Optimization of treatment and prognosis of acute and chronic eczema in patients with manifestations of intestinal dysbiosis

Abstract

Objective — the purpose of the work is to increase the effectiveness of treatment of patients with acute and chronic eczema by developing effective comprehensive corrective therapy based on the study of the immune defense system. Materials and methods. 47 patients with acute and chronic eczema before and after treatment were selected for the study. To assess the effectiveness of therapy in these patients, we evaluated the data of biochemical studies, indicators of cellular and humoral immunity, as well as the degree of changes in indicators of the microbiota of the colon cavity. Results and discussion. The most informative indicators of cellular and humoral immunity of patients with acute and chronic eczema in the acute stage, accompanied by manifestations of intestinal dysbiosis are determined: CD3+-lympho­cytes, IFN-γ, IL-4, IL-6 and IgA. The monitoring of these indicators is necessary and sufficient for controlling the effectiveness of prevention and treatment of this group of patients.According to the results of bacteriological examination of feces in all patients, the presence of dysbiosis of the colon of I—IV degrees was established. Patients with eczema also had a significantly lower content of bifidobacteria and lactobacilli in the colon cavity (by 2.09 and 2.58 times, respectively), bacteroids (by 1.96 times) and the total number of Escherichia coli (by 2.56 times) against the background of a larger number of Escherichia coli with enzymatic properties, opportunistic enterobacteria, enterococci and fungi of the genus Candida (by 1.87, 14.4, 4.20 and 3.22 times, respectively). After the treatment with the addition of pro- and prebiotics of the patients of the main group, the manifestations of dysbiosis of the colon were eliminated, while in the patients of the control group, the manifestations of dysbiosis persisted: lower content of bifidobacteria and lactobacilli in the colon cavity (by 1.82 and 2.32 times, respectively), bacteroids (by 1.2 times) and the total number of Escherichia coli (by 1.48 times) against the background of a bigger number of Escherichia coli with enzymatic properties, opportunistic enterobacteria, enterococci and fungi of genus Candida (by 1.32, 12.3, 3.24 and 2.85 times, respectively). Conclusions. The treatment aimed at normalizing the gastrointestinal tract and increasing the patient’s immunity, has an activating and stimulating effect on the therapeutic treatment complex of a patient with eczema. The addition of pro and prebiotics contributed to a significant reduction in the duration of treatment in patients compared with the indicator in individuals who received only conventional pathogenetic therapy.