Журнал "Нирки" Том 12, №1, 2023
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Фармакологічне обґрунтування практичного використання комбінованих засобів з D-манозою та екстрактом журавлини в терапії інфекцій сечовивідних шляхів
Автори: Кіреєв І.В., Литкін Д.В.
Національний фармацевтичний університет, м. Харків, Україна
Рубрики: Нефрологія
Розділи: Довідник фахівця
Версія для друку
Інфекції сечовивідних шляхів (ІСШ) вважаються одними з найпоширеніших інфекційних захворювань у світі. Понад 150 млн пацієнтів щорічно страждають від ІСШ, а серед жінок, старших від 18 років, приблизно 11 % повідомляють про принаймні один епізод ІСШ на рік. Ризик розвитку ІСШ також збільшується у вагітних, пацієнтів із захворюваннями простати, цукровим діабетом і катетеризацією тощо. Основною причиною розвитку ІСШ є уропатогенна кишкова паличка, що спричиняє понад 80 % усіх зареєстрованих епізодів хвороби. Бактерія закріплюється на уротелії, розмножується й колонізує сечовидільні шляхи, що й призводить до маніфестації захворювання. Зростаюча антибіотикорезистентність уропатогенних штамів і схильність ІСШ до рецидивів обумовлюють актуальність пошуку альтернативних профілактичних і терапевтичних підходів. Вдалою комбінацією в комплексному лікуванні й профілактиці ІСШ може вважатись комплексний засіб Урорубін, до складу якого входять D-маноза, проантоціанідини журавлини й екстракт шавлії лікарської. Фармакологічне обґрунтування використання D-манози та екстракту журавлини для профілактики ІСШ базується на їх властивості інгібувати адгезію бактерій до уротеліальних клітин. Екстракт шавлії лікарської чинить бактерицидну, протизапальну, аналгетичну, сечогінну, нефропротекторну й антиоксидантну дію. Метааналізи й систематичні огляди, сформовані за результатами клінічних досліджень вищезазначених речовин, свідчать про доцільність застосування таких комбінованих засобів з метою профілактики й комплексного лікування ІСШ, а також вказують на сприятливий профіль їх безпеки. Окрім цього, такі комбінації мають незначний ризик розвитку резистентності в бактерій на відміну від антибіотиків і синтетичних антибактеріальних засобів. Отже, Урорубін, що являє собою натуральний засіб на основі D-манози, стандартизований за вмістом проантоціанідинів екстракту журавлини та екстракту шавлії лікарської, може бути рекомендований при гострому та хронічному циститі, а також як засіб профілактики, у тому числі з метою запобігання рецидивам інфекцій сечовивідних шляхів.
Urinary tract infections (UTIs) are considered one of the most common infectious diseases in the world. More than 150 million patients suffer from a UTI annually, and among women over the age of 18, approximately 11 % report at least one episode of UTI per year. The risk of developing a UTI also increases in pregnant women, patients with prostate diseases, diabetes and catheterization, etc. The main cause of UTI development is uropathogenic Escherichia coli, which causes more than 80 % of all recorded episodes of the disease. The bacterium attaches itself to the urothelium, multiplies and colonizes the urinary tract, which leads to the manifestation of the disease. The growing antibiotic resistance of uropathogenic strains and the propensity of UTIs to relapse determine the urgency of finding alternative preventive and therapeutic approaches. A successful combination in the comprehensive treatment and prevention of UTI can be considered Urorubin, which includes D-mannose, cranberry proanthocyanidins and sage (Salvia officinalis) extract. The pharmacological justification for the use of D-mannose and cranberry extract to prevent UTI is based on their ability to inhibit bacterial adhesion to urothelial cells. Sage extract has a bactericidal, anti-inflammatory, analgesic, diuretic, nephroprotective and antioxidant effect. Meta-analyses and systematic reviews, based on the results of clinical studies of the above-mentioned substances, testify to the feasibility of using such combined agents for the prevention and comprehensive treatment of UTIs, and also indicate a favorable safety profile. In addition, these combinations have a small risk of developing resistance in bacteria, unlike antibiotics and synthetic antibacterial drugs. Therefore, Urorubin, which is a natural remedy based on D-mannose, standardized by the content of cranberry proanthocyanidins and sage extract, can be recommended for acute and chronic cystitis, as well as a preventive measure, including for the purpose of preventing recurrent urinary tract infections.
інфекції сечовивідних шляхів; фармакотерапія; профілактика; D-маноза; проантоціанідини журавлини; шавлія лікарська
urinary tract infections; pharmacotherapy; prevention; D-mannose; cranberry proanthocyanidins; sage
Вступ
Сучасний стан антибіотикотерапії в лікуванні ІСШ
Використання D-манози в терапії ІСШ
Фармакологічна роль проантоціанідинів журавлини в лікуванні й профілактиці ІСШ
Супутні шляхи фармакотерапії ІСШ
Висновки
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