medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-344medsovet-9355Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYЭффективность комбинированной терапии мебеверином и псиллиумом у пациентов с синдромом раздраженного кишечника с преобладанием запораEfficiency of combination therapy with mebeverine and psyllium in patients with irritable bowel syndrome with predominant constipationhttps://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.ruЧерепнинМ. А.CherepninM. A.

Черепнин Михаил Александрович, младший научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей

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

Mikhail A. Cherepnin, Junior Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

mikhail.cherepnin@yandex.ruhttps://orcid.org/0000-0001-7518-1895ТонкихЮ. Л.TonkikhJ. 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 Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

tjulia@bk.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 Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

alexander_vasyutin@mail.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”, Research Institute of Medical Problems of the NorthRussian Federation2025100920251913133139Copyright © Цуканов В.В., Черепнин М.А., Тонких Ю.Л., Васютин А.В., 20252025Цуканов В.В., Черепнин М.А., Тонких Ю.Л., Васютин А.В.Tsukanov V.V., Cherepnin M.A., Tonkikh J.L., Vasyutin A.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/9355Введение

Введение. Синдром раздраженного кишечника (СРК) является одной из наиболее актуальных проблем гастроэнтерологии, и подходы к его лечению быстро меняются.

Цель

Цель. Изучить эффективность терапии мебеверином и псиллиумом у пациентов с СРК с преобладанием запора (СРК-З).

Материалы и методы

Материалы и методы. Обследовано 177 пациентов с СРК-З. Пациенты были разделены на 4 группы: группа А – 42 пациента, которые 8 нед. получали препарат псиллиума 30 г в сутки; группа В – 48 больных, которые 4 нед. принимали мебеверин 400 мг в сутки; группа С – 49 больных, которые 8 нед. лечились мебеверином 400 мг в сутки; группа D – 38 пациентов, которые 8 нед. принимали мебеверин 400 мг в сутки и псиллиум 30 г в сутки. Диагностика СРК проводилась на основании Римских критериев IV. Осмотр пациентов с регистрацией клинических данных осуществлялся через каждые 2 нед. в течение 8 нед.

Результаты

Результаты. По шкале IBS-SSS в группе С сумма баллов снизилась за время терапии с 259 до 49 баллов, в группе D – c 240 до 33 баллов (p = 0,001 для обеих групп; рC/D = 0,36). Исследование динамики частоты и формы стула в течение 8 нед. продемонстрировало значительную эффективность псиллиума. Частота стула увеличивалась в группе А с 1,6 до 4,8 раза в неделю (р = 0,01), в группе D – с 1,5 до 5,5 раза в неделю (р = 0,03). У пациентов групп B и С столь очевидных положительных изменений частоты и формы стула не регистрировалось.

Заключение

Заключение. Комбинация мебеверина и псиллиума у пациентов с СРК-З, применяемая в течение 8 недель, показала хорошие результаты и дала возможность не только купировать проявления болевого синдрома, но и улучшить показатели моторики кишечника.

Introduction

Introduction. Irritable bowel syndrome (IBS) is one of the most pressing problems in gastroenterology, approaches to its treatment are rapidly changing.

Aim

Aim. To study the efficacy of mebeverine and psyllium therapy in IBS patients with predominant constipation (IBS-C).

Materials and methods

Materials and methods. A total of 177 patients with IBS-C were examined. The patients were divided into 4 groups: Group A – 42 patients received psyllium 30 g per day for 8 weeks; Group B – 48 patients received Mebeverine 400 mg per day for 4 weeks; Group C – 49 patients were treated with Mebeverine 400 mg per day for 8 weeks; Group D – 38 patients received Mebeverine 400 mg per day and psyllium 30 g per day for 8 weeks. IBS was diagnosed based on Rome IV criteria. Patients were examined with clinical data recorded every 2 weeks for 8 weeks.

Results

Results. According to the IBS-SSS scale, in group C the total score decreased during therapy from 259 to 49 points, in group D – from 240 to 33 points (in both groups p = 0.001; рC/D = 0,36). The study of the dynamics of stool frequency and form over 8 weeks demonstrated the significant effectiveness of psyllium. The frequency of stool increased in group A from 1.6 to 4.8 times per week (p = 0.01), in group D – from 1.5 to 5.5 times per week (p = 0.03). In patients of groups B and C, such obvious positive changes in the frequency and form of stool were not recorded.

Conclusion

Conclusion. The combination of mebeverine and psyllium in patients with IBS-C, used for 8 weeks, showed good results and made it possible to relieve both the manifestations of pain syndrome and improve intestinal motility indicators.

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