References

mrj

Современная ревматология

Modern Rheumatology Journal

1996-70122310-158X

IMA-PRESS, LLC

10.14412/1996-7012-2014-2-95-102

mrj-539

Research Article

ФАРМАКОТЕРАПИЯ

PHARMACOTHERAPY

Фармакотерапия люмбалгии

Pharmacotherapy for lumbago

Каратеев

А.Е.

Karateev

A.E.

1@ru.ru

ФГБУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой» РАМН, Москва, Россия

2014

08052014

8295102

2014

Каратеев А.

Karateev A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://mrj.ima-press.net/mrj/article/view/539

Неспецифическая боль в нижней части спины (БНЧС) – одно из самых распространенных ревматических заболеваний, с которым связано наибольшее число обращений за медицинской помощью. К сожалению, в нашей стране отсутствуют общепризнанная точка зрения на природу этой патологии и единая концепция ее терапии. Серьезной проблемой при ведении пациентов с БНЧС является неоправданно широкое применение дорогостоящих инструментальных методов диагностики и методов лечения с недоказанной и спорной эффективностью. Основными препаратами для лечения БНЧС были и остаются нестероидные противовоспалительные препараты (НПВП). Их терапевтический потенциал доказан большим числом хорошо организованных клинических исследований и не вызывает сомнений. Вместе с тем появляются новые методы фармакотерапии БНЧС, такие как эпидуральное введение ингибиторов фактора некроза опухоли α, использование ингибиторов факта роста нервов и препаратов, влияющих на дисфункцию ноцицептивной системы. В статье рассмотрены основные группы лекарственных средств, которые нашли свое место или изучались при БНЧС: НПВП, парацетамол, опиоиды, миорелаксанты, антидепрессанты и антиконвульсанты, глюкокортикоиды, локальные анестетики, генноинженерные биологические препараты, представлены основные данные об их эффективности и переносимости.

Nonspecific low back pain (NLBP) is one of the most common rheumatic disorders; it is responsible for the greatest number of patients seeking medical advice. Unfortunately, there is neither a generally acknowledged viewpoint on the nature of this pathology nor a unified conception of its treatment in Russia. The unreasonably wide use of expensive instrumental diagnostic methods and treatment options that have unconfirmed and disputable efficiency is a serious problem in managing NLBP patients. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been and remain basic medications used to treat NLBP. Their therapeutic potential has been proved in a large number of well-designed clinical trials and it is beyond any doubt. At the same time, there are new NLBP pharma- cotherapies, such as epidural injection of tumor necrosis factor-α inhibitors, the use of nerve growth factor inhibitors and nociceptive system dysfunction-affecting drugs. This paper considers the main groups of drugs (NSAIDs, paracetamol, opioids, myorelaxants, antidepressants and anticonvulsants, glucocor- ticoids, local anesthetics, and genetically engineered biological agents) that have found application or tested in NLBP and gives general data on their efficacy and tolerability.

боль в нижней части спиныдиагностикасовременная фармакотерапия.

nonspecific low back paindiagnosismodern pharmacotherapy.

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The authors declare that there are no conflicts of interest present.