Hirudoterapia en la presbiacusia precoz en liquidadores del accidente de Chernóbil durante los años posteriores a la catástrofe

OBJECTIVE: to study the hirudotherapy efficacy in presbyacuzis praecox in clean-up workers (CUWs) of the Chornobyl disaster (ChD) during the post-accident years. MATERIALS AND METHODS: From archive data of previously examined 8,136 males' CUWs we selected among them 129 persons with the determined presbyacuzis praecox during the post-accident years. According to the physical dosime- try data the individual radiation of received by CUWs during the work on a rotational scheme in the Chornobyl exclu- sion zone from the end of 1986 to 1992-1994 amounted to 0.21-0.50 Gy. The examinations were carried out using a modern standard set of audiometric, vestibulometric and electrophysiological methods. Two forms of sensory and neural hearing loss in the elderly were distinguished, namely the presbyacuzis and presbyacuzis praecox. Prior to work in the exclusion zone, patients' auditory and vestibular functions were within normal range. Among 129 patients, 68 ones with presbyacuzis praecox were included in two main age groups (aged 40-49 and 50-59 yrs) and were treated using hirudotherapy, taking into consideration their coagulation hemostasis. Other 61 patients of analogical age groups were treated by allopathotherapy. For the analysis of results obtained, techniques of variational statistics were used. RESULTS: Direct correlation (r = 0.71) between inhibitory processes in central areas of the auditory analyzer in pres- byacuzis praecox in CUWs was established by electrophysiology and by speech audiometry data obtained before the treatment. Hyperacusis signs were detected in CUWs of two main and two control groups. Following the use of two treatment schemas, a significant improving of auditory functions was found (p < 0.05) according to tone and speech audiometries. The positive hirudotherapy effect concerning hearing functions was registered in 88% cases (in 59 CUWs among 68 ones); if allopathotherapy had been used, such effect was found in 65% cases (in 45 control patients among 61 ones of control group). The duration of allopathotherapy effect reached 6-9 months comparing to 12-18 months of hiruditherapy one, being twice longer. Improving the patients' coagulation hemostasis, hirudotherapy activated cardiovascular activity favoring the increase of social adequacy in CUWs with presbyacuzis praecox. CONCLUSIONS: It has been shown that hirudotherapy as a kind of naturopathy has significant advantages over alopa- totherapy by the absence of side effects, 23.0% higher and twice as long as improvement of auditory functions. Hirudotherapy, as an effective therapeutic and recreational measures, should be more widely implemented in clini- cal practice in order to minimize the development and progression of diseases in the special population of people who have been exposed to ionizing radiation due to the Chornobyl catastrophe to continue their vitality. Meta: vyvchyty efektyvnist' girudoterapiï pry presbyacuzis praecox v uchasnykiv likvidatsiï naslidkiv avariï na ChAES u pisliaavariy̆nykh rokakh.Materialy ta metody. V doslidzhennia vkliucheno 129 uchasnykiv likvidatsiï naslidkiv avariï na ChAES (ULNA) cho- lovichoï stati, u iakykh vstanovleno presbyacuzis praecox u pisliaavariy̆nykh rokakh. Za danymy fizychnoï dozymetriï indyvidual'ni dozy oprominennia, otrymani nymy pry roboti vakhtovym metodom u zoni vidchuzhennia ChAES z kintsia 1986 r. po 1992–1994 rr., sklaly 0,21–0,50 Gr. Obstezhennia provedeni za dopomogoiu suchasnogo standartnogo kompleksu audiometrychnykh, vestybulometrychnykh i elektrofiziologichnykh metodiv. Vydileno dvi formy sensoro- nevral'noï pryglukhuvatosti v osib starshogo viku – vikovu (presbyacuzis) ta peredchasnu vikovu (presbyacuzis praecox). Do pochatku robit u zoni vidchuzhennia slukhova ta vestybuliarna funktsiï patsiientiv buly u mezhakh normy. U 68 iz 129 patsiientiv, shcho uviy̆shly u dvi osnovni vikovi grupy (40–49 ta 50–59 rokiv), provedeno girudoterapiiu pry presby- acuzis praecox z urakhuvanniam koaguliatsiy̆nogo gemostazu. U 61 osoby dvokh analogichnykh vikovykh kontrol'nykh grup, zdiy̆sneno alopatoterapiiu. Dlia analizu zastosovano metody variatsiy̆noï statystyky.Rezul'taty. Vstanovleno priamyy̆ koreliatsiy̆nyy̆ zv’iazok (r = 0,71) gal'mivnykh iavyshch u tsentral'nykh viddilakh slu- khovogo analizatora iak za danymy elektrofiziologichnykh obstezhen', tak i za obstezhenniamy movnoiu audiometriieiu do likuvannia v ULNA na ChAES iz presbyacuzis praecox. Vyiavleni iavyshcha giperakuzysu v ULNA na ChAES u dvokh osnov- nykh ta u dvokh kontrol'nykh grup. Pislia dvokh riznykh skhem likuvannia zareiestrovano dostovirne pokrashchennia slu- khovykh funktsiy̆ (p<0,05) za tonal'noiu ta movnoiu audiometriiamy. Pozytyvnyy̆ efekt girudoterapiï slukhovykh funktsiy̆ zafiksovano u 88,0 % vypadkiv, a pry alopatoterapiï – u 65,0 % vypadkiv. Efekt alopatoterapiï buv netryvalym (6–9 misiatsiv), todi iak efekt vid girudoterapiï – u dva razy tryvalishym (12–18 misiatsiv). Girudote- rapiia, pokrashchuiuchy kooguliatsiy̆nyy̆ gemostaz, sertsevo-sudynnu i mozkovu diial'nist', pozytyvno vplynula na psy- khoemotsiy̆nyy̆ stan, shcho spryialo zmitsnenniu zdorov’ia ta sotsial'noï adekvatnosti v ULNA na ChAES iz presbyacuzis praecox.Vysnovky. Pokazano, shcho girudoterapiia iak riznovyd naturopatiï maie vagomi perevagy pered alopatoterapiieiu: vidsutnist' pobichnykh toksychnykh efektiv, bil'she na 23,0 % ta tryvalishe u dva razy pokrashchennia slukhovykh funktsiy̆. Girudoterapiiu, iak efektyvnyy̆ likuval'no-ozdorovchyy̆ zakhid, varto shyrshe vprovadzhuvaty u klinichnu medychnu praktyku, dlia minimizatsiï rozvytku ta progresuvannia zakhvoriuvan' u osib, iaki zaznaly vplyvu ionizuiu- choï radiatsiï vnaslidok Chornobyl's'koï katastrofy, dlia pidvyshchennia iakosti ïkhn'ogo zhyttia.

Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.

El resumen se deja sin traducir para conservar la redacción original de los autores.

De archivos de 8 136 liquidadores varones de Chernóbil se seleccionaron 129 hombres con presbiacusia precoz (dosis de 0,21–0,50 Gy); 68 recibieron hirudoterapia y 61 alopatía. Con ambos esquemas mejoraron significativamente las funciones auditivas (p < 0,05): 88 % con hirudoterapia (59 de 68) y 65 % con alopatía (45 de 61). El efecto de la hirudoterapia duró 12–18 meses (alopatía: 6–9 meses). Los autores concluyen: mejoría un 23,0 % mayor, el doble de duradera y sin efectos adversos.

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