Kryvonosova O. Clinical, pathogenetical and theraputical aspects of the chronic gastrodudenal system deseases in patients with diabetes mellitus.

Object of the research: Insulin dependent diabetes mellitus accompanied by disease of the stomach and duodenum. Purpose of the research: To optimize the diagnosis of the disorders in the functional state of the stomach and D in patients with IDDM and to substantiate the protocol of correcting therapy with the consideration of the revealed gastroduodenal diseases. Methods of the research: Clinical laboratory, biochemical, immunological, instrumental. Theoretical and practical results: The necessity to study the functional state of the stomach and D in patients with IDDM with the purpose to improve the diagnosis of the gastroduodenal diseases which complicate main disease. The suggested complex was determined. The suggested complex of investigation allows differential approach to the choice of the treatment method which improves its therapeutic efficacy manifesting in improvement of the functional state of the stomach and D and optimization of IDDM treatment. A method of complex therapy for IDDM accompanied by the diseases of the gastrointestinal system which accelerates the process of healing and reduces the duration of hospital stay. Novelty: Manifestation of DG were established to be present in patients with IDDM against a background of progressing vegetative polyneuropathy. DG is an initial background for further destructive processes in the mucous membrane of the stomach and D, which later realize in CG and DUD. The necessity of pathomorphological investigation of the mucous membrane of the stomach and D in patients with IDDM was established. The existing methods of examination of patients with IDDM for Helicobacter and cytomegalovirus infection were compared. A new method of Helicobacter infection identification using staining according to Einarson was suggested. A high diagnostic value of immunological investigation and the study of LP and AOP systems in patients with IDDM was established. The use of complex treatment of patients with IDDM with chronic diseases of the gastroduodenal system including triple anti-Helicobacter therapy with metabolic (alpha-lipoic acid, immunotropic (cycloferon ) and prokinetic (Motilium) medications was substantiated. The suggested method was proven to promote control of the abdominal pain, dyspeptic, dyskinetic and asthenovegetative syndromes in patients with IDDM with DG, IDDM with CG and IDDM with DUD as well as reduction of manifestations of peripheral and vegetative neuropathy. Degree of introduction: The findings of the research were introduced into clinical practice of gastroenterology and endo-crinology departments of Kharkiv Regional Clinical Hospital, therapy department of Railroad Hospital No. 1 (Kharkiv), central district hospitals (Chuguyev, Blizniuki, Balakleya, Izium) and are used in the teaching process of therapy department at Kharkiv State Medical Univesity. Sphere of application: medicine, gastroenterology departments.