Ispol'zovanie preparatov, proizvedennykh po novym tekhnologiyam, v lechenii nealkogol'nogo steatogepatita


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Abstract

An open randomized clinical trial with randomization of patients with NASH and type 2 diabetes mellitus (n = 75) into 3 groups was performed. All patients received hypocaloric diet with restriction of carbohydrate. Patients in group 1 (n = 27) received metformin 500 mg 3 times a day, patients in group 2 (n = 23) received a comprehensive hepatoprotective drug containing essential phospholipids made by nanotechnology and glycyrrhizic acid 2 capsules 3 times per day, patients in group 3 (n = 25) received metformin and hepatoprotector in the indicated dosages. The assessment of results was carried out at 90 and 180 days. The data of study indicate that the combined treatment regimen leads to the relief of abdominal pain, dyspeptic and astenovegetative syndromes, normalization of biochemical parameters of cytolytic and cholestatic syndromes, reduction of dyslipidemia, decrease of degree of steatosis, hepatitis activity and stage of fibrosis in the liver on the background of improving of compensation of diabetes mellitus. Monotherapy with metformin or hepatoprotector is less effective in these patients.

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A. N Kazyulin

S. M Babina

References

  1. Полунина Т.Е., Маев И.В. Неалкогольная жировая болезнь печени: эпидемиология, патогенез, диагностика, лечение. Consillium Medicum. 2012; 1: 35-40.
  2. Маев И.В., Цуканов В.В., Лукичева Э.В. и др. Распространенность, патогенез и принципы лечения неалкогольной жировой болезни печени. Фарматека. 2011; 12: 12-15.
  3. Маев И.В., Андреев Д.Н. Неалкогольная жировая болезнь печени: механизмы развития, клинические формы и медикаментозная коррекция. Consilium medicum. Гастроэнтерология. 2012; 2: 36-39.
  4. Маев И.В., Андреев Д.Н., Дичева Д.Т., Гречко А.В., Пенкина Т.В. Неалкогольная жировая болезнь печени: современное состояние проблемы. Медицинский вестник МВД. 2012; 61(6): 35-40.
  5. Bellentani S., Scaglioni F., Marino M., et al. Epidemiology of nonalcoholic fatty liver disease. Dig. Dis. 2010; 28: 155-61.
  6. Wasmuth H.E., Trautwein C. Liver fibrosis: clinics, diagnostics and management. Internist. 2010; 51: 14-20.
  7. Santos L.F., Hernandez G., Puerta A.V., et al. Non alcoholic fatty liver disease. The new millennium Pandemia. Rev. Col. Gastroenterol. 2010; 25: 373-91.
  8. Шварц В.Я., Ногаллер A.M. Жировой гепатоз и неалкогольный стеатогепатит. Сибирский вестник гепатологии и гастроэнтерологии. 2011; 25: 5-9.
  9. Della Corte C., Alisi A., lorio R., et al. Expert opinion on current therapies for nonalcoholic fatty liver disease. Expert Opin. Pharmachother. 2011; 12: 1901-191.
  10. Wong V.W., Vergniol J., Wong G.L., et al. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. 2010; 51: 454-62.
  11. Feldstein A.E., Wiekowska A., Lopez A.R., et al. Cytokeratin-18 fragment levels as noninvasive biomarkers for nonalcoholic steatohepatitis: a multicenter validation study. Hepatology. 2009; 50: 1072-78.
  12. Loria P., Adinolfi L.E., Bellentani S., et al: Practice guidelines for the diagnosis and management of nonalcoholic fatty disease. Dig. Liver Dis. 2010; 42: 272-82.
  13. Полунина Т.Е. Неалкогольная жировая болезнь печени - мультифакторная патология. 2013; 13-14: 11-13.
  14. Kotronen A., Juurinen L., Tiikkainen M., et al. Increased liver fat, impaired insulin clearance, and hepatic and adipose tissue insulin resistance in type 2 diabetes. Gastroenterology. 2008; 135: 122-30.
  15. Promrat K., Kleiner D.E., Niemeier H.M., et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology. 2010; 51: 121-29.
  16. Serviddio G., Bellanti F., Giudetti A.M., et al. A silybin-phospholipid complex prevents mitochondrial dysfunction in a rodent model of nonalcoholic steatohepatitis. Pharmacol. Exp. Ther. 2010; 332(3): 922-32.
  17. Miyazaki Y., DeFronzo R.A. Visceral fat dominant distribution in male type 2 diabetic patients is closely related to hepatic insulin resistance, irrespective of body type // Cadiovasc. Diabetol. кой процесса, удобство применения в качестве скрининг-метода для пациентов групп риска, возможность регулярного мониторинга во время лечения для оценки эффективности проводимой терапии. 2009; 8: 44-52.
  18. Polyzos S.A., Kountouras J., Zavos C., Tsiaousi E. The role of adiponectin in the pathogenesis and treatment of nonalcoholic fatty liver disease. Diabetes Obes. Metab. 2010; 12(5): 365-83.
  19. Маев И., Дичева Д., Лебедева Е., Андреев Д. Возможности терапии неалкогольного стеатогепатита. Врач. 2012; 5: 53-56.
  20. Мехтиев С.Н., Гриневич В.Б., Бращенкова А.В., Кравчук Ю.А. Современные подходы к лечению неалкогольного стеатогепатита. Формирование стандарта терапии. Consilium medicum. 2008; 5: 7-11.
  21. Musso G., Gambino R., Cassader M., Paganu G. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology. 2010; 52(1): 79-104.
  22. Сторожаков Г.И., Байкова И.Е., Никитин И.Г. и др. Теоретические и практические аспекты применения глицирризина. Клин. перспект. гастроэнтерол. и гепатол. 2003; 1: 35-9.
  23. Sebastiani G., Alberti A. Non invasive fibrosis biomarkers reducebut not substitute the need for liver biopsy. World J. Gastroenterol. 2006; 21: 3682-694.
  24. Фролова А.А. Современные способы диагностики фиброза печени. ЖК. 2013; 1-2: 12.
  25. Pais R., Lupsor М., Silaghi A., Rusu M.L. Liver biopsy versus noninvasive methods - fibroscan and fibrotest in the diagnosis of non-alcoholic fatty liver disease: a review of the literature. Intern. Med. 2009; 47(4): 331.

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