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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">asurgery</journal-id><journal-title-group><journal-title xml:lang="ru">Амбулаторная хирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Ambulatornaya khirurgiya = Ambulatory Surgery (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2712-8741</issn><issn pub-type="epub">2782-2591</issn><publisher><publisher-name>ООО «ГРУППА РЕМЕДИУМ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/akh2025-017</article-id><article-id custom-type="elpub" pub-id-type="custom">asurgery-539</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРОКТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PROCTOLOGY</subject></subj-group></article-categories><title-group><article-title>Комбинированный подход в терапии кровоточащего геморроя</article-title><trans-title-group xml:lang="en"><trans-title>Combined drug therapy of hemorrhoidal bleeding</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абрицова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Abritsova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Абрицова Марьяна Владимировна, к.м.н., врач-колопроктолог, руководитель колопроктологического отделения,</p><p>115191, Москва, ул. 3-я Рощинская, д. 6</p></bio><bio xml:lang="en"><p>Maryana V. Abritsova, Cand. Sci. (Med.), Coloproctologist, Сhief of Coloproctology Department,</p><p>6, 3rd Roshinskay St., Moscow, 115191</p></bio><email xlink:type="simple">abritsovamv@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Торчуа</surname><given-names>Н. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Torchua</surname><given-names>N. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Торчуа Нина Рафаэльевна, к.м.н., врач-колопроктолог, многопрофильная клиника «Реал Транс Хайр»;</p><p>115191, Москва, ул. 3-я Рощинская, д. 6</p></bio><bio xml:lang="en"><p>Nina R. Torchua, Cand. Sci. (Med.), Coloproctologist,</p><p>6, 3rd Roshinskay St., Moscow, 115191</p></bio><email xlink:type="simple">n.r.torchua@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Многопрофильная клиника «Реал Транс Хайр»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Multidisciplinary Clinic Real Trans Hair</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>09</day><month>06</month><year>2025</year></pub-date><volume>22</volume><issue>1</issue><fpage>153</fpage><lpage>159</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Абрицова М.В., Торчуа Н.Р., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Абрицова М.В., Торчуа Н.Р.</copyright-holder><copyright-holder xml:lang="en">Abritsova M.V., Torchua N.R.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.a-surgeon.ru/jour/article/view/539">https://www.a-surgeon.ru/jour/article/view/539</self-uri><abstract><p>Геморроидальная болезнь – одно из наиболее распространенных проктологических заболеваний. Основными факторами риска являются гиподинамия, ожирение, беременность, хронические запоры, в т. ч. диссинергическая дефекация. Системные биофлавоноиды (диосмин и гесперидин) демонстрируют высокую эффективность медикаментозной терапии, особенно на ранних стадиях заболевания. Эти вещества укрепляют кровеносные сосуды, уменьшают воспаление и улучшают микроциркуляцию. Исследования подтверждают, что комбинация системных биофлавоноидов с местными средствами, такими как алгинат натрия, ускоряет регресс симптомов геморроя. Алгинат натрия обладает выраженным кровоостанавливающим, ранозаживляющим и противовоспалительным действием и широко используется в виде ректальных суппозиториев. При сравнении изолированного применения биофлавоноидов (Венарус® ) и комбинированной терапии (Венарус® и Венапрокт Алиум) было продемонстрировано, что комбинация препаратов эффективнее снижает частоту кровотечений, способствует уменьшению размеров геморроидальных узлов, снижает частоту рецидивов. Представленный опыт авторов демонстрирует, что применение препаратов Венарус® и Венапрокт Алиум эффективно при кровоточащем геморрое. Были проанализированы результаты лечения 23 пациентов (11 мужчин/12 женщин), в возрасте 43 ± 5 лет, обратившихся для первичной консультации с жалобами на выделение крови из заднего прохода во время дефекации и ранее не проходивших обследования толстой кишки. Комбинация Венарус® и Венапрокт Алиум, с учетом терапевтического эффекта каждого из препаратов, может быть перспективной не только в качестве самостоятельной консервативной терапии геморроя, но и на этапе реабилитации после хирургических вмешательств; это требует дальнейших исследований.</p></abstract><trans-abstract xml:lang="en"><p>Hemorrhoidal disease is one of the most common proctological pathologies. The main risk factors are physical inactivity, obesity, pregnancy, and chronic constipation, including dysynergic bowel movements. Systemic bioflavonoids (diosmin and hesperidin) demonstrate high efficacy, especially in the early stages of the disease. These substances strengthen blood vessels, reduce inflammation and improve microcirculation. Studies confirm that the combination of systemic flavonoids with topical agents such as sodium alginate accelerates the regression of symptoms. Sodium alginate in the form of candles has hemostatic, wound-healing and anti-inflammatory effects. When comparing the isolated use of bioflavonoids (Venarus® ) and combination therapy (Venarus® and Venaproct Alium), it was demonstrated that the combination of drugs is more effective in reducing the frequency of bleeding, reducing the size of hemorrhoids and reducing the frequency of relapses. The presented authors’ own experience demonstrates that the use of Venarus® and Venaproсt Allium drugs is effective in bleeding hemorrhoids. The results of treatment of 23 patients (11 men/12 women), aged 43 ± 5 years, who came for an initial consultation with complaints of blood discharge from the anus during defecation and who had not previously undergone colon examination, were analyzed. The use of a combination of Venarus® and Venaproct Alium, taking into account the therapeutic effects of each of the drugs, may be promising not only as an independent conservative therapy for hemorrhoids, but also at the stage of rehabilitation after surgical interventions, this requires further research.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>геморрой</kwd><kwd>комбинированная терапия</kwd><kwd>биофлавоноиды</kwd><kwd>натрия алгинат</kwd><kwd>острый геморрой</kwd><kwd>геморроидальное кровотечение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>hemorrhoids</kwd><kwd>combination therapy</kwd><kwd>bioflavonoids</kwd><kwd>sodium alginate</kwd><kwd>acute hemorrhoids</kwd><kwd>hemorrhoidal bleeding</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Шелыгин ЮА, Благодарный ЛА. 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