Sabat Z. Clinical and pathogenetic features of autonomic dysfunction in chronic pancreatitis, optimization of the treatment and rehabilitation complex

The aim of the study was to increase the effectiveness of protocol treatment based on a comprehensive assessment of the autonomic status of patients with chronic pancreatitis and its interrelationship with the parameters of the clinical course, the functional state of the pancreas, endotoxicosis, trophological status, quality of life and the psycho-emotional state of patients by including vegetatostabilizing and complex bioregulatory agents in it to correct the identified disorders. The features of ANS dysfunction in CP were determined depending on the patients' BMI and the clinical course of the disease. The pathogenetic concepts regarding the influence of autonomic dysfunction on the functional state of the pancreas, parameters of endotoxicosis, trophic status, quality of life and psychoemotional state of patients are deepened. Added scientific data on the aggravating effect of lipid metabolism disorders, the inflammatory process (according to leukocyte indices of blood) on the clinical course of CP: in patients with an excess body mass index and an existing chronic inflammatory process, a more severe degree of exocrine insufficiency of pancreas, a more frequent increase in the level of glucose and total cholesterol compared to with individuals of normal weight. Thus, the conducted research led to a theoretical generalization and a scientific and practical solution to the task of increasing the effectiveness of treatment and rehabilitation of patients with CP with ANS dysfunction outside of an exacerbation with the inclusion in the protocol therapy of the vegetostabilizing agent ginkgo biloba and a course of BRT based on the assessment of the clinical course and the dynamics of laboratory and instrumental parameters. The expediency of including in the protocol treatment of patients with CP and ANS dysfunction the vegetostabilizing drug ginkgo biloba and a combination of bioregulatory agents according to the author's scheme was proposed, evaluated and proven, based on the positive dynamics of clinical syndromes of the disease, endotoxicosis, the functional state of the pancreas, parameters of trophic status, improvement of the psycho-emotional state and quality of life of patients. The effectiveness of the proposed treatment programs for achieving a stable remission of the disease during the year was proven in terms of the number of exacerbations, hospitalizations, average duration of the hospitalization episode, quality of life and psycho-emotional state of patients with CP.