Циклический синдром рвоты у детей: опыт наблюдения 91 случая в Самарканде.

Abstract

AIM: To evaluate the clinical presentation, response to prophylactic therapy, and outcomes of children with cyclic vomiting syndrome (CVS) in Samarkand.

METHODS: Over a 2-year period from 2023 to 2024, 91 consecutive children with a final diagnosis of CVS were evaluated, treated, and followed at our center. Patients were randomized to receive either amitriptyline or propranolol as prophylactic therapy.

RESULTS: There were 44 boys and 47 girls. The mean age at symptom onset was 4.8 ± 3.5 years (range: neonatal period to 13 years), the mean age at final diagnosis was 6.8 years (range: 1.4 to 15 years), and the mean interval between the first attack and the final diagnosis of CVS was 1.5 ± 1.71 years (range: 1.5 months to 7 years). The mean duration of each attack was 4.36 days (range: a few hours to 11 days) and the mean interval between attacks was 1.7 months (range: 1 week to 13 months). In 73% of cases attacks began at midnight or in the early morning. Amitriptyline was effective in 47 of 83 (57%) patients (P < 0.001). Propranolol showed higher efficacy and was effective in 73 of 85 (86%) patients (P < 0.0001).

CONCLUSION: In our region there is a significant delay between the onset of initial symptoms and the final diagnosis of CVS. In patients with a typical clinical presentation examined by an experienced physician, invasive diagnostic procedures are not necessary. Propranolol appears to be more effective than amitriptyline for prophylactic use in children with CVS.