Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of dia...Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.展开更多
Objective: To study the effect of ultrashort wave therapy combined with antioxidant and neurotrophy therapy on nerve conduction function and serum cytokines in patients with diabetic peripheral neuropathy. Methods: A ...Objective: To study the effect of ultrashort wave therapy combined with antioxidant and neurotrophy therapy on nerve conduction function and serum cytokines in patients with diabetic peripheral neuropathy. Methods: A total of 128 patients who were diagnosed with DPN in South District of Guang'anmen Hospital of China Academy of Chinese Medical Sciences between May 2014 and February 2017 were selected as the research subjects and randomly divided into electrotherapy + drug group and routine drug group;the nerve conduction velocity as well as serum levels of nerve cytokines and inflammatory cytokines were measured before treatment and 8 weeks after treatment. Results: Median nerve and common peroneal nerve MNCV, median nerve and superficial peroneal nerve SNCV as well as serum CNTF, BDNF, SDF-1α, IGF-1, CAT and HO-1 levels of both groups 8 weeks after treatment were significantly higher than those before treatment while serum ICAM-1, TNF-α, IL-6, ET-1, MDA and 8-OHdG levels were significantly lower than those before treatment;median nerve and common peroneal nerve MNCV, median nerve and superficial peroneal nerve SNCV as well as serum CNTF, BDNF, SDF-1α, IGF-1, CAT and HO-1 levels of electrotherapy + drug group 8 weeks after treatment were significantly higher than those of routine drug group while serum ICAM-1, TNF-α, IL-6, ET-1, MDA and 8-OHdG levels were significantly lower than those of routine drug group. Conclusion: Ultrashort wave therapy combined with antioxidant and neurotrophy therapy for DPN can improve the nerve conduction function and neurotrophic state, and also inhibit the inflammatory response and oxidative stress response.展开更多
Objective To search for a good therapeutic method for treating diabetic neuropathy. Methods Patients were randomly divided into an acupuncture group （n =30） and a control group （n =26）. In the control group, glicl...Objective To search for a good therapeutic method for treating diabetic neuropathy. Methods Patients were randomly divided into an acupuncture group （n =30） and a control group （n =26）. In the control group, gliclazide, at the dose of 80 mg/d, for lowering blood sugar, and adenosine coenzyme B12, at the dose of 0.75 mg, for improving nutrition of nerves were orally administered. In the acupuncture group, acupuncture at bilateral Yishu point was added. Three weeks of treatments were given for both groups. Therapeutic effects and changes in fasting blood sugar, fasting glucose in urine and blood fat were observed. Results The total effective rate was 93.3% and 67.3% in the acupuncture and control group, respectively. Fasting blood sugar, fasting glucose in urine, total cholesterol and triglyceride were obviously lowered, and high density lipoprotein markedly elevated in the acupuncture group with significant differences, compared with those in the control group （P〈0.05）. Conclusion Acupuncture combined with medicine can improve disorder of fat metabolism in diabetic patients at the early and intermediate stages and depress and stabilize blood glucose to improve neural functions.展开更多
Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes.According to current guidelines,intensive glycemic con...Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes.According to current guidelines,intensive glycemic control requires individu-alized glucose goals rather than as low as possible.During intensive therapy,rapid blood glucose reduction can aggravate microvascular and macrovascular complications,and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy,hypoglycemia,obesity,lipodystrophy,and insulin antibody syndrome.Therefore,we need to develop individualized hypoglycemic plans for patients with diabetes,including the time required for blood glucose normalization and the duration of intensive insulin therapy,which deserves further study.展开更多
Diabetic neuropathy, the most common form of peripheral neuropathy, presents as different forms of focal or diffuse neuropathy, including the disabling, or potentially life-threatening clinical entities of painful dia...Diabetic neuropathy, the most common form of peripheral neuropathy, presents as different forms of focal or diffuse neuropathy, including the disabling, or potentially life-threatening clinical entities of painful diabetic neuropathy, autonomic neuropathy, and diabetic foot. The pathogenesis of diabetic neuropathy results from the concurrent action of various intersecting factors of nerve damage, such as oxidative stress and mitochondrial dysfunction, inflammation, microangiopathy and ischemia, triggered by hyperglycemia and related biochemical changes. Symptomatic treatment of diabetic neuropathy mainly concerns therapies for neuropathic pain, interventions targeted at the organ systems involved in autonomic neuropathy, and management of diabetic foot. Therapeutic approaches to the pathogenesis of diabetic neuropathy have focused on the different components of the causes of nerve damage, particularly oxidative stress, which has been demonstrated to play a central role. Alpha-lipoic acid, a potent lipophilic free radical scavenger, has been used in treatment of patients with diabetic neuropathy, displaying efficacy on the chief symptoms, including neuropathic pain, and showing that neuropathic deficits may be improved by treatment. Current evidence suggests a possible efficacy of alpha-lipoic acid not only for neuropathic symptoms, but also for reducing the risk factors for diabetic neuropathy.展开更多
Diabetic neuropathy (DN) is one of the common complications of diabetes mellitus (DM), its incidence can be as high as over 90%. The lesion can involve the sensory, motor and vegetative nerves. As a whole, the lesion ...Diabetic neuropathy (DN) is one of the common complications of diabetes mellitus (DM), its incidence can be as high as over 90%. The lesion can involve the sensory, motor and vegetative nerves. As a whole, the lesion can be divided into symmetric multiple neuropathy and asymmetric single neuropathy. Because the pathogenesis of the disease is not clear, no specific therapy is available so far. Besides control of blood sugar level, vitamin B, vasodilators and analgesics are often used in Western medicine for expectant treatment. Basic studies on chronic complications of DM show that aldose reductase and non-enzymatic glycosylation of protein are factors initiating the pathological changes, inhibitors against them have been tested in experimental studies and proved effective. Unfortunately, they are not used clinically due to severe side effects. Screening for herbal drugs to treat DN is still a popular trend in the TCM circle.展开更多
<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hyp...<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hypoxia and microvascular dysfunction. In this study, we investigated the effect of hyperbaric oxygen therapy as a method to transiently improve tissue oxygenation on diabetic retinopathy and neuropathy in a streptozotocin induced type-1 diabetic rat model (Wistar). <strong>Methods:</strong> Streptozotocin induced type-1 diabetic rats received 10 sessions of 2-h hyperbaric oxygen exposures (pO<sub>2</sub> = 309 kPa) over 2 weeks. Animals were exposed to light stimuli to produce light evoked potentials to estimate the effect of oxygen treatment on diabetic retinopathy. Sciatic nerves were exposed and stimulated to produce muscle evoked potential, which were recorded in the muscles of the foot and subsequently used to evaluate the effect of oxygen treatment on diabetic neuropathy. <strong>Results:</strong> We found significantly shorter light evoked potential latency and increased amplitude in hyperbaric oxygen treated animals. No change was found in nerve conduction. <strong>Conclusions:</strong> This study showed that hyperbaric oxygen therapy is a potentially effective treatment for diabetic retinopathy, improving both latency and amplitude of light evoked potentials.展开更多
Objective: To study the effects of -zinc sulfate combined with yiqiyangyinghuoxue therapy on related factors in patients with type 2 diabetes peripheral neuropathy. Methods: A total of 90 patients with type 2 diabetes...Objective: To study the effects of -zinc sulfate combined with yiqiyangyinghuoxue therapy on related factors in patients with type 2 diabetes peripheral neuropathy. Methods: A total of 90 patients with type 2 diabetes peripheral neuropathy in our hospital from September 2015 to September 2018 were enrolled in this study. The subjects were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group were treated with -zinc sulfate, the treatment group were treated with -zinc sulfate combined with yiqiyangyinghuoxue therapy, the two groups were treated for 3 months. The serum NSE, UA, Hcy, hs-CRP, BDNF, HMGB1, CysC, TGF-β1, 25-(OH)D3, ESM-1, NO and plasma ET, TNF of the two groups before and after treatment were compared. Results: There were no significantly differences of the serum NSE, UA, Hcy, hs-CRP, BDNF, HMGB1, CysC, TGF-β1, 25-(OH)D3, ESM-1, NO and plasma ET, TNF of the two groups before treatment. After treatment, the serum NSE, UA, Hcy, hs-CRP, HMGB1, CysC, TGF-β1, ESM-1 and plasma ET, TNF of the two groups were significantly lower than before treatment, the serum BDNF, 25-(OH)D3, NO of the two groups were significantly higher than before treatment, and that of the treatment group after treatment were significantly better than the control group. Conclusion: α-zinc sulfate combined with yiqiyangyinghuoxue therapy on patients with type 2 diabetes peripheral neuropathy has a good efficacy, can improve the neuropathy and vascular endothelial damage, improve related factors, and it was worthy clinical application.展开更多
Objective： To study the mechanism of moxibustion therapy on diabetic peripheral neuropathy for the peripheral neuroprotection. Methods： The DPN model was induced by intraperitoneal injection with streptozotocin （ST...Objective： To study the mechanism of moxibustion therapy on diabetic peripheral neuropathy for the peripheral neuroprotection. Methods： The DPN model was induced by intraperitoneal injection with streptozotocin （STZ）. The rats were given moxibustion at the acupoint Yishu （Extra） and the acupoint Zusanli （ST 36）. The treatment was carried out once a day and 15 minutes per acupoint, lasting for 56 d in total. The clinical effect of moxibustion was evaluated by detecting blood sugar, urine sugar, body weight and dietary intakes, as well as nerve conduction velocity with neuroelectrophysiological method. The structure variation of sciatic nerve was observed by HE staining and light microscopy, and the level of NGF in the sciatic nerve was determined by ELISA. Results： Compared with the model group, the plasma glucose was significantly lower in the moxibustion group （P〈0.01）, with significantly faster nerve conduction velocity （P〈0.01）, more notably changes in pathological appearance （P〈0.01） and higher level of nerve growth factor （NGF） （P〈0.01）. Conclusion： Moxibustion coUld improve the symptom and signs of peripheral neuropathy in rat models with DPN, which may relate to the increased NGF and enhanced peripheral nerve protection.展开更多
Background: The lower extremity muscle strength has been shown to be weaker in patients with diabetes mellitus, primarily due to the effects of diabetic polyneuropathy, a common diabetic complication. With respect to ...Background: The lower extremity muscle strength has been shown to be weaker in patients with diabetes mellitus, primarily due to the effects of diabetic polyneuropathy, a common diabetic complication. With respect to assessments of the lower extremity muscle strength, reference values for the knee extension force in healthy Japanese subjects have been reported. The clinical significance of applying knee extension force in the assessment of efficacy of exercise therapy and patient education has also been demonstrated, and the use of an individualized approach in physical exercise based on the quantitative assessment of the lower extremity muscle strength is becoming one of the most important strategies for promoting effective rehabilitation. Methods: The study is a multicenter, cross-sectional investigation. We will measure the knee extension force and evaluate the diabetic polyneuropathy in patients with type 2 diabetes using uniform equipment and methodology at all centers. We will compare the knee extension force between the subjects with and without diabetic polyneuropathy and will investigate the associations between the knee extension force and both glycemic control and exercise habits. The trial registration is UMIN CTR (UMIN000002810). Discussion: The lower extremity muscle strength has been insufficiently investigated in Japanese patients with diabetes. This study was designed to establish reference values for the knee extension force in Japanese diabetic patients with and without diabetic polyneuropathy.展开更多
文摘Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.
文摘Objective: To study the effect of ultrashort wave therapy combined with antioxidant and neurotrophy therapy on nerve conduction function and serum cytokines in patients with diabetic peripheral neuropathy. Methods: A total of 128 patients who were diagnosed with DPN in South District of Guang'anmen Hospital of China Academy of Chinese Medical Sciences between May 2014 and February 2017 were selected as the research subjects and randomly divided into electrotherapy + drug group and routine drug group;the nerve conduction velocity as well as serum levels of nerve cytokines and inflammatory cytokines were measured before treatment and 8 weeks after treatment. Results: Median nerve and common peroneal nerve MNCV, median nerve and superficial peroneal nerve SNCV as well as serum CNTF, BDNF, SDF-1α, IGF-1, CAT and HO-1 levels of both groups 8 weeks after treatment were significantly higher than those before treatment while serum ICAM-1, TNF-α, IL-6, ET-1, MDA and 8-OHdG levels were significantly lower than those before treatment;median nerve and common peroneal nerve MNCV, median nerve and superficial peroneal nerve SNCV as well as serum CNTF, BDNF, SDF-1α, IGF-1, CAT and HO-1 levels of electrotherapy + drug group 8 weeks after treatment were significantly higher than those of routine drug group while serum ICAM-1, TNF-α, IL-6, ET-1, MDA and 8-OHdG levels were significantly lower than those of routine drug group. Conclusion: Ultrashort wave therapy combined with antioxidant and neurotrophy therapy for DPN can improve the nerve conduction function and neurotrophic state, and also inhibit the inflammatory response and oxidative stress response.
文摘Objective To search for a good therapeutic method for treating diabetic neuropathy. Methods Patients were randomly divided into an acupuncture group （n =30） and a control group （n =26）. In the control group, gliclazide, at the dose of 80 mg/d, for lowering blood sugar, and adenosine coenzyme B12, at the dose of 0.75 mg, for improving nutrition of nerves were orally administered. In the acupuncture group, acupuncture at bilateral Yishu point was added. Three weeks of treatments were given for both groups. Therapeutic effects and changes in fasting blood sugar, fasting glucose in urine and blood fat were observed. Results The total effective rate was 93.3% and 67.3% in the acupuncture and control group, respectively. Fasting blood sugar, fasting glucose in urine, total cholesterol and triglyceride were obviously lowered, and high density lipoprotein markedly elevated in the acupuncture group with significant differences, compared with those in the control group （P〈0.05）. Conclusion Acupuncture combined with medicine can improve disorder of fat metabolism in diabetic patients at the early and intermediate stages and depress and stabilize blood glucose to improve neural functions.
文摘Intensive insulin therapy has been extensively used to control blood glucose levels because of its ability to reduce the risk of chronic complications of diabetes.According to current guidelines,intensive glycemic control requires individu-alized glucose goals rather than as low as possible.During intensive therapy,rapid blood glucose reduction can aggravate microvascular and macrovascular complications,and prolonged overuse of insulin can lead to treatment-induced neuropathy and retinopathy,hypoglycemia,obesity,lipodystrophy,and insulin antibody syndrome.Therefore,we need to develop individualized hypoglycemic plans for patients with diabetes,including the time required for blood glucose normalization and the duration of intensive insulin therapy,which deserves further study.
文摘Diabetic neuropathy, the most common form of peripheral neuropathy, presents as different forms of focal or diffuse neuropathy, including the disabling, or potentially life-threatening clinical entities of painful diabetic neuropathy, autonomic neuropathy, and diabetic foot. The pathogenesis of diabetic neuropathy results from the concurrent action of various intersecting factors of nerve damage, such as oxidative stress and mitochondrial dysfunction, inflammation, microangiopathy and ischemia, triggered by hyperglycemia and related biochemical changes. Symptomatic treatment of diabetic neuropathy mainly concerns therapies for neuropathic pain, interventions targeted at the organ systems involved in autonomic neuropathy, and management of diabetic foot. Therapeutic approaches to the pathogenesis of diabetic neuropathy have focused on the different components of the causes of nerve damage, particularly oxidative stress, which has been demonstrated to play a central role. Alpha-lipoic acid, a potent lipophilic free radical scavenger, has been used in treatment of patients with diabetic neuropathy, displaying efficacy on the chief symptoms, including neuropathic pain, and showing that neuropathic deficits may be improved by treatment. Current evidence suggests a possible efficacy of alpha-lipoic acid not only for neuropathic symptoms, but also for reducing the risk factors for diabetic neuropathy.
文摘Diabetic neuropathy (DN) is one of the common complications of diabetes mellitus (DM), its incidence can be as high as over 90%. The lesion can involve the sensory, motor and vegetative nerves. As a whole, the lesion can be divided into symmetric multiple neuropathy and asymmetric single neuropathy. Because the pathogenesis of the disease is not clear, no specific therapy is available so far. Besides control of blood sugar level, vitamin B, vasodilators and analgesics are often used in Western medicine for expectant treatment. Basic studies on chronic complications of DM show that aldose reductase and non-enzymatic glycosylation of protein are factors initiating the pathological changes, inhibitors against them have been tested in experimental studies and proved effective. Unfortunately, they are not used clinically due to severe side effects. Screening for herbal drugs to treat DN is still a popular trend in the TCM circle.
文摘<strong>Aim:</strong> Diabetes Mellitus is a global public health challenge with major and potentially devastating complications, and concomitant complications include retinopathy and neuropathy due to hypoxia and microvascular dysfunction. In this study, we investigated the effect of hyperbaric oxygen therapy as a method to transiently improve tissue oxygenation on diabetic retinopathy and neuropathy in a streptozotocin induced type-1 diabetic rat model (Wistar). <strong>Methods:</strong> Streptozotocin induced type-1 diabetic rats received 10 sessions of 2-h hyperbaric oxygen exposures (pO<sub>2</sub> = 309 kPa) over 2 weeks. Animals were exposed to light stimuli to produce light evoked potentials to estimate the effect of oxygen treatment on diabetic retinopathy. Sciatic nerves were exposed and stimulated to produce muscle evoked potential, which were recorded in the muscles of the foot and subsequently used to evaluate the effect of oxygen treatment on diabetic neuropathy. <strong>Results:</strong> We found significantly shorter light evoked potential latency and increased amplitude in hyperbaric oxygen treated animals. No change was found in nerve conduction. <strong>Conclusions:</strong> This study showed that hyperbaric oxygen therapy is a potentially effective treatment for diabetic retinopathy, improving both latency and amplitude of light evoked potentials.
文摘Objective: To study the effects of -zinc sulfate combined with yiqiyangyinghuoxue therapy on related factors in patients with type 2 diabetes peripheral neuropathy. Methods: A total of 90 patients with type 2 diabetes peripheral neuropathy in our hospital from September 2015 to September 2018 were enrolled in this study. The subjects were divided into the control group (n=45) and the treatment group (n=45) randomly. The control group were treated with -zinc sulfate, the treatment group were treated with -zinc sulfate combined with yiqiyangyinghuoxue therapy, the two groups were treated for 3 months. The serum NSE, UA, Hcy, hs-CRP, BDNF, HMGB1, CysC, TGF-β1, 25-(OH)D3, ESM-1, NO and plasma ET, TNF of the two groups before and after treatment were compared. Results: There were no significantly differences of the serum NSE, UA, Hcy, hs-CRP, BDNF, HMGB1, CysC, TGF-β1, 25-(OH)D3, ESM-1, NO and plasma ET, TNF of the two groups before treatment. After treatment, the serum NSE, UA, Hcy, hs-CRP, HMGB1, CysC, TGF-β1, ESM-1 and plasma ET, TNF of the two groups were significantly lower than before treatment, the serum BDNF, 25-(OH)D3, NO of the two groups were significantly higher than before treatment, and that of the treatment group after treatment were significantly better than the control group. Conclusion: α-zinc sulfate combined with yiqiyangyinghuoxue therapy on patients with type 2 diabetes peripheral neuropathy has a good efficacy, can improve the neuropathy and vascular endothelial damage, improve related factors, and it was worthy clinical application.
文摘Objective： To study the mechanism of moxibustion therapy on diabetic peripheral neuropathy for the peripheral neuroprotection. Methods： The DPN model was induced by intraperitoneal injection with streptozotocin （STZ）. The rats were given moxibustion at the acupoint Yishu （Extra） and the acupoint Zusanli （ST 36）. The treatment was carried out once a day and 15 minutes per acupoint, lasting for 56 d in total. The clinical effect of moxibustion was evaluated by detecting blood sugar, urine sugar, body weight and dietary intakes, as well as nerve conduction velocity with neuroelectrophysiological method. The structure variation of sciatic nerve was observed by HE staining and light microscopy, and the level of NGF in the sciatic nerve was determined by ELISA. Results： Compared with the model group, the plasma glucose was significantly lower in the moxibustion group （P〈0.01）, with significantly faster nerve conduction velocity （P〈0.01）, more notably changes in pathological appearance （P〈0.01） and higher level of nerve growth factor （NGF） （P〈0.01）. Conclusion： Moxibustion coUld improve the symptom and signs of peripheral neuropathy in rat models with DPN, which may relate to the increased NGF and enhanced peripheral nerve protection.
文摘Background: The lower extremity muscle strength has been shown to be weaker in patients with diabetes mellitus, primarily due to the effects of diabetic polyneuropathy, a common diabetic complication. With respect to assessments of the lower extremity muscle strength, reference values for the knee extension force in healthy Japanese subjects have been reported. The clinical significance of applying knee extension force in the assessment of efficacy of exercise therapy and patient education has also been demonstrated, and the use of an individualized approach in physical exercise based on the quantitative assessment of the lower extremity muscle strength is becoming one of the most important strategies for promoting effective rehabilitation. Methods: The study is a multicenter, cross-sectional investigation. We will measure the knee extension force and evaluate the diabetic polyneuropathy in patients with type 2 diabetes using uniform equipment and methodology at all centers. We will compare the knee extension force between the subjects with and without diabetic polyneuropathy and will investigate the associations between the knee extension force and both glycemic control and exercise habits. The trial registration is UMIN CTR (UMIN000002810). Discussion: The lower extremity muscle strength has been insufficiently investigated in Japanese patients with diabetes. This study was designed to establish reference values for the knee extension force in Japanese diabetic patients with and without diabetic polyneuropathy.
