Клінічна ефективність фітоентеросорбенту в комплексному лікуванні хворих із вперше діагностованим деструктивним туберкульозом легень

Introduction. Glaucoma is a chronic eye disease characterized by a constant or periodic increase in intraocular pressure, a decrease of visual fields and visual acuity, and by a special form of optic nerve atrophy with excavation in the disc area. The reflection of this slowly fl owing atrophy is a disturbance in the visual field and a complete irreversible loss of visual function. The prevalence of the disease increases with increasing age. The main methods of treatment are medical and surgical. Non-penetrating operations are recognized as the safest methods of surgical treatment of glaucoma. The most common complications of such operations include: detachment of the choroid, small anterior chamber syndrome, hyphema, cicatricial changes in the filtration cushion. Based on the analysis of literature data, it can be assumed that the inclusion of osteopathic correction in the complex therapy of patients with operated glaucoma can increase the effectiveness of therapy.The aim of the research was to study the clinical efficacy of osteopathic correction in the complex treatment of patients operated on primary open-angle glaucoma.Materials and methods. The study involved 20 patients (20 eyes) aged 70 to 75 years with developed and advanced stages of primary open-angle glaucoma, who underwent surgical treatment. The main (10 people) and control (10 people) groups were formed by simple randomization. Participants in the main group received standard medical therapy and osteopathic correction, while participants in the control group received only medical therapy. Changes in the following clinical parameters were evaluated: visual acuity, visual fi eld, intraocular pressure, thickness of the retinal nerve fiber layer, and severity of pain syndrome. Indicators were recorded at the beginning of the study (2 weeks after surgery) and at the end of the study (2–3 months after surgery).Results. Patients receiving osteopathic correction as part of the complex therapy after surgery of primary openangle glaucoma are characterized by a statistically significant (p<0,05) decrease in the severity of pain syndrome, an increase in the magnitude of the visual field and of the thickness of the retinal nerve fiber layer.Conclusion. The obtained results suggest the effectiveness of the inclusion of osteopathic correction in the complex treatment of patients with operated on primary open-angle glaucoma. It is recommended to continue the study with a larger sample size.

Among systemic factors in development of generalized periodontitis is psychological stress, the prevalence of which is constantly growing. This should be taken into account in the complex treatment of patients with generalized periodontitis. Considering this, a medical scheme for the preparation of patients with generalized periodontitis with the presence of psycho-emotional stress using a complex of adrenoblockers has been proposed.Objective: to determine the clinical efficacy of the proposed complex of adrenoblockers in the complex treatment of patients with generalized periodontitis and its influence on the level of psychoemotional stress.Material and research methods. For this study, 50 patients were selected with a generalized chronic periodontitis with the presence of psychoemotional stress. Medicamental treatment was performed using the proposed premedication with a complex of adrenoblockers. A comprehensive survey of the condition of the periodontal tissues of patients before treatment and after treatment was carried out. To assess the clinical efficacy of treatment a periodontal indexes were used. The level of psychological stress was assessed using the DASS-21 and Spielberger-Khanin questionnaires. The psychological stress level was determined cortisol content in oral fluid samples using the RP Elecsys kit (Roche Diagnostics, USA).Results. As a result of the investigation it was found that the usage of the proposed complex of adrenoblockers in the complex therapy of patients with chronic course of generalized periodontitis with the presence of psychoemotional stress can effectively inhibit the dystrophic-inflammatory process in periodontal tissues. This confirms by the decline in the indexes PMA, OHI-S, РВІ, PI. The level of cortisol in saliva after treatment decreases up to normal level.Conclusions. Usage of the proposed complex of adrenoblockers increases the effectiveness of treatment of chronic course of generalized periodontitis in patients with Key words: generalized periodontitis, psychoemotional stress, complex of adrenoblockers, cortisol level.the presence of psychoemotional stress and decreases psychoemotional stress level up to normal level

Introduction. Gout is a serious medical, social and economic problem today. It becomes even more important due to its comorbidity. The relationship of pathogenetic mechanisms in the development and progression of gout and non-alcoholic fatty liver disease (NAFLD) has been proven. The presence of concomitant pathology enhances the inflammatory reaction in the body and significantly complicates the course of the underlying disease.The aim of the study – to evaluate the indicators of systemic inflammatory response in patients with gout and gout with NAFLD when included in the complex therapy of the disease carbon enterosorbent carboline.Materials and Methods. 123 patients with gout in the period of exacerbation were examined, who were divided into two groups. Group I included 65 patients with gout without liver damage, group II – 58 people with concomitant NAFLD. To determine the effectiveness of treatment, both groups were divided into subgroups: IA (27 people) and IIA (23 patients) who received conventional treatment. Subgroups IB (38 patients) and IIB (35 subjects) additionally received enterosorbent carboline. The control group consisted of 30 healthy individuals. A general clinical examination (collection of complaints, history, objective examination), determination of pain intensity on a visual-analog scale (VAS), biochemical (uric acid level (UA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) ) and enzyme-linked immunosorbent assays (tumor necrosis factor-α) (TNF-α), interleukins 1 (IL-1β) and 10 (IL-10) were conducted.Results. Patients in both groups had typical clinical signs of joint syndrome. In patients with gout an increase in UA, CRP, ESR, imbalance of cytokine regulation (IL-1β, TNF-α, IL-10) was revealed. These changes increased in the presence of concomitant NAFLD. Significant decrease in the concentration of UA, CRP, ESR, cytokine content after treatment was in all subgroups, but more in patients who received carbon enterosorbent with basic therapy.Conclusions. The inclusion of the carbon enterosorbent carboline in the complex treatment of patients with gout and gout with NAFLD in the acute phase, promotes faster reverse dynamics of the clinical manifestations of the disease, accompanied by a more significant decrease of the level of UA, CRP, ESR and cytokines in blood serum.

Treatment of odontogenic phlegmon of the maxillofacial region remains an urgent problem of surgical dentistry due to the steady increase in their frequency, tendency to generalize the process and adverse effects. In this regard, there is a constant search for ways to improve the effectiveness of treatment of patients with odontogenic phlegmons of maxillofacial region. New technologies of drug treatment of this pathology are developed and put into practice.
 In recent years the attention of researchers in various conditions accompanied by the development of oxidative stress began to attract drugs that have antioxidant action, as it became known that the excess of reactive oxygen species in the regenerating wounds in the hearth of purulent inflammation affects the course of the course, wound healing. Interest in the treatment of various pathological conditions of the body is caused by the domestic antioxidant multifunctional enzyme "Bioceruline" which is composed of copper.
 In this regard, the purpose of our study was to evaluate the effectiveness of the use of "Biocerulin" in the complex treatment of patients with odontogenic phlegmon of maxillofacial region.
 The object of the clinical study was 45 patients with odontogenic phlegmons of the maxillofacial region from 18 to 55 years old, who were treated in the maxillofacial department of PU "Poltava M.V. Sklifosovskyi regional clinical hospital PRC». All patients were without somatic pathology in compensated clinical condition. Immediately after hospitalization, patients underwent an emergency opening of purulent lesion, revision and adequate drainage of the affected cellular spaces, removal of the "causal" tooth. The extent of surgery and the choice of optimal access depended on the location and prevalence of phlegmon. Depending on the treatment, patients were divided into comparison groups (22 patients) and the main group (23 patients). The traditional therapy was used in the comparison group. "Biocerulin"was prescribed for the patients of the main group in addition to the traditional therapy.
 Analysis of obtained data in the treatment of patients with phlegmon revealed that both groups of patients had clear differences in the clinical course of purulent-inflammatory process. On the 2nd day after the opening of the phlegmon theweakness, headache, and sleep disorders were noted in the most of the patients of the comparison group who received traditional therapy. Pain with varying degrees of intensity was present in all patients. Improvement of the general condition of patients of this group was noted not earlier than 3-5 days after surgery. The improvement of the general condition and reduction of pain, normalization or decrease in body temperature, the beginning of restoration of function of the jaw apparatuswere notedin patients of the main group on the background of the introduction of "Bioceruline" already on the 2-3rd day after surgery.
 Thus, on the basis of the conducted researches it is possible to conclude that the basic (traditional) conservative therapeutic measures used for patients of the comparison group are not effective enough for the relief of the local and general inflammatory process, which caused the prolonged nature of organ-specific and functional rehabilitation of patients as a whole. The use of "Bioceruline" in complex therapy of patients with odontogenicphlegmons of the maxillofacial regionprovides rapid and intensive recovery of the general condition of patients and accelerates reparative processes in the wound and shortens the treatment time via 1.4 bed-days.

Objective — to investigate efficacy of preparation of pro-vitamin B5 and vitamin U in the complex therapy of patients with chronic erosive gastritis, associated with H. pylori, combined with the pancreas excretory insufficiency, established by the morphological parameters.Materials and methods. The study involved 28 patients with H. pylori-associated gastritis combined with the pancreas excretory insufficiency, who were under regular medical check-up and supervision of a family doctor in the Ternopil City Municipal Institution Center of primary health care. The patients were allocated into two groups: the main (n = 1`6) and control (n = 12) groups. All patients received 10-days therapy with pantoprazole (Controloc, Nolpaza, Pantasun or other) in a dose of 40 mg twice a day, amoxicillin in a dose of 1000 mg (or metronidazole in a dose of 500 mg) twice a day, clarithromycin in a dose of 500 mg twice a day; patients of the main group received additional vitamin complex (Doctovit) 2 tablets a day after meals for over 2 months. At the baseline and 2 months after the treatment start, all patients underwent eso-gastroduodenoscopy, urease H. pylori test and biopsy with histological examination on 5 sites.Results. The total dynamics of improvement of the stomach mucosa morphological condition in the 1st group of patients was 0.9 points versus 1.6 points in the 2nd group of patients, which was 17 % and 32 %, respectively (p < 0.05). This testifies the efficacy and proves advisability to use this vitamin complex in the treatment and rehabilitation of patients with chronic gastritis, combined with the pancreas excretory insufficiency.Conclusions. In the complex treatment of patients with chronic gastritis, combined with the pancreas excretory insufficiency, it is advisable to use the complex of pro-vitamin B5 and vitamin U.

Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes mellitus, leading to the development of flaccid paresis, neuropathic pain syndrome, sensitive ataxia, as well as trophic disorders in the distal parts of the lower extremities.The purpose of the randomized, open-label, comparative, prospective study was to evaluate the effectiveness and tolerability of ipidacrine in the complex treatment of patients with DPN.Materials and methods. Patients with DPN (n = 60) were randomized into 2 groups. Both groups received basic therapy (alpha-lipoic acid, B vitamins, gabapentin); in the treatment of patients of the main group (n = 30), in addition, ipidacrine was used (Ipidacrine-SZ, North Star Co., Russia). We have analyzed the intensity of pain syndrome (VAS-P), the average daily dosage of gabapentin, and the results of the neuropathic dysfunctional scale (modified version, NDSm), Pittsburgh Sleep Quality Index, PSQI), Global Rating of Change Scale (GROC), the results of electroneuromyography (ENMG). The total duration of the observation and treatment period was 2 months.Results. After 2 months of therapy in the main group of patients, compared with the control group, there was significantly more complete pain control (VAS-P: 3.0 ± 0.9 vs 3.6 ± 0.8), a decrease in the average daily dosage of gabapentin (390 vs 500 mg/day), reduction in the severity of clinical manifestations of polyneuropathic syndrome (NDSm: 4.4 ± 1.0 vs 4.9 ± 1.0 points) and improvement in sleep quality (PSQI: 6.8 ± 1.3 vs 7.9 ± 1.7). According to ENMG data, patients in the main group showed a significant improvement in the neurophysiological parameters of both motor and sensory fibers, which was significantly more pronounced compared to the control group. A significantly larger proportion of patients in the main group assessed the improvement from the therapy as ‘pronounced’ (GROC: 10/33.3 % vs 6/20.0 %).Conclusions. The use of ipidacrine in complex therapy of patients with DPN can significantly reduce the clinical manifestations of disease and improve the neurophysiological parameters of the peripheral nerves of the lower extremities. Ipidacrine can be considered as a basic drug for the treatment of patients with neurological complications of diabetes mellitus.

Objective:The aim of this study was to examine fetal stem cells (FSCs) treatment safety and efficacy in complex therapy for cerebral palsy (CP) children.We studied clinical, neurological, and laboratory changes in CP patients before and after FSCs therapy.Materials and methods: 11 children diagnosed with CP were under observation in Cell Therapy Center EmCell including 6 boys aged from 2 to 13 years, whose mean age was 4.23 ± 0.24 yrs.and 5 girls aged from 2.5 to 12 years with mean age which constituted 3.92 ± 0.15 yrs.The patients were allocated to the Main Group (MG) who along with standard treatment received FSCs.Control group (CG) included 9 patients suffering from CP who underwent treatment solely with inclusion of conventional methods and consisted of 4 males (aged from 3 to 14 yrs.whose average age made up 4.01 ± 0.12 yrs.) and 5 females in age from 3 to 15 yrs.with mean age by 3.87 ± 0.18 yrs.FSCs were administered as a complex therapy for the patients with CP and the data of clinical and laboratory investigations were analyzed during the whole study period.Results: It has been identified that patients who were administered treatment by use of FSCs revealed improvements of their immune status. Conclusion:FSCs use in complex treatment of patients with CP stabilizes disease compensation and leads to improvement of immune blood findings.

Clinical and microbiological analysis of «Aquacel Ag + Hydrofiber dressing», «Aquacel Ag Foam dressing Hydrofiber» and «Granulex» (ConvaTec, USA; wound covering efficiency in complex treatment of patients with face and neck phlegmons was carried out. We proved positive influence and potent action of the wound dressing on reparative processes in postoperative purulent wounds in patients with face and neck phlegmons. Application of «Aquacel Ag + Hydrofiber dressing», «Aquacel AgFoam Hydrofiber dressing» and «Granuflex» wound covering in a complex therapy allowed to improve wound condition in earlier terms, put secondary sutures and reduce terms of patient hospital stay.

Goal. Improving the effectiveness of treatment of patients with chronic catarrhal gingivitis living in ecologically favorable conditions and in ecologically polluted regions of Prykarpattia, by adding to the complex therapy of quercetin and chlorhexidine dent. The results of research by a number of scientists indicate that the use of quercetin in complex therapy helps to restore the antioxidant system, improve oxygen uptake by tissues and peripheral circulation, improve the rheological properties of the patient's blood. These properties of the drug were used by us in research. Research methods. We studied changes in periodontal tissues in children living in ecologically favorable conditions and in ecologically polluted regions of Prykarpattia, conducted a comparative description of periodontal changes and proposed a treatment plan for patients with chronic catarrhal gingivitis supplemented with chlorhexidine dent and quercetin. We examined 60 children with chronic catarrhal gingivitis living in the contaminated areas of Prykarpattia (Burshtyn) and 15 people with intact periodontium living in environmentally stable conditions. All patients underwent a full range of therapeutic measures, taking into account the removal of dental plaque and rehabilitation of the oral cavity. In 1 group of patients (30 people) patients were treated with chlorhexidine, calendula and chamomile infusion and 1 % mefenamine paste. Patients of group 2 (30 people) – the drug quercetin on the mucous membrane of the gums under the individual gingival cap and chlorhexidine dent in the form of oral baths. For the purpose of comparative characterization of the two groups, an index assessment of the condition of periodontal tissues and a study of rheographic parameters of periodontal tissues were performed. Scientific novelty. At the present stage used drugs chlorhexidine dent 0.12 % and quercetin for the treatment of periodontal diseases in children living in environmentally unfavorable conditions, studied the state of hemodynamics in periodontal tissues, studied rheographic parameters and their dynamics under the influence of treatment and prevention complex in children with chronic catarrhal gingivitis and evaluated the effectiveness of the developed treatment and prevention complex in children with chronic catarrhal gingivitis living in environmentally unfavorable conditions. Conclusion. The results of the study did not show a significant difference between clinical and laboratory parameters in patients 1 and 2 groups before treatment (p > 0.05), but they differed significantly from those in the comparison group (p < 0.05), which points out that unfavorable environmental living conditions have an impact on the course of periodontal disease in children. We found a significant difference in the blood supply to periodontal tissues in patients with chronic catarrhal gingivitis compared with (p < 0.05). The results of the study showed that the use of quercetin and 0.12 % chlorhexidine solution in the complex treatment of patients with chronic catarrhal gingivitis provided a significant improvement in clinical and laboratory characteristics of periodontal tissues in children living in different environmental conditions, and stabilized these indicators in long-term observation.The use of the proposed treatment regimen for patients with chronic catarrhal gingivitis stimulates metabolic processes in periodontal tissues, reduces cyanosis, edema of periodontal tissues according to the results of rheography of periodontal tissues. After treatment, we observe the normalization of the rheological characteristics of the gums, which indicates an improvement in blood circulation in periodontal tissues in these patients (normalization of qualitative and quantitative characteristics of rheograms). Key words: chronic catarrhal gingivitis, ecologically polluted areas, chlorhexidine, quercetin, reorganic changes of periodontium.

Бактериальный вагиноз является частым спутником папилломавирусной инфекции. Он также может сочетаться с вагинальным кандидозом и склонен рецидивировать, что связано с наличием комменсалов влагалища Atopobium vaginae. Бактериальный вагиноз патогенетически связан с блокадой воспалительной реакции на уровне слизистой влагалища. Поэтому для санации необходимо использовать лекарственные средства, действующее вещество которых эффективно влияет на анаэробы, Gardnerella vaginalis, Atopobium vaginae, дрожжевые грибы, обладает иммуномодулирующими свойствами, не угнетает рост лактобацилл и не образует перекрестной резистентности с другими антибактериальными средствами. Всем указанным требованиям удовлетворяет мирамистин. Проведено изучение эффективности влагалищного применения свечей с мирамистином (препарат тамистол) в комплексном лечении пациенток с остроконечными кондиломами. Всего было обследовано 142 женщины. В I группу вошли 30 практически здоровых женщин, во II группу – 55 пациенток с остроконечными кондиломами (28 участниц подгруппы IIA с бактериальным вагинозом и 27 пациенток подгруппы IIБ с бактериальным вагинозом и хроническим рецидивирующим вагинальным кандидозом). В III группу вошли 57 женщин с остроконечными кондиломами (29 пациенток с бактериальным вагинозом в подгруппе IIIА и 28 женщин с бактериальным вагинозом и хроническим рецидивирующим вагинальным кандидозом в подгруппе IIIБ). Пациенткам II группы проводили химическую деструкцию остроконечных кондилом после ректального использования свечей с рекомбинантным интерфероном в течение 10 дней. Пациенткам III группы дополнительно назначали курс санации влагалища с помощью вагинальных свечей тамистол в течение 10 дней. Результаты выполненного исследования свидетельствуют, что применение свечей тамистол в комплексном лечении пациенток с остроконечными кондиломами значительно повышает эффективность лечебных мероприятий. Восстановление микробного пейзажа влагалища с помощью тамистола снижало необходимость повторных сеансов химической деструкции кондилом и количество рецидивов. Полученные результаты позволяют считать использование иммуномодуляторов и санации влагалища в комплексе лечения папилломавирусной инфекции теоретически обоснованным.

Objective — to study the restorative effect of immunoglobulin G (IgG) in patients on indicators of cellular immunity in patients with drug-resistant tuberculosis (DR-TB)/HIV co-infection at the level of CD4+ lymphocytes from 200 to 50 cells/μL. Materials and methods. The study involved 52 patients aged 20 to 55 years, the average age was (37.2 ± 7.8) years. All patients were HIV-positive with laboratory-confirmed DR-TB with mycobacterium resistance to first- and second-line drugs. Patients on DR-TB/HIV were divided as follows: Group 1 (cont­rol) — 26 patients with DR-TB/HIV with the CD4 lymphocyte count from 200 to 50 cells/μL, who received standard treatment with second-line antimycobacterial therapy (AMBT) and antiretroviral therapy (ARVT); Group 2 (basic) — 26 patients with DR-TB/HIV with a CD4 lymphocyte count from 200 to 50 cells/μL, who also received standard treatment of second-line AMBD and ARVT, with the addition of complex therapy with intravenous IgG. Results and discussion. In patients of Group 2, at the end of the 20th month of treatment, the normalization of T-helpers level was noted in 69.2 % of people, which reached the average values of (830.0 ± 15.2) cells/μL, with an increase to a subnormal level (408,0 ± 1.6) cells/μL in 30.8 % of patients (p < 0.05). Normalization of the T-helpers indicator in Group 1 was noted on the 20th month only in 42.3 % of people, and it amounted to (670.0 ± 14.5) cells/μL (р < 0.05). The relative (percentage) level of the T-helpers indicator in the 20th month reached normal values in 61.5 % (р < 0.05) of patients of Group 2, among patients of Group 1 — in 34.6 % of people (р < 0.05 ). The absolute number of T-suppressors at the end of the 20th month decreased to the norm in 76.9 % of patients and 46.2 % of patients in Groups 2 and 1, respectively (p < 0.05). In patients of Group 2, on the 20th month of treatment, the physiological level of the T-suppressors indicator (19—35) % was reached in 65.4 % of cases (р < 0.05); in Group 1, the normal level was registered in 38.5 % of patients (p < 0.05). The CD4+/CD8+ Ratio was below the norm in 100 % of patients of Group 1 during 14 months inclusive, and only on the 20th month it reached the norm in 23.1 % of patients (p < 0.05). Group 2 patients had normalization in 57.7 % of cases at the 20th month (р < 0.05). Conclusions. The additional use of intravenous IgG in the complex treatment of patients with DR-TB/HIV contributed to a faster recovery of the cellular link of immunity, which makes it possible to prescribe antiretroviral therapy to patients with DR-TB/HIV at an earlier time, prevent the development of systemic inflammation and improve the prognosis for survival.

Aim. To study the effect of ozone therapy on clinical indices and nonspecific antimicrobial resistance status in infantile form of atopic dermatitis. Materials and methods. 67 children (40 boys and 27 girls) aged 5-10 years with disseminated moderate atopic dermatitis were under observation. The observed patients were divided into two groups depending on the conducted therapy. Group 1 of patients with atopic dermatitis (35 patients) had generally accepted complex therapy, group 2 of patients with atopic dermatitis (32 patients) - complex treatment combined with ozone therapy. In both groups of patients with atopic dermatitis, blood serum anti-α-staphylolysine content, phagocytosis indices, toll-like receptors TLR-2 and TLR-6 were studied in the periods of exacerbation and clinical remission. Results. Ozone therapy included into complex treatment of patients with atopic dermatitis leads to activation and restoration of toll-like receptor function, normalization of blood serum anti-α-staphylolysine level, phagocytosis indices and faster occurrence of long clinical remission.

Cystitis is a common disease worldwide, with up to 36 million cases recorded annually in Russia alone. In 10 % of patients, the condition transforms into a chronic recurrent form. Up to 30 % of visits to outpatient urologists are related to acute or recurrent cystitis. The prevalence of chronic cystitis in women is closely linked to the anatomical and topographical characteristics of the genitourinary system, the presence of gynecological diseases, and hormonal status. Effective treatment for acute or chronic cystitis involves complex therapy, with the key to success lying in the appropriate selection of antibacterial drugs. The current study aimed to analyse the literature data on the effectiveness of Furamag® in the complex treatment of patients with acute and chronic cystitis. To achieve this objective, we conducted a search for articles in scientific databases such as PubMed, Medline, minzdrav.gov.ru, and elibrary.ru using the following keywords: «urinary tract infection», «acute cystitis», «chronic cystitis», «furazidine», «potassium furazidine». Based on the results of our search, we concluded that Furamag® has been successfully used for a long time in the treatment of both acute and chronic cystitis, demonstrating high efficacy and good patient tolerance. This explains its widespread use in routine clinical practice among urologists, gynecologists, and therapists.

The increased level of interleukins IL-4 and IL-13 in the area of skin lesions, which are secreted by type 2 T-helpers, eosinophils and other immunocompetent cells, plays a main role in the pathogenesis of AD according to modern concepts. The genetically engineered drug dupilumab selectively binds to the subunit of IL-4Rα receptor complexes for IL-4 and IL-13 and inhibits the signaling function of these cytokines. The drug is approved for the treatment of patients with moderate to severe AD who have indications for systemic therapy, regardless of the use of topical corticosteroids from 6 years age. The efficacy and safety of dupilumab in the treatment of patients with atopic dermatitis has been confirmed by the results of numerous clinical studies. Material and methods.The study included 11 patients with moderate and severe AD at the age from 18 to 48 years. All patients received systemic treatment with dupilumab, topically used methylprednisolone aceponate (two times a day for the first 4 weeks, then a calcineurin inhibitor two times a day until the end of the observation period), emollients (two times a day). The initial dose of dupilumab was 600 mg (two injections of 300 mg at different injection sites), then 300 mg every 2 weeks. Results. After 6 months of complex therapy 73 % of patients achieved IGA 0/1. The SCORAD index decreased by an average of 71.7 % after 6 months. The mean value of the NRS scale decreased by 63.2 %. There were no adverse events reported that would lead to drug withdrawal. Conjunctivitis was noted in 2 (18.2 %) patients. Conclusion. There was a marked decrease in the intensity of the main clinical symptoms (SCORAD), including pruritus (NRS), a significant decrease in the manifestations of anxiety and depression (PROMIS).

The article reflects the potential for correcting intestinal microbiota disorders in the complex therapy of patients with COVID-19. It has been noted that the inclusion of dietary fiber in the diet contributes to protection against disruption of the integrity of the intestinal barrier and may limit bacterial translocation into the systemic circulation. The possibility of using psyllium (Mucofalk) is reflected, the action of which is realized both through its sorption, cytoprotective and anti-inflammatory properties in viral lesions of the gastrointestinal tract, and through stimulation of the own beneficial intestinal microbiota. The paper presents studies of the prospects for the use of probiotics, synbiotics in the complex therapy of patients with COVID-19. Detailed data are provided on the mechanisms of the positive effect of short-chain fatty acid preparations on reducing the severity of the disease in patients with COVID-19. It was noted that taking the drug Zacofalk leads to a significant increase in its own butyrate-producing microbiota (Faecalibacterium prausnitzii) and suppression of the growth of opportunistic flora with pro-inflammatory activity. The results of a recent study are presented showing that in patients with a mild course of COVID infection with respiratory and intestinal symptoms, the administration of Zakofalk for 30 days (3 tablets per day) led to significantly faster stool normalization (by day 7), persistent normalization of the frequency and consistency of stools by the 21st day and a significantly more pronounced regression of bloating and abdominal pain, as well as a decrease in the risk of developing post-infectious irritable bowel syndrome.