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Pathogenesis and modern aspects of diagnosis and treatment of complex regional pain syndrome
Summary. Summary. Conducted an analytical overview of the current understanding of the leading pathogenetics mechanisms of CRPS, the principles of its diagnosis and treatment, allowed to develop a comprehensive method of treatment of patients with CRPS I with the using of pathogenesis-based combination of pharmacological preparations Aertal®, Mydocalm, Tebantin®, Ostalon® Calcium-D, as well as methods of physical therapy. The clinical study of the developed method efficacy in 56 patients with the diagnosis of CRPS I after fractures of the distal radius bone significantly (p <0,05) showed its effectiveness. Analysis of the results of treatment was carried out in the dynamics using standardized criteria for assessing the intensity of pain (VAS), neuropathic pain (questionnaire DN4), the functional activity of the hand and wrist joint (questionnaire ABILHAND) and subjective evaluation of a physician-patient relationship. In the 8 week treatment period in the study group patients achieved a more than three-fold reduction of pain on the VAS compared to baseline. Thus, at the end of the observation period, the severity of pain in the study group was almost half that of a comparison group of patients. The indicator DN4 8 week period of the study group patients disappeared neuropathic pain conditions, whereas in the control group remained neuropathic pain component. The functional activity of the wrist joint and brush in the main group at the end of observation consistent with the criteria on a scale ABILHAND «good», and in the comparison group — the criterion of «satisfactory». Evaluation of treatment the doctor and patient though, and was subjective, but also showed higher efficacy in the treatment of major clinical group.
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