medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-12-200-208medsovet-6349Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYСовременные возможности фармакологического воздействия на микрофлору и моторную активность кишечникаModern opportunities of pharmacological effect on gut microbiome and motor activityhttps://orcid.org/0000-0002-0535-2916ДроздовВ. Н.DrozdovV. N.

д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Dr. Sci. (Med.), Professor, Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

vndrozdov@yandex.ruhttps://orcid.org/0000-0001-6589-7654ШихЕ. В.ShikhE. V.

д.м.н., профессор, заведующая кафедрой клинической фармакологии и пропедевтики внутренних болезней,

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Dr. Sci. (Med.), Chair of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

chih@mail.ruhttps://orcid.org/0000-0002-7430-3341АстаповскийА. А.AstapovskiyA. A.

аспирант кафедры клинической фармакологии и  пропедевтики внутренних болезней, 

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Graduate student of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases,

8, Bldg. 2, Trubetskaya St., Moscow, 119991

al.astapovskii@gmail.comhttps://orcid.org/0000-0002-7163-7119СереброваС. Ю.SerebrovaS. Yu.

профессор кафедры клинической фармакологии и  пропедевтики внутренних болезней, 119991, Москва, ул. Трубецкая, д. 8, стр. 2;

д.м.н., главный научный сотрудник, 127051, Москва, Петровский бульвар, д. 8, стр. 2

Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, 8, Bldg. 2, Trubetskaya St., Moscow, 119991;

Dr. Sci. (Med.), Chief Researcher, 8, Bldg. 2, Petrovskiy Boulevard, Moscow, 127051

svetaserebrova@mail.ruhttps://orcid.org/0000-0001-5621-2721КомиссаренкоИ. А.KomissarenkoI. A.

д.м.н., профессор кафедры поликлинической терапии, 

127473, Москва, ул. Делегатская, д. 20, стр. 1

Dr. Sci. (Med), Professor of the Department of Polyclinic Therapy,

20, Bldg. 1, Delegatskaya St., Moscow, 127473

komisarenko@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Научный центр экспертизы средств медицинского примененияРоссияSechenov First Moscow State Medical University (Sechenov University); Scientific Centre of Expertise of Medical DevicesRussian FederationМосковский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian Federation202116092021012200208Copyright © Дроздов В.Н., Ших Е.В., Астаповский А.А., Сереброва С.Ю., Комиссаренко И.А., 20212021Дроздов В.Н., Ших Е.В., Астаповский А.А., Сереброва С.Ю., Комиссаренко И.А.Drozdov V.N., Shikh E.V., Astapovskiy A.A., Serebrova S.Y., Komissarenko I.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/6349

В настоящее время лактулоза известна в основном как слабительное средство, оказывающее гиперосмотическое действие, стимулирующее перистальтику кишечника. В этом качестве препарат давно себя зарекомендовал как эффективное и безопасное средство. Лактулоза  – одно из  немногих средств, которое разрешено к  применению у  беременных женщин и  детей младше 6  мес. с  функциональными запорами. Пребиотические свойства лактулозы открыты в  1957  г. После проведенных исследований было обнаружено, что она способствует росту полезных бифидо- и лактобактерий. Кроме использования в качестве эффективного слабительного и пребиотического средства лактулоза с 1966 г. с успехом применяется для лечения печеночной энцефалопатии. Механизм действия заключается в том, что лактулоза препятствует всасыванию избыточного количества аммиака, который образуется в толстой кишке посредством гидролиза белка и мочевины интестинальной микрофлорой. Лактулоза, обладающая широким спектром влияния на метаболизм азота кишечной микрофлорой, нейтрализует не только аммиак, но и другие бактериальные токсины. Благодаря проведенным исследованиям, в которых продемонстрирована достоверная эффективность препарата, ведущие профессиональные сообщества включили лактулозу в свои рекомендации в качестве препарата выбора для лечения пациентов с печеночной энцефалопатией на любой стадии процесса. В статье представлены современные данные об эффективности и безопасности использования лактулозы при различных заболеваниях. Кроме того, уделено внимание такому понятию, как микробиота. Описаны ее свойства и функции в организме человека. 

Currently, lactulose is known to most as a laxative that has a hyperosmotic effect, stimulating intestinal peristalsis. The drug has long established itself as a safe and effective medicine. Lactulose is one of the few drugs that is approved for use in pregnant women and children under 6 months of age with functional constipation. The prebiotic properties of lactulose were discovered in 1957. After research, it was found that it promotes the growth of beneficial bacteria, such as bifidobacteria and lactobacilli. In addition to being used as an effective weak and prebiotic agent, lactulose has been successfully used since 1966 for the treatment of hepatic encephalopathy. The mechanism of action of the drug is that it prevents the absorption of excess ammonia, which is formed in the large intestine, through the hydrolysis of protein and urea by the intestinal microflora. Lactulose, which has a wide range of effects on nitrogen metabolism by the intestinal microflora, affects not only ammonia, but also other bacterial toxins as a result of the studies that have demonstrated the reliable effectiveness of the drug, the world’s leading professional communities have included lactulose in their recommendations as the drug of choice for the treatment of patients with hepatic encephalopathy at any stage of the disease. The article presents current data on the effectiveness and safety of the use of lactulose in various diseases. In addition, attention is paid to such a concept as microbiota. Its functions and influence on the human body are described. 

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