MEDA VA ICHAK YARA KASALLIGI: ETIOLOGIYASI, PATOGENEZI, KLINIK BELGILARI,DIAGNOSTIKASI VA DAVOLASH USULLARI
Abstract
This scientific article provides a comprehensive overview of the etiology, pathogenesis, clinical features, diagnosis, and modern treatment methods of gastric and intestinal ulcer diseases. Helicobacter pylori bacteria and nonsteroidal anti-inflammatory drugs, especially aspirin, are analyzed as significant factors in the development of these diseases. Molecular mechanisms of pathogenesis, including the disruption of prostaglandin synthesis and alterations in the activity of COX-1 and COX-2 enzymes, are thoroughly explained.
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ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 238 MEDA VA ICHAK YARA KASALLIGI: ETIOLOGIYASI, PATOGENEZI, KLINIK BELGILARI,DIAGNOSTIKASI VA DAVOLASH USULLARI Rajabov Doston Rustam o‘g‘li Zarmed Universiteti, Buxoro kampusi, davolash ishi fakulteti talabasi Ilmiy rahbar: Muazzamov Bobur Baxodirovich, tibbiyot fanlari nomzodi, Dotsent Annotatsiya: Ushbu ilmiy maqolada meda va ichak yara kasalligining etiologiyasi, patogenezi, klinik belgilari, diagnostikasi va zamonaviy davolash usullari keng yoritilgan. Helicobacter pylori bakteriyasi va nosteroid yallig‘lanishga qarshi preparatlar, ayniqsa aspirin, ushbu kasalliklarning rivojlanishida muhim omillar sifatida tahlil qilingan. Molekulyar darajadagi patogenez mexanizmlari, shu jumladan, prostaglandinlar sintezining buzilishi, COX-1 va COX-2 fermentlari faoliyatining o‘zgarishi batafsil bayon etilgan. Kalit so‘zlar: Meda yara kasalligi, ichak yarasi, Helicobacter pylori, aspirin, COX-1, molekulyar patogenez, davolash. Аннотация: В данной научной статье подробно освещены этиология, патогенез, клинические признаки, диагностика и современные методы лечения язвенной болезни желудка и кишечника. Бактерия Helicobacter pylori и нестероидные противовоспалительные препараты, особенно аспирин, проанализированы как важные факторы в развитии данных заболеваний. Механизмы патогенеза на молекулярном уровне, включая нарушение синтеза простагландинов и изменения в активности ферментов COX-1 и COX-2, подробно описаны. Ключевые слова: Язва желудка, язва кишечника, Helicobacter pylori, аспирин, COX-1, молекулярный патогенез, лечение, Abstract: This scientific article provides a comprehensive overview of the etiology, pathogenesis, clinical features, diagnosis, and modern treatment methods of gastric and intestinal ulcer diseases. Helicobacter pylori bacteria and nonsteroidal anti-inflammatory drugs, especially aspirin, are analyzed as significant factors in the development of these diseases. Molecular mechanisms of pathogenesis, including the disruption of prostaglandin synthesis and alterations in the activity of COX-1 and COX-2 enzymes, are thoroughly explained. Keywords: Gastric ulcer, intestinal ulcer, Helicobacter pylori, aspirin, COX-1, molecular pathogenesis, treatment. KIRISH Meda va on ikki barmoqli ichak yara kasalliklari zamonaviy tibbiyotning dolzarb muammolaridan biri hisoblanadi. Bu kasalliklarning yuqori uchrashi, surunkali kechishi va asoratlar bilan kechishi uni chuqur o‘rganishni talab qiladi. Yara kasalligida meda va ichak shilliq qavatining turli darajada chuqurlashgan nuqsonlari vujudga keladi. Etiologiya Yara kasalligining asosiy sabablari quyidagilar hisoblanadi: - Helicobacter pylori infeksiyasi; - Aspirin va boshqa nosteroid yallig‘lanishga qarshi dorilar (NSAID); - Stress, genetik moyillik, noto‘g‘ri ovqatlanish; - Tamaki chekish va spirtli ichimliklar iste’moli.
ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 239 Aspirin COX-1 fermentini inhibitsiyalab, prostaglandinlar sintezini pasaytiradi. Bu shilliq qavatni himoya qiluvchi omillarni kamaytirib, yara hosil bo‘lishiga olib keladi. Patogenez Molekulyar darajada, Helicobacter pylori shilliq qavatga yopishib, ureaza fermenti yordamida ammiak hosil qiladi. Bu muhitni ishqoriylashtirib, shilliq qavatni zaiflashtiradi. Bundan tashqari, bakteriyaning CagA va VacA toksinlari hujayralararo signal uzatish tizimlarini buzadi, bu yallig‘lanish va nekrozni kuchaytiradi. Aspirin COX-1 ni inhibitsiyalab, prostaglandinlar sintezini to‘xtatadi. Natijada, qon aylanishi va bikarbonat ajralishi kamayadi, shilliq qavat zaiflashadi va yara hosil bo‘ladi. Klinik belgilari Yara kasalligining asosiy belgilariga quyidagilar kiradi: - Qorin yuqori qismida og‘riq; - Ko‘ngil aynishi, qusish; - Ishtahaning yo‘qolishi; - Og‘riq ovqatdan keyin kuchayishi yoki kamayishi; Diagnostika Diagnostika quyidagi usullar orqali amalga oshiriladi: - FEGDS (fibroezofagogastroduodenoskopiya); - Helicobacter pylori ga test (nafas testi, najasda antigen, biopsiya); - Laborator tahlillar (gemoglobin, qonning yashirin qon tahlili). Davolash Yara kasalligini davolash quyidagi bosqichlarda olib boriladi: 1. Helicobacter pylori ni yo‘qotish uchun eradikatsion terapiya (antibiotiklar: klaritromitsin, amoksitsillin + proton nasos inhibitörlari); 2. Gastrik kislotalilikni kamaytirish (omeprazol, pantoprazol); 3. Himoya vositalari (sukralfat, vismutli preparatlar); 4. Agar aspirin qabul qilinayotgan bo‘lsa, uni bekor qilish yoki gastrohimoya bilan almashtirish. Xulosa Yara kasalligi kompleks etiologik va patogenetik omillar asosida rivojlanadi. Helicobacter pylori infeksiyasi va NSAID, ayniqsa aspirin, ushbu kasalliklarning asosiy sabablari bo‘lib, ularning molekulyar ta’sir mexanizmlari davolash taktikasini belgilashda muhim ahamiyatga ega. Erta diagnostika va to‘g‘ri davolash usullarining qo‘llanishi bemorning sog‘ayishiga va asoratlarning oldini olishga xizmat qiladi. FOYDALANILGAN ADABIYOTLAR: 1. Sachs G, Howden CW. Peptic ulcer disease. Med Clin North Am. 2007;91(5): 1135-1150. 2. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection— the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6-30. 3. Lanas A. Nonsteroidal anti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis Res Ther. 2009;11(Suppl 2):S2. 4. Wallace JL. Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn't the stomach digest itself? Physiol Rev. 2008;88(4):1547-1565.
ISSN: 2582-4686 SJIF 2021-3.261,SJIF 20222.889, 2024-6.875 ResearchBib IF: 9.948 / 2024 VOLUME-5, ISSUE-11 240 5. Bjarnason I, Hayllar J, MacPherson AJ, Russell AS. Side effects of nonsteroidal antiinflammatory drugs on the small and large intestine in humans. Gastroenterology. 1993;104(6):1832-1847. 6. Lanza FL. A guideline for the treatment and prevention of NSAID-induced ulcers. Am J Gastroenterol. 1998;93(11):2037-2046. 7. Tarnawski AS. Cellular and molecular mechanisms of gastrointestinal ulcer healing. Dig Dis Sci. 2005;50(Suppl 1):S24-S33. 8. Szabo S. Molecular mechanisms of gastroduodenal mucosal defense and repair: translation to clinical therapeutics. Am J Med. 1995;98(2A):31S-41S. 9. Rainsford KD. Aspirin and the salicylates. Inflammopharmacology. 2004;12(1-2):3-8.