静脉上激光照射血液和光疗复合应用疗程对真性湿疹患者神经激素状态指标的影响

Emma E. Arutyunyan, S. Nagornev, I. I. Ivanova, E. Dontsova
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引用次数: 0

摘要

背景:在真性湿疹的发病机制中,压力占据着重要位置,在压力的影响下,下丘脑和脑干会受到刺激,下丘脑-垂体-肾上腺轴和自主神经系统也会被激活。压力引起的神经递质分泌会损害表皮的屏障功能,减缓伤口愈合,增加瘙痒和炎症,并通过改变 T 辅助细胞的免疫反应来抑制免疫。目的:评估应用静脉上激光照射血液和宽带中波光疗一个疗程对中度真性湿疹患者血液中促肾上腺皮质激素、皮质醇和β-内啡肽水平的纠正作用的严重程度。材料与方法:这项研究由 120 名中度真性湿疹患者参与。采用简单的固定随机法将所有患者分为 4 组。第一组(对照组,30 人)只接受基本药物治疗,包括使用解毒剂、降敏剂、抗组胺剂和局部糖皮质激素。第二组(对比组 1,人数=30)的患者还接受了一个疗程的静脉上激光照射血液治疗。第三组(对比组 2,人数=30)在基础治疗的基础上进行宽带中波光疗。第四组(主要组,人数=30)的患者除了接受基础治疗外,还接受了静脉上激光照射血液和光疗的联合疗程。采用 ELISA 方法两次测定患者血液中促肾上腺皮质激素、皮质醇和 beta-内啡肽的浓度(治疗开始前和治疗开始后 1 个月)。通过 EASI 指数的变化来评估各组患者的临床状况。此外,我们还使用 Spielberger-Khanin 问卷研究了反应性焦虑和个人焦虑水平的动态变化。结果:只有对比组和主要组的促肾上腺皮质激素、皮质醇和 beta-内啡肽呈正向变化,这证明通过综合使用静脉上激光血液照射和宽带中波光疗,能高效纠正患者的神经体液状态。在使用物理治疗因子进行综合治疗期间,评估参数的定量变化表明,通过不同的方式、应用点和机制实现物理治疗效果的生物潜力,它们之间的相互作用具有超加成作用。结论:获得的结果令人信服地证明,在纠正真性湿疹患者的神经内分泌状态时,额外使用静脉上激光照射血液与宽带中波光疗相结合的疗程是有效的。神经体液指标与疾病的临床和心理模式之间的密切相关性证明了所研究的神经内分泌指标的致病意义,这使我们能够将其动态变化视为治疗效果的信息标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The influence of a course of complex application of supravenous laser irradiation of blood and phototherapy on indicators of the neurohormonal status of patients with true eczema
BACKGROUND: In the pathogenesis of true eczema, an important place is occupied by stress, under the influence of which stimulation of the hypothalamus and brain stem occurs, as well as activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Stress-induced secretion of neurotransmitters impairs the barrier function of the epidermis, slows wound healing, increases itching and inflammation, and suppresses immunity by changing the immune response of T-helper cells. AIM: Assessment of the severity of the corrective effect of a course of application of supravenous laser irradiation of blood and broadband medium-wave phototherapy on the blood levels of adrenocorticotropin, cortisol and beta-endorphin in patients with true eczema with a moderate form of the course. MATERIALS AND METHODS: The study was carried out with the participation of 120 patients with a moderate form of true eczema. Using simple fixed randomization, all patients were divided into 4 groups. The first group (control, n=30) received only basic drug therapy, including the use of detoxification, hyposensitizing, antihistamines and topical glucocorticosteroids. Patients of the second group (comparison group 1, n=30) additionally underwent a course of supravenous laser irradiation of blood. In the third group (comparison group 2, n=30), broadband medium-wave phototherapy was performed against the background of basic therapy. Patients of the fourth group (main group, n=30) in addition to basic therapy received a course of combined exposure to supravenous laser blood irradiation and phototherapy. The concentrations of adrenocorticotropin, cortisol and beta-endorphin were determined in the blood of patients twice (before the start of treatment and 1 month after the start of therapy) using ELISA. The clinical condition of patients in the groups was assessed by changes in the EASI index. Additionally, we studied the dynamics of the level of reactive and personal anxiety using the Spielberger–Khanin questionnaire. RESULTS: Positive dynamics of adrenocorticotropin, cortisol and beta-endorphin were noted only in the comparison groups and the main group, which proves the high efficiency of correction of the neurohumoral status of patients through a course of complex use of supravenous laser blood irradiation and broadband mid-wave phototherapy. Quantitative changes in the assessed parameters during complex therapy with therapeutic physical factors indicate a supra-additive version of their interaction, realized through different modalities, points of application and mechanisms for realizing the biological potential of physiotherapeutic effects. CONCLUSION: The results obtained convincingly prove the effectiveness of an additional course of use of supravenous laser irradiation of blood in combination with broadband medium-wave phototherapy when correcting the neuroendocrine status in patients with true eczema. The close correlation between neurohumoral indicators and clinical and psychological patterns of the disease proves the pathogenetic significance of the studied neuroendocrine indicators, which allows us to consider their dynamics as informative criteria for the effectiveness of the treatment.
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