[Correction of small bowel function as a new direction for treating patients with metabolic syndrome].

Abstract:

AIM:To provide a rationale for and to evaluate the therapeutic efficiency of the combined use of pancreatic enzymes and actovegin in the combination therapy of patients with metabolic syndrome (MS) on the basis of comprehensive clinical and functional studies of the small bowel (SB). SUBJECTS AND METHODS:In the course of treatment, 120 patients with MS (verified using the diagnostic criteria elaborated by the All-Russian Research Society of Cardiology (2009)) underwent a comprehensive study of SB function: an isolated study of resorptive processes; evaluation of parietal and cavitary digestion, motor-evacuation function. The peripheral blood levels of gastrin, insulin, cortisol, thyroxine and thyrotropin were determined. RESULTS:The combined use of pancreatic enzymes and actovegin has a positive impact on the clinical and functional state of SB, which was manifested as restoration of its hydrolysis and absorption, as well as motor-evacuation function in the patients with MS. The treatment resulted in reductions in the levels of triglycerides from 2.85±0.34 to 1.53±0.18 mmol/l (p<0.01), total cholesterol from 6.08±0.16 to 5.19±0.21 mmol/l (p<0.05), and atherogenic factor from 5.21±0.28 to 2.93±0.34 (p<0.05). Posttreatment HOMA-IR decreased from 4.22±0.8 to 2.12±0.8. There were no substantial changes in insulin levels and insulin resistance index in the patients on standard therapy. CONCLUSION:The combined use of pancreatic enzymes and actovegin is pathogenetically sound in correcting SB dysfunctions and may be one of the most effective directions for the treatment of patients with MS. :Цель исследования. Обоснование и оценка терапевтической эффективности сочетанного применения панкреатических ферментов и актовегина в составе комплексной терапии у больных с метаболическим синдромом (МС) на основе комплексных клинико-функциональных исследований тонкой кишки (ТК). Материалы и методы. У 120 больных с МС (верификация с использованием критериев диагностики Всероссийского научного общества кардиологов, 2009) в динамике лечения проведено комплексное изучение функционального состояния ТК: изолированное исследование резорбтивных процессов, оценка состояния пристеночного и полостного пищеварения, моторно-эвакуаторная фикция. В периферической крови определяли уровень гастрина, инсулина, кортизола, тироксина и тиреотропина. Результаты. Сочетанное применение панкреатических ферментов и актовегина положительно влияет на клинико-функциональное состояние ТК, выражающееся в восстановлении нарушенных процессов гидролиза и абсорбции, а также моторно-эвакуаторной функции ТК у больных с МС. На фоне лечения отмечено снижение уровня триглицеридов с 2,85±0,34 до 1,53±0,18 ммоль/л (p<0,01), общего холестерина с 6,08±0,16 до 5,19±0,21 ммоль/л (p<0,05) и коэффициента атерогенности с 5,21±0,28 до 2,93±0,34 (p<0,05). Индекс HOMA-IR после лечения снизился с 4,22±0,8 до 2,12±0,8. При стандартной терапии существенных изменений не отмечено в уровнях инсулина и НОМА-IR. Заключение. Сочетанное применение панкреатических ферментов и актовегина патогенетически обосновано в коррекции нарушений функций ТК и может явиться одним из эффективных направлений лечения больных с МС.

journal_name

Ter Arkh

journal_title

Terapevticheskii arkhiv

authors

Vakhrushev YM,Lyapina MV

doi

10.17116/terarkh201789843-49

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

43-49

issue

8

eissn

0040-3660

issn

2309-5342

journal_volume

89

pub_type

杂志文章
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  • [A painless decrease in the ST segment during the 24-hour ECG monitoring of hypertensive patients].

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  • [The clinico-prognostic assessment of DNA antibodies and antinuclear factors in rheumatoid arthritis patients].

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  • [Study of the characteristics of various hematologic diseases using monoclonal antibodies LT1, LT2 and LT7].

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  • [Determination of coronary-myocardial reserve by stress echocardiography in patients with programmed pacemaker].

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  • [Dynamics of changes in levels of insulin, glucagon, and C-peptide during glucose tolerance test in patients with coronary atherosclerosis].

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