Herbal enterosorbent effect in newly diagnosed destructive pulmonary tuberculosis management
Background. The search for pathogenetic therapeutic methods aimed at improving the immune status of a patient with tuberculosis without prescribing of specific immunomodulators is still relevant. This became the basis for the planning our research. Enterosorbents belong to safe preparations with immunomodulatory properties, influencing directly and indirectly the state of systemic immunity due to their detoxification effect. The purpose of the research was to study the effect of phytoenterosorbent on the values of systemic immunity and its effectiveness in the complex treatment of patients with newly diagnosed destructive pulmonary tuberculosis. Materials and methods. A randomized controlled trial involved 125 patients with drug-susceptible forms of tuberculosis with pulmonary destruction and without it and 25 healthy volunteers. The state of the humoral and cellular components of immune system, neutrophil and monocytic phagocytosis were studied. Besides the enterosorbent effect on the blood concentration of anti-tuberculosis drug isoniazid in patients was studied. Results. Use of herbal enterosorbent in complex therapy in patients with newly diagnosed destructive pulmonary tuberculosis did not affect the values of cellular immunity, but contributed to the normalization of its B-cell indices: a significant decrease in the number of CD22+ lymphocytes, IgG, IgA levels and circulating immune complexes in patient’s blood, normalization of phagocytic activity of phagocytic cells. The use of herbal enterosorbent in the complex treatment of tuberculosis patients did not lead to a decrease in the blood concentration of anti-tuberculosis drug іsoniazid in the patients, but rather increased it and did not contribute to the deterioration of adverse reactions due to isoniazid. Conclusions. Complex treatment of patients with newly diagnosed destructive pulmonary tuberculosis with the use of herbal enterosorbent resulted in leveraged treatment effectiveness by the rate of cavern healing by 21.4 %.
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