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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">gastro-j</journal-id><journal-title-group><journal-title xml:lang="ru">Российский журнал гастроэнтерологии, гепатологии, колопроктологии</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Gastroenterology, Hepatology, Coloproctology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1382-4376</issn><issn pub-type="epub">2658-6673</issn><publisher><publisher-name>«Gastro» LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.22416/1382-4376-2019-29-4-50-59</article-id><article-id custom-type="elpub" pub-id-type="custom">gastro-j-397</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>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Эффективность физиологически активных нутриентов в лечении астенических расстройств у больных с хроническими диффузными заболеваниями печени</article-title><trans-title-group xml:lang="en"><trans-title>Efficacy of Physiologically Active nutrients in the Treatment of Asthenic Disorders in Patients with Chronic Diffuse Liver Diseases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8913-140X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маевская</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mayevskaya</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней119991, г. Москва, ул. Погодинская, д. 1, стр.1.</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor, Department of Propaedeutics of Internal Diseases</p><p>119991, Moscow, Pogodinskaya str., 1, building 1.</p></bio><email xlink:type="simple">liver.orc@mail.ru</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>Морозова</surname><given-names>М. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Morozova</surname><given-names>M. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, профессор, заведующая лабораторией психофармакологии 115522, г. Москва, Каширское шоссе, д. 34.</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Professor, Laboratory Head, Laboratory of Psychopharmacology115522, Moscow, Kashirskoye highway, 34.</p></bio><email xlink:type="simple">margmorozova@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бениашвили</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Beniashvili</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат медицинских наук, старший научный сотрудник лаборатории психофармакологии 115522, г. Москва, Каширское шоссе, д. 34.</p></bio><bio xml:lang="en"><p>Cand. Sci. (Med.), Senior Researcher, Laboratory of Psychopharmacology</p><p>115522, Moscow, Kashirskoye highway,</p></bio><email xlink:type="simple">beniashvilia@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9562-796X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Луньков</surname><given-names>В. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Lunkov</surname><given-names>V. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник Центра доказательной медицины 119991, г. Москва, ул. Погодинская, д. 1, стр. 1.</p></bio><bio xml:lang="en"><p>Junior Researcher, Centre for Evidence-Based Medicine</p><p>119991, Moscow, Pogodinskaya str., 1, building 1.</p></bio><email xlink:type="simple">vdlunkov@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>Ивашкин</surname><given-names>В. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Ivashkin</surname><given-names>V. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней19991, г. Москва, ул. Погодинская, д. 1, стр. 1.</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), RAS Academician, Prof., Head of Department, Department of Propaedeutics of Internal Diseases, Principal gastroenterologist119991, Moscow, Pogodinskaya str., 1, building 1.</p></bio><email xlink:type="simple">kont07@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Первый Московский государственный университет им. И.М. Сеченова» (Сеченовский университет) Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБНУ «Национальный центр психического здоровья»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Mental Health Research Centre</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>22</day><month>09</month><year>2019</year></pub-date><volume>29</volume><issue>4</issue><fpage>50</fpage><lpage>59</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маевская М.В., Морозова М.А., Бениашвили А.Г., Луньков В.Д., Ивашкин В.Т., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Маевская М.В., Морозова М.А., Бениашвили А.Г., Луньков В.Д., Ивашкин В.Т.</copyright-holder><copyright-holder xml:lang="en">Mayevskaya M.V., Morozova M.A., Beniashvili A.G., Lunkov V.D., Ivashkin V.T.</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.gastro-j.ru/jour/article/view/397">https://www.gastro-j.ru/jour/article/view/397</self-uri><abstract><p>В период после обострения хронических заболеваний печени у пациентов часто сохраняются общие симптомы (слабость или утомляемость, плохое настроение, расстройство сна, вегетативные нарушения — астенический синдром). Большой интерес в аспекте профилактики и лечения данной симптоматики в последние годы привлечен к нутрицевтическим продуктам, т.е. продуктам питания или обогащенным пищевым продуктам, оформленным в виде таблеток, саше и т. п.Цель исследования: изучить эффективность нутрицевтического продукта «ГЕПАТО Смарт» в лечении астенического синдрома у амбулаторных пациентов с хроническими диффузными заболеваниями печени с компенсированной функцией и функциональными нарушениями желчного пузыря в период после обострения.Материалы и методы. Включено 50 пациентов, выполнил программу 41 пациент. Нутрицевтический продукт (куркумин, пиперин, таншинон IIA, холин; стандартизован по куркумину и холину) назначали по 1 табл. 3 раза в день во время еды на 4 недели. Для объективизации общих симптомов использованы опросник D-FIS (Daily Fatigue Scale), четырехмерная шкала оценки дистресса, депрессии, тревоги и соматизации (4DSQ), опросник оценки качества жизни SF-36.Результаты. Через 4 недели курса нутрицевтического препарата «ГЕПАТО Смарт» отмечено статистически значимое снижение усталости по шкале D-FIS (р = 0,003), уровня дистресса, депрессии, тревоги и соматизации по опроснику 4DSQ (р = 0,005; р = 0,006; р = 0,003; р = 0,003 соответственно). Качество жизни пациентов по опроснику SF36 также улучшилось за счет как физического, так и психологического компонентов (р = 0,003). 16 пациентов продолжили прием препарата еще в течение 8 недель, чтобы сохранить достигнутый результат. В качестве дополнительного эффекта отмечено исчезновение боли в области правого подреберья в тех случаях, когда на момент включения в наблюдательную программу пациенты предъявляли эту жалобу. Профиль безопасности был хорошим, 1/3 пациентов отмечали появление изжоги, которая устранялась при приеме продукта вместе с едой.Заключение. Нутрицевтический продукт «ГЕПАТО Смарт» у пациентов с хроническими диффузными заболеваниями печени и функциональными нарушениями желчного пузыря приводит к улучшению общего состояния пациентов за счет достоверного уменьшения усталости и тревоги и повышает качество жизни за счет физического и психического компонентов здоровья.</p></abstract><trans-abstract xml:lang="en"><p>Over the period after an exacerbation of chronic liver diseases, patients often retain common symptoms (weakness or fatigue, bad mood, sleep disorder, vegetative disorders — asthenic syndrome). In the context of prevention and treatment of these symptoms, such nutraceutical products as enriched foods in the form of tablets, sachets, etc, have been increasingly attracting research attention.Aim. To study the efficacy of the “Hepato Smart” nutraceutical product for the treatment of asthenic syndrome in outpatients suffering from chronic diffuse liver diseases with compensated function and functional disorders of the gallbladder over the period after exacerbation.Materials and methods. The study included 50 patients, with 41 of them having completed the program. The nutraceutical product (curcumin, piperine, tanshinone IIA, choline; standardized for curcumin and choline) was assigned 1 pill 3 times a day with meals for 4 weeks. To objectify common symptoms, we used a D-FIS questionnaire (Daily Fatigue Impact Scale), a 4DSQ Four-Dimensional Symptom Questionnaire for assessing distress, depression, anxiety and somatization, and a SF-36 questionnaire for assessing the quality of life.Results. Following 4 weeks of the “Hepato Smart” course, a statistically significant decrease in fatigue was noted by D-FIS scores (p = 0.003), as well as a decrease in the level of distress, depression, anxiety and somatization by 4DSQ scores (p = 0.005; p = 0.006; p = 0.003; p = 0.003, respectively). The quality of patients’ life according to the SF36 questionnaire also improved due to both physical and psychological components (p = 0.003). 16 patients continued taking the preparation for another 8 weeks to maintain the achieved result. As an additional effect, the disappearance of pain in the right hypochondrium was noted in those cases when patients presented this complaint at the time of inclusion in the observation program. The safety profile was good, 1/3 of the patients noted the appearance of heartburn, which was eliminated when taking the product with food.Conclusion. The “Hepato Smart” nutraceutical product improves the general condition of patients with chronic diffuse liver diseases and functional disorders of the gallbladder due to a significant reduction in fatigue and anxiety. It also improves the quality of patients’ life due to the physical and mental components of health. </p></trans-abstract><kwd-group xml:lang="ru"><kwd>хронические диффузные заболевания печени</kwd><kwd>астенический синдром</kwd><kwd>качество жизни</kwd><kwd>нутрицевтический продукт</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chronic diffuse liver diseases</kwd><kwd>asthenic syndrome</kwd><kwd>quality of life</kwd><kwd>nutraceutical product</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">Маевская М.В., Ивашкин В.Т., Луньков В.Д., Крыжановский С.П., Пирогова И.Ю., Павлов Ч.С., Жаркова М.С., Бениашвили А.Г., Морозова М.А. 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