RU2843068C1 - Method of treating epigastric pain syndrome - Google Patents

Abstract

FIELD: medical science.

SUBSTANCE: invention refers to medicine, namely to gastroenterology, and may be used for treating the patients suffering epigastric pain syndrome. Therapeutic course makes 4 weeks. Patient takes omeprazole 20 mg for the night. Besides, the patient takes mineral water No. 1 of the Metallurg sanatorium with temperature of 20-25 °C 200 ml 3 times day 1 hour before meals.

EFFECT: method is simple, effective, can be used both in hospital, and out-patient conditions.

1 cl, 1 tbl, 1 ex

Description

The invention relates to medicine, namely to gastroenterology, and can be used in practical healthcare for pathogenetic therapy of patients with epigastric pain syndrome, aimed at reducing visceral hypersensitivity and gastric acid production.

Functional gastrointestinal diseases are a relevant area of modern gastroenterology, where the interests of practical and fundamental medicine intersect. A fairly common functional disorder of the gastrointestinal tract is functional dyspepsia, its overall prevalence in the population is 20.8% (Ford A.C., Marwaha A., Sood R. et al. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a meta-analysis. Gut. 2015; 64:1049-57). There are two main types of functional dyspepsia: postprandial distress syndrome and epigastric pain syndrome (EPS) (Lazebnik LB, Golovanova EV, Volel BA, et al. Functional diseases of the digestive system. Overlap syndromes. Clinical guidelines of the Russian National Gastroenterological Society and the Russian National Gastroenterological Society. Experimental and Clinical Gastroenterology. 2021; 192(8): 5-117). Hypersecretion of hydrochloric acid and visceral hypersensitivity play a key role in the development of EPS (Ivashkin VT, Maev IV, Sheptulin AA, et al. Clinical guidelines of the Russian State Academy for the diagnosis and treatment of functional dyspepsia. RZHGGK. 2017; 27(1):50-61).

Visceral hypersensitivity in functional dyspepsia is an increased sensitivity of the receptor apparatus of the gastroduodenal wall to mechanical, chemical and thermal irritants, due to which pain in the epigastric region occurs with a significantly lower impact (including hydrochloric acid of gastric juice) than in healthy people. Therapy for visceral hypersensitivity has not yet been developed, but it is a promising direction in the treatment of VEBS.

A method for treating patients with functional dyspepsia syndrome using omeprazole at a dose of 20 mg once a day for 4 weeks is known (Butorova L.I., Osadchuk M.A., Osadchuk M.M. et al. Optimization of therapeutic tactics for functional dyspepsia syndrome // Doctor.Ru. Gastroenterology. 2015; 12 (113): 80-86). The effectiveness of treatment is assessed by the dynamics of clinical manifestations of functional dyspepsia. The disadvantage of this method is the lack of therapeutic effect on visceral hypersensitivity of the stomach and duodenum as the main pathogenetic mechanism of functional dyspepsia. After stopping taking omeprazole, acid production in the stomach increases sharply, which, with persistent visceral hypersensitivity, leads to a rapid return of the clinical symptoms of functional dyspepsia.

A method for treating patients with functional dyspepsia is known using the herbal preparation Iberogast, 20 drops 3 times a day orally (Kucheryavy Yu.A., Andreev D.N. Modern Possibilities of Treating Functional Dyspepsia from the Standpoint of Current Clinical Guidelines. RMJ. 2017; 17: 1232-1237). The preparation, containing extracts of 9 plants, improves the evacuation function of the stomach, normalizes relaxation accommodation, reduces artificially induced afferent impulses, reduces the secretion of hydrochloric acid, and has a gastroprotective effect. The disadvantages of this method include a weak acid-suppressive effect, the absence of a training load on the gastric wall, the presence of components with opposite effects in the composition of the preparation, as well as the possibility of allergic reactions to plant extracts.

The objective of the claimed invention is to improve the quality of treatment of patients with epigastric pain syndrome by reducing visceral hypersensitivity and acid production. The solution to the above problem is achieved by the fact that according to the method of treating epigastric pain syndrome, including the internal use of mineral water (MW), the drug omeprazole is additionally used at night, and MW No. 1 of the Metallurg sanatorium (Izhevsk, Udmurt Republic) with a temperature of 20-25°C is used as MW.

From the analysis of patent and scientific and technical literature, the claimed set of features has not been identified, namely, those that ensure an increase in the effectiveness of the treatment of SEB by reducing visceral hypersensitivity and acid production through the simultaneous administration of the drug omeprazole and the internal use of MV No. 1 of the Metallurg sanatorium, which allows us to conclude that the claimed technical solution meets the criteria of “novelty” and “inventive step”.

The method is carried out as follows. The drug omeprazole is prescribed orally at a dose of 20 mg at night in combination with taking MV No. 1 from the Metallurg sanatorium, at a temperature of 20-25 ° C, 200 ml 3 times a day 60 minutes before meals for 4 weeks.

According to its physical properties, MV No. 1 of the Metallurg sanatorium is characterized as colorless, transparent, odorless, with a slightly salty taste, and has a stable chemical composition (Table 1).

Table 1.

Chemical composition of drinking water MV No. 1 of the Metallurg sanatorium (mg/l)

Cations Anions Undissociated molecules Na+K - 501.4 Cl - 390.5±0.8 Boric acid - 49.4±2.4 Ca - 5.0±0.1 _HCO3 - 329.4±9.9 Silicic acid - 5.6±1.1 Mg - 3.0±0.1 SO ₄ - 243.3±8.2 _NH4 - 0.4±0.1 _CO3 - 48.0±5.9 F - 3.8±0.1 Br - 1.1±0.9 Total cations - 509.8 Total anions - 1017.0

The advantage of the method is the positive effect of the combined use of omeprazole and MV No. 1 of the Metallurg sanatorium in SEB, more pronounced compared to monotherapy with omeprazole, in the form of relief of clinical symptoms due to a decrease in gastric acid production and visceral hypersensitivity of the stomach and duodenum to irritants. This method can be used both in inpatient and outpatient settings.

Example 1. Patient P., 30 years old. Complaints of burning pain in the upper abdomen, occurring on an empty stomach, 2-3 times a week for 3 years. Examination of the respiratory, circulatory, and urinary organs did not reveal any pathology. The abdomen is soft, moderately painful in the epigastrium. No laboratory abnormalities were found. Gastroduodenoscopy: organic pathology is excluded. Helicobacter infection is not detected. Ultrasound examination of the abdominal organs did not reveal any structural changes. pH in the body of the stomach is 1.7. Load drinking test (drinking water of different temperatures until a feeling of complete satiety): 25°C - 530 ml, 40°C - 225 ml, a difference of 58% (more than 50%) indicates visceral hypersensitivity. Diagnosis: Epigastric pain syndrome.

For 4 weeks, the patient took omeprazole at a dose of 20 mg at night in combination with MV No. 1 from the Metallurg sanatorium at a dose of 200 ml 3 times a day 60 minutes before meals, at a temperature of 20-25 ° C, for 4 weeks. On the 3rd day of treatment, the severity of pain in the upper abdomen decreased, by the 13th day, the manifestations of VESF were completely relieved. pH in the body of the stomach is 3.5. Load drinking test: 25 ° C - 645 ml, 40 ° C - 470 ml, a difference of 27% (less than 50%) indicates the absence of visceral hypersensitivity. Conclusion: high efficiency of the combination therapy.

Claims (1)

A method for treating epigastric pain syndrome, including taking omeprazole at a dose of 20 mg at night for 4 weeks, characterized in that mineral water No. 1 from the Metallurg sanatorium at a temperature of 20-25°C is additionally used, 200 ml 3 times a day 60 minutes before meals for 4 weeks.