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.
Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov Selecting the proper treatment of perennial allergic rhinitis (PAR) today is often unsuccessful. At present, PAR is characterized by the early beginning, quite often continuously relapsing course and resistance to antiallergic therapy. Study of the mechanisms of the course of the disease creates a basis for the rational therapy that assumes impact on the composite inflammatory response, not only on allergy symptoms. Aim - to reflect the importance of a modern approach to treatment of patients with perennial allergic rhinitis. Materials and methods. For analysis we decided to conduct a comparative study of monotherapy with topical glucocorticosteroids and combined therapy consisting of topical glucocorticosteroids together with intranasal antihistamine medications. Results. The research showed that the use of the combined therapy with topical glucocorticosteroids and intranasal antihistamine medications can be effective in patients with perennial allergic rhinitis, considerably improving the quality of life.
Введение. Проблема прогнозирования, своевременной профилактики и усовершенствования методов лечения круглогодичного аллергического ринита входит в ряд важнейших задач современной оториноларингологии. Ввиду этого многие коллеги пытаются найти наиболее эффективные схемы лечения для пациентов с круглогодичным аллергическим ринитом. В данной статье отражена важность современного подхода к терапии таких пациентов. Цель. Оценка большей эффективности и создание алгоритма лечения с применением мометазона, азеластина и цетиризина в комбинациях у взрослых пациентов с круглогодичным аллергическим ринитом, достижение максимального периода ремиссии, определение качественного уровня комфорта пациентов при применении различных схем медикаментозного лечения. Материалы и методы. Для анализа было принято решение провести сравнительное исследование между монотерапией топическими глюкокортикостероидами и комбинированной терапией, состоящей из топическихглюкокортикостероидов свместно с интраназальными антигистаминными препаратами, а также в комбинации с пероральными антигистаминными препаратами. Исследование проводилось на базе кафедры оториноларингологии Московского государственного медико-стоматологического университета имени А.И. Евдокимова. Результаты. Исследование показало, что у пациентов с круглогодичным аллергическим ринитом использование комбинированных препаратов топических глюкокортикостероидов с интраназальными антигистаминными препаратами может быть эффективным и значительно улучшать качество жизни, при этом за более короткий срок лечения и с пролонгированным эффектом от такой схемы медикаментозной терапии. Выводы. Данные, полученные в ходе исследования, помогли создать оптимальный алгоритм лечения пациентов с круглогодичным аллергическим ринитом с достижением 6-месячного периода ремиссии. Introduction. The problem of forecasting, timely prevention and improvement of treatment methods for year-round allergic rhinitis are among the most important tasks of modern otorhinolaryngology. In this context, many colleagues have been trying to find the most effective treatment regimens for patients with year-round allergic rhinitis. This article reflects the importance of modern approaches to therapy of patients with year- round allergic rhinitis. Purpose. To evaluate a greater efficacy and to create a treatment algorithm using mometasone, azelastine and cetirizine in combinations in adult patients with year-round allergic rhinitis, to achieve a maximum remission period, and to determine the qualitative level of patient comfort when using different medication regimens. Materials and methods. For the purpose of analysis, it was decided to conduct a comparative study of monotherapy with topical glucocorticosteroids and combined therapy consisting of topical glucocorticosteroids together with intranasal antihistamines, as well as in combination with oral antihistamines. The study was conducted at on the basis of the Department of Otorhinolaryngology of the Moscow State Medical and Dental University named after A.I. Evdokimov. Results. The study revealed that in patients with year-round allergic rhinitis, the use of combined topical glucocorticosteroids with intranasal antihistamines can be effective and significantly improve quality of life, thus in a shorter treatment period and with a prolonged effect of such drug therapy regimen. Conclusion. The data obtained during the study contributed to the creation of an optimal treatment algorithm for patients with year-round allergic rhinitis with achievement of a 6-month remission period.
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