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COMPLEX THERAPY OF CHRONIC PANCREATITIS COMPLICATED BY ANXIO-DEPRESSIVE DISORDERS IN RAILROAD WORKERS

Psychic disorders in patients, who suffer from chronic somatic diseases for a long time, can be grouped into one category called psychosomatic pathology. Co-morbid - psychosomatic - disorders are considered to be predictors of unfavourable prognosis significantly aggravating patients’ condition, quality of life and professional activity. It is important to timely diagnose and perform pharmacological correction of affective pathology. Special attention should be paid to patients, whose profession is associated with the operational activity. 110 railroad workers admitted to the in-patient department of the Non-state Health Care Facility “RoadHospital the Station Voronezh-1of JSC “Russian Railways” with the diagnosis “Chronic pancreatitis, recurrent” were examined in the study. On admission all patients were questioned using specialized diagnostic scales and questionnaires aimed at revealing of anxio-depressive disorders. The authors have found out negative impact of anxio-depressive disorders on the course of chronic pancreatitis with the development of stable pain syndrome, gastro-intestinal disorders, resistance to the performed pharmacotherapy, and decrease of reaction rate to presented stimuli. Examination of the patients suffering from chronic pancreatitis demonstrated that patients with MADD had more severe course of the disease. This manifested in more intensive pain syndrome, apparent symptoms of nausea, bitter taste in the mouth and diarrhea; these symptoms exceeded number of similar complaints in patients with chronic pancreatitis without MADD in 1.6 – 2.1 times. Tranquilizer “Adaptol” and anxiolytic “Afobazol” in combination with basic therapeutical medications efficiently eliminate gastroenterological and anxiety symptoms. However, “Adaptol” decreases rate of visual-motor reactions, whereas “Afobazol”, on the contrary, increases reaction rate to presented stimuli.

Иллюстрации

Table 1.  Findings of psycho-diagnostic examination (X±m).

Table 2. Gastroenterological findings according to VAS Scale (X±m).

Table 3. Findings of psycho-physiological functions prior to initiating therapy(Х±m).

Note: * - p<0,05, ** - p<0,01- confidence rating with the results of examination before the treatment onset.

Figure 1. Dynamics of the anxiety level according to the HADS Scale against the background of the complex therapy.

Table 4. Dynamics of the anxiety values according to Spielberger-Khanin test against the background of pharmacotherapy(Х±m).

Table 5. Results of psychological test according to “Health, Activity, Mood” questionnaire against the background of pharmacotherapy (Х±m).

Figure 2. Dynamics of gastroenterological symptoms against the background of the therapy.

Table 6. Findings of psycho-physiological functions in patients with chronic pancreatitis and MADD against the background of complex therapy including “Adaptol”(Х±m).

Table 7. Findings of psycho-physiological functions in patients with chronic pancreatitis and MADD against the background of complex therapy including “Afobazol”(Х±m).

Figure 3. Structure of direct medical costs at the in-patient stage.

Table 8. Treatment of chronic pancreatitis with basic preparations.

DOI: 10.18413/2500-235X-2016-2-4-73-86
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