medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-065medsovet-10111Research ArticleИНФЕКЦИИ В ОТОРИНОЛАРИНГОЛОГИИINFECTIONS IN OTORHINOLARYNGOLOGYВозможности патогенетического лечения пациентов с риносинуситами: эффективность и безопасность фитотерапииPossibilities of pathogenetic treatment of rhinosinusitis patients: Efficacy and safety of phytotherapyhttps://orcid.org/0000-0001-7414-1293СвистушкинВ. М.SvistushkinV. M.

Свистушкин Валерий Михайлович - д.м.н., профессор, заведующий кафедрой болезней уха, горла и носа.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Valeriy M. Svistushkin - Dr. Sci. (Med.), Professor, Head of the Department of Ear, Throat and Nose Diseases.

8, Bldg. 2, Trubetskaya St., Moscow, 119048

svistushkin_v_m@staff.sechenov.ruhttps://orcid.org/0000-0002-8617-0179НикифороваГ. Н.NikiforovaG. N.

Никифорова Галина Николаевна - д.м.н., профессор кафедры болезней уха, горла и носа.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Galina N. Nikiforova - Dr. Sci. (Med.), Professor, Department of Ear, Throat and Nose Diseases.

8, Bldg. 2, Trubetskaya St., Moscow, 119048

nikiforova_g_n@staff.sechenov.ruhttps://orcid.org/0000-0002-0051-3792ШевчикЕ. А.ShevchikE. A.

Шевчик Елена Александровна - к.м.н., доцент кафедры болезней уха, горла и носа.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Elena A. Shevchik - Cand. Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases.

8, Bldg. 2, Trubetskaya St., Moscow, 119048

shevchik_e_a@staff.sechenov.ruhttps://orcid.org/0000-0002-3700-7367ЗолотоваА. В.ZolotovaA. V.

Золотова Анна Владимировна - к.м.н., доцент кафедры болезней уха, горла и носа.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Anna V. Zolotova - Cand. Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases.

8, Bldg. 2, Trubetskaya St., Moscow, 119048

zolotova_a_v@staff.sechenov.ruhttps://orcid.org/0009-0000-2037-7284АсевоваХ. М.AsevovaKh. M.

Асевова Халимат Магомедсаидовна - аспирант кафедры болезней уха, горла и носа.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Khalimat M. Asevova - Postgraduate Student of the Department of Ear, Throat and Nose Diseases.

8, Bldg. 2, Trubetskaya St., Moscow, 119048

khalimaasevova@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation202605062026062832Copyright © Свистушкин В.М., Никифорова Г.Н., Шевчик Е.А., Золотова А.В., Асевова Х.М., 20262026Свистушкин В.М., Никифорова Г.Н., Шевчик Е.А., Золотова А.В., Асевова Х.М.Svistushkin V.M., Nikiforova G.N., Shevchik E.A., Zolotova A.V., Asevova K.M.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/10111

Риносинуситы представляют собой распространенную группу воспалительных заболеваний носа и околоносовых пазух, оказывающих значительное влияние на здоровье и качество жизни пациентов. Несмотря на частое назначение по поводу риносинусита системной антибиотикотерапии, большинству пациентов данное этиотропное лечение не показано, практически во всех клинических случаях рациональным является проведение патогенетического лечения. Цель работы – оценить по данным литературы эффективность и безопасность фитотерапии, включая миртол стандартизированный, при лечении пациентов с риносинуситом. Выполнен обзор литературы с использованием баз данных PubMed, Scopus, eLIBRARY.RU и Cochrane Library по ключевым словам: rhinosinusitis, phytotherapy, Myrtol standardized extract, pathogenetic treatment. Рассмотрены как экспериментальные исследования, так и клинические наблюдения. Продемонстрировано, что системная антибиотикотерапия показана лишь небольшой части пациентов с риносинуситом, у которых имеет место бактериальный процесс среднетяжелого и тяжелого течения. Основной упор делается на патогенетическое лечение, включая мукоактивные, противовоспалительные и секретолитические препараты. Фитотерапия, в частности стандартизированный экстракт миртола, демонстрирует доказательства улучшения мукоцилиарного клиренса, снижение воспалительной реакции и облегчение симптомов в эксперименте. Клинические исследования подтверждают безопасность и эффективность стандартизированного экстракта миртола при острых и хронических риносинуситах с минимальным риском нежелательных явлений. Патогенетическое лечение с использованием стандартизированной фитотерапии является перспективным методом ведения пациентов с риносинуситом. Стандартизированный экстракт миртола может быть рекомендован как безопасный и эффективный препарат, особенно у пациентов без показаний к системным антибиотикам.

Rhinosinusitis is a common group of inflammatory diseases of the nose and paranasal sinuses that have a significant impact on the health and quality of life of patients. Despite the frequent appointment of systemic antibiotic therapy for rhinosinusitis, this etiotropic treatment is not indicated in most patients, and pathogenetic treatment is rational in almost all clinical cases. To evaluate the efficacy and safety of phytotherapy, including the standardized drug myrtol, in the treatment of patients with rhinosinusitis according to literature data. A literature review was performed using the databases PubMed, Scopus, eLIBRARY. RU and Cochrane Library for the keywords: “rhinosinusitis”, “phytotherapy”, “Myrtol standardized extract”, “pathogenetic treatment”. Both experimental studies and clinical observations are considered. It has been demonstrated that systemic antibiotic therapy is indicated only in a small proportion of patients with rhinosinusitis who have a moderate to severe bacterial process. The main focus is on pathogenetic treatment, including mucoactive, anti-inflammatory and secretolytic drugs. Phytotherapy, in particular standardized myrtol extract, demonstrates evidence of improved mucociliary clearance, decreased inflammatory response, and symptom relief in the experiment. Clinical studies confirm the safety and efficacy of standardized myrtol extract in acute and chronic rhinosinusitis, with minimal risk of adverse events. Pathogenetic treatment using standardized phytotherapy is a promising method of managing patients with rhinosinusitis. Standardized myrtol extract can be recommended as a safe and effective drug, especially in patients without indications for systemic antibiotics.

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