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экспериментальная и клиническая гастроэнтерология | выпуск 117 | № 5 2015
информация | information
126. Potential therapy for irritable bowel syndrome in patients with type 2 diabetes mellitus
Runova A. A., Zhulina N. I., Kalinnikova L. A.
Nizhny Novgorod State Medical Academy, Russian Federation
The aim of the work was to assess the effect butyrate in patients with type 2 diabetes mellitus and irritable bowel syndrome (IBS). An open prospective study conducted for 43 patients with diabetes mellitus: 18 men and 25 women, average age (54.0±3.5) years, the duration of the disease ranged from 1 to 6 years. The level of glycosylated hemoglobin in patients was (7,39±0,10)% and was close to the targets. All the patients had irritable bowel syndrome (IBS) (according to the criteria of Rome III). The severity of abdominal pain syndrome and flatulence was evaluated subjectively by 10-point visual analog scale. Medicine drug «Zakofalk» (250 mg of butyrate + 250 mg inulin) was appointed on the 3 tablets per day for 12 weeks with a view to normalize bowel function. Held control of glycemia: fasting and postprandial glycaemia, glycated hemoglobin. Therapy of anti-diabetic drugs was unchanged.
After 12 weeks of therapy there was reduction of pain syndrome and abdominal flatulence at 95.8 % of patients. Positive dynamics was observed in carbohydrate metabolism: fasting glycemia had a downward trend from (6.8±0.4) mmol/l to (6.6±0.6) mmol/l; the postprandial glucose decreased from (8.9±0.6) mmol/l to (7.9±0.4) mmol/l (p<0,05). There was a reduction in glycosylated hemoglobin with (7.39±0.10)% to (7.26±0.08 % (statistically implausible).
Therefore, therapy of IBS drug butyrate («Zakofalk») in patients with type 2 diabetes is effective for the correction of the intestinal symptoms. The glycemic effect of butyrate is probably associated with the restoration of the functional activity of L-cells mucous membrane intestine and the normalization of the products of the peptide glucagon-like (GLP-1). GLP-1 stimulates the release of insulin postprandialny.
127. Eradication of Helicobacter pylori infection in duodenal ulcer patients. Side effects of standard triple therapy
Rustamov M. N.
Belarusian State Medical University, Minsk, Belarus
Purpose: to investigate the efficacy and drug-related side effects of a regimen that included proton pump inhibitors (PPIs), clarithromycin and amoxicillin in patients with Helicobacter pylori (Hp) -positive duodenal ulcer.
Material and methods. The study included 50 Hp-positive patients with duodenal ulcer. Hp infection was confirmed by a histological examination of samples obtained from the antrum and corpus of stomach during endoscopy and non-invasive Breath HELIK-Test. The eradication therapy consisted of 10-days twice daily oral administration of PPIs in standard dose, amoxicillin 1000 mg, clarithromycin 500 mg, then 20-days twice daily PPIs. Therapeutic success was confirmed by a negative histological examination and Breath HELIK-Test, performed 4-12 weeks after treatment.
Findings. Before the treatment 82 % of patients had pain syndrome and 70 % — dyspeptic complaints. During the treatment in 50 % of patients increased the frequency of dyspeptic complaints and in 42 % of them such complaints appeared for the first time and continued during 1,5 months after treatment. The
eradication rate was 70 %. Healing of duodenal ulcer was noted in 82 % cases. The level of basal pH was significantly (p<0,001) increased in the corpus of stomach from 1,39±0,41 to 1,83±0,31, in antrum 1,97±0,29 to 2,52±0,34 and in the duodenum from 4,09±0,59 to 5,14±0,95. After treatment significantly increased the levels of alanine transaminase from (36,78±0,78) IU/L to (42,52±1,22) IU/L, asparagines transaminase from (36,36±0,79) IU/L to (40,76±1,27) IU/L, alkaline phosphatase from (96,90±1,37) IU/L to (101,24±2,17) IU/L, and triglycerides from (1,57±0,07) mmol/l to (1,72±0,10) mmol/l, which must be noted as drug-related side effects of clarithromycin-based triple therapy. Increase of the levels of bilirubin from (19,41±0,24) mmol/l to (20,88±0,34) mmol/l and cholesterol from (5,17±0,16) mmol/l to (5,56±0,19) mmol/l were not statistically significant.
Conclusions. Standard triple Hp eradication therapy based on clarithromycin has low efficacy (70 %), causes or increases the frequency of dyspeptic complaints associated with the use of antibiotics, has a hepatotoxic effect.
128. Abilities of nonpharmacologic remedies in the treatment of helicobacter pylori-associated duodenal ulcer patients
Rustamov M. N.
Belarusian State Medical University, Minsk, Belarus
Purpose: to investigate the effect ofprobiotics and mineral water in the treatment of patients with Helicobacter pylori (Hp) -positive duodenal ulcer.
Material and methods. In this study 200 Hp-positive patients with duodenal ulcer were randomized into 4 groups, 50 patients in each. Hp infection was confirmed by a histological examination of samples obtained from the antrum and corpus of stomach during endoscopy
and non-invasive Breath HELIK-Test. Intragastric and intraduodenal pH-metry, blood analyses also were performed. The following eradication regimens were recommended: Group I: 10-days twice daily oral administration ofproton pump inhibitors (PPIs) in standard dose, amoxicillin 1000 mg, clarithromycin 500 mg, then 20-days twice daily PPIs plus once daily oral administration of probiotics, containing Lactobacillus bulgaricus DDS-14,
тезисы 15-го юбилейного съезда ногр... | abstracts 15th anniversary congress "gssr".
Lactobacillus rhamnosus, Lactobacillus acidophilus DDS-1 and Bifidobacterium bifidum during one month; Group II: PPIs and probiotics once daily and alkaline hydrocar-bonate-chloride sodium mineral water Essentuki-4200 ml trice daily during one month; Group III: PPIs and probiotics once daily and chloride sodium mineral water Minsk-4 200 ml trice daily during one month; Group IV: probiotics and PPIs once daily during one month. Therapeutic success was confirmed by a negative histological examination and Breath HELIK-Test, performed in 4-12 weeks after therapy.
Findings. In Group I dyspeptic complaints disappeared in 74 %, and decreased in 20 %. Disappearance of dyspeptic complaints was 78 %, 76 % and 74 % in II, III and IV groups respectively. Decrease of dyspeptic complaints was 20 %, 22 % and 24 % in II, III and IV
groups respectively. The eradication rates were 82 %, 80 %, 78 % and 68 % in I, II, III and IV groups, respectively. Healing of duodenal ulcer was noted in 84 %, 86 %, 84 % and 78 % of cases, in I, II, III and IV groups, respectively. Intragastric and intraduodenal pH was significantly increased in all groups, especially in II. After treatment in II, III and IV groups significantly decreased alanine transaminase, asparagines transaminase, blood bilirubin, alkaline phosphatase, cholesterol and triglycerides.
Conclusions. Adding probiotics to standard triple therapy improves efficacy of eradication. The combined use of PPIs, probiotics and alkaline hydrocarbon-ate-chloride sodium mineral water is a highly-effective alternative therapy in patients with Hp-associated duodenal ulcer.
129. Elaboration of optimal Helicobacter pylori erai
Rustamov M. N.
Belarusian State Medical University, Minsk, Belarus
Purpose: to investigate the efficacy of proton pump inhibitors (PPIs), probiotics and different mineral water in patients with Helicobacter pylori (Hp) -positive duodenal ulcer and to elaborate the optimal Hp eradication regimens in such patients.
Material and methods. In this study 250 Hp-positive patients with duodenal ulcer were randomized into 5 groups, 50 patients in each. Hp infection was confirmed by a histological examination of samples obtained from the antrum and corpus of stomach during endoscopy and non-invasive Breath HELIK-Test. Intragastric and intraduodenal pH-metry, blood analyses also were performed. The following eradication regimens were recommended: Group I: 10-days twice daily oral administration of PPIs in standard dose, amoxicillin 1000 mg, clarithromycin 500 mg, then 20-days twice daily PPIs; Group II: the same treatment plus once daily oral administration of probiotics, containing Lactobacillus bulgaricus DDS-14, Lactobacillus rhamnosus, Lactobacillus acidophilus DDS-1 and Bifidobacterium bifidum during one month; Group III: PPIs and probiotics once daily and alkaline hydrocarbonate-chloride sodium mineral water Essentuki-4 200 ml trice daily during one month; Group IV: PPIs and probiotics once daily and chloride sodium mineral water Minsk-4 200 ml trice daily during one month; Group V: probiotics and PPIs once daily during one month. Therapeutic success was confirmed by a negative histological examination and Breath HELIK-Test, performed in 4-12 weeks after therapy.
Findings. 82 % of patients had pain syndrome and 70 % — dyspeptic complaints. In 50 % of patients of group I increased the frequency of dyspeptic complaints and in 42 % of them such complaints appeared
regimens for patients with duodenal ulcer
for the first time. In Group II dyspeptic complaints disappeared in 74 %, and decreased in 20 %. Disappearance of dyspeptic complaints was 78 %, 76 %, 74 % in III, IV and V groups respectively. Decrease of dyspeptic complaints was 20 %, 22 %, 24 % in III, IV and V groups respectively. The eradication rate of Helicobacter pylori were 70 %, 82 %, 80 %, 78 % and 68 % in I, II, III, IV and V groups, respectively. Healing of duodenal ulcer was noted in 82 %, 84 %, 86 %, 84 % and 78 % of cases, in I, II, III, IV and V groups, respectively. Intragastric and intraduodenal pH was significantly increased in all groups, especially in III. After treatment in group I significantly increased alanine transaminase, asparagines transaminase, alkaline phosphatase, and triglycerides, which must be noted as drug-related side effects of clarithromycin-based triple therapy. In group II such changes did not happen. In III IV and V groups significantly decreased alanine transaminase, asparagines transaminase, blood bilirubin, alkaline phosphatase, cholesterol and triglycerides.
Conclusions. Standard clarithromycin-based triple eradication therapy causes or increases the frequency of dyspeptic complaints related with antibiotics has low efficacy and hepatotoxic effect. Adding probiotics to standard triple therapy improves efficacy of eradication. The combined use of PPIs, probiotics and alkaline hydrocarbonate-chloride sodium mineral water is a highly-effective alternative therapy in patients with Hp-associated duodenal ulcer. This regimen may especially be helpful in patients with a history of gastrointestinal adverse effects with antibiotics, comorbid patients with diseases of the hepatobiliary system and the metabolic syndrome.
130. Effect of probiotics different groups to reparations colonic mucosa in patients with acute infectious and post-infectious colitis
Shcherbakov I. T., Leontiev N. I., Grachev N. M., Solovyov A. I., Khrennikov B. N.
Moscow Institute of Epidemiology and Microbiology G. N. Gabrichevskogo, Russia, e-mail: [email protected]
Objective: to examine the state of the colonic mucosa and Post-colitis treated with a combined therapy of (CM) in patients with acute intestinal infections (AII) probiotic preparations of different groups.
