In this paper we describe the clinical efficacy of “Hepadif”in holiatry of patients with chronic viral hepatitis C

Davydenko, O.M.

Myronuk, O.V.

Sydorchuk, A.S.

Цифровий Репозиторій - Інтелектуальні Фонди Буковинського державного медичного університету

International periodic scientific journal   ONLINE     Indexed in: RSCI (РИНЦ) SCIENCE INDEX INDEXCOPERNICUS  SW        J o u r n a l Medicine, veterinary medicine and  pharmaceuticals  Issue №11 Volume 6 November 2016  Published by:  Scientific world, Ltd.  With the support of: Moscow State University of Railway Engineering (MIIT) Odessa National Maritime University  Ukrainian National Academy of Railway Transport State Research and Development Institute of the Merchant Marine of Ukraine (UkrNIIMF) Institute for Entrepreneurship and morehozyaystva Lugansk State Medical University Kharkiv Medical Academy of Postgraduate Education Alecu Russo State University of Bălţi Institute of Water Problems and Land Reclamation of the National Academy of Agrarian Sciences  Odessa Research Institute of Communications O  R  L  D  ISSN 2227-6920 www.sworldjournal.com ISSN 2227-6920 (Online)   This volume contains research papers of scientists in the field of Medicine, veterinary medicine and pharmaceuticals.  Editor: Markova Alexandra  Editorial board: Antraptseva Nadezhda, Doctor of Chemistry, Professor, Academician, Soros Associate Professor, Ukraine Bazheva Rima, Doctor of Chemistry, Professor, Russian Grizodub Alexander, Doctor of Chemistry, Professor, Ukraine Ermagambetov Bolat, Doctor of Chemistry, Professor, Kazakhstan Maxine Victor, Doctor of Chemical Sciences, Professor, Ukraine Vizir Vadim, Doctor of Medical Sciences, Professor, Ukraine Fedyanina Lyudmila, Doctor of Medical Sciences, Professor, Russian Akhmadiev Gabdulahat, Doctor of Veterinary Science, Professor, Academician, Russian  Shevchenko Larisa, Doctor of Veterinary Science, Professor, Ukraine Voloh Dmitry, Doctor of Pharmacy, Professor, Ukraine Georgievsky Victor, Doctor of Pharmacy, Professor, Academician, Ukraine  Gudzenko Alexander, Doctor of Pharmacy, Professor, Ukraine Tikhonov Alexander, Doctor of Pharmacy, Professor, Ukraine Shapovalov Valery, Doctor of Pharmacy, Professor, Ukraine Shapovalova Victoria, Doctor of Pharmacy, Professor, Ukraine Shapovalov Valentin, Candidate of Pharmaceutical Sciences, Associate Professor, Ukraine Ryschenko Oksana, Candidate of Pharmaceutical Sciences, Associate Professor, Ukraine      Please use the following format to cite material from this book (italics indicate the fields to change to your data): Author(s), 'Title of Paper," in SWorld Journal, Issue №11, Vol.6. Medicine, veterinary medicine and  pharmaceuticals (Scientific world, Ivanovo, 2016) – URL: http://www.sworldjournal.com/e-journal/j1106.pdf (date:...) - page - Article CID Number.     Published by: Scientific world, Ltd. Ivanovo, Russia e-mail: orgcom@sworld.education site: www.sworldjournal.com  The publisher is not responsible for the validity of the information or for any outcomes resulting from reliance thereon.  Copyright  © Authors, 2016   Paper Numbering: Papers are published as they are submitted and meet publication criteria. A unique, consistent, permanent citation identifier (CID) number is assigned to each article at the time of the first publication.  URL: http://www.sworldjournal.com/e-journal/j1106.pdf  Downloaded from SWorld. Terms of Use  http://www.sworld.education/e-journal/about-journal/terms-of-use SWorld Journal                                                                                                                                 Issue 11.Vol.6 j1106-001 Davydenko O.N., Myronyk O.V., Sydorchuk A.S. CLINICAL EFFICACY OF THE DRUG "GEPADIF" IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS C Bukovinian State Medical University Chernivtsi, Teatral’na Sq., 2, 58000 КЛІНІЧНА ЕФЕКТИВНІСТЬ ЗАСТОСУВАННЯ ПРЕПАРАТУ „ГЕПАДИФ” В КОМПЛЕКСНОМУ ЛІКУВАННІ ХВОРИХ НА ХРОНІЧНИЙ ГЕПАТИТ С  Abstract. In this paper we describe the clinical efficacy of “Hepadif”in holiatry of patients with chronic viral hepatitis C. Key words: chronic hepatitis C, treatment, clinical effectiveness, alaninaminotransferase (ALAT) level. Анотація. В роботі доведена ефективність препарату «Гепадиф» вкомплексному лікуванні хворих на хронічий гепатит С. Ключові слова. Хронічний гепатит С, лікування, клінічна ефективність, аланін амінотрансфераза. Introduction.  Actually relevant and unresolved problem is the treatment of chronic viral hepatitis. In Ukraine the incidence of chronic hepatitis has increased in 2 times [3, 4]. According to WHO, about 1% of world population are infected with hepatitis C virus [1, 2].  Chronic hepatitis C occur in varying degrees, accompanied with violations of metabolic processes [5]. The disruption of protein synthesis leads to changes in the amino acid composition of the blood, disorders of the processes of neutralization of ammonia and coagulation. Inflammatory and necrotic processes in the liver accompanied by impairment of lipid peroxidation, decreased antioxidant resources, resulting in damaged membrane of hepatocyte [8]. All this necessitates the inclusion of medications in the comprehensive treatment of patients with chronic hepatitis C. One such remedy is the "Hepadif". This combination drug, which is caused by complex influence of the components included in its composition. Stimulates the metabolism of fat components of the β-oxidative transformation of free fatty acids in the mitochondria of hepatocytes, biosynthetic processes, prevents necrosis of hepatocytes, normalize the process of proliferation of hepatocytes, the liver enzyme system and restores normal liver function [6].  The presence of adenosine, which is a component of coenzymes, nucleic acids, provides the regulation of hematopoiesis. B vitamins (cyanocobalamin, riboflavin, pyridoxine) regulate the redox processes involved in protein, fat and carbohydrate metabolism, in the metabolism of tryptophan, methionine, cysteine, glutamic acid and other amino acids. Pyridoxine promotes the normalization of lipid metabolism. Cyanocobalamin is involved in the process transmetilirovania, hydrogen transfer, the formation of methionine, nucleic acids, choline, creatine. Carnitine promotes the breakdown of long-chain fatty acids and the substitution of fatty acid metabolic shunt ISSN 2227-6920                                                                                     Medicine, veterinary medicine and pharmaceuticals 3 SWorld Journal                                                                                                                                 Issue 11.Vol.6 of carbohydrate, improves digestion. Antitoxic fraction liver extract antitoxic is the purified extract of the liver and has anti-toxic effect [7].  Main text.  The purpose of the study. To study the clinical efficiency "Hepadif" in complex treatment of patients with chronic hepatitis C. Materials and methods. The investigation included 43 patients with chronic hepatitis C, moderate severity course of 25-55 years. Males was 18, female – 25. Single-blind method, all patients randomized into two groups. Patients received basic therapy. Patients of the main group received “Hepadif” intravenously at the rate of 8,625 mg/kg body mass – contents of 1 vial of the drug is dissolved in 400-500 ml of 5% glucose solution for 5 days followed by administration of 2 capsules 2 times a day, regardless of meals during the month. Patients in the control group received Essencialle® Forte N 2 capsules 3 times a day. All patients underwent complex clinical and laboratory examination and estimation of the functional state of the liver. The data were analyzed statistically: the arithmetic mean was calculated and its error. The average difference between study groups was assessed using unpaired bilateral Student test.  The results of the study and their discussion. Under the influence of complex treatment with use of the drug "Hepadif" noted positive dynamics of clinical symptoms. So, on the 11th day of treatment complaints of general weakness showed 31.5% of patients of the main group, decrease in appetite in 32%, nausea – 15,8%, a feeling of heaviness in the epigastrium and right hypochondrium is 24.2%. At the end of treatment nausea and a feeling of heaviness had not said no patient, while 12.3% of patients in the control group, these symptoms persisted.  Under the influence of treatment significantly improved indicators of total bilirubin in both groups (table. 1). Table 1.  Dynamics of biochemical parameters of blood in patients in chronic hepatitis C (М±m) Parameter Basic group Control group Before treatment After treatment Before treatment After treatment Bilirubinum, mkmol/l 34,2±1,8 17,8±1,6* 31,7±1,9 19,6±1,8* ALAT, mmol/(l/hour) 1,2±0,3 0,64±0,13* 1,08±0,3 0,75±0,12 Alkaline phosphatase, IU 298,6±12,4 175,8±11,6* 302,3±12,7 338,5±12,1*  ** Tymol test, UA 6,4±0,8 5,3±0,6 6,3±0,7 5,4±0,6 Albuminum, g/l 51,7±4,2 52,3±4,2 53,4±4,4 54,1±4,2  Note: *- Р≤0,05 in patients before and after treatment  ** - Р≤0,05 after treatment in basic and control groups     ISSN 2227-6920                                                                                     Medicine, veterinary medicine and pharmaceuticals 4 SWorld Journal                                                                                                                                 Issue 11.Vol.6 Summary and Conclusions.  We were considered the inclusion of “Hepadif” into holiatry of chronic hepatitis C independently of gender. Dynamics of activity of ALAT and alkaline phosphatase were significantly positive in patients receiving "Hepadif". It should be noted that the normalization of biochemical parameters was faster in the main group of patients. As for the indicators of cholestasis, patients of the control group dynamics of alkaline phosphatase was significantly negative.  Thus, the present study demonstrated that the use of the drug "Hepadif" likely contributes to the improvement of biochemical parameters of blood, reduction of pathological processes in the liver, a more rapid regression of clinical symptoms.  References 1. Alter M.J. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention / M.J. Alter, W.L. Kuhnert, L. Finelli // MMWR Recomm. Rep. – 2003. – Vol. 52(RR-3). – P. 1-13. 2. Amon J.J., Garfein R.S., Ahdieh-Grant L. Prevalence of hepatitis C virus infection among injection drug users in the United States, 1994-2004. / J.J. Amon, R.S. Garfein, L. Ahdieh-Grant // Clin. Infect. Dis. – 2008. – Vol. 46 (12). – P. 1852-1858. 3. Fadeenko G.D., Kravchenko N.A., Vynogradova S.V. Svyaz` genetycheskyh faktorov s progressyrovanyem fybroza pecheny pry vyrusnyh gepatytah B y C// Suchasna gastroenterologiya. – 2006. – № 6 (32). – S.82-87. 4. Golubchykov M.V. Statystychnyj oglyad zaxvoryuvanosti naselennya Ukrayiny na xvoroby pechinky ta zhovchovy vidnyx shlyaxiv// Suchasna gastroenterologiya i gematologiya. – 2000. – № 2. – S. 53-55. 5. Moskaliuk V.D., Balaniuk I.V., Sydorchuk A.S., Randiuk Y.O. Klitynna reaktyvnyst’ i riven adaptatsyinogo napruzhennya u hvoryh z hronichnym virusnym hepatytom C / V.D. Moskaliuk, I.V. Balaniuk, A.S. Sydorchuk, Y.O. Randiuk // Infektsyini hvoroby. – 2016. – № 3 (85). – S. 33-37. 6. Perederyj V.G. Lechyt` yly ne lechyt pacyentov s xronycheskym vyrusnym gepatytom C, kotorym ne pokazana terapiya ynterferonom?// Suchasna gastroenterologiya. – 2001. – № 1 (3). – S. 60-63. 7. Perederyj V.G., Chernyavskyj V.V., Shypulyn V.P. Sravnytel`naya еffektyvnost` prymeneniya gepatoprotektorov pry chronycheskyx dyffuznyh zabolevanyyah pecheny`// Suchasna gastroenterologiya. –2008.– №3 (41). – S.81-83. 8. Sherlock S., Dooley J. Diseases of the Liver and Biliary system// Tent. edition. – 1997. – P. 385-400. Article sent: 28/11/2016 of © Aniuta Sydorchuk       ISSN 2227-6920                                                                                     Medicine, veterinary medicine and pharmaceuticals 5 

КЛІНІЧНА ЕФЕКТИВНІСТЬ ЗАСТОСУВАННЯ ПРЕПАРАТУ „ГЕПАДИФ” В КОМПЛЕКСНОМУ ЛІКУВАННІ ХВОРИХ НА ХРОНІЧНИЙ ГЕПАТИТ С

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Цифровий Репозиторій - Інтелектуальні Фонди Буковинського державного медичного університету