Динаміка клінічних симптомів й функціонального стану біліарної системи у хворих на хронічний безкам’яний холецистит на тлі цукрового діабету 2 типу під впливом комплексної терапії

Abstract

The urgent problem of modern medical science and practice is the rapid increase of comorbid pathology spreading among the population of the whole world. Among the nosological forms, which are quite often combined with each other, there are cardiovascular system, digestive tract and endocrine diseases, namely type 2 diabetes mellitus. Diseases of the biliary tract, in the form of chronic acalculous cholecystitis, occur in patients with type 2 diabetes more often than in its absence. There is no doubt that the combination of diseases of the gallbladder and type 2 diabetes significantly affects the course and prognosis of both diseases, and the development of complications is one of the main causes of disability and mortality in patients. In this regard, the priority areas of health protection are the search for preventive measures to eliminate the development of diseases, their complications and the amendment of therapeutic patterns. The purpose of the study was to evaluate the efficacy of complex therapy with the addition of ursodeoxycholic acid and alpha-lipoic acid in patients with concomitant chronic acalculous cholecystitis and type 2 diabetes on the basis of studying the dynamics of clinical symptoms and the content of bile acids in blood serum, as well as parameters of cholecystosonography (in overview and dynamic versions). Material and methods. In the course of the study, 62 patients with the combined course of chronic hepatitis and diabetes mellitus were examined. The age of the patients ranged from 44 to 75 years old. The duration of type 2 diabetes was from 1 to 19 years. The group was representative in terms of age and number of male and female probands. Upon admission to the hospital, all patients underwent a thorough examination using generally accepted clinical, laboratory and instrumental studies. Results and discussion. The complex treatment included hypoglycemic drugs, medical nutrition, prescription of antispasmodic and antibacterial therapy, ursodeoxycholic acid drugs at a dose of 15 mg / kg / day for 4 weeks, as well as preparations of alpha-lipoic acid 600 I / V drip for 10 days, followed by oral administration in within 12 weeks. In order to assess the effectiveness of therapy, clinical symptoms, serum levels of fatty acids, indicators of survey and dynamic cholecystosonography were evaluated after 3 months in the dynamics of treatment. Conclusion. The study showed that the addition of ursodeoxycholic acid and alpha-lipoic acid to the complex therapy was accompanied by positive effects due to an improvement in the contractility of the gallbladder, a decrease in the serum fatty acid content, improved the motor and cholesecretory functions of the gallbladder and the clinical condition of patients by eliminating abdominal pain and reducing the percentage of patients with chronic acalculous cholecystitis and type 2 diabetes with manifestations of dyspeptic, neuro-vegetative and asthenic syndromes