medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-101medsovet-8179Research ArticleИНФЕКЦИИINFECTIONSРецидивирующий цистит: как достичь совершенства в лечении?Recurrent cystitis: how to achieve perfection in treatment?https://orcid.org/0000-0001-8062-7775КульчавеняЕ. В.KulchavenyaE. V.

Кульчавеня Екатерина Валерьевна, д.м.н., профессор, профессор кафедры фтизиопульмонологии, Новосибирский государственный медицинский университет; научный руководитель отдела урологии, Клинический госпиталь «Авиценна» группы компаний «Мать и дитя»

630091, Новосибирск, Красный проспект, д. 52,

630132, Новосибирск, проспект Димитрова, д. 7

Ekaterina V. Kulchavenya, Dr. Sci. (Med.), Professor, Professor of the Department of Phthisiopulmonology, Novosibirsk State Medical University; Scientific Director of the Department of Urology, Clinical Hospital “Avicenna” of Group of Companies “Mother and Child”

52, Krasny Ave., Novosibirsk, 630091, 

7, Dimitrov Ave., Novosibirsk, 630132

urotub@yandex.ruhttps://orcid.org/0000-0001-6645-6455ХолтобинД. П.KholtobinD. P.

Холтобин Денис Петрович, д.м.н., профессор кафедры урологии и андрологии с курсом ДПО, Алтайский государственный медицинский университет; заведующий урологическим отделением руководитель клиники урологии, Клинический госпиталь «Авиценна» группы компаний «Мать и дитя»

656038, Барнаул, проспект Ленина, д. 40,

630132, Новосибирск, проспект Димитрова, д. 7

 

Denis P. Kholtobin, Dr. Sci. (Med.), Professor of the Department of Urology and Andrology with a Course of Additional Professional Training, Altai State Medical University; Head of the Urology Department, Head of the Urology Clinic, Clinical Hospital “Avicenna” of Group of Companies “Mother and Child”

40, Lenin Ave., Barnaul, 656038,

7, Dimitrov Ave., Novosibirsk, 630132

 

urology-avicenna@mail.ruhttps://orcid.org/0000-0002-2697-4001БрижатюкЕ. В.BrizhatyukE. V.

Брижатюк Елена Владимировна, к.м.н., врач-уролог

630132, Новосибирск, ул. Железнодорожная, д. 12/1

Elena V. Brizhatyuk, Cand. Sci. (Med.), Urologist

12/1, Office 6, Zheleznodorozhnaya St., Novosibirsk, 630132

elena.brizhatyuk@yandex.ruhttps://orcid.org/0000-0001-5013-2667ШевченкоС. Ю.ShevchenkoS. Yu.

Шевченко Сергей Юрьевич, к.м.н., заместитель главного врача, Городская больница №3; врач-уролог высшей категории, Центры семейной медицины «Здравица»

630056, Новосибирск, ул. Мухачева, д. 5/4,

630008, Новосибирск, ул. Шевченко, д. 31а

Sergey Yu. Shevchenko, Cand. Sci. (Med.), Deputy Chief Physician, City Hospital No. 3; Urologist of the Highest Category, Family Medicine Centers “Zdravitsa”

5/4, Mukhachev St., Novosibirsk, 630056, 

31A, Shevchenko St., Novosibirsk, 630008

shevchenko_s@list.ruhttps://orcid.org/0000-0002-5435-2955ТрейвишЛ. С.TreyvishL. S.

Трейвиш Любовь Степановна, к.м.н., заведующий акушерско-гинекологическим отделом, врач – акушер-гинеколог, детский гинеколог, гинеколог-эндокринолог

630132, Новосибирск, проспект Димитрова, д. 7

Lyubov S. Treyvish, Cand. Sci. (Med.), Head of the Obstetrics and Gynecology Department, Obstetrician-Gynecologist, Pediatric Gynecologist, Gynecologist-Endocrinologist

7, Dimitrov Ave., Novosibirsk, 630132

ms.lubov_tr@mail.ruТелинаЕ. В.TelinaE. V.

Телина Елена Владимировна, главный врач, генеральный директор, врач – акушер-гинеколог

630132, Новосибирск, проспект Димитрова, д. 7

Elena V. Telina, Chief Physician, General Director, Obstetrician-Gynecologist

7, Dimitrov Ave., Novosibirsk, 630132

urology-avicenna@mail.ruНовосибирский государственный медицинский университет; Клинический госпиталь «Авиценна» группы компаний «Мать и дитя»РоссияNovosibirsk State Medical University; Clinical Hospital “Avicenna” of Group of Companies “Mother and Child”Russian FederationКлинический госпиталь «Авиценна» группы компаний «Мать и дитя»; Алтайский государственный медицинский университетРоссияClinical Hospital “Avicenna” of Group of Companies “Mother and Child”; Altai State Medical UniversityRussian FederationЦентр семейной медицины «Алмита»РоссияFamily Medicine Center “Almita”Russian FederationГородская больница №3; Центры семейной медицины «Здравица»РоссияCity Hospital No. 3; Family Medicine Centers “Zdravitsa”Russian FederationКлинический госпиталь «Авиценна» группы компаний «Мать и дитя»РоссияClinical Hospital “Avicenna” of Group of Companies “Mother and Child”Russian Federation202401052024048491Copyright © Кульчавеня Е.В., Холтобин Д.П., Брижатюк Е.В., Шевченко С.Ю., Трейвиш Л.С., Телина Е.В., 20242024Кульчавеня Е.В., Холтобин Д.П., Брижатюк Е.В., Шевченко С.Ю., Трейвиш Л.С., Телина Е.В.Kulchavenya E.V., Kholtobin D.P., Brizhatyuk E.V., Shevchenko S.Y., Treyvish L.S., Telina 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/8179Введение

Введение. Инфекции мочевыводящих путей являются вторым наиболее распространенным типом бактериальных инфекций во всем мире. Лечение больных хроническим (рецидивирующим) циститом все еще представляет проблему и требует индивидуального подхода.

Цель

Цель. Оценить эффективность комбинированной терапии обострения хронического цистита.

Материалы и методы

Материалы и методы. В открытое сравнительное двунаправленное исследование были включены 65 пациенток в возрасте от 18 до 48 лет. Все пациентки получали антибактериальную терапию по поводу обострения хронического цистита в соответствии с клиническими рекомендациями «Цистит у женщин». По ее завершении группа сравнения (35 пациенток) никаких препаратов не принимала, а 30 пациенткам основной группы назначили биологически активную добавку Цистениум II по одной рассасывающейся таблетке 2 раза в день в течение 2 нед. Обследование включало оценку жалоб по шкале симптомов острого цистита Acute Cystitis Symptom Score (ACSS), общий анализ мочи и посев мочи на микрофлору. Эффективность лечения оценивали по окончании приема антибактериальных препаратов и через 2 нед.

Результаты

Результаты. По завершении антибактериальной терапии ни в одном случае не было достигнуто полного излечения (нормализация анализов мочи, отсутствие роста патогенной микрофлоры, отсутствие жалоб). На втором визите в обеих группах отмечено статистически значимое снижение баллов по шкале ACSS. В течение последующих двух недель симптоматика в группе сравнения не изменилась (р > 0,05), а в основной группе сумма баллов продолжала уменьшаться, достигнув в среднем 3,62 ± 0,42, что 5,5 раза меньше исходного и почти в 3 раза меньше суммы баллов по окончании антибактериальной терапии (р < 0,05). Динамика лейкоцитурии и бактериурии также была более выражена в основной группе.

Заключение

Заключение. После антибактериальной терапии по поводу рецидива хронического (рецидивирующего) цистита, как правило, имеются остаточные явления, которые нельзя расценить как проявления активного заболевания, но они беспокоят пациентку. Проведение вторым этапом двухнедельного курса патогенетического лечения комплексом, содержащим проантоцианидины Vaccinium macrocarpon типа А, витамин С и D-маннозу, позволяет повысить эффективность лечения.

Introduction

Introduction. Urinary tract infections are the second most common type of bacterial infections worldwide. Treatment of patients with chronic (recurrent) cystitis remains challenging and requires an individual approach.

Aim

Aim. To assess the efficacy of combined therapy for exacerbation of chronic cystitis.

Materials and methods

Materials and methods. A total of 65 women aged 18–48 years were enrolled in an open comparative bidirectional study. All participants received antibacterial therapy for exacerbation of chronic cystitis in accordance with the clinical guidelines for the treatment of cystitis in women. After the therapy was completed, the comparison group (35 patients) did not receive any drugs, whereas 30 patients from the treatment group were prescribed Cystenium II biologically active dietary supplement at a dose of 1 orally disintegrating tablet twice daily for 2 weeks. The examination included a measurement of the severity of complaints using the Acute Cystitis Symptom Score (ACSS), a clinical urinalysis and urine culture + sensitivity test. The efficacy of treatment was assessed following completion of antibiotic therapy and two weeks after the therapy.

Results

Results. After finishing antibiotic treatment, no patient has achieved full recovery (improvement of urinalyses, no growth of pathogenic microbial flora, no complaints). Both groups showed statistically significant decreases in ACSS scores on Visit 2. Over the following two weeks, the symptoms in the comparison group did not change (p > 0.05), and in the treatment group the sum of scores continued to decrease, reaching an average of 3.62 ± 0.42, which is 5.5 times less than the baseline level and almost 3 times less than the sum of scores following completion of antibacterial therapy (p < 0.05). The positive changes in leukocyturia and bacteriuria were also more pronounced in the treatment group.

Conclusion

Conclusion. After completion of antibiotic therapy for relapse of chronic (recurrent) cystitis, the patients usually have residual effects that cannot be regarded as presentations of an active disease, but they disturb patients. A two-week course of pathogenetic therapy with a combination drug containing A-type Vaccinium macrocarpon proanthocyanidins, vitamin C and D-mannose to be received as the second step can increase the efficacy of treatment.

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