напрямку (38,9 %) та з кефалометричними показниками (34,3 %).
Kro40Bi слова: юнаки-брахщефали з ортогнатич-ним прикусом, кореляцп, кефалометричш показники.
Стаття надiйшла 15.11.2017 р.
границы в преддверно-языковом направлении (38,9 %) и с кефалометрическими показателями (34,3 %).
Ключевые слова: юноши-брахицефалы с ортогнатичес-ким прикусом, корреляции, кефалометрические показатели.
Рецензент Срошенко Г.А.
DOI 10.26724 / 2079-8334-2018-1-63-52-56 UDC 572.087:612.13:796.071
PECULIARITIES OF RHEOVASOGRAPHY PARAMETERS OF THE SHIN IN VOLLEYBALL PLAYERS, WRESTLERS, ATHLETES OF MESOMORPHIC SOMATOTYPE
e-mail: [email protected]
Changes in time, amplitude and derivative of the rheovasograms of the shin in the adolescent athletes of a high level of skills who have been engaged in volleyball, athletics and wrestling with at least three years of sports have been determined. The control group was made up of almost healthy individuals aged 17-21 years. It was established that volleyball players, athletes and wrestlers of mesomorphic somatotype had significant differences in the size of the rheovasographic parameters of the shin between themselves and in comparison with those of the same constitutional type who were not engaged in sports. Sport specialization, which predetermined the features of muscular activity, to a greater extent than belonging to a separate constitutional type, led to changes in the regional circulation in the shin at representatives of different sports types.
Keywords: shin rheovasography, mesomorphic somatotype, volleyball players, athletes, wrestlers.
The paper is a fragment of RSW "Features of the indices of hemodynamics, depending on the parameters of the body structure in athletes of different sports" (State registration number 0115U004045).
The factor limiting the growth of sports achievements in many sports types is the complex of morphofunctional indices of the cardiovascular system. Sufficient regional blood circulation provides an important part in solving this problem, because adequate blood supply to working muscles, which during intense physical activity increases in dozens of times, makes it possible to complete a full range of training and competition programs [1, 13]. A large number of scientific studies in this area confirms the indisputable relevance of determining the features of peripheral hemodynamics in representatives of various sports [2, 5, 8, 17]. In addition, an individual inhomogeneity of elements of peripheral circulation was established, which was determined by the constitutional characteristics of the human body [4, 6, 15]. Publications in which hemodynamic parameters of athletes of different sports and their belonging to certain somatotypes were studied are unfortunately in small number [14, 16].
The purpose of the paper was to establish changes in the time, amplitude and derived indices of the shin rheovasography in volleyball players, wrestlers and athletes who belonged to the mesomorphic type of the constitution.
Material and methods. We conducted a comprehensive survey of young athletes aged 17 to 21 years of high level of athletic skill (from the first adult level to masters of sports), namely, 60 volleyball players, 88 athletes and 61 wrestlers. The control group consisted of 74 males, who were not engaged in sports and at the time of the survey were almost healthy. The rheovasographic parameters were determined using a computer diagnostic complex. The estimation of the quantitative parameters was carried out according to time, amplitude and derivatives using the Ronkin and Ivanov's method [12]. The determination of somatotypes was carried out according to the estimated modification of the Heath-Carter method [3].The somatotypological analysis showed that the greatest number of athletes and controls belonged to the mesomorphic type of constitution: 32 volleyball players, 40 wrestlers, 51 athletes, 25 non-sportsmen. The statistical processing of the results was carried out using the package "STATISTICA 5.5" (license number AXXR910A374605FA). The nature of the distributions for each of the received variation series was evaluated by the Shapiro-Wilk test, the mean and standard quadratic deviations for each sign and the validity of the difference in values were determined by the Man-Whitney U-test.
Results and discussion. We have established the marked differences in the size of the indices of the rheovasography of the shin between representatives of various sports and non-athletes [10] and athletes of different constitutional types [9]. Therefore, we compared the size of the parameters of peripheral hemodynamics on the example of the shin in the representatives of one somatotype, which differed in terms of motor activity and the peculiarities of sports activity. Most of the amplitude indices of the rheogram of the shin
in the mesomorphs of different groups had significant differences (Table 1). When comparing the value of the base impedance, its greatest mean values were revealed for volleyball players, the least ones were found in athletes; significant differences (p<0,001) were established between these groups. Individuals of the mesomorphic somatotype in control group had a significantly higher incidence as compared to athletes (p<0,001). The amplitude of the systolic wave in the mesomorphic wrestlers was the smallest in comparison with other groups of comparison; in volleyball players, the greatest, reliable difference was found between wrestlers and volleyball players (p<0,01) and non-athletes (p<0,05). The incisure amplitude in mesomorphic non-sports people was the highest, with the least number in wrestlers, and a significant difference was found between these groups (p<0,05). The amplitude of the diastolic wave in representatives of different sports of mesomorphic somatotype did not differ significantly (p<0,05), only the control group showed the highest mean values of this index. In mesomorphic volleyball players the amplitude of fast blood filling, which depends on the degree of dilation of the vascular walls and their elasticity [11] is greater than in athletes (p<0,05) and wrestlers (p<0,01) (Table 1).
Table 1
Peculiarities of the amplitude indices (Ohm) of the rheogram of the shin at athletes of the mesomorphic __somatotype____
Index Survey group M±o P1 p2 p3
Basic impedance Volleyball players 67,25±10,62 P1 p2 p3
Athletics 56,49±9,569 - <0,001 >0,05
Wrestlers 61,19±13,45 <0,001 - >0,05
Controls 63,94±6,645 >0,05 >0,05 -
Amplitude of the systolic wave Volleyball players 0,052±0,016 >0,05 <0,001 >0,05
Athletics 0,046±0,011 - >0,05 <0,01
Wrestlers 0,043±0,011 >0,05 - >0,05
Controls 0,049±0,011 <0,01 >0,05 -
Impedance incisure Volleyball players 0,015±0,005 >0,05 >0,05 <0,05
Athletics 0,015±0,006 - >0,05 >0,05
Wrestlers 0,014±0,006 >0,05 - >0,05
Controls 0,018±0,008 >0,05 >0,05 -
Amplitude of the diastolic wave Volleyball players 0,019±0,006 >0,05 >0,05 <0,05
Athletics 0,019±0,006 - >0,05 >0,05
Wrestlers 0,017±0,005 >0,05 - >0,05
Controls 0,020±0,006 >0,05 >0,05 -
Amplitude of rapid blood filling Volleyball players 0,022±0,006 >0,05 >0,05 >0,05
Athletics 0,019±0,005 - <0,05 <0,01
Wrestlers 0,018±0,005 <0,05 - >0,05
Controls 0,020±0,004 <0,01 >0,05 -
Note: here and thereafter: p1 - index of the statistically significant difference between the indices of shin rheograms in volleyball players and other groups; p2 - index of the statistically significant difference between the indices of the shin rheograms in athletes and other groups; p3 - index of the statistically significant difference between the rheogram data in the wrestlers and other groups.
We have found the longest time of propagation of the pulse wave at the shin in athletes (Table 2). They have a higher rate than volleyball players (p <0,001) and wrestlers (p<0,01). It should be noted that volleyball players showed the smallest duration of the rheographic wave and the longest time of the ascending part of the leg rheogram as compared with all the comparison groups. Wrestlers showed the least time of the ascending part of the rheogram with a score by 13.4% (p<0,001) lower as compared to volleyball players. Athletes and controls group showed the same level. An increase in the time of the ascending part of the rheogram indicates a slowing of blood flow to the shin in volleyball players, which may be due to the reduced ability of the vessel to stretch [11]. No significant differences (p<0,05) in the time of the descending part of the shin rheogram have been found in volleyball players, wrestlers and non-sportsmen of the mesomorphic somatotype. In athletes, this index was the biggest, reflecting a sufficient elasticity of the wall of their vessels [7] and can serve as an example of a rational adaptation of the regional blood circulation system to dynamic physical activity. There is a reliable difference between the time value of the downward part of the rheogram between athletes and volleyball players (p<0,001) and wrestlers (p<0,01). It was established that the time of rapid blood filling did not have a significant difference as compared with athletes-mesomorphs of different types of sports, i.e., did not depend on the type and volume of muscle activity. The time for slow blood flow in volleyball players is probably greater than in wrestlers, where this index is also significantly lower than that of athletes (Table 2).
It was established that the dicrotic index of the shin rheogram did not have a significant difference when comparing with the groups of athletes of the mesomorphic somatotype. In non-sports people, the dicrotic index had the highest values among all the comparison groups, and a significant difference was established between them and the group of volleyball players (Table 3). The diastolic index, the average speed
of fast and slow blood transfusion, had no significant differences when comparing with the groups of athletes and boys of the control group of the mesomorphic somatotype. We have found that volleyball players of the mesomorphic somatotype had a greater tone of all arteries than athletes and wrestlers (p<0,001) and non-sportsmen (p<0,001). Between athletes, wrestlers and non-sports people, this index was not significantly different (Table 3). The tone of large-diameter arteries in volleyball players is statistically significantly higher than in athletes and wrestlers (p<0,05). Due to the tonus of arteries of medium and small diameter, volleyball players significantly surpassed athletes of other groups (p<0,001) and juveniles of the control group (p<0,01). The least average values were in athletes. It should be noted that all the rheovasographic parameters of the vessel tone did not have a significant difference as compared to athletes, wrestlers and non-sportsmen groups of mesomorphic somatotype.
Table 2
Peculiarities of time indices (s) of rheograms of the shin in athletes of mesomorphic somatotype
Index Survey group M±0 P1 p2 p3
Duration of the rheographic wave Volleyball players 0,933±0,135 - <0,001 >0,05
Athletics 1,054±0,135 <0,001 - <0,01
Wrestlers 0,964±0,122 >0,05 <0,01 -
Control 1,006±0,153 <0,05 >0,05 >0,05
Time of the ascending part Volleyball players 0,152±0,027 - >0,05 <0,001
Athletics 0,145±0,025 >0,05 - >0,05
Wrestlers 0,134±0,015 <0,001 >0,05 -
Control 0,145±0,030 >0,05 >0,05 >0,05
Time of the downward part Volleyball players 0,781±0,131 - <0,001 >0,05
Athletics 0,909±0,136 <0,001 - <0,01
Wrestlers 0,830±0,121 >0,05 <0,01 -
Control 0,861±0,149 >0,05 >0,05 >0,05
Time for rapid blood flow Volleyball players 0,062±0,025 - >0,05 >0,05
Athletics 0,058±0,026 >0,05 - >0,05
Wrestlers 0,053±0,016 >0,05 >0,05 -
Control 0,059±0,028 >0,05 >0,05 >0,05
Time for slow blood flow Volleyball players 0,090±0,013 - >0,05 <0,01
Athletics 0,087±0,011 >0,05 - <0,05
Wrestlers 0,080±0,012 <0,01 <0,05 -
Control 0,086±0,010 >0,05 >0,05 >0,05
Table 3
Peculiarities of the indices of the ratios of the amplitude and temporal parameters of the shin rheogram _in athletes of the mesomorphic somatotype___
Index Survey group M±0 P1 p2 p3
Dicrotic index (%) Volleyball players 30,28±12,67 - >0,05 >0,05
Athletics 31,70±10,06 >0,05 - >0,05
Wrestlers 31,81±10,03 >0,05 >0,05 -
Control 36,16±14,79 <0,05 >0,05 >0,05
Diastolic index (%) Volleyball players 37,50±8,73 - >0,05 >0,05
Athletics 41,43±8,605 >0,05 - >0,05
Wrestlers 40,82±7,698 >0,05 >0,05 -
Control 40,32±8,894 >0,05 >0,05 >0,05
Average speed of fast blood flow (Ohm/s) Volleyball players 0,395±0,142 - >0,05 >0,05
Athletics 0,369±0,132 >0,05 - >0,05
Wrestlers 0,360±0,107 >0,05 >0,05 -
Control 0,391±0,116 >0,05 >0,05 >0,05
Average speed of slow blood flow (Ohm/s) Volleyball players 0,329±0,106 - >0,05 >0,05
Athletics 0,318±0,092 >0,05 - >0,05
Wrestlers 0,303±0,084 >0,05 >0,05 -
Control 0,339±0,086 >0,05 >0,05 >0,05
Index of the tone of all arteries (%) Volleyball players 16,12±3,240 - <0,001 <0,001
Athletics 13,50±2,997 <0,001 - >0,05
Wrestlers 13,58±2,259 <0,001 >0,05 -
Control 14,18±3,559 <0,01 >0,05 >0,05
Indices of tone of arteries of large diameter (%) Volleyball players 6,266±2,800 - <0,05 <0,05
Athletics 5,157±2,633 <0,05 - >0,05
Wrestlers 5,081±1,754 <0,05 >0,05 -
Control 5,400±2,553 >0,05 >0,05 >0,05
Indices of tone of arteries of medium and small diameter (%) Volleyball players 9,359±1,602 - <0,001 <0,001
Athletics 7,823±1,529 <0,001 - >0,05
Wrestlers 8,040±1,613 <0,001 >0,05 -
Control 8,340±2,125 <0,01 >0,05 >0,05
Ratio of arterial tone (%) Volleyball players 71,17±32,41 - >0,05 >0,05
Athletics 69,80±37,26 >0,05 - >0,05
Wrestlers 68,49±26,14 >0,05 >0,05 -
Control 69,18±31,09 >0,05 >0,05 >0,05
Thus, in volleyball players the significantly higher values of the tone of all arteries and the tone of arteries of large, medium and small diameters have been determined, which may be evidence of negative changes in the regional blood flow to the shin and signs of the organic pathology of the venous system. The ratio of arterial tone in individuals of mesomorphic somatotype of different groups did not have a statistically significant difference (Table 3).
It was established that volleyball players, athletes and wrestlers of mesomorphic somatotype showed significant reliable differences in the size of the rheovasographic parameters of the shin between themselves and in comparison with those of the same constitutional type who were not engaged in sports. Sport specialization, which predetermined the features of muscle activity rather than belonging to a separate constitutional type, led to changes in the regional blood circulation of the shin at representatives of different sports. The most significant changes in the rheovasographic indices were revealed in the volleyball players of the mesomorphic somatotype.
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9. Khapitska OP. Somatotypolohichni osoblyvosti parametriv peryferychnoyi hemodynamiky u sportsmeniv. Visnyk VNMU. 2016; 2 (20): 375-82. (in Ukraine)
10. Khapitska OP, Ivanytsya AO, Stefanenko IS, Sarafynyuk LA, Moroz VM. Zminy reohrafichnykh pokaznykiv homilky u sportsmeniv riznykh vydiv sportu. Fiziol Zh. 2017; 63(1): 51-9. (in Ukraine)
11. Podkolzina VA. Meditsinskaya fizika. Moskva: Meditsina; 2007. 32 p. (in Russian)
12. Ronkin MA, Ivanov LB. Reografiya v klinicheskoy praktike. Moskva: Nauchno-meditsinskaya firma MBN; 1997. 250 p. (in Russian)
13. Rowell LB. Ideas about control of skeletal and cardiac muscle blood flow: cycles of revision and new vision. J Appl. Physiol. 2004; 97 (№ 1): 384-92.
14. Sarafynyuk LA, Kyrychenko YuV, Kyrychenko IM. Osoblyvosti amplitudnykh pokaznykiv elektrokardiohramy u yunakiv i divchat sport- smeniv i nesport- smeniv riznykh somatotypiv. Biomedical and biosocial anthropology. 2014; 22: 10-20. (in Ukraine)
15. Vadzyuk SN, Hunas IV, Tsvyntarnyy AV. Osoblyvosti chasovykh i amplitudnykh pokaznykiv reovazohramy stehna u praktychno zdorovykh yunakiv i divchat riznykh somatotypiv. Ukrayinskiy morfologIchniy almanakh 2014; 12( 2): 92-4. (in Ukraine)
16. Yakusheva YuI. Pokaznyky tsentral'noyi hemodynamiky u voleybolistok z riznymy typamy statury tila. Bullrtin of problems in biology and medicine. 2015; 3 (123): 344-7. (in Ukraine)
17. Zamchiy TP, Salova YuP, Koryagina YuV. Osobennosti regionalnoy gemodinamIki sportsmenov, razvivayuschih vyinoslivost, silu i silovuyu vyinoslivost. Exercise therapy and Sports Medicine. 2012; № 7: 23-27. (in Russian)
2. Bredihina YuP, Kapilevich LV, Guzhov FA, Andreev VI. Harakteristika regionarnoy gemodinamiki nizhnih konechnostey u cportsmenov, zanimayuschihsya sportivnyim karate.Theory and Practice of Physical Culture. 2012; № 7: 49-51. (in Russian)
3. Carter JL, Heath BH. Somatotyping - development and. Cambridge University Press; 1990. 504 p.
4. Chaplyigina EV, Kaplunova OA, Shulgin AI, Makarenko ES. Harakteristika sosudov nizhnih konechnostey, po dannyim UZI, u devushek razlichnyih somatotipov. Medical News of North Caucasus. 2011; № 4: 80-2. (in Russian)
5. Hornero G, Diaz D, Casas O. Bioimpedance system for monitoring muscle and cardiovascular activity in the stump of lower-limb. Physiol. Meas. 2013; № 34: 189-201.
6. Ivanytsya A.O. Vikovi, statevi ta somatotypolohichni osoblyvosti chasovykh pokaznykiv reovazohramy homilky u praktychno zdorovykh yunakiv i divchat Podillya. Word of medicine and biology. 2014;1: 37-41. (in Ukraine)
7. Krupatkin AI. Klinicheskaya neyroangiofiziologiya konechnostey. Moskva: Nauchnyiy mir; 2003. 328 p. (in Russian)
8. Kudrya ON, Kiryanova MA, Kapilevich LV. Osobennosti perifericheskoy gemodinamiki sportsmenov pri adaptatsii k nagruzkam razlichnoy napravlennosti. Bulletin of Siberian Medicin. 2012; № 3: 48-52. (in Russian)
9. Khapitska OP. Somatotypolohichni osoblyvosti parametriv peryferychnoyi hemodynamiky u sportsmeniv. Visnyk VNMU. 2016; 2 (20): 375-82. (in Ukraine)
10. Khapitska OP, Ivanytsya AO, Stefanenko IS, Sarafynyuk LA, Moroz VM. Zminy reohrafichnykh pokaznykiv homilky u sportsmeniv riznykh vydiv sportu. Fiziol Zh. 2017; 63(1): 51-9. (in Ukraine)
11. Podkolzina VA. Meditsinskaya fizika. Moskva: Meditsina; 2007. 32 p. (in Russian)
12. Ronkin MA, Ivanov LB. Reografiya v klinicheskoy praktike. Moskva: Nauchno-meditsinskaya firma MBN; 1997. 250 p. (in Russian)
13. Rowell LB. Ideas about control of skeletal and cardiac muscle blood flow: cycles of revision and new vision. J Appl. Physiol. 2004; 97 (№ 1): 384-92.
14. Sarafynyuk LA, Kyrychenko YuV, Kyrychenko IM. Osoblyvosti amplitudnykh pokaznykiv elektrokardiohramy u yunakiv i divchat sport- smeniv i nesport- smeniv riznykh somatotypiv. Biomedical and biosocial anthropology. 2014; 22: 10-20. (in Ukraine)
15. Vadzyuk SN, Hunas IV, Tsvyntarnyy AV. Osoblyvosti chasovykh i amplitudnykh pokaznykiv reovazohramy stehna u praktychno zdorovykh yunakiv i divchat riznykh somatotypiv. Ukrayinskiy morfologIchniy almanakh 2014; 12( 2): 92-4. (in Ukraine)
16. Yakusheva YuI. Pokaznyky tsentral'noyi hemodynamiky u voleybolistok z riznymy typamy statury tila. Bullrtin of problems in biology and medicine. 2015; 3 (123): 344-7. (in Ukraine)
17. Zamchiy TP, Salova YuP, Koryagina YuV. Osobennosti regionalnoy gemodinamIki sportsmenov, razvivayuschih vyinoslivost, silu i silovuyu vyinoslivost. Exercise therapy and Sports Medicine. 2012; № 7: 23-27. (in Russian)
ОСОБЛИВОСТ1 РЕОВАЗОГРАФ1ЧНИХ ПАРАМЕТР1В
ГОМ1ЛКИ У ВОЛЕЙБОЛ1СТ1В, БОРЦ1В, ЛЕГКОАТЛЕТ1В МЕЗОМОРФНОГО СОМАТОТИПУ Мороз В. М., Хапщька О. П., Кириченко Ю. В., Кебаба С. О., Сарафинюк П. В.
Визначали змши часових, ампл^удних i похщних вщ них показниюв реовазограми гомшки у спортсмешв високого р1вня майстерносп юнацького вку, яю займаються волейболом, легкою атлетикою i боротьбою iз спортивним стажем не менше трьох роюв. Групу контролю склали практично здоровi особи у вщ 17-21 року. Встановлено, що волейболюти, легкоатлети та борщ з мезоморфним соматотипом мали достовiрнi вщмшносп у величиш реовазографiчних параметрiв гомшки мiж собою та у порiвняннi з особами того ж конституцюнального типу, яю не займалися спортом. Спортивна спецiалiзацiя, яка обумовлювала особливосп м'язово! дiяльностi, у бшьшш мiрi, шж належшсть до окремого конституцюнального
ОСОБЕННОСТИ РЕОВАЗОГРАФИЧНИХ ПАРАМЕТРОВ ГОЛЕНИ У ВОЛЕЙБОЛИСТОВ, БОРЦОВ, ЛЕГКОАТЛЕТОВ МЕЗОМОРФНОГО СОМАТОТИПА Мороз В. М., Хапицкая О. П., Кириченко Ю. В., Кулибаба С.
А., Сарафинюк П. В.
Определяли изменения временных, амплитудных и производных от них показателей реовазограммы голени у спортсменов высокого уровня мастерства юношеского возраста, которые занимаются волейболом, легкой атлетикой и борьбой со спортивным стажем не менее трех лет. Группу контроля составили практически здоровые лица в возрасте 17-21 года. Установлено, что волейболисты, легкоатлеты и борцы с мезоморфным соматотипом имели достоверные различия в величине реовазографичних параметров голени между собой и по сравнению с лицами того же конституционального типа, которые не занимались спортом. Спортивная специализация, которая обусловливает особенности мышечной деятельности, в большей мере, чем принадлежность к отдельному конституциональному
типу, призводила до змш регюиариого кровооб^у гомшки у иредставииюв рiзних видiв спорту.
Ключовi слова: реовазографiя гомiлки, мезоморфний соматотип, волейболюти, легкоатлети, борцi.
Стаття надiйшла 18.11.2017 р.
Б01 10.26724 / 2079-8334-2018-1-63-56-60 УДК 618.173:616.379-008.64:616.12-073:53.082.04
типу, приводит к изменениям регионарного кровотока голени у представителей различных видов спорта.
Ключевые слова: реовазография голени, мезоморфный соматотип, волейболисты, легкоатлеты, борцы.
Рецензент Срошенко Г.А.
ДИНАМ1КА ПОКАЗНИК1В ЕхоКГ У ПАЩеНТОК 13 КЛ1МАКТЕРИЧНИМ СИНДРОМОМ НА ТЛ1 Г1ПОТИРЕОЗУ П1Д ВПЛИВОМ КОМПЛЕКСНО! ТЕРАПП
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Обстежено 101 пащентку вiком 45-55 роюв iз клiмактеричним синдромом на та гтотиреозу. Жiнки групи 1(п=34) отримували лише базову терапiю згiдно Нацюиальиого консенсусу щодо ведення пацiенток у тмактерп. Жiнкам групи 2 (п=34) на тлi базово! терат! було застосовано фiзiотерапевтичне лiкування (ультразвукова тератя та контрастнi ванни 2 рази/тиждень протягом двох мiсяцiв). Жiнкам групи 3 (п=33) окрiм базово! терат! призначали антигомотоксикологiчнi препарати. Запропонованi комплекси позитивно впливали на стан серцево-судинно! системи хворих, а також зменшували ступiнь тяжкост клiмактеричного синдрому та важкосп психоемоцiйного компоненту. Бiльш ефективним був комплекс, що включав антигомотоксиколопчш засоби, що пiдтверджуеться динамiкою показниюв ЕхоКГ. 1з клiнiчноi' точки зору, отримаш результати дають обгрунтовану тдставу рекомендувати данi комплекси для корекцй функцiональних серцево-судинних порушень у жшок iз клiмактеричними розладами на та гiпофункцii' щитоподiбноi' залози.
Ключов! слова: юпмактеричний синдром, гшотиреоз, (}лзютерапевтичне лжування, аитигомотоксиколопчш засоби.
Робота е фрагментом НДР «Вiдновлення та збереження репродуктивного здоров 'я i якостi життя жшки в сучаснихумовах при акушерсъкш i гiнекологiчнiй патологи» (державний номер реестраци 0113и007336).
Змши демограф1чно! сигуацп в свт, i в Укрш'ш в тому числ1, свщчать, що сучасна жшка 1/3 життя проводить у сташ естрогенного дефщиту, тд час якого вщбуваегься згасання репродуктивно! функцп жшки. У жшок евроиейсько! иоиуляцп цей иерюд доводиться на вш 45-55 роюв ¡з тком менопаузи у вщ близько 50 роюв. При цьому, особлива увага вчених сьогодш прищляеться пол1пшенню якост життя жшок кшмактеричного перюду, осюльки на фот клiмакгеричних розлад1в вона значно иогiршуегься [3, 17]. За даним лiгерагури, 82,7 % жшок клiмакгеричного вiку вказують на страждання вiд тииових КР, 78,1 % - вщчувають приливи жару, 84,9 % - млявють, шдвищену стомлюванiсть, 67,3 % - головн болi, збiльшення маси тiла сиостер^аються у 62,4 % жшок, болi в суглобах, сиинi - у 48,7 %, закрепи i розлади сечовипускання - у 36,5 i 21,0 %, вiдиовiдно, 76,0 % жшок мають деиресивнi розлади, нервозшсть, иодразливiсть, безсоння, иослаблення иам'ятi. Таким чином, майже в 90 % жгнок естрогенна недостатнiсть, що супроводжуе меноиаузу, несириятливо иозначаеться на сташ здоров'я [9, 14]. Патогенетично обгрунтованим методом лiкування симитомiв, иов'язаних iз дефiцитом естрогенiв, е призначення замюно! гормонально! тераиii' (ЗГТ), метою яко! е фармакологiчна замiна гормонально! функцп яечникiв. Основним иоказанням до ЗГТ е наявтсть клiмактеричного синдрому середнього i тяжкого стуиеню [13]. Проте, незважаючи на значне число i високу достовiрнiсть клiнiчних даних, що стосуються ефекгивностi i безиечностi ЗГТ, доа тривають дискусii' з приводу корист i ризику застосування препарапв ЗГТ з урахуванням !хнього виливу на серцево-судинну систему (ССС), молочну залозу, виникнення громбоемболiчних ускладнень, когштивних розладiв тощо, а також щодо ведення иащенток iз иоеднаними патолопями, що являють особливий контингент хворих [7, 19]. Таким чином, необхщним е пошук комплементарних методiв л^вання, що розширюють можливостi лiкарiв.
Вивчення найбiльш частих захворювань, у тому чи^ ендокринних, що виникають унаслщок меноиаузи, або вже iснуючих соматичних розладiв, е вкрай актуальним, осюльки иоеднання захворювань ендокринно! системи i клiмактеричного синдрому створюе умови для взаемного обтяження, маскування клiнiчних проявiв захворювань або змiни иеребiгу основного ендокринного захворювання як самого ио соб^ так i на тл ЗГТ. Будь-яю ендокриннi дисфункцii' негативно впливають як на метаболiчнi процеси в усьому органiзмi, так i на емоцiйно-особистiсний фон иацiента. Наявтсть у пащентки цукрового дiабету, ожиршня, иатологii' щигоиодiбноi' залози або iнших ендокриноиатiй у бiльшостi вииадкiв потребуе iндивiдуального иiдходу з призначенням комплексного лшування клiмактеричних розладiв iз метою !хньо! адекватно! корекцл [6, 10].