References

asurgery

Амбулаторная хирургия

Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)

2712-87412782-2591

ООО «ГРУППА РЕМЕДИУМ»

10.21518/akh2024-039

asurgery-473

Research Article

ФЛЕБОЛОГИЯ

PHLEBOLOGY

Современные представления о фармакотерапии варикозной болезни таза у женщин

Modern ideas about pharmacotherapy of pelvic congestion syndrome in women

https://orcid.org/0000-0001-8146-2263

Ахметзянов

Р. В.

Akhmetzianov

R. V.

Ахметзянов Рустем Вилевич, д.м.н., доцент кафедры сердечно-сосудистой и эндоваскулярной хирургии; врач – сердечно-сосудистый хирург

420012, Россия, Казань, ул. Бутлерова, д. 49

420101, Россия, Казань, ул. Карбышева, д. 12а

Rustem V. Akhmetzianov, Dr. Sci. (Med.), Assistant Professor, Department of Cardiovascular and Endovascular Surgery; Cardiovascular Surgeon

49, Butlerov St., Kazan, 420012, Russia

12a, Karbyshev St., Kazan, 420101, Russia

arustemv@mail.ru

https://orcid.org/0000-0001-7160-3333

Бредихин

Р. А.

Bredikhin

R. A.

Бредихин Роман Александрович, д.м.н., профессор, доцент кафедры сердечно-сосудистой и эндоваскулярной хирургии; руководитель отделения сосудистой хирургии

420012, Россия, Казань, ул. Бутлерова, д. 49

420101, Россия, Казань, ул. Карбышева, д. 12а

Roman A. Bredikhin, Dr. Sci. (Med.), Professor, Department of Cardiovascular and Endovascular Surgery; Head of the Vascular Surgery Department

49, Butlerov St., Kazan, 420012, Russia

12a, Karbyshev St., Kazan, 420101, Russia

rbredikhin@mail.ru

Казанский государственный медицинский университет; Межрегиональный клинико-диагностический центрРоссияKazan State Medical University; Interregional Clinical Diagnostic CenterRussian Federation

2024

17112024

21294103

2024

Ахметзянов Р.В., Бредихин Р.А.

Akhmetzianov R.V., Bredikhin R.A.

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/473

Варикозная болезнь таза (ВБТ) не является редким и малоизученным заболеванием. Однако современное состояние фармакотерапии ВБТ характеризуется не только недостаточной изученностью данного вопроса, но и наличием противоречивых взглядов. Результаты ключевых публикаций доказывают, что основная тенденция лечения ВБТ ассоциирована с инвазивными методами. При этом фармакотерапия служит успешным решением, приводящим к купированию основных симптомов у большей части пациенток с ВБТ. Текущий обзор основан на анализе данных известной научной литературы и клинических рекомендаций. Он охватывает различные аспекты консервативного лечения пациенток с ВБТ и концентрируется на фармакотерапии. Данная публикация ставит своей целью обобщить известные данные, связанные с медикаментозной коррекцией ВБТ, на основе доказательной медицины. Обзор представляет информацию, связанную с историей подбора фармакотерапии, включающей комбинации препаратов различных групп с назначением анальгетиков, гормональных, психотропных, веноактивных препаратов и селективных вазоконстрикторов. Представлен объективный анализ каждой из указанных фармакологических групп препаратов с оценкой последующих перспектив, включающий не только известные лечебные средства, но и не используемые ранее в терапии ВБТ. Препаратом выбора в арсенале лечащего врача служат вазоактивные препараты на основе диосмина с наибольшей доказательной базой у микронизированной очищенной флавоноидной фракции (МОФФ). При наличии выраженного болевого синдрома целесообразно кратковременное назначение анальгетиков. Наличие тревожно-депрессивных расстройств, а также выраженных ХТБ может служить показанием к приему психотропных препаратов. Необходимы дальнейшие исследования, направленные на расширение потенциала фармакотерапии пациенток с ВБТ.

Pelvic congestion syndrome (PCS) is not a rare and poorly studied disease. However, the current state of PCS pharmacotherapy is characterized not only by insufficient study of this issue, but also by the presence of conflicting views. The results of key publications prove that the main trend in PCS treatment is associated with invasive methods. At the same time, pharmacotherapy is a successful solution leading to the relief of the main symptoms in most patients with PCS. The current review is based on the analysis of data from known scientific literature and clinical guidelines. It covers various aspects of conservative treatment of patients with PCS and focuses on pharmacotherapy. This publication aims to summarize the known data related to drug correction of PCS, based on evidence-based medicine. The review presents information related to the history of the selection of pharmacotherapy, including combinations of drugs of various groups with the appointment of analgesics, hormonal, psychotropic, venoactive drugs and selective vasoconstrictors. An objective analysis of each of the indicated pharmacological groups of drugs is presented with an assessment of subsequent prospects, including not only known therapeutic agents, but also those not previously used in the therapy of PCS. The drug of choice in the arsenal of the attending physician are vasoactive drugs based on diosmin with the largest evidence base in MPFF. In the presence of severe pain syndrome, short-term administration of analgesics is advisable. The presence of anxiety-depressive disorders, as well as severe CPP, can serve as an indication for taking psychotropic drugs. Further research is needed to expand the potential of pharmacotherapy for patients with PCS.

варикозная болезнь тазахронические тазовые болитазовые венозные заболеванияфармакотерапияконсервативное лечениеМОФФ

pelvic congestion syndromechronic pelvic painpelvic venous disorderspharmacotherapyconservative treatmentMPFF

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