TY - JOUR AU - Mudra, Uliana AU - Andreychyn, Serhiy PY - 2020/07/20 Y2 - 2024/03/28 TI - The effectiveness of complex therapy in patients with gout using carbon enterosorbent JF - Journal of Education, Health and Sport JA - J Educ Health Sport VL - 10 IS - 7 SE - Research Articles DO - 10.12775/JEHS.2020.10.07.014 UR - https://apcz.umk.pl/JEHS/article/view/JEHS.2020.10.07.014 SP - 138-147 AB - <p class="MsoNormal" style="margin-bottom: 0,0000pt; text-indent: 35,4500pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;" align="justify"><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">Introduction</span></strong><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">.</span></strong><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> Gout is a serious medical, social and economic problem today. It becomes even more important due to its comorbidity. The </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">relationship </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">of pathogenetic mechanisms in the development and progression of gout and non-alcoholic fatty liver disease (NAFLD) has been proven. The presence of concomitant pathology enhances the inflammatory reaction in the body and significantly complicates the course of the underlying disease</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">.</span></p><p class="MsoNormal" style="margin-bottom: 0,0000pt; text-indent: 35,4500pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;" align="justify"><strong><span style="font-family: 'Times New Roman'; line-height: 150%; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">The aim of the study </span></strong><span style="font-family: 'Times New Roman'; line-height: 150%; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">– to evaluate the indicators of systemic inflammatory response in patients with gout and gout with NAFLD when included in the complex therapy of the disease carbon enterosorbent carboline.</span><strong></strong></p><p class="MsoNormal" style="margin-bottom: 0,0000pt; text-indent: 35,4500pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;" align="justify"><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">Materials and Methods</span></strong><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">.</span></strong><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> 123 patients with gout in the period of exacerbation were examined, wh</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">o</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> were divided into two groups. Group I included 65 patients with gout without liver damage, group II </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">–</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> 58 people with concomitant NAFLD. To determine the effectiveness of treatment, both groups were divided into subgroups: IA (27 people) and IIA (23 patients) who received conventional treatment. Subgroups IB (38 patients) and IIB (35 subjects) additionally received enterosorbent carboline.</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> The control group consisted of 30 healthy individuals. A general clinical examination (collection of complaints, history, objective examination), determination of pain intensity on a visual-analog scale (VAS), biochemical (uric acid level (UA), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) ) and enzyme-linked immunosorbent assays (tumor necrosis factor-α) (TNF-α), interleukins 1 (IL-1β) and 10 (IL-10) were conducted.</span></p><p class="MsoNormal" style="margin-bottom: 0,0000pt; text-indent: 35,4500pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;" align="justify"><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">Results</span></strong><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">. </span></strong><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">Patients in both groups had typical clinical signs of joint syndrome. In patients with gout an increase in </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">UA</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">, CRP, ESR, imbalance of cytokine regulation (IL-1β, TNF-α, IL-10)</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> was revealed</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">. These changes increased in the presence of concomitant NAFLD. Significant decrease in the concentration of </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">UA</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">, CRP, ESR, cytokine content after treatment was in all subgroups, but more in patients who received carbon enterosorbent with basic therapy.</span></p><p class="MsoNormal" style="margin-bottom: 0,0000pt; text-indent: 14,2000pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;" align="justify"><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">Conclusions</span></strong><strong><span style="font-family: 'Times New Roman'; line-height: 150%;">. </span></strong><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">The inclusion of the carbon enterosorbent carboline in the complex treatment of patients with gout and gout with NAFLD in the acute phase, promotes faster revers</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">e dynamics</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> of the clinical manifestations of the disease, accompanied by a more significant decrease </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">of the level of UA, </span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">CRP, ESR and cytokines</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;"> in blood serum</span><span style="mso-spacerun: 'yes'; font-family: 'Times New Roman'; mso-fareast-font-family: Calibri; line-height: 150%; font-size: 12,0000pt;">.</span></p> ER -