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THE EFFICIENCY OF GLOSSALGIA AND STOMATALGIA COMPLEX
TREATMENT
HABIBOVA NAZIRA NASULLAEVNA
Bukhara State Medical Institute Dean of the Faculty of Dentistry, Dsc, Associate Professor phone: Bukhara (Usbekistan). ORCID ID 0000-0002-9383-5044
OLIMOVA DILDORA VOHIDOVNA Bukhara State Medical Institute, Assistant of the Department of General Hygiene and Ecology phone: Bukhara (Usbekistan).
ORCID ID 0000-0002-9438-5970
ABSTRACT
The article presents data about the efficiency of glossalgia and stomatalgia complex treatment. This pathology is rather widespread and distresses patients. The diseases are polygenic, pathogenesis is unplumbed, and treatment methods are multivarious and not always effective. This fact determined the timeliness of the chosen issue. For many years we have been applying different treatment methods. The received results allowed us to recommend some of them, for example cranial electrotherapy stimulation, cryotherapy, hirudotherapy, laser treatment, local immunomodulators, rinsing with antiseptics, split meals, examination by interns if indicated, and general treatment prescribed by different doctors.
Key words: glossalgia, stomatalgia, aetiopathogenesis, complex treatment.
ЭФФЕКТИВНОСТЬ КОМПЛЕКСНОГО ЛЕЧЕНИЯ ГЛОССАЛГИИ,
СТОМАЛГИИ
ХАБИБОВА НАЗИРА НАСУЛЛАЕВНА
Бухарский государственный медицинский институт, декан стоматологического факультета, доцент Бухара (Узбекистан).
ORCID ID 0000-0002-9383-5044 ОЛИМОВА ДИЛДОРА ВОХИДОВНА Бухарский государственный медицинский институт, ассистент кафедры общей гигиены и экологии телефон: Бухара (Узбекистан).
ORCID ID 0000-0002-9438-5970
АННОТАЦИЯ
В статье представлены сведения об эффективности комплексного лечения глоссалгии, стомалгии. Эта патология имеет высокую распространенность и причиняет много страданий пациентам. Заболевания полиэтиологичные, патогенез до конца не изучен, а методы лечения многообразны и не всегда эффективны, что и определило актуальность выбранной темы. Нами на протяжении многих лет применялись комбинации различных средств и методов лечения. Полученные результаты позволили рекомендовать некоторые из них: ТЭС-терапию, криотерапию, гирудотерапию, лазеротерапию, иммуномодуляторы местного действия, полоскания антисептиками, дробное питание, по показаниям общее лечение, назначенное специалистами различного профиля.
Ключевые слова: глоссалгия, стомалгия, этиопатогенез, комплексное лечение
Glossalgia (synonyms - glossodynia, paresthesia of the tongue) is a pathological condition accompanied by unpleasant or painful sensations in the language without visible changes. This pathology tends to rejuvenate in terms of age - [13, 17]. Currently, the term "stomalgia" is becoming more and more widespread, when unpleasant sensations are localized on the tongue and other areas of the oral mucosa. Scientists have been looking for various methods of treatment for many decades, but it is very difficult to achieve a cure for this pathology, which determined the relevance of the chosen topic - [5].
The etiology of stomalgia and glossalgia is not fully understood - [1, 2, 3, 18], but among the etiological factors are: diseases of the central and peripheral nervous system (stress features), pathology of internal organs and systems (digestive, endocrine, cardiovascular, etc.), galvanism (galvanosis) in the presence of various metals in the oral cavity, menopause, infectious and traumatic factors (sharp edges of the teeth, dental deposits, defective prosthetic structures, decreased bite and much more); dysfunction of the temporomandibular joint - [15].
These diseases gave rise to a catch phrase among doctors: "Maximum subjective sensations with a minimum of objective data." Patients present varied and vivid complaints: a burning sensation in various parts of the tongue and oral mucosa, swelling, heaviness in the tongue, speech becomes slurred, the tongue sticks to the palate, a feeling that it has been "sprinkled with pepper", "scalded with boiling water",
that the tongue does not fit in the mouth; complaints are often accompanied by changes in salivation towards a decrease in taste sensitivity, pains of a breaking and pressing character, and paresthesia.
On an objective examination, if there are no diseases of the internal organs and systems, as well as under certain conditions of the tongue (diamond-shaped, desquamative, folded tongue), this organ is without visible pathological changes, and the oral mucosa is pale pink, smooth, shiny. The tongue and mucous membrane of the oral cavity are mobile, painless with movements. The main pathognomonic symptom is the absence of pain and discomfort when eating. Currently, there are 6 variants of stomalgia, depending on the localization of paresthesias: mandibular, maxillary, mandibulomaxillary, frontoparietal, glossopharyngeal, oxypital. In these cases, it is necessary to consult a neurologist.
Particular attention should be paid to complaints and symptoms with galvanosis that occurs during the manufacture of various orthopedic structures, most often from dissimilar metals: burning, rawness, metallic taste in the mouth, the presence of prostheses, the touch of a metal spoon on the prostheses, xerostomia, there may be headaches, speech impairment , sleep and others. Modern methods and means proposed for the treatment of glossalgia and stomalgia are very diverse.
TES (transcranial electrical stimulation) is an impulse effect on the central links of regulation of all body systems: it stimulates and accelerates the healing process, has an anti-inflammatory and immunostimulating effect, normalizes the neuropsychiatric status and tone of the autonomic and central nervous system - [7]. Cryotherapy and cryodestruction are used in the treatment of many diseases of the oral mucosa and tongue. The mechanism of action of cryotherapy lies in the contact of the surface of the skin or mucous membrane of the oral cavity with gas, usually liquid nitrogen is used, cooled from -30 to -150 ° C.
During this procedure, blood begins to flow to small blood vessels and internal organs, thanks to which they receive useful substances, immunity is activated and the body's defense systems are activated [8, 9, 14].
Hirudotherapy has a reflex effect on the body: biting through the skin at the acupuncture points, the leech plays the role of a needle used in traditional Chinese reflexology. Mechanical action: in the past, many diseases were treated with bloodletting. The essence of the method was to relieve regional blood flow and improve blood circulation in the area of the affected organ. The leech does about the same. Biological action: when a leech bites through the skin or mucous membrane of a
patient, the secret of the leech's salivary glands enters his body, containing many biologically active substances, over 100 enzymes - [6, 11, 12, 16].
Contraindications to hirudotherapy: hemophilia, severe anemia (a significant decrease in red blood cells in the blood), pregnancy, autoimmune deficiency (decompensated forms of diseases: diabetes, oncological pathology, etc.). Laser therapy: the features of the laser effect are to stimulate regeneration, develop nonspecific factors of immunity, immunomodulation, analgesic effect, anti-inflammatory effect, and activate the endocrine glands - [4].
The drug "galavit" (immunomodulator) activates the functions of macrophages, increases the synthesis of interferons, enhances the production of antibodies synthesized against a specific pathogen, has an antioxidant effect, and has a hepatoprotective effect - [10]. The drug "malavit" is created from Altai herbs and minerals. Contains in its composition active complexes of copper, silver, ions of calcium, potassium, lithium, mineral malachite, mummy (traditional and white), extracts of roots and herbs, spring water, which provides a wide spectrum of drug action: decongestant, anti-inflammatory, antiviral, antifungal, bactericidal, stimulating tissue regeneration.
The aim of the study was to determine the clinical efficacy of complex treatment using modern methods and means of glossalgia and stomalgia.
Materials and methods of research
The effectiveness of the proposed complex therapy was studied in the clinic in patients aged 45-75 years and older. Among them, women predominated (94%). During the examination, a survey and examination were thoroughly carried out, special attention was paid to the collection of complaints, anamnesis, followed by consultations according to indications and treatment from specialists.
Differential diagnostics were carried out: with rhomboid, desquamative, fungal glossitis, stomatitis of various origins, the Möller-Gunther tongue (folate-iron deficiency anemia), tongue lining in diseases of internal organs and systems, precancerous and oncological diseases of the tongue and oral mucosa.
Complex treatment of glossalgia and stomalgia in patients of both groups, local treatment included: sanitation of the oral cavity, elimination of galvanosis, filling defects, sharp edges of teeth, orthopedic treatment and others, and general pathogenetic treatment: normalization of homeostasis (vitamin therapy), normalization of the functions of the autonomic nervous system required treatment by a neuropathologist (ganglion-blocking, phosphorus-lipo-containing drugs, sedatives,
blockade of the branches of the trigeminal nerve), according to the testimony of specialists in various fields.
There were 302 subjects under observation. The patients were divided into 2 clinical groups. In the comparison group (145 people), conventional treatment was carried out, they refused from the methods and means proposed by us by virtue of a number of circumstances (fear of leeches, poor blood clotting, poor general health, additional payment for TPP-laser cryotherapy, drugs "galavit", "malavit", etc.). The main group consisted of 157 patients who agreed with the means and methods proposed by us for complex treatment.
Patients of the main group were asked to additionally include in the complex treatment such methods and means as TES-therapy, cryotherapy, hirudotherapy, laser therapy (apparatus "Photosan"), local immunomodulators (galavit, imudon, etc.), rinsing with aniseptics malavit, stomatofit, phytopreparations, etc. fractional nutrition, with the presence of a bacterial factor is necessary it is imperative to determine the sensitivity to anti-inflammatory therapy.
The leech placement points were similar acupuncture. The staging was carried out directly to the focus of pathology or far from him.
Research results and their discussion
In the main group, 48 persons were identified with diseases of internal organs and systems, with phenomena of galvanosis due to In the comparison group, as a result of the conventional treatment - local and according to general indications, prescribed by specialists, were the following results were obtained: complete disappearance of symptoms of stomalgia and glossalgia was registered in 32 people.
Treatment proved to be ineffective in 97 persons who retained those or other complaints (burning, dryness, discomfort in the mouth and tongue), which is significantly less, than in the main group. Remission at intervals on average, up to one year was achieved in 16 patients, which is also significantly less than in the main group.
Thus, the results of this study indicate the effectiveness of complex treatment of patients with glossalgia and stomalgia, and the proposed methods and means can be recommended for practical healthcare. Patients with glossalgia and stomalgia, it is necessary to recommend complex treatment with the obligatory inclusion of TES therapy, cryotherapy, hirudotherapy, laser therapy, local immunomodulators, rinses with antiseptics, fractional food, by indications for general treatment prescribed by specialists in various fields.
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