Effectiveness of therapy for patients with chronic acalculous cholecystitis based on the comprehensive use of therapeutic physical factors

Purpose of the study: to evaluate the effectiveness of the combined use of therapeutic physical factors (amplipulse and general magnetic therapy), as well as manual therapy in the treatment of patients with chronic acalculous cholecystitis. Material and methods. The study involved 125 patients with chronic biliary tract obstruction aged 31 to 60 years with a disease duration of 12.5±0.19 years. Using the simple fixed randomization method, all patients were divided into three proportional groups. Patients in the control group (n=42) received standard therapy according to the corresponding protocol. Patients in the comparison group (n=41) received standard therapy supplemented with manual interventions aimed at restoring the mobility and motility of the hepatobiliary system organs. Patients in the main group (n=42) additionally received a course of combined physiotherapy in the form of amplipulse and general magnetic therapy. Evaluation of clinical efficacy in the selected groups was carried out based on the dynamics of the severity of subjective signs of chronic biliary tract obstruction, laboratory parameters of duodenal intubation and biochemical blood parameters characterizing the state of the hepatobiliary system. Results. It has been established that, compared with standard therapy, the combined use of hardware physiotherapy methods and massage procedures significantly increases the effectiveness of treatment, which is manifested in a significant (more than 1.5 times) decrease in the severity of clinical symptoms of the disease, a decrease in bile lithogenicity by 45 %, an increase in the contractile function of the gallbladder by 24 %, with a decrease in the level of cholesterol in bile by 21 % and an increase in the concentration of cholecystokinin in the blood by 31 %. Correlation analysis showed that cholecystokinin claims the role of a kind of center of the correlation galaxy of pathogenetic reactions of chronic acalculous cholecystitis. The use of statistical analysis of predictors made it possible to reveal that the effectiveness of complex physiotherapy increases in younger patients and with a shorter duration of the disease, as well as with higher values of cholecystokinin in the blood and a reduced potential for lithogenicity of bile. Conclusion. Supplementation of the standard protocol for the treatment of chronic acalculous cholecystitis with methods of combined hardware physiotherapy in the form of amplipulse and general magnetic therapy is accompanied by the development of a pronounced clinical effect, confirmed by the dynamics of clinical and laboratory parameters.