IMPROVEMENT OF THE TREATMENT OF CHRONIC NONCALCULOUS CHOLECYSTITIS IN PATIENTS WITH DIABETES MELLITUS TYPE 2

Abstract

The purpose of the work is to improve the medical treatment of chronic noncalculouscholecystitis (CNC) combined with diabetes mellitus type (DM).Material and methods. A detailed clinical examination was conducted in 60 patientswith DM type 2 and CNC. Patients were divided into two identical groups (30 persons inevery group), representative to the signs of gender, age, severity and duration of thedisease. Patients of the 1st group were treated in the traditional way, and the secondgroup - by the proposed method. Treatment of patients of the 1st group (30 pesons) wascarried out by the protocol method: clinical nutrition (diet No. 9/5), chophytol 1 tabletthree times a day, antispasmolitics and antibiotics (if indicated). Patients of the 2ndgroup (30 persons) were prescribed diet No. 9/5, a preparation of -lipoic acidthiogammа turbo and raphacholine C. All patients underwent a thorough examinationusing standard clinical, laboratory, biochemical and instrumental studies.Results. Applying the proposed treatment regimen, manifestations of pain, dyspeptic andastenovegetative syndromes were observed in significantly smaller numbers in patients ofthe 2nd group than in patients of the 1st group. In patients of the 2nd group,normalization of ultrasonographic signs of the gallbladder was observed. Also in patientsof the 2nd group there was a significant decrease in the duration of the I, III, IV and Vphases of multi-stage duodenal sounding with a decrease in the volume of secreted bile.Patients of the 2nd group showed a significant decrease in the levels of total lipids,cholesterol, bile acids, triacylglycerols, low density lipoproteins and an increase in highdensity lipoproteins and serum phospholipids relative to similar indices before treatmentand indices of patients of the 1st group after treatment. The same changes were in thelipid spectrum of bile in patients of both subgroups after the treatment. An increase intwo-component and a decrease in three-component indices of bile lithogenicity inpatients of the 2nd group relative to similar indicators before treatment and in patients ofthe 1st group after treatment were observed.Conclusion. The use of raphacholine C and thiogamma turbo in the complex treatment ofpatients with chronic noncalculous cholecystitis and diabetes mellitus type 2 has apositive effect on the reduction of symptoms of pain, dyspeptic and asthenovegetativesyndromes, the dynamics of biochemical changes in blood and bile.