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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">astmed</journal-id><journal-title-group><journal-title xml:lang="ru">Астраханский медицинский журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Astrakhan medical journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1992-6499</issn><publisher><publisher-name>ФГБОУ ВО Астраханский ГМУ Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17021/1992-6499-2025-4-18-31</article-id><article-id custom-type="elpub" pub-id-type="custom">astmed-631</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>НАУЧНЫЕ ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SCIENTIFIC REVIEWS</subject></subj-group></article-categories><title-group><article-title>Влияние нутритивной поддержки на состояние пациентов с хроническими диффузными заболеваниями печени токсико-алиментарной этиологии</article-title><trans-title-group xml:lang="en"><trans-title>The influence of nutritional support on the conditions of patients with chronic diffuse liver diseases of toxic-alimentary etiology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0000-0340-8317</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Комаров</surname><given-names>Г. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Komarov</surname><given-names>G. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Георгий Валерьевич Комаров, ассистент кафедры пропедевтики внутренних болезней, </p><p>Астрахань.</p></bio><bio xml:lang="en"><p>Georgii V. Komarov, Assistant Professor of the Department,</p><p>Astrakhan.</p></bio><email xlink:type="simple">gogich92@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2389-4636</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антонян</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Antonyan</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Виталина Викторовна Антонян, доктор медицинских наук, доцент, заведующая кафедрой пропедевтики внутренних болезней,</p><p>Астрахань.</p></bio><bio xml:lang="en"><p>Vitalina V. Antonyan, Dr. Sci. (Med.), Associate Professor, Head of the Department,</p><p>Astrakhan.</p></bio><email xlink:type="simple">antonian.vika@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3129-2443</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Умерова</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Umerova</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аделя Равильевна Умерова, доктор медицинских наук, профессор, заведующая кафедрой клинической фармакологии, </p><p>Астрахань.</p></bio><bio xml:lang="en"><p>Adela R. Umerova, Dr. Sci. (Med.), Professor, Head of the Department,</p><p>Astrakhan.</p></bio><email xlink:type="simple">arumerova@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5119-5571</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Островерхов</surname><given-names>О. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Ostroverkhov</surname><given-names>O. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Олег Павлович Островерхов, кандидат медицинских наук, доцент кафедры клинической фармакологии,</p><p>Астрахань.</p></bio><bio xml:lang="en"><p>Oleg P. Ostroverkhov, Cand. Sci. (Med.), Associate Professor of the Department,</p><p>Astrakhan.</p></bio><email xlink:type="simple">olostr@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Астраханский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Astrakhan State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>26</day><month>12</month><year>2025</year></pub-date><volume>20</volume><issue>4</issue><fpage>18</fpage><lpage>31</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Комаров Г.В., Антонян В.В., Умерова А.Р., Островерхов О.П., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Комаров Г.В., Антонян В.В., Умерова А.Р., Островерхов О.П.</copyright-holder><copyright-holder xml:lang="en">Komarov G.V., Antonyan V.V., Umerova A.R., Ostroverkhov O.P.</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.astmedj.ru/jour/article/view/631">https://www.astmedj.ru/jour/article/view/631</self-uri><abstract><p>Рассматривается влияние нутритивной поддержки на состояние пациентов, страдающих хроническими диффузными заболеваниями печени токсико-алиментарного генеза, включая алкогольную болезнь печени. Материалом для анализа послужили публикации отечественных и зарубежных авторов, в которых описываются современные стратегии нутритивного вмешательства, их значение в коррекции белковоэнергетической недостаточности, а также в профилактике и лечении мальнутриции и саркопении. Обобщённые результаты исследований демонстрируют, что грамотно организованная нутритивная терапия способствует восстановлению функциональных резервов печени, снижает частоту и выраженность осложнений, в том числе печёночной энцефалопатии, и положительно влияет на прогноз и качество жизни больных. Проведён анализ эффективности различных подходов – от лечебных диет и энтерального питания до парентеральных методов, с учётом их преимуществ, рисков и метаболических последствий. На основании проведённого обзора авторы приходят к выводу, что нутритивная поддержка должна рассматриваться как обязательный компонент комплексного лечения пациентов с хроническими диффузными заболеваниями печени токсико-алиментарной этиологии, а разработка единых стандартов её назначения является важной задачей для будущих клинических исследований.</p></abstract><trans-abstract xml:lang="en"><p>The influence of nutritional support on the condition of patients suffering from chronic diffuse liver diseases of toxic- alimentary origin, including alcoholic liver disease, is being examined. The material for analysis consisted of publications by both domestic and foreign authors, which describe modern strategies of nutritional intervention, their significance in correcting protein-energy deficiency, as well as in the prevention and treatment of malnutrition and sarcopenia. The summarized results of the studies demonstrate that properly organized nutritional therapy contributes to the restoration of liver functional reserves, reduces the frequency and severity of complications, including hepatic encephalopathy, and positively affects the prognosis and quality of life of patients. An analysis of the effectiveness of various approaches was conducted – from therapeutic diets and enteral nutrition to parenteral methods – taking into account their advantages, risks, and metabolic consequences. Based on this review, the authors conclude that nutritional support should be considered an essential component of comprehensive treatment for patients with chronic diffuse liver diseases of toxic- alimentary etiology, and the development of unified standards for its administration is an important task for future clinical studies.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нутритивная поддержка</kwd><kwd>мальнутриция</kwd><kwd>саркопения</kwd><kwd>хронические диффузные заболевания печени</kwd></kwd-group><kwd-group xml:lang="en"><kwd>nutritional support</kwd><kwd>malnourishment</kwd><kwd>sarcopenia</kwd><kwd>chronic diffuse liver diseases</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">Лазебник Л. Б., Радченко В. Г., Голованова Е. В., Звенигородская Л. А., Конев Ю. В., Селиверстов П. В., Ситкин С. И., Ткаченко Е. И., Авалуева Е. Б., Айламазян Э. К., Власов Н. 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