Особливості лікування гастроезофагеальної рефлюксної хвороби у хворих на цукровий діабету ІІ типу

Abstract

In the world scientific literature sources, the issue of the combined course of gastroesophageal reflux disease (GERD) and diabetes mellitus (DM) is actively discussed. Along with this, research is necessary to select effective therapeutic complexes that have a multidirectional positive effect in patients with comorbid pathology, especially in type 2 DM and GERD. The purpose of the study is to investigate the effectiveness of complex therapy (ursodeoxycholic acid and itopride hydrochloride) in patients with combination of GERD and type 2 DM.Materials and methods. 54 patients with combination of type 2 DM and GERD were examined. The treatment of the patients with type 2 DM was conducted in accordance with the clinical treatment protocol of the Ministry of Health of Ukraine and local protocols. The standard anti-helicobacter therapy has been carried out for 14 days in HP-positive patients with combination of GERD and type 2 DM. Ulsepan treatment was prolonged to 1 month, if necessary than longer. The itopride hydrochloride was prescribed in dose 50 mg 3 times a day for 1 month to normalize the functioning of upper gastrointestinal tract section. All patients with combination of type 2 DM and GERD have been prescribed ursodeoxycholic acid (UDCA) in dose 15 mg / kg body weight. UDCA treatment lasted for up to 6 months.Results. The study included patients with type 2 DM medium severity. The leading clinical manifestation of the upper digestive tract section in patients with type 2 DM was bloating of acid, heartburn and globus pharyngeus. The prescribed antisecretory therapy (if necessary, anti-helicobacter treatment) in combination with itopride hydrochloride and UDCA in patients with type 2 DM positively influenced on the clinical and endoscopic manifestation of GERD in patients with type 2 DM. Complex therapy with the use of UDCA resulted in a significant reduction in the number of patients with duodeno - gastral reflux (DER), namely from 48.1% to 3.7%, respectively (p <0.01). The expressed positive effect on the dynamics of the body mass index in patients with combination of type 2 DM and GERD was observed on the background of co mplex therapy with the use of UDCA.Conclusion. The use of itopride hydrochloride (Ganaton) in combination with pantoprazole (Ulsepan) is an effective method for correction of the esophageal and extra-esophageal clinical manifestations of GERD in patients with type 2 DM. UDCA (Holudexan) is a safe and effective way to reduce the severity of DGR in GERD, and also helps to reduce body weight in patients with type 2 DM with a violation of body mass index in course of its application.