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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">mrj</journal-id><journal-title-group><journal-title xml:lang="ru">Современная ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Modern Rheumatology Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1996-7012</issn><issn pub-type="epub">2310-158X</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/1996-7012-2015-2-66-74</article-id><article-id custom-type="elpub" pub-id-type="custom">mrj-625</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Лечение больных остеоартрозом различной локализации : место медленнодействующих препаратов</article-title><trans-title-group xml:lang="en"><trans-title>Treatment in patients with osteoarthritis at different sites: Place of slow-acting drugs</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чичасова</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Chichasova</surname><given-names>N. V.</given-names></name></name-alternatives><email xlink:type="simple">kafedraRheum@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Имаметдинова</surname><given-names>Г. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Imametdinоva</surname><given-names>G. R.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России, Москва, Россия 119048, Москва, ул. Трубецкая, 8, стр. 2</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia 8, Trubetskaya St., Build. 2, Moscow 119048</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБНУ НИИР им. В.А. Насоновой, Москва, Россия 115522, Москва, Каширское шоссе, 34А</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia 34A, Kashirskoe Shosse, Moscow 115522</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>09</day><month>06</month><year>2015</year></pub-date><volume>9</volume><issue>2</issue><fpage>66</fpage><lpage>74</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Чичасова Н.В., Имаметдинова Г.Р., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Чичасова Н.В., Имаметдинова Г.Р.</copyright-holder><copyright-holder xml:lang="en">Chichasova N.V., Imametdinоva G.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://mrj.ima-press.net/mrj/article/view/625">https://mrj.ima-press.net/mrj/article/view/625</self-uri><abstract><p>Основная цель лечения остеоартроза (ОА) – рациональная обезболивающая и противовоспалительная терапия, замедление пргрессирования болезни и сохранение качества жизни пациентов. Проведение анальгетической терапии у лиц пожилого возраста сдерживается наличием сопутствующей патологии, в первую очередь сердечно-сосудистой системы и желудочно-кишечного тракта. Группой экспертов создан алгоритм ведения больных ОА, в котором четко прослеживается осторожный подход к применению нестероидных противовоспалительных препаратов, подтверждается эффективность медленнодействующих средств (хондроитина сульфата – ХС и глюкозамина), внутрисуставного введения гиалуроната. Эксперты заключили, что в качестве базисной терапии ОА более безопасным и действенным является использование SYSADOA (симптоматических препаратов замедленного действия для лечения ОА), при необходимости в комбинации с короткими курсами парацетамола. В рекомендациях EULAR 2003 г. ХС и глюкозамин были выделены как препараты с хондропротективным эффектом. Согласно результатам многочисленных исследований, ХС и глюкозамин оказывают умеренное или значительное действие на болевой синдром и функциональную подвижность суставов при ОА, являются безопасными и характеризуются минимумом побочных эффектов. В качественных многолетних рандомизированных контролируемых исследованиях продемонстрирована способность ХС и глюкозамина замедлять прогрессирование сужения суставной щели при ОА. Показано также, что использование комбинации глюкозамина и ХС позволяет предотвратить потерю хряща.</p></abstract><trans-abstract xml:lang="en"><p>The main goal of osteoarthritis (OA) treatment is to perform rational analgesic and anti-inflammatory therapy, to slow down the progression of the disease, and to preserve quality of life in patients. The performance of analgesic therapy in the elderly is impeded by the presence of a concomitant disease, primarily that of the cardiovascular system and gastrointestinal tract. A group of experts has elaborated the algorithm for managing OA patients, which tracks a careful approach to using nonsteroidal anti-inflammatory drugs and confirms the efficacy of slow-acting agents (chondroitin sulfate (CS) and glucosamine) and intraarticular hyaluronate. The experts have concluded that the use of symptomatic slow-acting drugs for the treatment of OA (SYSADOA), if need be, in combination with short-term paracetanol cycles as basic therapy for this condition is safer and more effective. The 2003 EULAR guidelines identify CS and glucosamine as chondroprotectors. Many studies have shown that CS and glucosamine have a moderate or significant effect on joint pain syndrome and functional mobility in OA; they are safe and characterized by minimal side effects. Long-term qualitative randomized controlled trials have demonstrated that CS and glucosamine are able to slow down the progression of joint space narrowing in OA. It is also shown that the use of a combination of glucosamine and CS allows cartilage loss to be prevented.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартроз</kwd><kwd>алгоритм лечения</kwd><kwd>медленнодействующие препараты</kwd><kwd>глюкозамин</kwd><kwd>хондроитина сульфат</kwd></kwd-group><kwd-group xml:lang="en"><kwd>osteoarthritis</kwd><kwd>treatment algorithm</kwd><kwd>slow-acting drugs</kwd><kwd>glucosamine</kwd><kwd>chondroitin sulfate</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bijlsma JW, BerenbaumF, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011 Jun 18;377(9783):2115–26. doi: 10.1016/S0140- 6736(11)60243-2.</mixed-citation><mixed-citation xml:lang="en">Bijlsma JW, BerenbaumF, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. 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