Дисбіоз порожнини рота: проблема та вирішення

Objective — increase the effectiveness of treatment and prevention of candidiasis of oral mucosa in patients with diabetes mellitus of type 1 through the development of patogenetic reasonable method of therapy using complex drug preparations. Materials and methods. Depending on the composition of the treatment­and­prevention complex patients with candidiasis of oral mucosa with diabetes mellitus type 1 were distributed in to two groups: 25 patients constituted the tested group and the treatment was carried out according to the proposed us schemes, 23 patients of the control group were treated according to generally accepted methods. Treatment of patients from tested group with candidiasis of oral mucosa with diabetes mellitus type 1 conducted according to the proposed us scheme, namely: per os Flukonazol 1 capsule dose 100 mg 1 time daily during the 7—14 days; Claritin 1 tablet 1 time daily during 10 days; Immunal 20 drops 3 time daily during 14 days; synbiotic Baktulin 3 tablet 1 time daily during 20 days, holding in the mouth until resumption; vitamin and mineral complex Alphavit Diabetes 1 tablet 3 times daily during the month. Local treatment of patients included rinsing with antiseptic and anti­inflammatory solution Tantum Verde 3—4 times daily 15 ml during 20—30 seconds and rinsing with diluted in 5 times in prophylactic dental fluid Lizomukoid , which contains lysozyme, cetavlon and ovomukoid. In order to prevent relapses and consolidating, the patients with diabetes mellitus type 1 had repeated courses of Baktulin and Lizomukoid after 2 and 5 months. The effectiveness of the proposed health­care complex in patients with candidiasis of oral mucosa against the background of diabetes mellitus was assessed according to the clinical condition of the mucous membrane and the degree of infection of the mucous membranes of the oral cavity fungi of the genus Candida after 2 weeks, and then through 1, 3 and 6 months according to the results of a full range of clinical and laboratory research. Results and discussion. The suggested treatment of candidosis contributed to the decrease the disbiosis level by 2 times after 1 month, whereas patients from tested group it decreased by 1.5 times. In 3 months of Baktulin and Lizomukoid administration , the level of disbiosis decreased by 2.81 ± 0.31 vs 6.53 ± 0.62 before treatment (p 1 < 0.01), it evidences subclinical compensating disbiosis form. Patients from comparison group had 3.71 ± 0.38 vs 6.73 ± 0.65 before treatment (p 1 < 0.01), it evidences clinical subcompensating disbiosis form. Definitively, oral cavity microbiocenosis became normal after 6 months. The disbiosis level increased in 6 times due to urease activity increasing in 2.3, times and decrease of lysozyme activity in 2.6 times. Conclusions. The clinical and laboratory research shows that the proposed treatment and prevention complex in patients with candidiasis stomatitis with diabetes mellitus type 1 after 12 days improves the clinical state of the oral cavity in 12 days, and after 6 months restores the oral microbiocenosis. To prevent the relapses, it is recommended to repeat the treatment course of Baktulin and Lizomukoid in 2 and 5 months.