Оценка эффективности назначения репарантов у больных острыми риносинуситами

Abstract

Introduction. In patients with acute rhinosinusitis (ARS), under the influence of external and internal factors, the final proliferative stage of inflammation is often disrupted, which necessitates the administration of drugs that regulate reparative regeneration at the site of alteration. Objective. To evaluate the effectiveness of local administration of reparative drugs for inflammation of the mucous membrane (MM) in patients with ARS. Materials and methods. The study was conducted with the participation of 138 patients with ARS (age 19–50 years), who were divided into 4 groups. Group No. 1 (n = 34) received standard anti-inflammatory treatment; in the comparison groups, additional local reparative drugs were prescribed: in group No. 2 (n = 36), sodium deoxyribonucleate solution; in group No. 3 (n = 34), dexpanthenol; in group No. 4 (n = 34), sodium hyaluronate. To assess the severity of disturbances in the regeneration of the ciliated epithelium of the nose, the regeneration index was assessed based on an analysis of the state of the inflammatory reaction of the mucus, mucociliary transport time (MCT), and disturbances in the crystallization of the solid phase of the nasal secretion (NS) obtained by the method of wedge-shaped dehydration. Patients were monitored upon presentation, on days 5, 10, 21, 30, 42, and 60. Results. In group No. 2, already on the 5th day, there was a statistically significant (p ≤ 0.05) decrease in purulent discharge in the nasal cavity in comparison with other groups; on the 10th day, patients with a mild degree of severity of the inflammatory reaction of the mucous membrane predominated in this group. Pronounced positive dynamics in the structure of the solid phase of the NS and a statistically significant improvement in MCT in the groups taking reparative drugs were noted already from the 21st day of observation. Even by the 60th day in group No. 1, 25 (73.5%) patients had a mild degree of regeneration impairment, which was significantly higher than in the comparison groups. Conclusions. When using reparative drugs in patients with ARS, there was a significantly faster improvement in MCT, normalization of the solid phase of the NS, and a decrease in the proportion of people with identified disorders of reparative regeneration.