Kryukov A I, Pogonchenkova I V, Kulikov A G, Tovmasyan A S, Filina E V, Schepkina E V, Kuznetsov A I, Tarakanova O V
Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.
Pirogov Russian National Research Medical University, Moscow, Russia.
Vestn Otorinolaringol. 2024;89(4):4-13. doi: 10.17116/otorino2024890414.
Chronic pharyngitis (CP) is one of the most common diseases of the oropharynx. The number of referrals from patients with CP reaches 70% of the total number of referrals to an otorhinolaryngologist. The development of this disease is facilitated by the neuro-reflex factor and a violation of trophic and metabolic processes. It should be noted that of all forms of CP, the greatest impact on the quality of life is noted precisely in atrophic pharyngitis (AP), due to the presence of pronounced subjective sensations from the oropharynx. Many of the modern methods of treatment do not provide a lasting effect due only to the application, superficial local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes caused by a violation of trophic processes in the tissue. A promising direction in the treatment of atrophic pharyngitis is the use of a combined technique - ozone therapy and low-intensity laser therapy. The article presents the results of the application of fine-drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil in combination with low-intensity laser radiation on the projection of vessels supplying blood to the middle parts of the oropharynx.
Improving the effectiveness of treatment of patients with atrophic pharyngitis through the use of ozone therapy and low-intensity laser therapy.
A single-center experimental controlled randomized open-label study of 90 patients with AP aged 18 and over was conducted. All patients were randomly divided into three groups depending on the treatment performed: group I - traditional treatment method (rinsing the oropharynx with antiseptic solutions, the use of tablets for resorption), group II - treatment with ozone therapy (fine drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil), group III - treatment with ozone therapy and laser therapy. During the examination of patients, anamnesis collection, examination of ENT organs, cytological and microbiological examination of the mucous membrane of the posterior pharyngeal wall, contact endoscopy of the mucous membrane of the posterior pharyngeal wall were performed. 5-point visual analogue scales (VAS) were used to assess complaints and pharyngoscopic signs.
Our results showed a statistically significant improvement in the quality of life of patients with AP (=0.012), an improvement in the pharyngoscopic picture (=0.003). The results obtained by us indicate an improvement in microcirculation under the influence of ozone therapy and low-intensity laser radiation. The technique using ozone therapy and low-intensity laser therapy is characterized by a bactericidal and fungicidal effect. There is a decrease in the total contamination of the posterior wall of the oropharynx with pathogenic and saprophytic microflora (there is a decrease in the contamination of the posterior wall of the pharynx with saprophytic and pathogenic microflora (≤0.05), the differences are statistically significant). The technique using ozone therapy and low-intensity laser therapy has a pronounced anti-inflammatory effect, which was expressed in a decrease in the severity of dyskeratosis and hyperkeratosis. Thus, the use of ozone therapy in combination with laser therapy opens up new prospects for pathogenetically sound and effective treatment of AP.
慢性咽炎(CP)是口咽最常见的疾病之一。慢性咽炎患者的转诊人数占耳鼻喉科医生总转诊人数的70%。神经反射因素以及营养和代谢过程的紊乱促进了这种疾病的发展。应当指出,在所有慢性咽炎形式中,萎缩性咽炎(AP)对生活质量的影响最大,因为口咽会出现明显的主观感觉。许多现代治疗方法仅对口咽后壁改变的黏膜产生表面局部作用,而未考虑组织营养过程紊乱所引起的变化,因此无法提供持久疗效。萎缩性咽炎治疗的一个有前景的方向是使用联合技术——臭氧疗法和低强度激光疗法。本文介绍了用臭氧化油对咽后壁黏膜进行微量滴注并结合低强度激光照射口咽中部供血血管投影部位的应用结果。
通过使用臭氧疗法和低强度激光疗法提高萎缩性咽炎患者的治疗效果。
对90例18岁及以上的萎缩性咽炎患者进行了单中心实验性对照随机开放标签研究。根据所进行的治疗,将所有患者随机分为三组:第一组——传统治疗方法(用消毒溶液冲洗口咽,使用含片),第二组——臭氧疗法治疗(用臭氧化油对咽后壁黏膜进行微量滴注),第三组——臭氧疗法和激光疗法治疗。在对患者进行检查时,收集了病史,对口鼻咽喉器官进行了检查,对咽后壁黏膜进行了细胞学和微生物学检查,对咽后壁黏膜进行了接触式内镜检查。使用5分视觉模拟量表(VAS)评估症状和喉镜检查体征。
我们的结果显示,萎缩性咽炎患者的生活质量有统计学意义的改善(=0.012),喉镜检查结果有所改善(=0.003)。我们获得的结果表明,在臭氧疗法和低强度激光照射的影响下微循环有所改善。使用臭氧疗法和低强度激光疗法的技术具有杀菌和杀真菌作用。口咽后壁致病性和腐生性微生物的总污染有所减少(咽后壁腐生性和致病性微生物的污染有所减少(≤0.05),差异具有统计学意义)。使用臭氧疗法和低强度激光疗法的技术具有明显的抗炎作用,表现为角化不良和角化过度的严重程度降低。因此,臭氧疗法与激光疗法联合使用为萎缩性咽炎的病因明确且有效的治疗开辟了新前景。