MECHANISMS OF AUTONOMIC DYSFUNCTION REALIZATION DURING COMORBID GASTROESOPHAGEAL REFLUX DISEASE AND NEUROCIRCULATORY DYSTONIA WITH INSOMNIA AMONG YOUNG PEOPLE

  • Aleksey Oparin Kharkiv Medical Academy of Postgraduate Education
  • Anatoliy Oparin Kharkiv Medical Academy of Postgraduate Education
  • Iryna Balaklytska Kharkiv Medical Academy of Postgraduate Education
  • Ludmila Khomenko Kharkiv Medical Academy of Postgraduate Education
Keywords: gastroesophageal reflux disease, neurocirculatory dystonia, autonomic dysfunction, insomnia

Abstract

The aim of the study: to optimize diagnostics and treatment of comorbid gastroesophageal reflux disease (GERD) and concomitant neurocirculatory dystonia (NCD) with insomnia among young people by studying autonomic dysfunction and mechanisms of its realization.

Methods. The study was conducted in three groups of patients, homogeneous by gender and age. The first group included patients with GERD and insomnia, the second group counted those with NCD and insomnia, and the third group consisted of GERD with NCD and insomnia. We studied the quality of life (SF-36), quality of sleep (PSQI), the presence and severity of depression (PHQ-9), psychosomatic condition (Spielberger-Khanin scale), and determined the presence and severity of autonomic dysfunction syndrome (Wayne questionnaire), acidity of the stomach, ultrasound examination of the esophagus and stomach.

Results. The first group revealed sympathicotonia and increase of gastric juice aggression (in the stomach body 0.89±0.05) and reactive (47.2 points) and personal anxiety (52.7 points), which suggests the advisability of use PPI (omeprazole 20 mg 2 times a day for 5 weeks), and melatonin 3 mg per night during 3 weeks. The second group showed parasympathicotonia predominant, a more pronounced decrease in vitality scale (31.5±4.2), and a moderate increase in indicators of reactive (44.0 points) and personal anxiety (46.5 points), which suggests the advisability of use 3 mg of melatonin per night during 3 weeks. The third group demonstrated predominance of parasympathicotonia, motor disorders, a decrease in alkalizing function of antrum (5.4±0.17), depression (81.8 %), and the greatest decrease in indicators of sleep quality (11.7) and quality of life, which suggests the advisability of use PPI (omeprazole 20 mg 2 times per day during 5 weeks), with prokinetics (domperidone 10 mg 3 times per day during 5 weeks), and melatonin 3 mg per night during 3 weeks.

Conclusions. Autonomic dysfunction has a key influence on the main pathogenetic factors in the formation of both GERD and NCD and insomnia, and the type of autonomic tone determines the features of the clinical course of both isolated and combined pathology.

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Author Biographies

Aleksey Oparin, Kharkiv Medical Academy of Postgraduate Education

Department of Therapy, Rheumatology and Clinical Pharmacology

Anatoliy Oparin, Kharkiv Medical Academy of Postgraduate Education

Department of Therapy, Rheumatology and Clinical Pharmacology

 
Iryna Balaklytska, Kharkiv Medical Academy of Postgraduate Education

Department of Therapy, Rheumatology and Clinical Pharmacology

 
Ludmila Khomenko, Kharkiv Medical Academy of Postgraduate Education

Department of Therapy, Rheumatology and Clinical Pharmacology

 

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Published
2020-07-31
How to Cite
Oparin, A., Oparin, A., Balaklytska, I., & Khomenko, L. (2020). MECHANISMS OF AUTONOMIC DYSFUNCTION REALIZATION DURING COMORBID GASTROESOPHAGEAL REFLUX DISEASE AND NEUROCIRCULATORY DYSTONIA WITH INSOMNIA AMONG YOUNG PEOPLE. EUREKA: Health Sciences, (4), 3-10. https://doi.org/10.21303/2504-5679.2020.001349
Section
Medicine and Dentistry