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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2022-16-7-8-14</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-6854</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Функциональные заболевания органов ЖКТ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>Functional gastrointestinal diseases</subject></subj-group></article-categories><title-group><article-title>Функциональные заболевания желудочно-кишечного тракта: механизмы развития и принципы мультитаргетной терапии</article-title><trans-title-group xml:lang="en"><trans-title>Functional gastrointestinal diseases: mechanisms of development and principles of multitarget therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6114-564X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маев</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maev</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маев Игорь Вениаминович - доктор медицинских наук, академик РАН, профессор, заслуженный деятель науки РФ, лауреат премии Правительства РФ в области науки и техники, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1.</p></bio><bio xml:lang="en"><p>Igor V. Maev - Dr. Sci. (Med.), Professor, Academician RAS, Honored Scientist of the Russian Federation, Laureate of the Prize of the Government of the Russian Federation in the Field of Science and Technology, Head of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Yevdokimov Moscow State University of Medicine and Dentistry.</p><p>20, Bldg. 1, Delegatskaya St., Moscow, 127473.</p></bio><email xlink:type="simple">igormaev@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4007-7112</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Андреев</surname><given-names>Д. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Andreev</surname><given-names>D. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Андреев Дмитрий Николаевич - кандидат медицинских наук, доцент, лауреат премии Правительства РФ в области науки и техники, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1.</p></bio><bio xml:lang="en"><p>Dmitry N. Andreev - Cand. Sci. (Med.), Associate Professor, Laureate of the Prize of the Government of the Russian Federation in the Field of Science and Technology, Associate Professor of the Department of Propaedeutics of Internal Diseases and Gastroenterology, Yevdokimov Moscow State University of Medicine and Dentistry.</p><p>20, Bldg. 1, Delegatskaya St., Moscow, 127473.</p></bio><email xlink:type="simple">dna-mit8@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7923-9916</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Заборовский</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zaborovsky</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Заборовский Андрей Владимирович - доктор медицинских наук, доцент, заведующий кафедрой фармакологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1.</p></bio><bio xml:lang="en"><p>Andrew V. Zaborovsky - Dr. Sci. (Med.), Associate Professor, Head of Department of Pharmacology, Yevdokimov Moscow State University of Medicine and Dentistry.</p><p>20, Bldg. 1, Delegatskaya St., Moscow, 127473.</p></bio><email xlink:type="simple">azabor@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5815-2942</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лобанова</surname><given-names>Е. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Lobanova</surname><given-names>E. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лобанова Елена Георгиевна - доктор медицинских наук, профессор кафедры фармакологии.</p><p>127473, Москва, ул. Делегатская, д. 20, стр. 1.</p></bio><bio xml:lang="en"><p>Elena G. Lobanova - Dr. Sci. (Med.), Professor Department of Pharmacology, Yevdokimov Moscow State University of Medicine and Dentistry.</p><p>20, Bldg. 1, Delegatskaya St., Moscow, 127473.</p></bio><email xlink:type="simple">e.g.lobanova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Московский государственный медико-стоматологический университет имени А.И. Евдокимова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yevdokimov Moscow State University of Medicine and Dentistry</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>13</day><month>05</month><year>2022</year></pub-date><volume>0</volume><issue>7</issue><fpage>8</fpage><lpage>14</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маев И.В., Андреев Д.Н., Заборовский А.В., Лобанова Е.Г., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Маев И.В., Андреев Д.Н., Заборовский А.В., Лобанова Е.Г.</copyright-holder><copyright-holder xml:lang="en">Maev I.V., Andreev D.N., Zaborovsky A.V., Lobanova E.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/6854">https://www.med-sovet.pro/jour/article/view/6854</self-uri><abstract><p>В  настоящий момент   в  структуре   функциональных заболеваний  желудочно-кишечного  тракта  (ЖКТ) одними   из  наиболее распространенных   нозологических единиц   у взрослых  являются функциональная диспепсия (ФД) и синдром раздраженного кишечника (СРК).    Важной    проблемой   лечения данных   заболеваний  на  современном    этапе развития медицины  является низкая  эффективность   монотаргетных   препаратов,   что детерминируется многокомпонентностью   патогенеза. Действительно, доступные на  сегодняшний  день методы   медикаментозного  лечения ФД и СРК  обладают субоптимальной эффективностью, что иллюстрируется  последними    метаанализами,   демонстрирующими   высокие показатели  NNT (среднее   число  пациентов, которых необходимо     лечить,  чтобы   достичь  определенного   благоприятного исхода).    Помимо   этого, частый    перекрест («overlap») этих заболеваний  вынуждает   клинициста назначать несколько  разнонаправленных по фармакологическому действию   лекарственных   препаратов   больному, что неизбежно   ведет к  снижению    комплаентности. Оптимальной   стратегией ведения   пациентов   с ФД и  СРК    является тактика применения  мультитаргетных препаратов,   действующих на  несколько звеньев  патогенеза  рассматриваемых  патологий  и  обладающих  существенной   доказательной  базой  в  рамках   эффективности  и безопасности   использования.   Вышеназванными  характеристиками   обладает  препарат   STW 5 (Иберогаст®), включенный  в клинические рекомендации    Российской   гастроэнтерологической ассоциации   по  диагностике  и  лечению   пациентов  с ФД, опубликованные  в 2017 г., а также в клинические рекомендации   Российской   гастроэнтерологической  ассоциации   в коллаборации   с Ассоциацией   колопроктологов России  по  диагностике и  лечению    СРК,   изданные в 2021 г. Клиническая  эффективность Иберогаста   в рамках   лечения  ФД и СРК  была  продемонстрирована в ряде рандомизированных   исследований, результаты  которых свидетельствовали о  высокой   эффективности    препарата  и  его хорошей переносимости.</p></abstract><trans-abstract xml:lang="en"><p>Currently, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are among the most common nosological  units in the structure of functional gastrointestinal  diseases in adults. An important problem of treatment of these diseases at the current stage of medicine is low efficiency of monotarget drugs, which is determined by multicomponent pathogenesis. Indeed, the currently available  methods of drug treatment of FD and IBS have suboptimal  efficacy, as illustrated  by recent meta-analyses demonstrating high rates of NNT (the average number of patients who need to be treated to achieve a certain favorable outcome). In addition, the frequent “overlap” of these diseases forces clinicians to prescribe several drugs with different pharmacological actions to the patient, which inevitably leads to a decrease in compliance. The optimal strategy for managing patients with FD and IBS is the tactics of multitarget drugs that act on several links in the pathogenesis of these pathologies and have a significant evidence base in the effectiveness and safety of use. STW 5 (Iberogast®), included  in the clinical  guidelines  of the Russian Gastroenterological Association on the diagnosis and treatment of patients with FD, published in 2017, has the above-mentioned characteristics, as well as the clinical guidelines of the Russian Gastroenterological Association in collaboration with the Russian Association of Coloproctologists on the diagnosis and treatment of IBS, published in 2021. The clinical effectiveness of Iberogast in the treatment of FD and IBS has been demonstrated in a number of randomized trials, the results of which showed high efficacy of the drug and its good tolerability.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>желудочно-кишечный  тракт</kwd><kwd>функциональные заболевания</kwd><kwd>функциональная диспепсия</kwd><kwd>синдром  раздраженного кишечника</kwd><kwd>мультитаргетная  терапия</kwd><kwd>STW 5</kwd></kwd-group><kwd-group xml:lang="en"><kwd>gastrointestinal tract</kwd><kwd>functional diseases</kwd><kwd>functional dyspepsia</kwd><kwd>irritable bowel syndrome</kwd><kwd>multitarget therapy</kwd><kwd>STW 5</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Андреев Д.Н., Заборовский А.В., Трухманов А.С., Маев И.В., Ивашкин В.Т. 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