medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-15-58-67medsovet-6426Research ArticleЗАБОЛЕВАНИЯ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫDISEASES OF THE PANCREASКлинико-фармакологические подходы к лечению экзокринной недостаточности поджелудочной железы при хроническом панкреатитеClinical and pharmacological approaches to the management of exocrine pancreatic insufficiency in chronic pancreatitishttps://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 of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

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

https://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

https://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

https://orcid.org/0000-0001-5670-4750КотлячковаЮ. В.KotlyachkovaYu. V.

врач

127206, Москва, ул. Вучетича, д. 21

Medical Officer

21, Vuchetich St., Moscow, 127206

https://orcid.org/0000-0001-6669-2650ДобровольскаяЛ. Е.DobrovolskayaL. E.

заведующая неврологическим отделением для больных с острыми нарушениями мозгового кровообращения Регионального сосудистого центра №2

105187,  Москва, ул. Фортунатовская, д. 1

Head of the Neurological Department

1, Fortunatovskaya St., Moscow, 105187

https://orcid.org/0000-0001-9842-4503СтародубцевА. К.StarodubtsevA. K.

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

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

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

https://orcid.org/0000-0001-5621-2721КомиссаренкоИ. А.KomissarenkoI. A.

д.м.н., профессор кафедры поликлинической терапии

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

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

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

https://orcid.org/0000-0002-7163-7119СереброваС. Ю.SerebrovaS. Y.

д.м.н., главный научный сотрудник центра клинической фармакологии; профессор кафедры клинической фармакологиии пропедевтики внутренних болезней

119991,  Москва, ул. Трубецкая, д. 8, стр. 2; 127051,  Москва, Петровский бульвар, д. 8, стр. 2

Svetlana Y., Dr. Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases; Chief Researcher

8, Bldg. 2, Trubetskaya St., Moscow, 119991; 8, Bldg. 2, Petrovsky Boulevard, Moscow, 127051

svetaserebrova@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)Russian FederationГородская клиническая больница имени С.И. СпасокукоцкогоРоссияSpasokukotsky City Clinical HospitalRussian FederationГородская клиническая больница имени Ф.И. ИноземцеваРоссияInozemtsev City Clinical HospitalRussian FederationМосковский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияYevdokimov Moscow State University of Medicine and DentistryRussian 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 Devices Russian Federation2021171020210155867Copyright © Дроздов В.Н., Ших Е.В., Астаповский А.А., Котлячкова Ю.В., Добровольская Л.Е., Стародубцев А.К., Комиссаренко И.А., Сереброва С.Ю., 20212021Дроздов В.Н., Ших Е.В., Астаповский А.А., Котлячкова Ю.В., Добровольская Л.Е., Стародубцев А.К., Комиссаренко И.А., Сереброва С.Ю.Drozdov V.N., Shikh E.V., Astapovskiy A.A., Kotlyachkova Y.V., Dobrovolskaya L.E., Starodubtsev A.K., Komissarenko I.A., Serebrova S.Y.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/6426

Хронический панкреатит — многофакторное заболевание, при котором повторяющиеся эпизоды воспаления поджелудочной железы способствуют развитию фиброзной ткани, что приводит к возникновению хронической боли, а также экзокринной и эндокринной недостаточности. Заболеваемость и распространенность хронического панкреатита в мире растут, о чем свидетельствуют актуальные статистические данные. Кроме того, растут и ежегодные расходы, связанные с лечением экзокринной и  эндокринной недостаточности. Только в  США ежегодные расходы на  лечение данных осложнений составляют 75,1 млн долл. Экзокринная недостаточность — одно из частых осложнений, которое характеризуется дефицитом ферментов поджелудочной железы, приводящим к развитию синдрома мальабсорбции (нарушению всасывания питательных веществ, витаминов и минералов). Из-за увеличения заболеваемости и ухудшения качества жизни, связанного с данным состоянием, целью лечения является восполнение дефицита экзокринных ферментов с помощью пероральной заместительной терапии панкреатическими энзимами. Основа данной терапии состоит в том, чтобы доставить активированные, неразрушенные ферменты непосредственно в тонкий кишечник во время приема пищи. Во многих исследованиях было показано, что назначение заместительной ферментативной терапии улучшает симптомы, связанные с  экзокринной недостаточностью, способствует снижению прогрессирования остеопении и улучшает выживаемость таких пациентов. Применение панкреатина способствует коррекции экзокринной недостаточности у пациентов с хроническим панкреатитом. Представленные в статье данные свидетельствуют о  том, что препарат является безопасным и  эффективным средством, отвечает всем современным стандартам и требованиям и может использоваться для коррекции ферментативной недостаточности поджелудочной железы.

Chronic pancreatitis is a multifactorial disease in which repeated episodes of inflammation of the pancreas contribute to the development of fibrous tissue, leading to chronic pain, as well as exocrine and endocrine insufficiency. The incidence and prevalence of chronic pancreatitis in the world are growing, as evidenced by current statistics. In addition, the annual costs associated with the treatment of exocrine and endocrine insufficiency are also increasing. In the United States alone, the annual cost of treating these complications is $ 75.1 million. Exocrine insufficiency is one of the most frequent complications, which is characterized by a deficiency of pancreatic enzymes, leading to the development of malabsorption syndrome (impaired absorption of nutrients, vitamins and minerals). Due to the increased incidence and deterioration of the quality of life associated with this condition, the goal of treatment is to compensate for the deficiency of exocrine enzymes with oral pancreatic enzyme replacement therapy. The core of this therapy is to deliver activated, unbroken enzymes directly to the small intestine during a meal. Many studies have shown that prescribing enzyme replacement therapy improves symptoms associated with exocrine insufficiency, reduces the progression of osteopenia, and improves survival in such patients. The use of pancreatin contributes to the correction of exocrine insufficiency in patients with chronic pancreatitis. The data presented in the article indicate that the drug is a safe and effective agent, meets all modern standards and requirements, and can be used to correct enzymatic pancreatic insufficiency.

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