medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-21-96-105medsovet-7209Research ArticleНЕРВНО-ПСИХИЧЕСКИЕ РАССТРОЙСТВАNEUROPSYCHIATRIC DISORDERSСтресс как основа полиморбидности и способы его коррекции на ранних этапахStress as the basis of polymorbidity and ways to correct it in the early stageshttps://orcid.org/0000-0003-0491-8823ПоляковаО. А.PolyakovaO. A.

Полякова Ольга Александровна, к.м.н., ассистент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр.1

Olga A. Polyakova, Cand. Sci. (Med.), Assistant of the Department of Therapy and Polymorbid Pathology named after academician M.S. Vovsi 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

docpolyakova.olga@gmail.comhttps://orcid.org/0000-0002-9597-1648КротковаИ. Ф.KrotkovaI. F.

Кроткова Ирина Федоровна, к.м.н., доцент, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр.1

Irina F. Krotkova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Therapy and Polymorbid Pathology named after academician M.S. Vovsi 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

krotira@mail.ruhttps://orcid.org/0000-0002-7980-4372ЛитвиноваC. Н.LitvinovaS. N.

Литвинова Светлана Николаевна, к.м.н., доцент, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр.1

Svetlana N. Litvinova, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Therapy and Polymorbid Pathology named after academician M.S. Vovsi 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

tanya.lowyer@mail.ruhttps://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна, д.м.н., профессор, заведующий кафедрой терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр.1

Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after academician M.S. Vovsi 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

ostroumova.olga@mail.ruРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation20221911202202196105Copyright © Полякова О.А., Кроткова И.Ф., Литвинова C.Н., Остроумова О.Д., 20222022Полякова О.А., Кроткова И.Ф., Литвинова C.Н., Остроумова О.Д.Polyakova O.A., Krotkova I.F., Litvinova S.N., Ostroumova O.D.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/7209

Стресс является неотъемлемой частью повседневной личной и трудовой жизни каждого человека и одним из важных факторов, влияющих на здоровье и продолжительность жизни. Неадекватный, чрезмерный или длительный стресс, превышая естественные регуляторные возможности и адаптационные ресурсы организма, приводит к изменению гомеостаза и широкому спектру проблем, включая метаболический синдром, ожирение, психические расстройства, сердечно-сосудистые заболевания и др. Учитывая, что стресс в данном контексте выступает как фактор риска этих состояний, а они могут сочетаться у пациента, его можно рассматривать как основу развития у пациента полиморбидного фона. Полиморбидность – сочетание у больного сразу двух и более заболеваний, рассматривается в настоящее время как одна из самых серьезных проблем современной медицины, требующей от врача углубленных знаний в различных междисциплинарных областях. Полиморбидность связана с более частым обращением за медицинской помощью, более низким качеством жизни и более высоким риском преждевременной смертности. В связи с этим понимание патофизиологии стресса и знание способов его коррекции на ранних этапах является актуальной медицинской задачей, требующей решения. В настоящей работе приводится краткий обзор организации и (пато-)физиологии стрессовой системы человека, обсуждается роль стресса в развитии полиморбидности, в частности ее кардиометаболического фенотипа, на примере взаимосвязи острого и хронического психологического стресса с развитием сердечно-сосудистых заболеваний, описываются способы управления стрессом на ранних этапах, включая применение комбинированного препарата фенобарбитала и этилбромизовалерианата с мультимодальным спектром действия.

Stress is an integral part of every person’s daily personal and work life, and one of the important factors affecting health and longevity. Excessive or prolonged stress, exceeding natural regulatory capabilities and adaptive resources of the body, leads to changes in homeostasis and a wide range of problems, including metabolic syndrome, obesity, mental disorders, cardiovascular disease, etc. Given that stress in this context acts as a risk factor for these conditions, and they can be combined in a patient, it can be seen as the basis for the development of polymorbidity. Polymorbidity, the combination of two or more diseases in a patient, is currently regarded as one of the most serious problems of modern medicine, requiring from the doctor in-depth knowledge in various interdisciplinary areas. Polymorbidity is associated with more frequent use of medical care, lower quality of life, and a higher risk of premature mortality. In this regard, understanding the pathophysiology of stress and knowing how to correct it early is an urgent medical challenge that needs to be solved. The present work gives a brief overview of the organization and (patho-)physiology of the human stress system, discusses the role of stress in the development of polymorbidity, in particular its cardiometabolic phenotype, using the example of the relationship between acute and chronic psychological stress and the development of cardiovascular disease, describes ways of stress management in the early stages, including the use of the combined drug phenobarbital and ethylbromizovalerianate with a multimodal spectrum of action.

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