Sasyk H. Optimization of patients with chronic pancreatitis in combination with diabetes mellitus complex treatment with the drugs using, skhidnytsia mineral waters and reflexotherapy.

For the first time, the peculiarities of the clinical course of chronic pancreatitis in comorbidity with type 2 diabetes mellitus were analyzed and established based on the results of a comprehensive examination of patients. The pathogenetic links between the growth of insulin resistance and the activation of the kallikrein-kinin system, general and specific proteolysis, endotoxicosis and lipid peroxidation, weakening of enzymatic and non-enzymatic links of antioxidant protection, and increasing the degree of dysbiosis have been expanded. For the first time, the expediency of including ademethionine in the protocol treatment of chronic pancreatitis with comorbidity with type 2 diabetes mellitus was proposed and substantiated, which was confirmed by a decrease in clinical syndromes, normalization of lipid profile, decrease in glucose level - by 5,6%, HOMA index - by 18,8% and ultrasound score of the pancreas - by 40,8% (p<0,05). For the first time, a significant positive effect of drinking mineral waters of Skhidnytsia deposit in the complex drug therapy of patients with chronic pancreatitis and type 2 diabetes on the clinical course, fat and somatic protein metabolism and functional capacity of the pancreas, which is confirmed by reliable 6,8%, a decrease in glucose (by 26,5%), glycosylated hemoglobin (by 24,8%) and ultrasound score of the structure of the pancreas (by 48,6% (p<0,05)). For the first time the effectiveness of complex therapy of patients with chronic pancreatitis comorbid with type 2 diabetes with additional inclusion of acupressure and drinking mineral water, which leads to better correction of clinical syndromes by a total of 12,3% of lipidogram (p<0,05); functional capacity of the pancreas and restoration of its structure (by increasing the content of fecal α-elastase - by 29,3%, reducing the content of glucose - by 11,7%, glycosylated hemoglobin - by 33,7%, HOMA index - by 65,6%, ultrasound score of the structure of the pancreas - by 9,9% (p<0,05)).