Makhnitska I. Clinical and pathogenetic features of gastroduodenal disorders in chronic pancreatitis, complex approaches to their correction

The aim of the study was to establish the features of the clinical course, morphological, secretory and immunological parameters of chronic recurrent pancreatitis (CRP) in comorbidity with gastroduodenal disorders and to develop and scientifically substantiate their correction by including in the protocol therapy the combined agent of dexpanthenol (provitamin B5) and methylmethionine (vitamin U). The peculiarities of the clinical course of CRP in comorbidity with chronic gastritis (CG), associated with H.pylori, in relation to isolated CRP, were established, and a lower quality of life of patients with this comorbidity compared to those with isolated CRP according to the physical and psychological components of the SF-36 questionnaire, respectively, was established 11.5 % and 11.6 % (р≤0.05), as well as 1.52 times higher total score of the scales of the GSRS questionnaire. The morphological state of MM in CRP was studied and it was proved that even without clinical verification of diseases of the stomach and duodenum, there were changes in MM, which practically correspond to the phenomena of chronic nonatrophic gastritis, which requires correction, and it was also established that the condition of MM of the stomach and duodenum in a group of patients with a combination of CRP and CG, associated with H.pylori, was significantly more complicated than that with isolated CRP by a 2.3 times greater total number of pathological signs. By the method of basal-topographic express-pH-metry, it was established that in isolated CRP there is a predominance of normoacidity with a tendency to moderate hypoacidity, and in the research comorbidity of CRP with gastroduodenal changes – moderate hyperacidity with a tendency to the distribution of measurement points with a dominant interval expressed according to the revealed rating (59,81 ± 10.35%) – 4˃5˃3˃2-1 (р≤0.05 between 2-5 intervals), which requires mandatory correction. The understanding of the state of the immune system in comorbidity of CRP and CG, associated with H.pylori, with the establishment of increased immunodeficiency of the T-cell link according to the T-suppressor type. It was proposed for the first time and the feasibility of additional inclusion in the complex treatment of the combined agent of dexpanthenol (provitamin B5) and methylmethionine (vitamin U) according to the proposed scheme is scientifically justified.