В Москве 30 сентября 2017 г. при поддержке педиатрического респираторного общества состоялось заседание дискуссионного клуба «Спорные и нерешенные вопросы в терапии кашля у детей в амбулаторной практике», объединившее ведущих российских экспертов в области педиатрии, пульмонологии, иммунологии и оториноларингологии. предлагаем вашему вниманию согласованное мнение экспертов.
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In Moscow, on September 30, 2017, with the support of the Pediatric Respiratory Society, a meeting of the Discussion Club "Controversial and Unresolved Issues in the Treatment of Cough in Children in Outpatient Practice" was held, bringing together leading Russian experts in pediatrics, pulmonology, immunology and otorhinolaryngology. We bring to your attention the agreed opinion of experts.
1. Геппе Н.А., Дронов И.А., Баяндина Г.Н. Терапевтическая тактика при острых респираторных инфекциях у детей. Доктор. Ру. 2017; 4 (133). / Geppe N.A., Dronov I.A., Baiandina G.N. Terapevticheskaia taktika pri ostrykh respiratornykh infektsiiakh u detei. Doktor. Ru. 2017; 4 (133). [in Russian]
2. Захарова И.Н., Дмитриева Ю.А. Дифференцированный подход к терапии кашля у детей. РМЖ. 2013; 24: 1153. / Zakharova I.N., Dmitrieva Iu.A. Differentsirovannyi podkhod k terapii kashlia u detei. RMZh. 2013; 24: 1153. [in Russian]
3. Worrall G. Acute cough in children. Can Fam Physician 2011; 57 (3): 315–8.
4. Косенкова Т.В. Особенности муколитической терапии в педиатрической практике. Лекция. Вопр. практической педиатрии. 2016; 4 (11). / Kosenkova T.V. Osobennosti mukoliticheskoi terapii v pediatricheskoi praktike. Lektsiia. Vopr. prakticheskoi pediatrii. 2016; 4 (11). [in Russian]
5. Shields MD, Thavagnanam S. The difficult coughing child: prolonged acute cough in children. Cough 2013; 9 (1): 11.
6. Chang AB et al. Use of Management Pathways or Algorithms in Children With Chronic Cough: CHEST Guideline and Expert Panel Report. Chest 2017; 151 (4): 875–83.
7. Kantar A. Update on Pediatric Cough. Lung 2016; 194 (1): 9–14.
8. Chang AB. Cough: are children really different to adults? Cough Lond Engl 2005; 1: 7.
9. Дворецкий Л.И. Муколитические и мукорегулирующие препараты в лечении хронического бронхита. РМЖ. 2005; 15: 1012. / Dvoretskii L.I. Mukoliticheskie i mukoreguliruiushchie preparaty v lechenii khronicheskogo bronkhita. RMZh. 2005; 15: 1012. [in Russian]
10. Комплексный подход к лечению и профилактике острых респираторных инфекций у детей. Практическое руководство для врачей. Под ред. Н.А.Геппе, А.Б.Малахова. М., 2012. / Kompleksnyi podkhod k lecheniiu i profilaktike ostrykh respiratornykh infektsii u detei. Prakticheskoe rukovodstvo dlia vrachei. Pod red. N.A.Geppe, A.B.Malakhova. M., 2012. [in Russian]
11. Goldman RD. Treating cough and cold: Guidance for caregivers of children and youth. Paediatr Child Health 2011; 16 (9): 564–6.
12. Колосова Н.Г., Шахназарова М.Д., Шаталина С.И. Диагностика и лечение кашля у детей. Мед. совет. 2017; 1: 140–3. / Kolosova N.G., Shakhnazarova M.D., Shatalina S.I. Diagnostika i lechenie kashlia u detei. Med. sovet. 2017; 1: 140–3. [in Russian]
13. Зайцева О.В. Муколитические препараты в терапии болезней органов дыхания у детей: современный взгляд на проблему. РМЖ. 2003; 1: 49. / Zaitseva O.V. Mukoliticheskie preparaty v terapii boleznei organov dykhaniia u detei: sovremennyi vzgliad na problemu. RMZh. 2003; 1: 49. [in Russian]
14. Сорока Ю.А., Прохорова И.Н. Муколитическая терапия в педиатрической практике. Здоровье ребенка. 2010; 1: 73–8. / Soroka Iu.A., Prokhorova I.N. Mukoliticheskaia terapiia v pediatricheskoi praktike. Zdorov'e rebenka. 2010; 1: 73–8. [in Russian]
15. Самсыгина Г.А., Зайцева О.В., Корнюшин М.А. Бронхиты у детей. Отхаркивающая и муколитическая терапия. М., 1999. / Samsygina G.A., Zaitseva O.V., Korniushin M.A. Bronkhity u detei. Otkharkivaiushchaia i mukoliticheskaia terapiia. M., 1999. [in Russian]
16. Василевский И.В. Иммунологические аспекты оздоровления часто болеющих детей. Мед. панорама. 2003; 1: 43–6. / Vasilevskii I.V. Immunologicheskie aspekty ozdorovleniia chasto boleiushchikh detei. Med. panorama. 2003; 1: 43–6. [in Russian]
17. Илькович М.М., Гембицкая Т.Е., Панина Н.Т. Фармакологическая коррекция нарушений мукоцилиарного клиренса у больных острыми и хроническими заболеваниями легких. Пульмонология. 2009; 6: 101–6. / Il'kovich M.M., Gembitskaia T.E., Panina N.T. Farmakologicheskaia korrektsiia narushenii mukotsiliarnogo klirensa u bol'nykh ostrymi i khronicheskimi zabolevaniiami legkikh. Pul'monologiia. 2009; 6: 101–6. [in Russian]
18. Кобылянский В.И., Окунева Е.Ю. Коррекция мукоцилиарной недостаточности: возможности и перспективы. Тер. архив. 2006; 3: 74–84. / Kobylianskii V.I., Okuneva E.Iu. Korrektsiia mukotsiliarnoi nedostatochnosti: vozmozhnosti i perspektivy. Ter. arkhiv. 2006; 3: 74–84. [in Russian]
19. Козлов В.С., Шиленкова В.В., Азатян А.С., Крамной А.И. Мукоцилиарный транспорт и двигательная активность цилиарного аппарата слизистой оболочки носа у больных хроническим полипозным риносинуситом. Вестн. оториноларингологии. 2008; 2: 10–3. / Kozlov V.S., Shilenkova V.V., Azatian A.S., Kramnoi A.I. Mukotsiliarnyi transport i dvigatel'naia aktivnost' tsiliarnogo apparata slizistoi obolochki nosa u bol'nykh khronicheskim polipoznym rinosinusitom. Vestn. otorinolaringologii. 2008; 2: 10–3. [in Russian]
20. Озерская И.В., Геппе Н.А., Малявина У.С. Мукоцилиарная система респираторного тракта при бронхиальной астме и аллергическом рините. Лечащий доктор. 2011; 9: 17–20. / Ozerskaia I.V., Geppe N.A., Maliavina U.S. Mukotsiliarnaia sistema respiratornogo trakta pri bronkhial'noi astme i allergicheskom rinite. Lechashchii doktor. 2011; 9: 17–20. [in Russian]
21. Рачинский С.В., Таточенко В.К. Болезни органов дыхания у детей. М.: Медицина, 1987. / Rachinskii S.V., Tatochenko V.K. Bolezni organov dykhaniia u detei. M.: Meditsina, 1987. [in Russian]
22. Мельникова И.М., Мизерницкий Ю.Л., Батожаргалова Б.Ц., Логиневская Я.В. Современные принципы муколитической терапии у детей с острыми и хроническими бронхолегочными заболеваниями. Рос. вестн. перинатологии и педиатрии. 2011; 2 (56): 45–50. / Mel'nikova I.M., Mizernitskii Iu.L., Batozhargalova B.Ts., Loginevskaia Ia.V. Sovremennye printsipy mukoliticheskoi terapii u detei s ostrymi i khronicheskimi bronkholegochnymi zabolevaniiami. Ros. vestn. perinatologii i pediatrii. 2011; 2 (56): 45–50. [in Russian]
23. Симонова О.И. Муколитики в педиатрической практике: рациональный выбор, лечебные эффекты и особенности терапии. Вопр. соврем. педиатрии. 2013; 12 (4): 136–41. / Simonova O.I. Mukolitiki v pediatricheskoi praktike: ratsional'nyi vybor, lechebnye effekty i osobennosti terapii. Vopr. sovrem. pediatrii. 2013; 12 (4): 136–41. [in Russian]
24. Новикова Л., Баранова О., Илькович Ю. Применение ацетилцистеина в клинической пульмонологии. Врач. 2014; 2: 13–6. / Novikova L., Baranova O., Il'kovich Iu. Primenenie atsetiltsisteina v klinicheskoi pul'monologii. Vrach. 2014; 2: 13–6. [in Russian]
25. Braga P, Ziment I, Allegra L. Classification of agents that act on bronchial mucus. Drugs in Bronchial Mucology. New York: Raven Press, 1989; p. 59–67.
26. Государственный реестр лекарственных средств http://sites.reformal.ru/ grls.rosminzdrav.ru/ / Gosudarstvennyi reestr lekarstvennykh sredstv http://sites.reformal.ru/grls.rosminzdrav.ru/ [in Russian]
27. Малахов А.Б., Колосова Н.Г. и др. Терапевтические эффекты амброксола: новые свойства знакомого препарата. Педиатрия (Прил. к журн. Consilium Medicum.). 2016; 2: 33–6. / Malakhov A.B., Kolosova N.G., Shakhnazarova M.D. et al. Therapeutic effects of ambroxol: new features of a well-known medication. Pediatrics (Suppl. Consilium Medicum). 2016; 2: 33–36. [in Russian]
28. Беседина М.В. Ацетилцистеин – новый «старый знакомый». Практика педиатра. 2007; 5: 64–6. / Besedina M.V. Atsetiltsistein – novyi «staryi znakomyi». Praktika pediatra. 2007; 5: 64–6. [in Russian]
29. Livingstone CR et al. Model systems for the evaluation of mucolytic drugs: acetylcysteine and S-carboxymethylcysteine. J Pharm Pharmacol 1990; 42 (2): 73–8.
30. Зайцева О.В. Рациональный выбор муколитической терапии в лечении болезней органов дыхания у детей. РМЖ. 2009; 19: 1217–22. / Zaitseva O.V. Ratsional'nyi vybor mukoliticheskoi terapii v lechenii boleznei organov dykhaniia u detei. RMZh. 2009; 19: 1217–22. [in Russian]
31. Симонова О.И. Простые ответы на сложные вопросы о муколитиках для детей. Вопр. современ. педиатрии. 2015; 14 (4): 509–13. / Simonova O.I. Prostye otvety na slozhnye voprosy o mukolitikakh dlia detei. Vopr. sovremen. pediatrii. 2015; 14 (4): 509–13. [in Russian]
32. Ушкалова Е.А. Ацетилцистеин в клинической практике: настоящее и перспективы. Фарматека. 2007; 17: 30–6. / Ushkalova E.A. Atsetiltsistein v klinicheskoi praktike: nastoiashchee i perspektivy. Farmateka. 2007; 17: 30–6. [in Russian]
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38. Овсянников Д.Ю., Духанин А.С. Мукоактивная терапия у детей: взгляд педиатра и фармаколога. Вопр. практической педиатрии. 2016; 11 (4): 24–32. / Ovsiannikov D.Iu., Dukhanin A.S. Mukoaktivnaia terapiia u detei: vzgliad pediatra i farmakologa. Vopr. prakticheskoi pediatrii. 2016; 11 (4): 24–32. [in Russian]
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53. Roveta A, Debbia E, Schito G, Marchese A. Comparison of the activity of N-acetylctsteine, ambroxol, bromexine and sobrerol on Staphylococcus aureus biofilms. GIMMOC 2004; 8: 1–12.
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77. Локшина Э.Э., Зайцева С.В., Зайцева О.В. Новые возможности муколитической терапии у детей с острыми респираторными заболеваниями. Вопр. практ. педиатрии. 2011; 6 (1): 67–72. / Lokshina E.E., Zaitseva S.V., Zaitseva O.V. Novye vozmozhnosti mukoliticheskoi terapii u detei s ostrymi respiratornymi zabolevaniiami. Vopr. prakt. pediatrii. 2011; 6 (1): 67–72. [in Russian]
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80. Ernst E et al. Adverse drug reactions to herbal and synthetic expectorants. Int J Risk Safety Med 1995; 7: 219–25.
81. Локшина Э.Э., Зайцева О.В. Эффективность и безопасность ацетилцистеина в педиатрической практике. Педиатрия (Прил. к журн. Consilium Medicum). 2012; 1: 72–6. / Lokshina E.E., Zaitseva O.V. Effektivnost' i bezopasnost' atsetiltsisteina v pediatricheskoi praktike. Pediatrics (Suppl. Consilium Medicum). 2012; 1: 72–6. [in Russian]
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86. Муковисцидоз. Современные достижения и актуальные проблемы. Методические рекомендации. Изд. 4-е, перераб. и доп. Под ред. Н.И.Капранова, Н.Ю.Каширской. М.: МГНЦ, 2011. / Mukovistsidoz. Sovremennye dostizheniia i aktual'nye problemy. Metodicheskie rekomendatsii. Izd. 4-e, pererab. i dop. Pod red. N.I.Kapranova, N.Iu.Kashirskoi. M.: MGNTs, 2011. [in Russian]
87. Чикина С.Ю. Флуимуцил: разнообразие лекарственных форм и способов доставки. Пульмонология и аллергология. 2007; 3: 42–6. / Chikina S.Iu. Fluimutsil: raznoobrazie lekarstvennykh form i sposobov dostavki. Pul'monologiia i allergologiia. 2007; 3: 42–6. [in Russian]
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89. Сорока Н.Д. Муколитическая терапия затяжных вариантов течения заболеваний органов дыхания у детей. Вопр. современ. педиатрии. 2008; 7 (4): 111–4. / Soroka N.D. Mukoliticheskaia terapiia zatiazhnykh variantov techeniia zabolevanii organov dykhaniia u detei. Vopr. sovremen. pediatrii. 2008; 7 (4): 111–4. [in Russian]
90. Симонова О.И. Особенности применения и эффективность N-ацетилцистеина при респираторной патологии у детей. Врач. 2010; 2: 56–61. / Simonova O.I. Osobennosti primeneniia i effektivnost' N-atsetiltsisteina pri respiratornoi patologii u detei. Vrach. 2010; 2: 56–61. [in Russian]
91. Симонова О.И. Особенности применения муколитиков прямого типа действия в практике педиатра. Вопр. современ. педиатрии. 2011; 1 (10): 153–9. / Simonova O.I. Osobennosti primeneniia mukolitikov priamogo tipa deistviia v praktike pediatra. Vopr. sovremen. pediatrii. 2011; 1 (10): 153–9. [in Russian]
92. Муколитики в борьбе с кашлем. Материалы ХVIII Российского национального конгресса «Человек и лекарство». Эффективная фармакотерапия. Пульмонология и оториноларингология. 2011; 3. / Mukolitiki v bor'be s kashlem. Materialy KhVIII Rossiiskogo natsional'nogo kongressa «Chelovek i lekarstvo». Effektivnaia farmakoterapiia. Pul'monologiia i otorinolaringologiia. 2011; 3. [in Russian]
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1. Geppe N.A., Dronov I.A., Baiandina G.N. Terapevticheskaia taktika pri ostrykh respiratornykh infektsiiakh u detei. Doktor. Ru. 2017; 4 (133). [in Russian]
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1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
2 ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
3 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
4 ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф.Войно-Ясенецкого» Минздрава России. 660022, Россия, Красноярск, ул. Партизана Железняка, д. 1;
5 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1;
6 ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России. 119991, Россия, Москва, Ломоносовский пр-т, д. 2, стр. 1;
7 ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И.Мечникова» Минздрава России. 191015, Россия, Санкт-Петербург, ул. Кирочная, д. 41;
8 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России. 197022, Россия, Санкт-Петербург, ул. Льва Толстого, д. 6/8;
9 ГБУЗ СО «Областная детская клиническая больница №1». 620149, Россия, Екатеринбург, ул. С.Дерябиной, д. 32;
10 ФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава России. 450008, Россия, республика Башкортостан, Уфа, ул. Ленина, д. 3
1 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
2 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
3 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
4 Prof. V.F.Voino-Yasenetski Krasnoyarsk State Medical University of the Ministry of Health of the Russian Federation. 660022, Russian Federation, Krasnoyarsk, ul. Partizana Zhelezniaka, d. 1;
5 Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1;
6 National Medical Research Center of Children's Health of the Ministry of Health of the Russian Federation. 119991, Russia, Moscow, Lomonosovsky pr-t, d. 2, str. 1;
7 I.I.Mechnikov State Northwestern Medical University of the Ministry of Health of the Russian Federation. 191015, Russian Federation, Saint Petersburg, ul. Kirochnaia, d. 41;
8 I.P.Pavlov First Saint Petersburg State Medical University of the Ministry of Health of the Russian Federation. 197022, Russian Federation, Saint Petersburg, ul. L'va Tolstogo, d. 6/8;
9 Regional Children's Clinical Hospital №1. 620149, Russian Federation, Ekaterinburg, ul. S.Deriabinoi, d. 32;
10 Bashkir State Medical University. 450008, Russian Federation, Bashkortostan republic, Ufa, ul. Lenina, d. 3