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Комплексное лечение больного с диабетической полинейропатией
Комплексное лечение больного с диабетической полинейропатией
Камчатнов П.Р., Евзельман М.А. Комплексное лечение больного с диабетической полинейропатией. Consilium Medicum. 2016; 18 (2): 81–84. DOI: 10.26442/2075-1753_2016.2.81-84
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Аннотация
Сахарный диабет – распространенное заболевание, одним из осложнений которого становится диабетическая полинейропатия (ДПН). ДПН проявляется двигательными и чувствительными нарушениями, причем именно нейропатический болевой синдром становится важной причиной снижения качества жизни больных. Поражение вегетативной нервной системы в рамках ДПН ассоциировано с риском жизнеугрожающих состояний (инсульт, тяжелые нарушения ритма сердца) и наступлением летального исхода. Рассматриваются возможности применения препарата тиоктовой кислоты (Октолипен®) в качестве средства патогенетической терапии ДПН. Приведены данные об эффективности габапентина (Конвалис®) для купирования болевого синдрома при ДПН.
Ключевые слова: сахарный диабет, диабетическая полинейропатия, вегетативная полинейропатия, тиоктовая кислота, габапентин, Октолипен, Конвалис.
Key words: diabetes mellitus, diabetic neuropathy, autonomic neuropathy, tioctic acid, gabapentin, Octopilen, Convalis.
Ключевые слова: сахарный диабет, диабетическая полинейропатия, вегетативная полинейропатия, тиоктовая кислота, габапентин, Октолипен, Конвалис.
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Key words: diabetes mellitus, diabetic neuropathy, autonomic neuropathy, tioctic acid, gabapentin, Octopilen, Convalis.
Полный текст
Список литературы
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3. Witzel I-I, Jelinek H, Khalaf K et al. Identifying Common Genetic Risk Factors of Diabetic Neuropathies. Front Endocrinol (Lausanne) 2015; 6: 88–93.
4. Jin HY, Baek HS, Park TS. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy. Diabetes Metab J 2015; 39(6): 461–7.
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7. Гурьева И.В., Левин О.С. Диабетическая полинейропатия. Consilium Medicum. 2014; 16 (4): 12–6. / Gur'eva I.V., Levin O.S. Diabeticheskaia polineiropatiia. Consilium Medicum. 2014; 16 (4): 12–6. [in Russian]
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13. Mitkov M, Aleksandrova I, Orbetzova M. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv) 2013; 55 (1): 55–63.
14. Tesfaye S, Boulton A, Dickenson A. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013; 36 (9): 2456–65.
15. Snedecor S, Sudharshan L, Cappelleri J et al. Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy. Pain Pract 2014; 14 (2): 167–84.
16. Han T, Bai J, Liu W, Hu Y. A systematic review and meta-analysis of a-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167 (4): 465–71.
17. Maizels M, Mccarberg B. Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain. J Am Ac Fam Physicians 2005; 71; 3: 188–192.
18. Taylor C. Mechanisms of action of gabapentin. Rev Neurol (Paris) 1997; 153 (Suppl. 1): S39–45.
19. Backonja M, Beydoun A, Edwards K et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 1831–6.
20. Rowbotham M, Harden N, Stacey B, Bernstein P. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 1837–42.
21. Hempenstall K, Nurmikko T, Johnson R et al. Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review. PLoS Med 2005; 2 (7): 164–9.
22. Wiffen P, McQuay H, Edwards J, Moore R. Gabapentin for acute and chronic pain. The Cochrane Database of Syst Rev 2005; 3. Art. No.: CD005452.
23. Backonja M. Anticonvulsants (antineuropathics) for neuropathic pain syndromes. Clin J Pain 2000; 16 (2 Suppl.): S67–72.
24. Morello C., Leckband S., Stoner C. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch Intern Med 1999; 159 (16): 1931–7.
25. Dworkin R, O'Connor A, Audette J et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 2010; 85 (3 Suppl.): S3–14.
26. Храмилин В.Н., Андреева В.Л., Демидова И.Ю. Комбинированная терапия болевой диабетической полинейропатии: результаты пилотного исследования. Фарматека. 2014; 16.
2. Head KA. Peripheral Neuropathy: Pathogenic Mechanisms and Alternative Therapies. Alternative Med Rev 2006; 11: 294–300.
3. Witzel I-I, Jelinek H, Khalaf K et al. Identifying Common Genetic Risk Factors of Diabetic Neuropathies. Front Endocrinol (Lausanne) 2015; 6: 88–93.
4. Jin HY, Baek HS, Park TS. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy. Diabetes Metab J 2015; 39(6): 461–7.
5. Tremont-Lukats I, Megeff C, Backonja M. Anticonvulsants for neuropathic pain syndromes: mechanisms of action and place in therapy. Drugs 2000; 60 (5): 1029–52.
6. Koo BK. Screening of autonomic neuropathy in patients with type 2 diabetes. Diabetes Metab J 2014; 38: 346–8.
7. Gur'eva I.V., Levin O.S. Diabeticheskaia polineiropatiia. Consilium Medicum. 2014; 16 (4): 12–6. [in Russian]
8. Karayannis G, Giamouzis G, Cokkinos D et al. Diabetic cardiovascular autonomic neuropathy: clinical implications. Expert Rev Cardiovasc Ther 2012; 10 (6): 747–65.
9. Verrotti A, Prezioso G, Scattoni R, Chiarelli F. Autonomic neuropathy in diabetes mellitus. Front Endocrinol (Lausanne) 2014; 5: 205–10.
10. Cohena J, Estaciob R, Lundgrenc R et al. Diabetic autonomic neuropathy is associated with an increased incidence of strokes. Auton Neurosci 2003; 108 (1–2): 7–8.
11. Sun L, Chen Y, Wang X et al. The protective effect of alpha lipoic acid on Schwann cells exposed to constant or intermittent high glucose. Biochem Pharmacol 2012; 84 (7): 961–73.
12. Ziegler D, Ametov A, Barinov A et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy. The SYDNEY 2 trial. Diabetes Care 2006; 29: 2365–70.
13. Mitkov M, Aleksandrova I, Orbetzova M. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv) 2013; 55 (1): 55–63.
14. Tesfaye S, Boulton A, Dickenson A. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013; 36 (9): 2456–65.
15. Snedecor S, Sudharshan L, Cappelleri J et al. Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy. Pain Pract 2014; 14 (2): 167–84.
16. Han T, Bai J, Liu W, Hu Y. A systematic review and meta-analysis of a-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167 (4): 465–71.
17. Maizels M, Mccarberg B. Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain. J Am Ac Fam Physicians 2005; 71; 3: 188–192.
18. Taylor C. Mechanisms of action of gabapentin. Rev Neurol (Paris) 1997; 153 (Suppl. 1): S39–45.
19. Backonja M, Beydoun A, Edwards K et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 1831–6.
20. Rowbotham M, Harden N, Stacey B, Bernstein P. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 1837–42.
21. Hempenstall K, Nurmikko T, Johnson R et al. Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review. PLoS Med 2005; 2 (7): 164–9.
22. Wiffen P, McQuay H, Edwards J, Moore R. Gabapentin for acute and chronic pain. The Cochrane Database of Syst Rev 2005; 3. Art. No.: CD005452.
23. Backonja M. Anticonvulsants (antineuropathics) for neuropathic pain syndromes. Clin J Pain 2000; 16 (2 Suppl.): S67–72.
24. Morello C., Leckband S., Stoner C. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch Intern Med 1999; 159 (16): 1931–7.
25. Dworkin R, O'Connor A, Audette J et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 2010; 85 (3 Suppl.): S3–14.
26. Храмилин В.Н., Андреева В.Л., Демидова И.Ю. Комбинированная терапия болевой диабетической полинейропатии: результаты пилотного исследования. Фарматека. 2014; 16.
2. Head KA. Peripheral Neuropathy: Pathogenic Mechanisms and Alternative Therapies. Alternative Med Rev 2006; 11: 294–300.
3. Witzel I-I, Jelinek H, Khalaf K et al. Identifying Common Genetic Risk Factors of Diabetic Neuropathies. Front Endocrinol (Lausanne) 2015; 6: 88–93.
4. Jin HY, Baek HS, Park TS. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy. Diabetes Metab J 2015; 39(6): 461–7.
5. Tremont-Lukats I, Megeff C, Backonja M. Anticonvulsants for neuropathic pain syndromes: mechanisms of action and place in therapy. Drugs 2000; 60 (5): 1029–52.
6. Koo BK. Screening of autonomic neuropathy in patients with type 2 diabetes. Diabetes Metab J 2014; 38: 346–8.
7. Гурьева И.В., Левин О.С. Диабетическая полинейропатия. Consilium Medicum. 2014; 16 (4): 12–6. / Gur'eva I.V., Levin O.S. Diabeticheskaia polineiropatiia. Consilium Medicum. 2014; 16 (4): 12–6. [in Russian]
8. Karayannis G, Giamouzis G, Cokkinos D et al. Diabetic cardiovascular autonomic neuropathy: clinical implications. Expert Rev Cardiovasc Ther 2012; 10 (6): 747–65.
9. Verrotti A, Prezioso G, Scattoni R, Chiarelli F. Autonomic neuropathy in diabetes mellitus. Front Endocrinol (Lausanne) 2014; 5: 205–10.
10. Cohena J, Estaciob R, Lundgrenc R et al. Diabetic autonomic neuropathy is associated with an increased incidence of strokes. Auton Neurosci 2003; 108 (1–2): 7–8.
11. Sun L, Chen Y, Wang X et al. The protective effect of alpha lipoic acid on Schwann cells exposed to constant or intermittent high glucose. Biochem Pharmacol 2012; 84 (7): 961–73.
12. Ziegler D, Ametov A, Barinov A et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy. The SYDNEY 2 trial. Diabetes Care 2006; 29: 2365–70.
13. Mitkov M, Aleksandrova I, Orbetzova M. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv) 2013; 55 (1): 55–63.
14. Tesfaye S, Boulton A, Dickenson A. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013; 36 (9): 2456–65.
15. Snedecor S, Sudharshan L, Cappelleri J et al. Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy. Pain Pract 2014; 14 (2): 167–84.
16. Han T, Bai J, Liu W, Hu Y. A systematic review and meta-analysis of a-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167 (4): 465–71.
17. Maizels M, Mccarberg B. Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain. J Am Ac Fam Physicians 2005; 71; 3: 188–192.
18. Taylor C. Mechanisms of action of gabapentin. Rev Neurol (Paris) 1997; 153 (Suppl. 1): S39–45.
19. Backonja M, Beydoun A, Edwards K et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 1831–6.
20. Rowbotham M, Harden N, Stacey B, Bernstein P. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 1837–42.
21. Hempenstall K, Nurmikko T, Johnson R et al. Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review. PLoS Med 2005; 2 (7): 164–9.
22. Wiffen P, McQuay H, Edwards J, Moore R. Gabapentin for acute and chronic pain. The Cochrane Database of Syst Rev 2005; 3. Art. No.: CD005452.
23. Backonja M. Anticonvulsants (antineuropathics) for neuropathic pain syndromes. Clin J Pain 2000; 16 (2 Suppl.): S67–72.
24. Morello C., Leckband S., Stoner C. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch Intern Med 1999; 159 (16): 1931–7.
25. Dworkin R, O'Connor A, Audette J et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 2010; 85 (3 Suppl.): S3–14.
26. Храмилин В.Н., Андреева В.Л., Демидова И.Ю. Комбинированная терапия болевой диабетической полинейропатии: результаты пилотного исследования. Фарматека. 2014; 16.
________________________________________________
2. Head KA. Peripheral Neuropathy: Pathogenic Mechanisms and Alternative Therapies. Alternative Med Rev 2006; 11: 294–300.
3. Witzel I-I, Jelinek H, Khalaf K et al. Identifying Common Genetic Risk Factors of Diabetic Neuropathies. Front Endocrinol (Lausanne) 2015; 6: 88–93.
4. Jin HY, Baek HS, Park TS. Morphologic Changes in Autonomic Nerves in Diabetic Autonomic Neuropathy. Diabetes Metab J 2015; 39(6): 461–7.
5. Tremont-Lukats I, Megeff C, Backonja M. Anticonvulsants for neuropathic pain syndromes: mechanisms of action and place in therapy. Drugs 2000; 60 (5): 1029–52.
6. Koo BK. Screening of autonomic neuropathy in patients with type 2 diabetes. Diabetes Metab J 2014; 38: 346–8.
7. Gur'eva I.V., Levin O.S. Diabeticheskaia polineiropatiia. Consilium Medicum. 2014; 16 (4): 12–6. [in Russian]
8. Karayannis G, Giamouzis G, Cokkinos D et al. Diabetic cardiovascular autonomic neuropathy: clinical implications. Expert Rev Cardiovasc Ther 2012; 10 (6): 747–65.
9. Verrotti A, Prezioso G, Scattoni R, Chiarelli F. Autonomic neuropathy in diabetes mellitus. Front Endocrinol (Lausanne) 2014; 5: 205–10.
10. Cohena J, Estaciob R, Lundgrenc R et al. Diabetic autonomic neuropathy is associated with an increased incidence of strokes. Auton Neurosci 2003; 108 (1–2): 7–8.
11. Sun L, Chen Y, Wang X et al. The protective effect of alpha lipoic acid on Schwann cells exposed to constant or intermittent high glucose. Biochem Pharmacol 2012; 84 (7): 961–73.
12. Ziegler D, Ametov A, Barinov A et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy. The SYDNEY 2 trial. Diabetes Care 2006; 29: 2365–70.
13. Mitkov M, Aleksandrova I, Orbetzova M. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv) 2013; 55 (1): 55–63.
14. Tesfaye S, Boulton A, Dickenson A. Mechanisms and management of diabetic painful distal symmetrical polyneuropathy. Diabetes Care 2013; 36 (9): 2456–65.
15. Snedecor S, Sudharshan L, Cappelleri J et al. Systematic Review and Meta-Analysis of Pharmacological Therapies for Painful Diabetic Peripheral Neuropathy. Pain Pract 2014; 14 (2): 167–84.
16. Han T, Bai J, Liu W, Hu Y. A systematic review and meta-analysis of a-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167 (4): 465–71.
17. Maizels M, Mccarberg B. Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain. J Am Ac Fam Physicians 2005; 71; 3: 188–192.
18. Taylor C. Mechanisms of action of gabapentin. Rev Neurol (Paris) 1997; 153 (Suppl. 1): S39–45.
19. Backonja M, Beydoun A, Edwards K et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 1831–6.
20. Rowbotham M, Harden N, Stacey B, Bernstein P. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 1837–42.
21. Hempenstall K, Nurmikko T, Johnson R et al. Analgesic Therapy in Postherpetic Neuralgia: A Quantitative Systematic Review. PLoS Med 2005; 2 (7): 164–9.
22. Wiffen P, McQuay H, Edwards J, Moore R. Gabapentin for acute and chronic pain. The Cochrane Database of Syst Rev 2005; 3. Art. No.: CD005452.
23. Backonja M. Anticonvulsants (antineuropathics) for neuropathic pain syndromes. Clin J Pain 2000; 16 (2 Suppl.): S67–72.
24. Morello C., Leckband S., Stoner C. Randomized double-blind study comparing the efficacy of gabapentin with amitriptyline on diabetic peripheral neuropathy pain. Arch Intern Med 1999; 159 (16): 1931–7.
25. Dworkin R, O'Connor A, Audette J et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 2010; 85 (3 Suppl.): S3–14.
26. Храмилин В.Н., Андреева В.Л., Демидова И.Ю. Комбинированная терапия болевой диабетической полинейропатии: результаты пилотного исследования. Фарматека. 2014; 16.
Авторы
П.Р.Камчатнов*1, М.А.Евзельман2
1 ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ФГБОУ ВПО Орловский государственный университет им. И.С.Тургенева. 302026, Россия, Орел, ул. Комсомольская, д. 95
*pavkam7@gmail.com
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 I.S.Turgenev Oryol State University. 302026, Russian Federation, Oryol, ul. Komsomol'skaia, d. 95
*pavkam7@gmail.com
1 ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ФГБОУ ВПО Орловский государственный университет им. И.С.Тургенева. 302026, Россия, Орел, ул. Комсомольская, д. 95
*pavkam7@gmail.com
________________________________________________
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 I.S.Turgenev Oryol State University. 302026, Russian Federation, Oryol, ul. Komsomol'skaia, d. 95
*pavkam7@gmail.com
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