Oxidative stress and dynamics of its patterns following therapeutic physical factors in complex therapy of vasomotor rhinitis

Objective. To evaluate severity of oxidative stress and dynamics of lipid peroxidation in patients with VR undergoing postoperative therapy (pulsed low-intensity laser therapy in the infrared range and transcranial electrical stimulation) after cold plasma coblation. Material and methods. The study involved 137 patients with vasomotor rhinitis. All patients underwent cold plasma coblation of cavernous plexus of inferior turbinates. Basic postoperative therapy (BT) in all patients included irrigation of nasal cavity with saline solution and nasal cavity toilet. All patients were randomized into 4 groups. The first group (control, n=34) received only BT, the second group (comparison group 1, n=35) — BT and low-intensity laser therapy in the infrared range, the third group (comparison group 2, n=34) — transcranial electrical stimulation along with BT, the fourth group (main, n=34) — low-intensity laser radiation combined with transcranial stimulation. We assessed severity of oxidative stress considering serum primary and secondary lipid peroxidation products, as well as activity of antioxidant enzymes in erythrocytes. Quality of life in patients with VR was determined using the SNOT-22 questionnaire. Results. At baseline, high content of lipid peroxidation products under reduced activity of antioxidant enzymes in patients with vasomotor rhinitis indicates oxidative stress. Correlation analysis of oxidative stress and SNOT-22 scores additionally confirmed involvement of lipid peroxidation patterns in pathogenesis of vasomotor rhinitis. Low-intensity laser therapy and transcranial stimulation after cold plasma coblation decreased accumulation of peroxide metabolism products (more pronounced for low-intensity laser radiation). Maximum corrective effect on system of pro- and antioxidants was revealed for laser therapy combined with transcranial stimulation. An integrated physiotherapeutic approach contributed to significant decrease in concentration of lipid peroxidation products by 31—34% and increase in antioxidant enzymes by 33—69%. Conclusion. Clear corrective effect on lipid peroxidation processes is observed for a complex of low-intensity laser therapy and transcranial stimulation. Significantly higher efficiency is based on phenomenon of potentiation following a combination of factors with different modalities and mechanisms for realizing their biological potential.