According to WHO data in the world more than 200 million people use narcotics [1]. Usage of narcotic drugs affects to the somatic pathology character and demands pathogenic treatment development. The Altai cleared mummy is applied at the disturbance of acidic production damage (hypo, hyper antacid conditions) at the stomach and duodenum ulcer. It is used as a preparation rendering protective and antitoxic effect that allows recommending it for treatment of patients with the specified stomach pathology and drug addiction.
The purpose of our research was clinical-morphological justification of the possibility of Altai mummy preparation in complex treatment of the patients with drug addiction who has stomach and a duodenum ulcer.
Material and research methods. In clinical conditions it were surveyed 70 patients, who has distributed in two groups: the I group (main) were 40 patients with drug addiction had stomach and duodenum pathology aged from 18 till 40 years. Usage duration of opium group psychoactive agents composed from 1 to 10 years. The average daily dose of psychoactive agent was 2,0–3,0 grams. The II group (comparisons) composed 30 patients with stomach and duodenum pathology without drug addiction.
At the detailed poll in the anamnesis of both group patients (I and the II groups) are found the following risk factors as systematic food intake disturbances and diet regimen damage (at 70 % patients), long psychoemotional loads (64 %) and adverse heredity by the ulcerative disease (32 %). For the purpose HP eradication in the I group of patients is prescribed antibacterial therapy with amoxicillin 500 мg×2 times a day, clarithromycin 500 мg×2 once a day, a vegetative cytoprotector as mummy 0,2 g by 1 tablet×2 times in a day, proton pump inhibitor Omeprazol 20 mg 1×2 times a day within the 14 days.
The biopsy materials of the stomach and duodenum were taken on endoscopy, fixed at 10 % of formalin solution, filled with paraffin. Paraffinic sections painted with hematoxylinand Essen, methylene blue and looked through a light microscope. Contamination of a stomach mucosa with Helicobacter pylori (Нр) determined by stomach biopsy materials and urease express-test and morphologically by the coloring methylene blue [2].
Investigation results and discussion. The microscopic picture of the stomach and duodenum ulcers in both investigated groups had a morphological variety of processes, the inherent is long developing wavier pathological process with exacerbation and remission phase changes. Zones of exudation and destruction, fibrinoid necrosis, young and mature granulated and scar tissue, alternate with sites of necrotic mass sloughing and with epithelium growing up under it. At the bottom of ulcerative defects is visible necrosis zone sequestration and the replacement of them with leukocytes and mononuclear cells. On the background of an angiogenesis sites and the scar formation are observed different degree expression of lymphoplasmatic cellular infiltration and fibrosclerosis. On the border with destructed stomach and duodenum wall muscular elements are visible sites with the prolonged chronic inflammation, growth of granulated tissue and scar formation.
The detail comparative morphological investigation showed the inflammation processes intensity in the background of sequencing ulceration and regeneration processes, consists some mosaic picture and more meeting at the long duration opium addicts. Those processes are presented as intestinal methaplasia of duodenum to the stomach epithelium.
At the border with the stomach mucous ulcerative defect is visible a small on depth forces and a regenerating glandular epithelium. In that patients’ intramural nervous plexuses and ganglions is noted the cytoplasm vacuolation, a nodules pyknosis of the ganglionic cells and the expressed lymphoid cell infiltration.
Another feature of a peptic ulcer on the drug addiction background is the increased infiltration of a scar formatting ulcerative stroma with lymphocytes, plasmocytes with an admixture of neutrophil granulocytes and mast cells. In a granulation tissue of an ulcer wall in group of comparison cellular infiltration is more weak, neutrophils are single, lymphocytes and plasmocytes are prevailing. Here is finding the capillaries, set and unripe glands of the pseudopyloric type.
The hypersecretion reason, which found in part of the main group patients, is the parietal cell hyperplasia. It, allegedly, can be bound tone uroregulatory secretion mechanisms disturbance, probably taking place, as additional Exo–endogenic factor of opium narcotic influence.
Thus, it is possible to assume, that in pathogenetic mechanisms of opium narcomania influence on the duodenal ulcer morphgenesis there is elements influence as an «aggression» and «protection» factors. However, they have expressed opposite character.