COMPLEX BIOREGULATORY THERAPY IN RESTORATIVE TREATMENT OF PATIENTS WITH OSTEOARTHRITIS AND BILIARY GENESIS EXOCRINE PANCREATIC INSUFFICIENCY

Abstract

SUMMARY. Patients with osteoarthritis (OA) are usually in the age group over 40 years, and therefore often have more than one comorbid disease, so in their treatment, it is important to consider the impact of multiple drugs on not only joint function but also digestive, including excretory pancreatic insufficiency (EPI) of biliary genesis, and also gastroenterological syndromes.

The aim – to evaluate the impact of the proposed scheme of complex treatment with the inclusion of bioregulatory drugs on the parameters of joint and digestive functions under the conditions of comorbidity of OA with EPI of biliary genesis.

Material and Methods. We examined 61 patients with primary OA in comorbidity with EPI of biliary genesis without exacerbation of the main and concomitant diseases: chronic non-stone cholecystitis, functional diseases of the gallbladder and biliary system. OA symptoms were assessed by the WOMAC index (Western Ontario and McMaster University). The GSRS (Gastrointestinal Symptom Rating Scale) questionnaire was used to assess gastroenterological symptoms, containing 5 scales: abdominal pain (AP), indigestion syndrome (IS), diarrheal syndrome (DS), constipation syndrome (CS), and gastroesopharyngeal reflux syndrome.

Results. There was a statistically significant improvement in the WOMAC index for pain, stiffness, functional insufficiency, and total after treatment in both study groups, but in group II the therapeutic effect was statistically significantly more significant, indicating the feasibility of using bioregulatory drugs (BRD) on joint function in patients with primary OA and EPI of biliary genesis. There was a statistically significant deterioration in digestive function on the scales of the GSRS questionnaire (p<0.05) in the group of patients with basic OA therapy, which proved the presence of possible negative side effects of this therapy in combination with symptoms of the comorbid disease of the digestive system.

Conclusions: 1. Additional prescription of the proposed scheme of bioregulatory therapy with drugs of arthrotrophic (Zeel T), hepatotrophic (Hepel) and inflammation regulator (Traumel C) actions in the basic complex treatment of patients with primary OA with exocrine pancreatic insufficiency of biliary genesis caused statistically significant improvement according to the WOMAC index in comparison with similar parameters of the basic therapy group (p<0.05). 2. The prescription of an additional course of bioregulatory drugs contributed to statistically significant regression of gastrointestinal symptoms on the GSRS scale (p<0.05) in contrast to the dynamics of similar parameters in the group of standard basic therapy of OA.