asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2024-042asurgery-468Research ArticleФЛЕБОЛОГИЯPHLEBOLOGYФиксированные комбинации в фармакотерапии хронических заболеваний венFixed-dose combinations in pharmacotherapy of chronic venous diseaseshttps://orcid.org/0000-0002-3940-0787БогачевВ. Ю.BogachevV. Yu.

Богачев Вадим Юрьевич, д.м.н., профессор кафедры факультетской хирургии №2; хирург-флеболог 

117997, Россия, Москва, ул. Островитянова, д. 1 

117447, Россия, Москва, ул. Дмитрия Ульянова, д. 31 

Vadim Yu. Bogachev, Dr. Sci. (Med.), Professor of the Department of Faculty Surgery No. 2

1, Ostrovityanov St., Moscow, 117997, Russia

31, Dmitry Ulyanov St., Moscow, 117447, Russia 

vadim.bogachev63@gmail.comhttps://orcid.org/0000-0003-4488-9123БолдинБ. В.BoldinB. V.

Болдин Борис Валентинович, д.м.н., профессор, заведующий кафедрой факультетской хирургии №2 

117997, Россия, Москва, ул. Островитянова, д. 1 

Boris V. Boldin, Dr. Sci. (Med.), Professor, Head of the Department of Faculty Surgery No. 2

1, Ostrovityanov St., Moscow, 117997, Russia 

facultysurgery@gmail.comhttps://orcid.org/0009-0005-1238-2645КомовК. В.KomovK. V.

Комов Константин Витальевич, к.м.н., доцент, заведующий учебной частью, кафедра факультетской хирургии №2 

117997, Россия, Москва, ул. Островитянова, д. 1 

Konstantin V. Komov, Cand. Sci. (Med.), Associate Professor, Head of the Academic Department, Department of Faculty Surgery No. 2 

1, Ostrovityanov St., Moscow, 117997, Russia 

komov@me.comhttps://orcid.org/0000-0003-3811-5156ДженинаО. В.DzheninaO. V.

Дженина Ольга Вадимовна, к.м.н., врач-флеболог 

117447, Россия, Москва, ул. Дмитрия Ульянова, д. 31 

Olga V. Dzhenina, Cand. Sci. (Med.), Phlebologist

31, Dmitry Ulyanov St., Moscow, 117447, Russia 

helgelman@mail.ruРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова; Первый флебологический центрРоссияPirogov Russian National Research Medical University; First Phlebological CenterRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationПервый флебологический центрРоссияFirst Phlebological CenterRussian Federation2024171120242124451Copyright © Богачев В.Ю., Болдин Б.В., Комов К.В., Дженина О.В., 20242024Богачев В.Ю., Болдин Б.В., Комов К.В., Дженина О.В.Bogachev V.Y., Boldin B.V., Komov K.V., Dzhenina O.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.a-surgeon.ru/jour/article/view/468

Хронические заболевания вен представляют собой самую распространенную сосудистую патологию нижних конечностей, оказывающую негативное влияние на все составляющие качества жизни современного человека. В силу высокой распространенности профилактика и лечение хронических заболеваний вен являются одной из приоритетных задач национальных систем здравоохранения индустриально развитых стран. Многочисленные экспериментальные и клинические исследования, проведенные в последние годы, выявили важную роль в патогенезе хронических заболеваний вен сосудистого воспаления и дисфункции эндотелия, определяющих не только широкий спектр веноспецифических симптомов, но и запускающих процесс патологического ремоделирования стенки вены и ее клапанного аппарата, с последующим развитием варикозного синдрома и более тяжелых форм хронической венозной недостаточности. Современные представления о патогенезе хронических заболеваний вен позволяют выделить несколько приоритетных стратегий, направленных на коррекцию основных патофизиологических механизмов развития и прогрессирования заболевания. Одной из них выступает фармакотерапия с применением флеботропных препаратов, некоторые из которых способны подавлять веноспецифическое воспаление, улучшать состояние микроциркуляторного русла, повышать тонус и сократимость вен и, как следствие, положительно влиять на клинические проявления хронического заболевания вен. В данном обзоре представлен механизм действия нового для Российской Федерации флеботропного препарата, представляющего собой комбинацию экстракта корневищ иглицы колючей, гесперидина метилхалкона и аскорбиновой кислоты. Препарат обладает высоким уровнем доказательств клинической эффективности и безопасности для пациентов с различными формами хронических заболеваний вен. Исходя из уникальной особенности его механизмов действия оптимальными фокус-группами для его применения могут стать пациенты различных возрастных групп с начальными стадиями заболевания, в которых доминируют веноспецифические симптомы, и больные с хроническим венозным отеком.

Chronic venous diseases are the most common vascular diseases of the lower extremities, negatively affecting all components of the quality of life in the modern society. Due to their high prevalence, the prevention and treatment of chronic venous diseases are one of the priorities of national healthcare systems in industrially developed countries. In recent years, numerous experimental and clinical studies have uncovered an important role of vascular inflammation and endothelial dysfunction in the pathogenesis of chronic venous diseases, which determine not only a wide range of vein-specific symptoms, but are also the main drivers of pathological remodelling of the vein wall and its valve apparatus, followed by the development of varicose syndrome and more severe chronic venous insufficiency. Modern knowledge of the pathogenesis of chronic venous diseases enables us to identify several priority strategies aimed at managing the basic pathophysiological mechanisms of the development and progression of the disease. Pharmacotherapy with phlebotropic drugs is one of them. Some of these drugs are able to inhibit the vein-specific inflammation, improve the microcirculatory bed regulation, increase the vein tone and contractility and, as a result, have a positive effect on the clinical signs of chronic venous disease. This review presents the mechanism of action of a phlebotropic drug that is new to the Russian Federation. It is a combination of Ruscus aculeatus extract (Ruscus extract) with hesperidin methyl chalcone (HMC) and ascorbic acid. Studies showed a high level of evidence of clinical efficacy and safety of this drug for the treatment of patients with various forms of chronic venous diseases. Due to the unique features of its mechanisms of action, the optimal focus groups for its use may include patients of different age groups with early-stage disease, in which vein-specific symptoms predominate, and patients with chronic venous oedema.

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