No 14 (2014)

This article discusses the mechanisms of action of some neurohumoral substances on the motility of the gastrointestinal tract, including intestinal contractions. The first, the role of serotonin in the regulation of motor activity of the digestive tube is discussed. The comparative analysis of currently used serotoninergic drugs (tegaserod, prucalopride) affecting the motor activity of the esophagus, stomach and intestines is presented. The clinical manifestations of deficiency and an excess of serotonin in the human body, and ways for their correction are discussed.

The article presents the results of evaluation of the efficacy of schemes of treatment of patients with H. Pylori-associated diseases. Quaternary schemes with inclusion of proton pump inhibitor rabeprazole and bismuthate tripotassium dicitrate allow for a higher eradication rate than the classical triple therapy, and thus improve the clinical efficacy and cost-effectiveness of eradication therapy.

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.

The article discusses the basic principles of a comprehensive diagnosis of patients with Helicobacter pylori-associated diseases. The role of pathogenicity factors of Helicobacter pylori is analyzed. An algorithm for a staged evaluation of patients with concomitant H. pylori contamination of periodontal and gastroduodenal zones is presented.

The article presents a comparative description of the effect of different antispasmodic drugs according to the data of peripheral electrogastroenterography in patients with irritable bowel syndrome. Several features of action of antispasmodics in different modes of drug administration - protracted treatment, a single dose drug «on demand» - were evaluated. Antispasmodic Hyoscine butylbromide (Buscopan) has proved to be an effective drug in the treatment «on demand» for the relief of abdominal pain, that allows to recommend its use for this purpose in clinical practice.