COMPREHENSIVE TREATMENT EFFECT ON SEVERITY OF CLINICAL AND SPIROMETRIC INDICES BY WORKERS OF MINING AND METALLURGICAL INDUSTRIES – PNEUMOCONIOSIS COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

The article presents the results of studying the effect of complex treatment of mining and metallurgical industry workers – pneumoconiosis in combination with COPD patients, using solutions of bronchodilators, antiinflammatory drugs, mucoregulators with nebulizer, complex vitamin B and hyperbaric oxygenation on clinical symptoms and indicators of spirometry in the system of measures targeted at the treatment and prevention of this occupational lung disease. The object and methods of research. Active treatment group consisted of 25 people who received comprehensive treatment of pneumoconiosis in combination with chronic obstructive pulmonary disease (COPD). Experimental group consisted of 29 workers with pneumoconiosis in combination with COPD, who underwent a course of traditional treatment with a short-acting bronchodilator as needed (dosed inhaler), a tablet form of mucoregulator (ambroxol hydrochloride), and B vitamins intramuscularly during 15 days. The average age of workers was 58.6 ± 2.4 years, work experience in adverse conditions 18.9 ± 0.8 years. Results of the research and their discussion. The obtained data indicate that the total indicator that characterizes dyspnea on the scale of the International Research Council (IRC, in scores) after treatment decreased by 36.8% (p <0.001), the assessment of well-being by the questionnaire of the disease assessment test (DAT, in scores) decreased by 59.2% (p <0.001). In the experimental group, the severity of dyspnea on the IRC scale decreased by 14.3% (p <0.05), the assessment of patients’ well-being according to the DAT questionnaire decreased by 20.7% (p <0.001). Comparing the effectiveness of treatment in both groups, it was found that in the active treatment group the IRC was 9.6% lower than in the experimental group, and the DAT was lower by 25.5% (p <0.002). At the same time, a significant increase in volume and speed was detected in the active treatment group of workers: forced vital capacity of the lungs by 9.5%, p <0.01), the volume of forced exhalation in the first second by 26.4% (p <0.001), peak volumetric expiratory velocity by 64.2% (p <0.001), maximum volumetric velocity at 25% by 84.4% (p <0.001), maximum volumetric velocity at 50% by 63, 4% (p <0.001), and the maximum volumetric velocity at the level of 75% of the forced vital capacity of the lungs by 32.7% (p <0.02). The treatment resulted in a change of the ratio of forced vital capacity of the lungs to the volume of forced exhalation in the first second, the value of which increased by 23.5% (p <0.001). In the experimental group, the dynamics of spirometric parameters was also positive. The following indicators increased: vital capacity of lungs by 6.3%, peak volumetric expiratory rate by 10.0%, maximum volumetric velocity at the level of 75% of forced vital capacity of lungs by 24.6%, ratio of forced vital capacity of lungs to the volume of forced exhalation for the first second has not changed. When comparing spirometric indicators in workers of both groups, it was found that in the active treatment group they exceeded the similar ones in the experimental group: forced expiratory volume per second by 21.7% (p <0.05), peak volumetric expiratory rate by 46.6% (p <0.002), the maximum volumetric velocity at the level of 25% by 70.4% (p <0.001), the maximum volumetric expiratory rate at the level of 50% of the forced vital capacity of the lungs by 62.5% ( p <0,001), the ratio of forced vital capacity of the lungs to the volume of forced exhalation in the first second by 14.3% (p <0,001). The rate of bronchodilation test in workers of the active treatment group after treatment increased by 68.2%, in the experimental group by 18.6%. After the treatment, this figure in the active treatment group exceeded 2.2 times the figure in the experimental group. Conclusions. The obtained results indicate that the complex treatment allowed to achieve a significant positive effect in terms of clinical symptoms and the vast majority of volumetric and velocity indicators of spirometry. Confirmation of their significance is the comparison of data on the treatment of the active treatment group of sick workers with the experimental group. It was found that it led to a significantly more positive dynamics of clinical symptoms in terms of IRC and DAT, according to the most speed indicators of spirometry and forced expiratory volume in the first second. It should be noted that in the active treatment group of patients, bronchial obstruction was eliminated, and the bronchodilation test was more than twice as high as in the experimental group, which is evidence of a significant reduction in clinical manifestations and a significant improvement in respiratory function by this category of patients. Perspectives for further investigations. Obtaining new data on the study of the effectiveness of comprehensive treatment of mining and metallurgical industry workers – PC in combination with COPD patients, other indicators of clinical symptoms, quality of life, functional status and laboratory parameters determines the prospects for further research to comprehensively assess the effectiveness of treatment and prevention methods.