Abstract:
:The paper analyzes an evidence base for the pharmacotherapy of irritable bowel syndrome (IBS) A large number of randomized placebo-controlled trials (RPCTs) systematized in a number of meta-analyses suggest that monotherapy regimens with spasmolytics, antidepressants, dietary fibers, polyethylene glycol, rifaximin, probiotics, and mesalamine are effective. Only some RPCTs evaluate the efficiency of combined pharmacotherapy versus placebo for IBS. Since the basis for the pathophysiology of the latter is motility and functional disorders, visceral hypersensitivity, and, probably, impaired microbiota, we anticipate that the need to use combined approaches to treating the majority of patients with IBS, by covering a few components of its pathogenesis, is relevant. Thus, to choose pharmacotherapy for IBS in each specific case is a challenge as this is determined by the form of IBS, the availability of an approved medicine on the domestic market, the indications for use, possible long-term use, high safety, and efficacy evidence drawn from RPCTs. :Представлен анализ доказательной базы по фармакотерапии синдрома раздраженного кишечника (СРК). Большое число рандомизированных плацебо-контролируемых исследований (РКИ), систематизированных в ряд метаанализов, свидетельствуют об эффективности монорежимов лечения - спазмолитической терапии, антидепрессантов, пищевых волокон, полиэтиленгликоля, рифаксимина, пробиотиков и месалазина. Только отдельные РКИ оценивают эффективность комбинированной фармакотерапии СРК по сравнению с плацебо. Поскольку основа патофизиологии СРК - нарушение моторики и функции, висцеральная гиперчувствительность и, вероятно, нарушение микробиоты, мы предполагаем, что для большинства больных СРК актуальна необходимость комбинированных подходов в лечении с охватом нескольких звеньев патогенеза СРК. Таким образом, выбор фармакотерапии СРК в каждом конкретном случае является сложным решением, поскольку определяется формой СРК, доступностью апробированного лекарственного средства на внутреннем рынке, наличием показаний к применению, возможности длительного применения, высокой безопасности и свидетельств эффективности согласно результатам РКИ.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Maev IV,Cheremushkin SV,Kucheryavyi YA,Cheremushkina NVdoi
10.17116/terarkh20158724-10subject
Has Abstractpub_date
2015-01-01 00:00:00pages
4-10issue
2eissn
0040-3660issn
2309-5342journal_volume
87pub_type
杂志文章,评审abstract::The peculiarities of prevalence of coronary heart disease (CHD), its main risk factors and their interrelationships were studied on the basis of the results of epidemiological surveys of an organized population of men aged 20 to 59 engaged in research, and an unorganized male population in one of Moscow districts. A s...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::A study was made of the capacity of peritoneal macrophages to demonstrate the atherogenic potential of blood serum. Murine and human macrophages were found to be capable of intracellular accumulation of cholesterol during cultivation with blood sera from patients with coronary atherosclerosis. The data on the capacity...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The paper is concerned with the data on the brain stroke incidence and lethality among the population aged 25-64 years in 3 districts of Moscow during 1985. The rate of brain stroke was noted to be increased with age without any essential differences in the indicators in men and women. Comparison of the results of the...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:to evaluate the efficacy of cyclopheron used in patients with mild clinical manifestations of focal and infiltrative pulmonary tuberculosis (PT). SUBJECTS AND METHODS:Thirty first detected patients with PT, in whom a complex of their etiotropic therapy comprised cyclopheron, and 32 similar patients who received et...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2010-01-01 00:00:00
abstract::Basing on their psychophysiological, immunological and clinical findings, the authors emphasize the role of chronic infection, occupational hazards, adaptation to new climatic and social environment in pathogenesis of neurocirculatory asthenia (NA). The disease is also associated with sensitization to streptococcus, a...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Altogether 117 case reports were analyzed and 32 patients with associated gastric or duodenal ulcer and coronary heart disease (CHD) as well as 48 controls suffering from gastric or duodenal ulcer were examined. A relationship was established between the clinical picture and the course of associated ulcer disease and ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The status of the blood kinin system, activity of serum inhibitors of proteinases (alpha 1-protease inhibitor and alpha 2-macroglobulin) as well as indices of activity of trypsin-like proteinases, elastolytic and fibrinolytic activity, free antitryptic activity and complete content of acid stable inhibitors were studi...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:AIM:To evaluate the efficiency and safety of intravenous infusion of levosimendan in patients with idiopathic pulmonary hypertension (IPH) and its clinical, hemodynamic, and neurohumoral effects. SUBJECTS AND METHODS:The study included 9 patients (mean age 31.8 +/- 8.7 years) with Functional Class III and IV IPH and s...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:AIM:To study the incidence and risk factors of bacterial infections and the efficiency of empirical antibacterial therapy in patients in the early period after allogeneic hematopoietic stem cell transplantation (allo-HSCT). SUBJECTS AND METHODS:The study included 155 patients who had undergone allo-HSCT. Myeloablative...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201587788-93
更新日期:2015-01-01 00:00:00
abstract::A new method of tomography based on nmr (nmr-tomography) was used to examine 25 normal subjects and 35 patients with tumorous, vascular, inflammatory and demyelinization processes occurring in the brain, cervical division of the spinal cord and visceral cranium. Use was made of an nmr-tomograph with a resistive magnet...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Chronic cerebral circulatory insufficiency (CCCI) is a result of cerebral microangiopathy, most commonly due to uncontrolled hypertension. In this case, the brain is affected due to recurrent silent infarcts and/or microbleedings without clinical manifestations of stroke and chronic brain ischemia. Progressive cogniti...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.17116/terarkh201688493-99
更新日期:2016-01-01 00:00:00
abstract:AIM:Investigation of functional-metabolic activity of leukocytes by assessment of basic components of the microbicidal system in the course of chronic brucellosis with reference to the stage, severity, complications and concomitant diseases. MATERIAL AND METHODS:Time course of changes in myeloperoxidase, acid and alka...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::The most effective treatment for pathological obesity is bariatric surgery; however, a patient may postoperatively develop vitamin deficiencies. In inadequate intake of food and its malabsorption after surgery, there are chiefly deficiencies of vitamins B1, B6, B12, and vitamin E, leading to complications as central a...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:10.17116/terarkh20158712117-121
更新日期:2015-01-01 00:00:00
abstract:AIM:To evaluate telmisartan effects on 24-h blood pressure profile, sensitivity to insulin, carbohydrate and lipid metabolism in patients with metabolic syndrome (MS) and arterial hypertension (AH). MATERIAL AND METHODS:Twenty patients with MS and AH of the degree I-II received telmisartan in a dose 80 mg/day. 24-h BP...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract::A study of the indices of iron metabolism in 29 patients with hereditary hemorrhagic telangiectasia revealed a decrease in the level of serum iron, an increase in serum latent and total iron-binding capacity values. The level of blood transferrin studied by radial immunodiffusion was elevated. The level of ferritin in...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To evaluate the effect of the anxiolytic adaptol on blood pressure (BP) level in its concurrent use with a fixed dose angiotensin-converting enzyme (ACE) inhibitor/diuretic combination on quality of life and on the correction of psychoautonomic disorders. SUBJECTS AND METHODS:The trial included women aged 40-60 ye...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract:AIM:The aim of the study was to analyze the severity of the difference in these values in real clinical practice in patients suffering from arterial hypertension (AH) on the basis of an open multicenter register to monitor the effectiveness of therapy in patients with hypertension "HYPERION", conducted by the Eurasian ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:10.26442/terarkh201890421-28
更新日期:2018-04-19 00:00:00
abstract::A study was made of the nature of secondary immuno-deficiency, peculiarities of disordered function of regulatory T-lymphocytes (helpers and suppressors), and their interrelationships in different clinical variants of chronic glomerulonephritis (CGN). Altogether 94 CGN patients were examined, of them 34 were with urin...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::The results of a study of the efficiency of treatment in patients with chronic hepatitis C conducted in a complex of multicenter clinical trials of the impact of various antiviral therapy regimens including the interferon genesis inductor cycloferon are reviewed. Four hundred and seventy-eight patients with hepatitis ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract::Eighteen patients with relapsed or refractory Hodgkin's disease (HD) have been treated with high-dose chemotherapy (BEAM regimen) followed by autologous peripheral stem cells and/or bone marrow rescue. There were no treatment-related deaths. Overall response rate was 82%. With a median follow-up of 10 months (3-24 mon...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::A study was made of the possibilities of an individual approach to intraarticular administration of protease inhibitors, cytostatics and orgoteine in patients with rheumatoid arthritis (RA). The activity of hyaluronidase, superoxide dismutase, the level of rheumatoid factor and the phagocyte count in synovial fluid we...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To study clinical and psychological features of patients with coronary heart disease (CHD) and their comparison with obesity. MATERIALS AND METHODS:The presence and intensity of cardialgia, Ketle's index, body mass fat component, tolerance to isometric load were determined in 104 patients with stable angina of eff...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::In Russia, diabetes mellitus afflicts 8 million people, 90% of them had type 2 diabetes mellitus (T2DM) and this figure is growing steadily. At the same time there is a rise in the incidence of macrovascular events (unstable angina pectoris, myocardial infarction). Coronary heart disease and its attack are a major cau...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章,评审
doi:
更新日期:2010-01-01 00:00:00
abstract:AIM:To estimate a diagnostic value of antibodies to cyclic citrullinized peptide (CCP) in rheumatoid arthritis (RA). MATERIAL AND METHODS:The study was made of 85 RA patients. Of them, 48 patients had early RA, i.e. of 8 month and less duration. The control group consisted of 35 patients with non-differentiated arthri...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::The paper emphasizes a role of a local therapist in the timely detection and treatment of acute respiratory viral infections. It shows a certain difficulty in the differential diagnosis of acute respiratory disease and influenza. Attention is given on a need for a well-defined program to correct drug therapy, regimen,...
journal_title:Terapevticheskii arkhiv
pub_type: 社论
doi:
更新日期:2010-01-01 00:00:00
abstract:AIM:To study morphofunctional peculiarities of gastric mucosa in native and migrant rural population of North Siberia. MATERIAL AND METHODS:A comprehensive clinicomorphological examination including physical examination, ultrasonic scanning, cholecystography, duodenal intubation, intragastric pH-metry, esophagogastrod...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::Diagnostic algorithms for the recognition of diabetic angiopathies have been developed: an algorithm for the recognition of the most important syndromes of vascular involvement in patients with diabetes mellitus; an algorithm for the recognition of stages of diabetic retinopathy, and an algorithm for the recognition o...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::A total of 46 patients with reactive arthritides and 20 patients with rheumatoid arthritis (RA) were examined, as compared with 20 normal persons, for the blood serum content of the products of catabolic breakdown of cell receptors--R proteins (according to inhibition of the hemagglutination reaction between human red...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::A study was made of the rate of HLA system antigens in 75 patients with different clinical versions and immuno-pathological manifestations of systemic lupus erythematosus (SLE). A total of 350 normal subjects comprised the control group. During SLE, a high rate of DNW3, B8 and AI antigens was revealed. Associative rel...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::Altogether 44 patients with amyloidosis (7 with primary, 24 with secondary and 13 with hereditary associated with periodic disease) and different stages of renal impairment and 32 patients with chronic glomerulonephritis (CGN) (14 with the latent and 18 with the nephrotic form) were examined for chemotactic properties...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00