Effects of actovegin on the treatment efficacy of patients with gastroesophageal reflux disease with concomitant bronchial asthma
Journal Title: Український терапевтичний журнал - Year 2018, Vol 0, Issue 3
Abstract
Objective — to study the actovegin effects on the clinical course of comorbid pathology, the quality of life of patients and the state of oxidative stress, that is, the level of aggression and protection factors, against the background of the standard treatment regimen in patients with gastroesophageal reflux disease (GERD) with concomitant bronchial asthma (BA). Materials and methods. The work was carried out in accordance with the research work of the Department of Therapy, Rheumatology and Clinical Pharmacology of Kharkiv Medival Academy of Postgraduate Education (KhMAPE) «Pathogenetic mechanisms of formation of comorbid pathology in students suffering from GERD and their correction» (state registration N 0110U002441). The study involved 52 patients suffering from GERD with concomitant BA of mild and moderate severity, who were divided into two treatment groups. The first (main) group included 27 patients aged 20 to 45 years (mean age (32.3 ± 3.5) years), among them 16 (59.3 %) men, 11 women (40.7 %), with the disease duration of 1 to 5 years (mean duration (3.2 ± 0.56) years). The second treatment group included 25 patients aged 20 to 44 years (mean age (31.9 ± 3.2) years), among them 15 (60 %) men, 10 women (40 %), with the same duration of the disease (4.1 ± 0.58) years). The first treatment group of patients received standard therapy of GERD and BA, as well as actovegin in a dose of 200 mg 2 times a day for 4 weeks. Patients of the second treatment group (comparison) received only standard therapy: pump inhibitors and bronchodilators at the same dose for 28 days. The GERD diagnosis was established according to the Montreal consensus (2006), taking into account esophagogastroduodenoscopy, fluoroscopy of the esophagus and stomach and pH-metry results. Verification of the diagnosis of BA, determination of its form and severity was carried out in accordance with the recommendations of the GEA (GJNA) and the order of the Ministry of Health of Ukraine (2013), taking into account the spirography and chest radiography. The quality of life was assessed using a SF-36 unified questionnaire. The state of oxidative stress was assessed by the level of diene conjugates (DC); antioxidant protection for the superoxide dismutase (SOD) activity. The determination of the DC level was carried out in the blood with a spectrofluorometric method. The determination of the activity of SOD in the serum was carried out with colorimetric method. Statistical processing was carried out by the method of variation statistics using standard programs of correlation analysis with calculation of the average statistical values: M, m. The indices’ significance was assessed according to Student’s criterion. The difference was considered as significance at p < 0.05. To establish the relationship between the indicators, a correlation analysis was used to calculate the correlation coefficient (r) and an estimate of its significance. Results and discussion. It has been established that among patients in both groups during treatment, there was a reduction (elimination) of typical as esophageal complaints of GERD (heartburn, regurgitation), and the symptoms of concomitant BA (cough, shortness of breath, respiratory disturbance during sleep — an attack of suffocation). However, in patients of the main group who received supplemental actovegin, the terms of elimination of these pulmonological and esophageal symptoms were shorter in all patients. In parallel with the improvement of these indices by the end of the course of therapy, the increased QoL, improved metabolic processes was observed in both groups, that is, an increase in the level of activity of SOD and in the concentration of DC, which were more pronounced in the group of patients, who received additional actovegin. Conclusions. During the study it has been established that inclusion of actovegin in the standard treatment of patients with GERD with concomitant BA resulted in the significant normalization (activating) of the course of metabolic processes, increasing the parallel level of QOL of patients, significant reduction of the timing of clinical remission of both primary and associated pathology increase in the doses of drugs or their replacement.
Authors and Affiliations
О. A. Oparin, A. G. Oparin, G. G. Akhvlediani, О. А. Lobunets
Keywords
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- EP ID EP457050
- DOI 10.30978/UTJ2018-3-4-14
- Views 79
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