medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-12-20-24medsovet-3128Research ArticleНЕВРОЛОГИЯNEUROLOGYКупирование болевых синдромов. Новый взгляд на старую проблему?Relief of pain syndromes. New insight into the old problem?ЯкуповЭ. З.YakupovE. Z.

Якупов Эдуард Закирзянович - доктор медицинских наук, профессор, заведующий кафедрой неврологии, нейрохирургии и медицинской генетики.

420012, Казань, ул. Бутлерова, д. 49; тел.: +7(987) 290-25-62

Yakupov Eduard Zakirzyanovich - Dr. of Sci.(Med.), Professor, Head of Chair for Neurology, Neurosurgery and Medical Genetics.

420012, Kazan, Butlerova St., 49; Tel.: +7(987) 290-25-62

ed_yakupov@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Казанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education «Kazan State Medical University» of the Ministry of Health of the Russian FederationRussian Federation2019290820190122024Copyright © Якупов Э.З., 20192019Якупов Э.З.Yakupov E.Z.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/3128

Статья посвящена актуальной проблеме использования дополнительных методов при лечении болевых синдромов, в частности комплекса витаминов группы В в сочетании с холином и уридинмонофосфатом. Использование в клинической практике подобных комплексов связано с сочетанным противоболевым, репаративным, защитным эффектами. В работе освещается новое направление терапии, основанное на влиянии уридинмонофосфата на пуриновые рецепторы и опосредованном влиянии на ноцицептивные болевые синдромы в сочетании с защитным эффектом ремиелинизации и дополнительным аналитическим эффектом холина в сочетании с нейротропным комплексом витаминов группы В. Представлены данные по новому представителю данного класса - БАД Нейроуридин (компания «Юнифарм»), комплексное воздействие которого основано на патогенетическом подходе и поможет усилить клинические эффекты традиционных методов лечения.

The article is devoted to the urgent problem of additional methods in the treatment of pain syndromes, in particular a vitamin B complex combined with choline and uridine monophosphate. The use of such complexes in clinical practice is associated with combinational analgesic, reparative, and protective effects. The paper highlights a new direction of therapy based on the uridine monophosphate effect on purine receptors and the indirect effect on nociceptive pain syndromes combined with the protective effect of remyelination and the additional analytical effect of choline in combination with the neurotropic vitamin B complex. The author presents data on a new preparation in this class - dietary supplement Neurouridin (Unipharm), which combined effect is based on the pathogenetic approach and will help strengthen the clinical effects of traditional ionic treatments.

болевые синдромыболь в нижней части спиныуридинмонофосфатхолиннейротропный комплекс витаминовpain syndromeslower back painuridine monophosphatecholineneurotropic vitamin complexReferencesYaqub B.A. Siddique A., Sulimani R. Effects of methyl-cobalamine on diabetic neuropathy. Clin Neurol Neurosurg. 1992; 94(2):105-111.Yaqub B.A. Siddique A., Sulimani R. Effects of methyl-cobalamine on diabetic neuropathy. Clin Neurol Neurosurg. 1992; 94(2):105-111.Watanabe T., Kaji R., Oka N. et al. Ultra-high dose methylcobalamin promotes nerve regeneration in experimental acrylamide neuropathy. J Neurol Sci. 1994;122(2):140-143.Watanabe T., Kaji R., Oka N. et al. Ultra-high dose methylcobalamin promotes nerve regeneration in experimental acrylamide neuropathy. J Neurol Sci. 1994;122(2):140-143.Fonseca V.A., Lavery L.A., Thethi T.K. Metanx in type 2 diabetes with peripheral neuropathy: a randomized trial. Am J Med. 2013;126(2):141-9. doi: 10.1016/j.amjmed.2012.06.022.Fonseca V.A., Lavery L.A., Thethi T.K. Metanx in type 2 diabetes with peripheral neuropathy: a randomized trial. Am J Med. 2013;126(2):141-9. doi: 10.1016/j.amjmed.2012.06.022.Trippe B.S., Barrentine L.W., Curole M.V., Tipa E. Nutritional management of patients with diabetic peripheral neuropathy with Metanx: results of a real-world patient experience trial. Curr Med Res Opin. 2016;32(2):219-27. doi: 10.1185/03007995.2015.1103215.Trippe B.S., Barrentine L.W., Curole M.V., Tipa E. Nutritional management of patients with diabetic peripheral neuropathy with Metanx: results of a real-world patient experience trial. Curr Med Res Opin. 2016;32(2):219-27. doi: 10.1185/03007995.2015.1103215.Gareri P., Castagna A., Cotroneo A.M. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives. Clin Interv Aging. 2015;10:1421-1429. doi: 10.2147/CIA.S87886.Gareri P., Castagna A., Cotroneo A.M. The role of citicoline in cognitive impairment: pharmacological characteristics, possible advantages, and doubts for an old drug with new perspectives. Clin Interv Aging. 2015;10:1421-1429. doi: 10.2147/CIA.S87886.Secades J.J. Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol. 2016;63(3):1-73.Secades J.J. Citicoline: pharmacological and clinical review, 2016 update. Rev Neurol. 2016;63(3):1-73.Arenth P.M., Russell K.C., Ricker J.H., Zafonte R.D. CDP-choline as a biological supplement during neurorecovery: a focused review. PM R. 2011;3(6 Suppl 1):123-131. doi: 10.1016/j.pmrj.2011.03.012.Arenth P.M., Russell K.C., Ricker J.H., Zafonte R.D. CDP-choline as a biological supplement during neurorecovery: a focused review. PM R. 2011;3(6 Suppl 1):123-131. doi: 10.1016/j.pmrj.2011.03.012.Kanat O., Bagdas D., Ozboluk H.Y., Gurun M.S. Preclinical evidence for the antihyperalgesic activity of CDP-choline in oxaliplatin-induced neuropathic pain. J BUON. 2013;18(4):1012-1018.Kanat O., Bagdas D., Ozboluk H.Y., Gurun M.S. Preclinical evidence for the antihyperalgesic activity of CDP-choline in oxaliplatin-induced neuropathic pain. J BUON. 2013;18(4):1012-1018.Ozay R., Bekar A., Kocaeli H. et al. Citicoline improves functional recovery, promotes nerve regeneration, and reduces postoperative scarring after peripheral nerve surgery in rats. Surg Neurol. 2007;68(6):615-622. doi: 10.1016/j.surneu.2006.12.054.Ozay R., Bekar A., Kocaeli H. et al. Citicoline improves functional recovery, promotes nerve regeneration, and reduces postoperative scarring after peripheral nerve surgery in rats. Surg Neurol. 2007;68(6):615-622. doi: 10.1016/j.surneu.2006.12.054.Gallai V., Mazzotta G., Montesi S. et al. Effects of uridine in the treatment of diabetic neuropathy: an electrophysiological study. Acta Neurol Scand. 1992;86(1):3-7.Gallai V., Mazzotta G., Montesi S. et al. Effects of uridine in the treatment of diabetic neuropathy: an electrophysiological study. Acta Neurol Scand. 1992;86(1):3-7.Palomo-Guerrero M., Cosgaya J.M., Gella A. et al. Uridine-5'-triphosphate partially blocks differentiation signals and favors a more repair state in cultured rat Schwann cells. Neuroscience. 2018;372:255-265. doi: 10.1016/j.neuroscience.2018.01.010.Palomo-Guerrero M., Cosgaya J.M., Gella A. et al. Uridine-5'-triphosphate partially blocks differentiation signals and favors a more repair state in cultured rat Schwann cells. Neuroscience. 2018;372:255-265. doi: 10.1016/j.neuroscience.2018.01.010.Lamarca A., Gella A., Martianez T. et al. Uridine-5-triphosphate promotes in vitro schwannoma cell migration through matrix metalloproteinase-2 activation. PLoS One. 2014;9(6):e98998. doi: 10.1371/journal.pone.0098998.Lamarca A., Gella A., Martianez T. et al. Uridine-5-triphosphate promotes in vitro schwannoma cell migration through matrix metalloproteinase-2 activation. PLoS One. 2014;9(6):e98998. doi: 10.1371/journal.pone.0098998.Goldberg H., Mibielli M.A., Nunes C.P. et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res. 2017;10:397-404. doi: 10.2147/JPR.S123045.Goldberg H., Mibielli M.A., Nunes C.P. et al. A double-blind, randomized, comparative study of the use of a combination of uridine triphosphate trisodium, cytidine monophosphate disodium, and hydroxocobalamin, versus isolated treatment with hydroxocobalamin, in patients presenting with compressive neuralgias. J Pain Res. 2017;10:397-404. doi: 10.2147/JPR.S123045.Negrao L., Almeida P., Alcino S. et al. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. Pain Manag. 2014;4(3):191-196. doi: 10.2217/pmt.14.10.Negrao L., Almeida P., Alcino S. et al. Effect of the combination of uridine nucleotides, folic acid and vitamin B12 on the clinical expression of peripheral neuropathies. Pain Manag. 2014;4(3):191-196. doi: 10.2217/pmt.14.10.Gever J.R., Rothschild S., Henningsen R., Martin R., Hackos D., Panicker S., et al. AF-353, a novel, potent orally bioavailable P2X3/P2X2/3 receptor antagonist. British Journal of Pharmacology. 2010;160:1387-1398.Gever J.R., Rothschild S., Henningsen R., Martin R., Hackos D., Panicker S., et al. AF-353, a novel, potent orally bioavailable P2X3/P2X2/3 receptor antagonist. British Journal of Pharmacology. 2010;160:1387-1398.Ford A.P. In pursuit of P2X3 antagonists: Novel therapeutics for chronic pain and afferent sensitization. Purinergic Signalling. 2012;8:3-26.Ford A.P. In pursuit of P2X3 antagonists: Novel therapeutics for chronic pain and afferent sensitization. Purinergic Signalling. 2012;8:3-26.Nair A., Simonetti M., Birsa N., Ferrari M.D., van den Maagdenberg A.M., Giniatullin R., et al. Familial hemiplegic migraine Cav2.1 channel mutation R1920 enhances ATP-gated P2X3 receptor activity of mouse sensory ganglion neurons mediating trigeminal pain. Molecular Pain. 2010;6:48. doi 10.1186/1744-8069-6-48.Nair A., Simonetti M., Birsa N., Ferrari M.D., van den Maagdenberg A.M., Giniatullin R., et al. Familial hemiplegic migraine Cav2.1 channel mutation R1920 enhances ATP-gated P2X3 receptor activity of mouse sensory ganglion neurons mediating trigeminal pain. Molecular Pain. 2010;6:48. doi 10.1186/1744-8069-6-48.Inoue K., Tsuda M., Tozaki-Saitoh H. Modification of neuropathic pain sensation through microglial ATP receptor. Purinergic Sig. 2007;3:311-316.Inoue K., Tsuda M., Tozaki-Saitoh H. Modification of neuropathic pain sensation through microglial ATP receptor. Purinergic Sig. 2007;3:311-316.Кукушкин М.Л., Решетняк В.К. Пуринерги-ческие механизмы боли и обезболивания. Российский журнал боли. 2019;17(1):51-56. doi: 10.25731/RASP.2019.01.09.Kukushkin M.L., Reshetnyak V.K. Purinergic mechanisms of pain and analgesia. Russian Journal of Pain. 2019;17(1):51-56. (In Russ.) doi: 10.25731/RASP.2019.01.09.Kretschmar C., Kaumeier S., Haase W. Medica-mentous therapy of alcoholic polyneuropathy. Randomized double-blind study comparing 2 vitamin B preparations and a nucleotide preparation. Fortschr Med. 1996;114:32:439-43.Kretschmar C., Kaumeier S., Haase W. Medica-mentous therapy of alcoholic polyneuropathy. Randomized double-blind study comparing 2 vitamin B preparations and a nucleotide preparation. Fortschr Med. 1996;114:32:439-43.

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