Clinical Efficacy of Pentoxifylline Combined with Thioctic Acid in the Treatment of Painful Diabetic Peripheral Neuropathy

Objective:To observe the efficacy of pentoxifylline+thioctic acid in the treatment of patients with painful diabetic peripheral neuropathy(PDPN).Methods:70 patients with PDPN admitted from October 2019 to October 2022 were selected and randomly grouped,with pentoxifylline+thioctic acid treatment in Group A and thioctic acid treatment in Group B,and the treatment efficacy was compared.Results:The treatment efficacy in Group A was higher than that of Group B,P<0.05;the points of each symptom of PDPN in Group A were lower than that of Group B,P<0.05;the C-reactive protein and electromyography indexes of PDPN patients in Group A were better than that of Group B,P<0.05.Conclusion:PDPN patients treated with pentoxifylline+thioctic acid can optimize nerve function,inhibit inflammation progression,and reduce PDPN symptoms,which is an efficient and feasible treatment option.

Unique Traditional Chinese Medicine Therapy for Painful Diabetic Peripheral Neuropathy

Painful diabetic peripheral neuropathy is one of the common chronic complications of diabetes."Pain"is the most typical symptom in patients,which seriously affects their quality of life.Traditional Chinese medicine(TCM)treatment of the disease includes oral administration of Chinese medicine,TCM fumigation and acupuncture,etc.,which can significantly reduce the pain of patients and reduce the frequency of disease.Chinese decoctions regulate the imbalance of yin and yang in the human body through syndrome differentiation,so as to achieve the balance of yin and yang,which will then eliminate the disease.Chinese medicine fumigation make the medicine seep into the body from the skin to exert the medical effects,and nourish and dredge the meridians.There is no pain if the meridians are smooth flowing,there will be pain if the meridians are blocked,fumigation can be used alone or assisted by other treatment methods to enhance the efficacy.The characteristics of acupuncture are rapid painrelief,economic and convenient,and can quickly relieve pain for patients with low tolerance.

Extracellular signal-regulated protein kinase activation in spinal cord contributes to pain hypersensitivity in a mouse model of type 2 diabetes

Painful peripheral neuropathy is a common complication of diabetes mellitus. The symptom of pain can become a major factor that decreases the quality of life of patients with diabetes, while effective treatment is lacking. In the present study, we aimed to investigate the changes of pain threshold in the early stage of diabetes in db/db mice, an animal model of type 2 diabetes mellitus, and the underlying molecular mechanisms. We found that （1） db/db mice （with a leptin receptor-null mutation and characterized by obesity and hyperglycemia） showed hypersensitivity to mechanical and thermal stimuli at the early stage of diabetes; （2） phosphorylated extracellular signal- regulated kinase （pERK）, but not total ERK in the spinal cord and dorsal root ganglia in db/db mice significantly increased compared with wild-type mice. The increased pERK immunoreactivity occurred in both NeuN-expressing neurons and GFAP- expressing astrocytes, but not in Iba-l-expressing microglia; （3） both single and consecutive （for 5 days） intrathecal injections of U0126 （2 nmol per day）, a selective MEK （an ERK kinase） inhibitor beginning at 8 weeks of age, attenuated the bilateral mechanical allodynia in the von-Frey test and heat hyperalgesia in Hargreave＇s test; and （4） db/db mice also displayed increased nocifensive behavior during the formalin test, and this was blocked by intrathecal injection of U0126. Also, the expression of pERK1 and pERK2 was upregulated following the formalin injection. Our results suggested that the activation of ERK in spinal neurons and astrocytes is correlated with pain hypersensitivity of the type 2 diabetes animal model. Inhibiting the ERK pathway may provide a new therapy for pain control in type 2 diabetes.