Preview

Medical alphabet

Advanced search

Effectiveness of hymecromone monotherapy in treatment of patients with various pathologies of biliary tract

https://doi.org/10.33667/2078-5631-2021-40-14-20

Abstract

The aim of the study. To evaluate the effectiveness and safety of the use of hymecromone in the treatment of patients with diseases of the biliary tract.

Materials and methods 40 patients with various pathologies of the biliary tract were under observation: 20 patients (group 1) with functional disorders of the biliary tract (the diagnosis of functional disorders of the gallbladder was established on the basis of Roman criteria IV) and 20 patients (group 2) with post-cholecystectomy syndrome (the diagnosis was established on the basis of anamnesis data on cholecystectomy surgery and the results of ultrasound examination of the abdominal organs [absence of a gallbladder]). Before the start of therapy with hymecromonum, after the end of treatment and a month after treatment, patients underwent examinations: assessment of complaints (abdominal pain, bitterness in the mouth, constipation, abdominal heaviness, flatulence, appetite), assessment of dyspepsia on the GIS scale and assessment on the visual-analog scales of abdominal pain and general well-being), quantitative assessment of the severity of gastroenterological complaints according to the GSRS questionnaire, assessment of quality of life (SF‑36 questionnaire), ultrasound of the gallbladder with a trial breakfast for the assessment of bile excretion, clinical blood test, biochemical blood test (ALT, AST, bilirubin, alkaline phosphatase, GGTP, glucose, cholesterol), as well as an assessment of side effects. All patients were prescribed a diet necessary in the complex treatment of diseases of the biliary tract and monotherapy: hymecromone 400 mg three times a day 30 minutes before meals for 3 weeks. Statistical processing was carried out using the computer software package SPSS Statistics 17.0.

Results. After the treatment with hymecromone there was a significant decrease or complete relief of abdominal pain and dyspepsia, while 47.5 % of the subjects noted the disappearance of abdominal pain, and the remaining patients indicated a significant decrease in pain syndrome with only minor discomfort. The assessment on the visual-analog scales of abdominal pain and general well-being showed a significant reduction in pain (from 65 to 13 points) and an improvement in general well-being (from 65 to 6 points). When assessing dyspepsia on the GIS scale and gastroenterological complaints according to the GSRS questionnaire, there was a significant decrease in the severity of symptoms. The assessment of the quality of life (questionnaire SF-36) showed a significant improvement in the quality of life on all scales. According to the ultrasound of the abdominal organs with a trial breakfast, there was a restoration of the contractile ability of the gallbladder (p < 0.05). When analyzing possible side effects, it was noted that no side effects were observed either clinically or according to the results of blood tests.

Conclusions. As a result of treatment, it was found that the administration of hymecromone is highly effective and safe both for patients with functional disorder of the gallbladder and for patients with post-cholecystectomy syndrome. While maintaining a high efficiency, hymecromonum is characterized by a safe choleretic effect, which is especially important when

About the Authors

N. V. Baryshnikova
First Saint Petersburg State Medical University n.a. academician I. P. Pavlov; Institute of Experimental Medicine
Russian Federation

Baryshnikova Natalya V., PhD Med, associate professor at Dept of Internal Diseases of Faculty of Dentistry. F1,irst Saint Petersburg State Medical University n.a. academician I. P. Pavlov;  researcher, Institute of Experimental Medicine

Saint Petersburg



Ya. V. Sousova
Saint Petersburg State Pediatric Medical University
Russian Federation

Sousova Yana V., PhD Med, assistant at Dept of Faculty Therapy

Saint Petersburg



References

1. Kozlova N. M. Diseases of the biliary tract: a tutorial. Federal State Budgetary Educational Institution of Higher Education «Irkutsk State Medical University». Irkutsk: ISMU, 2020.76 p.

2. Ivashkin V. T., Maev I. V., Shulpekova Yu.O., Baranskaya E. K., Okhlobystin A. V., Trukhmanov A. S., Lapina T. L., Sheptulin A. A. Clinical guidelines of the Russian Gastroenterological Association for the diagnosis and treatment of biliary dyskinesia. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018; 28 (3): 63–80. DOI: 10.22416/1382–4376–2018–28–3–63–80.

3. Gimecromon-SZ. Register of Medicines of Russia [electronic resource]. URL: https://www.rlsnet.ru/tn_index_id_98761.htm (date of access 25.08.2021).

4. S. V. Nasonova, O. I. Lebedeva Odeston in the treatment of chronic diseases of the hepatobiliary system. Military Medical Journal, 2001, No. 3, 49–53.

5. Abate A, Dimartino V, Spina P, Costa PL, Lombardo C, Santini A, Del Piano M, Alimonti P. Hymecromone in the treatment of motor disorders of the bile ducts: a multicenter, double-blind, placebo-controlled clinical study. Drugs Exp Clin Res. 2001; 27 (5–6): 223–31. PMID: 11951580.

6. Hoffmann RM, Schwarz G, Pohl C, Ziegenhagen DJ, Kruis W. Gallensäure-unabhängige Wirkung von Hymecromon auf die Gallesekretion und die Motilität der Gallenwege [Bile acid-independent effect of hymecromone on bile secretion and common bile duct motility]. Dtsch Med Wochenschr. 2005 Aug 26; 130 (34–35): 1938–43. German. DOI: 10.1055/s-2005–872606. PMID: 16123896.

7. Cotton P. B., Eta G. H., Carter C. R. et al. Gallbladder and sphincter Oddi disorders. Gut. 2016; 150 (6): 1420–1429.

8. Medic.Studio: study and diagnostics [electronic resource]. URL: https://medic.studio/palliativnaya-meditsina/izuchenie-diagnostika-65793.html (date of treatment 08.24.2021).

9. Revicki D. A., Wood M., Wiklund I., Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. Qual Life Res. 1998 Jan; 7 (1): 75–83

10. Novik A. A., Ionova T. I. Guidelines for the study of the quality of life in medicine (3rd edition, revised and enlarged). Edited by Yu. L. Shevchenko. Moscow: RANS Publishing House, 2012. P. 528–530.

11. Baryshnikova N. V., Belousova L. N., Petrenko V. V., Pavlova E. Yu. Assessment of the quality of life of gastroenterological patients. Doctor. 2013. No. 7. P. 62–65.

12. Adam B., Liebregts T., Saadat-Gilani K. et al. Validation of the gastrointestinal symptom score for the assessment of symptoms in patients with functional dyspepsia. Alimentary Pharmacology and Therapeutics. 2005. Vol. 22, issue 4. P. 357–363.

13. Nedoshivin A. O., Kutuzova A. E., Petrova N. N. et al. Study of the quality of life and psychological status of patients with chronic heart failure. Heart Failure. 2000; 1 (4): 1–7.

14. Novik A. A., Ionova T. I., Kaidn P. Concept of the study of the quality of life in medicine. SPb: ELBI, 1999; 140 p.

15. Ware J. The status of health assessment 1994. Public Health. 1995; 16: 327–54. DOI: 10.1146/annurev.pu.16.050195.001551.

16. Ware J., Sherbourne C. The Mos SF-36 item short form health survey (SF-36): Conceptuel framework and item selection. Med. Care. 1992; 30: 473–83.


Review

For citations:


Baryshnikova N.V., Sousova Ya.V. Effectiveness of hymecromone monotherapy in treatment of patients with various pathologies of biliary tract. Medical alphabet. 2021;(40):14-20. (In Russ.) https://doi.org/10.33667/2078-5631-2021-40-14-20

Views: 1284


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)