Treatments for diabetic neuropathy
Treatments for diabetic neuropathy
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DOI：
10.1111/j.1529-8027.2012.00391.x
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发表时间：
2012-05-01
影响因子：
3.8
通讯作者：
Bril, Vera
中科院分区：
文献类型：
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作者：
Bril, Vera
糖尿病神经病变包括排除其他病症后的糖尿病患者的外周神经病症，并且可以是局灶性或弥漫性的。局灶性糖尿病性神经病变往往会自发消退，并通过安慰、物理治疗和止痛来治疗疼痛症状。糖尿病感觉运动性多发性神经病（DSP）是最常见的糖尿病神经病变形式，除了最佳血糖控制干预以及可能的生活方式和风险因素改变外，尚无法获得有效的疾病改善治疗。相比之下，最近的循证指南显示，疼痛性DSP的有效治疗方法包括：普瑞巴林、阿米替林、度洛沙汀、文拉法辛、加巴喷丁、阿片类药物、硝酸盐喷雾剂、辣椒素和经皮电神经刺激。治疗的选择是由个体患者的临床状况指导的。
Diabetic neuropathy comprises disorders of peripheral nerve in diabetes patients after exclusion of other disorders and can be focal or diffuse. The focal diabetic neuropathies tend to resolve spontaneously and are treated by reassurance, physiotherapy and analgesia for painful symptoms. Diabetic sensorimotor polyneuropathy (DSP) is the most frequent form of diabetic neuropathy and effective disease-modifying treatment is not available beyond the interventions of optimal glycemic control, and possibly lifestyle and risk factor modification. In contrast, a recent evidence-based guideline shows that effective treatments for painful DSP include: pregabalin, amitriptyline, duloxetine, venlafaxine, gabapentin, opioids, nitrate sprays, capsaicin, and transcutaneous electrical nerve stimulation. The choice of treatment is guided by the clinical status of the individual patient.