Preliminary Results of the Russian National Chronic Tonsillitis Program

Abstract

The article is devoted to the results of the 1st stage of the National program «Chronic tonsillitis». The program was approved by the Council of Experts of NMAO at the end of 2017. Within the framework of the Program, in 20 cities of the Russian Federation 620 out-patient otolaryngologists performed a prospective observational study, which involved 6250 patients aged 5 years to 86 years. Epidemiological data were collected and the results of inter-relapse treatment of chronic tonsillitis (HT) were evaluated. Participants with compensated form of CT received 2 courses of inter-relapse therapy and 5 times visited a doctor, patients with decompensated form of CT were observed during 7 visits and received 3 courses of therapy. Female patients predominated among all participants. The age group of patients older than 60 years was the smallest. Among the noted complaints, throat tickling was most often recorded (93% of patients), of the local signs of HT – looseness and scarring of the Palatine tonsils (92%). For the examined patients prevailed compensated form CT (86%). Among the types of decompensation were the leaders of recurrent angina is 53%. The degree of examination of patients before inclusion in the study did not exceed 30%, regardless of the form of CT. There were 6 groups in composition of inter-relapse treatment: a combination of local anaesthetics and immunomodulators herbal drugs (group 2, 11%), with Tonsilotren (group 1, 66%), local anaesthetics and immunomodulators without the use of these drugs (group 5, 2%), Tonsilotren monotherapy (group 3, 18%) or herbs (group 4, 1%). 6% was conducted lavage of lacunas of the tonsils without pharmacotherapy. After the end of the 1st course of therapy, the greatest clinical effect was achieved in groups 1, 3 and 6 (p < 0.01). A more pronounced positive trend was observed with respect to the presence of pus and caseous masses in lacunas, as well as edema and hyperemia of Palatine arches. Addition to standard therapy, herbal remedies, and especially Tonsilotren achieve the best therapeutic result. The average number of drugs in the scheme of anti-relapse therapy in groups 1, 2, and 5 was, respectively, 2.8±0.6; 3.6±0.5 and 3.8±0.8, with differences between groups 1 and 2 and groups 1 and 5 reached statistical significance, U-test, p < 0.01. The efficacy (IMOS), treatment satisfaction (IMPSS), and tolerability assessments for the 1st course of anti-relapse therapy were positive in all groups, with a prevalence of higher scores in groups 1, 2, 3, and 6.