Movement without pain: the use of NSAIDs in rheumatology.

For many people over the age of 50 pain in the joints become an unpleasant everyday reality - a person full of strength and energy is forced to limit his activity, abandon his usual activities and work. It becomes too difficult to play with the grandchildren, take care of your favorite garden, make time for seasonal hobbies (fishing, hunting, picking mushrooms). Morning awakenings are excruciating and painful, because stiffness and discomfort in the joints are especially noticeable after sleep.

Is there a drug that can fight pain, return the joy of movement and does not have a negative effect on the body with prolonged use? Anti-inflammatory drug Artrofoon from the company "Materia Medica" meets all these requirements.

Addresses the cause of pain

Joint pain indicates inflammation.

Artrofoon reduces the production of pro-inflammatory cytokines, inflammatory mediators that increase inflammation in the tissues of the joint. Thanks to this, the drug not only reduces pain, it eliminates the very cause of pain - the inflammatory process.

Can be used for a long time

Joint pain associated with age-related changes, are chronic, periodically exacerbate and require long-term treatment. And the use of traditional anti-inflammatory drugs (NSAIDs) has limitations on the duration of use due to an increased risk of unwanted side effects. Artrofoon has no such restrictions. Moreover, it is just recommended for long-term course treatment - Artrofoon allows you to achieve stable remission and forget about pain for a long time during rheumatoid arthritis, osteoarthritis and other inflammatory and degenerative diseases of the joints.

Can be combined with other drugs, incl. with NSAIDs and chondroprotectors

Joint diseases in older people are often not the only pathology. For treatment concomitant diseases(diabetes, hypertension, etc.) they have to use many other drugs that are sometimes not combined with drugs for treatment joint pain. With Artrofoon you can not be afraid drug interaction. It can be combined with any other medication prescribed by your doctor. Moreover, during an exacerbation of joint disease, it can be used against the background of NSAID treatment - to accelerate the onset of the effect, and after the symptoms disappear - alone or in combination with chondroprotectors to prolong the remission period.

Convenient to apply

Artrofoon is available in the form of lozenges. It does not need to be taken with water and can be taken anywhere. The regimen is also very simple - 2 tablets in the morning and 2 tablets in the evening.

During the period acute pain it is allowed to take up to 4 times a day (as part of complex therapy). Artrofoon is released in pharmacies without a doctor's prescription and is quite reasonable.

Improving methods treatment of joints and bones remains one of the main directions of modern medicine.

In terms of prevalence, diseases of the musculoskeletal system are in third place after diseases of the circulatory and digestive organs. In the structure of primary disability, they occupy the second place. In terms of temporary disability, they are in first place. What explains the fact that by the age of 50 almost every second person needs treatment of joints and bones.

There are several factors contributing to the development of osteoarticular diseases:

Traditional doctors pay little attention infectious cause bone diseases and articular. Basically, attention is drawn to the rheumatic, i.e. streptococcal nature. By the way, thanks to antibiotics, rheumatic bone diseases have given way to other infections.

Inflammatory arthritis includes: infectious arthritis, rheumatoid arthritis, gout, reactive arthritis. They are associated with inflammation of the synovial membrane - a thin film connective tissue lining the joint from the inside.

Degenerative arthritis includes: osteoarthritis, traumatic arthritis. These diseases are associated with damage to the articular cartilage that covers the ends of the bones at the point of their articulation.

Arthritis is characterized by pain in the joint, especially when moving, often there are restrictions on its mobility, swelling, change in shape, sometimes the skin over the joint turns red and fever appears. Symptoms of infectious arthritis are redness, swelling, pain when pressed, often observed general symptoms infectious disease- fever, chills, pain throughout the body. There are arthritis of one joint (monoarthritis) and many (polyarthritis). The main symptoms of arthrosis are: severe pain in the joint, decreased joint mobility. In the case of neglect of arthrosis, joint immobility occurs.

Arthrosis of the spine. Ankylosing spondyloarthrosis (Bekhterev's disease) leads to a limitation of the motor capabilities of the spine due to the connection, i.e. accretion, some joints. The results of the X-ray examination reveal that the spine, prone to arthrosis, looks like a bamboo stick.

AT last decade the frequency of arthritis caused by chlamydia has increased significantly. They often begin to develop in people treated with antibiotics for genital chlamydia. A new infection of the joints appeared - ureaplasma. Gonorrhea, tuberculosis, brucellosis, toxoplasmosis cause prolonged arthritis, quickly leading to arthrosis, limited mobility and disability.

It should be noted that arthritis often develops, and infection laboratory methods is not revealed. It can be hidden gonorrhea, atypical tuberculosis, ureaplasmosis, brucellosis, toxoplasmosis, fungi. Not identifying the cause of the disease skeletal system, traditional doctors conduct non-targeted treatment, therefore acute arthritis move into chronic stages and are complicated by arthrosis.

Clinical example: a 56-year-old patient came with pain in the right hip joint, limited mobility. The patient came leaning on a crutch. I have been ill for 2 years already, blood tests did not show any infection.

The most diagnosed group of diseases today is diseases of the joints. According to WHO (World Health Organization) statistics, joint diseases are in third place in terms of prevalence after diseases of the circulatory and digestive systems. According to studies, various joint lesions occur in every fourth inhabitant of Russia. And among people over 60, 97% of people complain of joint pain.

Doctors note that joint diseases have become much “younger”: more and more often young people who spend most of their time in the office sitting at a computer for more than eight to ten hours a day in the absence of regular physical training. Overweight also affects the ability of the joints to withstand stress.

In addition, joint diseases can be provoked by various infections and untreated injuries.

All diseases of the joints can be divided into several main forms:

Inflammatory (arthritis);
degenerative-dystrophic (arthrosis);
arthralgia (joint pain)

Each group of ailments is characterized by its own symptoms, but for most the symptoms are very similar:

Pain in the joints is the most common symptom that signals the presence of problems;
Joint pain at night. If your joint pain is so severe that it interferes with the quality of your sleep and causes you to wake up in the middle of the night, then this is a sign of osteoarthritis.
Joint stiffness after sleep, which occurs after a night of sleep or a long period of inactivity, such as after watching a movie, is a sign of rheumatoid arthritis.
Sudden pain in thumb feet indicates, most likely, an attack of gout, a common form of arthritis.
Pain in the knees when climbing stairs and, especially, when descending, indicates the presence of osteoarthritis. This condition is exacerbated if the person has excess weight, because the load on the diseased joints increases.
A flu-like condition accompanied by joint stiffness and pain may indicate rheumatoid arthritis, which is a systemic inflammatory disease that involves the entire body.
If you can't put a key in a lock, thread a needle, or button a shirt, it's usually due to rheumatoid arthritis, which affects the small joints and makes the fingers stiff.

If you notice at least one of the above signs, then this is a serious reason to see a doctor, since early diagnosis gives the patient a better chance of a full recovery.
The main methods of treatment of diseases of the joints.

Depending on the type of pathology, the age of the patient and the severity of the course of the disease, treatment methods can vary greatly. Therefore, only a doctor can prescribe competent treatment after complete examination patient. Traditionally, all methods are divided into therapeutic (conservative) means, surgery and alternative methods of treatment.

conservative methods

Almost all lesions of the musculoskeletal system can be treated with therapeutic agents. Depending on the direction of action, the drugs used are divided into two groups:

Etiotropic - that is, affecting the cause of the disease. For example, antibiotics are prescribed for the infectious nature of arthritis, and steroid hormones for autoimmune reactions.
Symptomatic - eliminating signs of the disease. Among them, the most important are anti-inflammatory drugs, which reduce pain and slow down the inflammation process.

In addition to medicines, conservative means include physiotherapy, massage, physiotherapy exercises and other methods.

Surgical intervention

With the ineffectiveness of therapeutic agents or in cases where the disease has become severe, can help surgical methods treatment of joint disease. Operations can also be performed to eliminate painful symptoms in order to alleviate the suffering of the patient and improve his quality of life. The most important are arthroplasty (restoration motor function) and arthrodesis (fixation in a given position). During the period of exacerbation, immobilization is often performed using a splint or tight bandage. In difficult situations, operations are performed to replace the joint with an artificial one, that is, they resort to prosthetics.

To alternative ways treatment includes cell therapy - treatment with mesenchymal stem cells.

This type of treatment can be complex and include both intravenous injections of mesenchymal stem cells and local injections into the cavity of affected joints. Also, intra-articular injections of mesenchymal stem cells can be used separately. This is done, as a rule, in cases where joint damage is not accompanied by systemic pathology and is local in nature - for example, with post-traumatic arthrosis or with any damage to one or more joints in initial stage development of the pathological process.

The introduction of stem cells helps to fight pathological changes in the tissues of the joints, initiating and stimulating the replacement of damaged joint tissues with healthy and fully functional ones, as well as helping to reduce the manifestations of the pathological process and improve the patient's quality of life.

As a rule, indications for the appointment of this type of treatment are many inflammatory and degenerative diseases of the joints (arthritis, arthrosis, osteochondrosis, gout, osteoarthritis, etc.), post-traumatic joint lesions, as well as the desire to reduce the time and improve the quality of rehabilitation of athletes in sports medicine.

The procedure for treatment with mesenchymal stem cells is quite simple: a patient under local anesthesia a small amount of adipose tissue is taken from the umbilical region. Subsequently, mesenchymal stem cells are isolated from this tissue, which are cultured to a certain volume and injected into the patient intravenously and as injections into the joint cavity. If the therapy includes only intra-articular injections, then mesenchymal stem cells are injected into the cavity of the damaged joint without cultivation.

Intra-articular injections of mesenchymal stem cells can be used alone or in combination with medications and recovery procedures.

Stem cell therapy is safe and eliminates the development of allergic reactions and other side effects.

As a result of treatment with stem cells, the severity of inflammatory and degenerative processes, painful and uncomfortable sensations in the joints decreases, and the effectiveness of other methods used to treat or rehabilitate a patient increases.

But whatever method of treatment you choose, remember that the disease is better to prevent than to cure. Protect your body with these simple preventive measures:

Lead physically active image life. At the same time, avoid heavy loads and sudden movements which can lead to injury or sprains.
Avoid prolonged hypothermia. Under the influence of cold, the muscles tense up, which leads to an increase in the load on the joints.
Watch your diet. Minimize your intake of spicy, fatty, fried and canned foods. Do not abuse carbohydrates. In winter and spring, be sure to take vitamin and amino acid complexes.
Use orthopedic products - insoles, mattresses, corsets, etc. Thanks to them, you will be able to maintain your body in a physiologically correct position during sleep and wakefulness. They will help to achieve maximum comfort in the performance of habitual activities and reduce the risk of joint diseases.
Get rid of bad habits.

At the first sign of pain, contact medical assistance. Timely consultation with a specialist will help to avoid the occurrence of serious, difficult to treat diseases and their complications.

Statistics of diseases of the musculoskeletal system

As the statistics of the disease with osteochondrosis show, the number of people suffering from this disease is second only to cardiovascular and oncological pathologies. Osteochondrosis is observed in almost 90% of the population. At the same time, the share of the lumbar region is 50%, cervical - more than 25%, thoracic - 12%, sacral - 13%. The statistics of diseases of the spine and other problems of the musculoskeletal system (musculoskeletal system) show an increase in rates by 30% every 10 years.

The statistics of bone diseases is due to the fact that the features of our body, which helped to survive in primitive times, in modern world act destructively. Moving from an office chair to a car, a person does not give a vital load to his motor apparatus, as a result, its degradation occurs.

Scientists have found that if you play sports for 5 months with osteoporosis, then the density of the bones of the body will increase by 3.9%. The diagram shows the statistics of the disease with flat feet in children under 17 years of age.

Scoliosis statistics recorded 69.3% of children under 17 suffering from this disease. For comparison, the table shows the statistics of joint diseases in Russia and the USA:

The number of patients in the United States (population - 313.9 million people)

Number of patients in Russia (population - 143 million people)

39–42 million people

17 million people

21 million people

1.5 million people

Caring for the state of the musculoskeletal system should be carried out from childhood. Often, parents are concerned only with the intellectual development of their children, dooming them to diseases with early age. Sports are dangerous for fragile bones - so they say caring parents. However, it is not. Acrobats who have learned to control their bodies are much more protected from injuries and accidents.

Epidemiology %B5%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B9_%D1%8F%D0%B7%D1%8B%D0%BA" \o "Ancient Greek" etc .-Greek ἐπιδημία - having a nationwide distribution; λόγος - teaching) - a general medical science that studies the patterns of occurrence and spread of diseases various etiologies in order to develop preventive measures. The subject of the study of epidemiology is the incidence - the totality of cases of a disease in a certain territory at a certain time among a certain population group.

Etiology %B5%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B9_%D1%8F%D0%B7%D1%8B%D0%BA" \o "Ancient Greek" etc .-Greek αἰτία - "cause" + other Greek λόγος - "word, doctrine") - a branch of medicine that studies the causes and conditions for the occurrence of diseases.

In a professional medical environment, the term "etiology" is also used as a synonym for "cause"

The problem of efficient and safe treatment diseases of the musculoskeletal system is one of the priority areas of medicine in general and rheumatology in particular. The urgency of this problem is primarily due to social aspect, namely, the high frequency of occurrence of this category of diseases in the population and typical development in patients with temporary and permanent disability. Thus, in Germany, temporary disability due to rheumatic joint damage is up to 24% of all insured persons, and in the UK, according to WHO data, temporary disability due to rheumatic diseases ranks third among other diseases. Similar statistics are available for Russia: temporary disability associated with diseases of the musculoskeletal system is in fourth place in terms of frequency of occurrence, and in third place in terms of the number of days of temporary disability. At the same time, diseases of the musculoskeletal system occupy the fifth place in Russia among other causes of disability in the population. Disappointing statistics relating to our country indicate that in Russia 40% of people over 70 suffer from deforming osteoarthritis, and 25% of them cannot tolerate daily physical exercise. More than half of patients diagnosed with rheumatoid arthritis are unable to work within 10 years after the onset of the disease, and 80% of them constantly experience severe pain significantly deteriorating the quality of life.

The foregoing indicates that the problem of therapy for rheumatic diseases of the musculoskeletal system is far from its final solution, and in the future, priority will undoubtedly be given to the development of integrated approaches to guarantee safety for the patient and at the same time affect the key links of the rheumatic process. In this regard, it deserves special attention the tactics of therapy with complex antihomotoxic drugs, which is being developed within the framework of the theory of homotoxicosis, which was formulated more than half a century ago by the German physician and researcher H. H. Reckeweg.

Therapy with complex antihomotoxic drugs, produced in dosage forms “similar” to allopathic drugs, consists in restoring disturbed regulatory processes in the body, activating detoxification functions, stimulating one’s own immune forces by inducing antitoxically active enzymes. data application point medicines is the protective system of the body, which includes a number of subsystems - reticulo-endothelial, pituitary-adrenal, neuro-reflex, liver and mesenchymal connective tissue. By latitude therapeutic action in the body and with a balanced composition, preparations of this type, which have an increased organo-, tissue-tropism, would be more correctly called complex biological agents. An important circumstance that predetermines the prospect of using these drugs in rheumatology is the fact that in this field of medicine there is an alternative holistic (from the standpoint of the whole organism) view of local arthrosis-arthritic processes in rheumatic diseases.

It is known that many rheumatic diseases of the joints belong to the group of so-called post- and para-infectious diseases. Such rheumatic processes are primarily understood as symptomatic arthritis, in which the pathogen is not detected in the joint cavity. Nevertheless, certain “temporal relationships” have been established between the infection digestive tract or genitourinary system and the appearance of the first symptoms of reactive arthritis - this period fits into the range from 10 to 30 days. At the same time, the symptoms of articular damage, as a rule, are not accompanied by any signs of a previously transferred acute infectious process and therefore, in diagnostic terms, they are practically not compared with the primary infectious agent. The latter can be salmonella, ersinia, shigella, chlamydia, mycoplasma, viruses, streptococci and other microorganisms, the identification of which as etiological reason articular pathology in this situation it becomes very difficult, and often the study gives a negative result. At the same time, in clinical terms, the relationship of rheumatic diseases of the musculoskeletal system with such previously transferred diseases as influenza, scarlet fever, tonsillar tonsillitis, ulcerative colitis, Crohn's disease, enterocolitis, etc. is well known.

From the point of view of the homotoxicological approach to the problem of rheumatic diseases, these joint lesions are a reflection of the phenomenon of "progressive vicariation": this term in homotoxicology defines any deterioration in clinical picture patient, which passes, as a rule, against the background of pronounced violation work of drainage and detoxification mechanisms. Various endotoxins (homotoxins) accumulating at the same time lead to the occurrence of more severe organ-tissue disorders (in relation to the problem we are considering - diseases of the joints). Therefore, rheumatoid arthritis from the standpoint of homotoxicology should be characterized as a kind of unsuccessful attempt by the body to normalize its homeostasis at the cost of a new disease. That is why even such a disease as rheumatoid arthritis, in the chain of successive events in the clinical picture of a particular patient, should be considered, according to H. H. Reckeweg, as “expedient defensive reaction”, relevant at a certain level of “homotoxicosis” (endotoxicosis). The clinical observations listed above concerning the relationship between joint diseases and infectious-viral pathological processes, in principle, confirm the legitimacy of such a position.

Nevertheless, it should be recognized that this method of normalizing drainage and detoxification mechanisms is completely ineffective, if we talk about the body as a whole, since with the development of each more serious disease general level endotoxicosis is aggravated, and more and more “deep” structures of certain organs and systems are involved in the pathological process. The most illustrative example in this respect is the modern medicine approach to the problem of the occurrence of "colitis syndrome" and associated joint diseases, in particular juvenile rheumatoid arthritis.

"Colitis Syndrome" covers the full spectrum of allergic and inflammatory diseases of the intestinal mucosa, including ulcerative colitis and Crohn's disease. The same hyperergic pathological processes include juvenile rheumatoid arthritis, which in the early stages of development is very similar to the various stages in the development of allergic intestinal diseases. In addition, statistical studies conducted in Germany found that in 70% of cases in families where there are people suffering from colitis, rheumatoid arthritis is also detected (in families where there are no such diseases, such a relationship was found only in 15 %). These data already suggest that common factor that determines the occurrence of the diseases under consideration are immune-mediated processes - allergies. At the same time, taking into account the fact that almost 80% of all immunological reactions in the body are localized in the intestinal lymph nodes, it is legitimate to believe that it is precisely the violations of various regulatory functions of the intestine that can be considered as one of the triggers for the development of other allergic processes in the body, including juvenile rheumatoid arthritis. It is characteristic that the symptoms of colitis correlate, according to the teachings of H. H. Reckeweg, with phases typical of the mucodermal tissue of the endoderm, and the symptoms of polyarthritis correlate with disorders in the “deeper” (internal) tissues, namely, in the cavodermal tissue of the mesenchyme. That is, the observed dynamics of diseases - from colitis to arthritis (polyarthritis) - indicates the undoubted progression of general endotoxicosis. Since both colitis and arthritis can be pathomorphologically characterized as inflammatory processes, very often, the factors provoking the development of articular pathology include the use of various potent allopathic drugs that block individual stages of an inherently protective inflammatory reaction in a particular intestinal disease.

Such a holistic view of the problem of the occurrence of rheumatic diseases of the musculoskeletal system can be considered as a theoretical justification for the biotherapeutic concept of the complex therapy of this type of pathology, in which antihomotoxic drugs play a leading role. This concept is based on four main components: intestinal sanitation combined with increased immunity; the use of antioxidants; removal of toxins from the mesenchyme; proper nutrition. These elements must be observed in the complex treatment of any rheumatic diseases and, as a rule, are supplemented by the use of special antihomotoxic drugs prescribed depending on the specifics of organ tissue disorders.

First component basic therapy, which consists in stimulating the immune system and activating the intestine as an immunological organ, is extremely important. So, despite the fact that a change in many factors humoral immunity in rheumatoid arthritis is not pathognomonic, in patients with this disease there is more low maintenance in the blood of immunoglobulins of classes A and G, compared with people suffering from intestinal diseases. It is known that IgA produced by intestinal crypts can, as it were, "seal" the intercellular space and "mask" various microbiological agents that cause intestinal disorders. At the same time, a decrease in the level of this immunoglobulin, as a rule, occurs in cases of atrophy of the intestinal villi, which in turn is considered as a morphological sign of intestinal intolerance (allergy). It is characteristic that an increase in the level of IgG - as the next protective barrier of the intestinal mucosa - occurs only with an abscess of the crypts that occurs in the presence of ulcerative colitis. Therefore, a generally diagnosed decrease in the activity of humoral immunity factors in patients rheumatoid arthritis may be associated with various morphofunctional disorders in gastrointestinal tract. Therefore, the biological treatment of rheumatic diseases of the musculoskeletal system must begin with the normalization of the intestines, which positively affects both the connective tissue in general and the connective tissue derivatives of the joints in particular. For this purpose, patients are prescribed the following antihomotoxic drugs: hepar compositum, hepel - activating detoxification functions of the liver and favorably affecting survival normal microflora in the intestines; mucosa compositum - a drug that stimulates the functions of the mucous membranes and restores their morphological structure; nux-vomica-homaccord - a remedy that activates the functions of the intestines, and above all the evacuation. Additional stimulation immune system patient (especially with a clear relationship between the rheumatoid process and a previous bacterial or viral infection) can be carried out with influenza-hel, echinacea compositum C, engistol.

Second mandatory component The mainstay of treatment for rheumatoid diseases is antioxidant therapy. In order to correctly assess the importance of antioxidants, it is necessary to understand the role of free radicals in the occurrence of chronic polyarthritis. Any inflammation of the articular tissues leads to the development of hypoxic conditions in them, which subsequently cause the formation of free oxygen radicals. It is known that free radicals lead to the proliferation of fibroblasts and contribute to the formation of pannus in patients with chronic polyarthritis, and peroxide inhibits the synthesis of proteoglycans in cartilage tissues. At the same time, in the joints similar diseases, as a rule, a lack of vitamins C and E is found. It is important to note that increasing pollution environment heavy metals, chemicals, malnutrition, harmful radiation, constant psycho-emotional stress facilitate the formation of free radicals, for the removal and binding of which sometimes there are not enough antioxidants that enter the body with food. Therefore, very often, patients need to additionally prescribe doses of antioxidant drugs recognized as effective. For example, for vitamin C, this dose is 1 teaspoon (5 g ascorbic acid), for vitamin E - 200 - 400 mg, for selenium - 150 mg. Undoubtedly, antihomotoxic drugs coenzyme compositum and ubiquinone compositum, which significantly affect the processes of energy exchange in the body, are important medicines at this stage of basic therapy; the use of these drugs is indicated for all so-called cellular phases of homotoxicosis, accompanied by destructive processes in cellular structures.

As noted above, the third component of an integrated biotherapeutic approach in the treatment of rheumatic joint lesions is the stimulation of the drainage functions of the connective tissue, which is partially carried out within the framework of the first direction, but often requires the appointment of separate antihomotoxic drugs acting at this level. The fact is that the mesenchyme (interstitial fluid space, or matrix) is a transitory area between the vascular endothelium and the cells of organs and tissues, in essence, determines the nature of metabolic processes in them, which largely depends on the pH level of this "intermediate" environment of the body. The last parameter of the matrix is ​​especially affected by various toxic overloads, including those resulting from the intake of strong drugs. The role of the failure of the drainage function of the mesenchyme in the occurrence of autoimmune diseases and allergic conditions. First of all, these pathological processes may be due to functional insufficiency granulocytes to neutralize immune complexes, due to their redundancy, and their deposition in various tissues. To stimulate the drainage functions of the connective tissue, it is recommended to prescribe the following antihomotoxic drugs - lymphomyosot, galium-hel.

An indispensable component of treatment (fourth) is the organization proper nutrition. Despite the fact that this component of complex therapy is widely known, many doctors neglect it or use it incorrectly in practice. Sugar for patients with rheumatoid diseases of the musculoskeletal system is one of the most hazardous products. Thus, it is well known that arising after sharp rise hyperinsulinism, the state of hyperinsulinism largely shifts the nature of metabolic processes in the body towards catabolism: paradoxically, too much sugar intake, provoking excessive release of insulin, often leads to a lack of glucose in the body. This, in turn, leads to the activation of contra-insular mechanisms and to compensatory replenishment of the body's needs for this important "energy product" due to the breakdown of endogenous glycogen stores (glycogenolysis). Naturally, under these conditions, when the feedback mechanisms are turned on, the body, in order to restore balance in metabolic processes, enhances insulin production, even by inhibiting the synthesis of other anabolic hormones, in particular growth hormone, which regulates rejuvenation processes in various cell populations. Aspects mentioned carbohydrate metabolism in the body, of course, indicate that increased consumption of sugar will most negatively affect the restoration of bone and cartilage structures of the joints. In addition, excessive carbohydrate intake in general contributes to obesity, and also increases fermentation in the large intestine, which can exacerbate clinical symptoms characteristic of articular pathology.

Many clinical researches showed that the consumption of plant and dairy foods, as well as therapeutic fasting relieves the symptoms of polyarthritis. In addition, it has been established that fatty acid contained in fish oil, effectively inhibit the biosynthesis of eicosanoids, which are inflammatory mediators and oxidation products arachidonic acid. The most important eicosanoid in joint inflammation is prostaglandin E2, which increases pain sensitivity and, together with thromboxane, causes inflammation, as well as leukotriene, which leads to the formation of edema. The effect of eicosanoids is significantly reduced by the use of antioxidants (vitamins A, C, E) and trace elements (manganese, copper, zinc, selenium).

All of the above - we are talking about the four components of a complex biological concept for the treatment of rheumatic diseases of the musculoskeletal system - does not at all detract from the importance of using antihomotoxic drugs prescribed to the patient for regulation individual symptoms , or correction of certain pathogenetically important processes implemented at the organ-tissue (articular) level. Despite the fact that these drugs are classified as “additional” drugs, their use should be considered as an equal fifth component of the holistic tactics for the treatment of articular pathology, to which, as a rule, doctors involved in classical medicine are more adapted. Nevertheless, it must be emphasized that this component of complex therapy is placed under the fifth number not by chance: only if the systemic changes occurring in the body that eventually caused rheumatic damage to the articular tissues (the first - fourth components) are eliminated, it is possible to effectively influence the local manifestations of pathological processes. It is important to emphasize that in relation to antihomotoxic drugs, it is wrong to talk about their absolute local therapeutic effect. Recent studies have shown that these drugs, even when applied locally, can initiate an auxiliary immunological reaction in patients, the general corrective effect of which is to significantly reduce the levels of pro-inflammatory cytokines in the body and, as a result, to restore the balance between the processes of fibrogenesis and fibrolysis in the connective tissue. fabrics. It is pro-inflammatory cytokines (in particular, tumor necrosis factor - TNF-a) that one of the main roles in the destruction of articular cartilage in progressive rheumatic processes is attributed. It should be noted that the antihomotoxic drugs used at the fifth stage of therapy contain, as a rule, the corresponding tissue components prepared according to homeopathic technology from the cartilaginous tissue structures of animals (pigs) and therefore are the most tropic to the affected joints of patients. For many years, drugs such as traumeel C (a drug with pronounced anti-inflammatory properties) have been especially popular with doctors and patients; goal T (indicated in chronic arthrosis with prolonged pain, as well as activating the synthesis of chondrocytes), discus compositum (significantly activating the metabolism of cartilaginous structures). Very often, these drugs are prescribed to patients in various combinations for special (periarticular, paravertebral, intraarticular) injections. But even monotherapy with these drugs gives encouraging results, especially if it is carried out under the supervision of a doctor. This is largely due to the balance of the composition of a single complex antihomotoxic agent, the multidirectional action of its individual components.

Thus, according to the results of multicenter studies conducted in Germany (1845 patients, 190 orthopedists), it was found that a four-five-week course of treatment with Target T (two ampoules per week in the form of intra-articular injections) led to a positive effect in gonarthrosis in 93.1 % of cases. Wherein side effects were registered only in 0.45% of cases, and even then in the form of reversible local inflammatory reactions and irritations that do not require an appointment additional treatment. Similar high performance were obtained by analyzing the results of treatment of 3241 patients with various diseases musculoskeletal system with the drug traumeel C, which was introduced into the body using various injections. It is these preparations - purpose T and traumeel C - that correspond to the organ-tissue pathogenetic principle biological treatment rheumatic diseases of the joints. Practical experience shows that this category of diseases is characterized by varying degrees the severity of inflammatory, as well as degenerative phenomena on the part of the articular and periarticular tissues. Therefore, the combination of these drugs in treatment regimens seems to be the most organic.

However, it must be recognized that only A complex approach to the preparation of biotherapy schemes in each specific case rheumatic diseases can guarantee the patient a stable therapeutic effect. At the same time, the attending physician always has to solve the following tasks: make the inflammation process manageable and eliminate the pain syndrome; affect immunoregulatory disorders; prevent exacerbations; contribute to the restoration of impaired joint functions. All these program activities may well be implemented with the help of complex antihomotoxic drugs for course appointments. Adequate drug regimen is a therapy with four to five drugs, taking into account all of the above components of biological therapy. Such complex therapy can be prescribed in the form of courses lasting from several weeks to several months, with the obligatory repetition of them within a year. The frequency of repetitions depends on the achieved results of treatment after the first course and is determined individually. The absence of both cumulative and toxic effects from the use of drugs of this class makes it possible to prescribe them in various combinations not only during basic drug courses, but also as a defining element of complex maintenance therapy during the period of rehabilitation treatment.

Unfortunately, historically, medicine based on the pathogenetic approach to treatment is based on the final links in the pathogenesis of a particular disease. At the same time, the mechanisms of sanogenesis are not studied enough, which does not allow fully, from the standpoint of the whole organism, to assess how involved in pathological process various defense mechanisms, causing, in fact, the appearance of certain clinical symptoms. Therefore, the holistic principles of biological therapy based on the rational use of antihomotoxic drugs should undoubtedly be of interest to all physicians involved in the treatment of rheumatic diseases of the musculoskeletal system - one of the problematic areas of clinical medicine.

A. A. Maryanovsky, Doctor of Medical Sciences

RSMU, Moscow

Kartilyago compositum- a homeopathic preparation produced in Russia according to the recipe and technology of the German company WALA-Heilmittel GmbH. The drug contains components of cartilage (Cartilago articularis) and is intended for the treatment of chronic inflammatory and degenerative diseases joints and intervertebral discs. The combination of two mineral components (Stannum, Aurum), which are part of the preparation, improves the microcirculation of synovial membranes, and plant components (Betula e foliis, Allium cepa e bulbo) normalize protein and fluid metabolism, and the last component of the drug of animal origin (Formica rufa) provides antirheumatic action.