Влияние Кверцетина На Клиническое Течение Неалкогольного Стеатогепатита И Диабетической Болезни Почек На Фоне Комплексного Лечения Больных Сахарным Диабетом Типа 2

Abstract

Background. The purpose of the study was to determine the probable effect of a complex of metformin, rosuvastatin, essential phospholipids, and quercetin on the clinical course of non-alcoholic steatohepatitis, diabetic kidney disease, type 2 diabetes mellitus, as well as on the state of blood lipid spectrum, parameters of carbohydrate metabolism compensation which are the factors of the progression of non-alcoholic steatohepatitis and diabetic kidney disease. Materials and methods. The dynamic of treatment was studied in 60 patients with non-alcoholic steatohepatitis with type 2 diabetes mellitus and stage I–III diabetic kidney disease, among whom 48 patients were diagnosed with mild non-alcoholic steatohepatitis and 12 with moderate activity. The comorbid disease in all patients with non-alcoholic steatohepatitis was type 2 diabetes mellitus of moderate severity, among which 15 people were at the stage of compensation, 45 were subcompensated. The state of carbohydrate metabolism was determined by fasting blood glucose and 2 hours after a meal by glucose oxidase method, fasting insulin content (DRG System) by enzyme-linked immunosorbent assay, blood glycosylated hemoglobin content ­using standard sets of reagents “Simko Ltd”. Results. One month after the start of therapy, asthenic syndrome of much lower intensity persisted only in 1 person (3.13 %) of the second group, while in the first group, it remained in 9 patients (32.1 %). At the same time in the majority of patients of the second group, the feeling of heaviness and pain in the right hypochondrium disappeared (in 31 (96.9 %) against 16 (57.1 %) in the first group (p < 0.05), respectively, and almost no dyspeptic symptoms disturbed (in 24 patients of group 2 (75.0 %) against 11 people (39.3 %) in group 1). A month after the start of treatment, no clinical manifestations of cholestasis were registered in 20 (62.5 %) patients of group 2 and only in 10 patients (35.7 %) in group 1 (p < 0.05). Quercetin in a complex treatment was found to have a positive effect on hepatomegaly regression, which remained in 5 patients (15.6 %) in group 2. Conclusions. The complex therapy with essential phospholipids, rosuvastatin, metformin in combination with quercetin in patients with comorbid non-alcoholic steatohepatitis, type 2 diabetes mellitus, and diabetic renal disease helps to eliminate the main clinical and laboratory symptoms of exacerbation of non-alcoholic steatohepatitis, helps to normalize blood glucose. The complex therapy with the addition of quercetin probably helped to increase the effectiveness of treatment of diabetic kidney di­sease against the background of type 2 diabetes mellitus, reduced the incidence of proteinuria, increased glomerular filtration rate, reduced hypercreatininemia.