[Stages in the improvement of drug therapy at a polyclinic]. / Etapy sovershenstvovaniia medikamentoznoi terapii v usloviiakh polikliniki.

Within 1968-1997 the authors studied the steps of introduction of the achievements of the medical science, technology and pharmacology to therapy of exacerbations and complications of peptic ulcer (PU). The scientific and practical value of endoscopic, histological, biochemical and bacteriological examinations in the improvement of the methods of pharmacotherapy of exacerbations and complications of PU was shown. Three phases of the PU development were indicated by the clinical signs and results of esophagogastroduodenoscopy, target biopsy and histological examinations. These data and available scientific achievements were assumed as a basis for the design of optimal drug combinations and their introduction to the medical practice. The use of such combinations made it possible to prevent relapses and life-threatening complications of the disease in the overwhelming majority of the patients. The best results of the pharmacotherapy were recorded in the years (1988-1997) when the drug combinations began to be used. The combinations provided eradication of Helicobacter pylori in the gastroduodenal mucosa and it was proved that in all the patients with PU and the relapsing lesions in the duodenum and in the overwhelming majority of the patients with gastric ulcer the disease developed at the background of chronic active gastroduodenitis associated with H.pylori. The success of the pharmacotherapy in the patients with PU was due to the use of the rational combinations of antibacterial and antisecretory agents.

[Current methods of ulcer therapy and their efficacy and cost]. / Sovremennye metody terapii iazvennoi bolezni, ikh éffektivnost' i stoimost'.

The purpose of this study is to assess the efficiency of the anti-ulcer therapy taking into account the economic aspects of treatment. We have examined 708 HP-positive(+) patients with stomach ulcers (SU) and duodenal ulcers (DU). Various schemes of anti-helicobacter and anti-secretory therapy were administered to them. Positive dynamics of some clinical data (local palpatory tenderness and abdominal wall resistance) and gastritis (gastroduodenitis) activity was discovered in all groups of patients. The cost of the treatment was determined with the help of marketing studies by taking the lowest price of drugs. There were no statistically reliable differences found groups of traditional treatment regimens by both results of HP eradication and the cost of eradicative and anti-secretory therapy. All drugs under study are highly effective for rapid relief of symptoms at an exacerbation of stomach ulcer associated with HP as well as the decrease of gastritis (gastroduodenitis) activity. It is possible to recommend them for both eradicative therapy and prolonged treatment.