МОЖЛИВОСТІ БІОРЕГУЛЯЦІЇ У КОМПЛЕКСНІЙ ТЕРАПІЇ ХРОНІЧНОГО ПАНКРЕАТИТУ У КОМОРБІДНОСТІ З ХРОНІЧНИМ ВІРУСНИМ ГЕПАТИТОМ С

Abstract

Key words: chronicpancreatitis, chronicviralhepatitis C, bioregulatorydrugs, Momordica compositum, Hepel, functional and structuralstate of the pancreas. Topicality. Insufficient development of primary and secondary prevention of chronic pancreatitis (CP), which occurs on the background of chronic viral hepatitis C (CVHC), requires a deeper study of the mechanism of its development and the establishment of clinical and pathogenetic features, which should be taken into account rehabilitation. One of such approaches to complex treatment of CP on the background of CVHC is the inclusion of drugs of bioregulatory therapy, which motivated thestudy. The aim is to investigate the parameters of the functional and structural state of the pancreas in chronic pancreatitis on the background of chronic viral hepatitis C, as well as their dynamics under the influence of complex therapy with the inclusion of bioregulatory drugs (BRD). Materials and methods. 106 patients with CP without exacerbation in combinationwith CVHC in the remission phase and without it were examined. The main group of the study included 72 patients with CP in the phase of unstable remission with concomitant CVHC in the latent stage. Patients with CP and concomitant CVHC were divided into two groups according to correction programs. It should be noted that patients in the study contingent of etiological antiviral therapy for CVHC infection for various reasons were not treated (refusal of antiviral treatment due to allergic history, personal intolerance, financial insolvency, etc.). Group I (36 patients) received only conventional treatment (CT). Group II (36 patients), in addition to CT, received additional BRD Momordica compositum for 1 amp. in / m 3 times a week for one month) and Hepel 1 tab. sublingually 3 times a day for 15-20 minutes before meals or after 1 hour after meals for one month. Results. After treatment an improvement in the structure of the pancreas and liver was observed, as evidenced by a decrease in the severity of Echoelastography and ultrasound. The score of ultrasound soft ware in the first group decreased by 28.6 %, and in the second group – decreased by 57.1 %; the rate of Echoelastography of the pancreas by 4.8% and 26.1 %, respectively, and the Echoelastography of the liver – by 15.3 % and 30.7 %, respectively. They also noted an improvement in the results of the coprogram and an increase in the level of fecal elastase-1: inthefirst group – by 23.8 %, and in the secondgroup – by 52.7 %. Discussion. Positive dynamics wasobserved in both groups, but in patients of group I after treatment it was less significant thaningroup II, where additionally a patient with CP on the background of CVHC received complex BRD (p <0.05). This proved a statistically significant higher efficacy of treatment using a complex bioregulatory corrector ofexocrine insufficiency (Momordica Compositum) and a complex bioregulatory hepatotropic drug (Hepeel) for one month. Conclusions: 1. Concomitant CVHC in the latent stage worsened the structural and functional state of the pancreas in CP, as well as the structural state of the liver according to EHR (p<0,05); 2. The use of complex bioregulatory therapy in addition to the conventional treatment of CP on the background of latent CVHC contributed to a statistically significant increase in its effectiveness in relation to conventional treatment: the level of fecal elastase-1 increased by 52.7% (p <0.05) compared to 23.8 %, pancreatic rigidity decreased by 26.1 % vs. 4.8 % (p <0.05), liver rigidity decreased by 30.7 % vs. 15.3 % (p <0.05).