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Боль в спине: использование витаминов группы В
Боль в спине: использование витаминов группы В
Беляев А.А., Котова О.В., Акарачкова Е.С. Боль в спине: использование витаминов группы В. Consilium Medicum. 2019; 21 (9): 91–94. DOI: 10.26442/20751753.2019.9.190567
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Аннотация
Заболевания опорно-двигательного аппарата широко распространены и имеют ряд негативных социальных и экономических последствий: влияние на производительность труда, дорогостоящее лечение, временная нетрудоспособность, инвалидность. Среди наиболее распространенных заболеваний опорно-двигательного аппарата выделяют цервикалгию, боль в пояснице – БП (иначе – боль в нижней части спины). От 65 до 90% населения будут страдать БП в какой-то момент их жизни. В большинстве случаев (до 80–90%) боль в спине носит неспецифический характер и связана преимущественно с дисфункцией мышечно-связочного аппарата. Описывают следующие факторы риска развития БП: психологические, социальные, физические, дефицит потребления витаминов и минералов. Наиболее распространенными препаратами для лечения неспецифической БП являются нестероидные противовоспалительные препараты, миорелаксанты, витамины группы В. Среди витаминов особое внимание уделяется витамину В12 (цианокобаламин), который прямо и косвенно работает как противоболевой препарат. К комбинированным препаратам, включающим витамины В1 (тиамина гидрохлорид 100 мг), В6 (пиридоксина гидрохлорид 100 мг), В12 (цианокобаламин 1 мг) в ампуле на 2 мл, представленным на российском рынке, относится Нейромультивит, фармакологические эффекты которого включают нейротрофическое, регенеративное, антиоксидантное, нейромодуляторное, аналгезирующее действие.
Ключевые слова: боль в пояснице, цервикалгия, факторы риска, цианокобаламин, тиамин, пиридоксин, Нейромультивит.
Ключевые слова: боль в пояснице, цервикалгия, факторы риска, цианокобаламин, тиамин, пиридоксин, Нейромультивит.
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Musculoskeletal system disorders are widespread and have negative social and economic impacts: influence labor efficiency, require expensive treatment, result in temporary disability and permanent disablement. Most common musculoskeletal system disorders include cervicalgia and lower back pain (LBP). From 65 to 90% of population with have LBP at a certain point of life. In most cases (up to 80–90%) back pain is non-specific and is associated with muscular-ligamentous apparatus dysfunction. The following risk factors of LBP are described: psychological, social, physical, and vitamins and minerals deficiency. The most common medications for non-specific LBP include non-steroid anti-inflammatory drugs, muscle relaxants, and vitamin B complex. Among vitamins special attention is given to vitamin В12 (cyanocobalamine) that has a direct and indirect analgesic. Neuromultivit is a combined medication on the Russian market that includes vitamins В1 (thiamine hydrochloride 100 mg), В6 (pyridoxine hydrochloride 100 mg), and В12 (cyanocobalamine 1 mg) in a 2 ml ampule. Its pharmacological effects include neurotrophic, regenerative, antioxidant, neuromodulatory, and antalgesic effects.
Key words: lower back pain, cervicalgia, risk factors, cyanocobalamine, thiamine, pyridoxine, Neuromultivit.
Key words: lower back pain, cervicalgia, risk factors, cyanocobalamine, thiamine, pyridoxine, Neuromultivit.
Полный текст
Список литературы
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2. Котова О.В., Акарачкова Е.С. Боль в шее: возможности терапии. Терапия. 2016; 2 (6): 70–5.
[Kotova O.V., Akarachkova E.S. Bol' v shee: vozmozhnosti terapii. Terapiia. 2016; 2 (6): 70–5 (in Russian).]
3. Hogg-Johnson S, van der Velde G, Carroll LJ et al. The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. J Manipulative Physiol Ther 2008; 32: S46–60.
4. Vos T, Flaxman AD, Naghavi M et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380 (9859): 2163–96.
5. Dunn KM, Croft PR. Epidemiology and natural history of low back pain. Eur Medicophys 2004; 40 (1): 9–13.
6. Heuch I, Heuch I, Hagen K et al. Is there an association between vitamin D status and risk of chronic low back pain? A nested case-control analysis in the Nord-Trøndelag Health Study. BMJ Open 2017; 7 (11): e018521. DOI: 10.1136/bmjopen-2017-018521
7. Freburger JK, Holmes GM, Agans RP et al. The rising prevalence of chronic low back pain. Arch Intern Med 2009; 169: 251–8.
8. Machado GC, Maher CG, Ferreira PH et al. Can Recurrence After an Acute Episode of Low Back Pain Be Predicted? Phys Ther 2017; 97 (9): 889–5. DOI: 10.1093/ptj/pzx067
9. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol 2010; 24 (6): 769–81. DOI: 10.1016/j.berh.2010.10.002
10. Котова О.В., Акарачкова Е.С. Боль в спине: эпидемиология, этиология, лечение. Consilium Medicum. 2017; 19 (2.3. Неврология и ревматология): 43–7.
[Kotova O.V., Akarachkova E.S. Back pain: epidemiology, etiology, treatment. Consilium Medicum. 2017; 19 (2.3. Neurology and Rheumatology): 43–7. (in Russian).]
11. Wertli MM, Rasmussen-Barr E, Weiser S et al. The role of fear avoidance beliefs as a prognostic factor for outcome in patients with nonspecific low back pain: a systematic review. Spine 2014; 14 (5): 816–36.
12. Boer MJ, Struys MM, Versteegen GJ. Pain-related catastrophizing in pain patients and people with pain in the general population. Eur J Pain 2012; 16 (7): 1044–52.
13. Никифоров А.С., Авакян Г.Н., Мендель О.И. Неврологические осложнения остеохондроза позвоночника. М.: ГЭОТАР-Медиа, 2015.
[Nikiforov A.S., Avakian G.N., Mendel' O.I Neurological complications of osteochondrosis of the spine. Moscow: GEOTAR-Media, 2015 (in Russian).]
14. Котова О.В., Акарачкова Е.С., Данилов А.Б. Вопросы длительной терапии болевых синдромов. Рус. мед. журн. 2015; 23 (30): 16–8.
[Kotova O.V., Akarachkova E.S., Danilov A.B. Voprosy dlitel'noi terapii bolevykh sindromov. Rus. med. zhurn. 2015; 23 (30): 16–8 (in Russian).]
15. Котова О.В., Акарачкова Е.С. Нимесулид: эффективность и безопасность применения. Consilium Medicum. 2016; 18 (2): 100–3.
[Kotova O.V., Akarachkova E.S. Nimesulide: efficacy and safety. Consilium Medicum. 2016; 18 (2): 100–3 (in Russian).]
16. Nestares MT, Salinas M, De Teresa C et al. Risk factors related with lifestyle in patients with musculoskeletal disorders. Nutr Hosp 2017; 34 (2): 444–53. DOI: 10.20960/nh.237
17. Котова О.В., Акарачкова Е.С. Кеторолак: применение, эффективность, безопасность. Неврология и ревматология (Прил. к жур. Consilium Medicum). 2016; 1: 70–3.[Kotova O.V., Akarachkova E.S. Ketorolac: application, effectiveness, safety. Neurology and Rheumatology (Suppl. Consilium Medicum). 2016; 1: 70–3 (in Russian).]
18. Котова О.В., Акарачкова Е.С. Нежелательные явления нестероидных противовоспалительных препаратов: возможные варианты выхода из ситуации. Consilium Medicum. 2017; 19 (2.2. Неврология и Ревматология): 85–90.
[Kotova O.V., Akarachkova E.S. Undesirable effects of non-steroidal anti-inflammatory drugs: possible options for resolving the situation. Consilium Medicum. 2017; 19 (2.2. Neurology and Rheumatology): 85–90 (in Russian).]
19. Van Tulder MW, Touray T, Furlan AD et al. Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the Cochrane collaboration. Spine 2003; 28 (17): 1978–92. DOI: 10.1097/01.BRS.0000090503.38830.AD
20. Geller M, Mibielli MA, Nunes CP et al. Comparison of the action of diclofenac alone versus diclofenac plus B vitamins on mobility in patients with low back pain. J Drug Assess 2016; 5 (1): 1–3.
21. Mibielli MA, Geller M, Cohen JC et al. Diclofenac plus B vitamins versus diclofenac monotherapy in lumbago: The DOLOR study. Curr Med Res Opin 2009; 25: 2589–99.
22. Buesing S, Costa M, Schilling JM, Moeller-Bertram T. Vitamin B12 as a Treatment for Pain. Pain Physician 2019; 22 (1): E45–E52.
23. Smith ME, Morton DG. The Digestive System. 2nd ed. London, England: Churchill Livingstone; 2010.
24. Nehra AK, Alexander JA, Loftus CG, Nehra V. Proton pump inhibitors: Review of emerging concerns. Mayo Clin Proc 2018; 93: 240–6.
25. Force RW, Nahata MC. Effect of histamine H2-receptor antagonists on vitamin B12 absorption. Ann Pharmacother 1992; 26: 1283–6.
26. Kornerup LS, Hvas CL, Abild CB et al. Early changes in vitamin B12 uptake and biomarker status following Roux-en-Y gastric bypass and sleeve gastrectomy [published online ahead of print February 15, 2018]. Clin Nutr DOI: 10.1016/j.clnu.2018.02.007
27. Madanchi M, Fagagnini S, Fournier N et al; Swiss IBD Cohort Study Group. The relevance of vitamin and iron deficiency in patients with inflammatory bowel diseases in patients of the Swiss IBD Cohort. Inflamm Bowel Dis 2018; 24: 1768–79. DOI: 10.1093/ibd/izy054
28. Kim S, Lim IK, Park GH, Paik WK. Biological methylation of myelin basic protein: Enzymology and biological significance. Int J Biochem Cell Biol 1997; 29: 743–51.
29. Suzuki K, Tanaka H, Ebara M et al. Electrospun nanofiber sheets incorporating methylcobalamin promote nerve regeneration and functional recovery in a rat sciatic nerve crush injury model. Acta Biomater 2017; 53: 250–9.
30. Okada K, Tanaka H, Temporin K et al. Methylcobalamin increases Erk1/2 and Akt activities through the methylation cycle and promotes nerve regeneration in a rat sciatic nerve injury model. Exp Neurol 2010; 222: 191–203.
31. Tamaddonfard E, Farshid AA, Samadi F, Eghdami K. Effect of vitamin B12 on functional recovery and histopathologic changes of tibial nerve-crushed rats. Drug Res 2014; 64: 470–5.
32. Sun H, Yang T, Li Q et al. Dexamethasone and vitamin B(12) synergistically promote peripheral nerve regeneration in rats by upregulating the expression of brain-derived neurotrophic factor. Arch Med Sci 2012; 8: 924–30.
33. Hong L, Zhang J, Shen J. Clinical efficacy of different doses of lipo-prostaglandin E1 in the treatment of painful diabetic peripheral neuropathy. J Diabetes Complications 2015; 29: 1283–6.
34. Chen M, Peyrin-Biroulet L, George A et al. Methyl deficient diet aggravates experimental colitis in rats. J Cell Mol Med 2011; 15: 2486–97.
35. Padi SSV, Naidu PS, Kulkarni SK. Involvement of peripheral prostaglandins in formalin-induced nociceptive behaviours in the orofacial area of rats. Inflammopharmacology 2006; 14: 57–61.
36. Erfanparast A, Escort M, Tamaddonfard E et al. Systemic and local peripheral injections of vitamin B12 suppressed orofacial nociception induced by formalin in rats. Drug Res 2014; 64: 85–90.
37. Hosseinzadeh H, Moallem SA, Moshiri M et al. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung 2012; 62: 324–9.
38. Bhatia P, Singh N. Homocysteine excess: Delineating the possible mechanism of neurotoxicity and depression. Fundam Clin Pharmacol 2015; 29: 522–8.
39. Bottiglieri T, Laundy M, Crellin R et al. Homocysteine, folate, methylation, and monoamine metabolism in depression. J Neurol Neurosurg Psychiatry 2000; 69: 228–32.
40. Martí-Carvajal AJ, Solà I, Lathyris D. Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev 2015; 1: CD006612.
41. Hosseinzadeh H, Moallem SA, Moshiri M et al. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung 2012; 62: 324–9.
42. Deng X-T, Han Y, Liu W-T, Song X-J. B Vitamins potentiate acute morphine antinociception and attenuate the development of tolerance to chronic morphine in mice. Pain Med 2017; 18: 1961–74. DOI: 10.1093/pm/pnw358
43. Ghazanfari S, Imenshahidi M, Etemad L et al. Effect of cyanocobalamin (vitamin B12) in the induction and expression of morphine tolerance and dependence in mice. Drug Res 2014; 64: 113–7.
44. Dimpfel W, Spüler M, Bonke D. Influence of repeated vitamin B administration on the frequency pattern analysed from rat brain electrical activity (TeleStereo-EEG). Klin Wochenschr 1990; 68: 136–41.
45. Mauro GL, Martorana U, Cataldo P et al. Vitamin B12 in low back pain: A randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci 2000; 4: 53–8.
46. Chiu CK, Low TH, Tey YS et al. The efficacy and safety of intramuscular injections of methylcobalamin in patients with chronic nonspecific low back pain: A randomised controlled trial. Singapore Med J 2011; 52: 868–73.
47. Беляев А.А., Котова О.В., Акарачкова Е.С. Кардиальная автономная невропатия у больных сахарным диабетом. Мед. совет. 2019; 1: 52–6.
[Beliaev A.A., Kotova O.V., Akarachkova E.S. Kardial'naia avtonomnaia nevropatiia u bol'nykh sakharnym diabetom. Med. sovet. 2019; 1: 52–6 (in Russian).]
48. Котова О.В., Акарачкова Е.С., Беляев А.А. Неврологические осложнения сахарного диабета. Мед. совет. 2019; 9: 40–4.
[Kotova O.V., Akarachkova E.S., Beliaev A.A. Nevrologicheskie oslozhneniia sakharnogo diabeta. Med. sovet. 2019; 9: 40–4 (in Russian).]
49. Котова О.В., Акарачкова Е.С. Диабетическая автономная полинейропатия. Журн. неврологии и психиатрии им. C.C.Корсакова. 2017; 117 (2): 169–73.
[Kotova O.V., Akarachkova E.S. Diabeticheskaia avtonomnaia polineiropatiia. Zhurn. nevrologii i psikhiatrii im. C.C.Korsakova. 2017; 117 (2): 169–73 (in Russian).]
50. Куцемелов И.Б., Беркут О.А., Кушнарева В.В., Постникова А.С. Алгоритмы и клинические рекомендации по использованию препарата Нейромультивит в неврологической практике. РМЖ. Медицинское обозрение. 2014; 31: 2186.
[Kutsemelov I.B., Berkut O.A., Kushnareva V.V., Postnikova A.S. Algoritmy i klinicheskie rekomendatsii po ispol'zovaniiu preparata Neiromul'tivit v nevrologicheskoi praktike. RMZh. Meditsinskoe obozrenie. 2014; 31: 2186 (in Russian).]
51. Котова О.В. Диабетическая автономная полиневропатия. Фарматека. 2012; 6: 40–4.
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52. Shipton MJ, Thachil J. Vitamin B12 deficiency – A 21st century perspective. Clin Med (Lond) 2015; 15 (2): 145–50. DOI: 10.7861/clinmedicine.15-2-145
53. Wang H, Li L, Qin LL et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev 2018; 3: CD004655. DOI: 10.1002/14651858.CD004655.pub3
54. Froud R, Patterson S, Eldridge S et al. A systematic review and meta-synthesis of the impact of low back pain on people’s lives. BMC Musculoskelet Dis 2014; 15: 50.
55. Беляев А.А., Котова О.В., Акарачкова Е.С., Климов Л.В. Боль в спине. Медикаментозные и немедикаментозные подходы к терапии. Неврология и ревматология. (Прил. к жур. Consilium Medicum). 2018; 2: 26–9. DOI: 10.26442/2414357X.2018.2.000054
[Belyaev A.A., Kotova O.V., Akarachkova E.S., Klimov L.V. Back pain. Drug and non-drug approaches to its treatment. Neurology and Rheumatology (Suppl. Consilium Medicum). 2018; 2: 26–9. DOI: 10.26442/2414357X.2018.2.000054 (in Russian).]
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35. Padi SSV, Naidu PS, Kulkarni SK. Involvement of peripheral prostaglandins in formalin-induced nociceptive behaviours in the orofacial area of rats. Inflammopharmacology 2006; 14: 57–61.
36. Erfanparast A, Escort M, Tamaddonfard E et al. Systemic and local peripheral injections of vitamin B12 suppressed orofacial nociception induced by formalin in rats. Drug Res 2014; 64: 85–90.
37. Hosseinzadeh H, Moallem SA, Moshiri M et al. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung 2012; 62: 324–9.
38. Bhatia P, Singh N. Homocysteine excess: Delineating the possible mechanism of neurotoxicity and depression. Fundam Clin Pharmacol 2015; 29: 522–8.
39. Bottiglieri T, Laundy M, Crellin R et al. Homocysteine, folate, methylation, and monoamine metabolism in depression. J Neurol Neurosurg Psychiatry 2000; 69: 228–32.
40. Martí-Carvajal AJ, Solà I, Lathyris D. Homocysteine-lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev 2015; 1: CD006612.
41. Hosseinzadeh H, Moallem SA, Moshiri M et al. Anti-nociceptive and anti-inflammatory effects of cyanocobalamin (vitamin B12) against acute and chronic pain and inflammation in mice. Arzneimittelforschung 2012; 62: 324–9.
42. Deng X-T, Han Y, Liu W-T, Song X-J. B Vitamins potentiate acute morphine antinociception and attenuate the development of tolerance to chronic morphine in mice. Pain Med 2017; 18: 1961–74. DOI: 10.1093/pm/pnw358
43. Ghazanfari S, Imenshahidi M, Etemad L et al. Effect of cyanocobalamin (vitamin B12) in the induction and expression of morphine tolerance and dependence in mice. Drug Res 2014; 64: 113–7.
44. Dimpfel W, Spüler M, Bonke D. Influence of repeated vitamin B administration on the frequency pattern analysed from rat brain electrical activity (TeleStereo-EEG). Klin Wochenschr 1990; 68: 136–41.
45. Mauro GL, Martorana U, Cataldo P et al. Vitamin B12 in low back pain: A randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci 2000; 4: 53–8.
46. Chiu CK, Low TH, Tey YS et al. The efficacy and safety of intramuscular injections of methylcobalamin in patients with chronic nonspecific low back pain: A randomised controlled trial. Singapore Med J 2011; 52: 868–73.
47. Beliaev A.A., Kotova O.V., Akarachkova E.S. Kardial'naia avtonomnaia nevropatiia u bol'nykh sakharnym diabetom. Med. sovet. 2019; 1: 52–6 (in Russian).
48. Kotova O.V., Akarachkova E.S., Beliaev A.A. Nevrologicheskie oslozhneniia sakharnogo diabeta. Med. sovet. 2019; 9: 40–4 (in Russian).
49. Kotova O.V., Akarachkova E.S. Diabeticheskaia avtonomnaia polineiropatiia. Zhurn. nevrologii i psikhiatrii im. C.C.Korsakova. 2017; 117 (2): 169–73 (in Russian).
50. Kutsemelov I.B., Berkut O.A., Kushnareva V.V., Postnikova A.S. Algoritmy i klinicheskie rekomendatsii po ispol'zovaniiu preparata Neiromul'tivit v nevrologicheskoi praktike. RMZh. Meditsinskoe obozrenie. 2014; 31: 2186 (in Russian).
51. Kotova O.V. Diabeticheskaia avtonomnaia polinevropatiia. Farmateka. 2012; 6: 40–4 (in Russian).
52. Shipton MJ, Thachil J. Vitamin B12 deficiency – A 21st century perspective. Clin Med (Lond) 2015; 15 (2): 145–50. DOI: 10.7861/clinmedicine.15-2-145
53. Wang H, Li L, Qin LL et al. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database Syst Rev 2018; 3: CD004655. DOI: 10.1002/14651858.CD004655.pub3
54. Froud R, Patterson S, Eldridge S et al. A systematic review and meta-synthesis of the impact of low back pain on people’s lives. BMC Musculoskelet Dis 2014; 15: 50.
55. Belyaev A.A., Kotova O.V., Akarachkova E.S., Klimov L.V. Back pain. Drug and non-drug approaches to its treatment. Neurology and Rheumatology (Suppl. Consilium Medicum). 2018; 2: 26–9. DOI: 10.26442/2414357X.2018.2.000054 (in Russian).
Авторы
А.А. Беляев1, О.В. Котова*2, Е.С. Акарачкова2
1 ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского» Департамента здравоохранения г. Москвы, Москва, Россия;
2 АНО «Международное общество "Стресс под контролем"», Москва, Россия
*ol_kotova@mail.ru
1 Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia;
2 International Society “Stress under Control”, Moscow, Russia
*ol_kotova@mail.ru
1 ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского» Департамента здравоохранения г. Москвы, Москва, Россия;
2 АНО «Международное общество "Стресс под контролем"», Москва, Россия
*ol_kotova@mail.ru
________________________________________________
1 Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia;
2 International Society “Stress under Control”, Moscow, Russia
*ol_kotova@mail.ru
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