EFFICIENCY OF DIFFERENT SCHEMES OF ANTIHELICBACTER THERAPY IN PATIENTS WITH CHRONIC GASTRODUODENAL DISEASES AND TYPE 2 DIABETES MELLITUS
Yu.L. Fedorchenko, M.V. Martynyuk
Department of Faculty Therapy with the Course of Endocrinology, Far Eastern State Medical University of RMH, Khabarovsk, Russia
Purpose. Evaluation of the effectiveness of different antihelicobacter therapy schemes for patients with chronic gastroduodenal di-seases (CGDD) in combination with type 2 diabetes mellitus (DM2). Material and Methods. An open comparative randomized study included 138 patients with CGDD and DM2. Patients were divided into 4 groups, depending on the type of scheme of eradication therapy of Helicobacter pylori. Results. The classical 10-day triple therapy (TT) has shown a lowest efficiency – 68.7%. Optimization of the TT scheme with the replacement of omeprazole by rabeprazole and prolongation of treatment up to 14 days made it possible to achieve 80.6% eradication of the pathogen. The addition of bismuth and probiotic preparations to the optimized TT scheme increased its efficiency to 94.1%. Additional appointment of metronidazole and probiotic within the optimized TT (enhanced combination therapy) allowed to achieve the best result of eradication – 97.2%. The regimens of treatment for Helicobacter pylori infection with addition of bismuth preparation and/or probiotic were found to be safe from the perspective of development of adverse effects. Conclusions. For patients with a combination of CGDD and DM2 infected with H. pylori, the most effective regimens of eradication therapy include enhanced optimized triple therapy (rabeprazole 20 mg twice a day, clarithromycin 1 g/day, amoxicillin 2 g/day) and enhanced combination therapy (rabeprazole 20 mg twice a day, clarithromycin 1 g/day, amoxicillin 2 g /day, metronidazole 1500 mg/day, S. boulardii 500 mg twice a day). These schemes proved to be the most effective from the standpoint of achieving clinical and endoscopic remission, and also the safest in terms of adverse effects arising during the eradication of H. pylori, in comparison with the classic regimens of treatment.
Keywords: chronic gastroduodenal diseases, type 2 diabetes mellitus, Helicobacter pylori, antihelicobacter therapy
About the Autors
Corresponding author: Yu.L. Fedorchenko – MD, Prof. at the Department of Faculty Therapy with the Course of Endocrinology Far Eastern State Medical University of RMH, Khabarovsk, Russia; e-mail: firstname.lastname@example.org