Vishnevsky B. Pathogenetic substantiation of principles of stepped restorative treatment of the patients with arthrosis (clinico-experimental investigation)

Dissertation includes 2 parts - experimental and clinical investigations. In model experiments on 223 animals (rats, Vistar line) with knee joint arthrosis with and without synovitis the new data on mechanisms of laser irradiation impact, electromagnetic waves of milimetric range as monotherapy or in combination with nonsteroid antiinflammatory drugs (NSAD) or with osteoisys chronomodulator are obtained. Physico-pharmacologic treatment complex strengthens therapeutic effect which is manifested in prevailing of restorative processes and controling of destructive ones. On the basis of these data for the arthrosis patients a therapeutic-restorative complex which includes laser irradiation,UHF-therapy, balneotherapy and their combination with NSAD, a preparation of chondromodulating action of osteoisy, alphlutop medicine and hyaluronic acid was formed. In clinical investigation on 463 patients with arthrosis, stage I, II, III in the period of a relative remission the signs of chronicity of pathologic process are revealed. The presence of disbalance in functioning of oxidant and antioxidant systems is determined to be accompanied with the increased level of lysosomal ferments. This enables to prognosticate instability of therapeutic effect, a short period of remission, chronicity and disease progressing, dictates the necessity of repeated treatment courses. The realization of three-stepped or two-stepped restorative treatment allows to achieve a stable remission period from 6 to 12 months.