Mechanisms of additivity of physiotherapeutic factors in complex therapy of polypous rhinosinusitis complicated by comorbidities

Objective. To analyze the features of various physiotherapeutic complexes in the treatment of polypous rhinosinusitis, including those complicated by bronchial asthma and atopic dermatitis, by using the ideas of V.S. Ulashchik. Material and methods. The study included 90 patients with isolated polypous rhinosinusitis, as well as associated bronchial asthma (88 patients) and atopic dermatitis (67 patients). All patients received basic therapy and dupilumab (control group). Alternating magnetic field and low-intensity infrared laser were additionally used for polyposis rhinosinusitis. Bronchial asthma required additional interval hypoxia training, atopic dermatitis — phototherapy. All examinations were conducted before and 6 months after completion of each preventive course. Results. Favorable dynamics of clinical and biochemical markers of disease in case of combined physiotherapy for isolated polyposis rhinosinusitis averaged 51.1+1.45%, in concomitant bronchial asthma — 37.6+1.03%, atopic dermatitis — 60.6+2.82%. Synergism of therapeutic effects of combined physiotherapy for isolated polyposis rhinosinusitis was additive, in combination with bronchial asthma — subadditive, in combination with atopic dermatitis — superadditive. Conclusion. Our results allow us to assess the mechanisms of additivity of various preformed physical factors using coefficient of synergism. This can underlie new effective methods of combined physiotherapy for somatic diseases with emphasis on superadditive (mutually potentiating) combination of biological potential of each factor.