Effectiveness of magnetoreflexotherapy combined with phytotherapy in the complex treatment of bronchial asthma in port workers of the city of Port Sudan (Sudan)

The dissertation examines the effectiveness of the combined use of magnetoreflexotherapy and phytotherapy in the complex treatment of bronchial asthma among port workers in the city of Port Sudan (Sudan). The work is situated at the intersection of rehabilitation medicine, pulmonology, and public health, and is prompted by the rising incidence of bronchial asthma in the Republic of Sudan, including among port workers, as well as by the limited accessibility of pharmacological therapy. The author compares isolated drug treatment with the combined application of pharmacological agents, magnetoreflexotherapy, and herbal preparations (Glycyrrhiza glabra, Plantago major, Mentha piperita), evaluates the dynamics of clinical indicators and external respiratory function, and carries out a pharmacoeconomic analysis of direct expenditure on medicinal agents.

The study relies on standardised instrumental methods of investigating external respiration and on a protocol of clinical monitoring of patients with mild and moderate severity of the disease. Particular attention is paid to the selection of acupuncture points, the composition of the phytotherapeutic collections, the preventive effect of repeated courses, and the possibility of reducing course doses of medicinal preparations when non-pharmacological methods are included.

Throughout the world, the incidence of bronchial asthma is increasing despite the health-care programmes being implemented. Epidemiological studies carried out in different countries of the world have revealed a general pattern in the morbidity of bronchial asthma. Scientific projections indicate that in each subsequent decade the number of patients will rise by 1-2%. Bronchial asthma (BA) is a chronic inflammatory disease of the airways in which many cells and cellular elements play a role. Chronic inflammation causes an associated increase of airway hyperresponsiveness, leading to recurrent episodes of wheezing, breathlessness, a feeling of tightness in the chest, and coughing, particularly at night or in the early morning.

These episodes are usually associated with widespread and variable bronchial obstruction that is reversible, either spontaneously or under the influence of treatment [GINA, 2002].

Bronchial asthma is among the most common human diseases (5-8% in the general population). In many countries of the world, including Russia, statistics indicate a continuing tendency towards an increase in morbidity, disability, and mortality caused by BA [Chuchalin A.G., 2002].

For example, in Great Britain mortality over the past 20 years has increased sevenfold, in North America two- to threefold, and in Russia over the last years of the twentieth century twofold [Ovcharenko et al., 2003].

In terms of its relative weight, BA currently accounts for more than 50% of all allergic diseases and 25% of the total number of pulmonary diseases [Clinical guidelines. Chuchalin A.G., 2002].

The same tendencies are observed in the Republic of Sudan. However, because of the local conditions of life in the republic, obtaining complete statistical data is very difficult. This is promoted by the nomadic way of life of a considerable part of the population, military actions taking place on part of the territory of the state, the low commitment of the population to systematic treatment, and the substantial, by the standards of the population's level of living, material expenditure on drug treatment. According to the far from complete data obtained in approximately the same population of the city of Port Sudan, the incidence of BA increased from 0.5% in 2001 to 0.9% in 2003. Among port workers, the incidence increased during the same period from 0.9% to 1.5%.

In this connection, all investigations aimed at selecting the most comprehensive and rapid methods for treating exacerbations of BA in inhabitants of the Republic of Sudan and at preventing them with low financial expenditure are unquestionably topical.

No investigations have hitherto been conducted concerning the choice of treatment for patients with bronchial asthma, the prevention of exacerbations of this disease, and their optimisation under the specific conditions of life in the Republic of Sudan.

AIM OF THE STUDY:

To investigate the effectiveness of treatment and prevention of exacerbations of BA with the combined use of pharmacological agents, magnetoreflexotherapy, and phytotherapy in comparison with isolated drug treatment, and to optimise the method of combined treatment of BA in port workers of the city of Port Sudan (Sudan).

OBJECTIVES:

1. To determine the effectiveness of the combination of acupuncture points in magnetoreflexotherapy of bronchial asthma.

2. To investigate the effect of Glycyrrhiza glabra (licorice), Plantago major (greater plantain), and Mentha piperita (peppermint) on the treatment of bronchial asthma.

3. To study the influence of magnetoreflexotherapy and phytotherapy added to drug treatment in patients suffering from bronchial asthma of mild and moderate severity.

4. To evaluate the changes in external respiratory function under the influence of magnetoreflexotherapy and phytotherapy added to drug treatment of bronchial asthma.

5. To calculate the reduction in direct expenditure on medicinal agents for the therapy of bronchial asthma when magnetoreflexotherapy and phytotherapy are included.

SCIENTIFIC NOVELTY.

For the first time, investigations have been carried out on the effectiveness of drug treatment of BA under conditions of shortage of medicinal agents when used in different combinations with magnetoreflexotherapy and phytotherapy. Evidence has been obtained of the effectiveness of such combined treatment in mild and moderate severity of the disease. The economic effectiveness of combined treatment of BA has been evaluated.

Main propositions put forward for defence.

1. Magnetoreflexotherapy and phytotherapy added to drug treatment of bronchial asthma in port workers of the city of Port Sudan (Sudan) enhance the broncholytic effect.

2. Combined therapy of bronchial asthma makes it possible to obtain the same, and sometimes a greater, therapeutic effect than with more intensive isolated drug therapy.

3. In port workers of the city of Port Sudan with bronchial asthma of mild and moderate severity, in combination with drug treatment phytotherapy is more effective in the treatment of the moderate form of the disease, while magnetoreflexotherapy is more effective in the treatment of patients with mild bronchial asthma.

4. Repeated courses of rehabilitation medicine (once every six months) exert a preventive influence on exacerbations of the disease, which is more pronounced when magnetotherapy and phytotherapy are used together.

5. Magnetoreflexotherapy and phytotherapy added to drug treatment of patients suffering from bronchial asthma of mild and moderate severity allow these methods to be used more widely in bronchopulmonary pathology and also make it possible to reduce course doses of medicinal agents and the direct expenditure on their use.