Современные достижения в лечении гастроэзофагеальной рефлюксной болезни: фокус на эзофагопротекцию
Современные достижения в лечении гастроэзофагеальной рефлюксной болезни: фокус на эзофагопротекцию
Маев И.В., Андреев Д.Н., Кучерявый Ю.А., Шабуров Р.И. Современные достижения в лечении гастроэзофагеальной рефлюксной болезни: фокус на эзофагопротекцию. Терапевтический архив. 2019; 91 (8): 4–11. DOI: 10.26442/00403660.2019.08.000387
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Аннотация
Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) характеризуется высокой заболеваемостью и значительным снижением качества жизни пациентов, а также является основным фактором риска развития аденокарциномы пищевода. На сегодняшний день антисекреторная терапия с использованием ингибиторов протонной помпы (ИПП) является «золотым стандартом» консервативного лечения ГЭРБ, однако в ряде случаев данная терапия оказывается безуспешной. Согласно различным исследованиям, частота рефрактерной ГЭРБ может достигать 30–40%. Последние научные данные в области генетики и патофизиологии ГЭРБ демонстрируют, что нарушение барьерной функции слизистой оболочки пищевода и увеличение ее проницаемости может служить одной из ведущих причин рефрактерности. Таким образом, оптимальная терапия пациентов с ГЭРБ должна быть направлена не только на подавление секреции соляной кислоты, но и на восстановление барьерной функции слизистой оболочки, обеспечивая эзофагопротективное действие. Для достижения этих целей разработан продукт Альфазокс, состоящий из смеси низкомолекулярной гиалуроновой кислоты и низкомолекулярного хондроитин сульфата, растворенных в биоадгезивном носителе (полоксамер 407). Клиническая эффективность данного продукта подтверждена тремя проспективными рандомизированными плацебо-контролируемыми исследованиями. Альфазокс оказывает заживляющее и восстанавливающее действие по отношению к эпителию пищевода, а благодаря высокой способности к биоадгезии обеспечивает защиту слизистой оболочки органа в течение длительного времени. Комбинированная терапия ГЭРБ с применением ИПП и эзофагопротекторов открывает новые перспективы ведения пациентов с ГЭРБ.
Ключевые слова: гастроэзофагеальная рефлюксная болезнь, лечение, рефрактерность, эзофагопротекция, Альфазокс, гиалуроновая кислота, хондроитин сульфат.
Keywords: gastroesophageal reflux disease, treatment, refractoriness, esophagoprotective, Alfasoxx, Esoxx, hyaluronic acid, chondroitin sulfate.
Ключевые слова: гастроэзофагеальная рефлюксная болезнь, лечение, рефрактерность, эзофагопротекция, Альфазокс, гиалуроновая кислота, хондроитин сульфат.
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Keywords: gastroesophageal reflux disease, treatment, refractoriness, esophagoprotective, Alfasoxx, Esoxx, hyaluronic acid, chondroitin sulfate.
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Авторы
И.В. Маев, Д.Н. Андреев, Ю.А. Кучерявый, Р.И. Шабуров
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва, Россия
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Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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