SI "National institute of therapy named after L. T. Malaya of NAMS of Ukraine", Kharkiv
Introduction. Students are at increased risk of the combined functional pathology, caused by a combination of unfavorable factors, such as constant mental and emotional stress, informational stress, insufficient material provision, need to combine study with work, frequent violations disturbances in work, rest and nutrition, smoking, alcohol consumption.
Purpose. To increase the effectiveness of treatment of irritable bowel syndrome (IBS) in persons of organized student population by additional prescription of herbal preparation – Iberogast.
Materials and methods. The study was performed on 305 persons (181 (59,3 %) females and 124 (40,7%) males) of mean age (20,8 ± 0,1). All patients were divided into two groups: I – IBS patients, 6,6 % (20 individuals), II – patients with "overlap syndrome" of functional diseases of the digestive system (FDDS) – 5,2 % (16 individuals). Non-pharmacological treatment, including modification of trigger factors of lifestyle and nutrition, was conducted in patients with IBS. Depending on the designated medical treatment, patients were divided into two groups: treatment "A" (n = 18) – combined therapy with prescription of non-drug interventions, diet lowFODMAPs, phytopreparation "Iberogast" and, if necessary, from the 4th week – pantoprazole – 20 mg 2 per day and itopride hydrochloride – 50 mg 3 times a day. The treatment "B" (n = 18) – didn’t include herbal medicine. The treatment covered 8 weeks.
Results. IBS was diagnosed in 11,8 % of the examined persons, 44,4 % patients with IBS had an "overlap syndrome" of FDDS. On the 28th day of treatment, all persons noted improvement in health and reducing the intensity of complaints from
(210,1 ± 11,3) to (96,8 ± 7,2) points according to the IBS-SSS scale (r = 0,776, p < 0,001) and on the 56th day – up to (35,6 ± 4,2) points (r = 0,601, p < 0,001). When evaluating indices of the total IBS-SSS score in patients after 4 weeks of therapy the therapeutic response in group "A" was better (83.6±8.8) comparing with (110,0 ± 10,7) points in group "B" (p = 0,066). The total score IBS-SSS decreased by (64,9 ± 2,2) % (28th day) in patients receiving Iberogast, while in patients with "B" treatment this indicator was significantly lower – (43,3 ± 2,0) %, p < 0,001. A comparison of the total score IBS-SSS on the 56th day of treatment revealed no significant differences in the studied groups. However, the percentage of the total dynamics of IBS-SSS scores in the course of therapy was significantly different – -(88,7 ± 1,8) in group "A" and -(78,3 ± 2,3)% in group "B", p = 0,001.
Conclusions. The revealed peculiarities in the response to therapy in patients with IBS show pronounced efficiency of the combined treatment, including prescription of herbal medicine, changes in lifestyle and nutrition. Additional prescriptions of herbal medicines with a multifactorial effect on the digestive system – Iberogast, having shown its efficacy already in 4 weeks of therapy, promoted better leveling of clinical manifestations of IBS after the eight-week course of treatment.
Key words: irritable bowel syndrome, "overlap syndrome", clinical manifestations, herbal medicine, population of students