摘要
目的:介绍痛性糖尿病周围神经病变的治疗药物,为临床个体化治疗方案提供参考。方法:查阅最新研究文献、2010年后全球发布的5种糖尿病周围神经病变诊治指南,对比不同指南的差异,分析药物治疗的作用机制、用法、效果、不良反应等。结果:度洛西丁、普瑞巴林、加巴喷丁和三环类抗抑郁药是痛性糖尿病周围神经病变主要的治疗药物,但仍需依据患者的具体情况如是否伴有睡眠障碍、肥胖、肝肾功能等患者特点选择治疗药物。一线的单药治疗方案不能为患者提供疼痛缓解时,可采用换药、联合用药等二线、三线治疗方案。结论:痛性糖尿病周围神经病变发病机制复杂,在严格控制血糖的前提下,应依据患者特点选择最合适的治疗方案。
OBJECTIVE To introduce the therapeutic drugs for painful diabetic peripheral neuropathy and provide a reference for clinical individualized treatment.METHODS According to the latest research literatures,and five guidelines for the diagnosis and treatment of diabetic peripheral neuropathy released globally after 2010,guidelines and the mechanism,usage,effects and adverse reactions of drug therapy are analyzed.RESULTS Duloxetine,pregabalin,gabapentin and tricyclic antidepressants are the main therapeutic agents for patients with painful diabetic peripheral neuropathy.However,the treatment should take the condition of patients into account,such as sleep disorders,obesity,liver and kidney features.When First-line monotherapy can not provide pain relief for patients,you may use dressing or combination therapy as second and third line treatment options.CONCLUSION The pathogenesis of painful diabetic peripheral neuropathy is complex.Under the strict control of blood glucose,the most appropriate treatment should be based on the characteristics of patients.
出处
《中国医院药学杂志》
CAS
北大核心
2017年第24期2475-2478,共4页
Chinese Journal of Hospital Pharmacy
关键词
痛性糖尿病周围神经病变
指南
个体化治疗方案
painful diabetic peripheral neuropathy
guideline
individualized treatment regimen
