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生活方式建议的指导可以改善与血糖紊乱或代谢综合征相关的神经病变的感觉神经生理参数。一项初步研究。

Coaching of lifestyle recommendations improves sensory neurophysiological parameters in neuropathies related to glycemic disorder or metabolic syndrome. A pilot study.

机构信息

EA 4391, Faculté de médecine de Créteil, Université Paris Est Créteil, 94010 Créteil, France; EA 2363, UFR SMBH, Université Paris 13, 93000 Bobigny, France; Service de physiologie, Explorations fonctionnelles et médecine du sport, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, 93000 Bobigny, France.

EA 4391, Faculté de médecine de Créteil, Université Paris Est Créteil, 94010 Créteil, France; Service d'explorations fonctionnelles, CHU Habib Bourguiba, Sfax, Tunisia.

出版信息

Neurophysiol Clin. 2019 Feb;49(1):59-67. doi: 10.1016/j.neucli.2018.12.004. Epub 2019 Jan 4.

Abstract

OBJECTIVES

Metabolic abnormalities, such as, glycemic disorders and metabolic syndrome (GDMS) are one of the main causes of peripheral neuropathies. The objective of this study was to evaluate the impact of adding specific coaching care (CC) to standard care (SC) of therapeutic education based on lifestyle recommendations for neuropathies associated with GDMS.

METHODS

This prospective randomized study included two groups of four patients (SC vs. CC) with examiners blinded to group allocation. The SC group had one day of therapeutic education on lifestyle measures (physical activity and diet recommendations) followed by only one phone call of reinforcement. The CC group received an additional weekly phone call of reinforcement for 3 months. Clinical, biological and neurophysiological variables were compared between the two groups at baseline and for the percentage of change at 3 months.

RESULTS

All patients (4 men and 4 women) had diabetes or pre-diabetes, which was associated with metabolic syndrome in 5 cases. There was no difference on any variable at baseline, but at 3 months, Mann-Whitney test showed a difference (P=0.0008) between the two groups regarding the sensory neurophysiological variable, which deteriorated in the SC group (median: -6.0%) and improved in the CC group (median: +12.4%). No significant difference was observed between the two groups for the other variables at 3 months.

CONCLUSION

The weekly coaching of recommendations for lifestyle measures over a period of three months allows an improvement of GDMS neuropathies, at least in terms of sensory aspects, as evidenced by neurophysiological assessments.

摘要

目的

代谢异常,如血糖紊乱和代谢综合征(GDMS),是周围神经病变的主要原因之一。本研究旨在评估在基于生活方式建议的治疗性教育标准护理(SC)基础上,添加特定的指导护理(CC)对与 GDMS 相关的神经病变的影响。

方法

这是一项前瞻性随机研究,包括两组各四名患者(SC 组与 CC 组),评估员对分组情况不知情。SC 组接受一天的生活方式措施(体力活动和饮食建议)治疗性教育,随后仅进行一次强化电话随访。CC 组则在三个月内每周接受一次强化电话随访。在基线和三个月时,对两组的临床、生物学和神经生理学变量进行比较。

结果

所有患者(4 名男性和 4 名女性)均患有糖尿病或前驱糖尿病,其中 5 例伴有代谢综合征。基线时两组间无任何变量存在差异,但在三个月时,曼-惠特尼检验显示两组间的感觉神经生理学变量存在差异(P=0.0008),SC 组恶化(中位数:-6.0%),CC 组改善(中位数:+12.4%)。在三个月时,两组间其他变量无显著差异。

结论

三个月内每周对生活方式建议进行指导,至少在神经生理学评估方面,可改善 GDMS 神经病变,尤其是在感觉方面。

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