Dynamics of quality of life indicators in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of complex treatment

Abstract

Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues.

Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy.

Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III  Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment.

Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10%  in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3 <0.05).Physical Functiong Scale (PF) improved by 17.9% in patients of the Comparison Group (p <0.05) and by 30.38%; 27.47%, 29.17%, respectively (p1, p2, p3 <0.05). Role Physical Scale (RP) scores improved by 25.14% in Comparison Group (p <0.05) and by 33.6 %, 22.58%  and 40.20% respectively (p1, p2, p3 <0.05). Dynamics of data in Body Pain (BP) scale improved by 21.84%  in patients of the Comparison Group (p <0.05) and by 37.28%, 25.46%, 35.92% (p1, p2, p3 <0.05).As can be seen from it, under the influence of complex therapy, the values of the Vitality (VT) increased by 17.18% in patients of Group I, by 21.93% – in Group II, by 37.87%– in Group III (p1, p2, p3 <0.05). Among patients of the Comparison Group, the influx of strength and energy felt 9.50% (p <0.05). Data of Social Functioning Scale (SF) improved by 8.8% in patients of the Comparison Group (p <0 , 05) and by 22.7%,  29.6%, 29.31%, respectively(p1, p2, p3 <0.05). Mental Health Scale (MH) improved by 17.23% in patients of Group I, by 22.41%  – in Group II, by 21.96% – in Group III (p1, p2, p3 <0.05) and 14.22% - in the Comparison Group (p <0.05). Also in patients were positive dynamics of the Role Emotional functioning scale (RE): by 27.37% in patients of Group I, by 12.36%– in Group II, by 15.7%  – in the Group III (p1, p2, p3 <0.05) and 9.05% - in patients of the Comparison Group (p < 0.05).

Conclusions. Thus, the inclusion in the standard therapy of gastroesophageal reflux disease in patients with its development on the background of undifferentiated connective tissue dysplasia of magnesium lactate dihydrate in combination with pyridoxine hydrochloride ("Magne -B6 ") and calcium carbonate in combination with cholecalciferol ("Calcium-D3 Nicomed") contributed to a significant improvement in their quality of life