Clinical and pathogenetic aspects of acupressure application in comprehensive rehabilitation of patients with chronic pancreatitis in combination with type 2 diabetes mellitus

Abstract

Background. In the complex treatment and rehabilitation of patients with the most common diseases, various methods of reflexotherapy (RT) are successfully used. Among them, a worthy place is occupied by acupressure (AP) — a massage performed by pressing the pads of the fingers in the areas of biologically active points with the help of conventional techniques. There are some publications devoted to the positive results of the RT use in chronic pancreatitis (CP) and type 2 diabetes mellitus (DM2), but they need further development and evidence. The purpose of the study was to investigate the effectiveness of comprehensive rehabilitation of patients with chronic pancreatitis with concomitant diabetes mellitus with the inclusion of acupressure course in combination with drinking mineral waters (DMW) of Skhidnytsia deposit for the impact on clinical course, endogenous intoxication parameters and pro- and antioxidant status. Materials and methods. We examined 53 patients with CP and concomitant diabetes. The mean age of patients was (52.86 ± 0.83) years; the average duration of the di­sease is (10.96 ± 0.39) years. Patients were divided into two groups accor­ding to the complexes of rehabilitation treatment. Group I (conventional therapy (CT) + DMW — 30 patients) received a combination of conventional treatment according to the protocol (CT) with the inclusion of ademetionine (sublingual tablets agepta 400 mg) for one month and a course of drinking mineral water accor­ding to the proposed method. Group II (23 patients) (CT + DMW + AP) in addition to CT + DMW received an AP course according to the scheme developed by the authors based on the re­commendations of Kyiv (E.L. Macheret et al.) and Beijing schools by Kong Lin out of 11 sessions. Results. Improvement of the well-being of patients and reduction of the intensity of symptoms and syndromes of CP in patients of both groups under the rehabilitation programs were observed in both groups by analyzing the number of patients with clinical signs in the treatment dynamics and testing by a special GSRS questionnaire. The higher efficiency of the proposed program with acupressure was proved by the pain elimination from 50.0 % in group I to 68.97 % in group II; by the dynamics of the total quality of life according to the GSRS questionnaire from 1.7 to 2.2 times, respectively (p < 0.001); by the decrease of the endotoxicosis index from 31.61 to 53.40 %, respectively (p < 0.001); by the growth of the level of antioxidant system of glutathione protection (SH-groups) from 19.45 to 36.08 % (p < 0.001). Conclusions. Inclusion of a course of acupressure according to the proposed scheme of 11 sessions in the program of monthly comprehensive rehabilitation with hepatotropic sublingual drug ademetionine and a course of drinking mineral waters of Skhidnytsia deposit for 14 days in patients with chronic pancreatitis with concomitant type 2 diabetes mellitus. This proved the feasibility of using a course of acupressure in the rehabilitation of such patients.