Age, gender and professional pecularities of functional disorders of gallbladder with of sludge phenomenon
and urine diathesis formation were studied. The positive effects of healthy lifestyle violations eliminating in addition to
phytotherapeutic agens with choleretic, diuretic and laxative activities together with increased amount of water intake
were esteblished

Boreyko, L.D.

Lukashevich, I.V.

Senyuk, B.P.

Shevchuk, N.A.

Yurnyuk, S.V.

Цифровий Репозиторій - Інтелектуальні Фонди Буковинського державного медичного університету

100Medical sciences EUROPEAN ASSOCIATION OF PEDAGOGUES, PSYCHOLOGISTS AND MEDICS “SCIENCE”Senyuk B.P.Associate professor of Departmentof Internal MedicineHigher State Educational Establishment of Ukraine„Bukovinian State Medical University”Teatralna Sq., 2, Chernivtsi, Ukraine, 58002Lukashevich I.V.Associate professor of Departmentof Internal MedicineHigher State Educational Establishment of Ukraine„Bukovinian State Medical University”Teatralna Sq., 2, Chernivtsi, Ukraine, 58002Yurnyuk S.V.Assistant professor of Department of Forensic Medicine and Medical LawHigher State Educational Establishment of Ukraine„Bukovinian State Medical University”Teatralna Sq., 2, Chernivtsi, Ukraine, 58002Boreyko L.D.Associate professor of Department of Patients Care and HNEHigher State Educational Establishment of Ukraine „Bukovinian State Medical University”Teatralna Sq., 2, Chernivtsi, Ukraine, 58002Shevchuk N.A.3rd year studentHigher State Educational Establishment of Ukraine „Bukovinian State Medical University”Teatralna Sq., 2, Chernivtsi, Ukraine, 58002Сенюк Б.П.Доцент кафедри пропедевтики внутрішніх хворобВищого державного навчального закладу України „Буковинський державний медичний університет” Театральна площа, 2, Чернівці, Україна, 58002Лукашевич І.В.Доцент кафедри пропедевтики внутрішніх хворобВищого державного навчального закладу України „Буковинський державний медичний університет” Театральна площа, 2, Чернівці, Україна, 58002Юрнюк С.В.Асистент кафедри судової медицини та медичного правознавстваВищого державного навчального закладу України „Буковинський державний медичний університет” Театральна площа, 2, Чернівці, Україна, 58002Борейко Л.Д.Доцент кафедри догляду за хворими та вищої медсестринської освітиВищого державного навчального закладу України „Буковинський державний медичний університет” Театральна площа, 2, Чернівці, Україна, 58002Шевчук Н.А.Студентка 3 курсуВищого державного навчального закладу України „Буковинський державний медичний університет” Театральна площа, 2, Чернівці, Україна, 58002UDC 616FEATURES OF DIET AND PHYTOTHERAPY CORRECTION OF SLUDGE-PHENOMENON AT CHOLECYSTOPATHY AND URIC ACID DIATHESISОСНОВИ ДІЄТИЧНОЇ І ФІТОТЕРАПЕВТИЧНОЇ КОРЕКЦІЇ СЛАДЖ-ФЕНОМЕНУ ПРИ ХОЛЕЦИСТОПАТІЯХ І СЕЧОКИСЛОМУ ДІАТЕЗІSummary. Age, gender and professional pecularities of functional disorders of gallbladder with of sludge phenomenon and urine diathesis formation were studied. The positive effects of healthy lifestyle violations eliminating in addition to phytotherapeutic agens with choleretic, diuretic and laxative activities together with increased amount of water intake were esteblished.  Key words: sludge-phenomenon, cholecystopathy, uric acid diathesis, phytotherapy, correction.Анотація. Розглянуті вікові, гендерні та професійні особливості формування холецистопатій з явищами сладж-феномену та сечокислого діатезу. Встановлені позитивні ефекти усунення порушень здорового способу життя та харчування в доповненні фітотерапевтичними засобами жовчогінної, сечогінної та послаблюючої дії на тлі підвищеного рідинного компоненту їжі.Ключові слова: сладж-феномен, холецистопатія, сечокислий діатез, фітотерапія, корекція.In recent decades in developed countries is noted increase fre-quency of diseases of hepatobiliary and genitourinary systems [3, 4]. Typically, pathological conditions of these systems are considered by relevant experts as independent phenomena. Despite significant ad-vances in diagnosis and treatment for certain nosological forms, the relationship between pathologies of these systems (except heavy clini-cal situations as hepatorenal syndrome) pays little attention [1, 2, 3]. Usually it is not enough clinical motivated. However, the results of wide-spread introduction into clinical practice of ultrasonography of abdomi-nal organs some pathological phenomens need attention, pathogenic 101Direction 2“THE UNITY OF SCIENCE” JULY, 2017Medical sciencescomprehension and correction treatment and prevention measures. One of them is sludge-phenomenon at cholecystopathy and uric acid diathesis (UAD).Objective: To investigate the frequency of occurrence of events ultrasonography urine acid diathesis and sladge - phenomenon at cho-lecystopathy, explore possible cooperative etiopathogenetic ways of development and to develop ways of correction.Material and methods. During five years of observation, were conducted 340 patients with chronic calculous  cholecystitis and biliary dyskinesia (from 29 people total) with symptoms of sludge-phenome-non during mild exacerbation or unstable remission. Age of patients’ fluctuations within 22-70 years, prescription of disease - 3-29 years, the dominant contingent was female patients 210 (61.76%). Diagnostic complex predicted software examination of the abdomen, general blood and urine, duodenal probe, determining biochemical parameters frac-tions of bilirubin, glucose, total cholesterol and triglycerides, alkaline phosphatase, alanine, aspartic transaminase gamma glutamyl trans-peptidase (GGTP), creatinine, uric acid, urea, calcium, phosphorus, iron and magnesium in blood serum. Observations were conducted in outpatient mode: duration from 0.5 to 2 years with checking out visit every 3-4 months.Research results. Found that all patients had dominant clinical torpid recurrent cholecystopathy and only 38 patients had on this back-ground short duration dysuria phenomenon unilateral short pain, some-times slight blunt pain, which patients evaluated as manifestations of osteochondrosis and did not pay attention for this sight, sometimes suc-cessfully used antispasmodics. However, in  319 (93.8%) patients  of the total membership during ultrasound study found the phenomenon of sludge-phenomenon ¼ to ½, sometimes more, increase  volume of gall-bladder, thickness and density of wall echomorphology in normal liver, but often with a thickening of the walls of intrahepatic bile ducts. In all of these patients were found also microliths in pelvis system of kidneys, often quite intense densities.  However, in 21 patients without biliary sludge phenomena only 6 persons had minor ultrasonic signs of urine acid diathesis. Characteristic that in the repeated urinalysis special pathological changes were not detected and the salt aftertaste (mainly oxalateuria) was only moderate. However, in the portions (especially bladder) of bile was stated visual rich sediment micro - bilirubinate of calcium, cholesterol, clots of mucus accumulation epithelium ect.In blood of 112 (32.94%) patients are fixed tends to upper limit of normal erythrocyte and decrease sedimentation rate to 2.3 mm / hour, mainly in women. Biochemical studies in 92 (27.06%) patients in the parameters of alkaline phosphatase and GGTP pointed to mild cho-lestasis phenomena (exceeding standards in 1.5-3 times), discovered a clear tendency to preserve creatinine, uric acid in the upper normal range, a moderate increase of total cholesterol levels (6,3 ± 0,21mmol / dL) and triglycerides (2,29 ± 0,16 mmol / l).At age and gender aspects frequency combination of these events was highest in the age of 35-60 years, mostly women with a tendency to excessive weight gain or obesity I-II degree. Sedentary lifestyle was recorded only in half of the patients. Parturition and pregnancy haven’t had signs of the phenomena studied.The clinical feature of this combination of studied pathology was tendency to torpid, recurrent course cholecystopathy, reduced efficien-cy hepatoprotect -Bile therapy necessity extended the application of the reduced quality of life of patients and a tendency to asthenic-depressive effects. Attempts by some patients often used in the medical complex 4-6 duodenal sounding rinse gave a brief improvement.So torpidity cholecystopathy flow, the phenomenon of sludge-phenomenon seal intrahepatic bile ducts, biochemical confirmation cholestasis syndrome and duodenal sounding results can be regarded as signs of decline in the quality and functioning of bile stabilization of the gallbladder. However that may be relevant to the manifestations of ACS. In terms of the identified biochemical disorders connection is not visible, but the ultrasonic study gives high frequency combination of these phenomena.In search of a possible connection we have analyzed the lifestyle and eating behavior of patients. In our opinion, the most important role has played rhythm disturbance and character of a food. Almost all pa-tients due to habits and professional conditions was marked displace-ment main meals from morning to evening with long intervals between meals (8 hours or more, 1-2 meals a day), eating too much at night, deficient breakfast, often without it, untimely or inadequate dinner. Es-pecially severe sludge phenomenon appeared in fans of fast-food.Equally important was the neglect by patients fluid food compo-nents, almost all its quota was 0.7-1.5 liters per day, often eating cold food , not enough fruits, vegetables, juices, vegetable oils, dairy prod-ucts, tea, normal or mineral water and so on. Dominated by monot-onous type of food, the tendency to piquant food: 187 (55.0%) was recorded chronic constipation.  The lack of physical activity of most pa-tients has professional tone. There is no dependent of manifestations of ACS or sludge-phenomenon of living area and excessive amounts of sediment in the boiling water used for food.  In a survey found that almost all the patients had a poor picture of the principles of healthy eating, the importance of it for health, haven’t seen in their eating style principal causes problems to their health and haven’t looked for educa-tional sources for learning. In 1/3 of the patients their lifestyle and food was a family tradition.Due to all what we have saying, we developed a program of re-habilitation of patients in which the main focus was given to the nor-malization and adding value to the diet, temporal aspects of nutrition, especially increasing the daily quota fluid component to 2, 2-3, 0 liters depending on body mass index. One-third of the quota determined on soups and milk products, the second third - is 500-700 grams of fruit and vegetable weight according to the season with a tendency to in-herent diuretic or laxative effect, the last third-herbal teas with chola-gogue action to 500ml and 300-500ml of benign water. Always correc-tion bowel function was performed by vegetable oil, dairy products and acidic component pectin food. Patients with sit professions constantly were asked to improving daily exercise, especially jogging, walking, and breathing exercises for yoga or moderate physical work.Extras herbal remedies intended hepatoprotective, choleretic, di-uretic effect (Hepabene, Нераtорнytum, Syrian, Uronephron, Phytoly-sin, etc.) during 1.5-3 months. The results were assessed on the basis of case-control.Proper compliance was withstood by 206 (60.59%) patients, mostly men 119 (57.8%). Established that they achieved substantial clinical improvement during 2-3 month course of rehabilitation, ultrasonic dy-namic of sludge phenomenon, and SKD was also positive, but to elimi-nate these phenomena was needed for at least six months. This trend has been slower in patients’ aged 60 years and younger age group (35-50 years) with a tendency to obesity or obesity-II degree. It is important that in this group of patients for further supported compliance of their health with the program was high, and cholecystopathy recurrences were 2.3 times rare, shorter and milder. In the rest of the patients (98 persons), which due to various circum-stances only partly able to realize the proposed program, the results of rehabilitation were weaker, improvement occurred later and was un-102Medical sciences EUROPEAN ASSOCIATION OF PEDAGOGUES, PSYCHOLOGISTS AND MEDICS “SCIENCE”stable. A shortcoming in nutrition and life style weakly was compensat-ed even by treatment in the sanatoriums in Truskavets and Satanova. Ultrasonography picture was improving, but in none case could not to eliminate the phenomenon of sludge-phenomenon or ACS.Vital evidence of low and unstable effectiveness of this costly re-covery, inspired 48 people from this group took actions for the imple-mentation of the proposed program and reached the similar results of rehabilitation, which first group of patients had.So cholecystopathy with symptoms of sludge-phenomenon as pos-sible early stage calculus cholecystitis and ACS have a high degree of compatibility, the basis of which is dominated by exogenous factors as significant and long-term disturbances chronic aspects nutrition, food quality, ignoring liquid component of food, lack of exercise, low edu-cational qualification on healthy lifestyles and nutrition, social factors. These factors with age provide stability by pathological changes at the level of hepatobiliary and genitourinary systems, and promote lipid me-tabolism in the body and developing of atherosclerosis.Conclusions.1. Cholecystopathy with symptoms of sludge-phenomenon andurate diathesis frequent combination of these pathological conditions, expression and frequency of which increases with the age of patients. Their detecting is a defining role of ultrasound researching.2. One of the leading causes of their origin is an essential andprolonged violation chronic rhythms and quality of food, especially the neglect of liquid, fruit and vegetable, pectin components of foods, veg-etable oils. 3. One of the most effective ways to improve the rehabilitation ofsuch patients is correction time and quality aspects of food with high liquid component in combination with herbal remedies, cholagogue hepatoprotective, diuretic and laxative action. 4. An important aspect of the success of this approach is a con-scious patients continuing need for mastery of modern knowledge of healthy lifestyles and nutrition.Література1. Волошин О. І., Васюк В. Л., Малкович Н. М., Сенюк Б. П. Основи фітотерапії і гомеопатії. – Вижниця:"Черемош".– 2011. – 625 с.2. Волошин О. І., Бойчук Т. М., Волошина Л. О. Оздоровче харчування: стан і перспективи ХХІ століття. –Чернівці, Букрек, 2014. – 523 с.3. Нейко Є. М., Скробач Н. В. Хронічний холецистит. – Архів клін. мед. – 2003. - №1. – С. 6-14.4. Мак Нелли П. Р. Секреты гастроэнтерологии. 2 изд. – М.: Бином. – 2005. – С. 334-351.REFERENCES:1. Voloshyn O. I., Vasyuk V. L., Malkovych N. M., Senyuk B. P. Osnovy fitoterapiyi i homeopatiyi. – Vyzhnytsya:"Cheremosh". – 2011. – 625 s.2. Voloshyn O. I., Boychuk T. M., Voloshyna L. O. Ozdorovche kharchuvannya: stan i perspektyvy ХХI stolittya. – Chernivtsi, Bukrek, 2014. – 523 s.3. Neyko Ye. M., Skrobach N. V. Khronichnyy kholetsystyt. – Arkhiv klin. med. – 2003. - №1. – S. 6-14.4. Mak Nelly P. R. Sekretи hastroеnterolohyy. 2 yzd. – M.: Bynom. – 2005. – S. 334-351.

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FEATURES OF DIET AND PHYTOTHERAPY CORRECTION OF SLUDGE-PHENOMENON AT CHOLECYSTOPATHY AND URIC ACID DIATHESIS

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FEATURES OF DIET AND PHYTOTHERAPY CORRECTION OF SLUDGE-PHENOMENON AT CHOLECYSTOPATHY AND URIC ACID DIATHESIS

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Цифровий Репозиторій - Інтелектуальні Фонди Буковинського державного медичного університету

Цифровий Репозиторій - Інтелектуальні Фонди Буковинського державного медичного університету