Динамика вегетативных, инсомнических и нейропсихологических проявлений в процессе терапии постковидного синдрома

Введение. Астения, вегетативные проявления, нарушения сна и психоэмоционального фона –спутники перенесенной коронавирусной инфекции, вопрос медикаментозной коррекции которых в настоящее время особенно актуален. Указанные симптомы в течение длительного времени нарушают привычный образ жизни пациентов, а в особых случаях приводят к нетрудоспособности.
Цель исследования. Изучить психические, соматоформные и когнитивные аспекты тревожных расстройств после коронавирусной инфекции в процессе лечения тофизопамом (Грандаксин®) по 150 мг/сут.
Материалы и методы. В исследовании приняли участие пациенты, перенесшие новую коронавирусную инфекцию, у которых после окончания лечения по поводу основного заболевания были жалобы, позволяющие предполагать наличие тревожного расстройства. Для оценки уровня тревоги использовалась шкала Гамильтона (HAM-A). Обследование пациентов проводилось до начала лечения, спустя 2, 4 и 6 нед. терапии.
Результаты и обсуждение. До начала терапии у всех больных отмечался общий высокий уровень тревоги: средний балл по HAM-A составлял 31,4 ± 2,92 балла. По окончании терапии Грандаксином® у всех больных отмечалось снижение уровня тревоги: в среднем 12,08 ± 2,27 балла по HAM-A (p < 0,001). Максимальное снижение выраженности вегетативных расстройств было отмечено к концу 6-й нед. терапии Грандаксином®. Так, показатель данной субшкалы уменьшился более чем в 2 раза: с 2,46 ± 0,54 до 1,05 ± 0,28 балла (р < 0,001). Степень выраженности инсомнии в течение 6 нед. терапии Грандаксином® уменьшилась с 2,56 ± 0,54 до 0,96 ± 0,45 балла (p < 0,001).
Заключение. Нарушения психоэмоционального фона (чаще в виде повышения тревожности), расстройства сна, вегетативные нарушения, астенический синдром значительно влияют на качество жизни пациентов, перенесших новую коронавирусную инфекцию. Вовлечение структур вегетативной нервной системы и центральных структур, регулирующих ГАМК-ергическую трансмиссию, приводит к значимым вегетативным сбоям, что требует патогенетически обоснованной лекарственной коррекции данных нарушений.

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