medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-114medsovet-10080Research ArticleНЕВРОЛОГИЯ, ПСИХИАТРИЯNEUROLOGY AND PSYCHIATRYЭнтеросорбенты в комплексной терапии алкогольного абстинентного синдромаEnterosorbents in the combination therapy of alcohol withdrawal syndromehttps://orcid.org/0000-0001-7226-8485ПахомоваС. А.PakhomovaS. A.

Пахомова Светлана Александровна, к.м.н., доцент кафедры психиатрии, наркологии, психотерапии и клинической психологии

410012, Саратов, ул. Б. Казачья, д. 112

Svetlana A. Pakhomova, Cand. Sci. (Med.), Associate Professor, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

112, Bolshaya Kazachya St., Saratov, 410012

sve-pakhomova@yandex.ruhttps://orcid.org/0000-0001-6837-5894БарыльникЮ. Б.BarylnikYu. B.

Барыльник Юлия Борисовна, д.м.н., заведующая кафедрой психиатрии, наркологии, психотерапии и клинической психологии

410012, Саратов, ул. Б. Казачья, д. 112

Yulia B. Barylnik, Dr. Sci. (Med.), Head of the Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

112, Bolshaya Kazachya St., Saratov, 410012

juljab@yandex.ruhttps://orcid.org/0000-0002-2102-164XРунноваА. Е.RunnovaA. E.

Руннова Анастасия Евгеньевна, д.ф.-м.н., заведующая кафедрой биофизики и цифровых технологий

410012, Саратов, ул. Б. Казачья, д. 112

Anastasiya E. Runnova, Dr. Sci. (Phys. and Math.), Head of the Department of Biophysics and Digital Technologies

112, Bolshaya Kazachya St., Saratov, 410012

a.e.runnova@gmail.comhttps://orcid.org/0000-0002-7138-4852АбросимоваЮ. С.AbrosimovaJu. S.

Абросимова Юлия Сергеевна, к.м.н., доцент кафедры психиатрии, наркологии, психотерапии и клинической психологии

410012, Саратов, ул. Б. Казачья, д. 112

Julia S. Abrosimova, Cand. Sci. (Med.), Associate Professor, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

112, Bolshaya Kazachya St., Saratov, 410012

julia-abrosimova@yandex.ruhttps://orcid.org/0000-0001-7019-9877ГаниловаЮ. А.GanilovaYu. A.

Ганилова Юлия Александровна, старший преподаватель кафедры биофизики и цифровых технологий

410012, Саратов, ул. Б. Казачья, д. 112

Yulia A. Ganilova, Senior Lecturer, Department of Biophysics and Digital Technologies,

112, Bolshaya Kazachya St., Saratov, 410012

ganilova@yandex.ruМакарянЕ. С.MakaryanE. S.

Макарян Елена Самвеловна, ассистент кафедры психиатрии, наркологии, психотерапии и клинической психологии

410012, Саратов, ул. Б. Казачья, д. 112

Elina S. Makaryan, Assistant, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

112, Bolshaya Kazachya St., Saratov, 410012

makarian.elena@yandex.ruhttps://orcid.org/0009-0004-4055-5817КасимовО. В.KasimovO. V.

Касимов Олег Валерьевич, к.м.н., главный врач УКБ №4, ассистент кафедры психиатрии, наркологии, психотерапии иклинической психологии

410012, Саратов, ул. Б. Казачья, д. 112

Oleg V. Kasimov, Cand. Sci. (Med.), Chief Physician, University Clinical Hospital No. 4, Assistant, Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology

112, Bolshaya Kazachya St., Saratov, 410012

kodvm@mail.ruБакулинЕ. А.BakulinE. A.

Бакулин Егор Алексеевич, врач-ординатор Университетской клинической больницы №4

410012, Саратов, ул. Б. Казачья, д. 112

Egor A. Bakulin, Resident Physician, University Clinical Hospital No. 4

112, Bolshaya Kazachya St., Saratov, 410012

bakulinegor14@yandex.ruСаратовский государственный медицинский университет им. В.И. РазумовскогоРоссияSaratov State Medical University named after V.I. RazumovskyRussian Federation2026310520262055463Copyright © Пахомова С.А., Барыльник Ю.Б., Руннова А.Е., Абросимова Ю.С., Ганилова Ю.А., Макарян Е.С., Касимов О.В., Бакулин Е.А., 20262026Пахомова С.А., Барыльник Ю.Б., Руннова А.Е., Абросимова Ю.С., Ганилова Ю.А., Макарян Е.С., Касимов О.В., Бакулин Е.А.Pakhomova S.A., Barylnik Y.B., Runnova A.E., Abrosimova J.S., Ganilova Y.A., Makaryan E.S., Kasimov O.V., Bakulin E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10080Введение

Введение. Алкогольный абстинентный синдром (ААС) остается одной из наиболее значимых клинических проблем в наркологии, а поиск дополнительных обоснованных подходов к терапии сохраняет актуальность. Одним из таких направлений может явиться применение энтеросорбентов.

Цель

Цель. Определить эффективность включения энтеросорбента в комплексную терапию ААС.

Материалы и методы

Материалы и методы. В исследование было включено 60 пациентов с ААС, рандомизированных в 2 группы по 30 человек: группу со стандартной терапией и группу стандартного лечения с добавлением диоксида кремния коллоидного. Оценка эффективности терапии проводилась на 7-й и 14-й день по изменениям клинических симптомов (оценивали с помощью шкал HAM-A, MFI-20, ШОКУА, BIS-11) и лабораторных показателей, тяжесть ААС определяли ежедневно на протяжении 7 дней по шкале CIWA-Ar.

Результаты

Результаты. По суммарному баллу CIWA-Ar статистически значимых межгрупповых различий по отдельным суткам наблюдения не выявлено. Включение диоксида кремния коллоидного в основной группе ассоциировалось со снижением тревоги по шкале HAM-A уже к 7-му дню, наблюдалась более выраженная редукция астенической симптоматики по шкале MFI-20. При анализе обсессивного и компульсивного компонентов патологического влечения к алкоголю по шкале ШОКУА различия между группами в интервале 1–14 дней достигали статистической значимости. Уровень импульсивности по шкале BIS11 снижался в обеих группах к 7-му и к 14-му дням терапии. В основной группе отмечено снижение ГГТ на 7-й и 14-й дни терапии и общего билирубина к 14-му дню.

Выводы

Выводы. Включение диоксида кремния коллоидного в комплексную терапию ААС ассоциировано с более выраженным регрессом тревожной и астенической симптоматики, снижением обсессивно-компульсивного влечения к алкоголю к 14-му дню терапии и более благоприятной динамикой отдельных биохимических показателей.

Introduction

Introduction. Alcohol withdrawal syndrome (AWS) remains one of the most significant clinical problems in addiction medicine, and the search for additional evidence-based therapeutic approaches remains relevant. One such approach may be the use of enterosorbents.

Aim

Aim. To determine the effectiveness of including an enterosorbent in the combination therapy of alcohol withdrawal syndrome.

Materials and methods

Materials and methods. The study included 60 patients with alcohol withdrawal syndrome who were randomized into two groups of 30 patients each: a standard therapy group and a standard therapy plus colloidal silicon dioxide group. Treatment efficacy was assessed on days 7 and 14 based on changes in clinical symptoms, evaluated using the HAM-A, MFI-20, OCDS, and BIS-11 scales, and laboratory parameters. The severity of alcohol withdrawal syndrome was assessed daily for 7 days using the CIWA-Ar scale.

Results

Results. No statistically significant between-group differences in total CIWA-Ar scores were found on any individual day of observation. The addition of colloidal silicon dioxide was associated with a reduction in anxiety according to the HAM-A scale as early as day 7, and this effect persisted until day 14. The main group also showed a more pronounced reduction in asthenic symptoms according to the MFI-20 scale. Analysis of the obsessive and compulsive components of pathological alcohol craving assessed by the Obsessive-Compulsive Drinking Scale showed statistically significant between-group differences over the day 1 to day 14 interval. The BIS-11 score decreased in both groups by days 7 and 14 of therapy. In the main group, decreases in gamma-glutamyl transferase levels were observed on days 7 and 14, and total bilirubin levels decreased by day 14.

Conclusions

Conclusions. The inclusion of colloidal silicon dioxide in the combination therapy of alcohol withdrawal syndrome was associated with a more pronounced reduction in anxiety and asthenic symptoms, a decrease in obsessive-compulsive alcohol craving by day 14 of therapy, and a more favorable trend in selected biochemical parameters.

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The authors declare that there are no conflicts of interest present.