Anti-inflammatory activity of differentiated therapy in the treatment of community-acquired pneumonia in patients with gastroesophageal reflux disease and dyspepsia

The purpose – to study the state of primary and secondary inflammatory messengers in patients with community-acquired pneumonia (CAP) combined with gastroesophageal reflux disease (GERD) and gastric dyspepsia syndrome (GDS) against the background of complex treatment with the addition of a herbal preparation based on Iberica salsify and the addition of topical lysates at the stage of outpatient recovery.

Materials and methods. We observed 56 patients with mild CAP, diagnosed with GERD+D at the prehospital stage (study group), who were divided into groups A and B depending on the type of therapy. Patients in group A (30 people) received treatment according to existing clinical guidelines. Patients in group B (26 people) received a herbal preparation in addition to their existing therapy, 20 drops. Three times daily before discharge and then after discharge for 3–4 weeks, along with standardized lyophilisate of topical bacterial lysates, 1 capsule on an empty stomach for 10 days (special treatment). Patients were monitored upon admission to treatment, upon discharge, and a month after discharge on an outpatient basis. Along with routine examinations, the levels of interleukins (IL)-1, IL-6, IL-8, IL-4, and IL-10 were determined in patients. The control group consisted of 34 healthy donors. diagnosed with GERD+D at the prehospital stage (the main group), who, depending on the therapy received, were divided into groups A and B. Patients of group A (30 people) received treatment according to existing clinical recommendations, designated as generally accepted. In group B patients (26 people), the drug Iberian bitter (Iberogast) was added to the therapy 20 drops 3 times a day before discharge and then after discharge – up to 3–4 weeks, along with standardized lyophilizate of bacterial lysates (OM-85) 1 capsule on an empty stomach for 10 days (special treatment). Patients were monitored upon admission to treatment, upon discharge, and a month after discharge on an outpatient basis. Along with routine examinations, the levels of interleukins (IL)-1, IL-6, IL-8, IL-4, and IL-10 were determined in patients. The control group consisted of 34 healthy donors.

Results. Clinical manifestations of СAP combined with GERD included, along with characteristic syndromes for СAP, signs of esophageal and extraesophageal manifestations of GERD. During laboratory examination, elevated levels of CRP, pro-inflammatory IL-1, IL-6, IL-8 and antiinflammatory cytokines IL-4, IL-10 were noted. After applying special treatment, more effective results were obtained: a more complete recovery from СAP and the majority of GERD symptoms in group B patients were eliminated, cytokine status was restored during laboratory testing, along with normalization of blood and CRP parameters. In group A patients, all the cytokines studied remained elevated.

Conclusion. The results obtained confirm the need for additional anti-inflammatory and immunostimulating treatment in patients with СAP combined with GERD and dyspepsia to prevent immediate and long-term complications of СAP and GERD.

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