Mildronate. Chronic fatigue syndrome
https://doi.org/10.33667/2078-5631-2020-7-15-20
Abstract
Chronic fatigue syndrome (CFS) is a state of constant, impairing quality of life, fatigue, lasting more than 6 months, inexplicable by any of coexisting patient’s pathological conditions. The prevalence of CFS in the world is approximately 2 % of the population (120–140 mln inhabitants of Earth). The etiology of CFS is unknown. Several theories of development of CFS have been proposed (immune, infectious, endocrine, metabolic, neurological, psychiatric), however, none of them fully explains the clinical manifestations of CFS. There is no specific treatment for this condition. This article presents the clinical case of a patient B 45 years old with CFS, who received treatment with regular physical exercises, diet (limiting consumption of coffee and caffeine-containing products, alcohol, salt intake to less than 5 g per day, an increase in the consumption of plant foods and products containing potassium, calcium, magnesium), as well as intake of Mildronat, a positive dynamics was observed, manifested by an increase in productivity at work, decrease in fatigue, a decrease in the daily variability of blood pressure and a decrease in heart rate at rest.
About the Authors
A. V. FilippovaRussian Federation
Moscow
A. P. Pereverzev
Russian Federation
Moscow
E. Yu. Ebzeeva
Russian Federation
Moscow
O. D. Ostroumova
Russian Federation
Moscow
References
1. Официальный сайт клиники Майо. Available at: www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490 (дата обращения: 16.03.2020).
2. Справочник MSD. Available at: www.msdmanuals.com/ru/профессиональный/специальные-темы/синдром-хронической-усталости/синдром-хронической-усталости (дата обращения: 16.03.2020).
3. Пигарова Е. А., Плещева А. В., Дзеранова Л. К., Рожинская Л. Я. Синдром хронической усталости: современные представления об этиологии // Ожирение и метаболизм. 2010. № 3.
4. Darbishire L, Ridsdale L, Seed PT. Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care. Br J Gen Pract. 2003; 53 (491): 441–445.
5. Reynolds KJ, Vernon SD, Bouchery E, Reeves WC. The economic impact of chronic fatigue syndrome. Cost Eff Resour Alloc. 2004; 2 (1): 4.
6. Bierl C, Nisenbaum R, Hoaglin DC, et al. Regional distribution of fatiguing illnesses in the United States: a pilot study. Popul Health Metr. 2004; 2 (1): 1.
7. Комаров С. Г. Синдром хронической усталости как социально-биологический маркер дезадаптации населения / С. Г. Комаров // Вести. Рос. ун-та дружбы народов. – 2007. – № 6 – С. 349–354.
8. Комаров С. Г. Стигмы здоровья населения в переходный период к рыночному развитию в Российской Федерации (синдром хронической усталости и наркомания) /Г.А. Комаров, Г. Ф. Кузьменок, С. Г. Комаров // Общественное здоровье, управление здравоохранением и подготовка кадров: Матер. всеросс. науч конф, посвящ. 85-лет каф. обществ здоровья и здравоохр. ММА им. И М. Сеченова. – М., 2007. – С. 104–107.
9. Комаров С. Г. Просопографический «портрет» современных руководителей учреждений здравоохранения и распространенность у них компонентов синдрома хронической усталости / С. Г. Комаров // Медицина Кыргызстана. Ежемес. науч-практ. медиц жури:. Матер. Первого съезда Кыргызской ассоциации обществен здравоохран. – 2007. – № 3 – С. 134–137.
10. Комаров С. Г. Синдром хронической усталости у молодых городских жителей как результат социальной и экологической дезадаптации / С. Г. Комаров // Медико-физиологические проблемы экологии человека: Матер. Всерос. конф. с междунар. участием. – Ульяновск, – 2007. – С. 126–128.
11. Комаров С. Г. Синдром хронической усталости – болезнь цивилизации. алгоритмы диагностики и оказания медицинской помощи / С. Г. Комаров // Научн. тр. VIII Междун конгр. «Здоровье и образование в XXI веке; концепция болезней цивилизации». – М., Изд-е РУДН, 2007. – С. 320–322.
12. Jason L. A., Richman J. A., Rademaker A. W., Jordan K. M., Plioplys A. V., Taylor R. R., McCready W., Huan C. F., Plioplys S. A community-based study of chronic fatigue syndrome // Arch. Int. Med., 1999, 159: Р. 2129–2137.
13. Jason L. A., Taylor R. R., Kennedy C. L., Jordan K., Song S., Johnson D. E., Torres S. R. Chronic fatigue syndrome: sociodemographic subtypes in a community-based sample // Eval Health Profess., 2000, 23 (3): Р. 243–263.
14. Reeves W. C., Jones J. F., Maloney E., Heim C., Hoaglin D. C., Boneva R., Morrissey M., Devlin R. Prevalence of chronic fatigue syndrome in metropolitan, urban, and rural Georgia // Population Health Metrics 2007, 8 (5): Р. 5.
15. Reyes M., Nisenbaum R., Hoaglin D. C., Emmons C., Stewart G., Randall B., Stewart J. A., Abbey S., Jones J. F., Gantz N., Minden S., Reeves W. C. Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas // Arch. Intern. Med. 2003, 163: Р. 1530–1536.
16. Joseph R. Yancey, Sarah M. Thomas. Chronic Fatigue Syndrome: Diagnosis and Treatment. Am Fam Physician. 2012; 86 (8): 741–746.
17. Sharpe MC, Archard LC, Banatvala JE, et al. A report – chronic fatigue syndrome: guidelines for research. J R Soc Med. 1991; 84 (2): 118–121.
18. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A; International Chronic Fatigue Syndrome Study Group. The chronic fatigue syndrome: a comprehensive approach to its de nition and study. Ann Intern Med. 1994; 121 (12): 953–959.
19. Chronic Fatigue Syndrome. Centers for Disease Control and Prevention, Alanta, USA (доступно от 07.06.2010 по ссылке: www.cdc.gov/cfs/health-careprofessionals.htm).
20. National Collaborating Centre for Primary Care (Great Britain), Royal College of General Practitioners. Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy): Diagnosis and Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (or Encephalopathy) in Adults and Children. London, England: National Collaborating Centre for Primary Care, Royal College of General Practitioners; 2007.
21. Пропедевтика внутренних болезней: учебник. – 2-е изд., доп. и перераб. / Н. А. Мухин, В. С. Моисеев. – М.: ГЭОТАР-Медиа, 2015. – 848 с.: ил.
22. Price JR, Mitchell E, Tidy E, Hunot V. Cognitive behaviour therapy for chronic fatigue syndrome in adults. Cochrane Database Syst Rev. 2008; (3): CD 001027.
23. White PD, Goldsmith KA, Johnson AL, et al.; PACE trial management group. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial. Lancet. 2011; 377 (9768): 823–836.
24. Wearden AJ1, Emsley R. Mediators of the effects on fatigue of pragmatic rehabilitation for chronic fatigue syndrome. J Consult Clin Psychol. 2013 Oct; 81 (5): 831–8. DOI: 10.1037/a0033561. Epub 2013 Jun 24.
25. Kogelnik AM, Loomis K, Hoegh-Petersen M, Rosso F, Hischier C, Montoya JG. Use of valganciclovir in patients with elevated antibody titers against human herpesvirus-6 (HHV-6) and Epstein-Barr virus (EBV) who were experiencing central nervous system dysfunction including long-standing fatigue. J Clin Virol. 2006; 37 (suppl 1): S 33–S 38.
26. Blockmans D, Persoons P, Van Houdenhove B, Lejeune M, Bobbaers H. Combination therapy with hydrocortisone and udrocortisone does not improve symptoms in chronic fatigue syndrome: a randomized, placebo-controlled, double-blind, crossover study. Am J Med. 2003; 114 (9): 736–741.
27. Cleare AJ, Miell J, Heap E, et al. Hypothalamo-pituitary-adrenal axis dysfunction in chronic fatigue syndrome, and the effects of low-dose hydrocortisone therapy. J Clin Endocrinol Metab. 2001; 86 (8): 3545–3554.
28. Blockmans D, Persoons P, Van Houdenhove B, Bobbaers H. Does methylphenidate reduce the symptoms of chronic fatigue syndrome? Am J Med. 2006; 119 (2): 167. e23–167.e30.
29. Hartz AJ, Bentler SE, Brake KA, Kelly MW. The effectiveness of citalopram for idiopathic chronic fatigue. J Clin Psychiatry. 2003; 64 (8): 927–935.
30. Blacker CV, Greenwood DT, Wesnes KA, et al. Effect of galantamine hydrobromide in chronic fatigue syndrome: a randomized controlled trial. JAMA. 2004; 292 (10): 1195–1204.
31. Williams G, Waterhouse J, Mugarza J, Minors D, Hayden K. Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy. Eur J Clin Invest. 2002; 32 (11): 831–837.
32. Zachrisson O, Regland B, Jahreskog M, Jonsson M, Kron M, Gottfries CG. Treatment with staphylococcus toxoid in fibromyalgia/chronic fatigue syndrome – a randomised controlled trial. Eur J Pain. 2002; 6 (6): 455–466.
33. Comhaire F., Deslypere J. P. News and views in myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS): the role of comorbidity and novel treatments. Medical hypotheses 134 (2020) 109444. DOI: 10.1016/j.mehy.2019.109444.
34. Рубрикатор клинических рекомендаций России. Available at: cr.rosminzdrav.ru/#!/ (дата обращения: 16.03.2020).
35. Государственный реестр лекарственных средств Российской Федерации. Available at: grls.rosminzdrav.ru (дата обращения: 16.03.2020).
36. Хлебодаров Ф. Е., Тюриков П. Ю., Михин В. П., Дисфункция сосудистого эндотелия и ее коррекция цитопротекторами у больных стабильной стенокардией напряжения и артериальной гипертонией. Российский кардиологический журнал № 6 (80) / 2009.
37. Bryan Williams, Giuseppe Mancia, Wilko Spiering, Enrico Agabiti Rosei, Michel Azizi, Michel Burnier, Denis L Clement, Antonio Coca, Giovanni de Simone, Anna Dominiczak, Thomas Kahan, Felix Mahfoud, Josep Redon, Luis Ruilope, Alberto Zanchetti, Mary Kerins, Sverre E Kjeldsen, Reinhold Kreutz, Stephane Laurent, Gregory YH Lip, Richard McManus, Krzysztof Narkiewicz, Frank Ruschitzka, Roland E Schmieder, Evgeny Shlyakhto, Costas Tsioufis, Victor Aboyans, Ileana Desormais, ESC Scientific Document Group, 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH), European Heart Journal, Volume 39, Issue 33, 01 September 2018, Pages 3021–3104, doi.org/10.1093/eurheartj/ehy339.
38. М. Е. Стаценко, С. В. Недогода, С. В. Туркина, И. А. Тыщенко, Л. В. Полетава, В. В. Цома, А. А. Ледяева, Е. В. Чумаков. Астенические расстройства у пациентов пожилого возраста с артериальной гипертензией: возможность коррекции астении мальдонием. Рациональная фармакотерапия в кардиологии 2013: 9 (1).
39. Bozzini S, Albergati A, Capelli E, et al. Cardiovascular characteristics of chronic fatigue syndrome. Biomed Rep. 2018; 8 (1): 26–30. DOI: 10.3892/br.2017.1024.
40. Frith J, Zalewski P, Klawe JJ, Pairman J, Bitner A, Tafil-Klawe M, Newton JL. Impaired blood pressure variability in chronic fatigue syndrome – a potential biomarker. QJM. 2012 Sep; 105 (9): 831–8. DOI: 10.1093/qjmed/hcs085. Epub 2012 Jun 4.
41. Verdecchia P., Angeli F., Gattobigio R. et al. Impact of Blood Pressure Variability on Cardiac and Cerebrovascular Complications in Hypertension. Am J Hypertens 2007; 20: 154–161.
42. Mancia G., Bombelli M., Facchetti R. et al. Long-term prognostic value of blood pressure variability in the general population: results of the Pressioni Arteriose Monitorate e Loro Associazioni Study. Hypertension 2007; 49: 1265–1270.
43. Stolarz-Skrzypek K., Thijs L., Richart T. et al. Blood Pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome. Hypertension Res 2010; 33: 757–766.
44. Eguchi К., Hoshide S., Schwartz J. E., et al. Visit-to-visit and Ambulatory Blood Pressure Variability as Predictors of Incident Cardiovascular Events in Patients with Hypertension. Am J Hypertens 2012; 25 (9). DOI: 10.1038/ajh.2012.75.
Review
For citations:
Filippova A.V., Pereverzev A.P., Ebzeeva E.Yu., Ostroumova O.D. Mildronate. Chronic fatigue syndrome. Medical alphabet. 2020;(7):15-20. (In Russ.) https://doi.org/10.33667/2078-5631-2020-7-15-20