Dissertation for the degree of candidate of medical scients, specialty 14.01.33. medical rehabilitation, physiotherapy and resort therapy. Shypyk National Medical Academy of Postgraduate Education, Kiyv, 2017. Aim: The goal of the study is to improve the diagnosis and rehabilitation of patients with hemorrhagic stroke in late regenerative period by applying the complex, phased rehabilitation, which is based on the results of clinical and laboratory testing with the diagnostics of nucleic acid metabolism. Methods: We investigated the effectiveness of rehabilitation using naturopathic treatments, such as: hirudotherapy, apitherapy, acupuncture and manual therapy on 66 patients suffering from the effects of hemorrhagic stroke at the end of the recovery period. For objectification of these studies we used rating scales, which are used at the beginning of treatment, in the first and third months of rehabilitation. The evaluation of neurological status was performed on the stroke scale of National Institute of Health (NIHSS), the increasing muscle tone - on the modified scale of Eshfort (MAS). The dynamics of the functional state of patients was assessed on Rankine scale, activity index in everyday life - on Bartel, cognitive function on the scale of Mini-Mental State Examination (MMSE), psycho-emotional state was assessed on the Beck and Montgomery-Asberg depression scale (MADRS). In the study we determined the level of nucleic acids (DNA, RNA) and the activity of acid and alkaline nucleases in serum at the beginning, after the first month and at the end of treatment. Results: When in restorative treatment the multidisciplinary approach (medical, physical, social, professional, labor and psychological rehabilitation) was used together with non-drug products (apitherapy, acupuncture, manual therapy and hirudotherapy), the results in the study group,compared to the control group, were significantly better by the Bartel index (depending on others; P<0,001), MMSE scale (cognitive functions; P<0,001), by the scales of psycho-emotional state diagnosis of Montgomery-Asberg (P<0.001) and Beck (P<0,01). These, with positive dynamics, scales can be considered as the performance criteria for rehabilitation in patients with parenchymal hemispherical hemorrhagic stroke in the late recovery period. During the prescribed rehabilitation we observed: the reduction of DNA concentration is more pronounced in patients of the main group (P<0.01), the reduction of the amount of RNA in serum after 3 months treatment - in patients of the main group, compared with the growing rate of the comparison group patients (P<0.001). During the treatment of the main group, their DNA-ase I, II, RNA-ase I, II of the serum were significantly decreased (p<0,05-0,001), in the control group DNA-ase I significantly decreased (p<0.001), while DNA-ase II, RNA-ase II increased (p<0,01-0,001) and RNA-ase II did not change (p<0.05). After the treatment, the level of DNA-ase I was significantly greater in the main group than in the control (p<0.001). DNA-ase II, RNA-ase I, II were significantly lower than in the serum of patients in the control group (p<0.001). Summary: The purpose of the rehabilitation program using non-drug therapies for patients suffering from the effects of hemorrhagic stroke in late recovery period improves the overall functional performance state of patients , reduces spasticity of the affected muscles and disability, improves the psycho-emotional state of the patient.
