温针疗法治疗糖尿病周围神经病变临床疗效观察

目的探究应用温针疗法治疗糖尿病周围神经病变临床疗效。方法于2018年2月—2019年1月期间择取该院收治的68例糖尿病周围神经患者开展课题研究,将其随机划分为两组进行治疗并比较其临床疗效。调研组患者应用温针疗法,常规组患者注射弥可保治疗。结果调研组患者中共计有19例得到显效治疗,11例得到有效治疗,临床疗效优于常规组患者,组间差异有统计学意义(χ^2=9.827,P<0.05);调研组患者接受治疗后神经传导速度高于常规组患者,差异有统计学意义(t=9.852、9.958,P<0.05)。结论利用温针疗法治疗糖尿病周围神经病变疾病疗效好,可有效改善患者肢体神经传导,建议在临床中应用。     

血清骨钙素水平与2型糖尿病周围神经病变的关系

目的 分析2型糖尿病患者血清骨钙素水平与糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的关系.方法 选取2018年7月—2019年12月于内蒙古包钢医院内分泌科就诊的T2DM患者120例,将其分为2型糖尿病无周围神经病变组(NDPN组,n=60)、2型糖尿病合并周围神经病变组...     

交感神经皮肤反应与神经传导测定对糖尿病周围神经病变的诊断价值

[摘要]目的 分析比较交感神经皮肤反应与神经传导速度对糖尿病周围神经病变的诊断价值。方法 选取本院2014年1月-2015年12月门诊收治的43例2型糖尿病患者和43例健康体检者,同时行神经电图检测,包括感觉神经传导速度、运动神经传导速度和交感神经皮肤反应,并对结果进行记录和统计学分析。结果 糖尿病组的正中神经、尺神经、腓总神经、胫神经的运动神经传导速度和正中神经、尺神经、腓肠神经、腓浅神经的感觉神经传导速度均明显低于健康组（P＜0.01）;健康组上下肢的起始潜伏期均明显少于糖尿病组（P＜0.01）,但糖尿病组上下肢的波幅与健康组相比较,差异均无统计学意义（P＞0.05）;糖尿病组患者的下肢的神经传导速度的异常率（34.84%）明显高于上肢（18.85%）,两者差异存统计学意义（χ2=16.97,P＜0.01）;上肢的交感神经皮肤反应异常率（35.24%）低于下肢（55.74%）,差异存统计学意义（χ2=10.33,P＜0.01）;神经传导速度和交感神经皮肤反应总异常率分别为25.58%、45.49％,交感神经皮肤反应的总异常率显著高于神经传导速度,差异存统计学意义（χ2=39.96,P＜0.01）。 结论 神经传导速度和交感神经皮肤反应作为糖尿病自主神经及周围神经病变诊断的重要指标,可为糖尿病周围神经病的早期诊断提供重要依据,且交感神经皮肤反应对糖尿病周围神经病早期诊断的敏感性更高。     

Failure of Improved Glycaemic Control to Reverse Diabetic Autonomic Neuropathy

A prospective trial was conducted in 20 insulin-treated diabetic patients with established autonomic dysfunction to test the effect of a 2-year improvement in glycaemic control. On entry, the patients aged 34.6 ± 10.8 years (mean ± SD), duration 20.2 ± 10.4 years, had evidence of poor control (HbA₁ > 9.5% on at least two consecutive tests, and at least one abnormality in the 11 different neuropathic function tests used. These included four of pupillary function, six of cardiovascular function and one of vibration sensitivity. The method used to improve control was conventional insulin treatment combined with home monitoring of blood glucose and regular adjustment of insulin dosage under the supervision of a diabetic specialist nursing sister. The HbA₁ level on entry was 13.0 ± 0.7% (mean ± SEM) which fell to 10.4 ± 0.4% at 3 months and to 9.3 ± 0.4% at 24 months. The neuropathy tests were performed at 0, 3, 6, 12, 18, and 24 months and significant changes were recorded in five. These changes (in two pupillary and three cardiovascular tests) all indicated worsening function which exceeded that explicable by aging. One cardiovascular test showed slower rates of deterioration in patients achieving the greatest improvements in control. It was concluded that a prolonged period of improved control failed to reverse established autonomic dysfunction of diabetes.     

Autonomic and Peripheral Nerve Function in Early Diabetic Neuropathy

ABSTRACT. Sundkvist G, Lilja B, Rosén I, Agardh C-D (Departments of Internal Medicine and Clinical Physiology, Malmö General Hospital, and Departments of Clinical Neurophysiology and Internal Medicine, University Hospital, University of Lund, Lund, Sweden). Autonomic and peripheral nerve function in early diabetic neuropathy. Possible influence of a novel aldose reductase inhibitor on autonomic function. Acta Med Scand 1987; 221:445–53. Autonomic and peripheral nerve functions as well as the possible short-term effect of a novel aldose reductase inhibitor (ARI) on neuropathy were evaluated in 30 male type I diabetics (age 25–44 years, mean 34; duration of diabetes 10–20 years, mean 34) with neurographic signs of peripheral neuropathy (PN). Autonomic neuropathy (AN) was established by the heart rate reactions to deep breathing (E/I ratio = vagal function) and to tilt (acceleration index = sympathetic and vagal functions; the brake index = vagal function). Twenty-nine patients, 13 with AN, completed the study. Among neurographic variables, only sural nerve function tests correlated with autonomic functions. Patients with AN showed significantly lower mean sensory action potential amplitudes (SAPA) sural, indicating axonal losses, than patients without AN (3.58±0.79 μV vs. 7.34±1.12 μV; p<0.01). PN as measured by neurography did not improve during ARI treatment. On the other hand, vagal function (brake indices) improved (p<0.05) during ARI in AN patients.     

消痹汤联合温针灸治疗糖尿病周围神经病变疗效分析

目的 研究消痹汤联合温针灸治疗糖尿病周围神经病变的疗效.方法 选取2016年12月—2019年12月该院治疗的50例糖尿病周围神经病变疾病患者作为研究,根据床位号进行分组,单号患者作为温针灸组,对患者采取温针灸进行治疗,而双号患者作为联合治疗组,对患者联合采取消痹汤药物进行治疗.分析疗效.结果 联合治疗组与温针灸组患者...     

依帕司他联合甲钴胺治疗糖尿病周围神经病变的疗效分析

目的 探讨依帕司他联合甲钴胺治疗糖尿病周围神经病变的临床疗效.方法 选择该科2018年9月—2020年9月收治的87例2型糖尿病周围神经病变患者,随机分为对照组(43例)和依帕司他组(44例).对照组采用甲钴胺治疗,依帕司他组增加依帕司他治疗,对比两组治疗前后神经病变改善情况,并监测氧化应激指标变化及用药安全性.结果 ...     

糖尿病周围神经病变的诊断方法

糖尿病周围神经病变( DPN)难以治愈,不仅影响患者生活质量,还易造成其足部疼痛、溃疡、截肢等不良后果.现有的DPN诊断方法或对早期病变灵敏度低,如临床评分方法、单丝检测;或为侵入性检查,如皮肤活检、神经活检,亟需灵敏、简单、有效且安全的方法.一些新的诊断技术如泌汗功能检测、足底压力测定、角膜共聚焦显微镜等也已在临床上开始应用.     

A Meta-analysis of Trials on Aldose Reductase Inhibitors in Diabetic Peripheral Neuropathy

Peripheral neuropathy is one of the most common and disabling long-term seque lae of diabetes mellitus. Aldose reductase inhibitors (ARIs) have been proposed and are increasingly used in many countries for the prevention and treatment of diabetic neuropathy. The aim of this study was to review existing evidence on the effectiveness of ARIs in the treatment of peripheral diabetic neuropathy, with particular reference to the type and clinical relevance of the end point used and to the consistency of results across studies. Thirteen randomized clinical trials (RTCs) comparing ARIs with placebo, published between 1981 and 1993 were included in the meta-analysis. Nerve conduction velocity (NCV) was the only end point reported in all trials. Treatment effect was thus evaluated in terms of NCV mean difference in four different nerves: median motor, median sensory, peroneal motor, and sural sensory. A statistically significant reduction in decline of median motor NCV was present in the treated group as compared to the control group (mean 0.91 ms⁻¹; 95 % CI 0.41–1.42 ms⁻¹). For peroneal motor, median sensory, and sural sensory nerves results did not show any clear benefit for patients treated with ARIs. When the analysis was limited to trials with at least 1-year treatment duration, a significant effect was present for peroneal motor NCV (mean 1.24 ms⁻¹; 95 % CI 0.32–2.15 ms⁻¹) and a benefit of borderline statistical significance was also present for median motor NCV (mean 0.69 ms⁻¹; 95% CI −0.07−1.45 ms⁻¹). A heterogeneous picture emerged when looking at the results of different studies and serious inconsistencies were also present in the direction of treatment effects among nerves in the same studies. Although the results of 1-year treatment on motor NCV seem encouraging, the uncertainty about the reliability of the end-point employed and the short treatment duration do not allow any clear conclusion about the efficacy of ARIs in the treatment of peripheral diabetic neuropathy.     

依帕司他治疗糖尿病周围神经病变的效果分析

目的 对糖尿病周围神经病变患者采用依帕司他治疗的效果进行研究.方法 选择该院2019年1月—2020年1月收治的糖尿病周围神经病变患者104例作为该次研究纳入的研究对象,按照随机数字表法将其划分为常规组和联合组,每组52例.采用甲钴胺治疗常规组患者,在此基础上,采用依帕司他治疗联合组.对两组患者的治疗效果进行观察和比较...     

Depression Symptoms in Patients with Diabetic Peripheral Neuropathy

AIMThe study aimed to investigate the possible relationship between diabetic peripheral neuropathy (DPN) and the development of depressive symptoms in patients with type 2 diabetes mellitus (T2D).METHODSA comparative non-experimental study was conducted. Ninety-five T2D individuals aged 65 years and more were recruited. The sample was divided into two groups: 50 participants with T2D and without DPN and 45 participants with T2D and DPN. The Patient Health Questionnaire 9 (PHQ-9) was used to collect information about low mood and depression symptoms in the subjects recruited.RESULTSParticipants with DPN recorded higher scores on PHQ-9 than those with T2D only. The mean PHQ-9 score for the DPN group (6.09) was significantly higher than that for the T2D only group (2.24) (p < 0.001). Participants with DPN were more likely to have mild to moderate or moderately severe low mood and depression symptoms than T2D only participants who exhibited minimal to no low mood and depressive symptoms.CONCLUSIONSThe association between DPN and depression is confirmed by this study, with significant depressive symptoms found in patients with neuropathy when compared to diabetes patients with no neurological complications. It is therefore important that discomfort and emotional problems caused by DPN should be taken seriously and addressed closely in the management of DPN in order to prevent depression. Also, a change in screening practices to identify patients with diabetes and depressive symptoms is required.     

抗阻运动结合模块化营养指导对糖尿病周围神经病变患者神经传导功能的影响

目的 探讨抗阻运动结合模块化营养指导对糖尿病周围神经病变患者神经传导功能的影响.方法 选择2018年9月—2020年7月收治的86例糖尿病周围神经病变患者为研究对象,随机数字表法分为对照组与观察组,各43例,对照组接受常规护理,观察组在对照组基础上实施抗阻运动结合模块化营养指导,对两组血糖控制情况及神经传导功能、生活质...     

美国糖尿病协会关于糖尿病神经病变的诊断和治疗指南

本文系统地介绍了美国糖尿病协会关于糖尿病神经病变的诊断和治疗指南,包括糖尿病周围神经病变的定义和分类、诊断标准和临床表现、流行病学,如何早期筛查、预防及治疗原则.     

红花注射液治疗糖尿病周围神经病变的机制探讨

目的 :观察红花注射液治疗糖尿病周围神经病变 (DPN )的疗效 ,探讨其机制。方法 :采用红花注射液治疗DPN 80例 ,同时与山莨菪碱治疗的 2 0例作对照 ,观察红花注射液对DPN病人肌电图、空腹血糖、糖化血红蛋白、6-酮 -前列环素F1a( 6-Ke to -PGF1a)、内皮素 (ET )、血栓素(TXB2 )等指标的影响。结果 :治疗组显效率为 61.2 5 % ,对照组为 2 0 .0 0 %(P <0 .0 1) ,治疗组总有效率为82 .5 0 % ,对照组为 45 .0 0 % (P <0 .0 1) ,治疗组在治疗后 ,神经传导速度明显改善 (P <0 .0 1) ,空腹血糖、糖化血红蛋白略有下降 (P >0 .0 5 ) ,6-Keto -PGF1a有明显改善 (P <0 .0 5 ) ,ET、TXB2 有明显下降 (P <0 .0 5 )。结论 :红花注射液治疗DPN有较好疗效 ,其机制可能是通过改善病人血管内皮细胞功能从而达到治疗目的的。