糖尿病性神经病变药物治疗现状

糖尿病并发神经病变达90％,其中周围神经病变占84.29％。主要症状为自发性疼痛,有时引起糖尿病性恶病质,给病人带来很大痛苦。现就近年来的药物治疗介绍如下。 1 慢心律(Mexiletine) Dejgard等采用双盲交叉法评估了慢心律对慢性痛性糖尿病性神经病变的疗效。16例病人随机分为2组(9例与7例),交叉服用慢心律或安慰剂26周。慢心律头3天150mg/d,第2个3天300mg/d,以后减为10mg/(kg.d)。结果显示,慢心律可使症状     

糖尿病痛性神经病变

<正>糖尿病神经病变是糖尿病患者中最常见也是最易致残的慢性并发症之一。目前糖尿病神经病变的发病机制包括多元醇通路亢进、非酶蛋白质糖基化、肌醇耗竭及脂代谢异常在内的代谢学说,和血供障碍学说、氧化应激学说、神经营养因子的缺乏以及免疫学说,其产生背景是长期高血糖。而从中医学的角度,糖尿病周围神经病变属于消渴痹证,是因消渴(糖     

谷胱甘肽治疗糖尿病神经病变

目的：观察谷胱甘肽对糖尿病神经病变的疗效。方法：２８例糖尿病神经病变病人（男性１２例,女性 １６例,年龄 ６２ ａ± ｓ ５ ａ）在应用降糖药较好控制血糖后加用谷胱甘肽 １．８ ｇ加入 ０．９％氯化钠注射液 ２５０ ｍＬ静脉滴注,ｑｄ, ７～１０ ｄ为一个疗程,应用 ２个疗程。结果：显效 １８例,显效率 ６４％,有效 ８例,总有效率 ９３％,肌电图示病人神经传导速度明显改善（Ｐ＜０．０５和Ｐ＜０．０１）。结论：谷胱甘肽是治疗糖尿病神经病变的良好药物。     

糖尿病神经病变的特点与治疗

糖尿病神经病变是糖尿病患者最常见的并发症之一，患病率可高达60％～90％。多为病程长及血糖控制不理想所致。     

糖尿病的神经病变及治疗

<正>糖尿病神经病变在临床上是较常见的并发症之一,特别是较偏远的地方很多都以神经病变为糖尿病首发症状。但其患病率报道不一,为10%~96%,造成这种差异的原因主要是由于缺乏统一的诊断标准和     

糖尿病性神经病变的药物治疗

糖尿病性神经病变系指糖尿病患者并发神经系统损害,可累及神经系统各个部分,是糖尿病最常见的并发症之一。近年来,发现许多药物对治疗本病有确切疗效,现就有关文献作一综述。１　氟桂利嗪氟桂利嗪是选择性钙通道阻滞剂。据报道［１］６０例糖尿病周围神经病变病人随机分为２组,在进糖尿病饮食和用普通胰岛素,消渴丸,二甲双胍及格列齐特等降糖药物治疗基础上,治疗组３０例给予氟桂利嗪１０ｍｇ,ｐｏ,ｑｎ,２周后改为５ｍｇ,ｐｏ,ｑｎ;对照组３０例采用维生素Ｂ１１００ｍｇ及维生素Ｂ１２０．５ｍｇ,ｉｍ,ｑｄ,山莨菪碱３０…     

糖尿病性神经病变的药物治疗

从代谢障碍、血管障碍、离子通道假说等方面阐述糖尿病性神经病变的多种发病机制，讨论用药方案以及各种药物的作用机制。     

糖尿病神经病变的药物治疗

报道利多卡因 山莨菪碱,山莨菪碱 复方丹参、蝮蛇抗栓酶、藻酸双酯钠、酚妥拉明、前列腺素E_1、阿米替林 硫酸锌、醛糖还原酶抑制剂等几种药物治疗糖尿病神经病变.     

糖尿病性神经病变的其它药物治疗

糖尿病性神经病变的治疗颇为棘手,以往常用维生素B_1、B_6、B_(12)等,收效甚微。近年来发现一些“老药”用于治疗本病,取得显著效果,现介绍如下。1 利多卡因Kastrup 用随机双盲交叉研究观察静滴利多卡因(5mg/kg)对糖尿病性神经病变的作用,发现给药后症状明显改善。作者认为利多卡因可能象治疗心律失常一样,由于切断了异常的神经冲动线路而改善症状。晚     

糖尿病神经病变——防治并重

糖尿病神经病变是糖尿病最常见、最复杂的慢性并发症之一,可累及中枢神经及周围神经,是造成糖尿病患者反复住院的主要原因.糖尿病神经病变息病率较高,各项研究统计相差较大.可能受诊断标准‘检测方法及调查对象的年龄.病程.生活方式、种族、糖尿病类型等影响.     

卡马西平治疗糖尿病痛性神经病变的疗效观察

目的:评价卡马西平治疗糖尿病痛性神经病变的临床疗效及安全性。方法:将53例糖尿病痛性神经病变患者随机分为两组,对照组27例,在胰岛素强化控制血糖及良好控制血压、血脂的基础上,应用生理盐水250 ml 盐酸丁咯地尔注射液0.1 g,静脉滴注/天;治疗组26例,在对照组治疗基础上加用卡马西平0.1 g,每日3次。进行随机双盲对照研究,疗程14～21天。采用VRS5疼痛缓解标准评价卡马西平的疗效及安全性。结果:治疗组加用卡马西平后疗效优于对照组(P<0.01),疼痛缓解率达84.6%,治疗期间及治疗后无明显不良反应发生。结论:卡马西平治疗糖尿病痛性神经病变的临床疗效明显,与对照组比较有显著性差异(P<0.01),疼痛缓解时间也较对照组明显为早(P<0.05),而且安全,无严重不良反应。     

中药治疗糖尿病周围神经病变概况

目的找出治疗搪尿病周因神经病变（DPN）的有效中药。方法从发病机制入手．结合中医整体调节,标本兼治的治疗理念．整理文献。根据126味药材使用频率进行筛选。结论活血化瘀、扶气葬阴药材使用最为广泛,分别达到51．0％和47．1％。中西医结合治疗DPN优势互补．更能使中药在治疗糖尿病并发症方面发挥作用。     

银杏叶提取物佐治糖尿病周围神经病变40例临床观察

目的探讨银杏叶提取物佐治糖尿病周围神经病变的临床疗效及作用机制。方法将80例2型糖尿病合并周围神经病变的患者随机分为治疗组和对照组,每组40例。两组均给予降糖、改善神经营养障碍、应用醛糖还原酶抑制剂、抗焦虑及对症支持处理等常规治疗,治疗组在此基础上加用银杏叶提取物静脉滴注。两组疗程均为4周,疗程结束后评价疗效。结果治疗组总有效率高于对照组（经Ridit检验,P〈0．01）。治疗组神经系统症状、体征及神经传导速度均明显改善（P〈0.01或P〈0．05）,无不良反应。结论银杏叶提取物协助治疗糖尿病周围神经病变疗效确切,安全可靠。     

Estimated prevalence of peripheral neuropathy and associated pain in adults with diabetes in France

ABSTRACT

Objective: To estimate the point prevalence of diabetic peripheral neuropathy (DPN) and pain associated with DPN (pDPN) in French adults with diabetes and compare severity of symptoms across demographic subpopulations.

Design: The participant-administered portion of the Michigan Neuropathy Screening Instrument (MNSI) and selected items of the Brief Pain Inventory (BPI) formed part of a computer-aided telephone survey posed to a representative, random sample of French households from March 1, 2005 to April 30, 2005. Questions from the MNSI and the BPI were used to assess the point prevalence of DPN and pDPN in French adults with self-reported diabetes.

Results: The mean age of the study sample was 68 years (SD = 15), the mean duration of diabetes was 15 years (SD = 12) and 56% of participants were female. The prevalence rates of DPN and pDPN in French adults with diabetes were 11 and 8%, respectively. The average age and diabetes duration of participants with DPN and pDPN were not different from participants in the total sample. Among those participants with pDPN, 35% classified their pain as severe, 49% as moderate, and 17% as mild. The prevalence of DPN was higher in participants with type 1 diabetes (14%) than those with type 2 (9%). Among participants with DPN, 88% with severe pain received pain treatment compared to 71% with moderate pain and 58% with mild pain. The most significant limitation of this study is the lack of validation for administering only a portion of the MNSI, but other limitations include the imprecision associated with self-reported questionnaires, a survey sample that does not include participants with undiagnosed diabetes, and a bias toward elderly participants.

Conclusion: This study concluded that 8% of participants with diabetes in France had pDPN.     

Plasma apelin levels in diabetic patients with and without neuropathy

The aim of this study was to investigate the plasma apelin levels in diabetic patients with and without neuropathy. All consecutive diabetic patients who presented for routine follow-up at our outpatient clinic were invited to participate in this clinical study. Forty diabetic patients (20 female and 20 male) and twenty-two non-diabetic control subjects (9 female and 13 male) were included in the study. Neurological evaluations in diabetic subjects were done by nerve conduction studies and evaluated with the Neuropathy Symptom Score. Fasting plasma glucose, HbA1_c, lipid and apelin levels were measured in each subject. The mean plasma apelin level was significantly higher in the diabetic patients than in the control subjects (p = 0.026). Apelin levels were statistically similar between diabetic patients with and without neuropathy (p = 0.43). Further, plasma apelin levels were found to be higher in diabetic patients with neuropathy when compared with those of healthy control subjects (p = 0.02). In diabetic patients with neuropathy, plasma apelin levels correlated significantly with diabetes duration (r = 0.5, p = 0.02). We propose that apelin levels in diabetic patients are higher in the presence of neuropathy and longer disease duration, although this might not solely suffice as an indicator for the presence of neuropathy in diabetic patients. Drawing attention to the possible association between the apelinergic system and diabetes mellitus, we believe that further studies with larger samples should be carried out also to investigate the presence of retinopathy and nephropathy.     

Isolation,characterization, development and evaluation of phytoconstituent based formulation for diabetic neuropathy

BackgroundMorus alba Linn, referred to as white mulberry, is a potential traditional medicine for diabetes and neuroprotection.AimIsolation, characterization, development and evaluation of phytoconstituent based formulation for diabetic neuropathy.Material and methodsThe stem Bark of M. alba was peeled and subjected to extraction. A phytoconstituent was then isolated by column chromatography and characterized using Mass spectroscopy, FTIR, and NMR. The isolated phytoconstituent was used to formulate a nanoemulsion. Nanoemulsion was also characterized for viscosity, surface tension, refractive index, pH, and particle size. Selected nanoemulsion formulations were then tested for acute oral toxicity and diabetic neuropathy, including behavioral, hematological, histopathological, and biomarker examinations.ResultsThe spectral analysis affirmed that the isolated compound was found to be chrysin. A nanoemulsion formulation was made using the chrysin and was characterized and found to be stable during the stability testing and fulfilled all other testing parameters. Then acute oral toxicity study of the formulations was found to be safe. Formulations were found to possess significant results against diabetic neuropathy in rats. Biomarkers were analyzed for their mechanistic involvement in reducing neuropathy in rats, and it was found that the oxidative pathway was considerably restored, suggesting that chrysin causes these effects via this pathway.ConclusionsResults suggests that isolated phytoconstituent (chrysin) from the bark of Morus alba derived nanoemulsion has protective and beneficial effects by diminishing the oxidative damage against alloxan-induced diabetic neuropathy in rats.     

苯那普利与甲钴铵合用治疗糖尿病周围神经病变的临床观察

目的 观察盐酸苯那普利与甲钴铵合用治疗糖尿病周围神经病的疗效。方法 选择符合诊断标准的2型糖尿病周围神经病变84例，在血糖控制正常的基础上随机分成两组。在常规用药的基础上，治疗组42例应用盐酸苯那普利，疗程12周，观察治疗效果。结果 治疗组痛觉过敏与感觉减退有效率达到65％与67％，明显高于对照组的34％与37％（P〈0．05），神经传导速度（SVC）改善也明显优于对照组（P〈0．01）。结论 盐酸苯那普利联合甲钴铵治疗糖尿病周围神经病变疗效理想。     

抗抑郁治疗对糖尿病痛性神经病变伴抑郁焦虑的影响

目的了解糖尿病痛性神经病变患者伴随抑郁焦虑情况及抗抑郁治疗对糖尿病痛性神经病变伴抑郁焦虑患者疗效的影响。方法用Zung编制的抑郁自评量表调查78例糖尿病痛性神经病变患者伴抑郁焦虑情况,将54例糖尿病痛性神经病变伴抑郁焦虑患者随机分为治疗组和对照组,在常规糖尿病痛性神经病变治疗基础上,治疗组给予抗抑郁药物舍曲林治疗。结果糖尿病痛性神经病变患者伴随抑郁焦虑达87.1%,治疗组与对照组比较,抑郁焦虑的改善程度明显提高,治疗组的空腹餐后血糖及糖基化血红蛋白水平也有明显的改善,治疗组疼痛的缓解率也明显提高。结论抗抑郁治疗不但可以减轻糖尿病痛性神经病变伴抑郁焦虑的负性情绪,还可以改善血糖及缓解神经病变的疼痛。     

银杏达莫与甲钴胺联合治疗糖尿病周围神经病变

目的：观察银杏达莫与甲钴胺联合治疗糖尿病周围神经病变（DPN）的效果。方法：对75例糖尿病周围神经病变患者进行随机对照观察,治疗组39例,对照组36例。治疗组予以银杏达莫与甲钴胺治疗,对照组给予甲钴胺治疗,连用8周。结果：治疗组的DPN症状、体征,各项神经传导速度与对照组比较有显著改善。结论：银杏达莫与甲钴胺联用可明显提高DPN的治疗效果。     

针灸治疗运动性疲劳的现状与思考

通过查阅近年来文献,归纳针灸疗法治疗运动性疲劳的机理、方法和疗效及存在的问题。结果发现相关研究存在无统一法则,无统一标准,不系统等问题。如何以中医理论为指导,结合临床实践形成统一的治法治则,是针灸治疗运动性疲劳乃至其他运动性疾病都必须首先解决的问题。