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The article presents current data from the scientific medical literature on the effective use of the R(+)-enantiomer of α-lipoic acid in various pathological conditions. The authors analyze the literature data on the comparative assessment of the activity of racemic and dextrorotatory forms of thioctic (alpha-lipoic) acid in low back pain, the effect of the R(+)-enantiomer in combination with hyperbaric oxygen therapy on the production of interleukin-6, tumor necrosis factor α and vascular endothelial growth factor in the healing of chronic ulcers of the lower extremities, as well as the use of R-α-lipoic acid in patients with mild to moderate carpal tunnel syndrome. It should be noted that recently around the world there is a tendency to gradual transition from the course treatment of diabetic neuropathy towards long-term and continuous use of pathogenetic therapies in order to maintain their positive effects. Alpha-lipoic acid is widely used in neurological practice, as evidenced by our data. Also, α-lipoic acid is actively used in gastroenterology in the treatment of chronic liver diseases. Currently, the action of α-lipoic acid is being actively studied in terms of the prevention and treatment of atherosclerosis. Based on the analyzed data, the authors concluded that it is the R(+)-enantiomer of α-lipoic acid that has a positive biological effect, and treatment with it should be carried out almost constantly, taking breaks in its intake. The duration of R-α-lipoic acid use depends on the specific clinical situation, and given the current personalized approach to treatment, as shown by the analysis of modern medical sources, people with diabetes in a state of decompensation of carbohydrate metabolism should be prescribed it for 6 months continuously with a break of 2 months and repeated courses.
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