The thesis contains theoretical generalization of the study results and achieves a modern solution of an urgent research task in the area of clinical medicine, in particular, medical rehabilitation, physiotherapy and balneology, is to improve the efficiency of treatment of patients with coronary heart disease due to the simultaneous application of ω-3 PUFA and combined magnetotherapy on the main pathogenetic links of the disease.
It is shown that the use of the protocol complex for patients with stable angina pectoris significantly and quickly enough (end of week 1 - the beginning of the second week) improves the main indicators of the clinical course of the disease (reduction of angina attacks, hypertension and signs of CHF). At the same time, it should be noted that the effect of antianginal drugs in the future (from the third week) is exhausted and becomes unchanged, hypotensive - insufficiently stable, because it is accompanied during the next 2 months of observation with periodic rise of blood pressure, as well as signs of CHF, which in some patients decrease, but not eliminated completely. All of this, in general, improves the quality of life of patients, but at an insufficient level.
It has been established that the use of atorvastatin in the protocol therapy at a daily dose of 20 mg is accompanied by a significant reduction in the level of the most atherogenous lipid fractions (TC, LDL), but they do not reach the target levels, and there is no observed effect on TG and HDL. Also, the indicated drug complex has virtually no effect on coagulation hemostasis, the processes of violated LPO and AOS, and the influence on the variability of the heart rate has a positive but weak effect.
It has been proven that the use of ώ-3 polyunsaturated fatty acids (ώ-3 PUFAs) is associated with further decrease in the number of angina attacks (week IV-VI), but this effect is mild and not caused directly by antianginal action. Considerably higher ώ-3 PUFA effect on hypertension (especially systolic blood pressure) and chronic heart failure is noticed, which finally results in some improvement in the quality of life, yet not sufficient enough to achieve normative parameters.
It is proved that use of ώ-3 PUFA in the protocol complex is accompanied by a further decrease in the amount of nitrates (IV-VI weeks), but the effect is weak and not due to antianginal effects. Significantly greater effect is observed in ώ-3 PUFAs for hypertension and CHF, which, in the end, leads to some improvement in the quality of life, however, not to normative indicators.
It has been established that ώ-3 PUFAs have a complex hypolipidemic effect on all atherogenic fractions, including TG (except for HDL), significantly reduce fibrinogen levels, and also have a pronounced antioxidant effect on the LPO and a particularly non-enzymatic link of AOS (SS and SH groups). At the same time there was only a tendency to leveling the vegetative imbalance, however, the effect was weak and unstable.
It has been proven that the use of magnetotherapy with two types of different magnetic fields with concomitant use of ώ-3 PUFAs allows achieving the reliable maximal effect on many IHD manifestations, in particular: decrease of attacks (since week II till the end of follow-up period – week VIII), more considerable decrease of hypertension and chronic heart failure signs, increase of quality of life, improvement in levels of all lipid fractions including HDL to the target ones, higher hypocoagulative and antioxidant effect, as well as correction of affected vagosympathetic balance.
It was shown that the addition of MT to ώ-3 PUFAs on the background of the traditional drug complex allows for positive effects on the pathogenetic links of stable forms of CHD that have not been observed for a specific effect of ώ-3 PUFAs, namely: significant antianginal effects are observed, as a result of which the quality of life indicators increase significantly, increase in HDL and correction of disturbed vegetative provision.
It is proved that the use of magnetotherapy with two types of different magnetic fields simultaneously with ώ-3 PUFAs on the background of traditional therapy is accompanied by optimal positive effects, namely: reduction of the number of angina attacks (from the second week to the end of the observation period - VIII weeks), more reduction of signs of CHF and hypertension, improving the quality of life, improving all lipid fractions, including TG and HDL, the largest hypocoagulant and anti-oxidant effects, as well as correction of disturbed vagosympathetic balance.
The method of simultaneous use of omega-3 PUFA and magnetic therapy, aimed at increasing the effectiveness of treatment of patients with stable forms of CHD, has been developed and introduced into the practice of public health care.
