В современном мире инфекции верхних дыхательных путей и ЛОР-органов занимают первое место в структуре общей заболеваемости в мире, а удельный вес данной патологии составляет у взрослых 27,6%, у подростков-39,9% и у детей-61% [4]. Неутешительные данные статистики обусловливают неугасающий интерес к данной проблеме в практической медицине.
Significant role of getting the required amount of air into the human body belongs to the breathing by the nose. The nasal cavity prepares the air for reciprocity with the lower respiratory tract owing to the complex structure of the mucous membrane. When nasal obstruction occurs, breathing is carried out mainly through the mouth, and there is a violation of the basic functions of the nose, as well as the ingress of unadapted aggressive air to the sensitive alveolar structures of the lungs. This leads first to functional, and then to morphological and structural changes. In addition, difficult nasal breathing leads to impaired aeration of the paranasal cavities, middle ear cavity and hypoxia of all organs of the body. Even short episodes of nasal obstruction affect the quality of life, and prolonged untreated or incorrectly treated acute viral rhinosinusitis can spill over into lingering bacterial diseases of the ENT organs. Decongestants are used to eliminate nasal congestion. Decongestants include a wide range of substances that are used topically or systemically, in the form of monotherapy or in combination with other substances. The most popular drugs in this group are topical decongestants, since they have the most pronounced effect. The main nasal decongestants can be divided into two groups: sympathomimetic amines: primary aliphatic; phenolic and non-phenolic compounds, as well as imidazoline derivatives. Among the modern vasoconstrictor drugs oxymetazoline. Using it strictly according to the instructions within 3–5 days guarantees the absence of the development of local and systemic complications.
Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.Allergic rhinitis (AR) and chronic rhinosinusitis (CR) can be diagnosed as an independent or combined pathology, as well as a possible complication of each other. Allergic rhinitis is a disease characterized by IgE-mediated inflammation of the nasal mucosa and the presence of daily manifestations of more than one hour and at least two of the following symptoms: nasal obstruction, rhinorrhea, sneezing, nasal itching. The frequency of psychosomatic disorders is quite high and ranges in the population. Studying the mechanisms of disease development provides the basis for rational therapy, not just symptom relief. We have considered the use of elimination therapy for CR associated with AR. This type of treatment is available to all categories of patients, including children and pregnant women at any gestational age. On the basis of the Department of Otorhinolaryngology of A. I. Evdokimov Moscow State Medical University in 2019–2020, a clinical study was conducted, which showed that such a combination of isotonic saline solution and antiseptic leads to improvement of patients and accelerates the recovery. In the process of monitoring 36 patients: in 35 of them achieved clinical cure, 1 patient required the appointment of antibiotic therapy due to the development of symptoms of purulent sinusitis. The results indicate a pronounced advantage of treatment in combination with elimination drugs, which was expressed in a reduction of symptoms during the first week of treatment, their complete regression was noted on the 30th day of use of the drug. Thus, chronic rhinosinusitis and allergic rhinitis are an important medical and social problem, and treatment of such patients requires only an integrated approach with obligatory consideration of the pathogenesis of the disease.
The article discusses the current problems of the treatment of acute respiratory infections, excessive use of antibiotics and the growth of resistance to them, which is ahead of the development of effective antimicrobial drugs. The results of the research of a new drug (Rafamin) are presented. Rafamin is combining antiviral and antibacterial effects, and may be in demand both for the treatment of acute respiratory viral infections and for the prevention of bacterial complications. The mechanism of action of the drug is associated with the activation of immune mechanisms involved in the recognition of pathogens of both viral and bacterial nature and the launch of a subsequent humoral and cellular response that ensures the elimination of the pathogen. The effects of Rafamin are realized due to targeted effects on the system of the major histocompatibility complex, interferon gamma and CD4-receptor of T-lymphocytes.
Cough is considered to be one of the leading clinical symptoms associated with the pathological changes in the respiratory system. Notwithstanding a great variety of therapeutic pharmaceutical products possessed of the antitussive action, physicians tend the give preference to the preparations producing the combined effect. The present article reports the results of the clinical study designed to evaluate the effectiveness and safety of the application of rengalin exhibiting the combined antitussive, anti-inflammatory, and broncholytic action in the patients presenting with the postnasal drip syndrome. The comparison of the therapeutic effects of rengalin with those of other therapeutic modalities frequently employed for the management of postnasal drip give evidence of the high efficiency of this product for the optimization of the treatment of this condition and the associated chronic cough.
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