疼痛性糖尿病外围神经病变:临床管理的实际指导和挑战
Frank G Preston1, David R Riley1, Shazli Azmi2
1Department of Cardiovascular & Metabolic Medicine, Institute of Life Course and Medical Sciences and the Pain Research Institute, University of Liverpool, Liverpool, UK.
概括
疼痛性糖尿病外围神经病变 (PDPN) 影响全球数以百万计的人,导致严重的残疾. 目前的治疗方法只能提供部分缓解,因此需要采用整体方法和开发新药,以获得更好的结果.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 疼痛管理 疼痛管理
背景情况:
- 疼痛性糖尿病外围神经病变 (PDPN) 影响了近25%的糖尿病患者,影响全球超过1亿人.
- 虽然PDPN显著影响日常功能,情绪,睡眠和生活质量,但仍未得到充分的诊断和治疗.
- 这种复杂的疼痛状况因睡眠不足和情绪低落而加剧,需要全面的以患者为中心的护理策略.
研究的目的:
- 审查PDPN目前的诊断工具和国际管理指南.
- 综合现有药理和非药理治疗选择的证据.
- 突出了对PDPN的新,基于机制的治疗方法和个性化医疗方法的需求.
主要方法:
- 对PDPN的诊断标准和评估工具的全面审查.
- 综合了主要医学协会 (AACE,AAN,ADA,加拿大糖尿病协会,DDG,IDF) 的国际临床指南.
- 评估目前用于PDPN管理的药理和非药理治疗策略.
主要成果:
- 在PDPN诊断和治疗方面存在重大知识差距,尽管其患病率很高.
- 目前的治疗方法旨在减少30-50%的疼痛,完全缓解是罕见的.
- 超过50种新的分子实体正在临床开发中治疗神经病痛,显示出未来的希望.
结论:
- 有效的PDPN管理需要一个整体的,以患者为中心的方法,结合药理和非药理干预措施.
- 迫切需要新的止痛药和个性化医疗策略来改善治疗结果.
- 未来的研究应该专注于基于机制的治疗方法,以推进PDPN患者的护理.
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