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№4' 2017
OTORHINOLARYNGOLOGYInternational Medical Journal, Vol. 23., Iss. 4, 2017, P. 66−71.
THE EFFICACY OF ELIMINATION THERAPY IN TREATMENT OF ACUTE AND CHRONIC RHINOSINUSITIS
Kharkiv Medical Academy of Postgraduate Education
City Clinical Hospital № 30, Kharkiv, Ukraine
The necessity to improve the methods of rhinosinusitis treatment and the role of the nasal mucosa microflora species in the pathogenesis and the effectiveness of treatment are shown. A comparative study of the effectiveness of lorect in elimination therapy of acute and chronic rhinosinusitis was performed. The dynamics of microbiocenoses and the degree of contamination of the mucous membrane of the nasal cavity on day 1−7 of treatment, the effect on the restoration of functional and objective indices (nasal breathing, excretory function, mucosa state), the degree of regression of manifestations of intoxication syndrome were studied. To assess the latter, a visual analogue scale was used. The dynamics of objective symptoms and functional indicators was assessed on a 4−point scale on days 1, 3, 5 and 9. It was revealed that with good tolerability and absence of side effects in patients, the use of lorect was accompanied by a reduction in the colonization of the mucous membrane of the nasal cavity with gram−negative flora and associations in favor of opportunistic and saprophyte microflora, against a background of reduction in the number of strains and the degree of microbial contamination. This positive dynamics of the mucosa sanation with lorect was accompanied by a significant improvement in the state of health and disappearance of subjective symptoms. The difference in the dynamics of objective indices in the main and control groups was shown on day 3 of treatment with lorect (reduction of hyperemia and edema of the mucosa, discharge from the nose, improvement of nasal breathing) with almost complete regression of symptoms and recovery of nasal breathing on day 6−7. Thus, the clinical effectiveness of the drug is based on its bactericidal effect on the pathogenic microflora, which contributes to a reduction in microbial contamination of the nasal mucosa, changes in the composition of microbiocenoses, and decrease in the pathogenicity of microorganisms. Its advantage is universality of the antimicrobial effect, including the gram−negative flora, resistant to the action of antibiotics and contributing to the development of intoxication syndrome, regardless of the form of sinusitis, the features of the course and sensitivity of microflora to antibiotics. The revealed high clinical efficacy of lorect gives grounds for recommending it for irrigation (elimination) therapy in acute and chronic bacterial rhinosinusitis, adenoiditis.
Key words: rhinosinusitis, adenoiditis, elimination therapy, microbiocenosis, lorect.