smjournalСпортивная медицина: наука и практикаSports medicine: research and practice2223-25242587-9014NEICON10.47529/2223-2524.2021.3.6smjournal-299Research ArticleФАРМАКОЛОГИЧЕСКАЯ ПОДДЕРЖКАSPORTS PHARMACOLOGYβ2-агонисты в спорте: распространенность и влияние на спортивные результатыβ2-agonists in sports: prevalence and impact on athletic performancehttps://orcid.org/0000-0001-8405-859XДеревоедовА. А.DerevoedovA. A.

Деревоедов Александр Анатольевич, к.м.н., ведущий научный сотрудник организационно-исследовательского отдела 

121059, Москва, Большая Дорогомиловская ул., 5

Aleksandr A. Derevoedov, M.D., Ph.D. (Medicine), Leading Researcher of the Organizational and Research Department 

5, Bolshaya Dorogomilovskaya str., Moscow, 121059

https://orcid.org/0000-0002-0267-9761ЖолинскийА. В.ZholinskyA. V.

Жолинский Андрей Владимирович, к.м.н., директор 

121059, Москва, Большая Дорогомиловская ул., 5

Andrey V. Zholinsky, M.D., Ph.D. (Medicine), Director 

5, Bolshaya Dorogomilovskaya str., Moscow, 121059

https://orcid.org/0000-0002-4574-6506ФещенкоВ. С.FeshchenkoV. S.

Фещенко Владимир Сергеевич, к.м.н., начальник организационно-исследовательского отдела 

121059, Москва, Большая Дорогомиловская ул., 5

Vladimir S. Feshchenko, M.D., Ph.D. (Medicine), Head of the Organizational-Research Department 

5, Bolshaya Dorogomilovskaya str., Moscow, 121059

https://orcid.org/0000-0002-6206-2771ВыходецИ. Т.VykhodetsI. T.

Выходец Игорь Трифанович, к.м.н., заместитель начальника Управления организации спортивной медицины

123182, Москва, Волоколамское шоссе 30

Igor T. Vykhodets, M.D., Ph.D. (Medicine), Deputy Head of the Office of the Organization of Sports Medicine

30 Volokolamskoe highway, Moscow, 123182

https://orcid.org/0000-0002-7682-2057ПавловаА. А.PavlovaA. A.

Павлова Анна Александровна, врач по спортивной медицине отдела медицинского обеспечения спортивных сборных команд и соревнований 

121059, Москва, Большая Дорогомиловская ул., 5

Anna A. Pavlova, sports medicine physician of the Department of medical support of sports teams and competitions

5, Bolshaya Dorogomilovskaya str., Moscow, 121059

dr_pavlova@hotmail.comФГБУ «Федеральный научно-клинический центр спортивной медицины и реабилитации Федерального медико-биологического агентства»РоссияFederal Research and Clinical Center of Sports Medicine and Rehabilitation of Federal Medical Biological AgencyRussian FederationФедеральное медико-биологическое агентствоРоссияThe Federal Medical Biological AgencyRussian Federation2021261120211133442Copyright © Деревоедов А.А., Жолинский А.В., Фещенко В.С., Выходец И.Т., Павлова А.А., 20212021Деревоедов А.А., Жолинский А.В., Фещенко В.С., Выходец И.Т., Павлова А.А.Derevoedov A.A., Zholinsky A.V., Feshchenko V.S., Vykhodets I.T., Pavlova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.smjournal.ru/jour/article/view/299

На основе анализа материалов текстовых баз данных медицинских научных публикаций определены особенности протекания нарушений бронхиальной проходимости у спортсменов высокой квалификации в зависимости от особенностей вида спорта и характера нагрузки, а также у здоровых лиц. Выявлены пути влияния β2-агонистов на основные функциональные показатели спортсменов, а также взаимосвязь между динамикой этих показателей и спортивными результатами.

Порядок применения β2-агонистов рассмотрен с точки зрения документов антидопинговых организаций с учетом положений Международного стандарта ВАДА «Запрещенный список» 2021 года. Препараты, разрешенные для использования в спорте в форме ингаляций, не оказывали существенного влияния на ключевые параметры вентиляции легких и эффективность спортивного выступления. В то же время таблетированные формы любых β2-агонистов, а также кленбутерол, запрещенные для применения без запроса на терапевтическое использование, увеличивали мышечную силу, скоростную выносливость, пиковую мощность в тесте Вингейта, что подтверждает их возможное влияние на спортивный результат.

Результаты большинства исследований носят разнонаправленный характер и не позволяют сделать однозначный вывод о влиянии β2-агонистов на результат. Этому же способствует небольшое количество рандомизированных клинических исследований при незначительном числе наблюдений.

В тех случаях, когда спортсмены получали разрешение на терапевтическое использование β2-агонистов во время крупных соревнований, это не повышало вероятность выигрыша.

Необходимо проведение дальнейшего изучения влияния β2-агонистов на спортивный результат в ходе проведения рандомизированных контролируемых исследований с целью индивидуализации терапии и предупреждения бронхиальной обструкции у спортсменов

Respiratory disorders caused by exercise are expressed in the development of exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA), which are observed in athletes, especially in cyclic sports, much more often than in the population. Ventilation impairments are exacerbated by inhaled allergens, industrial pollutants and adverse environmental conditions, which increase the risk of EIB and asthma symptoms in athletes. The use of β2-agonists can prevent or eliminate ventilation disorders, however, it requires taking into account current anti-doping rules, which allow the use of certain substances in sports without a request for therapeutic use. The studies of the influence of β2-agonists on functional indicators of athletes and sports performance do not allow to make an unambiguous conclusion about its results. Medications with β2-agonists, approved for use in sports in the form of inhalation, do not have a significant effect on the performance of athletes at major sports competitions. At the same time, the systemic use of these substances and the use of any form of terbutaline caused a positive dynamics in functional indicators, which could lead to an illegal increase in the effectiveness of sports performance. Most of the conclusions about the effect of β2-agonists on outcome are based on a small number of studies, their heterogeneity, and an insignificant number of observations. It is necessary to continue studying the effects of β2-agonists in the course of randomized clinical trials in order to individualize therapy and prevent bronchial obstruction in athletes

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