Object of study: chronic pancreatitis (CP) in combination with dysbiosis of the colon (DSC). The purpose of the study: optimization of comprehensive treatment and rehabilitation of patients with CP in combination with DSC by examining the clinical-pathogenic features of disorders trophological status on the basis of comprehensive clinical-laboratory, instrumental examination and evaluation of the quality of life of patients. Research methods: clinical, questionnaires, anthropometric, ELISA (fecal ?-elastase, ferritin), methods of analysis of the immune status (reaction membrane immunofluorescence using monoclonal antibodies CD3, CD22, CD4, CD8, CD16, the method of radial monotypes serum immunoglobulins IgA, IgM, IgG, the detection of circulating immune complexes, complement activity - hemolytic test), biochemical and bacteriological method (a study of the microflora of the colon), ultrasound (US) examination of the abdominal cavity, methods of statistical analysis. Scientific novelty of the received results: we studied the pathogenic effect of dysbiotic changes in the formation of excretory disorders of the pancreas (P), tropologycal disorders in CP. It has been proven that the decrease in the content of lacto- and bifidobacterias and an increase in the number of probation pathogenic microorganisms, the total number of E. coli significantly led to the formation and deepening tropological violations: protein deficiency, anemic syndrome, secondary immunodeficiency (SID). Justified and identified common clinical predictors (age of patients, duration of CP, the condition of exocrine insufficiency of the P at the level of fecal ?-elastase, structural-functional state of P - US-criteria and koprograma, expressed in points) formation and progression tropological violations at CP. Augmented scientific evidence about the pathogenic role of secondary ID, activate humoral immunity and disimmunoglobulinemia, the decrease of total hemolytic activity of the complement system in the processes of depletion of the visceral protein pool and the formation of torpid inflammatory process in patients with CP in the phase of unstable remission. For the first time on the basis of uni - and multivariant regression analysis of the calculated and proposed to use mathematical formulas to predict levels of lacto- and bifidobacteria, transferrin and ferritin on the basis of available clinical and anamnestic parameters: age of patients, duration of illness, indicators US-criteria and koprograma, expressed in points, of hemoglobin for screening assessment of the parameters of the microflora of the colon and iron deficiency in patients with CP. First proposed and justified a new combined drug and non-drug (adapted method of DENS for the treatment of CP) treatment programs established violations for use in the practice of physicians of different specialties, especially for General practitioners - family medicine.
