Проктологічні захворювання та їх консервативне ліування

Анотація

Review of the literature on the problems of the occurrence of proctological diseases, in particular hemorrhoids, anal fissures, proctitis and paraproctitis, their prevalence, microflora, treatment with local drugs and prospects for the therapy of proctological diseases with local means based on essential oil. Hemorrhoids, anal fissures, proctitis and acute paraproctitis are among the most common diseases affecting people of working age. A combination of such diseases occurs in 20-25% of patients. Proctological diseases are of particular importance in the conditions of martial law in Ukraine. Military personnel on the front lines have problems due to untimely feeding, different climatic conditions, not always maintaining hygiene, heavy equipment loads, etc. disorders of the gastrointestinal tract can occur, which leads to the inconvenience of performing one's duties and their incapacity. Due to untimely application for qualified medical care, about 30% of patients require surgical intervention, while in the initial stages of the disease, there is a possibility of using conservative treatment. Pathogens that cause pathology of the mucous membrane of the rectum are most often staphylococci, streptococci, Escherichia coli and Proteus. Pathogenic microflora can penetrate into the pararectal tissue through the ducts of the anal glands, the damaged mucous membrane of the rectum, hematogenous, lymphogenous way, from the neighboring organs affected by the inflammatory process, with the subsequent development of a purulent process in the perirectal tissue and clinical manifestations of HP. The main and more common cause of the development of paraproctitis is considered to be damage to the anal crypt, which accounts for almost 90%. The microflora of the rectum, the skin of the perianal region has more than 20 transient and permanent types of microorganisms, mostly conditionally pathogenic. Paraproctitis can be caused by both non-specific microflora, which is in the rectum, and specific microorganisms. It was established that the microflora of the interstitial wound in patients with acute paraproctitis had a mixed character and a wide variability of sensitivity to different antibacterial drugs. Traditionally, local treatment of proctological diseases includes the use of suppositories and ointments that contain various active ingredients, such as local anesthetics, corticosteroids, antibiotics, and anti-inflammatory agents. The analysis of the pharmaceutical market of Ukraine indicates the absence of local drugs, the composition and action of which would correspond to modern pathogenetic ideas and approaches to the pharmacotherapy of proctological diseases, in particular, combined drugs in the form of suppositories, which effectively reduce inflammatory phenomena of the mucous membrane of the rectum and at the same time have an antimicrobial and analgesic effect. To solve the problem of conservative treatment of this group of diseases, the development of a drug based on essential oil of hops, which has a complex of biologically active substances, and in combination with non-steroidal anti-inflammatory drugs, is able to have a complex effect on the key links of the pathogenesis of their development and the main clinical manifestations.

Key words: proctological diseases, hemorrhoids, anal fissure, proctitis, paraproctitis, microorganisms, conservative therapy, essential oils.