Efficiency of Skhidnytsia’ Drinking Mineral Waters Using to Improve the Quality of Life of the Patients with Chronic Pancreatitis in Combination with Diabetes mellitus

Abstract

Chronic pancreatitis (CP) and diabetes mellitus (DM) with their consequences cause significant economic losses to patients and their families, as well as to health systems and national economies. Quality of life (QOL) of patients with a combined course of CP and diabetes is an extremely important problem of medical science and practice.The objective: to investigate the effectiveness of comprehensive rehabilitation of patients with chronic pancreatitis with concomitant diabetes mellitus with the inclusion of ademethionine and a course of treatment with drinking mineral waters of Skhidnytsia deposit on the impact on quality of life parameters according to SF-36 and GSRS questionnaires.Materials and methods. We examined 60 outpatients with CP and concomitant diabetes in remission, who were divided into two groups according to treatment programs: 1 group received protocol treatment (pancreatin, proton pump inhibitor, antispasmodic and/or prokinetic, metformin 1000 mg twice a day, ademethionine (400 mg) one tablet 2 times a day for one month, group 2 – in addition to the program of group 1, received a course of drinking mineral water (DMV) according to the proposed scheme. QL was determined by the general international questionnaire MOS SF-36 and special questionnaire GSRS (Gastrointestinal Symptom Rating Scale) in the dynamics of treatment.Results. The decrease in the intensity of abdominal pain in group 1 was 1.6 times, and in group 2 – 2.2 times. The frequency of dyspeptic syndrome probably decreased (p <0.001) in both groups: by 46.66 % – in group 1 and by 70.00 % – in group 2; a 1.7 – fold decrease in the intensity of dyspepsia was observed in patients of group 1 and in group 2 – dyspeptic disorders bothered patients 2 times less. Thus, the rehabilitation complex with the inclusion ohf et DMV course was more effective. In general, one month after the start of medical rehabilitation on the QOL scale of gastroenterological patient GSRS, the total intensity of gastrointestinal symptoms and syndromes on QOL of patients with CP in comorbidity with diabetes mellitus decreased 1.7 times and 2.1 times in groups 1 and 2, respectively, which proved significantly (p<0,001) higher efficiency of the rehabilitation program with the inclusion of the course of DMV according to the proposed method.Conclusion. The use of oral form of ademethionine per 1 month and a 2-week course of drinking mineral waters of the Skhidnytsia deposit according to the proposed scheme significantly increased the effectiveness of the monthly protocol rehabilitation program on the dynamics of physical and mental parameters of quality of life questionnaire SF-36: role physical functioning – by 23,6 % and 16,8 % respectively; pain intensity – by 44,8 % and 33.4 %; general health indicators – by 36.7 % and 36.7 %; vital activity – by 33.4 % and 18.9 % (p<0.001), which allows us to recommend this program for implementation in clinical practice.