Лікування герпетичного стоматиту (клінічне спостереження)

Abstract

У статті розглядаються загальні питання герпетичної інфекції, симптоматика її проявів у порожнині рота та принципи лікування герпетичного стоматиту. Показана позитивна динаміка клінічних проявів ГС у хворих, які додатково до основної терапії отримували інозин пранобекс (зменшення больового синдрому, симптомів стоматиту, лімфаденіту і покращення епітелізації ерозій). Наведений клінічний випадок лікування герпетичного стоматиту середнього ступеня тяжкості із застосуванням препарату інозиту пранобексу у комплексній фармакотерапії; В статье рассматриваются общие вопросы герпетической инфекции, симптоматика ее проявлений в полости рта и принципы лечения герпетического стоматита. Показана положительная динамика клинических проявлений ГС у больных, которые дополнительно к основной терапии получали инозин пранобекс (уменьшение болевого синдрома, симптомов стоматита, лимфаденита и улучшение эпителизации эрозий). Приведен клинический случай лечения острого герпетического стоматита средней степени тяжести с применением препарата инозина пранобекс в комплексной фармакотерапии; Herpetic infection occupies an important place among viral diseases. This can be explained by the prevalence of the herpes simplex virus (HSV), its persistence, the recurring course of the disease and the resistance to various therapeutic measures. Aim of the study. Determine the effectiveness of the drug inosine pranobex in the complex therapy of herpetic stomatitis. Object and methods of research. 73 patients with Herpetic Stomatitis were under observation (2012-2017), aged 18 to 54 years (31 men and 42 women) with the following clinical forms of lesions: primary herpetic stomatitis was observed in 21 persons (28.8%), recurrent herpes of the oral cavity – 37 people (50.7%), recurrent labial herpes – 15 people (20.5%). The duration of the disease was from 6 months to 8 years. Verification of the diagnosis was made on the basis of the history, clinical and laboratory data: the results of DNA polymerase scraping from elements of the rash on the Simple Herpes Virus in all patients and the results of serological tests for the presence of specific IgM and IgG antibodies to HSV-1. Pharmacotherapy of patients with Herpetic Stomatitis included etiotropic, pathogenetic and symptomatic treatment, both general and local. The patients were divided into 2 groups. The first group (30 patients – 41.09%) received standard therapy, the second group (43 patients – 58.91%) additionally received inosine pranobex 1000 mg 4 times a day for 7 days to the main therapy. Results and its discussion. Patients of the second group had more positive dynamics of clinical manifestations of Herpetic Stomatitis, reduction of pain syndrome, intoxication, general weakness, symptoms of gingivitis, stomatitis. The temperature normalized in the first group on the third-fourth day in 27 patients (90%), whereas in the second group it was in 42 patients (95.34%) on the second-third day. Epithelization of erosions of the oral mucosa in patients of the first group was on the sixth-seventh day, in the second group it was on the fourth-fifth day. Complete recovery occurred in the second group three days earlier than in the first group of patients. Clinical case. Patient K., 31 years, of age came to the therapeutic department of the dental clinic with complaints of pain and rash on the skin and lips, temperature rise to 38°C, general weakness. Bubbles, erosions, crusts on the mucous membrane of the red border and the skin around the lips, on the cheeks, firm palate during examination were detected. The mucous membrane was hyperemic, edematic, painful on palpation. Submandibular nodes enlarged, weakly painful. The diagnosis was made on the basis of data of anamnesis, clinical and laboratory studies: acute herpetic stomatitis of moderate severity. The first three days of treatment, based on acyclovir, did not have a positive clinical dynamics. The patient refused acyclovir, and inosine pranobex was prescribed 1.0 g 4 times a day for 7 days against the background of the main therapy. Conclusions. The drug inosine pranobex showed excellent clinical efficacy in the complex therapy of Herpetic Stomatitis and can be an alternative to acyclic nucleosides for treating patients with viral mucosal lesions of the oral cavity. Prospects for further research. We consider it important to prescribe inosine pranobex in the treatment of patients with viral infections of SAD.