The object of the study: clinical parameters, bone mineral density, pro- and antioxidant protection system, endotoxicosis and connective tissue destruction parameters, secretory function of the pancreas and quality of life in 90 patients with osteoarthritis in combination with chronic pancreatitis and 30 patients with osteoarthritis. The aim of the study: to increase the efficiency of treatment and rehabilitation of patients with osteoarthrosis in combination with chronic pancreatitis in the practice of a family doctor by developing a comprehensive optimized treatment scheme, taking into account indicators of bone tissue condition, pro- and antioxidant status, endogenous intoxication and connective tissue destruction, with the inclusion of pharmacological and drug-free substances. Methods of study: clinical and anamnestic, sociological - questionnaires, statistical, anthropometric - goniometry, biochemical - malonic aldehyde, SH-groups, superoxide dismutase, catalase, ceruloplasmin, middle mass molecules at wavelengths of 254 and 280 nm, oxyproline, immuno-enzymatic - fecal ?- elastase, instrumental - X-ray of the joints of knee, hip, hand and foot, dual-energy X-ray densitometry of the lumbar region of the spine and femur, ultrasound examination of the pancreas. The scientific novelty of the results: the clinical and pathogenetic features of the formation and the course of osteoarthrosis in patients with chronic pancreatitis were first determined, the relationship between the clinical course of osteoarthrosis and the clinical characteristics of chronic pancreatitis was revealed, the effect of oxidative stress and the progression of endotoxicosis in patients with osteoarthrosis with chronic pancreatitis on the development of osteodeficiency and the severity of functional joint failure and Ro-stage. The gender features of bone tissue under osteoarthritis in comorbidity with chronic pancreatitis and the interdependence of bone mineral density from pro-and antioxidant system indexes and endotoxicosis and the main characteristics of chronic pancreatitis have been substantiated for the first time. For the first time, expediency was proved and the efficiency of complex medical and rehabilitation programs of medical correction of the revealed violations with the use of intracellular enzymotherapy (Wobenzim) and superficial multicellular multicolored application (M.G. Lyapko applicator) was demonstrated to reduce endotoxication and oxidative stress, improve the mineral density of bone tissue and decrease in the depth of osteophytes, improving the functional capacity of the joints, decreasing the severity of pain syndrome with osteoarthritis in combination with chronic pancreatitis.
