糖尿病周围神经病变的早期诊断及治疗进展

Progress in Early Diagnosis and Treatment of Diabetic Peripheral Neuropathy

糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)是糖尿病的常见并发症,它是神经性疼痛和下肢截肢的主要原因,也是引发足部溃疡和下肢截肢的第一危险因素。DPN不仅使糖尿病患者身心痛苦,其昂贵的治疗费用和致残的风险,对于家庭和社会也是沉重的负担。而目前对于DPN发病机制的认识不够充分,临床治疗重点除了改善血糖,控制心血管风险,主要是缓解其临床症状。在总结前人文献的基础上,本文对DPN的早期诊断和治疗现状以及未来的治疗趋势做一综述。目前对于DPN早期诊断最为先进的设备和方法包括DPN Check、神经垫和泌汗神经检测。DPN的早期诊断对于早期预防和治疗DPN起到了非常关键的作用。DPN的治疗目前主要是控制血糖、抑制疼痛、抗氧化应激治疗、改善患者微循环、营养神经以及中医药治疗。中医药的治疗对于DPN非常重要,中西医结合治疗是未来治疗DPN的发展趋势。

Diabetic peripheral neuropathy(DPN)is one of common complications of diabetes mellitus.It is the leading cause of neuropathic pain and lower limb amputation,and the strongest risk factor for foot ulcers and amputation.DPN not only causes physical and mental pain to diabetic patients,but also causes heavy burden to family and society.However,the current understanding of its pathogenesis is not sufficient,and the focus of clinical treatment is to alleviate its clinical symptoms,improve blood glucose and control cardiovascular risk factors.Based on the summary of previous literature,this article reviews the current status of early diagnosis and treatment of DPN,as well as future treatment trends.At present,the most advanced devices and methods for early diagnosis of DPN include DPN Check,nerve pad and sudomotor nerve test.The early diagnosis of DPN plays a very key role in the early prevention and treatment of DPN.At present,the treatment of DPN mainly includes blood glucose control,pain inhibition,antioxidative stress treatment,microcirculation improvement,nerve nutrition and traditional Chinese medicine treatment.The treatment of traditional Chinese medicine is very important for DPN,and the future treatment trend is the combination of traditional Chinese and Western medicine.