The effect of complex treatment of patients with non-alcoholic steatohepatitis in combination with type 2 diabetes on the course of the inflammatory process: adiponectin and proinflammatory cytokines
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Abstract
The objective: optimization of treatment for patients with nonalcoholic steatohepatitis (NASH), combined with type 2 diabetes by the pathogenetic approach, depending of the characteristics of the course of this disease.
Materials and methods. The study was carried out on 30 patients with NAFLD – in the NASH stage. Control group – 20 healthy persons. To identify the diagnosis of NAFLD, the clinical, laboratory, biochemical and instrumental studies were comprehensively taken into account, according to the examination standards for patients with pathology of the gastrointestinal tract.
Results. With the use of complex treatment with combined glucose reducing (gliclazidum and pioglitazoni hydrochloridum) and lipotropic (ademetioninum) therapy, the results of treatment showed their antiinflammatory effect with decreasing the levels of TNF-α, IL-6 and C-reactive protein, and an increase in the level of adiponectin.
Conclusion. A significant improvement in the subjective and objective state of patients was observed. The pain syndrome remained 1.8 times smaller than the number of patients before treatment; dyspeptic syndrome – decreased by 1.7 times, a decrease in appetite – a decrease of 1.9 times, asthenovegetative syndrome – a decrease of 1.9 times. Combined hypoglycemic and lipotropic therapy against baseline therapy positively influenced the state of hepatocytes: the activity of ALT, alkaline phosphatase, gamma-glutamyltranspeptidase decreased (p<0.05). Especially important was a significant reduction in the number of patients with stage III hepatosis – a decrease of 2.5 times. In all patients, the indices of cytolysis, mesenchymal-inflammatory syndrome, and protein and lipid metabolism parameters stabilized reliably.##plugins.themes.bootstrap3.article.details##
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