Evaluation of the treatment strategy for complicated allergic rhinitis.

OBJECTIVE: Aim: To carry out a comprehensive evaluation of treatment modification for patients with seasonal allergic rhinitis (SAR) complicated by anxiety-neurotic disorders. PATIENTS AND METHODS: Materials and Methods: Patients with SAR in the acute stage on the background of anxiety disorders were studied. Immunological studies were carried out, an assessment of the dynamics of indicators of the quality of life of patients, the level of anxiety / depression was assessed. In the clinical group, a variant of therapy modification was proposed. RESULTS: Results: Significant changes in the subpopulation ratio of lymphocytes, an increase in the immunoregulatory index, which indicated the severity of the immunological process, were revealed in SAR patients in the acute stage against the background of anxiety disorders. At the same time, a significant activation of the humoral link of immunity was observed: an increase and a significant increase in IgE in the blood serum and an increase in the content of sIgA in the nasal secretion. In most patients, eosinophilia was found in the peripheral blood and in the rhinocytogram before treatment. In the study of the quality of life of patients, changes in many parameters were found. CONCLUSION: Conclusions: The combination of "Nazafort Allergy Protection" and Atarax seems to be the most successful, which significantly improved the physical and psycho-emotional state of patients with SAR, complicated by anxiety and neurotic disorders. This combination led to an increase in the stress resistance of patients.

NEUROMETABOLIC STRATEGY OF PHARMACOTHERAPY FOR PATIENTS WITH SERONEGATIVE ARTHRITIS.

OBJECTIVE: The aim: The search for optimization of the strategy of neurometabolic pharmacotherapy in patients with seronegative arthritis is relevant: ankylosing spondylitis and psoriatic arthritis, taking into account the nature of the psychological response to the disease. PATIENTS AND METHODS: Materials and methods: The study included (1st observation group) 36 patients with AS (17 men and 19 women) aged 25 to 65 years, average duration of AS - 10.9 ± 0.63 years. Degree of pathological process activity was determined taking into account the Bath AS disease activity index (BASDAI) - in accordance with EULAR criteria. The second group included 32 patients with a diagnosis of PSA (19 men and 13 women) aged 25 to 65 years according to the CASPAR 2006 criteria, the average duration of psoriasis is 13.9 ± 1.9 years, PSA - 10.6 ± 0.58 years. To study the psycho-emotional state, the Spielberger anxiety self-assessment scale was used. To identify the symptoms of depression was used Hamilton Depression Scale (HDS). RESULTS: Results: In the study groups noted a high frequency of inadequate socio-psychological response to the disease. In groups of patients with seronegative arthritis, multidirectional maladaptive reactions were noted: in ankylosing spondylitis, a hypochondriac type of response is characteristic, and in psoriatic arthritis, anxiety disorders with different response options. At the end of the observation period in both groups there was an improvement in almost all studied indicators of clinical and laboratory activity. CONCLUSION: Conclusions: There was a significant improvement in the psycho-emotional status of patients, which makes it possible to improve the quality of life of patients and contribute to the optimization of treatment and rehabilitation measures.