NAUSEA (nausea) — a peculiar burdensome feeling in an anticardium, in a breast and an oral cavity, quite often preceding vomiting and often followed by the general weakness, faintness, perspiration, the increased salivation, a cold snap of extremities, pallor of skin, decrease in the ABP. Believe that at the heart of T. excitement of the emetic center lies (see the Centers of a nervous system), a cut on extent of excitement it is not enough for formation of vomiting (see). Feeling of T. connect with the beginning antiperistaltic movements of a stomach. Pathogenetic proximity of T. and vomitings is confirmed by uniformity of the reasons of their emergence, and also efficiency of use at them the same pharmaceuticals. As well as vomiting, T. it is most often observed in connection with organic pathology of of N of page, intoxication and as a result of reflex excitement of the emetic center at diseases of a vestibular mechanism, bodies of the alimentary system, less often it forms on type patol. conditioned reflex. It is accepted to distinguish so-called brain, reflex, including motive, toxic and exchange forms T.
T., carried to a brain form, it can be observed practically at any organic diseases of a brain, including at increase in intracranial pressure of any genesis, napr, at a cherepnomozgovy injury, at inflammatory diseases of a meninx (meningitis, arachnoidites), encephalitis, strokes, atherosclerotic damage of intracranial, carotid and vertebral arteries, at dynamic frustration of cerebral circulation.
Toxic it is accepted to call T., connected with influence Khimich. substances ekzo-and endogenous origin. Toxic T. develops at various inf. exogenous intoxications, at medicinal therapy (morphine, anesthetics, nek-ry cytostatics and an antitube. means, an Euphyllinum, guanyl guanidines, etc.), and also at diseases and patol. the states which are followed by accumulation in an organism of toxicants (diabetic keto-acidosis, a renal failure, a radial illness, etc.). Mechanisms of development of toxic T. can be various. The possibility of direct chemical excitement of the emetic center is called in question. In most cases the substances circulating in blood (e.g., drugs of a foxglove), affect the special hemoretseptorny starting (trigger) zone which is localized in the field of a bottom of the IV ventricle, the irritation leads a cut, in turn, to excitement of the emetic center. A number of toxicants causes in essence reflex T., irritating receptors of a mucous membrane of a stomach (e.g., copper sulfate).
Reflex T. arises in response to irritation of receptors of various bodies, in particular a root of language, a pharynx, a back wall of a throat, a stomach, intestines (especially its ileocecal zone), a liver and bilious ways, a pancreas, a peritoneum, an inner ear, and also pleura, bronchial tubes, a pericardium, kidneys, a uterus and its appendages. Afferent impulses are transferred in a myelencephalon through a vagus nerve, in much smaller measure — through phrenic, spinal and sympathetic nerves. T. enters a symptom complex of such diseases as acute and hron. gastritis, peptic ulcer, carcinoma of the stomach, food toxicoinfection, cholecystitis, pancreatitis, acute appendicitis, helminthic intestinal invasions, etc. It is observed at acute peritonitis, ginekol. diseases (extrauterine pregnancy, apoplexy of an ovary, hron. the adnexitis), sometimes accompanies hepatic and renal colic. Reflex T. it is described at phrenic pleurisy, a pericardis.
A specific place is held by so-called motive T., arising as result of irritation of a vestibular mechanism. At the healthy person it appears during the movement with accelerations, in the conditions of a motion desease (see) at rotary motions of a trunk (on a roundabout, during dance, etc.). T. it is observed also at diseases of an inner ear, Menyer's disease (see Menjer a disease), an arachnoiditis or a tumor mosto-mozzhech-kovogo a corner, at defeat of vestibular nuclei of a brainstem. In such cases it is combined with a row nevrol. and otonevrol. symptoms (dizziness, disturbances of gait, hearing, etc.).
One of options of reflex T. the psychogenic T is., arising at unpleasant and the more so the visual and olfactory feelings causing disgust and even at the thought of them. Psychogenic T. it is noted at the persons having neurosises and neurosis-like states. Patients with a neurasthenia, hysterical women sometimes usual test T. in the mornings, at disorders, overfatigue, in conflict situations etc. T. can be one of somatic displays of psychoses.
Exchange call T., arising at hypovitaminoses, nek-ry endocrine diseases (hron. adrenal insufficiency, hypothyroidism, premenstrual syndrome, sometimes hyperparathyreosis). At the same time a certain role in genesis of T. belongs to disturbances of intermediary metabolism, but it is difficult to exclude a role of secondary defeats went. - kish. a path with emergence of premises for reflex T.
Treatment at the diseases which are followed by T., shall be defined first of all nozol. form of a disease. Symptomatic therapy of T. it is appointed at the established diagnosis of a disease and can be various on character and volume. In mild cases of psychogenic T. happens to distract enough from unpleasant feelings and impressions. Morning T. at vegetativnolabilny people, T. after long starvation or overfatigue pass after a glass of hot tea. Swallowing of pieces of ice, intake of novocaine can help. Sometimes, to get rid of T., patients artificially cause vomiting. Bent to motive T. it can be reduced by a training of a vestibular mechanism.
Medicinal treatment of T. apply at patients with nonresectable tumors against the background of radiation therapy, at treatment a cytostatics-mi, an antitube. means, at Menyer's disease, a sea sickness, intoxication cordial glycosides and in other cases an emphasis -
mine or considerably in the expressed T. For this purpose use the atroppno-nodobny and aitigistaminny drugs possessing, in addition to we M-care olitich for it whom actions, the oppressing influence on the emetic center, and also neuroleptics of group of a fe-notiazin (aminazine, etc.), phenyl propyl ketone (haloperidol), eglonyl (Sulpiridum) and Metoclopramidum (a raglan, cerucal), acting at the level of a hemoretseptorny trigger zone. At motive T. atropinopodobny drugs are most effective: Scopolaminum the guide
robromid 0,25 mg inside or subcutaneously, Aeronum (for prevention of a sea sickness), and also antihistamines. T. at diseases went. - kish. path and postoperative T. are well stopped eglonyl of ohms and Metoclopramidum, apply the last also at toxic T., sometimes in combination with neuroleptics.
Bibliography: Paradise y V. A. Psycho
tropny means in clinic of internal diseases, page 183, M., 1982; X and r to e-
D. A. Pharmakologiya's HIV, page 246, M., 1980; Gibbs D. Diseases of the alimentary system, Noasea and vomiting, Brit, med. J., v. 2, p. 1489, 1976; Signs and symptoms, ed. by C. M. MacBryde a. R. S. Biacklow, Philadelphia — Toronto, 1970.
V. K. Velikov.