В статье подробно рассмотрены патофизиологические механизмы возникновения боли, а также наиболее часто используемая в клинической практике классификации боли в горле. Рекомендовано применение системных антибактериальных препаратов на основе критериев Centor. Дано обоснование применению топических препаратов в лечении боли в горле. Рассмотрены основные группы топических препаратов, их преимущества и недостатки. Представлен диагностический и лечебный алгоритм действий врача у пациента с болью в горле.
Ключевые слова: боль в горле, инфекционно-воспалительные заболевания глотки, патогенез боли, топическая терапия боли в горле.
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The article discusses in detail the pathophysiological mechanisms of pain, as well as the most commonly used classification of sore throat in clinical practice. The use of systemic antibacterial drugs based on Centor criteria is recommended. The rationale for the use of topical drugs in the treatment of sore throat is given. The main groups of topical preparations, their advantages and disadvantages are considered. A diagnostic and therapeutic algorithm for the actions of a doctor in a patient with a sore throat is presented.
Key words: sore throat, infectious and inflammatory diseases of the pharynx, pathogenesis of pain, topical treatment of sore throat.
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[Kozlov S.N., Stravinskii L.S., Razina S.A. Farmakoterapiia ostrogo tonzillofaringita v ambulatornoi praktike. Therapeutic Archive. 2004; 76 (5): 45–51 (in Russain).]
9. Centor RM, Witherspoon JM, Dalton HP et al. The diagnosis of strep throat in adults in the emer-gency room. Med Decis Making 1981; 1: 239–46.
10. Jeffrey A et al. Antibiotic treatment of adults with sore throat by community primary care physicians. JAMA 2001; 286 (10): 1181–6.
11. Panagakou SG et al. Risk factors of antibiotic misuse for upper respiratory tract infections in children: results from a cross-sectionalknowledge-attitude practice study in Greece. SRN Pediatr 2012; 685302.
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1._x0001_Shopabaeva A.R., Serikbaeva E.A., Lataeva E.Kh. Rol' obezbolivaiushchikh preparatov: na puti k preodoleniiu boli. Vestnik KazNMU. 2017; 4: 258–9 (in Russain).
2._x0001_Linder JA, Stafford RS. Antibiotic treatment of adults with sore throat by community primary care physicians. JAMA 2001; 286: 1181–6.
3._x0001_Vital and health statistics. From the Center for Disease Control and Prevention/National Center for Health Statistics. Ambulatory health care visits by children: principal diagnosis and place of visit. Series 13, No. 137. http://www.cdc.gov/nchs/data/ series/sr_13/sr13_137.pdf
4._x0001_Pain: a guide for doctors and students. Ed. N.N.Yahno. Moscow: MEDpress-inform, 2009 (in Russain).
5._x0001_Mal'tseva G.S. Bol' v gorle – patogeneticheskaia terapiia. Rossiiskaia otorinolaringologiia. 2005; 6: 106–9 (in Russain).
7._x0001_Koreshkina M.I. Nevropaticheskaia bol'. Problemy i resheniia. Nervnye bolezni. 2016; 4: 34–7 (in Russain)
8._x0001_Kozlov S.N., Stravinskii L.S., Razina S.A. Farmakoterapiia ostrogo tonzillofaringita v ambulatornoi praktike. Therapeutic Archive. 2004; 76 (5): 45–51 (in Russain).
9. Centor RM, Witherspoon JM, Dalton HP et al. The diagnosis of strep throat in adults in the emer-gency room. Med Decis Making 1981; 1: 239–46.
10. Jeffrey A et al. Antibiotic treatment of adults with sore throat by community primary care physicians. JAMA 2001; 286 (10): 1181–6.
11. Panagakou SG et al. Risk factors of antibiotic misuse for upper respiratory tract infections in children: results from a cross-sectionalknowledge-attitude practice study in Greece. SRN Pediatr 2012; 685302.
Авторы
Мальцева Галина Семеновна – д-р мед. наук, ученый секретарь ФГБУ СПб НИИ ЛОР. E-mail: g.s.maltseva@gmail.com; ORCID: https://orcid.org/0000-0003-0670-9566
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Galina S. Maltseva – D. Sci. (Med.), Saint Petersburg Research Institute of Ear, Throat, Nose and Speech. E-mail: g.s.maltseva@gmail.com; ORCID: https://orcid.org/0000-0003-0670-9566