Assessment of clinical state of the palatine tonsils of patients with chronic tonsillitis after immynotherapy in the form of vaccination with bacterial antigens

Abstract

Aim. Determine the effect of mucosal vaccination on changes in the clinical status of patients with chronic tonsillitis. Materials and Metods. In these clinical studies, 92 patients aged 18 to 40 years participated. We formed two groups of patients, the first group - 62 patients with chronic tonsillitis (СT), which in turn was divided into two subgroups: 1st subgroup - 31 patients, receiving Respibron vaccine mucosal therapy (sublingual); 2nd subgroup - 31 patients received - Broncho-Wax (OM-85, per os); and the second - a control group (CG), 30 practically healthy donors, without the pathology of the upper respiratory tract. In these studies, СT patients received mucosal vaccines, as prescribed, for three months. The collection of material, namely complaints and an objective review of ENT organs, took place in several stages: before vaccination, 10 days after the end of the application, and after 6 months. The obtained results were compared with the data of the СG. The collection of materials for clinical research was conducted on the basis of the Lviv Regional Clinical Hospital. Results and Discussions. As a result of the research, the most frequent complaints were made of screened patients with CT, prior to mucosal immunization. The data obtained show that in patients with CT, there were almost all of the above complaints: 40.3% in the throat; 32,2% pain in the throat; pains that irradiated in the ears, or 32,25% of toothache; bad breath 96,7%; cork cork 56,4%; increased fatigue and a feeling of weakness 95.16%; increase in body temperature to 37.1-37.2°С 93.5%; swelling and pain, in the area of the submandibular lymph nodes 30,6%; pain in the area of the heart, joints and kidneys 8%. In patients with CG complaints from ENT organs were not detected. The following data were obtained by analyzing the clinical status of patients in the studied groups according to the proposed scale score before mucosal vaccination: in patients with CT in 1st and 2nd subgroups, respectively, the degree of hyperemia of braces was 0.71 and 0.81 points; presence of caseo-purulent detritus in gaps - 1,42 and 1,35 points; the size of the tonsils is 0.68 and 0.61; the condition of the submandibular lymph nodes - 0,38 and 0,45; the number of exacerbations for the year - 1.5 and 1.48; presence of concomitant diseases - 0,19 and 0,19 points; Thermometry of the body with exacerbation of chronic tonsillitis - 1 and 1.2. Thus, in patients with CT, the average amount of points on clinical parameters in the 1st subgroup was 0.84 points, and in the 2nd subgroup 0.87 points, which exceeded the results obtained in CG, where the average score was equal to zero. The obtained results showed that the treatment with the use of mucosal vaccines, in both subgroups of the group of patients with CT, had a positive effect, which was confirmed by a decrease in their average amount of points established according to clinical parameters. Particularly noticeable was the decrease in the parameters of hyperemia of the braces, the number of caseosis - purulent detritus in the gaps of the palatine tonsils, exacerbations and body temperature, and the size of the lymph nodes and manifestations of concomitant diseases decreased quite intensively, but the size of the tonsils itself was less variable. Conclusions. Our research suggests that the use of mucosal vaccines in patients with different state of lymphocyte ring was accompanied by significant clinical relief of the patient's data. Consequently, given the effectiveness of the use of these vaccines, we can recommend them for use in patients with chronic tonsillitis.

Keywords

• chronic tonsillitis, immunotherapy, vaccination with bacterial antigens