Medicina v Kuzbasse (Oct 2017)
BUILING THE INFLAMMATORY PROCESS IN BRONCHES AT THE PHASE OF PATIENTS REHABILITATION WITH PROFESSIONAL CHRONIC OBSTRUCTIVE LUNG DISEASE
Abstract
Subject. Parameters of local immunity of a mucous membrane of a respiratory tract in the patients with chronic obstructive pulmonary disease (COPD) of occupational genesis on a background of the application of Miramistin inhalations, laser therapy and sinusoidal modulated current (SMC) phoresis of Miramistin before the main course of rehabilitation. Objective. A new method for rapid relief of the inflammatory process in the bronchi in the patients with occupational COPD on the basis of the correction of the mechanisms for the protection of the mucous membrane of the respiratory tracts. Methods. All the patients were divided into two equal groups: the study and the control. The main group of the patients consistently prescribed inhalations of 0.01 % Miramistin, laser therapy, SMC-phoresis of 0.01 % of Miramistin for 5 days. The patients in the control group were prescribed medication in the standard treatment of COPD exacerbation. Before and after the treatment, all the patients were examined for local immunity of the nasal mucosa and sputum: the concentrations of secretory immunoglobulin A (SIgA) and the activity of lysozyme (AL), cytograms of impression smears of nasal secretions and sputum with the definition of cellular composition (cylindrical epithelial (CE) and flat epithelial (FE) cells, alveolar macrophages (AM), neutrophils (N)), as well as functional activity of neutrophils (FAN), functional activity of alveolar macrophages (FAAM). Main results. In the study group the aggravation of bronchopulmonary process was stopped after 3 procedures on a background of normalization of the parameters of local factors of the protection of the mucosa of the respiratory tract. After a three-day course of the proposed method the total volume of the main rehabilitation complex was carried out. In the control group COPD aggravation was delayed up to 7-10 days that impeded the implementation of the rehabilitation program in full. Conclusions. In case of exacerbation of occupational COPD at the stage of rehabilitation for rapid relief of inflammation of the mucosa of respiratory tract, it is advisable to prescribe Miramistin inhalation, laser therapy and SMC- phoresis of Miramistin. The proposed sequence of the application of physical factors contributes to the recovery of the protection of the mucosa of the respiratory tract and as a result an anti-inflammatory effect is manifested.
