manifested by hyperthermia, hypothermia, frowning syndrome. Hyperthermia may have a constant or paroxysmal character.

Speaking of own disease, patients who are diagnosed with a common psychosomatic syndrome, noted that the symptoms of the disease is very wide. In other words, sometimes a person seems to have absolutely everything hurts. Consequently, the main feature of the symptoms of this ailment is the manifestation of manifestations.

Today, experts define three different types of neurocirculatory dystonia: hypertensive , cardiac , hypotensive . The symptoms of neurocirculatory dystonia by cardiac type are expressed by insignificant changes in blood pressure. However, the person suffers from the manifestation of the rapid rhythm of the heart, interruptions in cardiac activity, shortness of breath. In people who suffer from dystonia of this type, there is a tendency to the periodic manifestation of tachycardia, changes in cardiac rhythm, as well as to other changes in cardiac activity.

With neurocirculatory dystonia on hypotensive type The patient has symptoms of heart failure. We are talking about reduced systolic pressure, lowering symptomatic activity and cardiac index. A person suffers from headaches, he is very quickly tired, it feels weakness in the muscles, his extremity flaws, leather pale. As a rule, this form of dystonia suffer from people who have an asthenic physique.

For neurocirculatory dystonia by hypertensive type Characterized transient lifts of blood pressure. But at the same time most people do not feel worsening well-being. As a result, the disease is diagnosed late, and, in most cases, this happens when planned inspections. In addition to increasing blood pressure with dystonia in the patients, severe fatigue, headaches, rapid heartbeat are observed. Considering these symptoms, we can say that the signs of this form of neurocirculatory dystonia are similar to symptoms. hypertension . Therefore, for accurate diagnostics, a thorough inspection of a specialist and the appointment of further examination is needed.

In addition to these forms of the disease, dystonia for mixed type is also diagnosed, in which the patient has blood pressure fluctuations.

Diagnostics

Install the diagnosis of "Vegetative dystonia" (psychegetative syndrome, vegetative neurosis) can only be carried out in the case of a comprehensive examination. Initially, it is necessary to exclude all the somatic diseases that could provoke the manifestation of certain symptoms. It is especially important to do this if there are only violations in the work of one of the systems.

To conduct high-quality diagnostics, consultations are often needed by several doctors - specialists from different profiles. Very important is the patient's poll. Specialist needs to be detailed to ask the patient about his sensations and learn in detail about the subtleties of all manifestations.

In the process of examination, with suspected pinshegetive syndrome, electrocardiogram, MRI and computed tomography, dopplerography of vessels are often assigned. Treatment is appointed individually, taking into account all the features of the manifestations of the disease.

Treatment

If possible, the treatment of psychohetative syndrome is carried out without the use of medicines. The patient is assigned reflexology, massage, medical physical education sessions. Methods of physiotherapy, resort treatment are also practiced. Reduce the degree of manifestations of hyperventilation helps respiratory gymnastics. But if there are sharp manifestations of symptoms of the disease, then benzodiazepine drugs may be prescribed to patients for certain times. If a person is worried about constant pain, he is appointed a course of treatment antidepressants .

In the presence of an anxious-depressive state with sleep impairments, it is advisable to receive antidepressants having a sedative effect. Preparations - beta blockers are used with, arterial hypertension, tachycardia. If the vegetative dystonia is manifested by arterial hypotension, the patient is recommended a course of treatment with ginseng tincture, lemongrass, Eleutherococcus.

Due to the diverse symptoms in the treatment, other drugs are also applied, which are appointed individually. The correct lifestyle, hardening, treatment, aimed at the general strengthening of the body is also important.

In some cases, an explicit positive effect is provided by the use of rational psychotherapy, in the process of which the patient is aware that he does not have a disease threatening life.

Sanitary-resort treatment is also practiced, which is effectively valid due to the influence of the patient climate change. Under the influence of modified climatic conditions, the cardiovascular system of the patient functions in the adaptation mode and adapts to all other organism systems. Climatic conditions also allow to train the body's protective forces, therefore, struggling with disease becomes much easier.

In addition, the treatment of ionaterapy is practiced, the course of which lasts about 30 days. With vegetative dystonia, symptomatically recommended sedatives.

Given the tendency to high or low pressure, it is possible to receive medicinal herbs, as well as drugs manufactured based on them. At elevated pressure, it is recommended to take, ordinary souls. Before bedtime it is useful to use bee honey. At low pressure it is necessary to use the infusion of Eleutherococcus, the Chinese lemongrass.

Smoking and alcoholic beverages are contraindicated in patients with vegetative dystonia. But sports and daily water treatments with the use of a contrasting soul will ensure improvement in well-being. Useful for the health of patients with pillastic bathing syndrome in open reservoirs, running, walking in the fresh air.

The doctors

Medicine

Prevention

As prevention, the use of all measures described above, aimed at normalizing human lifestyle. In addition, special attention should be paid to recreation and sleep mode. A person must sleep daily at least 8 hours.

An important factor is the right approach to the daily diet. In the diet, all dishes should be high in vitamins and minerals. At the same time, products exciting the nervous system is better not to use. We are talking about coffee, tea, chocolate, spices, smoked salts, salting.

Diet, nutrition in pilovgetative syndrome

List of sources

• Vegetative disorders (clinic diagnostics treatment) / Edited by A.M.Wesin. Medical information agency. M.: 1998;
• Vane A.M., Dyukova G. M., Vorobyova O.V., Danilov A.B. Panic attacks. Guide for doctors. Eidos Media. 2004;
• Mental disorders in general student practice and their treatment / Yu.A. Alksandrovsky M.: Goeotar-Honey, 2004;
• Spelevich A. B. Depression in general student practice. M., 2000.