Complex physiotherapeutic technologies for various diseases

Objective. To evaluate the effectiveness and features of interaction between therapeutic physical factors in various diseases. Materials and methods. The studies enrolled 120 patients with skin involution following metabolic syndrome, 116 patients with peri-implantitis and 120 patients with true eczema associated with metabolic syndrome. For each disease, 4 groups of patients were identified: group 1 — basic treatment complex, groups 2 and 3 — additional procedures with physical factors, group 4 — combined physiotherapy in addition to basic complex. Skin involution required transcranial magnetic therapy and oxygen barotherapy, peri-implantitis — ozone therapy and mesodiencephalic modulation, true eczema — phototherapy and mesodiencephalic modulation. Effectiveness of treatment was assessed considering clinical manifestations, immunocompetent and microcirculatory-tissue systems, metabolic parameters, inflammatory reactions, indicators of oxidative stress, as well as synergy coefficients of physiotherapeutic factors and effectiveness of combined effect. Results. Combined physiotherapy has a clear advantage over basic treatment complex that is most evident in concomitant abnormalities (skin involution and true eczema following metabolic syndrome). In skin involution, dynamics of clinical and morphological parameters, as well as functional state of skin after combined physiotherapy differed slightly from that after basic treatment. At the same time, advantages of combined physical factors were obvious regarding other parameters. Combined physiotherapy was significantly superior to basic treatment complex for peri-implantitis and true eczema following metabolic syndrome. Interaction of therapeutic physical factors was more often supra-additive and additive, although subadditive synergism occurred in some cases (for example, clinical signs of disease and skin status in involution). Conclusion. Combined physiotherapy, especially in preformed physical factors according to their influence on specific pathological reactions of a particular disease and systemic mechanisms of pathological process and sanogenesis, underlies new more effective methods for treating diseases, especially in their comorbid course. Synergy coefficients of physical factors and effectiveness of their combined use allow us to re-evaluate the mechanisms of therapeutic action of combined physiotherapy.