medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-15-119-126medsovet-7082Research ArticleЗАБОЛЕВАНИЯ КИШЕЧНИКАBOWEL DISEASESЭффективность пробиотиков в лечении синдрома раздраженного кишечникаEfficacy of probiotics for the treatment of irritable bowel syndromehttps://orcid.org/0000-0002-9980-2294ЦукановВ. В.TsukanovV. V.

Цуканов Владислав Владимирович, д.м.н., профессор, заведующий клиническим отделением патологии пищеварительной системы у взрослых и детей

660022, Красноярск, ул. Партизана Железняка, д. 3г

Vladislav V. Tsukanov, Dr. Sci. (Med.), Professor, Head of the Clinical Department of the Digestive System Pathology of Adults and Children 

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022 

gastro@impn.ruhttps://orcid.org/0000-0002-6481-3196ВасютинА. В.VasyutinA. V.

Васютин Александр Викторович, к.м.н., старший научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей

660022, Красноярск, ул. Партизана Железняка, д. 3г

Alexander V. Vasyutin, Cand. Sci. (Med.), Senior Research Fellow of the Clinical Department of the Digestive System Pathology of Adults and Children 

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022 

alexander@kraslan.ruhttps://orcid.org/0000-0001-7518-1895ТонкихЮ. Л.TonkikhJu. L.

Тонких Юлия Леонгардовна, к.м.н., ведущий научный сотрудник клинического отделения патологии пищеварительной системы взрослых и детей

660022, Красноярск, ул. Партизана Железняка, д. 3г

Julia L. Tonkikh, Cand. Sci. (Med.), Leading Research Fellow of the Clinical Department of the Digestive System Pathology of Adults and Children 

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022 

tjulia@bk.ruФедеральный исследовательский центр «Красноярский научный центр Сибирского отделения Российской академии наук», Обособленное подразделение «Научно-исследовательский институт медицинских проблем Севера»РоссияFederal Research Center “Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences”, Separate Subdivision “Scientific Research Institute of Medical Problems of the North”Russian Federation202206102022015119126Copyright © Цуканов В.В., Васютин А.В., Тонких Ю.Л., 20222022Цуканов В.В., Васютин А.В., Тонких Ю.Л.Tsukanov V.V., Vasyutin A.V., Tonkikh J.L.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/7082

Выполнен обзор современных данных литературы, обосновывающий высокую распространенность и социальную значимость синдрома раздраженного кишечника (СРК). В различных регионах мира распространенность СРК колеблется от 10 до 15%. Патогенез СРК является мультифакториальным процессом, включающим нарушения моторики, вялотекущее иммунное воспаление, изменение кишечной проницаемости, дисбиоз, воздействие инфекционных агентов, нарушения питания, нейрогуморальную дисрегуляцию, изменения центральной нервной системы (психологический стресс, когнитивная дисфункция) в сочетании с генетическими факторами. Сложность патогенеза обусловливает гетерогенность клинических проявлений СРК, среди которых могут наблюдаться формы с преобладанием болевого синдрома, запора, диареи, метеоризма, что, в свою очередь, затрудняет подходы к лечению этого заболевания. Сейчас признано определяющее значение фекального дисбиоза для патогенеза функциональной патологии кишечника. Систематический обзор 2019 г. продемонстрировал отчетливое снижение родов Bifidobacterium и Faecalibacterium, увеличение семейств Lactobacillaceae, Enterobacteriaceae и рода Bacteroides у больных СРК в сравнении со здоровыми лицами. Римские критерии IV пересмотра, рекомендации Британского общества гастроэнтерологов, Объединенной европейской гастроэнтерологии и Европейского общества нейрогастроэнтерологии и моторики, Российской гастроэнтерологической ассоциации обосновывают применение пробиотиков для лечения СРК. Плацебо-контролируемые клинические исследования подтверждают действие Bifidobacterium longum 35624 для нормализации частоты и формы стула, купирования общей симптоматики, боли в животе, метеоризма, а также для повышения качества жизни у больных СРК. Экспертный совет, состоявшийся 18 марта 2022 г. в Москве под председательством главного внештатного специалиста гастроэнтеролога Минздрава РФ академика РАН В.Т. Ивашкина, подтвердил эффективность пробиотиков в лечении СРК.

A review of current literature data was made, substantiating the high prevalence and social significance of irritable bowel syndrome (IBS). In different regions of the world, the prevalence of IBS ranges from 10% to 15%. The pathogenesis of IBS is a multifactorial process, including dysmotility, sluggish immune inflammation, changes in intestinal permeability, dysbiosis, exposure to infectious agents, malnutrition, neurohumoral dysregulation, changes in the central nervous system (psychological stress, cognitive dysfunction) in combination with genetic factors. The complexity of the pathogenesis determines the heterogeneity of the clinical manifestations of IBS, among which there may be forms with a predominance of pain, constipation, diarrhea, flatulence, which in turn complicates approaches to the treatment of this disease. The decisive importance of fecal dysbiosis for the pathogenesis of functional bowel pathology is now recognized. A 2019 systematic review showed a clear decrease in the genera Bifidobacterium and Faecalibacterium, an increase in the families Lactobacillaceae, Enterobacteriaceae and the genus Bacteroides in patients with IBS compared with healthy individuals. The Rome IV criteria, the recommendations of the British Society of Gastroenterology, the United European Gastroenterology and the European Society for Neurogastroenterology and Motility, the Russian Gastroenterological Association substantiate the use of probiotics for the treatment of IBS. Placebo-controlled clinical studies confirm the action of Bifidobacterium longum 35624 to normalize the frequency and form of stools, relieve general symptoms, abdominal pain, bloating, and improve the quality of life in patients with IBS. The expert council, held on March 18, 2022 in Moscow, chaired by the chief gastroenterologist of the Ministry of Health of the Russian Federation, Academician of the RAS V.T. Ivashkin, confirmed the effectiveness of probiotics for the treatment of IBS.

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