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[一种局部用抗菌剂治疗急性扁桃体咽炎的新疗效]

[New effects of a topical antimicrobial (agent) in the treatment of acute tonsillopharyngitis].

作者信息

Ovchinnikov A Yu, Miroshnichenko N A, Nikolaeva Yu O

机构信息

Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.

出版信息

Vestn Otorinolaringol. 2023;88(4):93-102. doi: 10.17116/otorino20238804193.

Abstract

Sore throat is the leading symptom of acute tonsillopharyngitis associated with previous acute respiratory viral infections, including COVID-19. The pathogenesis of these nosologies is based on the cumulative result of the primary direct damaging effect of viruses and secondary alternative inflammatory changes in the mucosal epithelium in the focus of infection, which, against the background of changes in the functions of the regional microbiota, leads to the development of viral-bacterial inflammation that goes beyond the protective-reparative level. In the treatment of acute tonsillopharyngitis after exclusion of GABHS etiology, topical etiotropic drugs are often used. It is desirable to achieve a uniform distribution of active ingredients, and to maximize the use of additional pharmacological capabilities (irrigation-eliminative action, reparative effect). To build up the evidence base for the effectiveness of just such medicines on the basis of the Department of Otorhinolaryngology of the Moscow State Medical University named after. A.I. Evdokimov, an observational prospective comparative study was conducted, using, in addition to the clinical assessment method, cytomorphological approaches (cytomorphometry). The results of the study demonstrated that gargling with a solution of hydroxymethylquinoxylindioxide (Dioxydin 0.25 mg/ml solution for topical application) in adult patients with acute tonsillopharyngitis provides rapid relief of pain, a decrease in the severity of inflammation symptoms, and also makes it possible to achieve limitation of the degree of destruction of the epithelium in the height of inflammation and a more complete and rapid recovery of the damaged mucous membrane by the time of recovery.

摘要

喉咙痛是与先前急性呼吸道病毒感染(包括新冠病毒感染)相关的急性扁桃体咽炎的主要症状。这些疾病的发病机制基于病毒的原发性直接损伤作用和感染灶黏膜上皮继发性替代性炎症变化的累积结果,在局部微生物群功能改变的背景下,导致病毒 - 细菌炎症发展到超出保护 - 修复水平。在排除A组β溶血性链球菌病因后治疗急性扁桃体咽炎时,常使用局部病因针对性药物。期望实现活性成分的均匀分布,并最大限度地利用额外的药理作用(冲洗清除作用、修复作用)。为了以莫斯科国立医科大学A.I.叶夫多基莫夫命名的耳鼻喉科系为基础,建立此类药物有效性的证据基础,开展了一项观察性前瞻性比较研究,除临床评估方法外,还采用了细胞形态学方法(细胞形态计量学)。研究结果表明,成年急性扁桃体咽炎患者用羟甲基喹喔啉二氧化物溶液(局部应用的0.25毫克/毫升多氧霉素溶液)漱口可迅速缓解疼痛,减轻炎症症状的严重程度,还能在炎症高峰期限制上皮破坏程度,并在恢复时使受损黏膜更完全、更快地恢复。

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