Pancreatitis Final

Department of Public health services

of Moscow

Municipal hospital № 79

REPORT

About use of the treatment-and-prophylactic alimentary additive «Energolam-plus» at patients with acute and chronic surgical pathology.

Deputy Head of the Surgical Department

Doctor of medical science      S.G. Tsatsanashvili

Manager of the Surgical Department
Doctor of medical science      S.G. Gabibov

June, 10, 2003

Moscow

INTRODUCTION

Human diseases are evolving together with human evolution. The factors of the external ambience are changing, new methods of treatment and diagnostics are appearing, and many human diseases vary its aetiopathogenesis. It can be related in full measure to the acute surgical diseases (an acute and chronic pancreatitis, an acute and chronic cholecystitis, a peptic ulcer of a stomach and a duodenum). In the beginning of last century the acute pancreatitis and an acute cholecystitis were described as casuistry, that at present on frequency of the diseases organ to abdominal cavity they yield only acute appendicitis. Medical and social-economic importance of the problem is concluded in the existing of steady increase to diseases amongst persons of the able-bodied age.

Rapid development of industrial methods of research (a laparoscopy, ultrasonic methods, a computer tomography and others) have allowed clinicians «to see» a pancreas, bile bladder and to estimate a degree of its recruitment phenomenon in pathological process. There are necessary fundamental clinical-morphological researches and treatments which now it is not enough for an assessment of character of morphological changes, developments of medical tactics and a substantiation of the forecast.

The present report is devoted to results of studying of an opportunity for the immune-stimulated activity of the new biologically active additive from sea foods «Energolam-plus». One of the important components of complex pathogenetic therapy of surgical diseases is an application of the preparation «Energolam-plus» having antioxidant and immune stimulating properties which intensifying is directed on enriching of a tissular metabolism, rising of body resistance to a various sort to surgical complications.

One of such preparations is the medical alimentary active additive «Energolam-plus» with adaptogenic actions, developed and manufactured by    “Bio-shelf” Company, keeping in each capsule:

  • 50 mg of hard-roe of the sea hedgehogs sublimated at low temperature;
  • 150 mg dry kelp;
  • the balanced complex of polyunsaturated fatty acids;
  • phosphotides;
  • amino -and nucleic acids;
  • complex  of the liposoluble (A, D, E) and water-soluble ( C, Bl, B2, В12, РР, etc.) vitamins;
  • trace elements (iodine, iron, copper, cobalt, etc.) in  easy assimilating form;
  • complex of unique natural biologically active materials (saponins, prostaglandin, echinochrom).

Taking into account the composition, it is possible to speak that use of the given preparation is pathogenetic proved in line-of-treatment of acute and chronic diseases.

The purpose of research

The purpose of the given research is studying of an opportunity to apply of the treatment-and-prophylactic alimentary additive «Energolam-plus» in complex therapy at patients with a surgical pathology. The researched group included 40 patients with the surgical pathology treated in a hospital in emergency and scheduled order in various time from the beginning of disease. The age of patients was in range from 35 to65 years. There were 16 women and 24 men.

There were the following surgical nosologies:

  • acute pancreatitis – 8;
  • chronic pancreatitis – 8;
  • an acute cholecystitis – 9;
  • chronic cholecystitis – 6;
  • acute peptic ulcer – 5;
  • exacerbation of a chronic peptic ulcer — 4

Three groups of patients have been formed based on a degree of gravity of disease at the moment of entering in a hospital. In dependence on gravity of clinical presentations (pain in abdominal regions, nausea, vomiting, and temperature reaction) patients received «Energolam-plus» in different course doses in a combination with antibacterial, disintoxication, desensitizing therapy.

The schema of application of a preparation

The first group included 17 patients who have treated in a hospital with an acute surgical pathology. In this group «Energolam-plus» had been appointed in a combination with other preparations. The daily dose included 6 capsules, 2 capsules 3 times per day during 6 days with the subsequent decrease of a daily dose up to 3 capsules during 10 days, then 1 capsule during 14 days.

The second group included 14 patients who have treated in a hospital with a chronic surgical pathology. «Energolam-plus» had been appointed in a combination with other preparations in this group also. The daily dose compounded 2 capsules in one stage 1 time per day within meal during 15 days, with the subsequent reception 1 capsule during 15 days.

The third group included 9 patients with a peptic ulcer. «Energolam-plus» had been appointed in a combination with Н2-blockers in a daily dose of 2 capsules in one stage during 30 days.

Assessment of efficacy of a preparation was made based on the basic criteria: clinic-laboratory parameters, ultrasonic diagnostics, and esophagogastroduodenoscopy. Clinic-laboratory control carried out up to and right after the terminals of a 30-day’s course of reception «Energolam-plus». In control group researches were lead in similar time-terms.

Results of clinical inspection of basic groups and control group – Table 1

Dynamics of clinical signs at the surveyed patients before treatment, after treatment and a difference in a percentage ratio (B – before, A – after, D – difference):

Analysis of results of the lead treatment with application «Energolam-plus» testifies to the following. Use of the alimentary additive in the combined therapy yields undoubtedly positive in three investigated groups in comparison to parameters in control group. Especially significant differences are marked between the second, third group and the control group which was not receiving a preparation. It is necessary to note, that the preparation demonstrated more complete and rapid cupping of the mentioned-above clinical presentations. There is the undoubted advantage.

As may be seen from the table, clinical presentations of exocrinous insufficiency are polymorphic and connected to educing infringement of process of digestion as a result of ferment deficiency. The patients with exocrinous insufficiency are the persons having not less then three attributes listed in the table. Manifestation of these attributes specifies, in our opinion, the presence of exocrinous insufficiency.

In the given work we think to specify positive influence of a preparation on the patients with diabetes. It is assumed that infringement of incretory function of a pancreas is detected at 18-25 % of patients. The endocrine infringements, as a rule, precede its incretory distresses. In many respects it is possible to explain by weakness of pancreatic islet of a regenerative hyperplasia. At microscopic examination of our patients’ pancreas tissues the atrophy of acidosic cells and hypertrophy of the pancreatic islet were found.

We estimated a set of symptoms of incretory failure under the following schema: concentration of sugar in a blood and urine was defined, and further, under indications, a functional trial with glucose by means of the Straub-Traugott method was carried out. Last one was applied to all patients with normal concentration of sugar in a blood and after the triple control for patients with a transitional hyperglycemia (from above 5,3 millimole /l), revealed in the season of an exacerbation of disease. Results of researches are given in the Table 2.

The characteristic of a set of symptoms of incretory failure at chronic pancreatitis – Table 2

As may be seen from the table, the transitional (2-3 days) hyperglycemia is marked by us at 23,3 % of patients that is a characteristic attribute of incretory failure in the season of an exacerbation of disease. It is necessary to note that the hidden pancreatic islet failure was found at 3 from 10 patients afterwards. The diabetes with a proof hyperglycemia was diagnosed for 6 patients, and at 4 from them it was diagnosed for the first time in our clinic.

The given researched group, alongside with the standard methods of treatment, was treated with additional application of 1 capsule of preparation «Energolam-plus» for the night that yielded stable reduction of glucose in a blood (morning digits from 5 up to 5,4 millimole /l).

At analysis of clinical parameters of a blood significant enriching parameters at researched patients of 1-st, 2-nd and, especially, at 3-rd group were indicated. Taking into account intoxication and reduction of digits of a white and red blood at patients, application in a combination to other preparation of the additive «Energolam-plus» resulted the presence of stable enriching of digits of hematological parameters that specifies enriching of function of a hemopoiesis at persons with the reduced immune biological reactivity of an organism.

The given changes are specified in the Table 3

Results of the lead research testify to efficacy of application «Energolam-plus» in complex treatment of patients with a surgical pathology, irrespective of age parameters and attributes of an immune depression, substantial improvement of clinical-biochemical parameters at patients on a background of good survivability and absence of side effects. Application of the given additive promotes rapid regeneration of functions of an organism; warn possible postoperative consequences, that in turn reduces stay of the patient in a hospital.

Thus, «Energolam-plus» can be recommended to surgical patients:

1. For various age categories as preoperative preparation with the purpose of rising of immune activity of an organism that reduces possible earlier postoperative complications.

2. Application of the alimentary additive «Energolam-plus» at various surgical complications in a combination with antibacterial, disintoxicating, desensitizing therapy considerably strengthens therapeutic action of the last.

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