DIAGNOSING AND TREATMENT BY MEANS OF A NEW INTEGRATIVE
Atopic dermatitis (AD) is a chronically relapsing disease with genetic predisposition. Its manifestation leads to development of a specific skin affection and peculiar general symptoms, particularly, severe, easily triggered itching. Continuously growing frequency of AD and transforming of AD to other forms of atopy, particularly, atopic asthma, broncho obstructive syndrome, allergic rhinitis, etc., make it a pressing problem to find new approaches to differential diagnostics and treatment of AD.
AT is determined by multiple factors. Genetic factors, for instance, certain genes of chromosomes 11(11q13) and 5(5q31,1) stipulate ice hyperproduction, genetic markers "LA" in males ,"LWA" phenotype and A2B8 haplotype in females facilitate AD transformation to other atopic conditions, at the same time, exogen factors (food, physical and emotional stress, helio and geomagnetic factors, weather unfavorable changes, pharmacological agents, etc.) are extremely important for realization of the genetic predisposition to AD development and relapse. Accordingly to our own data, food and certain drugs can cause intensive histamine liberation while rapid change of weather and helio and geo physical factors cause choline ergic index increasing.
The purpose of the research was clinical trial for revealing and developing a principally new and highly effective combined method of AD therapy
DIAGNOSING AND DIFFERENTIAL DIAGNOSING
AD cybernetic modeling and a special diagnostic and differential diagnostic programs for AD diagnosing were developed. International British Classification on AD (1994) were taken as criteria for AD diagnosing, the severity of AD was assessed by means of international scale system - SCORAD. The computer program analyzed all data regarding each patient, weather meteo geo physical parameters and calculated weather pathogenesity index for each patient every day.
RESEARCH MATERIAL AND METHODS
89 patients (4-49 years old, 44 M, 45F) took part in the research. The history of AD in patients was from 6 months to 17 years. 97% of all patients from time to time had taken different medications (H1 histamine inhibitors, oral and topical glucocorticoids, immunomodulators, etc.)for controlling their AD. In 11,5% of the patients such treatment had caused paradoxical effects, exacerbating the disease, in the rest patients the treatment had provided predominantly short term remission and moderate positive clinical effect.
In all patients before and after our new kind of therapy blood histamine, cholinestherase, acetyl choline, cyclic AMP and cyclic GMP were measured. This therapy included different modes of laser irradiation combined with oral and applied photo modulating plant medications. All patients were randomly distributed to three clinical groups. The first group of patients took external laser therapy (ELT) with phytoapplication; the second group took intravenous laser therapy (ILT) with phytoapplication; the third group received simultaneously ELT and ILT combined with phytoapplication (EILT). In ELT He-Ne (10-50 mWt) and nitrogen (0,5-1,0 mWt) lasers were used, ILT was performed by means of He-Ne laser (1 mWt) and disposable intravenous fiber optic catheter. The number of treatments in all groups was determined by AD severity, age, sex, body weight, individual sensitivity and response to laser exposure and phyto application, etc. was in range of 10-17 procedures. During the treatment the diet was modified for providing optimal for laser therapy pH organism's pH, patients' chronobiological rhythms, chronotherapeutical consideration were taken into account as well. The control group included 31 patients suffering from other than AD skin diseases (contact dermatitis, seborrheic dermatitis, etc.).
.THE RESULTS AND DISCUSSION
The results of clinical trial demonstrated the effectiveness of Integrative laser therapy combined with phyto application in all three groups of patients, but the therapy results were best in EILT group received external + intravenous laser therapy combined with phytoapplication. The result of EILT was clinically impressive and surpassed the results of ELT and ILT combined therapy. All three modes of integrative therapy were safe and have no significant by effects. During the clinical trial multi factor analysis of other influencing factors showed that practically all of them are able to modulate the course of the disease.
The data of the research revealed the importance of diet and showed that certain kinds of food (citrus fruit, some mushrooms, strawberry, some fishes, chocolate, etc), antibiotics, medications, food dyers and flavorers were powerful liberators of histamine. These histamine liberators were ranged accordingly to their ability to provoke histamine liberation. Also were revealed and ranged IgE production stimulating atopens, particularly, air allergens, home dust, home acatofauna (Dermatophagoides pteromyssimus), bacterial and viral factors, etc. Weather meteo pathological factors demonstrated their capacity to influence the course of AD and other skin diseases as well. Rapid change of geo magnetic field (magnetic storm), cyclone and anti cyclones (abrupt change of atmosphere pressure), the sun activation, the air components proportion change were the factors that also significantly modulated AD course, particularly, rapid change of geo magnetic field caused AD deterioration by means of cholin estherase activity dwindling, increasing of histamine production and acetyl choline and cGMP activity, decreasing cAMP activity and cAMP/cGMP proportion. Intestinal dysbacteriosis and digestive tract abnormalities and dysfunction played a role of a background co-factor.
1. Laser therapy combined with phyto application is an effective method of treatment of AD. Accordingly to preliminary results of randomized open trial, combined external and intra venous laser therapy with phytoapplication is the most effective mode of trialed Integrative therapy.
2. For achieving best results in treatment of AD and prevention of its relapses some AD causative exo- and endogen co-factors (food, drugs, allergens, pollutants, weather and helio geomagnetic factors, etc.) should be controlled and corrected.
FURTHER DEVELOPMENT OF THE RESEARCH
Extremely promising preliminary results of AD treatment by means of Integrative therapy (LT + phyto application) make it reasonable to continue accumulating data regarding effectiveness of Integrative therapy by means of randomized double blind placebo controlled trial. It is also reasonable to use for effectiveness comparison with the Integrative therapy a control group receiving the most effective up-to-date therapy of AD. On bio chemical and bio molecular levels Ca-calmoduline, NO-synthase, complement - (C5alpha), IL-1-6-8, T-immunity cells (T-killer, T-helper, TNF) should be studied.