Mob neuropathy mob ntshav qab zib > Mob ntshav qab zib muaj teeb meem

Mob neuropathy mob rau sab hauv yog ib qho kev mob ntxig ntawm cov hlab ntsha hauv lub cev los ntawm cov teeb meem metabolic tshwm sim los ntawm ntshav qab zib mellitus. Tus kab mob yog pom los ntawm kev hnov mob tsis taus thiab ua kom lub cev tsis ua haujlwm.

Tus mob ntshav qab zib neuropathy tau dav thiab kuaj pom, raws li ntau tus kws sau ntawv, nyob hauv 30-50% ntawm cov neeg mob uas muaj qee yam ntshav qab zib.

Cov Neeg Ua thiab Teeb Meem Qhov Tseeb

Lub luag haujlwm tseem ceeb hauv lub pathological mechanism ntawm tus mob ntshav qab zib neuropathy belongs rau microangiopathies, uas yog, kev puas tsuaj rau cov leeg ntshav me tshaj plaws uas ua rau ob leeg ntawm cov leeg ntshav thiab cov hlab ntsha leeg. Cov ntshav tsis txaus rau cov hlab ntsha cov hlab ntsha ua rau cov khoom noj tsis txaus siab hauv nws thiab ua rau kom muaj cov khoom ntau oxidative kev nyuab siab. Raws li qhov tshwm sim, cov ntaub so ntswg poob siab, kev coj ntawm cov hluav taws xob cuam tshuam paug tsis zoo. Thaum kawg, lub paj fiber ntau atrophies.

Qhov tseeb uas ua rau muaj kev pheej hmoo ntawm kev mob ntshav qab zib mob hlwb:

laus lawm
leeg ntshav siab
decompensated hyperglycemia,
mob ntshav qab zib ntev,
haus luam yeeb
rog dhau.

Cov qauv ntawm tus kabmob

Nyob ntawm cov ntawv sau txog saum toj no, muaj:

autonomic neuropathy. Nws yog txuam nrog kev ua txhaum ntawm kev sib txuam ntawm sab hauv plab hnyuv siab raum,
peripheral neuropathy. Feem ntau pob txha caj qaum yog cuam tshuam.

Hauv kev siv tshuaj, kev faib tawm syndromic yog siv dav:

Generally symmetric polyneuropathy. Nyob ntawm qhov tshwm sim tseem ceeb ntawm kev hnov mob lossis lub cev muaj zog, nws tau muab faib ua qhov txiav txim siab thiab lub cev muaj zog, feem. Nrog kev ua kom puas tsuaj rau ob qho tib si ntawm cov hlab ntaws, lawv hais txog kev sib xyaw ua ke neuropathy.
Autonomic (vegetative) neuropathy. Nws yog cais rau hauv sudomotor, hlab plawv, ua pa, urogenital thiab lub plab zom mov.
Multifocal (focal) neuropathy. Nws suav nrog kev kho mob ua paug, mob taub hau, ua kom mob hlwb, mob leeg hlwb, mob plexopathy (radiculoneuropathy), amyotrophy.

Qee zaum hauv ib daim ntawv cais, central neuropathy yog qhov txawv, uas ua rau nws tus kheej:

cov teeb meem mob cerebrovascular,
encephalomyelopathy
mob hlwb tsis meej pem.

Qib kabmob ntawm tus kabmob

Peb theem ntawm cov neuropathy uas mob ntshav qab zib yog qhov txawv:

Subclinical.
Clinical (tsis mob, mob thiab ntev daim ntawv mob).
Qeb ntawm kev rov ua mob qeeb (mob ntshav qab zib ko taw, ko taw deformity, thiab lwm yam).

Tus mob ntshav qab zib neuropathy tau dav thiab kuaj pom, raws li ntau tus kws sau ntawv, nyob hauv 30-50% ntawm cov neeg mob uas muaj qee yam ntshav qab zib.

Cov ntawv ntawm qhov mob ntshav qab zib neuropathy yog cim los ntawm:

kev hnov ntawm tingling, hlawv, loog ntawm daim tawv nqaij (paresthesia),
plab hlaub mob leeg,
mob hauv cov ntiv tes thiab ntiv taw, tes thiab taw,
poob ntawm qhov kub thiab txias rhiab
nce tactile rhiab heev (hyperesthesia),
leeg tsis muaj zog
weakening ntawm qhov heev ntawm cov leeg reflexes,
Kev tsis pom zoo kev ua haujlwm ntawm txav thiab gait.

Lub caij nyoog ua rau mob insomnia, thiab tom qab ntawd ua rau muaj kev ntxhov siab loj.

Nrog rau daim ntawv ntawm kev mob ntshav qab zib neuropathy, kev pom qhov mob ntawm lub zog ntawm lub hlwb tsis txaus uas ua rau pom cov kab mob ntawm sab hauv, uas ua rau muaj kev cuam tshuam ntawm lawv lub luag haujlwm. Cov duab hauv tsev kho mob hauv daim ntawv no tau txiav txim los ntawm yam kab ke hauv lub cev ua kom ntau dua:

Mob plawv ntshav qab zib neuropathy. Nws tshwm sim hauv thawj xyoo ntawm kev ua mob ntshav qab zib. Tachycardia, orthostatic hypotension (txo qis hauv ntshav thaum tus neeg mob txav mus rau ib qho chaw ntsug), thiab qee yam kev hloov pauv hauv electrocardiogram (ua kom ntev li QT luv) yog tus yam ntxwv. Txoj kev pheej hmoo ntawm kev tsim cov tsis muaj mob ntawm myocardial infarction ntau zog.
Lub plab zom mov muaj ntshav qab zib mob neuropathy. Cov chaw kuaj mob muaj qhov tshwm sim vim kev mob siab tsis txaus, mob plab (mob plab tsis ua hauj lwm), lub plab hnyuv plab hnyuv. Cov neeg mob feem ntau kuaj pom tias mob plab thiab duodenal mob rau lub plab, mob plab zais plab dyskinesia, qis acidity gastritis, mob gallstone, thiab mob rog hepatosis.
Urogenital ntshav qab zib mob neuropathy. Muaj qhov ua txhaum ntawm lub suab ntawm qhov mob tso zis thiab tso zis, uas ua rau tso zis tsis ua haujlwm lossis tso zis, thiab tseem tsim qhov kev ntsuas ua ntej rau kev txhim kho ntawm kev sib kis thiab mob ntawm cov mob tso zis (cystitis, pyelonephritis). Nyob rau hauv cov txiv neej, urogenital neuropathy tuaj yeem ua txhaum kev mob kev hnov mob ntawm noob qes thiab mob erectile kawg, thiab rau cov poj niam - anorgasmia thiab dryness ntawm lub paum ntawm lub paum.
Sudomotor ntshav qab zib neuropathy. Nws yog qhov tshwm sim los ntawm kev tawm hws ntau ntawm tag nrho lub cev (hauv nruab nrab hyperhidrosis) nrog kev tawm hws tsawg ntawm xib teg thiab taw (nrog rau distal an- lossis hypohydrosis). Qhov no qhia ntawm neuropathy yog feem ntau pom meej meej thaum hmo ntuj thiab thaum noj mov.
Kab mob ntshav qab zib mob neuropathy. Nws yog nrog los ntawm kev poob qis hauv kev ua ke ntawm surfactant, hyperventilation ntawm lub ntsws, ntu sij hawm ntawm apnea.

Txhawm rau tiv thaiv kev txhim kho mob ntshav qab zib neuropathy, nws yog qhov tsim nyog los tswj theem ntawm cov piam thaj hauv cov ntshav, noj txoj cai thiab ua lub neej muaj sia.

Kev kuaj mob

Kev kuaj mob ntawm tus mob ntshav qab zib neuropathy, tshwj xeeb tshaj yog cov kev noj haus ntawm tus kab mob, feem ntau nyuaj. Ua ntej, kev kuaj kab mob anamnesis, ces kev tshuaj xyuas yog ua tiav, uas suav nrog:

kev txiav txim siab ntawm kev mloog zoo ntawm cov piam thaj, insulin, glycosylated hemoglobin, C-peptide hauv cov ntshav cov ntshav,
ntsuas ntshav ntsuas
kev txiav txim siab ntawm kev ntsuas ntawm peripheral cov hlab ntsha,
kev soj ntsuam kom zoo ntawm lub taw txhawm rau txhawm rau txheeb xyuas corns, corns, fungus lesions, deformities.

Ntxiv nrog rau qhov endocrinologist, lwm tus kws kho mob nqaim (neurologist, gastroenterologist, kws kho plawv, kws kho poj niam, andrologist urologist, ophthalmologist, podologist, orthopedist) koom nrog kev kuaj mob ntshav qab zib neuropathy.

Thaum muaj kev soj ntsuam cov tsos mob ntawm kev puas tsuaj rau lub plawv mob, lub algorithm ntawm kev kuaj mob thawj zaug yog ntxiv los ntawm ECG, echocardiography, kev kuaj plawv (kuaj ntshav orthostatic, Valsalva kuaj). Kev kuaj ntshav kuj tseem ua rau cov ntsiab lus ntawm lipoproteins thiab cov cholesterol.

Kev soj ntsuam neurological rau xav tias tsam ntshav qab zib mob neuropathy muaj xws li:

xob ntsuas hlau
electromyography
kev txheeb xyuas qhov tsis zoo thiab ntau hom kev hnov (rhiab, tactile, kev co, qhov kub, qhov mob).

Nrog rau chav kawm atypical ntawm tus mob ntshav qab zib neuropathy, nws yuav tsim nyog los ua me me ntawm daim tawv nqaij thiab (lossis) calf hlab ntsha, tom qab los ntawm kev txheeb xyuas keeb kwm ntawm cov khoom tau txais.

Nrog cov cim ntawm pathology ntawm txoj hnyuv huam, hauv qab no yog qhia:

Helicobacter kev xeem
Ultrasound ntawm lub plab zom plab,
duab hluav taws xob sib txawv ntawm lub plab thiab cov hnyuv,
Endoscopy.

Kev kuaj mob ntawm urogenital ntawv ntawm tus mob ntshav qab zib neuropathy muaj xws li:

urinalysis
Nechiporenko qhov kev sim,
Zimnitsky tus qauv,
electromyography ntawm cov leeg ntawm lub zais zis,
cev nqaij urography
cystoscopy
Ultrasound ntawm ob lub raum thiab zais zis nrog rau kev txiav txim yuav tsum muaj ntawm tus nqi ntawm cov zis.

Kev kho mob ntshav qab zib neuropathy yog ntev thiab ntau yam, cuam tshuam rau ntau cov txheej txheem ntawm cov txheej txheem pathological. Nws yog qhov tsim nyog kom ua tiav qib siab tshaj plaws ntawm kev them nyiaj rau ntshav qab zib. Rau qhov no, los ntawm kev tswj cov piam thaj hauv cov ntshav ntshav, cov koob tshuaj uas yuav tsum tau muaj ntawm cov tshuaj hypoglycemic lossis insulin yog xaiv. Ib qho ntxiv, kev hloov kho lub neej yog qhov yuav tsum tau ua:

kev siv hluav taws xob zoo (cov lus 9. raws li Pevzner),
kev tawm dag zog lub cev tsis tu ncua,
kev tswj lub cev hnyav.

Txhawm rau txhim kho cov txheej txheem hauv lub cev, cov vitamins B, tshuaj tua kab mob (vitamin E, alpha-lipoic acid), cov ntsiab lus (cov tshuaj zinc thiab magnesium npaj) yog cov kws kho.

Nrog rau mob hnyav, cov tshuaj uas tsis yog tshuaj steroidal coj los qhia, ntxiv rau cov tshuaj anticonvulsants.

Kev siv dag zog hauv lub cev yog siv: acupuncture, kho lub teeb, kho laser, kho mob, kho hluav taws xob ntawm lub paj hlwb, zaws.

Kev tu ko taw kom yog tseem ceeb:

moisturizing tawv nqaij ntawm taw nrog ib tug tshwj xeeb cream,
ib txwm da dej
kev kho mob pedicure
hnav khau kom yooj yim uas tsis nyem ko taw thiab tsis tshiav nws (yog tias tsim nyog, hnav khau orthopedic).

Kev kho mob ntawm kev noj haus cov ntaub ntawv ntawm kev mob ntshav qab zib neuropathy yuav tsum tau nqa tawm mus rau hauv tus account cov yam ntxwv ntawm kev tsim kho mob tshwm sim.

Yuav muaj teeb meem thiab tshwm sim

Cov teeb meem tseem ceeb ntawm cov ntawv kho mob ntsig txog mob neuropathy uas mob ntshav qab zib yog:

cev qhuav dej ntawm tus thawj ntawm ko taw,
rauj deformation ntawm cov ntiv taw,
cov tawv nqaij ua tsis zoo ntawm cov qis qis,
mob ntshav qab zib mob ko taw.

Lub caij nyoog mob nyob rau hauv lub taw thiab txhais tes nrog ntshav qab zib neuropathy ua rau insomnia thiab, tom qab ntawd, kev nyuaj siab loj heev.

Tsis tas li, mob ntshav qab zib neuropathy tuaj yeem ua rau qhov kev txhim kho ntawm:

asymptomatic hypoglycemia,
ua txhaum ntawm thermoregulation,
mob hemeralopia,
daim ntawv pov thawj
cov kev tso tawm sab nrauv (mob ntshav qab zib cachexia).

Nrog rau kev paub txog thaum ntxov thiab kev kho mob nquag los ntawm mob ntshav qab zib neuropathy, nws muaj peev xwm nres kev mob ntawm tus mob. Txoj kev kuaj mob rau cov mob uas mob ntshav qab zib neuropathy tsis tshua zoo siab.

Kev Tiv Thaiv

Txhawm rau tiv thaiv kev txhim kho mob ntshav qab zib neuropathy, koj xav tau:

tswj cov piam thaj hauv kev ntsuas ntshav,
zaub mov noj
qoj ib ce tab sis ib txwm muaj,
nruj ua raws li cov txheej txheem insulin kho mob lossis kev tswj hwm ntawm cov tshuaj muaj ntshav qab zib kom kws kho mob sau tseg,
raws sij hawm kho cov kab mob concomitant,
kev tiv thaiv kev kho mob tas li ntawm tus endocrinologist, tus kws kho mob hlwb thiab lwm tus kws tshaj lij pom zoo.

Yees duab los ntawm YouTube ntawm lub ncauj lus:

Kev Kawm Ntawv: kawm tiav los ntawm Tashkent State Medical lub koom haum nrog kev kawm tiav kho mob hauv xyoo 1991. Rov kawm dua cov chav qhia kev kawm siab heev.

Kev ua haujlwm kev ua haujlwm: tus kws kho mob-rov ua haujlwm ntawm lub nroog poj niam txoj haujlwm, tus rov ua haujlwm ntawm chav tuam tsev kho mob.

Cov ntaub ntawv no tau muab tso ua ke thiab muab rau kev qhia xov xwm nkaus xwb. Mus ntsib koj tus kws kho mob thaum pom thawj yam mob. Kev siv tshuaj rau tus kheej yog qhov txaus ntshai rau kev noj qab haus huv!

Yuav Khoom Ntxov Rau Khoom Noj

Yuav Khoom Ntxov Rau Khoom Noj tsiag ntawv los ntawm kev puas tsuaj rau qhov ua paug ntawm qhov nruab nrab ntawm qaum thiab qis. Muaj qhov hnov ntawm hlawv, loog, mob, feem ntau yog thaum tsaus ntuj, qhov hnov ntawm "nkag mus."

Muaj peev xwm ua kom tsis muaj zog ntawm cov nqua, kev tsis khov ntawm lub gait, qhov tsis hnov ntawm caj ces thiab caj npab thiab ceg. Qhov pom ntawm daim ntawv no ntawm polyneuropathy yog feem ntau ua ntej ntawm kev mob ntshav qab zib ko taw.

Autonomic neuropathy

Cov kab mob kev tshwm sim ntawm lub hlwb tsis nco qab muaj qhov sib txawv, uas ua rau muaj teeb meem loj hauv kev kuaj mob.

Daim ntawv mob plawv tshwm sim los ntawm kev tshwm sim ntawm kev puas tsuaj rau cov leeg leeg ntawm lub plawv, muab cov khoom sab hauv ntawm cov hlab plawv. Raws li kev puas tsuaj rau lub paum ntawm qhov chaw mos, qhov cuam tshuam ntawm lub plawv ntawm lub plawv pib tshwm sim, lub plawv dhia ceev ceev tshwm - tachycardia, uas mob siab rau thaum lub dag zog thiab so, orthostatic hypotension, lub sijhawm uas tsis nco qab - lub sijhawm ua haujlwm syncopal tuaj yeem sau tseg. Autonomic cardiovascular neuropathy yog qhov tseem ceeb ua rau tsis muaj dab tsi mob myocardial infarction hauv cov neeg mob ntshav qab zib mellitus.

Ntawm lub plab zom mov neuropathies txhim kho kev cuam tshuam ntawm lub cev muaj zog thiab kev khiav tawm hauv lub plab, lub plab, lub plab, lub plab zom mov. Feem ntau muaj dyskinesia ntawm lub gallbladder, mob gallstone, cuam tshuam ntawm peristalsis.

Urogenital daim ntawv pom los ntawm kev ua txhaum ntawm lub suab ntawm lub zais zis thiab txoj hlab tso zis, qhov tso zis tsis zoo, tso zis lossis tso zis tsis ua haujlwm, txo qis potency. Feem ntau mob txeeb zig. Rau daim ntawv ua pa kev mob ntsws ntawm kev ua pa tsis ua haujlwm, tsis nyob ntawm lub ntsws tsis tso pa tawm yog yam ntxwv.

Pathogenesis thiab kev faib tawm

Cov hauv qab no yam tseem ceeb los ua lub luag haujlwm tseem ceeb hauv DPN:

1. Microangiopathy (kev ua haujlwm thiab / lossis kev hloov pauv hauv cov hlab ntsha ua lub luag haujlwm rau microcirculation ntawm cov hlab ntsha leeg).

2. Kev ntshaib plab metabolic:

Kev ua kom muaj cov polyol shunt (lwm txoj hauv kev ntawm cov metabolism hauv qabzib, nyob rau hauv uas nws tau hloov mus rau sorbitol (siv cov enzyme aldose reductase) thiab tom qab ntawd kom fructose, kev txuam nrog cov metabolites no ua rau kev nce hauv osmolarity ntawm qhov chaw intercellular).
Ib qho kev txo qis ntawm myo-inositol, uas ua rau txo qis ntawm kev sib txuas ntawm phosphoinositol (ib qho kev tiv thaiv ntawm cov qog ua haujlwm ntawm cov hlab ntsha), uas thaum kawg ua rau txo qis hauv lub zog metabolism thiab ua rau lub siab tsis zoo ntawm lub paj hlwb tsis muaj zog.
Tsis-enzymatic thiab enzymatic glycation ntawm cov protein (glycation ntawm myelin thiab tubulin (cov qauv ntawm cov hlab ntsha) ua rau demyelination thiab kev ua haujlwm tsis zoo ntawm cov hlab ntsha tsis haum, glycation ntawm cov protein ntawm lub qab daus membrane ntawm cov hlab ntsha coj nws ua rau nws cov tuab thiab cov txheej txheem hauv cov hlab ntaws).
Cov kev tiv thaiv oxidative kev nyuaj siab (nce oxidation ntawm qabzib thiab lipids, txo cov antioxidant tiv thaiv ua rau tsub zuj zuj ntawm cov dawb radicals nrog cytotoxic cuam tshuam ncaj qha).
Kev tsim kho ntawm autoimmune complexes (raws li qee cov lus ceeb toom, tshuaj tiv thaiv rau cov tshuaj insulin los tiv thaiv kev loj hlob ntawm cov hlab ntsha, uas ua rau atrophy ntawm cov hlab ntsha).

Kev sib raug zoo ntawm ntau yam ntawm lub pathogenesis ntawm DPN yog qhia hauv daim duab 1.

Kev faib tawm thiab qhov tseem ceeb kho mob ntawm DPN

Distal hnov los yog sensorimotor neuropathy

Nrog cov qhov txhab muaj zog tshaj hauv cov plaub:

kub los sis rab phom suab phom tua,
kev hyperalgesia
paresthesia
tsis hnov mob los yog kub,
ko taw mob,
tsis muaj visceral mob.

Nrog kev puas tsuaj loj rau cov fibers loj:

poob ntawm kev co rhiab
poob ntawm proprioceptive rhiab,
areflexia.

Tshuaj Neuropathy

Mob mob neuropathy

Mob viav voos demyelinating neuropathy

Qhov kev cuam tshuam ntawm cov tub ntxhais kawm reflex.
Kev sib tsoo tsis sib haum.
Asymptomatic hypoglycemia.
Autonomic gastrointestinal neuropathy:
atony ntawm lub plab,
atony ntawm lub zais zis,
uas mob ntshav qab zib enteropathy ("mob raws plab nocturnal"),
cem quav
quav txau.
Lub hlwb leeg neuropathy ntawm cov hlab plawv:
tsis muaj mob myocardial ischemia,
orthostatic hypotension,
lub siab tuaj cuam tshuam tuaj
lub cev nqaij daim tawv,
tachycardia ntawm so,
lub plawv dhia
hloov hauv circadian atherosclerosis,
tsis kam ua qoj ib ce.
Lub qhov txhab ntawm lub zais zis cia li tsis tuaj yeem.
Autonomic neuropathy ntawm kev ua me nyuam (erectile kawg, retrograde ejaculation).

Lub paj hlwb thiab multifocal neuropathies

Oculomotor cov hlab (III).
Kev Tsim Kho Me Nyuam (VI).
Thaiv cov hlab ntshav (IV).

Asymmetric qhov tsawg tshaj plaws qhov siab nqeg ntawm lub cev tsis muaj zog neuropathy

Asymmetric tso siab lub cev muaj zog neuropathy.
Mob hauv qab, duav, hauv caug.
Tsis muaj zog thiab atrophy ntawm cov flexion, adductors thiab quadriceps leeg ntawm tus ncej.
Poob ntawm reflex los ntawm quadriceps leeg.
Hloov kho qhov tsis hnov lus me.
Lub cev yuag.

Qhov mob nyob ib ncig ntawm nraub qaum, hauv siab, plab.
Tsis tshua muaj rhiab lossis dysesthesia.

Ntsuas (qhov):
- nqaj ceg sab sauv: cov leeg nruab nrab hauv lub qhov carpal,
- sab ceg qis: tib lub hlab ntsha, leeg ib leeg.
Tsis raug nyom.

Kev kho thiab tiv thaiv DPN

Lub hom phiaj tseem ceeb ntawm kev kho thiab tiv thaiv ntawm DPN yog qhov ua kom zoo ntawm kev tswj glycemic. Ntau cov kev tshawb fawb tau ua nyob rau hauv xyoo tas los no tau ua pov thawj tias ua tiav cov ntshav qabzib hauv cov ntshav ntau dhau 1 hnub tiv thaiv kev nthuav dav ntawm DPN. Qhov kev kho mob niaj hnub thiab muaj peev xwm ntawm cov tshuaj neuropathy yuav tsis muaj txiaj ntsig yam tsis muaj kev them nyiaj ntxiv rau cov ntshav qab zib.

Nws paub tias nyob rau hauv cov ntshav qab zib muaj qhov tsis txaus ntawm ntau cov vitamins thiab kab kawm, txawm li cas los xij, rau kev kho mob ntawm DPN, lub luag haujlwm tseem ceeb tshaj plaws yog ua si los ntawm kev tshem tawm qhov tsis muaj pab pawg ntawm cov vitamins B. Neurotropic vitamins (pab pawg B) yog coenzymes koom nrog ntau cov txheej txheem biochemical, txhim kho cov xovtooj ntawm lub zog, thiab tiv thaiv kev tsim cov khoom kawg. glycation ntawm cov nqaijrog. Kev npaj ntawm cov vitamins no tau siv los kho DPN ntev lub sijhawm. Txawm li cas los xij, kev siv cais ntawm txhua qhov ntawm cov vitamins B ntxiv ob peb ntxiv kev txhaj tshuaj lossis ntsiav tshuaj rau kev kho mob ntawm cov neeg mob, uas tsis yooj yim kiag li. Cov tshuaj Neuromultivitis zam kev ntxiv tshuaj ntau ntawm cov tshuaj, txij li ib ntsiav tshuaj, zaj duab xis-txheej, twb muaj:

thiamine hydrochloride (vitamin B1) - 100 mg,
pyridoxine hydrochloride (vitamin B6) - 200 mg,
cyanocobalamin (vitamin B12) - 0.2 mg.

Thiamine (vitamin B1) hauv tib neeg lub cev vim los ntawm phosphorylation cov txheej txheem hloov mus rau hauv cocarboxylase, uas yog coenzyme koom nrog ntau yam enzyme kev hloov pauv. Thiamine ua si lub luag haujlwm tseem ceeb hauv kev ua kom tau cov carbohydrate, protein thiab cov rog rog, ua kom tau txais txiaj ntsig hauv cov txheej txheem ntawm cov kev xav tsis zoo hauv synapses.

Pyridoxine (vitamin B6) yog qhov tsim nyog rau kev ua haujlwm ntawm lub nruab nrab ntawm cov hlab ntsha nruab nrab thiab lub paj hlwb. Hauv daim ntawv phosphorylated, nws yog coenzyme koom nrog cov metabolism hauv cov amino acids (decarboxylation, transamination, thiab lwm yam). Nws ua raws li coenzyme ntawm cov enzymes tseem ceeb tshaj plaws uas ua hauv cov ntaub so ntswg mob. Koom nrog cov biosynthesis ntawm ntau cov neurotransmitters, xws li dopamine, norepinephrine, adrenaline, histamine thiab γ-aminobutyric acid.

Cyanocobalamin (vitamin B12) yog qhov tsim nyog rau kev tsim cov ntshav ib txwm thiab erythrocyte kom loj hlob, thiab tseem koom nrog ntau ntawm cov khoom siv tshuaj biochemical uas ua kom muaj kev ua haujlwm tseem ceeb ntawm lub cev: hauv kev hloov pauv ntawm cov pab pawg methyl (thiab lwm cov roj carbon-tawg), hauv kev sib xyaw ntawm nucleic acids, protein, hauv kev sib pauv ntawm amino acids, carbohydrates, lipids. Nws muaj cov txiaj ntsig zoo ntawm cov txheej txheem hauv cov hlab ntsha hlwb (ua kom sib xyaw ntawm cov nucleic acids thiab lipid muaj pes tsawg leeg ntawm cerebrosides thiab phospholipids). Coenzyme cov ntawv cyanocobalamin - methylcobalamin thiab adenosylcobalamin yog qhov tsim nyog rau kev hloov ntawm tes thiab kev loj hlob.

Cov kev tshawb fawb ntawm lub xeev ntawm qhov kev tawm dag zog ntawm cov neeg mob ntshav qab zib hom 2 qhia tau hais tias Neuromultivitis muaj qhov cuam tshuam zoo ntawm kev tawm tsam thiab kev tshee tshee ntawm lub taw, thiab tseem txo qhov kev siv ntawm qhov mob mob. Qhov no qhia txog qhov txo qis ntawm kev pheej hmoo ntawm kev tsim muaj mob rau cov mob ncauj taw thiab qhov nce ntawm lub neej zoo ntawm cov neeg mob uas muaj lub cev tsis sib xws. Nws tseem yuav tsum tau sau tseg qhov yooj yim ntawm kev ua ib chav kawm ntawm kev kho mob rau sab nraud, vim tias cov tshuaj tsis tas yuav tsum yog kev tswj hwm hauv tsoomfwv

Alpha lipoic acid yog coenzyme ntawm cov enzymes tseem ceeb ntawm Krebs lub voj voog, uas tso cai rau koj los kho lub zog sib npaug ntawm cov hlab ntsha cov leeg, nrog rau cov tshuaj tiv thaiv kab mob (raws li lub cev oxidizing tus neeg sawv cev), uas ua rau nws tuaj yeem tiv thaiv kev puas tsuaj ntxiv rau cov hlab ntsha thiab tiv thaiv cov leeg ntawm cov leeg dawb. Pib, rau 2-4 lub lis piam. (yam tsawg kawg nkaus - 15, qhov zoo tshaj - 20) lip-lipoic acid yog kho raws li niaj hnub iv nqus dej ntawm 600 mg / hnub. Tom qab, lawv hloov mus rau kev noj tshuaj uas muaj 600 mg ntawm α-lipoic acid, 1 ntsiav tshuaj / hnub rau 1.5-2 lub hlis.

Rau kev kho mob ntawm daim ntawv ua rau mob DPN, cov tshuaj loog yooj yim, tsis siv tshuaj tiv thaiv tsis haum tshuaj (acetylsalicylic acid, paracetamol) tuaj yeem raug ntxiv rau cov tshuaj saum toj no. Ntawm lawv, nws tsim nyog teev rau hauv cov tshuaj Neurodiclovit, muaj cov tshuaj diclofenac thiab B vitamins (B1, B6, B12), uas muaj cov lus tshaj tawm analgesic, anti-inflammatory thiab antipyretic effect.

Kev siv ntawm cov pawg ntawm cov tshuaj no xws li tricyclic antidepressants (amitriptyline 25–50–100 mg thaum tsaus ntuj), gabapentin (koob tshuaj pib - 300 mg, nce los ntawm 300 mg txhua 1-3 hnub, ntau kawg noj - 3600 mg), pregabalin (koob tshuaj thaum pib) tau qhia - 150 mg, nce rau 300 mg nyob rau hauv 3-7 hnub, ntau kawg koob - 600 mg (muab faib ua 2-3 koob)), duloxetine (pib koob - 60 mg 1 r. / Hnub, qee zaum nce txog 60 mg 2 r. / hnub, qhov ntau tshaj yog 120 mg).

Rau kev kho mob ntawm autonomic gastrointestinal neuropathy tau siv:

nrog atony ntawm lub plab: cisapride (5–40 mg 2–4 p. / hnub 15 feeb ua ntej noj mov), metoclopramide (5-10 mg 3–4 p. / hnub), domperidone (10 mg 3 p. / hnub),
nrog enteropathy (raws plab): loperamide (thawj koob yog 2 mg, tom qab ntawd 2–12 mg / hnub rau qhov tso quav ntau npaum li ntawm 1-2 p. / hnub, tab sis tsis tshaj 6 mg rau txhua 20 kg ntawm tus neeg mob qhov hnyav ib hnub).

Rau kev kho mob ntawm autonomic neuropathy ntawm cov hlab plawv (so haujlwm tachycardia), cardioselective β-blockers, calcium channel blockers (e.g. verapamil, Diltiazem Lannacher) yog siv.

Rau kev kho mob ntawm kev kho erectile, hom 5 phosphodiesterase inhibitors (yog tias tsis muaj contraindications), tshuaj intracavernous ntawm alprostadil, prosthetics, kev tawm tswv yim txog kev puas siab puas ntsws siv.

Rau kev tiv thaiv dav dav ntawm hypovitaminosis thiab cov kev tsis sib haum xeeb, cov neeg mob ntshav qab zib yog cov tshuaj multivitamin npaj. Hauv qhov no, kev coj noj coj ua ntawm cov vitamins B hauv kev siv tshuaj kho (Neuromultivitis) kuj ua haujlwm tau zoo.