THE METHODOLOGY OF ASSESSING THE EFFECTIVENESS OF THE THERAPY
Objectives: To substantiate the methodology for assessing the effectiveness of drug therapy, based on the effect of therapy not only on the target organ or function, but also on the regulatory and adaptive status (RAS) of the organism. Material and methods: The cardio-respiratory synchronism test (CRS), proposed as one of the rationale for the concept of the hierarchical system of cardiac rhythmogenesis in an integral organism, was used to evaluate the RAS, since it characterizes the complex reaction of the two most important vegetative functions – respiratory and cardiac. The technique of obtaining cardio-respiratory synchronism in humans, analyzing its parameters and calculating the regulatory-adaptive status index (iRAS) by the parameters of the CRS is described. Results: Pronounced changes in iRAS under cyclic changes in the body of pregnant women with psycho-emotional stress before delivery are shown expressed. These observations revealed high information value of the method in assessing the dynamics of regulatory and adaptive capabilities of the organism. Monotherapy of arterial hypertension was carried out by agents of different groups. The treatment outcomes were compared in those patients who reached the target blood pressure level in 6 months (140/90 mm Hg). It was found that under the same effectiveness of therapy according to the target function parameter – the level of blood pressure, preparations of different groups had unequal influence on the body's RAS. In the treatment with lisinopril, hydrochlorothiazide, nifedipine, and diltiazem, iRAS increased; when treated with atenolol and doxazosin, on the contrary, it decreased below the baseline values before the start of the therapy. Conclusion: The evaluation of the dynamics of RAS provides a new methodological approach to the characterization of the effectiveness of drug therapy, based on the assessment of the effect not only on the target organ or function, but also on the regulatory and adaptive capabilities of the organism.