Effectiveness of hymecromone monotherapy in treatment of patients with various pathologies of biliary tract

Abstract

The aim of the study. To evaluate the effectiveness and safety of the use of hymecromone in the treatment of patients with diseases of the biliary tract.Materials and methods 40 patients with various pathologies of the biliary tract were under observation: 20 patients (group 1) with functional disorders of the biliary tract (the diagnosis of functional disorders of the gallbladder was established on the basis of Roman criteria IV) and 20 patients (group 2) with post-cholecystectomy syndrome (the diagnosis was established on the basis of anamnesis data on cholecystectomy surgery and the results of ultrasound examination of the abdominal organs [absence of a gallbladder]). Before the start of therapy with hymecromonum, after the end of treatment and a month after treatment, patients underwent examinations: assessment of complaints (abdominal pain, bitterness in the mouth, constipation, abdominal heaviness, flatulence, appetite), assessment of dyspepsia on the GIS scale and assessment on the visual-analog scales of abdominal pain and general well-being), quantitative assessment of the severity of gastroenterological complaints according to the GSRS questionnaire, assessment of quality of life (SF‑36 questionnaire), ultrasound of the gallbladder with a trial breakfast for the assessment of bile excretion, clinical blood test, biochemical blood test (ALT, AST, bilirubin, alkaline phosphatase, GGTP, glucose, cholesterol), as well as an assessment of side effects. All patients were prescribed a diet necessary in the complex treatment of diseases of the biliary tract and monotherapy: hymecromone 400 mg three times a day 30 minutes before meals for 3 weeks. Statistical processing was carried out using the computer software package SPSS Statistics 17.0.Results. After the treatment with hymecromone there was a significant decrease or complete relief of abdominal pain and dyspepsia, while 47.5 % of the subjects noted the disappearance of abdominal pain, and the remaining patients indicated a significant decrease in pain syndrome with only minor discomfort. The assessment on the visual-analog scales of abdominal pain and general well-being showed a significant reduction in pain (from 65 to 13 points) and an improvement in general well-being (from 65 to 6 points). When assessing dyspepsia on the GIS scale and gastroenterological complaints according to the GSRS questionnaire, there was a significant decrease in the severity of symptoms. The assessment of the quality of life (questionnaire SF-36) showed a significant improvement in the quality of life on all scales. According to the ultrasound of the abdominal organs with a trial breakfast, there was a restoration of the contractile ability of the gallbladder (p < 0.05). When analyzing possible side effects, it was noted that no side effects were observed either clinically or according to the results of blood tests.Conclusions. As a result of treatment, it was found that the administration of hymecromone is highly effective and safe both for patients with functional disorder of the gallbladder and for patients with post-cholecystectomy syndrome. While maintaining a high efficiency, hymecromonum is characterized by a safe choleretic effect, which is especially important when