References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2022-16-2-76-84

medsovet-6738

Research Article

НЕРВНО-ПСИХИЧЕСКИЕ РАССТРОЙСТВА

NEUROPSYCHIATRIC DISORDERS

Динамика вегетативных, инсомнических и нейропсихологических проявлений в процессе терапии постковидного синдрома

Dynamics of vegetative, insomnia and neuropsychological manifestations during the treatment of post-COVID syndrome

https://orcid.org/0000-0001-5012-945X

Александрова

Е. А.

Alexandrova

E. A.

к.м.н., доцент, кафедра неврологии, психиатрии и наркологии факультета дополнительного профессионального образования

603005, Россия, Нижний Новгород, пл. Минина и Пожарского, д. 10/1

Cand. Sci. (Med.), Associate Professor, Department of Neurology, Psychiatry and Narcology, Faculty of Additional Professional Education

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950, Russia

dalex1970@mail.ru

https://orcid.org/0000-0001-7033-053X

Паршина

Е. В.

Parshina

E. V.

к.м.н., заведующая неврологическим отделением

603126, Россия, Нижний Новгород, ул. Родионова, д. 190

Cand. Sci. (Med.), Head of Neurological Department

190, Rodionov St., Nizhny Novgorod, 603126, Russia

parshina_elena_v@mail.ru

https://orcid.org/0000-0003-0123-3116

Бородачева

И. В.

Borodacheva

I. V.

к.м.н., невролог

603126, Россия, Нижний Новгород, ул. Родионова, д. 190

Cand. Sci. (Med.), Neurologist

190, Rodionov St., Nizhny Novgorod, 603126, Russia

borodacheva.333@rambler.ru

https://orcid.org/0000-0003-3956-2986

Юлин

В. С.

Yulin

V. S.

невролог

603126, Россия, Нижний Новгород, ул. Родионова, д. 190

Neurologist

190, Rodionov St., Nizhny Novgorod, 603126, Russia

vadik.yulin@yandex.ru

https://orcid.org/0000-0001-7142-5282

Суслов

А. Г.

Suslov

A. G.

к.м.н., невролог

603126, Россия, Нижний Новгород, ул. Родионова, д. 190

Cand. Sci. (Med.), Neurologist

190, Rodionov St., Nizhny Novgorod, 603126, Russia

suslov99@mail.ru

https://orcid.org/0000-0002-4768-1355

Беляков

К. М.

Beliakov

K. M.

д.м.н., доцент, кафедра неврологии, психиатрии и наркологии факультета дополнительного профессионального образования

603005, Россия, Нижний Новгород, пл. Минина и Пожарского, д. 10/1

Dr. Sci. (Med.), Associate Professor, Department of Neurology, Psychiatry and Narcology, Faculty of Additional Professional Education

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950, Russia

kirmih@mail.ru

https://orcid.org/0000-0003-0775-326X

Фомин

С. В.

Fomin

S. V.

невролог

603126, Россия, Нижний Новгород, ул. Родионова, д. 190

Neurologist

190, Rodionov St., Nizhny Novgorod, 603126, Russia

serjfom30@mail.ru

Приволжский исследовательский медицинский университетРоссияPrivolzhsky Research Medical UniversityRussian Federation

Нижегородская областная клиническая больница имени Н.А. СемашкоРоссияN.A. Semashko Nizhny Novgorod Region Clinical HospitalRussian Federation

2022

12032022

027684

2022

Александрова Е.А., Паршина Е.В., Бородачева И.В., Юлин В.С., Суслов А.Г., Беляков К.М., Фомин С.В.

Alexandrova E.A., Parshina E.V., Borodacheva I.V., Yulin V.S., Suslov A.G., Beliakov K.M., Fomin S.V.

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/6738

Введение. Астения, вегетативные проявления, нарушения сна и психоэмоционального фона –спутники перенесенной коронавирусной инфекции, вопрос медикаментозной коррекции которых в настоящее время особенно актуален. Указанные симптомы в течение длительного времени нарушают привычный образ жизни пациентов, а в особых случаях приводят к нетрудоспособности.Цель исследования. Изучить психические, соматоформные и когнитивные аспекты тревожных расстройств после коронавирусной инфекции в процессе лечения тофизопамом (Грандаксин®) по 150 мг/сут.Материалы и методы. В исследовании приняли участие пациенты, перенесшие новую коронавирусную инфекцию, у которых после окончания лечения по поводу основного заболевания были жалобы, позволяющие предполагать наличие тревожного расстройства. Для оценки уровня тревоги использовалась шкала Гамильтона (HAM-A). Обследование пациентов проводилось до начала лечения, спустя 2, 4 и 6 нед. терапии.Результаты и обсуждение. До начала терапии у всех больных отмечался общий высокий уровень тревоги: средний балл по HAM-A составлял 31,4 ± 2,92 балла. По окончании терапии Грандаксином® у всех больных отмечалось снижение уровня тревоги: в среднем 12,08 ± 2,27 балла по HAM-A (p < 0,001). Максимальное снижение выраженности вегетативных расстройств было отмечено к концу 6-й нед. терапии Грандаксином®. Так, показатель данной субшкалы уменьшился более чем в 2 раза: с 2,46 ± 0,54 до 1,05 ± 0,28 балла (р < 0,001). Степень выраженности инсомнии в течение 6 нед. терапии Грандаксином® уменьшилась с 2,56 ± 0,54 до 0,96 ± 0,45 балла (p < 0,001).Заключение. Нарушения психоэмоционального фона (чаще в виде повышения тревожности), расстройства сна, вегетативные нарушения, астенический синдром значительно влияют на качество жизни пациентов, перенесших новую коронавирусную инфекцию. Вовлечение структур вегетативной нервной системы и центральных структур, регулирующих ГАМК-ергическую трансмиссию, приводит к значимым вегетативным сбоям, что требует патогенетически обоснованной лекарственной коррекции данных нарушений.

Introduction. Asthenia, vegetative manifestations, sleep disturbances and psycho-emotional background are companions of the coronavirus infection, the issue of drug correction of which is especially relevant. These symptoms disrupt the habitual way of life of patients for a long time, and in special cases lead to disability.Aim. To study the mental, somatoform and cognitive aspects of anxiety disorders after coronavirus infection during treatment with tofisopam (Grandaxin®) 150 mg/day.Materials and methods. The study included patients who had experienced a new coronavirus infection, who, after the end of treatment for the underlying disease, had complaints suggesting the presence of an anxiety disorder. The Hamilton scale was used to assess the level of anxiety. Examination of patients was carried out before the start of treatment, after 2, 4 and 6 weeks of therapy.Results and discussion. Prior to the start of therapy, all patients had an overall high level of anxiety: the average HAM-A score was 31.4 ± 2.92 points. At the end of Grandaxin® therapy, all patients showed a decrease in the level of anxiety: the average HAM-A score was 12.08 ± 2.27 points (p < 0.001). The maximum decrease in the severity of vegetative disorders was noted by the end of the 6th week of therapy with Grandaxin®. Thus, the indicator of this subscale decreased by more than 2 times – from 2.46 ± 0.54 to 1.05 ± 0.28 points (p < 0.001). The severity of insomnia during six weeks of therapy with Grandaxin® decreased from 2.56 ± 0.54 to 0.96 ± 0.45 points (p < 0.001).Conclusion. Psycho-emotional disorders (more often in the form of increased personal anxiety), sleep disorders, vegetative disorders, asthenic syndrome significantly affect the quality of life of patients who have had a new coronavirus infection. Involvement of the structures of the autonomic nervous system and central structures that regulate GABAergic transmission leads to significant vegetative failures, which requires pathogenetically substantiated drug correction of these disorders.

астениятревогавегетативные нарушениярасстройства снаCOVID-19тофизопам

astheniaanxietyautonomic disorderssleep disordersCOVID-19tofisopam

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