RESUMO
UNLABELLED: Non-alcoholic fatty liver disease (NAFLD) is one of the most widespread diffuse liver pathologies among the patients over 40 years of age. The available algorithms for the pharmacological treatment of this disease do not always ensure the desirable results which makes their further development and improvement with the use of natural and preformed physical factors an important priority. AIM: The objective of the present study was to evaluate the effectiveness of the internal course of mineral waters of different balneological types and a bischofite aqueous solution for the treatment of the patients presenting with NAFLD. PATIENTS AND METHODS: A total of 120 patients with non-alcoholic fatty liver disease were examined and treated with the use of the anamnestic, clinical, biochemical and immunochemical methods as well as sonographic studies of the digestive system and the statistical analysis. RESULTS: The data on the effectiveness of the use of mineral waters of different balneological types and a bischofite aqueous solution in the treatment of NAFLD are presented. It is shown that the use of an aqueous solution of bischofite improves the clinical course of the underlying disease (p<0.05), concomitant diseases of the biliary tract (p<0.02) and irritable bowl syndrome complicated by constipation (p<0.003); also, it improves the functional state of the liver and the blood lipid profile (p<0.02) and significantly reduces insulin resistance (p<0.01), primarily due to the reduction of hyperinsulinemia (p<0.01). Using the mineral waters with the predominance of sulfates can improve the clinical course of liver diseases (p<0.01), biliary tract and intestines (p<0.02), normalize the functional state of the liver including that in the patients with non-alcoholic steatohepatitis (p<0.05,) significantly improve the blood lipid profile (p<0.02) due to the substantial improvement of disordered carbohydrate metabolism including that in the patients suffering from type 2 diabetes mellitus (p<0.05). The application of mineral waters with the elevated content of hydrocarbons improves the clinical course of NAFLD with the concomitant esophagogastroduodenal pathology (p<0.001) and simultaneously reduces the severity of insulin resistance due to the lowering of the level of hyperinsulinemia (p<0.001). Moreover, the mineral water-based therapy improves tolerance to carbohydrates, in the first place in the patients with type 2 diabetes mellitus (p<0.01), and restores the background lipid profile (p<0.05). CONCLUSION: The studies has demonstrated the high efficiency of the non-pharmacological treatment resulting in the multifaceted and oppositely directional influence on the patients presenting with non-alcoholic fatty liver disease. The possibility of the differentiated application of mineral water and an aqueous solution of bischofite for the treatment of this pathology is confirmed depending on the stage of the disease, the severity of metabolic disorders, the presence of a concomitant pathology of the digestive system, type 2 diabetes mellitus, and hypertension.
