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疼痛性糖尿病周围神经病变的治疗

Treatment of painful diabetic peripheral neuropathy.

作者信息

Rosenberg Casandra J, Watson James C

机构信息

Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA

Department of Neurology, Mayo Clinic, Rochester, MN, USA.

出版信息

Prosthet Orthot Int. 2015 Feb;39(1):17-28. doi: 10.1177/0309364614542266.

Abstract

BACKGROUND

Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat.

OBJECTIVE

To discuss current treatment recommendations for painful diabetic peripheral neuropathy.

STUDY DESIGN

Literature review.

METHODS

Systematic review of the literature discussing treatment of painful diabetic peripheral neuropathy. Existing treatment guidelines were studied and compared.

RESULTS

Painful diabetic peripheral neuropathy occurs in about one in six people with diabetes. This condition impairs quality of life and increases healthcare costs. Treatment recommendations exist, but individual patient therapy can require a trial-and-error approach. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. Adequate medication titration and a reasonable trial period should be allowed.

CONCLUSION

The treatment of painful diabetic peripheral neuropathy can be challenging, but effective management can improve patient's quality of life.

CLINICAL RELEVANCE

Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control.

摘要

背景

疼痛性糖尿病周围神经病变会损害生活质量且治疗困难。

目的

探讨疼痛性糖尿病周围神经病变的当前治疗建议。

研究设计

文献综述。

方法

对讨论疼痛性糖尿病周围神经病变治疗的文献进行系统综述。研究并比较现有的治疗指南。

结果

约六分之一的糖尿病患者会发生疼痛性糖尿病周围神经病变。这种情况会损害生活质量并增加医疗成本。虽然存在治疗建议,但个体患者的治疗可能需要采用反复试验的方法。许多治疗选择具有辅助益处或副作用,在开始治疗前应予以考虑。通常,需要联合使用多种作用机制不同的治疗方式才能充分控制疼痛。应进行充分的药物滴定并给予合理的试验期。

结论

疼痛性糖尿病周围神经病变的治疗可能具有挑战性,但有效的管理可以改善患者的生活质量。

临床意义

疼痛性糖尿病周围神经病变会损害生活质量且治疗困难。许多治疗选择具有辅助益处或副作用,在开始治疗前应予以考虑。通常,需要联合使用多种作用机制不同的治疗方式才能充分控制疼痛。

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