Журналов:     Статей:        

Рецепт. 2019; : 192-213

Уточнение эффективности комбинации гвайазулена с диметикономпри диспепсии на основе самооценки пациентами

Мараховский Ю. Х., Адаменко Е. И., Жарская О. М., Карасева Г. А.

Аннотация

Объектом настоящего исследования являлось лекарственное средство Пепсан-Р, содержащее комбинацию в одной форме двух активных субстанций - гвайазулен (guaiazulene, fzunol) и диметикон, использование которого предназначено для коррекции функциональных нарушений органов пищеварения. В качестве функционального расстройства выбрана необследованная диспепсия. Цель работы - уточнить эффективность комбинации гвайазулена с диметиконом препарат Пепсан-Р при диспепсии на основе самооценки пациентами. В работе использованы поисково-информационные методы для сбора опубликованных ма- териалов в периодических изданиях, находящихся в режиме онлайн и доступных базах опубликованных работ. Применены методы тестирования симптомов самими пациентами по краткому опроснику по диспепсии университета Лидса (SF-LDQ - short form Leeds dyspepsia questionnaire) и специальной анкете самооценки удовлетворенности пациентов лечением. Статистический анализ полученных данных проведен с использованием статистической программы Statistica 6, версия 6.1, серия 1203d, WinPepi (2004 г.), и программы NCSS 2004R.В проведенном исследовании определена динамика клинических проявлений необследованной диспепсии в процессе лечения препаратом Пепсан-Р на основе самооценки симптомов пациентами. Полученные результаты достоверно доказали высокую степень эффективности лекарственного средства Пепсан-Р: отмечено купирование всех оцененных симптомов по Лидскому опроснику для диспепсии (ртренд<0,05) с наличием «дозозависимого эффекта», т. е. увеличение результативности на 28-й день приема, по сравнению с 14-м днем, с суммарным шансом (OR) уменьшения симптомов на 28-й день, равным 27,09 (95%-й доверительный интервал (ДИ) Fisher’s = 7,63-96,17). Определена достоверная положительная оценка пациентами удовлетворенности лечением (суммарно 7-8 позиций из 8) у 70% пациентов (95% ДИ(Fisher’s) = 45,7-88,1).

Список литературы

1. (1991) Malaya meditsinskaya entsiklopediya [Small medicinal encyclopedia]. M.: Bol’shaya Rossiiskaya entsiklopediya / Meditsina / Sovetskaya entsiklopediya, 1991-1996, vol. 6. (in Russian)

2. Petrovskii B. (ed.) Entsiklopedicheskii slovar’ meditsinskih terminov [Encyclopedic dictionary of medicinal terms]. M.: Sovetskaya entsiklopediya, 1982-1984, vol. 3. (in Russian)

3. Ivashkin V.T. (2011) Diagnostika i lechenie funktsional’noi dispepsii [Diagnosis and treatment of functional dyspepsia]. Funktsional’naya dispepsiya i hronicheskii gastrit: metodicheskie rekomendatsii dlya vrachei [Functional dyspepsia and chronic gastritis: methodical guidelines for physicians]. M., Gl. 3, 28 p. (in Russian)

4. Ivashkin V.T. (2017) Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniyu funktsional’noi dispepsii [Clinical guidelines of Russian gastroenterological association on diagnosis and treatment of functional dyspepsia]. Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii, no 27, pp. 50-61.

5. Baker M.R. Dypspesia - Management of Dyspepsia in Adults in Primary Care: Review of Clinical Guideline. National Institute for Clinical Excellence (NICE) [Electronic resource]. National Collaborating Centre, 2011-2017. Available at: https://www.nice.org.uk/guidance/cg17/ documents/dyspepsia-review-decision2. Date of access: 04.01.2019.

6. Jones R. (2007) Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease. Int J Clin Pract., vol. 61, pp. 1301-1307.

7. McColl E. (2005) Assessing symptoms in gastro-esophageal reflux disease: how well do clinicians assessments agree with those of their patients? Am J Gastroenterol., vol. 100, pp. 11-18.

8. Moayyedi P. (1998) The Leeds Dyspepsia Questionnaire: a valid tool for measuring the presence and severity of dyspepsia. Aliment Pharmacol Ther., vol. 12, pp. 1257-1262.

9. Faser A. (2007) The Short-Form Leeds Dyspepsia Questionnaire validation study. Aliment Pharmacol Ther., vol. 15, pp. 477-486.

10. Moayyedi P. (1999) Helicobacter pylori Eradication in General Practice: Medical Benefits and Health Economics. Leeds: Institute of Epidemiology and Health Services Research, University of Leeds.

11. Drossman D.A. (2016) Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology, vol. 150, pp. 1262-1279.

12. Drossman D.A. (2016) Rome IV - Functional GI disorders: disorders of gut-brain interaction.

13. Gastroenterology, vol. 150, pp. 1257-1261.

14. Talley N.J. (2016) Functional gastroduodenal disorders. AGA Institute-Rome Foundation lectureship: the launching of Rome IV: what’s new and why? Dig Dis Week. San Diego.

15. Talley N.J. Functional Dyspepsia: Advances in Diagnosis and Therapy. Gut and Liver, vol. 11, no 3, pp. 349-357.

16. Suzuki H. (2009) Japanese herbal medicine in functional gastrointestinal disorders.

17. Neurogastroenterol Motil., vol. 21, pp. 688-696.

18. Suzuki H. (2014) Randomized clinical trial: ikkunshito in the treatment of functional dyspepsia-a multicenter, double-blind, randomized, placebo-controlled study. Neurogastroenterol Motil., vol. 26, pp. 950-961.

Recipe. 2019; : 192-213

Clarification of the Guaiazulene with Dimethicone Combination Effectiveness in Dyspepsia Basedon the Patients’ Self-Assessment

Marakhouski Yu. ., Adamenko E. ., Zharskaya O. ., Karasiova G. .

Abstract

The object of this study was the drug containing a combination of two active substances - guaiazulene (guaiazulene, fzunol) and dimethicone - in one form, the use of which is intended for the correction of functional digestive disturbances. Non-examined dyspepsia was chosen as a functional disorder.Aim of the study was to clarify the effectiveness of guaizulene with dimethicone combination for dyspepsia based on self-assessment by the patients.We used search and information methods for collecting published materials in periodicals, available online and in the available databases of published works.The methods of testing the symptoms by the patients themselves were used according to a Short- Form Leeds Dyspepsia Questionnaire Symptoms (SF-LDQ) and a special questionnaire for the self- assessment of patient satisfaction with treatment. Statistical analysis of the data was performed using Statistica 6, version 6.1, 1203d series, WinPepi (2004), and NCSS 2004R program.The dynamics of clinical manifestations of unexamined dyspepsia treated with combination drug (guaiazulene with dimethicone) was determined in the performed study by the patients’ self- assessment of symptoms. The obtained results reliably proved a high degree of guaiazulene with dimethicone combination effectiveness: all of the assessed by the Short-Form Leeds dyspepsia questionnaire symptoms were relieved (p<0.05) with a “dose-dependent effect”, i.e. efficiency increase was determined on the 28th day of treatment compared with the 14th day, with a total chance (odds ratio, OR) of reducing symptoms on the 28th day equal to 27.09 (95% Fisher’s confidence interval (CI) = 7.63-96.17). A reliable positive patients’ assessment of satisfaction with treatment was marked (7-8 positions in total out of 8) in 70% of patients (95% confidence interval (CI) Fisher’s = 45.7-88.1).
References

1. (1991) Malaya meditsinskaya entsiklopediya [Small medicinal encyclopedia]. M.: Bol’shaya Rossiiskaya entsiklopediya / Meditsina / Sovetskaya entsiklopediya, 1991-1996, vol. 6. (in Russian)

2. Petrovskii B. (ed.) Entsiklopedicheskii slovar’ meditsinskih terminov [Encyclopedic dictionary of medicinal terms]. M.: Sovetskaya entsiklopediya, 1982-1984, vol. 3. (in Russian)

3. Ivashkin V.T. (2011) Diagnostika i lechenie funktsional’noi dispepsii [Diagnosis and treatment of functional dyspepsia]. Funktsional’naya dispepsiya i hronicheskii gastrit: metodicheskie rekomendatsii dlya vrachei [Functional dyspepsia and chronic gastritis: methodical guidelines for physicians]. M., Gl. 3, 28 p. (in Russian)

4. Ivashkin V.T. (2017) Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniyu funktsional’noi dispepsii [Clinical guidelines of Russian gastroenterological association on diagnosis and treatment of functional dyspepsia]. Rossiiskii zhurnal gastroenterologii, gepatologii, koloproktologii, no 27, pp. 50-61.

5. Baker M.R. Dypspesia - Management of Dyspepsia in Adults in Primary Care: Review of Clinical Guideline. National Institute for Clinical Excellence (NICE) [Electronic resource]. National Collaborating Centre, 2011-2017. Available at: https://www.nice.org.uk/guidance/cg17/ documents/dyspepsia-review-decision2. Date of access: 04.01.2019.

6. Jones R. (2007) Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease. Int J Clin Pract., vol. 61, pp. 1301-1307.

7. McColl E. (2005) Assessing symptoms in gastro-esophageal reflux disease: how well do clinicians assessments agree with those of their patients? Am J Gastroenterol., vol. 100, pp. 11-18.

8. Moayyedi P. (1998) The Leeds Dyspepsia Questionnaire: a valid tool for measuring the presence and severity of dyspepsia. Aliment Pharmacol Ther., vol. 12, pp. 1257-1262.

9. Faser A. (2007) The Short-Form Leeds Dyspepsia Questionnaire validation study. Aliment Pharmacol Ther., vol. 15, pp. 477-486.

10. Moayyedi P. (1999) Helicobacter pylori Eradication in General Practice: Medical Benefits and Health Economics. Leeds: Institute of Epidemiology and Health Services Research, University of Leeds.

11. Drossman D.A. (2016) Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology, vol. 150, pp. 1262-1279.

12. Drossman D.A. (2016) Rome IV - Functional GI disorders: disorders of gut-brain interaction.

13. Gastroenterology, vol. 150, pp. 1257-1261.

14. Talley N.J. (2016) Functional gastroduodenal disorders. AGA Institute-Rome Foundation lectureship: the launching of Rome IV: what’s new and why? Dig Dis Week. San Diego.

15. Talley N.J. Functional Dyspepsia: Advances in Diagnosis and Therapy. Gut and Liver, vol. 11, no 3, pp. 349-357.

16. Suzuki H. (2009) Japanese herbal medicine in functional gastrointestinal disorders.

17. Neurogastroenterol Motil., vol. 21, pp. 688-696.

18. Suzuki H. (2014) Randomized clinical trial: ikkunshito in the treatment of functional dyspepsia-a multicenter, double-blind, randomized, placebo-controlled study. Neurogastroenterol Motil., vol. 26, pp. 950-961.