r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-1-5-15r-n-j-261Research ArticleОБЗОРЫREVIEWSЭволюция представлений о лечении болезни Альцгеймера: от прошлых лет до наших днейThe evolution of ideas about the treatment of Alzheimer’s disease: from the past to the present dayhttps://orcid.org/0000-0002-4830-907XВоробьевС. В.VorobevS. V.

Санкт-Петербург

Saint Petersburg

sergiognezdo@yandex.ruhttps://orcid.org/0000-0002-4723-802XЕмелинА. Ю.EmelinA. Yu.

Емелин Андрей Юрьевич — д.м.н., профессор

Россия, 194044, Санкт-Петербург, ул. Академика Лебедева,6

Andrey Yurʹevich Emelin

Saint Petersburg, Russia, Academician Lebedev st. 6, 194044

emelinand@rambler.ruhttps://orcid.org/0000-0002-6484-286XЯнишевскийС. Н.YanishevskijS. N.

Санкт-Петербург

Saint Petersburg

stasya71@yandex.ruФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Минздрава России; 3ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава РоссииРоссияAlmazov National Medical Research Centre; Saint Petersburg State Pediatric Medical UniversityRussian FederationФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны РоссииРоссияMilitary Medical Academy named after S.M. KirovRussian FederationФГБУ «Национальный медицинский исследовательский центр имени В.А. Алмазова» Минздрава России; ФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Минобороны РоссииРоссияAlmazov National Medical Research Centre; Military Medical Academy named after S.M. KirovRussian Federation202207032022271515Copyright © Воробьев С.В., Емелин А.Ю., Янишевский С.Н., 20222022Воробьев С.В., Емелин А.Ю., Янишевский С.Н.Vorobev S.V., Emelin A.Y., Yanishevskij S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/261

Когнитивные нарушения представляют одни из важнейших проявлений различной церебральной патологии. Среди всех нозологических форм, протекающих с формированием деменции, наиболее часто встречается болезнь Альцгеймера. На различных этапах исторического развития учеными проводились многочисленные исследования, направленные на установление эффективных средств ее терапии. В древние времена акцент делался на использование таких средств, как ванны, диеты, вино, массаж, умственная тренировка. Кроме того, практиковались различные обряды, ритуалы. Большая роль отводилась использованию отваров, настоек на основе лекарственных растений, часто с добавлением минералов и продуктов животного происхождения. В XIX столетии распространение получили физический уход, нахождение в семье, попытки вовлечения в повседневную деятельность, ограничительные мероприятия. В процессе развития наук в начале XX столетия стали применяться фармакологические препараты. Первоначально это были успокаивающие и мочегонные средства на основе брома и йода. Затем в практику вошли сосудорасширяющие, другие «сосудистые» средства. По мере накопления данных о патогенезе заболевания были разработаны препараты, влияющие на ацетилхолинергическую трансмиссию и другие нейромедиаторные системы. Также предпринимались попытки использования средств с нейротрофическими, антиоксидантными, противовоспалительными свойствами. Современным направлением терапии, учитывающим основные патобиохимические изменения, формирующиеся в головном мозге при болезни Альцгеймера, является антиамилоидная стратегия, направленная на модификацию течения заболевания.

Cognitive disorders are one of the most important manifestations of various cerebral pathologies. Among all the nosological forms that occur with the formation of dementia, Alzheimer’s disease is the most common. At various stages of historical development, scientists conducted numerous studies aimed at establishing effective means of its therapy. In ancient times, the emphasis was on the use of such means as baths, diets, wine, massage, mental training. In addition, various rites and rituals were practiced. A large role was given to the use of decoctions, tinctures based on medicinal plants, often with the addition of minerals and animal products. In the XIX century, physical care, being in a family environment, attempts to involve in everyday activities, restrictive measures became widespread. In the process of the development of sciences at the beginning of the XX century, pharmacological preparations began to be used. Initially, these were sedatives and diuretics based on bromine and iodine. Then vasodilating and other “vascular” means came into practice. As data on the pathogenesis of the disease accumulated, drugs that affect cholinergic transmission and other mediator systems were developed. There have also been attempts to use drugs with neurotrophic, antioxidant, and anti-inflammatory properties. The most modern direction of therapy, taking into account the main pathobiochemical changes formed in the brain in Alzheimer’s disease, is an antiamyloid strategy aimed at modifying the course of the disease.

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