s and ulcers. The flow of sympathetic impulses cause
excessive release of mediators (catecholamines), which leads to disasption of trophic
tissues. Important role in ulcer formation belongs to the parasympathetic nervous system
. Stress leads primarily to stimulate the function of the hypothalamus.
Stimulation of the anterior hypothalamus of parasympathetic paths
causes hypersecretion of hydrochloric acid and pepsin, gipermotoriku and hypertonicity of the stomach and
stimulation of posterior hypothalamus, due to sympathetic impulses leads to
vasospasm and ischemia [38].
Dysfunction of autonomic nervous system (NS) is regarded as
pathogenetic factor of non-infectious gastrointestinal pathology [5, 13, 21,
37].
ANS dysfunction occurs in children with functional disorders of the stomach (WDF).
Initial vagotonia was observed in 71%, amphotonic - 23%, sympathotony - 6%. By
data klinoortostaticheskoy samples revealed normal, hypersympathicotonic
and asimpatikotonicheskaya autonomic reactivity (VR). Moreover, the dominant
normal BP (59%) and 24% of children observed hypersympathicotonic BP [13].
In children with biliary dyskinesia (DZHVP), which refers to
functional disorders, also have ANS dysfunction . Thus, in children with type
gipomotornym dyskinesia sympathetic tone dominates the National Assembly, and in children with
gipermotornoy DZHVP predominant focus of the original
parasympathetic autonomic tone (ICT). In addition, in all types of notes DZHVP
adequate BP, normal or excess water [29, 36]. According to Stankevich, ZA
[34], autonomic disturbances in DZHVP have a mixed sympathetic-and
parasimpatikotonichesky character. Increased activity of the sympathetic NA
marked spasm in the sphincter of Oddi and gallbladder of hypotension (R). The predominance of parasympathetic tone
NA - with hypotonia of Oddi's sphincter and
gipermotorike gallbladder.
The relationship between VNS and gastroduodenal motility, which plays an important role in the development of gastroduodenal pathology
(GFC) [24]. When gipermotorike stomach and duodenum
(KDP) noted the predominance of parasympathetic
VNS at gipomotorike - sympathetic. Balance between the ANS is characterized
for normomotoriki stomach and duodenum [28]. One reason for the chronicity of pathological
process in gastroduodenal mucosa (CO GDZ) are
sphincter disorders, which are a manifestation of duodenogastric reflux (DGR),
gastroesophageal reflux (GER). In the development of sphincter disturbances priority
role for ANS dysfunction. The dependence between the state
ANS parasympathetic and the presence of DGR in patients with chronic
gastroduodenitis (CGD) [36]. Samarina OV [30] showed that in patients with
sphincter disorders prevalent hypersympathicotonic BP and insufficient
vegetative maintenance activities (VOD). Autonomic disorders are important
importance in the genesis of gallstones (cholelithiasis). Increased sympathetic tone
level VNS, pathological variations of BP and water are the cause of violations
bile secretion by the inhibitory effect on motor function of the gall bladder
. Stagnation of bile contributes to the formation of the inflammatory process,
Development neurodystrophic changes bladder wall.
This leads to an even greater violation of its contractile capacity of up to
atony, and the formation of concretions [2]. According to Bulatov [3],
pathology of biliary system (DZHVP, chronic cholecystitis, cholelithiasis) identified
violation of the functional state of ANS, characterized by a predominance of parasympathetic tone
, amid relative asthenia sympathetic
department, the presence of hypersympathicotonic BP and insufficient WATERS. At the expense of
chronic cholecystitis have a different view according to which a given
disease are often encountered sympathetic and parasympathetic
effect [28].
When ANS imbalance in patients with chronic pancreatitis is the predominant influence of the sympathetic
of VNS [28]. Lateral TD, Zapasdnovym AM [2] is set
dependence of the duration of the disease (GSD) of the IWT. Children with sympathicotonia
duration of illness was greater than in children with vagotonia and Aiton.
According to these authors [2], the nature of pain also depends on
ICT. Dull pain weremorefrequent in simpatotonikov, attack - a vagotonikov.
Pankova EN [27] revealed a clear dependence of the humoral factors
immunity to the type of SPC and BP in children with chronic colitis. Thus, significant changes
detected in patients with parasympathetic ICT with
hypersympathicotonic BP. In addition, the most striking clinical manifestations
chronic colitis (HC), and expressed the morphological changes in
mucosa (CO), large intestine, including atrophy and subatrophy were
identified in children with parasympathetic ICT focus. Several other data obtained
Skobtsovoy OB [31].
The author shows that in children 10.6 years of age suffering from HC prevails
amphotonic and lack of water, and vagotonic type predominates in children 11-15 years old,
and also holds the excess WATERS. According Dulkin LA [13], in children,
suffering from HK, the original vagotonia detected in 56% and sympathicotony - in 44%
patients. Revealed normotonicheskaya (20%), hypersympathicotonic (40%) and
asimpatikotonicheskaya BP (40%).
in the pathogenesis of HGDP important role for the functioning of the SPA, as proved that
HGDP arises from the depletion of protective and adaptive mechanisms [24,
35] as a possible mechanism of transmission are considered the prevalence
parasympathetic regulation, leading to a breach of the secretory-motor function
stomach. Violation of trophic coolant due to the decrease of sympathetic activity
level VNS. In the study of the state of VNS in chronic gastroduodenal pathology
(HGDP) (chronic gastroduodenitis, peptic ulcer, ulcer disease
duodenum - CGD, GU, DU) yielded conflicting results
.
According to Maltsev SV et al. [24], in children during acute CGD
holds vagotonic type of VNS, hypersympathicotonic,
asimpatikotonicheskaya BP and insufficient WATERS. Similar results were obtained
Kuberger AM et al. [21] for BP and water. However, according to Dulkin
LA [13], the CGD is also dominated by the initial vagotonia, but also holds
sympathetic orientation ICT. Somewhat different results were obtained Mazurin,
Vasadze [23], the results of studies which, together with vagotonia
(dominant), there is a mixed tone. Tase sympathicotonia
not observed. According to Gonchar NV [9] HGDP prevails vagotonia,
identified in 60%, 30% - sympathotony and 10% of cases - amphotonic that not
agrees with Denisov, M.Yu. [16], which resulted in the majority of children identified
sympathotony (60%), amphotonic - 28% and only 6% of cases -
vagotonia.
In studies conducted Tyurina NS [35], all children with HGDP prevails
eytonichesky (normal) IWT. Predominated hypersympathicotonic BP,
that indicates some instability of the autonomic nervous
activity and a sharp voltage adaptation mechanisms in children with HGDP. Revealed
normal and excessive WATERS. In children with erosive processes and surface DG
vagotonia and sympathicotony observed with equal frequency. However,
sympathicotonic ICT focus in children with erosive and ulcerative lesions DG
- the area combined with a distinctive clinical picture and severe
disease.
According Dudnikova EV [12], the most prominent clinical picture occurs in children with
parasympathetic thasst of ICT. Denisova, EM [10] found,
that children with superficial hypertrophic and subatroficheskim DG prevails
parasympathetic direction of ICT, hypersympathicotonic BP, which
is a compensatory mechanism against the background of the original vagotonia, and insufficient
WATERS. In children with erosive gastroduodenitis (EHD) dominated the mixed tone of the ANS,
and vagotonia - 32% of cases, there is hypersympathicotonic BP and
excess WATERS. In addition, children with disease duration less than a year on the background of the original
vagotonia revealed sympathicotonic BP is determined by a
easy type of disease, rapid response to treatment and long
remission.
According Okunev, SA [26], children with superficial and focal atrophic
changes of gastric mucosa (GM) and the KDP dominated vagotonia and
insufficient WATERS. At a superficial gastritis, DG holds the excess BP and
for chamber-atrophic gastritis, DG vice versa - reducing BP, indicating
a lack of sympathetic activity level of the SPA. Indicator BP in patients with
surface forms of the disease exceeded the value of BP in children with atrophic changes
CO 3 times. In terms of BP's proposed method of differential diagnosis
superficial and atrophic forms of diseases, which with 80%
likely to allow a diagnosis without examining endoscopy and histological examination of biopsy specimens
CO [26].
In studying the state of VNS in patients with BU also received mixed results.
Some authors show a predominance of parasympathetic ANS [6, 12]
others - the sympathetic [28]. So, according to Kravtsova TY et al. 1993
[19], and duodenal ulcer noted the predominance of parasympathetic influences, there is
reduced BP and the lack of WATER. Soloviev, VG, [33] identified a significant predominance of sympathetic
level VNS (these patients were in the majority - 50-53%),
but part of the patients had normal tone and the parasympathetic ANS.
According to Dmitrieva VL [11], among patients with duodenal ulcer patients with
predominate Aiton. Between the number of patients with vagotonia and sympathotony
statistically significant difference was not. According Kokueva OV [18], for duodenal ulcer is characterized by
gipervagotoniya, with the tone of the stomach, usually elevated, peristalsis
strengthened. These movement disorders are usually combined with giperatsidnyh and
increased enzymatic activity of gastric juice. When mediogastralnoy
ulcer vagal tone is lowered, sympathetic tone dominates Division
VNS, thus reducing both the tonic and peristaltic waves
stomach, there is a failure zamykatelnoy gatekeeper function that leads to the development of the GDR
[17 , 18]. Zimmerman JS et al. [39] found,
that in acute gastric ulcer increased reactivity of the sympathetic nervous system
, but the tone of it remains within normal limits. Thus, the concentration of
catecholamines in the blood was significantly higher than the norm, and their daily urinary excretion
not exceeded the level in gastric juice on an empty stomach was moderately elevated
. These developments reveal a violation of adaptation-trophic function
sympathetic nervous system in patients with gastric ulcer. The dependence of the autonomic tone of
terms of scarring of the ulcer and the course of the disease [4].
According to the survey with a favorable disease course (no
complications, scarring of the period to three months) is protective
mobilization mechanisms, including - increased activity of the sympathetic level VNS and
increase adrenergic influences on metabolic processes. When
poor course (complications, frequent recurrences), but the term
scarring up to 1 month, showed improvement ergotropic system, using
still remaining reserves, and for a long time neasbtsuyuschihsya ulcers observed
depletion of regulatory mechanisms, failure to provide adequate reaction
organism that, in my opinion, is the cause of strengthening the functions
trophotropic system [4]. The dependence of BP and water on the duration of
disease and clinical symptoms.
substantially in recent years has increased the likelihood of chronic stress,
which may be a factor in worsening health. Lukyanov, EM et al. [22]
studied the mechanism of stress development and characteristics of adaptation of children with chronic pathology
gastroduodenal (HPGDZ). Thus, a group of children,
adapt to stress, characterized by the predominance vagotonia,
parasympathetic reactivity. Children with subcompensated and decompensated stage
stress characterized by the predominance sympathic and
sympathicotonic reactivity.
main indicators characterizing the state of the suprasegmental of VNS were investigated
Kryuchkova ON [20] in healthy adolescents, adolescents and adults
duodenal ulcer. The results showed that 60% of healthy children found
normal, 40% - sympathotony. Adolescents suffering from ulcer, duodenum, along with
Aiton (dominant - 50%) and sympathotony (35,5%) revealed vagotonia
(14,4%). Other information regarding and W obtained in adult patients, where
was predominant parasympathetic orientation ICT (66,7%), and normotoniya -
30%. Autonomic reactivity in healthy adolescents, mostly
was reduced in patients revealedmoreand perverted. And adults are often
detected elevated BP. In patients with duodenal ulcer in most cases revealed the lack of vegetative
security (AT), which is unusual for a healthy
teenagers who BO was normal, elevated or excessive.
Kryuchkova ON [20] established the similarity of pathological changes in patients with duodenal ulcer
adolescents and in patients with primary CGD of the same age, which allows
regarded as the primary CGD early stage of BU.
in the pathogenesis of BU importance attached to hemodynamic disturbances, especially
microcirculatory disorders. Dmitriev, VL and Dudnikova EV [11, 12]
found that in patients with microcirculatory disorders BU has varying degrees of severity
the depth of which depends on the condition of the SPA. Maximally expressed
microcirculatory disorders were patients with a predominance of sympathetic nervous system
, and least pronounced - in patients with Aiton.
Increased acid production and proteolytic activity of gastric juice,
reduction of gastric mucus glycoproteins, which occurs during exacerbation
HGDP [15] found in all types of ANS with the greatest changes in vagotonikov
[12]. Change of acidogenic function of the stomach and proteolytic activity of gastric juice
toward aggression is a result of a breach
sympathetic nerve conduction due to pressure or prejudice them in the intervertebral foramen
07.09 vertebrae. In this case, basal
acid production and proteolytic activity of gastric juice increased
due to increased parasympathetic tone of NA [8].
chronic inflammatory process that develops in the system of holistic
body, causing disorders of the nervous system. In this regard,
children with diseases of the digestive disorder characterized neuropsychological
plan [1, 32]. This circumstance allows one to classify the pathology of the digestive organs
to psychosomatic [7, 16, 25]. Link connecting mental and
visceral manifestations in psychosomatic pathology is VNS [14,
40].
In summary, the published data suggest an important role
ANS dysfunction in the formation of pathology of the digestive system.

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