EFFECTIVENESS OF CLINICAL NUTRITIONAL PREPARATIONS IN THE CORRECTION OF NUTRITIONAL DISORDERS IN PATIENTS WITH CHRONIC PANCREATITIS

Y.N. BUTOVA, A.A. YAKOVLEV

Rostov State Medical University, Rostov-on-Don, RUSSIA

The aim of the study: To carry out comparative analysis of clinical effectiveness, to assess the dynamics of indicators of nutritional status in patients with exacerbation of chronic pancreatitis (CP), nutritional deficiency (ND) against standard treatment and with the inclusion of preparations of Clinical Nutrition (PCN).

Materials and methods. The open randomized study included 80 patients (58 women, 22 men) with CP ND aged 44 - 70 years (average age 59 ± 3,2 years), randomized into 2 major (I and II) research groups, 40 patients in each, respectively. Subject to the composition of patients with ND, patients of main groups were divided into two groups A and B: IA group - 32 (40%) patients with CP and ND of the 1^st st., IB - 8 (10%) patients with CP and ND of the 2^nd st., IIA group - 34 (42.5%) patients with CP and ND of the 1^st t. and IIB - 6 (7.5%) patients with CP and ND of the 2^nd st. Patients of the group I, were treated in accordance with the standard (recommended) of medical care for patients with CP. Patients of the group II, were prescribed PCN: peptamen and modulen (Nestle) in the mode of successive addition. The effectiveness of the therapy was evaluated on the 3^rd and 4^th weeks of treatment with the use of integral indicator of the dynamics of arrest of main clinical symptoms of relief, normalization of indicators of nutritional status (somatometric and laboratory component), and the integral indexes of remission of CP.

Results. In patients of IIA and IIB groups, abdominal pain was arrested by the completion of the treatment on average of: 14.6+3.0 and 20.2+2.1 days, respectively, that is, 4.1 and 4.6 days less than in groups with basic therapy (p <0,05), normalization of stool on the 12.4+2.0 and 12.3+2.3 days of treatment, respectively was observed, that is 1.7 and 4.1 days earlier that in groups with basic treatment. On the 4^th week of observations in groups IIA and IIB there was registered a positive dynamics, in the form of increase of patients with normal nutritional status and / or transformation of the degree of nutritional deficiency into less severe. The frequency of clinical remission at 3 and 4 weeks of treatment in 1 and 2 groups of patients was, at average, 52.6%, 76.1%, 55.6% and 100% respectively.

Conclusions. Optimization of treatment of CP PCN (peptamen, modulen) is accompanied by clinically useful characteristics of the disease: it provides correction of ND, increases satisfaction with treatment.

Date: 2014-12-28; view: 982