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我们是否低估了糖尿病单神经病或多发性神经病对手部功能表现和生活质量的影响?

Do we underestimate influences of diabetic mononeuropathy or polyneuropathy on hand functional performance and life quality?

机构信息

Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Diabetes Investig. 2018 Jan;9(1):179-185. doi: 10.1111/jdi.12649. Epub 2017 Apr 25.

Abstract

AIMS/INTRODUCTION: The purpose of the present study was to identify whether there are differences in hand dexterity, hand functional performance and quality of life between diabetes patients with mononeuropathy and polyneuropathy of their hands to further present the importance regarding the impacts of diabetic neuropathic deficits on patients' functional capacity.

MATERIALS AND METHODS

The neurological deficits of 127 patients with type 2 diabetes were examined by electrophysiological tests for the median and ulnar nerves, and were stratified into the diabetic mononeuropathy, diabetic polyneuropathy and non-diabetic neuropathy groups by sensory amplitude of these nerves. The Purdue pegboard test, Michigan Hand Outcomes Questionnaire, and Diabetes-39 were carried out to understand patients' hand dexterity, functional hand performance and quality of life, respectively.

RESULTS

The results showed significant differences in all subtests of the Purdue pegboard test among the three groups. Furthermore, aesthetics, patient's satisfaction of the Michigan Hand Outcomes Questionnaire and diabetes control, sexual functioning, energy, and mobility of the Diabetes-39 also showed significant differences among the three groups.

CONCLUSIONS

The present study shows the patients with polyneuropathy suffer from more negative impacts on hand functional performance and quality of life than those with mononeuropathy and without neuropathy. These findings might assist both patients and clinicians in better realizing the impacts of neuropathic hands, and planning suitable strategies of intervention or health education to prevent declines in hand functions.

摘要

目的/引言:本研究旨在确定手部单神经病和多发性神经病的糖尿病患者在手部灵巧性、手部功能表现和生活质量方面是否存在差异,进一步强调糖尿病神经病变对患者功能能力的影响的重要性。

材料和方法

通过对正中神经和尺神经的电生理测试,对 127 例 2 型糖尿病患者的神经病变进行检查,并根据这些神经的感觉幅度将其分为糖尿病单神经病、糖尿病多发性神经病和非糖尿病性神经病组。通过 Purdue 钉板测试、密歇根手功能问卷和 Diabetes-39 分别了解患者的手部灵巧性、手部功能表现和生活质量。

结果

结果表明,三组患者在 Purdue 钉板测试的所有子测试中均存在显著差异。此外,密歇根手功能问卷的美学、患者满意度以及 Diabetes-39 的糖尿病控制、性功能、精力和活动能力在三组之间也存在显著差异。

结论

本研究表明,多发性神经病患者的手部功能表现和生活质量受到的负面影响比单神经病患者和无神经病患者更严重。这些发现可能有助于患者和临床医生更好地认识到手部神经病变的影响,并规划适当的干预或健康教育策略,以防止手部功能下降。

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