The role and place of Actovegin in the complex therapy of cytokine metabolism in patients with GERD with concomitant bronchial asthma
Journal Title: Сучасна гастроентерологія - Year 2018, Vol 0, Issue 5
Abstract
Objective — to study the advisability of the Actovegin inclusion in the standard treatment regimen for patients with GERD and concomitant mild to moderate BA in terms of its effects on the clinical course of this comorbid pathology, as well as on the level of proinflammatory and anti-inflammatory cytokines. Materials and methods. The study involved 60 patient with GERD and concomitant mild to moderate BA who were divided into 2 treatment groups. The first group of patients received standard GERD therapy (proton pump inhibitor— omeprazole 20 mg twice daily) and standard BA therapy (beta2-agonists of short and long-acting, m-cholinolytics), and Actovegin 200 mg twice daily day for 28 days. Patients of the second treatment group (comparison group) received only standard therapy— proton pump inhibitors and bronchodilators at the same dose for 4 weeks. The GERD diagnosis was established according to the Montreal Consensus (2006), with account of the data of esophagogastroduodenoscopy, fluoroscopy of the esophagus and stomach and the results of pH-metry. Verification of the diagnosis of asthma was carried out in accordance with the recommendations of the WHO (GJNA) and the order of the Ministry of Health of Ukraine (2013), with account of the spirography and chest radiography. The blood levels of interleukins (IL-4 and IL-6) were determined with the method of immuno-enzyme analysis using the «Vector Best» test systems. Statistical processing was carried out by the method of variational statistics using standard programs of correlation analysis with calculation of arithmetic mean values: M, m. The reliability of the indicators was assessed according to Student’s t-criterion. Results. It has been established that against the background of therapy, most patients began to feel well, less worried about esophageal complaints (heartburn, belching, pain in the epigastric region) and bronchial symptoms (dyspnea, cough, bronchospasm attacks, disturbed breathing during sleep. However, in patients of the first group these clinical manifestations completely disappeared by 3 to 5 days earlier (an average in 9.3 ± 0.51 and 11.4 ± 1.21 days) than in patients on second group (in 12.1 ± 1.10 and 14.3 ± 1.12 days) Moreover, in most patients of the first group, the most pronounced effect, particularly with regards to arresting the night-time attacks of laboured breathing, led to a decrease in the dose and frequency of use of beta2-agonists of short action, while in 7 (22.5 %) patients of the second group, on the contrary, it was necessary to mimic the frequency of beta2-agonists reception. After the course of therapy, the clinical effect of the improvement of quality of life, was accompanied by the reduction of cytokines’ levels, more significant in patients of the first group. Conclusions. The obtained results clearly demonstrate the positive effect of Actovegin not only on the clinical course of gastroesophageal reflux disease with concomitant asthma, but also confirms the pathogenetic feasibility of its inclusion in the standard treatment regimen for this category of patients.
Authors and Affiliations
O. A. Oparin, A. G. Oparin, G. G. Akhvlediani
Keywords
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- EP ID EP417878
- DOI 10.30978/MG-2018-5-25
- Views 118
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