Majkova T. State of adaptable reactions of an organism and their role in pathogenesis of combined pathology of gastroduodenal zone and pancreatobiliary part of digestive system.

Object of the study: Structural functional organization of continuum of regulation of the digestive functions in patients with peptic ulcer and chronic gastroduodenitis in combination with acalculous cholecystitis and chronic pancreatitis. Purpose of the study: To determine the state of adaptation reactions under the influence of the leading risk factors as well as their role in pathogenesis of combined pathology of the digestive organs and substantiate therapeutic principles. Methods of the investigation: clinical, social hygienic, psychological, instrumental (esophagogastroduodenoscopy, sonoscopy, ECG), functional (gastric and duodenal examination, sonoscopy), biochemical, morphological, immunological, statistical methods. Theoretical and practical results: Based on complex in-vestigation, the ideas about pathogenetic features of combined pathology of gastroduodenal and pancreaticobiliary organs with the account of adaptation organism reactions were formulated. Determining the risk of development ofdeadaptation of the patients with combined pathology of the digestive organs allows to form the groups requiring optimization of the follow-up and treatment. The obtained data about the systemic character of the functional and structural changes of the digestive organs due to structural functional deorganisation of the continuum of regulation of neurohumoral, vegetative, immune system is the main paradigm of the pathogenesis of the combined pathology of the digestive organs and should be considered the main direction of the therapeutic measures. A new method of diagnosis of the accompanying diseases of the duodenum using evaluation of the basal portion of the gastric secretion which allows to improve the efficacy of the diagnosis of the digestive organs was worked out. A new method to objectivize the tissue echo-density visualized by acoustic studies was developed. A method of diagnosis of humoral link of the immunity using hemodynamic indices was improved. Novelty: The leading role of adaptation reactions indevelopment of combined pathology of the digestive organs was determined. For the first time, adaptation organism reactions as an individual response to exogenic factors was studied in the patients with pep-tic duodenal ulcer with chronic gastroduodenitis accompanied by chronic cholecystitis and pancreatitis. Their influence on the de-velopment of the combined pathology was established. It was proved that at systemic chronic stress-reactions the combined pa-thology is realized due to the influence of the etiological factors on the function of the adaptive systems, changes in the rhythmic activity of regulation systems of all levels of organization (organ-ism-organ-cell) and deadaptive exhaustion of their functional re-serve. It was proved that in combined gastrointestinal pathology destabilization of the connections between the stress-realizing and stress-limiting systems responsible for the changes in the neuro-humoral factors and development of deintegration processes in the vegetative, immune, neurohumoral systems. Circadian rhythm of main physiological processes was described for the first time; its regulating influence on the digestive functions in combined diges-tive pathology was established. Degree of introduction: The findings of the work were intro-duced to the work of gastroenterology and therapy departments in Dnepropetrovsk, Zaporozhie as well as hospitals of Poltava, Zaporozhie, Vinnitsa, Donetsk, Cherkassy, Odessa, Ternopol, Lugansk regions and Republic of Crimea. The findings of the re-search are used in the teaching process at department of therapy and gastroenterology of Zaporozhie Medical Academy for Post-graduate Training (Ministry of Heath of Ukraine). Sphere of application: medicine, gastroenterology.