Assessment of the efficacy of the combination of α-lipoic acid preparation and synbiotics in the protocol therapy of hypothyroidism combined with chronic pancreatitis

Abstract

Hypothyroidism (Ht) is a common clinical condition with variable prevalence. This disease is often associated with chronic pancreatitis (CP). Consensus exists regarding the necessity to treat patients with Ht in comorbidity with CP to reduce the risk of complications and the frequency of exacerbations, to reduce the activity of the progression of the pathological process, and to improve the quality of life.
 Objective — to evaluate the effects of additional use of thioctic acid and synbiotics combination in the conventional treatment on the indicators of the functional state of thyroid gland (THG) and pancreas in patients with Ht in comorbidity with CP.
 Materials and methods. Investigation involved 107 patients with a comorbid course of Ht and CP, who were divided into 3 groups according to the complex treatment programs: the first group consisted of 32 subjects, who received protocol treatment (PT) of Ht and CP, the second included 36 patients (PT + α‑lipoic acid preparation (Dialipon Turbo), the third — 39 patients (PT + α‑lipoic acid preparation + synbiotic (Lactimak Forte). The groups were comparable by age and gender. The functional state of the pancreas was assessed using the level of fecal α‑elastase (enzyme immunoassay), pancreatic α‑amylase (immunochemical method), and the coprogram index in points. Thyroid function was assessed by the levels of thyrotropic hormone TSH, free triiodothyronine T3 and free thyroxine T4 (chemiluminescent immunoassay). The obtained data were processed with statistical methods.
 Results. The positive dynamics was established in all groups, but the degree of its expression differed. Thus, the level of fecal α‑elastase increased by 57.54% — in the 1st group, by 78.27% — in the 2nd group, by 89.94% — in the 3rd group; pancreatic α‑amylase decreased by 29.68% — in the 1st group, by 39.19% — in the 2nd group, by 42.44% — in the 3rd group; the total coprogram index decreased by 25.11% — in the 1st group, by 47.57% — in the 2nd group, by 84.91% — in the 3rd group. T3 dynamics was 13.9% in the 1st group, 48.69% in the 2nd group, 78.17% in the 3rd group. Dynamics of T4 — 11.3% in the 1st group, 29.98% — in the 2nd group, 35.37% — in the 3rd group. The dynamics of TSH was 19.66%, 31.81%, 69.41%, respectively.
 Conclusions. It has been proven that the use of the proposed treatment regimen including the combination of the drug α‑lipoic acid and the synbiotic Laktimak Forte promoted the improvement of pancreas functions and levels of thyroid hormones compared to those in the group of protocol treatment: the level of fecal α‑elastase increased by 89.94%; pancreatic α‑amylase — by 42.44%; coprogram index — by 84.91%; T3 — by 78.17%; T4 — by 35.37%; TSH — by 69.41% (p <0.01).