Opportunities for prevention of recurrent obstructive bronchitis in children during the season of acute respiratory infections
Authors: Geppe N.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Kolosova N.G. , Denisova V.D. , Grebeneva I.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation,   Children's Clinical Multidisciplinary Center of the Moscow region, Mytishchi, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: July 2024

The possibility of preventing episodes of bronchial obstruction (BO) in order to reduce the risk of bronchial asthma formation attracts the attention of many researchers and doctors. Ammonium glycyrrhizinate (Reglisam, "VIFITECH") is of practical interest in the search for promising anti-inflammatory drugs in this matter. Patients and methods. The study involved 110 children aged 3 to 7 years with symptoms of acute obstructive bronchitis, who had a history of at least 2 episodes of BO in the previous 6 months. Formed: the comparison group (n = 30) – received inhalations of ICS up to 1 month and SABA on demand and the main group (Reglisam) (n = 80) – additionally, the drug was prescribed to Reglisam for 24 weeks. The duration of patient follow-up was 24 weeks, five visits to the clinic were performed (day 1, week 1, week 4, week 12, week 24) and two telephone contacts (weeks 8 and 16). During visits, the following indicators were evaluated: computed bronchophonography (CBFG), cough on a visual analog scale (VAS), and the volume of additional therapy. Results. In the main Reglisam group, by the 3rd day of treatment, the intensity of daytime and nighttime cough was 30% lower relative to the comparison group (1.92 ± 0.05 vs 2.74 ± 0.03 points and 1.8 ± 0.04 vs 2.6 ± 0.04 points, respectively (p < 0.05)), 70% of patients in the Reglisam group showed a decrease of CBFG to normal values, the proportion of such patients in the comparison group did not exceed 50%. In the Reglisam group, the average duration of BO was 38% less relative to the comparison group (6.9 ± 0.2 vs 11.2 ± 0.8 days, (p < 0.05)), the duration of SABA use was 46% less relative to the comparison group (4.13 ± 0.7 vs 7.62 ± 0.8 days, p < 0.05). When patients were followed up for the next 23 weeks in the main Reglisam group, the average number of ARI was 41% and BO was 83% less relative to the comparison group (1.3 ± 0.05 vs 2.2 ± 0.1 cases, 0.3 ± 0.001 vs 1.8 ± 0.21, respectively (p < 0.05). In the Reglisam group, the average duration of ARI cases did not exceed 6.6 ± 0.2 days, in the comparison group it was significantly 40% longer (10.9 ± 0.4 days (p < 0.05)). In the treatment of ARI in the main Reglisam group, the need for the use of ICS and SABA was 2 times lower relative to the comparison group (35% vs 77% and 50% vs 100%, respectively (p < 0.05). Conclusion. The inclusion of Reglisam in the complex therapy of acute obstructive bronchitis contributed to a rapid and effective reduction in the intensity of cough symptoms by the 3rd day of treatment, reducing the duration of use of SABA and the duration of the disease in general. In dynamics, against the background of a prophylactic course of Reglisam (23 weeks) during the epidemiological season of ARI, there was a significant decrease in the frequency of ARI, virus-induced relapses of OB and, as a consequence, the need for the use of ICS and SABA. Key words: coronavirus infection, COVID-19, post-COVID syndrome, children, rehabilitation, bronchial asthma, ammonium glycyrrhizinate, glycyrrhizic acid