Object of the study: acid-dependent diseases (ADD) in combination with primary hypothyroidism (HT) against a background of autoimmune thyroiditis. Purpose of the research: to optimize the treatment of patients having ADD with HT with regard for the leading clinical-pathogenetic variants of the combined pathology. Methods of the research: general clinical, functional, biochemical, immunological, radiological, sonological, morphological, statistical ones. Theoretical and practical results: the conducted researches make it possible to broaden the existing notions about peculiarities in the course of ADD in combination with primary HT. In order to reveal signs of the typological characteristic of certain variants in the course of ADD combined with HT the necessity of studying the gastrin (G-17) link activity in the regulation and the hypophysis-thyroid system was proved. The use of the suggested algorithm for treating patients with ADD with HT on the basis of the revealed clinical-pathogenetic variants ensures a positive dynamics in the course of the diseases and prevents any progression of morphofunctional changes in the oesophagogastroduodenal region. The additional employment of the stochastic component of GastroSoft program in the detection of G-17, pepsinogens, Helicobacter pylori with help of GastroPanel test panel makes it possible to increase the objectiveness and informativeness when diagnosing the state of the gastric mucous membrane (MM). The practical recommendations and conclusions of the work can be used in the work of doctors of therapeutics, gastroenterology and endocrinology departments of regional, city and district hospitals in their observation of patients having ADD in combination with primary HT. Novelty: for the first time, proceeding from the study of relationships between the hypophysis-thyroid system and G-17 link of the regulation and their influence on the secreting, motor-evacuating functions of the stomach and resistance of its MM, objective laws in the combined development of the course of ADD wit HT by three leading clinical-pathogenetic variants: hyposecretory, dysmotor, thyrogastral. It was found out that some unbalance in the activity of the hypophysis-thyroid system in HT changed the direction of functioning of G-17 link of regulation, thereby creating conditions for a pathogenic influence of aggression factors on the resistance of the gastric MM and motor-evacuating function of the oesophagogastroduodenal region with subsequent severe morphological changes in its MM and reflecting on the clinical signs of the diseases. An inhibitory influence of the excess concentration of the thyrotrophic hormone on the factors of MM resistance of the stomach and its motor-evacuating function was proved. It was revealed that the most severe functional disturbances and morphological changes in MM of the oesophagus, stomach and duodenum developed in the thyrogastral clinical-pathogenetic variant. It was proved that HT adds more pronounced dyspeptic signs to the clinical picture of ADD, especially in patients with gastro-oesophageal reflux disease, as it was confirmed by a correlation dependence of the rate of revealed dyspeptic complaints upon the functional state of the hypophysis-thyroid system. For the first time, a differential approach to treating patients with regard for the revealed clinical-pathogenic variants of the course of ADD with HT was grounded and its efficacy was proved. Degree of introduction: the suggested diagnostic methods and the algorithm of treatment were introduced into the work of the Endocrinology and Therapeutics Departments of Dnipropetrovsk City Multi-Type Hospital No. 4, the Department of Diseases of Stomach and Duodenum of the Institute of Gastroenterology of the Academy of Medical Sciences of Ukraine, the Therapeutics and Gastroenterology Departments of Dnipropetrovsk City Hospitals Nos 6 and 11, the Therapeutics and Endocrinology Departments of Dnipropetrovsk City Hospital No. 9, the Therapeutics Department of the Central District Hospital of Dnipropetrovsk District, Kharkiv City Hospital No. 11, as it was confirmed by the appropriate certificates of introduction. Sphere of application: medicine, therapy.
