medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2013-12-34-37medsovet-1160Research ArticleКардионеврологияCardioneurologyКомбинированная терапия боли в спине витаминами группы B и нестероидными противовоспалительными средствамиCombination therapy of back pain with B vitamins and non-steroidal anti-inflammatory drugsCтроковИ. А.StrokovI. A.noemail@neicon.ruДроконоваО. О.DrokonovaO. O.noemail@neicon.ruАхмеджановаЛ. Т.AkhmedzhanovaL. T.noemail@neicon.ruПервый МГМУ им. И.М. СеченоваРоссияFirst MSMU named after I.M. SechenovRussian Federation2013301220130123437Copyright © Cтроков И.А., Дроконова О.О., Ахмеджанова Л.Т., 20132013Cтроков И.А., Дроконова О.О., Ахмеджанова Л.Т.Strokov I.A., Drokonova O.O., Akhmedzhanova L.T.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/1160

В статье освещаются подходы к лечению боли в спине. Представлены данные доказательной медицины относительно эффективности нестероидных противовоспалительных средств и витаминов группы В при ноцицептивной и невропатической боли.

The article highlights the approaches to the treatment of back pain. There is evidence-based data on the efficiency of non-steroidal anti-inflammatory medicines and B vitamins in nociceptive and neuropathic pain.

дорсалгияноцицептивная больневропатическая больнестероидные противовоспалительные средствадиклофенаквитамины группы Втиаминпири-доксинцианокобаламинdorsalgianociceptive painneuropathic painnon-steroidal anti-inflammatory drugdiclofenacB vitaminsthiaminepyridoxinecyanocobalaminReferencesSchmidt C, Raspe H, Pfingstein M, et al. Back pain in the German adult population. Spine, 2007; 37:2005-2011.Schmidt C, Raspe H, Pfingstein M, et al. Back pain in the German adult population. Spine, 2007; 37:2005-2011.Fraynhagen R, Baron R, Gockel U, et al. PainDetect: a new screening questionnaire to detect neuropathic components in patients with back pain. Curr Med Res Opin, 2006; 22:1911-1920.Fraynhagen R, Baron R, Gockel U, et al. PainDetect: a new screening questionnaire to detect neuropathic components in patients with back pain. Curr Med Res Opin, 2006; 22:1911-1920.Неспецифическая боль в нижней части спины. Диагностика, лечение, предупреждение. М.: ООО «КомплектСервис», 2008.Неспецифическая боль в нижней части спины. Диагностика, лечение, предупреждение. М.: ООО «КомплектСервис», 2008.Насонов Е.Л. Нестероидные противовоспалительные препараты при ревматических заболеваниях: стандарты лечения. РМЖ, 2001; 7-8:265-270.Насонов Е.Л. Нестероидные противовоспалительные препараты при ревматических заболеваниях: стандарты лечения. РМЖ, 2001; 7-8:265-270.Grosser T, Fries S, Fitzgerald GA. Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunities. J Clin Invest, 2006; 116:4-15.Grosser T, Fries S, Fitzgerald GA. Biological basis for the cardiovascular consequences of COX-2 inhibition: therapeutic challenges and opportunities. J Clin Invest, 2006; 116:4-15.Bjorkman RL, Hedner T, Hallman KM, et al. Localization of the central antinociceptive effects of diclofenac in the rat. Brain Res, 1992; 1-2:66-73.Bjorkman RL, Hedner T, Hallman KM, et al. Localization of the central antinociceptive effects of diclofenac in the rat. Brain Res, 1992; 1-2:66-73.Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: Издательская группа «ГЭОТАР-Медиа», 2010.Подчуфарова Е.В., Яхно Н.Н. Боль в спине. М.: Издательская группа «ГЭОТАР-Медиа», 2010.Mooney S, Leuendorf JE, Hendrickson C, et al. Vitamin B6: a long known compound of surprising complexity. Molecules, 2009; 14 (1):329-351.Mooney S, Leuendorf JE, Hendrickson C, et al. Vitamin B6: a long known compound of surprising complexity. Molecules, 2009; 14 (1):329-351.Kobzar G, Mardia V, Ratsep I, et al. Effect of vitamib B(6) vitamers on platelet aggregation. Platelets, 2009; 20:120-124.Kobzar G, Mardia V, Ratsep I, et al. Effect of vitamib B(6) vitamers on platelet aggregation. Platelets, 2009; 20:120-124.Wang Z.B., Gan Q., Rupert R.L., Zeng Y.M., Song X.J. Thiamine, pyridoxine, cyanocobalamin and their combinatuin inhibit thermal, but not mechanical hyperalgesia in rats with primary sensory neuron loss. Pain, 2005; 114:266-277.Wang Z.B., Gan Q., Rupert R.L., Zeng Y.M., Song X.J. Thiamine, pyridoxine, cyanocobalamin and their combinatuin inhibit thermal, but not mechanical hyperalgesia in rats with primary sensory neuron loss. Pain, 2005; 114:266-277.Caram-Salas NL, Reyes-Garcia G, Medina-Santillian R, et al. Thiamine and cyanocobalamin relieve neuropathic pain in rats: synergy with dexamethasone. Pharmacology, 2006; 77 (2):53-62.Caram-Salas NL, Reyes-Garcia G, Medina-Santillian R, et al. Thiamine and cyanocobalamin relieve neuropathic pain in rats: synergy with dexamethasone. Pharmacology, 2006; 77 (2):53-62.Mixcoatl-Zecuatl T, Quinonez-Bastidas GN, Caram-Salas NL, et al. Synergistic antiallodinic interaction between gabapentin or car-bamazepine and either benfotiamine or cyanocobalamin in neuropathic rats. Methods Find Exp Clin Pharmacol, 2008; 30:431-441.Mixcoatl-Zecuatl T, Quinonez-Bastidas GN, Caram-Salas NL, et al. Synergistic antiallodinic interaction between gabapentin or car-bamazepine and either benfotiamine or cyanocobalamin in neuropathic rats. Methods Find Exp Clin Pharmacol, 2008; 30:431-441.Granados-Soto V, Sanchez-Ramirez G, La-Torre MR, et al. Effect of diclofenac on the antiallodinic activity of vitamin B12 in a neuropathic pain model in the rat. Proc West Pharmacol Soc, 2004; 47:92-94.Granados-Soto V, Sanchez-Ramirez G, La-Torre MR, et al. Effect of diclofenac on the antiallodinic activity of vitamin B12 in a neuropathic pain model in the rat. Proc West Pharmacol Soc, 2004; 47:92-94.Jurna I, Carrison KH, Kömen W, et al. Acute effects of vitamin B6 and fixed combinations of vitamin B1, B6 and B12 on nociceptive activity evoked in the rat thalamus: dose-response relationship and combinations with morphine and paracetamol. Klin Wochenschr, 1990; 68 (2):129-135.Jurna I, Carrison KH, Kömen W, et al. Acute effects of vitamin B6 and fixed combinations of vitamin B1, B6 and B12 on nociceptive activity evoked in the rat thalamus: dose-response relationship and combinations with morphine and paracetamol. Klin Wochenschr, 1990; 68 (2):129-135.Hung KL, Wang CC, Huang CY, et al. Cyanocobalamin, vitamin B12, depresses glutamate release through inhibition of voltage-dependent Ca2+ influx in rat cerebrocortical nerve terminals. Eur J Pharmacol, 2009; 602 (2-3):230-237.Hung KL, Wang CC, Huang CY, et al. Cyanocobalamin, vitamin B12, depresses glutamate release through inhibition of voltage-dependent Ca2+ influx in rat cerebrocortical nerve terminals. Eur J Pharmacol, 2009; 602 (2-3):230-237.Franca DS, Souza AL, Almeida KR, et al. B vitamins induce an antinoceceptive effect in the acetic acid and formaldehyde models of nociception in mice. Eur J Pharmacol, 2001; 421 (3):157-164.Franca DS, Souza AL, Almeida KR, et al. B vitamins induce an antinoceceptive effect in the acetic acid and formaldehyde models of nociception in mice. Eur J Pharmacol, 2001; 421 (3):157-164.Sánchez-Ramírez GM, Caram-Salas NL, Rocha-Gonzáles HI, et al. Benfotiamine relieves inflamatory and neuropathic pain in rats. Eur J Pharmacol, 2006; 150 (1-2):48-53.Sánchez-Ramírez GM, Caram-Salas NL, Rocha-Gonzáles HI, et al. Benfotiamine relieves inflamatory and neuropathic pain in rats. Eur J Pharmacol, 2006; 150 (1-2):48-53.Moallem SA, Hosseeinzaden H, Farahi S. A study of acute and chronic anti-nociceptive and anti-inflammatory effects of thiamine in mice. Iran Biomed J, 2008; 12(3):173-178.Moallem SA, Hosseeinzaden H, Farahi S. A study of acute and chronic anti-nociceptive and anti-inflammatory effects of thiamine in mice. Iran Biomed J, 2008; 12(3):173-178.Song XS, Huang ZJ, Song XJ. Thiamine suppressed thermal hyperalgesia, inhibits hyperexitability, and lessens alterations of sodium currents in injured, dorsal root ganglion neurons in rats. Anesthesiology, 2009; 110(2):387-400.Song XS, Huang ZJ, Song XJ. Thiamine suppressed thermal hyperalgesia, inhibits hyperexitability, and lessens alterations of sodium currents in injured, dorsal root ganglion neurons in rats. Anesthesiology, 2009; 110(2):387-400.Eckert M, Schejbal P. Therapy of neuropathies with a vitamin B combination. Symptomatic treatment of painful diseases of the peripheral nervous system with a combination preparation of thiamine, pyridoxine and cyanocobalamin. Fortschr Med, 1992; 110 (29):544-548.Eckert M, Schejbal P. Therapy of neuropathies with a vitamin B combination. Symptomatic treatment of painful diseases of the peripheral nervous system with a combination preparation of thiamine, pyridoxine and cyanocobalamin. Fortschr Med, 1992; 110 (29):544-548.Jurna I. Analgetic and analgesia-potentiating action of B vitamins. Schmerz, 1998; 12 (2):136-141.Jurna I. Analgetic and analgesia-potentiating action of B vitamins. Schmerz, 1998; 12 (2):136-141.Mauro GL, Martorana U, Cataldo P, et al. Vitamin B in low back pain: a randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci, 2000; 4 (3):53-58.Mauro GL, Martorana U, Cataldo P, et al. Vitamin B in low back pain: a randomised, double-blind, placebo-controlled study. Eur Rev Med Pharmacol Sci, 2000; 4 (3):53-58.Tafaei A, Siavash M, Majidi H, et al. Vitamin B(12) may more effective than nortriptyline in improving painful diabetic neuropathy. Int J Food Sci Nutr, 2009; Feb 12:1-6.Tafaei A, Siavash M, Majidi H, et al. Vitamin B(12) may more effective than nortriptyline in improving painful diabetic neuropathy. Int J Food Sci Nutr, 2009; Feb 12:1-6.Данилов А.Б. Витамины группы В в лечении острых болей в спине: миф или реальность? Лечащий врач, 2007; 4:1-8.Данилов А.Б. Витамины группы В в лечении острых болей в спине: миф или реальность? Лечащий врач, 2007; 4:1-8.Юдельсон Я.Б., Рачин А.Л., Белогорохов О.О. Эффективность и безопасность применения препарата нейродикловит при дорсалгии. Фарматека, 2008; 20:1-3.Юдельсон Я.Б., Рачин А.Л., Белогорохов О.О. Эффективность и безопасность применения препарата нейродикловит при дорсалгии. Фарматека, 2008; 20:1-3.Левин О.С. Вертеброгенная пояснично-крестцовая радикулопатия. Фарматека, 2010; 13:26-33.Левин О.С. Вертеброгенная пояснично-крестцовая радикулопатия. Фарматека, 2010; 13:26-33.Bromm K, Hermann WM, Schulz H. Do the B-vitamine exhibit antinociceptive efficacy in men? Results of a placebo-controlled repeated-measures double-blind study. Neurophysiology, 1995; 31 (3):156-165.Bromm K, Hermann WM, Schulz H. Do the B-vitamine exhibit antinociceptive efficacy in men? Results of a placebo-controlled repeated-measures double-blind study. Neurophysiology, 1995; 31 (3):156-165.

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