EFFICIENCY OF APPLICATION OF THE COMBINED HEPATOPROTECTOR IN COMPLEX TREATMENT OF CHRONIC PANCREATITIS WITH CONCOMITANT LIVER DAMAGE

Abstract

SUMMARY. Comorbidity of chronic pancreatitis (CP) and chronic viral hepatitis C (CVHC) is quite common and problematic, even after etiotropic treatment of viral hepatitis C infection. The aim – to investigate the state of the functional capacity of the pancreas and general clinical and selected biochemical parameters of patients with CP against the background of treated CVHC under the influence of the proposed complex treatment with the additional inclusion of the hepatotrophic drug heparizin (HZ). Material and Methods. 45 patients with CP comorbid with CVHC were studied. All patients were examined according to generally accepted algorithms and received a generally accepted complex of treatment according to the protocol (GAT) for CP in accordance with the order of the Ministry of Health of Ukraine No. 638 dated 2014 and CVHC – according to the Clinical Guideline of the Ministry of Health of Ukraine, based on evidence "Viral Hepatitis C" dated 2020. All outpatient patients with a comorbid course of CP and CVHC were divided into 2 groups to study the effectiveness of the proposed correction programs: 1 group (20 patients) received a generally accepted complex of treatment according to the protocol (GAT) for three months, Group 2 (GAT+HZ) – 25 patients with CP and CVHC) – received GAT with the additional inclusion of the hepatotrophic agent Heparizin PLC, 1 capsule 3 times a day after meals for 3 months. Results. A more significant level of effectiveness of the treatment complex with the additional inclusion of the hepatotrophic drug heparizin was established in relation to this protocol treatment for the restoration of the functional and structural state of the pancreas according to the studied parameters: the content of fecal α-elastase increased by 54.4 % vs. 39.9 %, respectively, and glucose content decreased – by 15.6 % vs. 10.0 %, the co-program score decreased – by 40.2 % vs. 25.1 %, the US score of the software structure decreased – by 74.4 % vs. 33.6 % (p <0.05). Conclusions: The reliable positive effect of heparizin on the disturbed parameters of the functional state of the pancreas and liver in CP in combination with CVHC was proven and allowed to assert the anti-inflammatory activity of heparizin, optimizing its effect on protein metabolism and functions of the pancreas and liver. It is recommended to additionally include the hepatotrophic agent heparizin to the protocol complex therapy of patients with chronic pancreatitis against the background of treated etiologically CVHC at the stage of outpatient rehabilitative treatment.