medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-188medsovet-9210Research ArticleРАЦИОНАЛЬНАЯ ФАРМАКОТЕРАПИЯRATIONAL PHARMACOTHERAPYОпыт применения комбинированных мукоактивных препаратов при ведении пациентов с продуктивным кашлемExperience of using combined mucoactive drugs in the management of patients with productive coughhttps://orcid.org/0000-0002-4293-3285ОрловаН. В.OrlovaN. V.

Орлова Наталья Васильевна, д.м.н., профессор кафедры факультетской терапии института материнства и детства

117997, Москва, ул. Островитянова, д. 1

Natalia V. Orlova, Dr. Sci. (Med.), Professor of the Department of Faculty Therapy of the Institute of Maternity and Childhood

1, Ostrovityanov St., Moscow, 117997

vrach315@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation20252206202509192199Copyright © Орлова Н.В., 20252025Орлова Н.В.Orlova N.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/9210

Кашель является распространенным симптомом при респираторных заболеваниях. Образование слизи в дыхательных путях и кашлевой рефлекс связаны с физиологической защитной функцией. Продуктивный кашель при воспалительных заболеваниях обусловлен гиперсекрецией слизи; что может приводить к нарушению мукоцилиарного клиренса; увеличению риска инфекции; окклюзии дыхательных путей; снижению эффективности терапии; выраженному нарушению качества жизни и другим осложнениям. В статье приведены клинические случаи острого бронхита и обострения хронической обструктивной болезни легких (ХОБЛ); демонстрирующие тактику ведения; включая подходы к антибактериальной терапии; а также эффективность применения комбинированных мукоактивных препаратов при продуктивном кашле. Клинический случай острого бронхита демонстрирует излечение без применения антибактериальной терапии и эффективность комбинированного муколитического препарата для облегчения продуктивного кашля. На примере клинического случая обострения ХОБЛ разобраны критерии назначения антибактериальной терапии; а также эффективность назначения комбинированного мукоактивного препарата для облегчения кашля и улучшения откашливания мокроты. Обоснованность и эффективность применения комбинированных мукоактивных препаратов; приведенные в клинических случаях; сопоставлены с отечественными и зарубежными клиническими рекомендациями. Приведены результаты клинических исследований; доказавших эффективность применения фиксированной комбинации препаратов сальбутамол + бромгексин гидрохлорид + гвайфенезин при продуктивном кашле; а также улучшение характеристик мокроты по сравнению с другими группами комбинаций муколитических препаратов.

Cough is a common symptom of respiratory diseases. The formation of mucus in the respiratory tract and the cough reflex are associated with a physiological protective function. Productive cough in inflammatory diseases is caused by hypersecretion of mucus; which can lead to impaired mucociliary clearance; increased risk of infection; airway occlusion; decreased therapy effectiveness; severe impairment of quality of life; and other complications. The article presents clinical cases of acute bronchitis and exacerbation of chronic obstructive pulmonary disease; demonstrating management tactics; including approaches to antibacterial therapy; as well as the effectiveness of combined mucoactive drugs for productive cough. A clinical case of acute bronchitis demonstrates a cure without the use of antibacterial therapy and the effectiveness of the combined mucolytic drug salbutamol + bromhexine hydrochloride + guaifenesin to relieve productive cough. Using the example of a clinical case of COPD exacerbation; the criteria for prescribing antibacterial therapy; as well as the effectiveness of prescribing a combined mucoactive drug to relieve cough and improve sputum expectoration; are analyzed. The validity and effectiveness of the use of combined mucoactive drugs; given in clinical cases; are compared with domestic and foreign clinical recommendations. The results of clinical studies that have proven the effectiveness of using a fixed combination of salbutamol + bromhexine hydrochloride + guaifenesin for productive cough; as well as improved sputum characteristics compared with other groups of mucolytic drug combinations; are presented.

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