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Рецензент: д.мед.н., проф. Ю.Г. Бурмак
ДЗ «Луганський державний медичний університет»
ГЗ «Луганский государственный медицинский университет»
91045, кв. 50-летия Обороны Луганска, 1 г, Луганск, Украина
State Establishment "Lugansk State Medical University"
91045,50 Rokyv Oborony Luganska Block, 1G, Lugansk,Ukraine
In the current conditions in the clinic of internal diseases comorbidity, which is one of the most difficult problems of modern medicine, is common found [2,7]. Irritable Bowel Syndrome (IBS) - is one of the most common gastrointestinal diseases today, whose frequency is 28,0% [1, 8, 12, 13]. It is believed that the mechanisms of IBS associated with disorders of the nervous and humoral regulation of gut motor function [3, 4, 9], but the psychological and emotional factors thus play a crucial role [5, 13]. Thus, according to clinical and epidemiological studies was found that in a large industrial regions, including the Donbass, in 20-25% of patients with disorders of the digestive system, there are chronic bronchopulmonary disorders, including chronic obstructive pulmonary disease (COPD) [10, 11], due to the presence of common pathogenesis, including psycho-emotional disorders .
Under medical supervision after primary treatment was located 86 persons aged 25 to 55 years, in which comorbid diseases observed during 1 to 12 years. Among the patients examined dominated by women (60.0%). In patients with IBS, combined with COPD, were diagnosed stage I (mild) COPD and form of IBS with constipation.
Patients were randomized divided into 2 groups - I (47 people), which in the period of medical rehabilitation received adaptol 500 mg twice a day for a month and II (39 persons), who used only conventional means.
In patients with comorbid disorders as COPD combined with IBS showed signs of hypochondriacal and anxious-hypochondriacal syndromes, autonomic dysfunction.
In the dynamic monitoring of clinical parameters of patients was found that the inclusion of medical rehabilitation with adaptol helped reduce the duration of hypochondriacal manifestations and anxiety-hypochondriacal syndromes and asthenic-neurotic, asthenovegetative complaints. Purpose of adaptol also contributed to a more prolonged clinical remission in patients in I group.
Thus, the I group of patients examined after medical rehabilitation for anxiety levels of hospital anxiety and depression scale HADS averaged 6,2 ± 1,8 points, the level of depression - 7,1 ± 0,4 points, corresponding to the absence of anxiety and depression (40 people - 85.1%). In the II group, the absence of anxiety and depression has been found only in 14 patients (35.9%) (p <0.05).
However, after rehabilitation in all patients of I group according to questionnaire by the Zung scale during this period screening depressive symptoms was absent, in the II group - remained in 11 patients (29.0%).
Thus, the analysis of the characteristics of psychosomatic status in the I group and after medical rehabilitation using adaptol recorded more rapid improvement of psychological status of patients with COPD in combination with IBS than in the II group, where patients received only conventional methods. After medical rehabilitation data were obtained on a significant increase QOL in patients of I group on all scales of the questionnaire SF-36.
So, psychoremedial performance of adaptol in patients with COPD in combination with IBS compared with the group in which adaptol not intended, revealed a significant decrease of the number of anxiety-neurotic complaints, improved of mood background, normalization of sleep, as well as the elimination of depressive symptoms, increased exercise tolerance load and improve QOL of patients.
1. Дзяк Г.В. Функційні захворювання кишечнику / Г.В. Дзяк, В.І. Залєвський, Ю.М. Степанов. - Дніпропетровськ: Ліра ЛТД, 2004. - 200 с.
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