Koshukova G. Pathogenetic grounding for use of therapeutic physical factors for patients with rheumatoid arthritis at the outpatient phase

Research object: 412 patients with rheumatoid arthritis. Purpose: To study the features and to give pathogenesis substantiation of the therapeutic physical factors use in rheumatoid arthritis (RA) on an outpatient phase of treatment. Methods: Clinical, laboratory-biochemical, immunofermental, functional, questioning, statistical. Theoretical and practical results: It is shown that even in a period of small clinical manifestations the RA revealed expressed disorders in interaction processes regulation in the form of their function high effort and significant inconsistency of their structural subsystems activity. Disorders of the central mechanisms of regulation humoral components in the form of opioid peptide ?-endorphin production failure are established, a significant imbalance of vegetative nervous system is revealed, the existence of the thyroid and hypophysial -adrenal regulation disorders are demonstrated. Disorders of regulatory mechanisms depend on the period of the disease and the degree of inflammation activity. It was also shown the existence of significant disorders of the humoral immune system and expressed nonspecific autoimmune reaction, even in the absence of clinical signs of inflammation (remission phase), significant vegetative dysfunction and patients emotional disturbances, significant disorders of peripheral circulation, the adaptive capacity of RA patients at the outpatient phase of treatment reducing. It was demonstrated that all of these disorders depend on the degree of inflammation activity and the disease lingering. There were studied the mechanisms of action and defined the results of physical therapeutic factors: bioresonance stimulation of system (the adrenal glands region) and local (the joints zone) activity, electric sleep therapy and low frequency magnetic therapy action on RA patients Novelty: For the first time the state of the main regulatory systems (endorphins system, the vegetative nervous system, thyroid and hypophysial-adrenal system) on a background of basic disease-modifying drugs regular intake in RA patients was studied, and their importance in the pathogenesis of the disease, including dependence of its course duration and degree of inflammatory activity was demonstrated. For the first time the effect of physical therapeutic factors on regulatory mechanisms in RA patients was studied and their favorable influence on the regulatory system that was manifested in the establishment of their activity coordination with the transition to the physiological functioning regime was shown. It was proved the methods of physiotherapy, which influence on the regulatory mechanisms in RA patients in addition to the basic standard medical therapy clinical advisability. Efficiency: The use of therapeutic physical factors in addition to the basic medication improves patients quality of life on 8.88-11.97%, whereas, the simulating of these physical factors use improves the quality of life only on 1.10%. The degree of implementation: Articles, abstracts, patents, inclusion in the educational process of higher medical education. Sphere, sector of implementation: Medicine.