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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">clinmed</journal-id><journal-title-group><journal-title xml:lang="ru">Клиническая медицина</journal-title><trans-title-group xml:lang="en"><trans-title>Clinical Medicine (Russian Journal)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0023-2149</issn><issn pub-type="epub">2412-1339</issn><publisher><publisher-name>ООО «Медицинское информационное агентство»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/0023-2149-2026-104-4-264-271</article-id><article-id custom-type="elpub" pub-id-type="custom">clinmed-1454</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>ОБЗОРЫ И ЛЕКЦИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS AND LECTURES</subject></subj-group></article-categories><title-group><article-title>Ранняя диагностика и вопросы коморбидности в клинической практике</article-title><trans-title-group xml:lang="en"><trans-title>Early diagnostics and comorbidity issues in clinical practice</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1817-3228</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тимурзиева</surname><given-names>А. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Timurzieva</surname><given-names>A. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тимурзиевa Алинa Бoрисoвна – канд. мед. наук, стaрший нaучный сoтрудник</p><p>Аuthor ID: 1073051</p><p>Москва</p></bio><bio xml:lang="en"><p>Alina B. Timurzieva – Candidate of Medical Sciences, Senior Researcher</p><p>Author ID: 1073051</p><p>Mоscow</p></bio><email xlink:type="simple">alinko9977z@mail.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/0000-0002-6966-5559</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зудин</surname><given-names>А. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Zudin</surname><given-names>A. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зудин Александр Борисович – д-р мед. наук, директор</p><p>Author ID: 878732</p><p>Москва</p></bio><bio xml:lang="en"><p>Alexander B. Zudin – Doctor of Medical Sciences, Director</p><p>Author ID: 878732</p><p>Mоscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Далинина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dalinina</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Далинина Елена Александровна – заместитель главного врача</p><p>Москва</p></bio><bio xml:lang="en"><p>Elena A. Dalinina – Deputy Chief Physician</p><p>Mоscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Национальный научно-исследовательский институт общественного здоровья им. Н.А. Семашко»&#13;
Минобрнауки</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.A. Semashko National Research Institute of Public Health</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Центр диагностики и лечения им. Н.А. Семашко</institution><country>Россия</country></aff><aff xml:lang="en"><institution>N.A. Semashko Diagnostic and Treatment Center</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>20</day><month>06</month><year>2026</year></pub-date><volume>104</volume><issue>4</issue><fpage>264</fpage><lpage>271</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Тимурзиева А.Б., Зудин А.Б., Далинина Е.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Тимурзиева А.Б., Зудин А.Б., Далинина Е.А.</copyright-holder><copyright-holder xml:lang="en">Timurzieva A.B., Zudin A.B., Dalinina E.A.</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.clinmedjournal.com/jour/article/view/1454">https://www.clinmedjournal.com/jour/article/view/1454</self-uri><abstract><p>Заболевания ЛОР-органов являются широко распространенными. Нередко в клинической практике встречается сочетанная патология. Поздняя диагностика патологии ЛОР-органов, сочетающейся с другими заболеваниями, а также сложность использования системного подхода при ведении пациентов с коморбидной патологией в оториноларингологии приводят к снижению качества жизни пациентов, полипрагмазии и нежелательных реакций во время терапии, снижению ожидаемой продолжительности здоровой жизни и значительному экономическому бремени. Целью нашего исследования было обосновать необходимость использования системного подхода для решения задач коморбидной патологии и ранней диагностики заболеваний ЛОР-органов и других органов и систем. В ходе исследования применяли методы контент-анализа, аналитический и собственный клинический опыт. Результаты и обсуждение. Проведенное исследование продемонстрировало важность разработки клинических рекомендаций, стандартов, порядков оказания медицинской помощи в деятельности врачей и предотвращении рисков, связанных с оказанием медицинской помощи. Рассмотрены проблемы эффективности взаимодействия специалистов различного профиля, использования междисциплинарного подхода на практике, вопросы коморбидности, ранней диагностики и рационального применения препаратов при наличии сопутствующей патологии, возможности совершенствования нормативно-правовых документов и другие важные аспекты оториноларингологии. В ходе проведенного исследования были сформулированы некоторые проблемы организации медицинской помощи пациентам с коморбидной патологией при заболеваниях ЛОР-органов, предложены способы решения некоторых из них на основе собственного опыта, данных отечественной и зарубежной литературы, а также нормативно-правовой документации. Заключение. Решение вопросов, связанных с применением междисциплинарного подхода, мультидисциплинарного взаимодействия, рассмотрение проблем коморбидности, обеспечение ранней диагностики и профилактики заболеваний ЛОР-органов, а также других органов и систем, играют важную роль в практическом здравоохранении. Разработка нормативно-правовой документации при лечении патологии уха, горла и носа для регламентации практической деятельности специалистов-работников поликлиник и стационаров в комбинации с индивидуальным подходом в диагностике и лечении сочетанной патологии в оториноларингологии и других направлениях клинической медицины могут быть ценны для предотвращения рисков, связанных с оказанием медицинской помощи, и повышения качества организации медицинской помощи.</p></abstract><trans-abstract xml:lang="en"><p>ENT-diseases are widespread. Combined pathology is often encountered in clinical practice. Late diagnosis of ENT- pathology combined with other diseases, as well as the complexity of using a systemic approach to solving the problems of managing patients with comorbid pathology in Otorhinolaryngology lead to a decrease in the quality of life of patients, the emergence of polypharmacy and adverse reactions during therapy, a decrease in healthy life expectancy and a significant economic burden. The aim of our study was to substantiate the need to use a systemic approach to solving the problems of comorbid pathology and early diagnosis of ENT-diseases and another pathology. The study used content analysis, analytical methods and the use of our own clinical experience. Results and discussion. The study demonstrated the importance of developing clinical guidelines, standards, procedures for the provision of medical care in the activities of doctors and preventing risks associated with the provision of medical care. The problems of the effectiveness of interaction between specialists of various profiles, the use of an interdisciplinary approach in practice, issues of comorbidity, early diagnosis and rational use of drugs in the presence of concomitant pathology, the possibility of improving regulatory documents and other important aspects of Otorhinolaryngology are considered. In the course of the study, some problems of organizing medical care for patients with comorbid pathology in ENT-diseases were formulated, ways to solve some of them were proposed based on our own experience, data of world literature, as well as regulatory documentation. Conclusion. The solution of issues related to the use of an interdisciplinary approach, multidisciplinary interaction, consideration of comorbidity problems, ensuring early diagnosis and prevention of ENT-diseases, as well as other pathology, play an important role in practical Healthcare. The development of regulatory and legal documentation for the treatment of ear, throat and nose pathology to regulate the practical activities of specialists working in outpatient clinics and hospitals in combination with an individual approach to the diagnosis and treatment of combined pathology in otolaryngology and other areas of clinical medicine can be valuable in terms of preventing risks associated with the provision of medical care and improving the quality of the organization of medical care.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ранняя диагностика</kwd><kwd>системный подход</kwd><kwd>коморбидность</kwd><kwd>эффективное взаимодействие специалистов</kwd><kwd>полипрагмазия</kwd><kwd>заболевания ЛОР-органов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>early diagnostics</kwd><kwd>systemic approach</kwd><kwd>comorbidity</kwd><kwd>effective interaction of specialists</kwd><kwd>polypharmacy</kwd><kwd>ENTdiseases</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">Ali M.A., Taishan W.S., Almaymoni A.A., Al Sulaiman I.N., Althunayyan T.S., Abdullah Z.A., Alharbi M., Alalwani H.H., Alzahrani T.M., Felemban G. 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