The role and place of Actovegin in the complex therapy of cytokine metabolism in patients with GERD with concomitant bronchial asthma

Objective — to study the advisability of the Actovegin inclusion in the standard treatment regimen for patients with GERD and concomitant mild to moderate BA in terms of its effects on the clinical course of this comorbid pathology, as well as on the level of proinflammatory and anti-inflammatory cytokines.Materials and methods. The study involved 60 patient with GERD and concomitant mild to moderate BA who were divided into 2 treatment groups. The first group of patients received standard GERD therapy (proton pump inhibitor— omeprazole 20 mg twice daily) and standard BA therapy (beta2-agonists of short and long-acting, m-cholinolytics), and Actovegin 200 mg twice daily day for 28 days. Patients of the second treatment group (comparison group) received only standard therapy— proton pump inhibitors and bronchodilators at the same dose for 4 weeks. The GERD diagnosis was established according to the Montreal Consensus (2006), with account of the data of esophagogastroduodenoscopy, fluoroscopy of the esophagus and stomach and the results of pH-metry. Verification of the diagnosis of asthma was carried out in accordance with the recommendations of the WHO (GJNA) and the order of the Ministry of Health of Ukraine (2013), with account of the spirography and chest radiography. The blood levels of interleukins (IL-4 and IL-6) were determined with the method of immuno-enzyme analysis using the «Vector Best» test systems. Statistical processing was carried out by the method of variational statistics using standard programs of correlation analysis with calculation of arithmetic mean values: M, m. The reliability of the indicators was assessed according to Student’s t-criterion.Results. It has been established that against the background of therapy, most patients began to feel well, less worried about esophageal complaints (heartburn, belching, pain in the epigastric region) and bronchial symptoms (dyspnea, cough, bronchospasm attacks, disturbed breathing during sleep. However