The dissertation research contains a rational approach to solving the problem, which involves elucidating new aspects of the pathogenesis and clinical features of rosacea and the development on this basis of comprehensive treatment of patients using angioprotective therapy.
The aim of the work is to increase the effectiveness of treatment of patients with rosacea through complex differentiated therapy based on the elucidation of the role of vasoactive mediators of prostanoid and neuropeptide nature.
As a result of a general clinical and laboratory examination of 107 women with rosacea, erythematous-telangiectatic stage of dermatosis was found in 43 (40.2%), papulopustular - in 64 (59.8%).
To implement the objectives of the study included 107 women with rosacea, aged 20 to 55 years with chronic recurrent disease of moderate severity and 30 healthy individuals, comparable in age and sex.
When studying the clinical features of rosacea among all 107 examined patients, it was found that the first and earliest clinical manifestation of dermatosis was the appearance of episodes of hot flashes (with local reddening of the skin and a feeling of moderate heat in this area) with a presence of 95 (88.8%) ) dysmorphophobia (which was diagnosed by the method of questionnaire survey, GV Bocharova-Marakhovskaya et al., 2010); At the same time, erythematous-squamous stage of the disease was more often observed in patients under 35 years of age (in 41 out of 43 - 95.3%), after 35 years - papulopustular (in 40 out of 64 - 62.5%).
In order to improve the treatment of patients with rosacea on the basis of their clinical and laboratory examination, a comprehensive differentiated method of treatment with a combined appointment of general and topical vasocorrective therapy was developed.
For general angiocorrective therapy in the system of complex treatment of women with rosacea, at the initial stage in addition to the standard therapy was prescribed a drug from the pharmacological group "Angioprotectors. Capillary stabilizing agents. Bioflavonoids » (Code ATX C05C A03) in the form of tablets "Flebodia" (registration certificate № UA / 8590/01/01 from 01.08.2018, Order № 1422/2; manufacturer "Innothera Chouzy", France) - orally 1 tablets a day in the morning before breakfast (the duration of the course did not exceed two months).
The effectiveness of the therapy was established based on the results of a follow-up evaluation after two months: clinical recovery and significant improvement after a differentiated method of treatment with a combination of general and topical vasocorrective therapy was observed in 87.1% of patients, which is significantly (p˂0.05) more often than the results of treatment of patients with rosacea who received only standard therapy 54, 2%).
The scientific novelty of the study is the use in the examination of patients with rosacea of а comprehensive study of angioregulatory biologically active compounds (neuropeptides, eicosanoids).
For the first time a complex study of angioregulatory biologically active compounds (neuropeptides, eicosanoids) was used in the examination of patients with rosacea.
For the first time in patients with rosacea, connections have been established between the clinical features of the course of dermatosis and the studied parameters of angioregulatory compounds.
For the first time a complex appointment of general and topical angiocorrective therapy was used in the system of treatment of patients with rosacea.
For the first time the mechanisms of influence of the developed complex treatment of patients with rosacea with the use of general and topical angiocorrective therapy on the studied indicators of angioregulatory compounds of the organism have been studied.
The practical significance of the obtained results is that a new method of treatment of patients with rosacea has been developed, scientifically substantiated and proposed, which consists in prescribing angiocorrective therapy (general - Phlebodia) and topical (darsonvalization), which provides 1.8 times more frequent clinical recovery and significant improvement compared to standard therapy, and in the long term - to reduce the recurrence rate by 1.7 times, which prevents further development of complications of the disease.
Thus, for the first time a differentiated method of treatment with combined appointment of general and topical vasocorrective therapy of rosacea with the use of the drug diosmin - "Flebodia" was developed and substantiated for vasoconstrictive action on venous and lymphatic tissue, also antiplatelet and anti-inflammatory action) and topical vasocorrection - a device for local darsonvalization "CROWN" (for drainage of the excretory ducts of the sebaceous and sweat glands, improving tissue respiration, normalization of the endocrine system at both peripheral and central levels).
