Comparative evaluation of the effectiveness of balneotherapy and balneotherapy in combination with intravenous laser irradiation of blood at the period of spa treatment of patients with psoriasis

Abstract

Background. Psoriasis is one of the most common, chronic, recurrent dermatoses. To date, a sufficient pool of studies has been accumulated confirming the multifactorial genesis of psoriasis due to genetic and environmental factors. Aim. Сomparative assessment of the effect of different options for spa treatment (ST) balneotherapy and balneotherapy in combination with intravenous laser blood irradiation (ILBI) in patients with psoriasis vulgaris on the level of IL-6 and IL-17, dermatological and psycho-emotional status, assessment of quality of life. Methods. The comparative study involved 108 patients with psoriasis vulgaris, stationary stage (men — 57.4%, women — 42.6%; the average age was 36.2 [24.5; 47.9] years) who underwent spa treatment, which were subsequently divided into 2 groups: 52 patients who received balneotherapy along with the traditional complex of ST were included in the 1 group, 56 patients who received complex treatment were included in the 2 group. The effectiveness of ST was evaluated using the PASI index, the HARS and HDRS scale, the SF-36 questionnaire. The dynamics of IL-6 and IL-10 levels in blood plasma were evaluated. The total duration of the study was 6 months and 14 days: the treatment phase was 14 days and the follow-up phase was 3 and 6 months after the completion of ST. Results. After 14 days of ST in the group in which balneotherapy was performed in combination with IVBI, a statistically significant decrease in the PASI index was more pronounced compared to the group in which balneotherapy was performed (p). Balneotherapy did not have a pronounced effect on psychoemotional status. On the contrary, balneotherapy in combination with ILBI contributed to a statistically significant decrease in the final indicators on the HARS and HDRS scales. The decrease in IL-6 and IL-17 levels was statistically significant in both groups and there were no differences between them. The complex use of balneotherapy and ILBI in comparison with the group of balneotherapy was accompanied by a more pronounced improvement in QOL. The combined use of balneotherapy and ILBI in the follow-up phase showed a long-term positive effect: 6 months after the completion of ST, the number of patients who had clinical remission was statistically significantly higher compared to the group in which balneotherapy was performed (87.4 vs. 44.7%). Conclusion. The advantage of the combined use of balneotherapy and ILBI compared with balneotherapy in patients with psoriasis vulgaris on CL was shown. The complex use of balneotherapy and ILBI of significant indicators of inflammatory biomarkers, improvement of the dermatological and psycho-emotional state, quality of life parameters and good overpopulation. More pronounced effectiveness of the complex use of balneotherapy and ILBI compared to balneotherapy of the quality, diversity of pathophysiological mechanisms of psoriasis and the presence of several targets for pathogenetic therapy.