Анальгетический потенциал витаминов группы В

Abstract

B vitamins are the most important cofactors of axonal transport, neurotransmitter synthesis and many cellular metabolic pathways. B vitamins (B1 – thiamine, B6 – pyridoxine, B12 – cyanocobalamin) neurotropic role has long been discussed as modulators of inflammation and pain. The analgesic effect of neurotropic B vitamins is known for oral administration and parenteral administration, both in animal model experiments and in clinical practice. Each of the B vitamins participates in energy, fat, protein, water-salt metabolism, has a regulating effect on the trophism and the nervous system. Synergistic interactions have been proven: intra-group accumulation of the effects of B vitamins, and potentiation of the action of medicine drugs of other groups (nonsteroidal anti-inflammatory drugs (NSAIDs), anticonvulsants) when administered together with vitamins of group B. Vitamins of group B suppress the activity of proinflammatory mediators, regulate neurotransmitters of nociceptive and neuropathic pain. Some of these processes include targeted activation of the descending pain modulation system and specific intracellular pathways that have anti-inflammatory, antioxidant and regenerating effects on the nervous system. The analgesic efficacy of B vitamins has been demonstrated both in monotherapy and in complex therapy together with NSAIDs in the treatment of patients with lower back pain, polyneuropathy of various etiologies (diabetic, alcoholic, toxic). The effectiveness of the complex of high-dose B vitamins exceeds the effectiveness of monotherapy with one of the vitamins. Vitamin B12 enhances the antinociceptive effect of NSAIDs to a greater extent than B1 and B6, therefore, in clinical practice it is recommended to use a complex of vitamins of this group. The use of a combination of B vitamins (B1, B2, B3, B5, B6, B7, B9, B12) with choline, inosine and paraaminobenzoic acid in chronic pain is justified, since they affect the pathogenetic mechanisms of pain formation. Drug, containing a complex of 11 B vitamins, may be used for chronic pain syndrome.