Amiraslanova I. T.

APPROBATION OF OPTIMIZED REGIMENS OF ERADICATION THERAPY PEPTIC ULCER OF THE STOMACH AND DUODENUM, ASSOCIATED WITH HELICOBACTER PYLORI


About the author:

Amiraslanova I. T.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scentific article

Annotation:

Goal. Improving the effectiveness of anti-Helicobacter therapy by overcoming the growing resistance of H. pylori to antibacterial drugs. Methods. The study included 120 male and female patients aged 18 to 65 years with gastric ulcer and 12 duodenal ulcer associated with H. pylori infection, who had not received eradication therapy before and at the time of gastrobioptate intake and had not taken proton pump inhibitors (PPIS) fifteen days prior to the study. To compare the effectiveness of the antihelicobacteric regimens used, patients with almost identical complaints were divided into two groups of 60 patients each by random selection. For each group, appropriate combinations of drugs were used: scheme No. 1 – rabeprazole 20 mg 2 times a day + clarithromycin 500 mg 2 times a day + amoxicillin 1000 mg 2 times a day and scheme No. 2 – rabeprazole 20 mg 2 times a day + josamycin 500 mg 2 times a day + amoxicillin 1000 mg 2 times a day. A probiotic (lactobacillus rhamnosus GG-6milyard, saccharomyces boulardii-2,5 milyard, Bifidobacterium lactis Bb-12, inulin-50mq) was added to both groups to level the side effects of the antibiotics used and to improve the results of the applied ET. After the end of the 10-day course of antibiotic therapy, patients of both groups continued to receive rabeprazole for the next four weeks. The morphological picture in dynamics was studied in 40 patients from each group before and after treatment. To do this, FGDs was combined with a targeted biopsy of 5 points of the mucous membrane. Results. In patients of both groups of 40 people in each, included in the morphological study, inflammation was recorded in both the fundal and antral part of the stomach, and in the duodenal zone, the inflammatory process was observed in the first group in 17 (42.5%), and in the second in 14 (35.0%) people. In 30 (75.0%) patients of group 1, in 26 (65.0%) patients of group 2, gastritis activity was mainly more pronounced in the antrum compared to the fundal. Thus, in the fundal part of the stomach in 10 (25.0%) of the first, in 14 (35.0%) of the studied patients of the 2nd group, the activity of the process was noted. In both comparison groups, the activity of inflammation was mainly strong and moderate. The atrophic process was mainly registered in the antral part of the stomach – in the first group in 32 (26.7%) people, in the second in 30 (25.0%) patients. Fundus atrophy was observed in 8 (6.7%) patients of the first group and 5 (4.2%) people of the second group. By overcoming H. pylori resistance to antibiotics (to clarithromycin) by optimizing the classical three-component scheme with the replacement of clarithromycin with josamycin and the addition of probiotic to the approved schemes leads to an increase in the effectiveness of antiHelicobacter treatment. This fact in this study is clearly demonstrated when comparing the dynamics of endoscopic and histo-morphological pictures of the gastric mucosa and 12 – duodenum in patients of both study groups. Conclusion. The replacement of clarithromycin with josamycin in the classical three-component antihelicobacter scheme leads to a significant improvement in endoscopic and morphological parameters in patients suffering from gastric ulcer and 12-duodenal ulcer associated with H. pylori infection.

Tags:

Helicobacter pylori, eradication therapy, clarithromycin, josamycin

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Publication of the article:

«Bulletin of problems biology and medicine» Issue 4 Part 1 (153), 2019 year, 65-69 pages, index UDK 616.342-002

DOI: