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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,
