mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2015-3-33-42mrj-637Research ArticleОБЗОРЫREVIEWS«Малая ревматология»: несистемная ревматическая патология околосуставных мягких тканей верхней конечности. Часть 2. Медикаментозные и немедикаментозные методы леченияMinor rheumatology: Nonsystemic rheumatic disease of juxta-articular soft tissues of the upper extremity. Part 2. Drug and non-drug treatmentsКаратеевАндрей ЕвгеньевичKarateevAndrei Evgenyevich

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

aekarateev@rambler.ruКаратеевД. Е.KarateevD. E.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ЕрмаковаЮ. А.ErmakovaYu. A.

115522, Москва, Каширское шоссе, 34А

34A, Kashirskoe Shosse, Moscow 115522

ФГБНУ Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation201518092015933342Copyright © Каратеев А.Е., Каратеев Д.Е., Ермакова Ю.А., 20152015Каратеев А.Е., Каратеев Д.Е., Ермакова Ю.А.Karateev A.E., Karateev D.E., Ermakova Y.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/637

Лечение ревматической патологии околосуставных мягких тканей (РПОМТ) верхней конечности (тендинит ротаторов плеча, эпикондилит, синдром де Кервена, «щелкающий палец», синдром запястного канала) основывается на комплексном применении медикаментозных и немедикаментозных методов. Основными препаратами, эффективность которых доказана при этой патологии, являются нестероидные противовоспалительные препараты (НПВП) и глюкокортикоиды (ГК). В статье рассмотрены наиболее крупные и известные исследования, составляющие «доказательную базу» целесообразности использования при РПОМТ таких средств, как НПВП, локальное ведение ГК, гиалуроновой кислоты и обогащенной тромбоцитами плазмы, а также различных немедикаментозных методов. Немедикаментозные методы (физиотерапия, упражнения и программы реабилитации) должны рассматриваться как необходимая составная часть терапевтического процесса у пациентов с хронической болью, связанной с РПОМТ. Сохранение выраженной боли и нарушения функции, несмотря на консервативную терапию, следует считать показанием для хирургического лечения.

The treatment of rheumatic diseases of juxta-articular soft tissues (RDJAST) of the upper extremity (rotator cuff tendinitis, epicondylitis, de Quervain’s syndrome, trigger finger, carpal tunnel syndrome) entails a combination of drug and nondrug therapies. The basic agents that have been proven to be efficacious in this pathology are nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticosteroids (GCs). The paper considers the largest and known studies that are an evidence base for the expediency of using agents, such NSAIDs, local administration of GCs, hyaluronic acid, and plateletrich plasma, as well as different non-drug treatments, in RDJAST. The latter (physiotherapy, exercises, and rehabilitation programs) should be regarded as a necessary component of the therapeutic process in patients with RDJAST-associated chronic pain. Preservation of obvious pain and impaired function despite medical therapy should be regarded as an indication for surgical treatment.

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