Study on pathophysiological mechanisms responsible for the subset of orthostatic dysregulation and new integrative treatments.

研究直立性失调的病理生理机制和新的综合治疗。

基本信息

批准号：
14570782
负责人：
TANAKA Hidetaka
金额：
$ 2.11万
依托单位：
Osaka Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2002
资助国家：
日本
起止时间：
2002 至 2005
项目状态：
已结题

项目摘要

We determined the criteria of four subsets or orthostatic dysregulation ; instantaneous orthostatic hypotension (INOH), postural tachycardia syndrome (POTS), delayed orthostatic hypotension and neurally-mediated syncope (NMS). INOH, sudden drop of blood pressure associated with active standing, is caused by blurred activation of sympathetic activation in the arteriolar vessels. This also involves the excessive pooling of blood in the lower part of the body, thus causing tachycardia during standing. POTS, showing tachycardia >= 115 during standing, is associated with augmentation of sympathetic activity of the heart. The loss of plasma volume or reduction of circulating blood during orthostatic stress is also involved in POTS. NMS is characterized with sudden reduction of blood pressure associated with loss of consciousness with or without cardioinhibitory mechanisms. This episode sometimes develops after severe increase in heart rate during standing in children with INOH and POTS. Thes … More e types of orthostatic intolerance were found to cause impairment of cerebral circulation only during upright posture in about half of the patients, resulting in various disabling symptoms, such as orthostatic dizziness, strong fatigue, fainting and lowering brain function including cognition and thinking. These disadvantages reduce quality of life in patients, thus causing psychological distress as well. There has been one report on the relation between orthostatic intolerance and gene mutation, although we did not find such a patient during the research period. New treatments have been also developed in this study from the biological and psychosocial aspect ; non-pharmacological treatments, medication and psychosocial support. The first alternative includes the repair of circadian rhythm, exercise training with adequate degree and sodium / water intake. We also invented an inflatable abdominal bandage which inhibits blood pooling in the lower part of the body. Regarding medication midodline was found as a most effective and a safe drug for INOH and POTS. We established the comprehensive support network system for patients with orthostatic dysregulation and school absenteeism from the bio-psycho-socio-ethical aspect. In this system, we incorporated a new occupational stuff, named "mental associates", who is usually an university postgraduate is expected to visit home of a child with school absenteeism and psychosomatic diseases for the purpose of metal support, tutoring and rehabilitation in society, under the control of medical specialists. A trained mental associate carried out his task according to the elaborated original program. We have experienced 17 cases. A mental associate performed a task once a week for 90 minutes including going out home and step-by-step tutoring, resulting recovery of emotional steadiness, decision-making and sociality. Less

我们确定了四个子集或原位失调的标准；瞬时体位性低血压（INOH），姿势心动过速综合征（POTS），延迟的体位性低血压和天然介导的晕厥（NMS）。 InoH，与主动站立相关的血压突然下降是由小动脉血管中交感神经激活的模糊引起的。这也涉及到身体下部的血液过多，这一事件有时在站立期间115之后发展。在站立期间显示心动过速> = 115的花盆与心脏交感神经活动的增强有关。在定位应力期间，血浆体积的损失或循环血液减少也参与了盆栽。 NMS的特征是与有或没有心脏抑制机制的意识丧失相关的血压突然降低。在站立的Inoh和Pots儿童中，心率严重增加后，有时会出现这一事件。在大约一半的患者中直立姿势时，发现更多类型的E e静脉内肠道才会导致脑循环损害，从而导致各种残疾症状，例如体位性头晕，强烈的疲劳，精度，精度和降低脑功能，包括认知和思维。这些灾难降低了患者的生活质量，从而造成心理困扰。尽管在研究期间我们没有找到这样的患者，但已经有一份关于体位耐肠和基因突变之间关系的报告。这项研究也从生物学和社会心理方面开发了新的治疗方法。非药物治疗，药物和社会心理支持。第一个替代方法包括修复昼夜节律，具有足够程度的运动训练以及钠 /水的摄入量。我们还发明了一种充气的腹绷带，该腹部绷带抑制了身体下部的血液集合。关于药物中线是一种最有效，最安全的药物，用于Inoh和Pots。我们为从生物心理 - 社会伦理方面的正常失调和学校缺勤的患者建立了全面的支持网络系统。在这个系统中，我们合并了一种名为“心理协会”的新占领物，通常是大学研究生，他们将在医学专家的控制下拜访一个旷工和心理疾病的儿童的家中，以实现金属支持，辅导和康复的目的。训练有素的心理助理根据详尽的原始计划执行了任务。我们经历了17例。一名心理同事每周执行一次任务90分钟，包括外出回家和逐步辅导，从而恢复了情感稳定，决策和社会性。较少的