medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2022-044medsovet-7530Research ArticleПРАКТИКАPRACTICEПрименение синбиотика для коррекции микрофлоры кишечника и лечения пациентов с синдромом раздраженного кишечникаUse of a synbiotic for the correction of gut microbiota and treatment of patients with irritable bowel syndromehttps://orcid.org/0000-0002-5484-0537ХалаиджеваК. Н.KhalaidzhevaK. N.

Халаиджева Ксения Николаевна, аспирант кафедры клинической фармакологии и пропедевтики внутренних болезней 

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

Kseniya N. Khalaidzheva, Postgraduate Student of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases 

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

Kseniyakhalaidzheva@mail.ruhttps://orcid.org/0000-0002-0535-2916ДроздовВ. Н.DrozdovV. N.

Дроздов Владимир Николаевич, д.м.н., профессор, профессор кафедры клинической фармакологии и пропедевтики внутренних болезней 

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

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

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

vndrozdov@yandex.ruРязанцеваО. В.RyazantsevaО. V.

Рязанцева Ольга Владимировна, к.м.н., доцент, кафедры клинической фармакологии и пропедевтики внутренних болезней 

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

Оlga V. Ryazantseva, Cand. Sci.  (Med.), Associate Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases 

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

ryazantseva_o_v@staff.sechenov.ruhttps://orcid.org/0000-0001-6589-7654ШихЕ. В.ShikhE. V.

Ших Евгения Валерьевна, д.м.н., профессор, заведующая кафедрой клинической фармакологии и пропедевтики внутренних болезней 

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

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

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

chih@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20231205202306275280Copyright © Халаиджева К.Н., Дроздов В.Н., Рязанцева О.В., Ших Е.В., 20232023Халаиджева К.Н., Дроздов В.Н., Рязанцева О.В., Ших Е.В.Khalaidzheva K.N., Drozdov V.N., Ryazantseva О.V., Shikh E.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/7530

Введение. Синдром раздраженного кишечника (СРК) – хроническое функциональное заболевание кишечника, при котором боль в животе связана с дефекацией, изменением частоты и характера стула. Высокая социально-медицинская значимость этого заболевания обусловлена большой распространенностью в мире, влиянием на качество жизни и значительными затратами для пациентов, здравоохранения и общества. В настоящее время в качестве одного из провоцирующих заболевание факторов рассматривается состояние кишечной стенки и изменение качественного и количественного состава микрофлоры кишечника. Учитывая роль микробиоты в развитии синдрома раздраженного кишечника, целесообразно применение пробиотических препаратов в качестве терапии СРК. Цель. Оценить влияние синбиотика Максилак® на микробиоту кишечника и клинические проявления СРК. Материалы и  методы. Исследование проведено у  15  (9  женщин и  6  мужчин) больных СРК с  диареей, средний возраст 42,6 ± 3,7 года. Максилак® применяли по 1 капсуле вечером во время еды в течение 21 дня. Всем больным перед началом и по окончании лечения проводили бактериологическое исследование кала и оценивали клинические проявления: частоту стула в течение недели, боль в животе по ВАШ (мм), выраженность метеоризма по ВАШ (мм). Результаты и обсуждение. Отмечалась положительная динамика изменения микробиоты кишечника: значимое увеличение КОЕ бифидо- и лактобактерий, типичных E.coli и энтерококков. Количество КОЕ гемолитических E.coli, золотистого стафилококка и грибов рода Candida статистически значимо уменьшилось. У больных на фоне приема Максилак® частота дефекаций снизилась с 31 до 16 раз в неделю (р < 0,05); боль в животе с 55 до 35 баллов по ВАШ (р < 0,05); проявления метеоризма с 60 до 40 баллов по ВАШ (р < 0,05). Выводы. Синбиотик Максилак® является одним из препаратов, который может быть эффективно и безопасно использован в комплексной терапии СРК.

Introduction. Irritable bowel syndrome (IBS) is a chronic functional bowel disorder that presents with abdominal pain associated with defecation, a change in stool frequency and a change in the appearance of the stool. The high socio-medical significance of this disorder is determined by high global prevalence, impact on quality of life and significant costs for patients, health care and society. Currently, the intestinal wall status, and the qualitative and quantitative changes in gut microbiota are considered as  one of the factors provoking the disorder. Given the role of microbiota in the development of irritable bowel syndrome, it is advisable to use probiotics as a therapy for IBS. Aim. To evaluate the effect of synbiotic Maxilac® on the gut microbiota and clinical signs of IBS. Materials and methods. A total of 15 (9 women and 6 men, mean age 42,6 ± 3,7 years) patients with diarrhea-predominant IBS (IBS-D) were enrolled in the study. They received Maxilac® at a dose of 1 capsule in the evening with meals for 21 days. Before and after treatment, all patients underwent bacteriological testing of faeces and assessment of clinical signs: stool frequency during the week, abdominal pain measurements using a VAS scale (mm), bloating severity measurements using a VAS scale (mm). Results and discussion. The study showed positive changes in the intestinal microbiota: a significant growth of bifidobacteria and lactobacilli (CFU), typical E.coli and enterococci. The number of hemolytic E. coli, Staphylococcus aureus and Candida fungi (CFU) was significantly reduced. In the Maxilac® group, the defecation frequency decreased from 31 to 16 times a week (p < 0.05); abdominal pain from 55 to 35 VAS scores (p < 0.05); bloating from 60 to 40 VAS scores (p < 0.05). Conclusions. The synbiotic Maxilac® is one of the drugs that can be efficiently and safely used as part of combination therapy for IBS.

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