CC BY
15УДК 616.15-08:616.831.
DOI: 10.24411/2181-0443/2020-10129
ПОВЫШЕНИЕ ЭФФЕКТИВНОСТИ НАРУЖНОГО ОТИТА ПРИ ПОМОЩИ
ГИРУДОТЕРАПИИ
Бахритдинов Зухритдин Пазлитдинугли
Андижанский государственный медицинский институт
В статье приведены результаты изучения эффективности гирудотерапии у больных патологии наружного отита. Изучалась функциональная активность слухового нерва у 68 больных с патологием наружном отите. На протяжении двух недель больным проводили гирудотерапию (16-28 пиявок). В результате лечения отмечено повышение функциональной активности органа, нормализация гидродинамики, положительные сдвиги общей и местной гемодинамики. Полученные результаты позволяют рекомендовать гирудотерапию в комплексном лечении больных наружном отите.
Ключевые слова: наружной отит, гирудотерапия.
ТАШКИ КУЛОК ЯЛЛ^ЛАНИШИНИ ГИРУДОТЕРАПИЯ ЁРДАМИДА ДАВОЛАШ САМАРАДОРЛИГИНИ ОШИРИШ
Ма;олада таш;и отит патологияси булган беморларда гирудотерапия самарадорлигини урганиш натижалари келтирилган. Биз таш;и отит патологияси булган 68 беморда, эшитувнервининг функционал фаоллигини ургандик. Икки х,афта давомида беморларга гирудотерапия (16-28 зулук) утди. Даволаш натижасида органнинг функционал фаоллигининг ошиши, умумий ва мах,аллий гемодинамикада ижобий силжишлар ;айд этилди. Олинган натижалар таш;и отит патологияси булган беморларни комплекс даволашда гирудотерапияни тавсия этишга имкон беради.
Калит сузлар: таш;и отит, гирудотерапия.
INCREASING THE EFFECTIVENESS OF EXTERNAL OTITIS WITH HIRUDOTHERAPY
The article presents the results of studying the effectiveness of hirudotherapy in patients with otitis externa pathology. The functional activity of the auditory nerve was studied in 68 patients with otitis externa pathology. For two weeks the patients underwent hirudotherapy (16-28 leeches). As a result of the treatment, an increase in the functional activity of the organ, the normalization of hydrodynamics, and positive shifts in general and local hemodynamics were noted. The results obtained make it possible to recommend hirudotherapy in the complex treatment of patients with external otitis media.
Key words: otitis externa, hirudotherapy.
Relevance. Otitis externa is a group of inflammatory diseases of the external ear (auricle, external auditory canal and outer layer of the tympanic membrane) of various etiology [3,7]. The fairly widespread prevalence and significant increase in morbidity, persistent course and high probability of recurrence against the background of a number of predisposing factors determine the close attention of otorhinolaryngologists to various aspects of this pathology [1,4].
Preference in the treatment of patients with otitis externa is given to a group of drugs with topical action [2,5]. One of the most effective methods for treating patients with diffuse otitis externa is hirudotherapy, which has proven itself in clinical practice [6].
Purpose of the study. The aim of this study was to assess the effectiveness of hirudotherapy in the complex therapy of patients with external otitis media.
Materials and research methods. The functional activity of the auditory nerve was studied in 68 patients with
otitis externa pathology. For two weeks the patients underwent hirudotherapy (16-28 leeches).
Discussion. Hirudotherapy is an effective adjunctive treatment for many diseases. For example, glaucoma, otitis media, furunculosis, chronic constipation and even obesity. Leeches also have a beneficial effect on the entire body, normalizing metabolism and
strengthening the immune system.
Hirudotherapy is an effective way to treat acute inflammatory diseases of the ENT organs. Sometimes hirudotherapy is used as a separate method, but most often it is used in conjunction with antibiotic therapy and physiotherapy.
Patients with otitis externa make up from 17 to 23% of the total number of patients who seek medical help from an otorhinolaryngologist. Considering that otitis externa often occurs against the background of otitis media, the frequency of detection of such patients will increase many times. Moreover, it should be noted that recently the frequency of lesions of the outer ear has a steady tendency to increase all over the world [1]. Otitis externa can be classified based on the etiology of the disease, the localization of the inflammatory process, as well as the duration of the course of the disease itself.
In otolaryngology, hirudotherapy began to be used not so long ago. Today, in our clinic, with the help of medical leeches, we successfully treat sinusitis, frontal sinusitis, acute neuritis of the auditory nerve, otitis media, ear noises, chronic sensorineural hearing loss, diseases of the paranasal sinuses, idiopathic and drug-induced forms of vasomotor rhinitis.
The indications for the inclusion of hirudotherapy in the complex of therapeutic measures in
otorhinolaryngology are: acute neuritis of the auditory nerves, ear noises with neuritis of the auditory nerves, middle and external acute otitis with severe pain syndrome, adhesive otitis media,
secondary trigeminal neuralgia in the background inflammatory changes in the paranasal sinuses.
The place where the leeches are placed depends on the localization of the inflammatory process. If the inflammation is localized at the entrance to the ear canal, then the leeches are placed on the tragus and directly at the site of inflammation. With diffuse lesions of the entire auditory canal, leeches are placed in the behind-the-ear region, retreating 1 cm from the place of attachment of the auricle and parallel to it. The number of leeches for one session is 1-3 pieces. The duration of the session is 5-7 minutes. 2-4 sessionsarerecommendedforthecourseoft reatment.
The inclusion of hirudotherapy in the complex of therapeutic measures made it possible to eliminate the pain syndrome within a day, and the average time of disability of patients decreased by 1.1 days and amounted to 5.1 days.
The rapid development of scientific medicine in the second half of the 19th century, the flourishing of microbiology, the introduction of antiseptics and asepsis led to a sharp decline in the use of leeches. They came to be seen as a possible source of infection. Therefore, instead of hirudotherapy, "vein" bloodletting or bloodletting with the help of blood-suction cups began to be widely used, as a simpler and more reliable method. And in the first decade of the 20th pitch, leeches almost completely disappeared from the arsenal of medicinal products.
Although it was subsequently shown that both the secretion of the salivary glands and the contents of the intestinal canal of the leech have bacteriostatic properties in relation to a number of pathogenic microorganisms, however, hirudotherapy has not received such wide distribution as before. Theabundanceofsyntheticpharmaceutical shasdramaticallyreducedthedemandform edicinalleeches.
The methods of hirudotherapy, both local and general, have been developed and tested at the Department of Otorhinolaryngology of the Andijan State Medical Institute together with the laboratory of the AGMI clinic on the basis of traditional, historically established methods of treatment with leeches.
Medical leeches have several important medicinal properties that are actively used in modern otolaryngology to treat various diseases and pathologies.
Summing up, it should be noted that the treatment of acute external diffuse otitis media, given its poly-etiology, is sometimes a difficult task. The correct diagnosis is facilitated by a competently collected medical history, otoscopy and microbiological research data. The basis of therapy for otitis externa is the use of hirudotherapy.
Conclusion. The expediency of the study is that the results of the study will expand the understanding of the etiology, risk factors, the mechanism of development, the variety of clinical manifestations of otitis externa, the effectiveness of their hirudotherapy.
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