ТОФИЗОПАМ В КОРРЕКЦИИ КЛИНИЧЕСКИХ ПРОЯВЛЕНИЙ
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30 ȀǼȂǶǵǼǽǮǺ ǰ ǸǼǾǾdzǸȄǶǶ ǸǹǶǻǶȅdzǿǸǶȃ ǽǾǼȍǰǹdzǻǶǷ, ǰdzDZdzȀǮȀǶǰǻȉȃ Ƕ ǶǻǿǼǺǻǶȅdzǿǸǶȃ ǻǮǾȁȆdzǻǶǷ ȁ ǽǮȄǶdzǻȀǼǰ ǿ DzǶǿǽǹǮǵǶȍǺǶ ǿǼdzDzǶǻǶȀdzǹȊǻǼǷ ȀǸǮǻǶ ǿdzǾDzȄǮ Ɍ. ȼ. Ɇɟɞɜɟɞɟɜɚ*, ɉ. Ⱥ. ɑɢɠɨɜ, ɞɨɤɬɨɪ ɦɟɞɢɰɢɧɫɤɢɯ ɧɚɭɤ, Ɇ. ɉ. ɋɦɢɪɧɨɜɚ, ɤɚɧɞɢɞɚɬ ɦɟɞɢɰɢɧɫɤɢɯ ɧɚɭɤ, Ɇ. Ⱥ. Ƚɭɪɦɚɱ ȽȻɈɍ ȼɉɈ «əɪɨɫɥɚɜɫɤɚɹ ɝɨɫɭɞɚɪɫɬɜɟɧɧɚɹ ɦɟɞɢɰɢɧɫɤɚɹ ɚɤɚɞɟɦɢɹ» Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ Ɋɨɫɫɢɢ, 150002, Ɋɨɫɫɢɹ, ɝ. əɪɨɫɥɚɜɥɶ, ɭɥ. Ɋɟɜɨɥɸɰɢɨɧɧɚɹ, ɞ. 5 ɊȿɁɘɆȿ ɋ ɰɟɥɶɸ ɢɡɭɱɟɧɢɹ ɷɮɮɟɤɬɢɜɧɨɫɬɢ ɬɨɮɢɡɨɩɚɦɚ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ɞɢɫɩɥɚɡɢɹɦɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɟɪɞɰɚ ɨɛɫɥɟɞɨɜɚɧɨ 55 ɱɟɥɨɜɟɤ ɫ ɩɨɦɨɳɶɸ ɜɨɩɪɨɫɧɢɤɚ ɢ ɫɯɟɦɵ Ⱥ. Ⱦ. ɋɨɥɨɜɶɟɜɨɣ, ɚɧɤɟɬɵ ɛɚɥɥɶɧɨɣ ɨɰɟɧɤɢ ɫɭɛɴɟɤɬɢɜɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɫɧɚ, ɲɤɚɥɵ MFI-20, ɝɨɫɩɢɬɚɥɶɧɨɣ ɲɤɚɥɵ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɫɬɚɧɞɚɪɬɧɨɝɨ ɜɟɝɟɬɚɬɢɜɧɨɝɨ ɬɟɫɬɚ ɐɂɌɈ. ɍɫɬɚɧɨɜɥɟɧɨ, ɱɬɨ ɬɨɮɢɡɨɩɚɦ ɜ ɞɨɡɟ 50 ɦɝ/ɫɭɬ ɞɨɫɬɨɜɟɪɧɨ ɭɦɟɧɶɲɚɟɬ ɜɵɪɚɠɟɧɧɨɫɬɶ ɜɟɝɟɬɚɬɢɜɧɨɣ ɞɢɫɮɭɧɤɰɢɢ, ɱɚɫɬɨɬɭ ɠɚɥɨɛ ɧɚ ɛɨɥɢ ɜ ɫɟɪɞɰɟ, ɫɟɪɞɰɟɛɢɟɧɢɟ, ɛɨɥɢ ɜ ɠɢɜɨɬɟ, ɝɨɥɨɜɧɵɟ ɛɨɥɢ, ɝɨɥɨɜɨɤɪɭɠɟɧɢɟ, ɱɭɜɫɬɜɨ ɧɟɯɜɚɬɤɢ ɜɨɡɞɭɯɚ, ɜɵɪɚɠɟɧɧɨɫɬɶ ɨɛɳɟɣ ɢ ɮɢɡɢɱɟɫɤɨɣ ɚɫɬɟɧɢɢ, ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɚ ɬɚɤɠɟ ɧɨɪɦɚɥɢɡɭɟɬ ɫɨɧ ɢ ɩɨɜɵɲɚɟɬ ɮɢɡɢɱɟɫɤɭɸ ɚɤɬɢɜɧɨɫɬɶ, ɪɚɛɨɬɨɫɩɨɫɨɛɧɨɫɬɶ, ɦɨɬɢɜɚɰɢɸ ɢ ɨɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ ɩɚɰɢɟɧɬɨɜ. Ʉɥɸɱɟɜɵɟ ɫɥɨɜɚ: ɞɢɫɩɥɚɡɢɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɟɪɞɰɚ, ɬɨɮɢɡɨɩɚɦ, ɜɟɝɟɬɚɬɢɜɧɚɹ ɞɢɫɮɭɧɤɰɢɹ, ɤɥɢɧɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ, ɚɫɬɟɧɢɹ, ɧɚɪɭɲɟɧɢɹ ɫɧɚ. * Ɉɬɜɟɬɫɬɜɟɧɧɵɣ ɡɚ ɩɟɪɟɩɢɫɤɭ (corresponding author) e-mail: [email protected] Ⱦɢɫɩɥɚɡɢɢ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɟɪɞɰɚ (ȾɋɌɋ) ɯɚɪɚɤɬɟɪɢɡɭɸɬɫɹ ɪɚɡɧɨɨɛɪɚɡɧɨɣ ɤɥɢɧɢɱɟɫɤɨɣ ɫɢɦɩɬɨɦɚɬɢɤɨɣ, ɩɪɢɱɟɦ ɱɚɫɬɨ ɫɨɩɪɨɜɨɠɞɚɸɬɫɹ ɜɵɪɚɠɟɧɧɵɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ ɫɢɧɞɪɨɦɚ ɜɟɝɟɬɚɬɢɜɧɨɣ ɞɢɫɮɭɧɤɰɢɢ (ɋȼȾ) [2, 10, 11]. ɍ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ, ɧɚɪɹɞɭ ɫ ɠɚɥɨɛɚɦɢ ɧɚ ɪɚɛɨɬɭ ɪɚɡɥɢɱɧɵɯ ɫɢɫɬɟɦ ɨɪɝɚɧɢɡɦɚ, ɦɨɝɭɬ ɧɚɛɥɸɞɚɬɶɫɹ ɚɫɬɟɧɢɹ, ɩɨɜɵɲɟɧɧɚɹ ɬɪɟɜɨɠɧɨɫɬɶ, ɞɟɩɪɟɫɫɢɜɧɵɟ ɫɨɫɬɨɹɧɢɹ, ɧɚɪɭɲɟɧɢɹ ɫɧɚ [3, 6, 12]. ȼɫɟ ɷɬɨ ɜɥɢɹɟɬ ɧɚ ɨɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ, ɜɵɡɵɜɚɟɬ ɛɵɫɬɪɭɸ ɭɬɨɦɥɹɟɦɨɫɬɶ, ɪɚɡɞɪɚɠɢɬɟɥɶɧɨɫɬɶ, ɫɧɢɠɟɧɢɟ ɪɚɛɨɬɨɫɩɨɫɨɛɧɨɫɬɢ ɢ ɤɚɱɟɫɬɜɚ ɠɢɡɧɢ. ȼ ɫɜɹɡɢ ɫ ɜɵɲɟɩɟɪɟɱɢɫɥɟɧɧɵɦ ɚɤɬɭɚɥɶɧɵɦ ɩɪɟɞɫɬɚɜɥɹɟɬɫɹ ɩɨɢɫɤ ɩɪɟɩɚɪɚɬɚ, ɷɮɮɟɤɬɢɜɧɨ ɤɭɩɢɪɭɸɳɟɝɨ ɪɚɡɧɨɨɛɪɚɡɧɵɟ ɫɨɦɚɬɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ ɢ ɜɟɝɟɬɚɬɢɜɧɵɟ ɪɚɫɫɬɪɨɣɫɬɜɚ ɭ ɥɢɰ ɫ ȾɋɌɋ. ɏɨɪɨɲɢɟ ɩɟɪɫɩɟɤɬɢɜɵ ɢɦɟɟɬ ɛɟɧɡɨ- ɞɢɚɡɟɩɢɧɨɜɵɣ ɞɧɟɜɧɨɣ ɬɪɚɧɤɜɢɥɢɡɚɬɨɪ ɬɨɮɢɡɨɩɚɦ (ɝɪɚɧɞɚɤɫɢɧ ɮɢɪɦɵ «EGIS») [12], ɨɞɧɚɤɨ ɜɥɢɹɧɢɟ ɝɪɚɧɞɚɤɫɢɧɚ ɧɚ ɫɨɦɚɬɢɱɟɫɤɢɟ ɠɚɥɨɛɵ, ɜɟɝɟɬɚɬɢɜɧɭɸ ɞɢɫɮɭɧɤɰɢɸ, ɚɫɬɟɧɢɸ, ɬɪɟɜɨɝɭ, ɞɟɩɪɟɫɫɢɸ ɢ ɫɨɧ ɭ ɛɨɥɶɧɵɯ ɫ ȾɋɌɋ ɢɫɫɥɟɞɨɜɚɧɨ ɧɟɞɨɫɬɚɬɨɱɧɨ. ɐɟɥɶ ɢɫɫɥɟɞɨɜɚɧɢɹ – ɢɡɭɱɢɬɶ ɜɥɢɹɧɢɟ ɝɪɚɧɞɚɤɫɢɧɚ ɧɚ ɤɥɢɧɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ, ɜɟɝɟɬɚɬɢɜɧɵɟ ɧɚɪɭɲɟɧɢɹ, ɫɨɧ, ɜɵɪɚɠɟɧɧɨɫɬɶ ɚɫɬɟɧɢɢ, ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ɞɢɫɩɥɚɡɢɟɣ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɟɪɞɰɚ (ȾɋɌɋ). ǺǮȀdzǾǶǮǹ Ƕ ǺdzȀǼDzȉ Ɉɛɫɥɟɞɨɜɚɧɨ 55 ɛɨɥɶɧɵɯ (13 ɦɭɠɱɢɧ ɢ 42 ɠɟɧɳɢɧɵ) ɜ ɜɨɡɪɚɫɬɟ ɨɬ 18 ɞɨ 24 ɥɟɬ ɫ ɪɚɡɥɢɱɧɵɦɢ ȾɋɌɋ (ɩɪɨɥɚɩɫɵ ɦɢɬɪɚɥɶɧɨɝɨ ɢ ɬɪɢɤɭɫɩɢɞɚɥɶɧɨ- TOFISOPAM IN THE CORRECTION OF CLINICAL MANIFESTATIONS, VEGETATIVE AND INSOMNIC DISORDERS IN PATIENTS WITH HEART CONNECTIVE TISSUE DYSPLASIA Medvedeva T. V., Chizhov P. A., Smirnova M. P., Gurmach M. A. ABSTRACT In order to study to¿sopam ef¿cacy in patients with heart connective tissue dysplasia 55 patients were examined by questionnaire and scheme by A.D.Solovyova, questionnaire of point evaluation of sleep subjective characteristics, MFI-20 scale, hospital scale of anxiety and depression, standard vegetative test of the Central Institute of Traumatology and Orthopedics. It was stated that Grandaxin in the dose of 50 mg daily decreased for certain the manifestation of vegetative dysfunction, frequency of heart pain complaints, palpitation, abdominal pains, headaches, vertigo, sense of air de¿ciency, signs of general and physical asthenia, anxiety and depression and also normalized the sleep, increased physical activity, ability to work, motivation and general health status. Key words: heart connective tissue dysplasia, to¿sopam, vegetative dysfunction, clinical manifestations, asthenia, sleep disorders. Ɍ. 17, ʋ 2, 2012 ȼɟɫɬɧɢɤ ɂɜɚɧɨɜɫɤɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɚɤɚɞɟɦɢɢ 31 ɝɨ ɤɥɚɩɚɧɨɜ, ɚɧɨɦɚɥɶɧɨ ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɯɨɪɞɵ ɜ ɢɡɨɥɢɪɨɜɚɧɧɨɦ ɜɢɞɟ ɢɥɢ ɢɯ ɤɨɦɛɢɧɚɰɢɢ) ɢ ɪɚɡɧɨɨɛɪɚɡɧɵɦɢ ɤɥɢɧɢɱɟɫɤɢɦɢ ɩɪɨɹɜɥɟɧɢɹɦɢ. Ʉɨɧɬɪɨɥɶɧɭɸ ɝɪɭɩɩɭ ɫɨɫɬɚɜɢɥɢ 49 ɥɢɰ ɚɧɚɥɨɝɢɱɧɨɝɨ ɜɨɡɪɚɫɬɚ ɛɟɡ ȾɋɌɋ. ȼɫɟ ɨɛɫɥɟɞɨɜɚɧɢɹ ɩɪɨɜɨɞɢɥɢɫɶ ɞɨ ɢ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɝɪɚɧɞɚɤɫɢɧɨɦ ɜ ɞɨɡɟ 50 ɦɝ ɜ ɫɭɬɤɢ ɜ ɬɟɱɟɧɢɟ 3 ɧɟɞɟɥɶ. ɉɪɨɜɨɞɢɥɢ ɨɛɳɟɟ ɤɥɢɧɢɱɟɫɤɨɟ ɨɛɫɥɟɞɨɜɚɧɢɟ ɫ ɚɤɰɟɧɬɨɦ ɧɚ ɜɵɹɜɥɟɧɢɟ ɠɚɥɨɛ ɢ ɨɛɴɟɤɬɢɜɧɵɯ ɩɪɨɹɜɥɟɧɢɣ ɋȼȾ. ɇɚɥɢɱɢɟ ɢ ɜɵɪɚɠɟɧɧɨɫɬɶ ɋȼȾ ɭɫɬɚɧɚɜɥɢɜɚɥɢ ɫ ɩɨɦɨɳɶɸ ɜɨɩɪɨɫɧɢɤɚ ɞɥɹ ɜɵɹɜɥɟɧɢɹ ɜɟɝɟɬɚɬɢɜɧɵɯ ɢɡɦɟɧɟɧɢɣ (ȼȼȼɂ) ɢ ɫɯɟɦɵ ɢɫɫɥɟɞɨɜɚɧɢɹ ɞɥɹ ɜɵɹɜɥɟɧɢɹ ɩɪɢɡɧɚɤɨɜ ɜɟɝɟɬɚɬɢɜɧɵɯ ɧɚɪɭɲɟɧɢɣ (ɋȼȼɇ) Ⱥ. Ⱦ. ɋɨɥɨɜɶɟɜɨɣ [3]. ɋȼȾ ɞɢɚɝɧɨɫɬɢɪɭɟɬɫɹ ɩɪɢ ɫɭɦɦɟ ɛɚɥɥɨɜ ɩɨ ȼȼȼɂ ɛɨɥɟɟ 15, ɩɨ ɋȼȼɇ – ɛɨɥɟɟ 25. ɍ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɪɚɡɧɨɨɛɪɚɡɧɚɹ ɤɥɢɧɢɱɟɫɤɚɹ ɫɢɦɩɬɨɦɚɬɢɤɚ ɋȼȾ ɜɫɬɪɟɱɚɟɬɫɹ ɞɨɫɬɨɜɟɪɧɨ ɱɚɳɟ, ɱɟɦ ɭ ɥɢɰ ɛɟɡ ȾɋɌɋ, ɚ ɋȼȾ, ɭɫɬɚɧɨɜɥɟɧɧɵɣ ɩɨ ȼȼȼɂ ɢ ɋȼȼɇ, ɜɵɪɚɠɟɧ ɫɢɥɶɧɟɟ (ɬɚɛɥ. 1, 2). ɉɨɤɚɡɚɬɟɥɢ ɗɄɉ ɢ ɄɌ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɞɨ ɥɟɱɟɧɢɹ ɛɵɥɢ ɞɨɫɬɨɜɟɪɧɨ ɧɢɠɟ, ɱɟɦ ɭ ɥɢɰ ɛɟɡ ȾɋɌɋ (ɬɚɛɥ. 3), ɱɬɨ ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬ ɨ ɫɧɢɠɟɧɢɢ ɬɨɧɭɫɚ ɫɨɨɬɜɟɬɫɬɜɟɧɧɨ ɫɢɦɩɚɬɢɱɟɫɤɨɝɨ (ɷɪɝɨɬɪɨɩɧɨɝɨ) ɢ ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɨɝɨ (ɬɪɨɮɨɬɪɨɩɧɨɝɨ) ɨɬɞɟɥɨɜ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɭ ɨɛɫɥɟɞɨɜɚɧɧɵɯ ɫ ȾɋɌɋ. Ɉɞɧɨɜɪɟɦɟɧɧɨ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɛɵɥɢ ɞɨɫɬɨɜɟɪɧɨ ɫɢɥɶɧɟɟ ɜɵɪɚɠɟɧɵ ɪɚɡɥɢɱɧɵɟ ɩɪɨɹɜɥɟɧɢɹ ɚɫɬɟɧɢɢ, ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ (ɬɚɛɥ. 4). Ʉɪɨɦɟ ɬɨɝɨ, 42 (76,4%) ɛɨɥɶɧɵɯ ɫ ȾɋɌɋ ɨɬɦɟɬɢɥɢ ɭ ɫɟɛɹ ɧɚɪɭɲɟɧɢɹ ɫɧɚ, ɩɪɢɱɟɦ ɭ 33 (78,5% ɨɬ ɝɪɭɩɩɵ ɥɢɰ ɫ ɧɚɪɭɲɟɧɢɹɦɢ ɫɧɚ) ɢɧɫɨɦɧɢɱɟɫɤɢɟ ɧɚɪɭɲɟɧɢɹ ɧɨɫɢɥɢ ɷɩɢɡɨɞɢɱɟɫɤɢɣ ɯɚɪɚɤɬɟɪ, ɭ 8 (19,1%) – ɤɪɚɬɤɨɜɪɟɦɟɧɧɵɣ, ɭ 1 (2,4%) – ɯɪɨɧɢɱɟɫɤɢɣ. ɋɪɟɞɧɢɣ ɛɚɥɥ ɚɧɤɟɬɵ ɨɰɟɧɤɢ ɫɭɛɴɟɤɬɢɜɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɫɧɚ ɫɨɫɬɚɜɢɥ 18,14 ± 0,48. ȼɵɹɜɥɟɧɵ ɫɥɟɞɭɸɳɢɟ ɬɢɩɵ ɞɢɫɫɨɦɧɢɢ: ɬɪɭɞɧɨɫɬɶ ɡɚɫɵɩɚɧɢɹ – ɭ 23 (54,8%) ɱɟɥɨɜɟɤ, ɞɧɟɜɧɚɹ ɫɨɧɥɢɜɨɫɬɶ – ɭ 12 (28,6%), ɱɚɫɬɵɟ ɧɨɱɧɵɟ ɩɪɨɛɭɠɞɟɧɢɹ – ɭ 5 (11,9%), ɨɬɫɭɬɫɬɜɢɟ ɧɨɱɧɨɝɨ ɫɧɚ – ɭ 2 (4,7%). ɂɧɫɨɦɧɢɱɟɫɤɢɟ ɧɚɪɭɲɟɧɢɹ ɜɨɡɧɢɤɚɥɢ ɜ ɪɟɡɭɥɶɬɚɬɟ: ɫɬɪɟɫɫɨɜ ɢ ɠɢɡɧɟɧɧɵɯ ɫɨɛɵɬɢɣ – ɭ 25 (59,6%) ɱɟɥɨɜɟɤ, ɧɨɱɧɨɣ ɪɚɛɨɬɵ – ɭ 5 (11,9%), ɛɨɥɟɡɧɢ – ɭ 6 (14,3%), ɯɪɚɩɚ – ɭ 3 (7,1%), ɫɦɟɧɵ ɱɚɫɨɜɵɯ ɩɨɹɫɨɜ – ɭ 3 (7,1%). ɋɬɚɧɞɚɪɬɧɵɣ ɜɟɝɟɬɚɬɢɜɧɵɣ ɬɟɫɬ ɐɂɌɈ, ɪɚɡɪɚɛɨɬɚɧɧɵɣ Ⱥ. ɂ. ɇɟɱɭɲɤɢɧɵɦ ɢ Ⱥ. Ɇ. Ƚɚɣɞɚɦɚɤɢɧɨɣ [8], ɜɤɥɸɱɚɥ ɢɡɦɟɪɟɧɢɟ ɷɥɟɤɬɪɨɤɨɠɧɨɣ ɩɪɨɜɨɞɢɦɨɫɬɢ (ɗɄɉ) ɧɚ ɩɥɸɫɟ ɢ ɦɢɧɭɫɟ ɫ ɩɨɦɨɳɶɸ ɫɥɚɛɨɝɨ ɩɨɫɬɨɹɧɧɨɝɨ ɬɨɤɚ ɧɢɡɤɨɝɨ ɧɚɩɪɹɠɟɧɢɹ ɢ ɤɨɠɧɨɣ ɬɟɦɩɟɪɚɬɭɪɵ (ɄɌ) ɫ ɩɨɦɨɳɶɸ ɷɥɟɤɬɪɨɬɟɪɦɨɦɟɬɪɚ (ɜ °ɋ) ɜ 24 ɫɢɦɦɟɬɪɢɱɧɵɯ ɬɨɱɤɚɯ ɧɚ ɪɭɤɚɯ ɢ ɧɨɝɚɯ. ɇɚɪɭɲɟɧɢɹ ɫɧɚ ɢɫɫɥɟɞɨɜɚɥɢɫɶ ɫ ɩɨɦɨɳɶɸ ɚɧɤɟɬɵ ɛɚɥɥɶɧɨɣ ɨɰɟɧɤɢ ɫɭɛɴɟɤɬɢɜɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɫɧɚ ɋɨɦɧɨɥɨɝɢɱɟɫɤɨɝɨ ɰɟɧɬɪɚ Ɇɢɧɡɞɪɚɜɫɨɰɪɚɡɜɢɬɢɹ ɊɎ. ɋɭɦɦɚ ɛɚɥɥɨɜ, ɪɚɜɧɚɹ 22 ɢ ɛɨɥɟɟ, ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬ ɨɛ ɨɬɫɭɬɫɬɜɢɢ ɧɚɪɭɲɟɧɢɣ ɫɧɚ, 21–19 – ɨ ɧɚɥɢɱɢɢ ɩɨɝɪɚɧɢɱɧɨɝɨ ɫɨɫɬɨɹɧɢɹ, ɦɟɧɟɟ 19 – ɨ ɧɚɥɢɱɢɢ ɧɚɪɭɲɟɧɢɣ ɫɧɚ [7]. ɇɚɥɢɱɢɟ ɬɨɝɨ ɢɥɢ ɢɧɨɝɨ ɩɪɨɹɜɥɟɧɢɹ ɚɫɬɟɧɢɢ ɞɢɚɝɧɨɫɬɢɪɨɜɚɥɨɫɶ ɩɨ ɲɤɚɥɟ MFI-20 (ɨɛɳɚɹ, ɮɢɡɢɱɟɫɤɚɹ ɢ ɩɫɢɯɢɱɟɫɤɚɹ ɚɫɬɟɧɢɹ, ɫɧɢɠɟɧɢɟ ɚɤɬɢɜɧɨɫɬɢ ɢ ɦɨɬɢɜɚɰɢɢ) [13], ɟɫɥɢ ɤɨɥɢɱɟɫɬɜɨ ɛɚɥɥɨɜ ɜ ɤɚɠɞɨɣ ɝɪɭɩɩɟ ɩɪɟɜɵɲɚɥɨ 12. ɋ ɩɨɦɨɳɶɸ ɝɨɫɩɢɬɚɥɶɧɨɣ ɲɤɚɥɵ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ [1] ɫɭɞɢɥɢ ɨɛ ɨɬɫɭɬɫɬɜɢɢ ɞɨɫɬɨɜɟɪɧɨ ɜɵɪɚɠɟɧɧɵɯ ɫɢɦɩɬɨɦɨɜ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ – ɩɪɢ ɫɭɦɦɟ ɛɚɥɥɨɜ ɨɬ 0 ɞɨ 7, ɨ ɫɭɛɤɥɢɧɢɱɟɫɤɢ ɜɵɪɚɠɟɧɧɵɯ ɬɪɟɜɨɝɟ ɢ ɞɟɩɪɟɫɫɢɢ – ɩɪɢ ɫɭɦɦɟ ɛɚɥɥɨɜ ɨɬ 8 ɞɨ 10, ɨ ɤɥɢɧɢɱɟɫɤɢ ɜɵɪɚɠɟɧɧɵɯ ɬɪɟɜɨɝɟ ɢ ɞɟɩɪɟɫɫɢɢ – ɩɪɢ ɫɭɦɦɟ ɛɚɥɥɨɜ, ɪɚɜɧɨɣ 11 ɢ ɜɵɲɟ. Ɉɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ ɨɰɟɧɢɜɚɥɢ ɩɨ 100-ɦɢɥɥɢɦɟɬɪɨɜɨɣ ɜɢɡɭɚɥɶɧɨ-ɚɧɚɥɨɝɨɜɨɣ ɲɤɚɥɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɢɣ ɚɧɚɥɢɡ ɩɪɨɜɨɞɢɥɢ ɩɪɢ ɩɨɦɨɳɢ ɩɪɨɝɪɚɦɦɧɵɯ ɩɚɤɟɬɨɜ «Statistica 8.0», «Ȼɢɨɫɬɚɬɢɫɬɢɤɚ 4.03». Ⱦɥɹ ɨɰɟɧɤɢ ɫɬɚɬɢɫɬɢɱɟɫɤɨɣ ɡɧɚɱɢɦɨɫɬɢ ɪɚɡɥɢɱɢɣ ɩɚɪɚɦɟɬɪɢɱɟɫɤɢɯ ɞɚɧɧɵɯ ɢɫɩɨɥɶɡɨɜɚɥɢ ɤɪɢɬɟɪɢɣ t ɋɬɶɸɞɟɧɬɚ, ɩɚɪɧɵɣ ɤɪɢɬɟɪɢɣ ɋɬɶɸɞɟɧɬɚ. Ʉɨɥɢɱɟɫɬɜɟɧɧɵɟ ɞɚɧɧɵɟ ɩɪɟɞɫɬɚɜɥɟɧɵ ɚ ɜɢɞɟ Ɇ ± m, ɝɞɟ Ɇ – ɫɪɟɞɧɟɟ ɡɧɚɱɟɧɢɟ ɩɨ ɝɪɭɩɩɟ, m – ɫɪɟɞɧɹɹ ɨɲɢɛɤɚ ɫɪɟɞɧɟɝɨ. Ⱦɥɹ ɨɰɟɧɤɢ ɤɚɱɟɫɬɜɟɧɧɵɯ ɞɚɧɧɵɯ ɢɫɩɨɥɶɡɨɜɚɥɢ ɤɪɢɬɟɪɢɣ Ȥ2, ɤɪɢɬɟɪɢɣ Ȥ2 ɫ ɩɨɩɪɚɜɤɨɣ Ƀɟɬɫɚ, ɬɨɱɧɵɣ ɤɪɢɬɟɪɢɣ Ɏɢɲɟɪɚ. Ɋɚɡɥɢɱɢɹ ɫɱɢɬɚɥɢ ɫɬɚɬɢɫɬɢɱɟɫɤɢ ɡɧɚɱɢɦɵɦɢ ɩɪɢ p < 0,05. ǾdzǵȁǹȊȀǮȀȉ Ƕ ǼǯǿȁǴDzdzǻǶdz ɉɪɢɦɟɧɟɧɢɟ ɝɪɚɧɞɚɤɫɢɧɚ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɞɨɫɬɨɜɟɪɧɨ ɭɦɟɧɶɲɢɥɨ ɜɵɪɚɠɟɧɧɨɫɬɶ ɋȼȾ ɩɨ ȼȼȼɂ ɢ ɋȼȼɇ (ɬɚɛɥ. 2) ɢ ɧɨɪɦɚɥɢɡɨɜɚɥɨ ɛɨɥɶɲɢɧɫɬɜɨ ɩɨɤɚɡɚɬɟɥɟɣ ɗɄɉ ɢ ɄɌ (ɬɚɛɥ. 3). ɉɨɫɥɟɞɧɟɟ ɫɜɢɞɟɬɟɥɶɫɬɜɭɟɬ ɨ ɩɨɜɵɲɟɧɢɢ ɧɚ ɮɨɧɟ ɬɟɪɚɩɢɢ ɝɪɚɧɞɚɤɫɢɧɨɦ ɬɨɧɭɫɚ ɫɢɦɩɚɬɢɱɟɫɤɨɝɨ ɢ ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɨɝɨ ɨɬɞɟɥɨɜ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ [8]. Ɉɞɧɨɜɪɟɦɟɧɧɨ ɧɚ ɮɨɧɟ ɬɟɪɚɩɢɢ ɝɪɚɧɞɚɤɫɢɧɨɦ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɭɫɬɚɧɨɜɥɟɧɨ ɞɨɫɬɨɜɟɪɧɨɟ ɭɦɟɧɶɲɟɧɢɟ ɱɚɫɬɨɬɵ ɠɚɥɨɛ ɧɚ ɛɨɥɢ ɜ ɫɟɪɞɰɟ, ɫɟɪɞɰɟɛɢɟɧɢɟ, ɛɨɥɢ ɜ ɠɢɜɨɬɟ, ɧɚɪɭɲɟɧɢɹ ɫɬɭɥɚ, ɝɨɥɨɜɧɵɟ ɛɨɥɢ, ɝɨɥɨɜɨɤɪɭɠɟɧɢɟ, ɱɭɜɫɬɜɨ ɧɟɯɜɚɬɤɢ ɜɨɡɞɭɯɚ (ɬɚɛɥ. 1). Ƚɪɚɧɞɚɤɫɢɧ ɞɨɫɬɨɜɟɪɧɨ ɨɫɥɚɛɢɥ ɜɵɪɚɠɟɧɧɨɫɬɶ ɨɛɳɟɣ ɢ ɮɢɡɢɱɟɫɤɨɣ ɚɫɬɟɧɢɢ, ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɩɨɜɵɫɢɥ ɮɢɡɢɱɟɫɤɭɸ ɚɤɬɢɜɧɨɫɬɶ, ɪɚɛɨɬɨɫɩɨɫɨɛɧɨɫɬɶ, ɦɨɬɢɜɚɰɢɸ ɢ ɭɥɭɱɲɢɥ ɨɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ ɢ ɫɨɧ ɩɚɰɢɟɧɬɨɜ (ɬɚɛɥ. 4). ɋɭɦɦɚ ɛɚɥɥɨɜ ɚɧɤɟɬɵ ɨɰɟɧɤɢ ɫɭɛɴɟɤɬɢɜɧɵɯ ɯɚɪɚɤɬɟɪɢɫɬɢɤ ɫɧɚ ɭɜɟɥɢɱɢɥɚɫɶ ɫ 18,14 ± 0,48 ɞɨ 21,05 ± 0,42 (ɪ < 0,05) ɢ ɩɪɚɤɬɢɱɟɫɤɢ ɞɨɫɬɢɝɥɚ ɧɨɪɦɵ. ɉɨɫɥɟ ɥɟɱɟɧɢɹ ɭɦɟɧɶɲɢɥɨɫɶ ɱɢɫɥɨ ɩɚ- 32 Ɍɨɮɢɡɨɩɚɦ ɩɪɢ ɞɢɫɩɥɚɡɢɹɯ ɫɨɟɞɢɧɢɬɟɥɶɧɨɣ ɬɤɚɧɢ ɫɟɪɞɰɚ Ɍɚɛɥɢɰɚ 1. ɑɚɫɬɨɬɚ ɠɚɥɨɛ ɭ ɨɛɫɥɟɞɨɜɚɧɧɵɯ ɛɟɡ ȾɋɌɋ ɢ ɫ ȾɋɌɋ ɞɨ ɢ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɝɪɚɧɞɚɤɫɢɧɨɦ ɀɚɥɨɛɵ ɋɟɪɞɰɟɛɢɟɧɢɟ Ʉɚɪɞɢɚɥɝɢɢ Ʌɚɛɢɥɶɧɨɫɬɶ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɞɚɜɥɟɧɢɹ Ʌɚɛɢɥɶɧɨɫɬɶ ɱɚɫɬɨɬɵ ɫɟɪɞɟɱɧɵɯ ɫɨɤɪɚɳɟɧɢɣ Ƚɨɥɨɜɧɵɟ ɛɨɥɢ, ɦɢɝɪɟɧɢ Ƚɨɥɨɜɨɤɪɭɠɟɧɢɹ ɑɭɜɫɬɜɨ ɧɟɯɜɚɬɤɢ ɜɨɡɞɭɯɚ (ɝɢɩɟɪɜɟɧɬɢɥɹɰɢɨɧɧɵɣ ɫɢɧɞɪɨɦ) Ɍɨɲɧɨɬɚ Ȼɨɥɢ ɜ ɠɢɜɨɬɟ ɇɚɪɭɲɟɧɢɹ ɫɬɭɥɚ (ɡɚɩɨɪ ɢɥɢ ɩɨɧɨɫ) ɋɧɢɠɟɧɢɟ ɪɚɛɨɬɨɫɩɨɫɨɛɧɨɫɬɢ, ɛɵɫɬɪɚɹ ɭɬɨɦɥɹɟɦɨɫɬɶ ɜ ɝɪɭɩɩɟ ɥɢɰ ɛɟɡ ȾɋɌɋ 8,16 ± 3,9 30,61 ± 6,6 12,24 ± 4,7 14,29 ± 5,0 42,86 ± 7,1 18,37 ± 5,5 22,45 ± 6,0 14,29 ± 5,0 22,45 ± 6,0 20,41 ± 5,8 42,86 ± 7,1 ɑɢɫɥɨ ɫɥɭɱɚɟɜ, % ɜ ɝɪɭɩɩɟ ɥɢɰ ɫ ȾɋɌɋ ɞɨ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ 80,0 ± 5,4* 32,73 ± 6,3# 32,73 ± 6,3 5,45 ± 3,1* 40,0 ± 6,6 47,27 ± 6,7+ 65,45 ± 6,4# 74,55 ± 5,9+ 85,45 ± 4,8# 32,73 ± 6,3# 80,0 ± 5,4+ 7,27 ± 3,5* 5,45 ± 3,1* 74,55 ± 5,9# 40,0 ± 6,6 47,27 ± 6,7+ 40,0 ± 6,6# 60,0 ± 6,6# 65,45 ± 6,4+ 47,27 ± 6,7# 65,45 ± 6,4# 14,55 ± 4,8+ ɉɪɢɦɟɱɚɧɢɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɡɧɚɱɢɦɨɫɬɶ ɪɚɡɥɢɱɢɣ ɫ ɩɪɟɞɲɟɫɬɜɭɸɳɟɣ ɝɪɭɩɩɨɣ p < 0,05: # – ɩɨ ɤɪɢɬɟɪɢɸ Ȥ2, + – ɩɨ ɤɪɢɬɟɪɢɸ Ȥ2 ɫ ɩɨɩɪɚɜɤɨɣ Ƀɟɬɫɚ, * – ɩɨ ɬɨɱɧɨɦɭ ɤɪɢɬɟɪɢɸ Ɏɢɲɟɪɚ, ^ – ɩɨ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ, ^^ – ɩɨ ɩɚɪɧɨɦɭ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ. Ɍɚɛɥɢɰɚ 2. ȼɵɪɚɠɟɧɧɨɫɬɶ ɋȼȾ ɩɨ ȼȼȼɂ ɢ ɋȼȼɇ ɭ ɨɛɫɥɟɞɨɜɚɧɧɵɯ ɛɟɡ ȾɋɌɋ ɢ ɫ ȾɋɌɋ ɞɨ ɢ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɝɪɚɧɞɚɤɫɢɧɨɦ ɉɨɤɚɡɚɬɟɥɶ ȼ ɝɪɭɩɩɟ ɥɢɰ ɛɟɡ ȾɋɌɋ ɋȼȾ ɩɨ ɋȼȼɇ, ɛɚɥɥɵ 17,2 ± 1,52 ȼ ɝɪɭɩɩɟ ɥɢɰ ɫ ȾɋɌɋ ɞɨ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ 46,81 ± 4,53^ 31,31 ± 3,37^^ ɉɪɢɦɟɱɚɧɢɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɡɧɚɱɢɦɨɫɬɶ ɪɚɡɥɢɱɢɣ ɫ ɩɪɟɞɲɟɫɬɜɭɸɳɟɣ ɝɪɭɩɩɨɣ p < 0,05: ^ – ɩɨ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ, ^^ – ɩɨ ɩɚɪɧɨɦɭ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ. Ɍɚɛɥɢɰɚ 3. ɉɨɤɚɡɚɬɟɥɢ ɫɬɚɧɞɚɪɬɧɨɝɨ ɜɟɝɟɬɚɬɢɜɧɨɝɨ ɬɟɫɬɚ ɐɂɌɈ ɭ ɨɛɫɥɟɞɨɜɚɧɧɵɯ ɛɟɡ ȾɋɌɋ ɢ ɫ ȾɋɌɋ ɞɨ ɢ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɝɪɚɧɞɚɤɫɢɧɨɦ ɉɨɤɚɡɚɬɟɥɶ ȼ ɝɪɭɩɩɟ ɥɢɰ ɛɟɡ ȾɋɌɋ ɗɄɉ + ɫɪɟɞɧɹɹ, ɦɤȺ ɗɄɉ – ɫɪɟɞɧɹɹ, ɦɤȺ ɗɄɉ ɫɩɪɚɜɚ, ɦɤȺ ɗɄɉ ɫɥɟɜɚ, ɦɤȺ ɄɌ ɫɪɟɞɧɹɹ, °ɋ ɄɌ ɫɩɪɚɜɚ, °ɋ ɄɌ ɫɥɟɜɚ, °ɋ ɗɄɉ ɧɚ ɪɭɤɚɯ, ɦɤȺ ɗɄɉ ɧɚ ɧɨɝɚɯ, ɦɤȺ ɄɌ ɧɚ ɪɭɤɚɯ, °ɋ ɄɌ ɧɚ ɧɨɝɚɯ, °ɋ 5,65 ± 0,27 5,21 ± 0,24 5,44 ± 0,24 5,40 ± 0,22 29,35 ± 0,34 29,25 ± 0,33 29,35 ± 0,34 5,61 ± 0,24 5,28 ± 0,24 29,76 ± 0,35 28,92 ± 0,40 ȼ ɝɪɭɩɩɟ ɥɢɰ ɫ ȾɋɌɋ ɞɨ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ 3,22 ± 0,51^ 4,39±0,45* 2,98 ± 0,55^ 3,92 ± 0,43 4,08 ± 0,44* 3,05 ± 0,52^ 4,23 ± 0,43* 3,16 ± 0,54^ 28,17 ± 0,34 27,67 ± 0,41^ 28,24 ± 0,33* 27,58 ± 0,42^ 28,1 ± 0,37 27,76 ± 0,4^ 4,7 ± 0,54* 3,43 ± 0,72^ 3,62 ± 0,42 2,78 ± 0,4^ 29,36 ± 0,49 30,04 ± 0,48 26,3 ± 0,52 25,97 ± 0,58^ ɉɪɢɦɟɱɚɧɢɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɡɧɚɱɢɦɨɫɬɶ ɪɚɡɥɢɱɢɣ ɫ ɩɪɟɞɲɟɫɬɜɭɸɳɟɣ ɝɪɭɩɩɨɣ p < 0,05: ^ – ɩɨ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ, * – ɩɨ ɩɚɪɧɨɦɭ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ. Ɍɚɛɥɢɰɚ 4. Ⱦɢɧɚɦɢɤɚ ɩɪɨɹɜɥɟɧɢɣ ɚɫɬɟɧɢɢ ɩɨ ɲɤɚɥɟ MFI-20, ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ ɩɨ ɝɨɫɩɢɬɚɥɶɧɨɣ ɲɤɚɥɟ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɨɛɳɟɝɨ ɫɚɦɨɱɭɜɫɬɜɢɹ ɩɨ ɜɢɡɭɚɥɶɧɨ-ɚɧɚɥɨɝɨɜɨɣ ɲɤɚɥɟ ɭ ɨɛɫɥɟɞɨɜɚɧɧɵɯ ɛɟɡ ȾɋɌɋ ɢ ɫ ȾɋɌɋ ɞɨ ɢ ɩɨɫɥɟ ɥɟɱɟɧɢɹ ɝɪɚɧɞɚɤɫɢɧɨɦ ɉɨɤɚɡɚɬɟɥɶ Ɉɛɳɚɹ ɚɫɬɟɧɢɹ ɩɨ ɲɤɚɥɟ MFI-20, ɛɚɥɥɵ Ɏɢɡɢɱɟɫɤɚɹ ɚɫɬɟɧɢɹ ɩɨ ɲɤɚɥɟ MFI-20, ɛɚɥɥɵ ɋɧɢɠɟɧɢɟ ɮɢɡɢɱɟɫɤɨɣ ɚɤɬɢɜɧɨɫɬɢ ɩɨ ɲɤɚɥɟ MFI-20, ɛɚɥɥɵ ɋɧɢɠɟɧɢɟ ɦɨɬɢɜɚɰɢɢ ɩɨ ɲɤɚɥɟ MFI-20, ɛɚɥɥɵ ɉɫɢɯɢɱɟɫɤɚɹ ɚɫɬɟɧɢɹ ɩɨ ɲɤɚɥɟ MFI-20, ɛɚɥɥɵ Ɍɪɟɜɨɝɚ ɩɨ ɝɨɫɩɢɬɚɥɶɧɨɣ ɲɤɚɥɟ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɛɚɥɥɵ Ⱦɟɩɪɟɫɫɢɹ ɩɨ ɝɨɫɩɢɬɚɥɶɧɨɣ ɲɤɚɥɟ ɬɪɟɜɨɝɢ ɢ ɞɟɩɪɟɫɫɢɢ, ɛɚɥɥɵ Ɉɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ ɩɨ ɜɢɡɭɚɥɶɧɨ-ɚɧɚɥɨɝɨɜɨɣ ɲɤɚɥɟ, ɦɦ ȼ ɝɪɭɩɩɟ ɥɢɰ ɛɟɡ ȾɋɌɋ 7,0 ± 0,2 10,0 ± 0,3 7,0 ± 0,2 4,0 ± 0,1 7,0 ± 0,3 4,8 ± 0,5 3,8 ± 0,5 89,9 ± 1,1 ȼ ɝɪɭɩɩɟ ɥɢɰ ɫ ȾɋɌɋ ɞɨ ɥɟɱɟɧɢɹ ɩɨɫɥɟ ɥɟɱɟɧɢɹ 12,75 ± 0,50^ 11,47 ± 0,48* 10,87 ± 0,51 10,07 ± 0,47* 12,4 ± 0,53^ 11,64 ± 0,51* 11,31 ± 0,33^ 10,82 ± 0,38 10,33 ± 0,56^ 10,36 ± 0,53 8,57 ± 0,53^ 5,92 ± 0,43*2 7,07 ± 0,41^ 5,61 ± 0,41* 68,0 ± 2,9^ 75,5 ± 2,4* ɉɪɢɦɟɱɚɧɢɟ. ɋɬɚɬɢɫɬɢɱɟɫɤɚɹ ɡɧɚɱɢɦɨɫɬɶ ɪɚɡɥɢɱɢɣ ɫ ɩɪɟɞɲɟɫɬɜɭɸɳɟɣ ɝɪɭɩɩɨɣ p < 0,05: ^ – ɩɨ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ, * – ɩɨ ɩɚɪɧɨɦɭ ɤɪɢɬɟɪɢɸ ɋɬɶɸɞɟɧɬɚ. Ɍ. 17, ʋ 2, 2012 ȼɟɫɬɧɢɤ ɂɜɚɧɨɜɫɤɨɣ ɦɟɞɢɰɢɧɫɤɨɣ ɚɤɚɞɟɦɢɢ ɰɢɟɧɬɨɜ ɫ ɱɚɫɬɵɦɢ ɧɨɱɧɵɦɢ ɩɪɨɛɭɠɞɟɧɢɹɦɢ (ɛɨɥɟɟ 3 ɪɚɡ ɡɚ ɧɨɱɶ) – ɫ 34 ɞɨ 21 (ɪ < 0,05) ɢ ɩɥɨɯɢɦ ɤɚɱɟɫɬɜɨɦ ɭɬɪɟɧɧɟɝɨ ɩɪɨɛɭɠɞɟɧɢɹ – ɫ 11 ɞɨ 5 (ɪ < 0,05), ɨɬɦɟɱɟɧɵ ɬɟɧɞɟɧɰɢɢ ɤ ɫɨɤɪɚɳɟɧɢɸ ɜɪɟɦɟɧɢ ɡɚɫɵɩɚɧɢɹ ɢ ɤɨɥɢɱɟɫɬɜɚ ɫɧɨɜɢɞɟɧɢɣ, ɭɜɟɥɢɱɟɧɢɸ ɩɪɨɞɨɥɠɢɬɟɥɶɧɨɫɬɢ ɫɧɚ. Ɇɨɠɧɨ ɩɪɟɞɩɨɥɚɝɚɬɶ, ɱɬɨ ɧɨɪɦɚɥɢɡɚɰɢɹ ɚɤɬɢɜɧɨɫɬɢ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɢ ɭɦɟɧɶɲɟɧɢɟ ɜɵɪɚɠɟɧɧɨɫɬɢ ɤɥɢɧɢɱɟɫɤɨɣ ɫɢɦɩɬɨɦɚɬɢɤɢ, ɧɨɪɦɚɥɢɡɚɰɢɹ ɫɧɚ ɨɛɭɫɥɨɜɥɟɧɵ ɜɥɢɹɧɢɟɦ ɝɪɚɧɞɚɤɫɢɧɚ ɧɚ ɥɢɦɛɢɤɨ-ɪɟɬɢɤɭɥɹɪɧɵɣ ɤɨɦɩɥɟɤɫ [2, 4], ɜ ɬɨɦ ɱɢɫɥɟ ɝɢɩɨɬɚɥɚɦɭɫ. ɗɬɢ ɫɬɪɭɤɬɭɪɵ ɹɜɥɹɸɬɫɹ ɜɚɠɧɵɦɢ ɡɜɟɧɶɹɦɢ ɢɧɬɟɝɪɚɰɢɨɧɧɵɯ ɫɢɫɬɟɦ, ɤɨɧɬɪɨɥɢɪɭɸɳɢɯ ɜɟɝɟɬɚɬɢɜɧɵɟ, ɷɧɞɨɤɪɢɧɧɵɟ, ɫɨɦɚɬɢɱɟɫɤɢɟ ɢ ɩɫɢɯɢɱɟɫɤɢɟ ɮɭɧɤɰɢɢ [9]. ɉɪɨɬɢɜɨɬɪɟɜɨɠɧɵɣ ɷɮɮɟɤɬ ɝɪɚɧɞɚɤɫɢɧɚ ɜ ɨɩɪɟɞɟɥɟɧɧɨɣ ɫɬɟɩɟɧɢ ɫɜɹɡɚɧ ɫ ɬɟɦ, ɱɬɨ ɨɧ ɩɨɬɟɧɰɢɪɭ- 33 ɟɬ ɞɟɣɫɬɜɢɟ ȽȺɆɄ, ɭɫɢɥɢɜɚɹ ɬɨɪɦɨɡɧɵɟ ɜɥɢɹɧɢɹ ɩɨɫɥɟɞɧɟɣ ɧɚ ɷɦɨɰɢɨɧɚɥɶɧɭɸ ɫɮɟɪɭ [5]. ǰȉǰǼDzȉ Ƚɪɚɧɞɚɤɫɢɧ ɭ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɨɤɚɡɵɜɚɟɬ ɪɚɡɧɨɩɥɚɧɨɜɨɟ ɥɟɱɟɛɧɨɟ ɞɟɣɫɬɜɢɟ: ɩɨɜɵɲɚɟɬ ɬɨɧɭɫ ɫɢɦɩɚɬɢɱɟɫɤɨɝɨ ɢ ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɨɝɨ ɨɬɞɟɥɨɜ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɢ ɭɦɟɧɶɲɚɟɬ ɩɪɨɹɜɥɟɧɢɹ ɜɟɝɟɬɚɬɢɜɧɨɣ ɞɢɫɮɭɧɤɰɢɢ; ɤɭɩɢɪɭɟɬ ɤɥɢɧɢɱɟɫɤɢɟ ɩɪɨɹɜɥɟɧɢɹ; ɧɨɪɦɚɥɢɡɭɟɬ ɫɨɧ; ɭɦɟɧɶɲɚɟɬ ɚɫɬɟɧɢɸ, ɬɪɟɜɨɝɭ, ɞɟɩɪɟɫɫɢɸ ɢ ɭɥɭɱɲɚɟɬ ɨɛɳɟɟ ɫɚɦɨɱɭɜɫɬɜɢɟ. ȼɫɟ ɜɵɲɟɫɤɚɡɚɧɧɨɟ ɩɨɡɜɨɥɹɟɬ ɪɟɤɨɦɟɧɞɨɜɚɬɶ ɝɪɚɧɞɚɤɫɢɧ ɞɥɹ ɥɟɱɟɧɢɹ ɩɚɰɢɟɧɬɨɜ ɫ ȾɋɌɋ ɫ ɪɚɡɧɨɨɛɪɚɡɧɨɣ ɤɥɢɧɢɱɟɫɤɨɣ ɫɢɦɩɬɨɦɚɬɢɤɨɣ ɢ ɜɟɝɟɬɚɬɢɜɧɵɦɢ ɪɚɫɫɬɪɨɣɫɬɜɚɦɢ ɜ ɫɨɱɟɬɚɧɢɢ ɫ ɢɧɫɨɦɧɢɱɟɫɤɢɦɢ ɧɚɪɭɲɟɧɢɹɦɢ. ǹǶȀdzǾǮȀȁǾǮ 1. Ȼɟɥɨɜɚ Ⱥ. ɇ., ɓɟɩɟɬɨɜɚ Ɉ. ɇ. ɒɤɚɥɵ, ɬɟɫɬɵ ɢ ɨɩɪɨɫɧɢɤɢ ɜ ɦɟɞɢɰɢɧɫɤɨɣ ɪɟɚɛɢɥɢɬɚɰɢɢ : ɪɭɤ-ɜɨ ɞɥɹ ɜɪɚɱɟɣ ɢ ɧɚɭɱɧɵɯ ɪɚɛɨɬɧɢɤɨɜ. – Ɇ. : Ⱥɧɬɢɞɨɪ, 2002. – ɋ. 439. 2. ȼɟɝɟɬɚɬɢɜɧɵɟ ɧɚɪɭɲɟɧɢɹ ɩɪɢ ɩɪɨɥɚɩɫɟ ɦɢɬɪɚɥɶɧɨɝɨ ɤɥɚɩɚɧɚ / Ⱥ. Ɇ. ȼɟɣɧ [ɢ ɞɪ.] // Ʉɚɪɞɢɨɥɨɝɢɹ. – 1995. – ʋ 2. – ɋ. 55–58. 3. ȼɟɣɧ Ⱥ. Ɇ. ȼɟɝɟɬɚɬɢɜɧɵɟ ɪɚɫɫɬɪɨɣɫɬɜɚ: ɤɥɢɧɢɤɚ, ɥɟɱɟɧɢɟ, ɞɢɚɝɧɨɫɬɢɤɚ. – Ɇ. : Ɇɟɞ. ɢɧɮɨɪɦ. ɚɝ-ɜɨ, 2000. – ɋ. 44–57. 4. Ⱦɸɤɨɜɚ Ƚ. Ɇ. Ƚɪɚɧɞɚɤɫɢɧ ɜ ɤɥɢɧɢɱɟɫɤɨɣ ɩɪɚɤɬɢɤɟ // Ʌɟɱɟɧɢɟ ɧɟɪɜɧɵɯ ɛɨɥɟɡɧɟɣ. – 2005. – ʋ 2. – ɋ. 25–29. 5. Ⱦɸɤɨɜɚ Ƚ. Ɇ., ɋɚɤɫɨɧɨɜɚ ȿ. ȼ., Ƚɨɥɭɛɟɜ ȼ. Ⱥ. Ƚɪɚɧɞɚɤɫɢɧ ɜ ɧɟɜɪɨɥɨɝɢɱɟɫɤɨɣ ɩɪɚɤɬɢɤɟ // ɀɭɪɧ. ɧɟɜɪɨɥɨɝɢɢ ɢ ɩɫɢɯɢɚɬɪɢɢ ɢɦ. ɋ. ɋ. Ʉɨɪɫɚɤɨɜɚ. – 2009. – ʋ 9. – ɋ. 44–48. 6. Ɂɟɦɰɨɜɫɤɢɣ ɗ. ȼ. ɋɨɟɞɢɧɢɬɟɥɶɧɨɬɤɚɧɧɵɟ ɞɢɫɩɥɚɡɢɢ ɫɟɪɞɰɚ. – ɋɉɛ. : ɉɨɥɢɬɟɤɫ-ɇɨɪɞ-ȼɟɫɬ, 2000. – ɋ. 31–33. 7. ɂɧɫɨɦɧɢɹ: ɫɨɜɪɟɦɟɧɧɵɟ ɞɢɚɝɧɨɫɬɢɱɟɫɤɢɟ ɢ ɥɟɱɟɛɧɵɟ ɩɨɞɯɨɞɵ / ə. ɂ. Ʌɟɜɢɧ [ɢ ɞɪ.]. – Ɇ. : Ɇɟɞɩɪɚɤɬɢɤɚ, 2005. – 116 ɫ. ɇɟɱɭɲɤɢɧ Ⱥ. ɂ., Ƚɚɣɞɚɦɚɤɢɧɚ Ⱥ. 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