痛性糖尿病周围神经病变患者的药物治疗方案探讨

发布时间：2018-06-23 00:18

本文选题：痛性糖尿病周围神经病变 + 指南　；参考：《中国医院药学杂志》2017年24期

【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。
[Abstract]:Objective: to introduce the therapeutic drugs of painful diabetic peripheral neuropathy and to provide reference for individual treatment. Methods: 5 kinds of diabetic peripheral neuropathy guidelines published in the world after 2010 were reviewed. The differences of different guidelines were compared and the mechanism, usage, effect and adverse reactions of drug therapy were analyzed. Results: Doloxetine, PreBahrain, gabapentin and tricyclic antidepressants are the main drugs for the treatment of painful diabetic peripheral neuropathy, but depending on the patient's specific conditions, such as sleep disorders, obesity, Patients with liver and kidney function and other characteristics of the choice of treatment drugs. First-line single-drug therapy can not provide patients with pain relief, can be changed, combined with other two-line, three-line treatment. Conclusion: the pathogenesis of painful diabetic peripheral neuropathy is complicated. Under the premise of strictly controlling blood sugar, the most suitable treatment should be selected according to the characteristics of the patients.
【作者单位】：中南大学湘雅医院药学部;
【分类号】：R587.2;R747.9

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