Медицинский совет (Nov 2020)
Optimizing the management of smoking patients with acute rhinosinusitis
Abstract
Introduction. Viral infection is the main cause of damage to the ciliated epithelium of the nasal cavity mucosa, which in turn leads to disruption of mucociliary transport, increased viscosity and mucus hypersecretion in the sinuses and deceleration of its evacuation. Smokers suffer from chronic obstructive pulmonary diseases, in particular obstructive bronchitis. Their cough symptom complex sharply increases in acute respiratory viral infection (ARVI), especially when the mucociliary airway system is affected. The etiotropic treatment of this combined pathology is a therapy capable of affecting the entire mucociliary system of the upper and lower respiratory tract, including a drug based on ivy leaf extract, with the active ingredient of the saponin group.Aim of the study. To determine the effectiveness of phytopreparation in preventing exacerbation of chronic bronchitis of smokers in patients with acute viral rhinosinusitis.Materials and methods. Complex examination of 20 active smokers suffering from acute viral rhinosinusitis (AVR), including computed tomography of the lungs, was conducted. The randomized study included the use of phytopreparations in the complex therapy of acute rhinosinusitis in patients with obstructive bronchitis.Results and discussion. Use of medicines based on ivy extract in the complex treatment of acute rhinosinusitis in smokers allowed to achieve reduction of AVR symptom complex complicated by exacerbation of chronic bronchitis by the 5th day of the disease. Dynamics of cough complaints reduction in comparison groups reflects the beneficial effect of ivy extract in smokers with ARVI, complicated by AVR, and in the absolute majority of cases allows avoiding bacterial complications.Conclusion. The conducted study proved the effectiveness of Gedelix in the complex treatment of viral acute rhinosinusitis in smokers. In the absolute majority of cases (80% of the total number of patients in the group) it was possible to avoid long-term exacerbation of chronic bronchitis and bacterial complications.
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