Clinical and experimental substantiation of the use of bentonite suspension in the complex rehabilitation of patients with chronic viral hepatitis C with concomitant non-alcoholic fatty liver disease

Introduction. One of the most severe diffuse liver diseases is chronic viral hepatitis C (CHC) combined with non-alcoholic fatty liver disease (NAFLD). After completing the treatment of CHC with drugs of direct antiviral action, there remains a high risk of further progression of liver fibrosis associated with the presence of comorbid pathology - NAFLD in patients. The above circumstances initiated us to search for new non-drug technologies to treat this category of patients. Purpose of the work: to study the effectiveness of use bentonite suspension in rats with a model of NAFLD and to substantiate the practicality of using bentonite in the complex treatment of CHC patients with concomitant NAFLD. Methods: experimental, anamnestic and clinical, general clinical, biochemical, determination of the HOMA index, leptin and adiponectin levels, ultrasonographic studies of the digestive system, bacteriological examination of feces, statistical methods.Results: According to microscopic examination, bentonite application in animals with the NAFLC model leads to a decrease in liver steatosis, restoration of bile formation and bile secretion, and protein-synthesizing liver function. In the blood, there was a positive dynamics to the restoration of energy-dependent transmembrane ion transport according to the activity of Na+/K+ -ATPase and Mg2+/Ca2+ -ATPase (in the liver tissue) and the balance of the antioxidant system (to restrain malondialdehyde and catalase activity). We examined 40 patients with CHC with concomitant NAFLD, who completed the course of antiviral therapy (AVT) and were divided into two groups. 1 (control) group (20 people) received a basic treatment complex (diet therapy, which corresponded to the Mediterranean diet, a regimen of dosed physical exertion, patients of 2 groups (20 people, the main group) additionally received a preparation based on bentonite clay inside - 10 days (1 dose three times a day) Evaluation of the effectiveness of treatment was carried out one month after the start of treatment. Conclusion: The treatment carried out in both groups was accompanied by positive dynamics in most of the diseaseʹs symptoms. But a significant advantage was observed in the second group, where the normalization of cholestatic and dyslipidemic syndromes was established, that is, the effect on the pathogenetic links of the progression of NAFLD was proved. The results obtained confirm the practicality of using the drug with bentonite in the complex treatment of CHC patients with concomitant NAFLD. Keywords: chronic viral hepatitis C, non-alcoholic fatty liver disease, bentonite clay,

Possibilities of using natural mineral waters in the treatment of patients with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a chronic pathology that is increasingly diagnosed in different countries. The pathogenesis of NAFLD associated with insulin resistance, abdominal obesity, atherogenic dyslipidemia, arterial hypertension, endothelial dysfunction, impaired adipokine secretion, that is, components of metabolic syndrome. Treatment of NAFLD should be comprehensive and lengthy, although there are no standardized approaches to the treatment of NAFLD. Meanwhile, drug therapy carries certain risks: the development of serious adverse reactions with prolonged use. The work highlights modern views on the etiology, epidemiology, pathogenesis, drug and non-drug treatment of non-alcoholic fatty liver disease (NAFLD). Experimental and clinical studies on the mechanism of biological action, the effects of using different in composition and mineralization of mineral waters on the course of NAFLD had presented. Based on experimental and clinical studies, ideas about the specificity of the action of mineral waters of various balneological types and mineralization on the clinical course of NAFLD at different stages of the disease, the effect on the functional state of the liver, and the dynamics of lipid and carbohydrate metabolism had detailed. It is concluded that mineral waters could be successfully used in the complex treatment of NAFLD patients.