Comparative aspects of traditional therapy and laser therapy for the treatment of subacute thyroiditis de Quervain

Objective. To study the effectiveness of laser therapy in treating patients with subacute thyroiditis de Quervain, and to compare the obtained results with the results after traditional therapy with glucocorticoids. Results. The authors compared results of traditional treatment of 49 patients with subacute thyroiditis with glucocorticoids and the results of treatment of 122 patients with the same pathology who were treated with a combined technique having a basic curative factor - infrared spectrum of laser light. All patients were treated in the endocrinological therapeutic department for the same period of time (2002-2006). Laser therapy included infrared laser light with wavelength 0.89 mkm, defocused beam with power 3.5 Wt, pulse frequency 3,000 Hz, irradiated surface of 1 cm², absorbed dose 2.5-3 J. The irradiation was done in the contact-mirror technique in the projection of the thyroid gland, exposure time 3-5 min. per each lobe. The course of treatment consisted of 10 sessions. In case of mild subacute thyroiditis, laser therapy was used as a monotherapy. In moderate subacute thyroiditis laser therapy was combined with non-steroid anti-inflammatory drugs (Ortophenum, Nimesulide). Patients with a severe form who had no desired effect were injected 20 mg of Kenalog into the diseased lobe at the end of treatment. Average terms of hospitalization of patients receiving glucocorticoid therapy were 22 days, of patients receiving laser therapy - only 12 days. Of 49 patients having glucocorticoid therapy, 6 patients (12.2%) were hospitalized again with the disease recurrence. Of 122 patients having laser therapy the disease recurrence was seen in 5 patients (4.1%). All of them had a repeated course of treatment which included laser therapy and one or two Kenalog injections; no «re-recurrences» were registered. These data were obtained in 2004. The authors have a patent of the Russian Federation ( No 2345804) for their technique which was registered on February 10, 2009.

подострый тиреоидит, лазеротерапия, традиционная терапия, subacute thyroiditis, laser therapy, traditional therapy

1. Актуальные проблемы лазерной медицины: сборник научных трудов / Под ред. Н.Н. Петрищева. - Спб.: Изд-во СПбГМУ, 2001. - 296 с.

2. Аль-Шукри С.Х., Ткачук В.Н., Соколов А.В., Слесаревская М.Н. Актуальные проблемы лазерной медицины. Сб. научных трудов. - СПб., 2001. - С. 174-179.

3. Аристархов Р.В., Кириллов Ю.Б., Аристархов В.Г. Причины ошибочных хирургических вмешательств у больных с подострым тиреоидитом де Кервена // Мат-лы ежегодн. научн. конф-ции РязГМУ - Рязань, 2009. - C. 66.

4. Аристархов В.Г., Аристархов Р.В. Лазеротерапия, как новый метод лечения подострого тиреоидита де Кервена // Российский медико-биологический вестник имени акад. И.П. Павлова. - 2001. - № 1-2. - С. 136-138.

5. Артемов А.М., Игнатков В.Я. Возможности ультразвуковой диагностики при аутоиммунных заболеваниях щитовидной железы // Актуальные пробл. совр. эндокринол. - М., 2001. -С. 263.

6. Бомаш Н.Ю. Морфологическая диагностика заболеваний щитовидной железы. - М.: Медицина, 1981. - 173 с.

7. Вагапова Г.Р., Никишова Т.В., Анчикова Л.И. Лечение больных подострым тиреоидитом // Казанский мед. журнал. - 1995. -№ 2. - С. 88-89.

8. Валдина Е.А. Заболевания щитовидной железы. - СПб.: Питер, 2001. - 416 с.

9. Минченко Е.Ю., Котова Г.А., Артемова А.М. и др. О диагностике подострого тиреоидита // Пробл. эндокринол. - 1992. -№ 5. - С. 28-30.

10. Патент РФ № 2345804. «Способ лечения подострого тиреоидита де Кервена с помощью низкоинтенсивной лазеротерапии инфракрасного спектра и нестероидных и стероидных препаратов». Аристархов В.Г., Аристархов Р.В., 2009.

11. Фомина И.Ю. Роль высокочастотной эхографии в диагностике подострого тиреоидита де Кервена. Автореферат канд. мед. наук. - Н. Новгород, 2003. - 26 с.