COMPARATIVE ANALYSIS OF THE EFFICIENCY OF PROGRAMS FOR THE COMPLEX CORRECTION OF COLON MICROBIOCENOSIS IN PATIENTS WITH HYPOTHIREOSIS ON THE BACKGROUND OF CHRONIC PANCREATITIS
DOI:
https://doi.org/10.11603/1681-2727.2023.2.14099Keywords:
chronic pancreatitis, hypothyroidism, thyroid gland, α-lipoic acid drug, synbiotic, microbiocenosis of the large intestineAbstract
SUMMARY. A positive relationship between the state of the thyroid gland and the composition of the intestinal microbiota has been established. A limited number of studies indicate the effectiveness of probiotic products on levothyroxine metabolism and thyroid hormone activity in hypothyroidism. The relationship between Ht and chronic pancreatitis (CP) is poorly understood and there is currently no convincing evidence to support a direct relationship between the two conditions. The microbiocenosis of the large intestine is a complex ecosystem of microorganisms in the body, which has far-reaching consequences for human health. Understanding its complex interaction with diseases such as hypothyroidism and CP is important for elucidating the mechanisms of development of these nosologies and potential ways of treatment, especially in the combined course. That is why the study of the condition of the microbiocenosis of the large intestine and its correction is a promising area in the comorbid course of hypothyroidism against the background of CP.
Materials and methods. 107 patients with a comorbid course of hypothyroidism and CP were studied, who were divided into 3 groups according to complex treatment programs: group 1 – 32 patients (received protocol treatment of hypothyroidism and CP, group 2 – 36 patients (protocol treatment + α-lipoic acid preparation (dialipon turbo), group 3 – 39 patients (protocol treatment + preparation of α-lipoic acid + synbiotic (lactimac forte), comparable in age and gender.
Results and discussion. Application of the proposed programs led to an increase in the proportion of patients with a normal composition of microbiocenosis of the large intestine in group 1 – to 18.7 %, in group 2 – to 25.0 %, and in group 3 – to 59.0 %. The number of patients with dysbiosis of various degrees after treatment decreased in the comparison groups from 81.2 % in group 1 to 75.0 % in group 2 and up to 41.0 % in group 3, which proved the high efficiency of the proposed treatment programs for patients on hypothyroidism on the background of CP.
Thus, the content of Bifidobacterium bifidum in the 1st group after therapy with PL increased by 2.39 times, in group 2 by 69.45 times (by two orders of magnitude), in group 3 by 259.07 times (by three orders of magnitude). Lactobacillus content in the 1st group after therapy increased by 2.88 times, in group 2 by 9.45 times (by one order of magnitude), in group 3 by 76.7 times (by two orders of magnitude). This proved a significantly higher effectiveness of the treatment program with the inclusion of α-lipoic acid on the content of saprophytic sucrolytic flora when using protocol therapy, while the additional inclusion of a synbiotic increased the effectiveness of the previous complex, which led to the normalization of the content of these microorganisms.
Conclusions. It has been proven that the inclusion of α-lipoic acid in the protocol therapy of patients with hypothyroidism against the background of CP, and especially in combination with a synbiotic, ensured positive dynamics of the composition and ratio of the microbiocenosis of the colon: the proportion of patients with a normal composition of the microbiocenosis of the large intestine in the group of protocol therapy increased to 18,8 %, in the group with the inclusion of α-lipoic acid – up to 25.0 %, in the group with the inclusion of α-lipoic acid and synbiotics – up to 59.0 %, and the number of patients with dysbiosis of various degrees after treatment decreased accordingly from 81.3 % in group 1, up to 75.0 % in group 2 and up to 41.0 % in group 3.
According to the dynamics of bacteriogram parameters, under the influence of treatment, a statistically higher level of effectiveness of the therapeutic program with the additional inclusion of the combination of α-lipoic acid and synbiotics was established compared to the protocol program and the program with the addition of α-lipoic acid (p<0.01), which allows recommending additional use of the drug α-lipoic acid and synbiotics in the complex correction of microbiocenosis of the large intestine in the combined course of hypothyroidism and chronic pancreatitis.
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