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Современная ревматология

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Фармакотерапия хронической боли в спине: есть ли перспективы?

https://doi.org/10.14412/1996-7012-2017-3-112-120

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Аннотация

Лечение хронической боли в спине (ХБС) – сложная терапевтическая задача. Гетерогенность патологии, различные фенотипы боли, наличие коморбидных заболеваний и индивидуальная чувствительность к лекарственным препаратам требуют использования широкого спектра обезболивающих средств с разным механизмом действия. 
В настоящем обзоре кратко рассмотрена доказательная база основных фармакологических групп, которые применяются для лечения ХБС в реальной клинической практике или проходят клинические испытания: нестероидные противовоспалительные препараты (НПВП), глюкокортикоиды, ингибиторы фактора некроза опухоли (ФНО) α, ингибиторы фактора роста нервов, опиоиды, антидепрессанты и миорелаксанты, а также антибиотикотерапия. Показано, что в настоящее время даже в перспективе не существует лекарств, применение которых способно полностью решить проблему ХБС. Лечение целесообразно начинать с НПВП. Хотя их эффективность при ХБС относительно невысока, тем не менее использование НПВП позволяет добиться определенного уменьшения боли и создать условия для успешного применения других классов препаратов и немедикаментозных методов. Рассмотрены достоинства нимесулида, который может считаться препаратом первой линии среди НПВП по соотношению эффективности, относительной безопасности и доступности.

Об авторах

Г. И. Шварцман
ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России
Россия
191015, Санкт-Петербург, ул. Кирочная, 41


А. Е. Каратеев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
115522, Москва, Каширское шоссе, 34А


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Для цитирования:


Шварцман Г.И., Каратеев А.Е. Фармакотерапия хронической боли в спине: есть ли перспективы? Современная ревматология. 2017;11(3):112-120. https://doi.org/10.14412/1996-7012-2017-3-112-120

For citation:


Shvartsman G.I., Karateev A.E. Pharmacotherapy of chronic back pain: Are there prospects? Modern Rheumatology Journal. 2017;11(3):112-120. (In Russ.) https://doi.org/10.14412/1996-7012-2017-3-112-120

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ISSN 1996-7012 (Print)
ISSN 2310-158X (Online)