Diabetic peripheral neuropathy

  Diabetic peripheral neuropathy is a general term for a variety of lesions that occur in the peripheral nervous system in diabetes. It is one of the major complications of diabetes mellitus and is characterized by a high incidence and early onset of symptoms.  Clinically, diabetic peripheral neuropathy most often involves the femoral nerve, sciatic nerve, median nerve, radial nerve, ulnar nerve, peroneal nerve and lateral femoral cutaneous nerve. Early symptoms are mainly sensory disturbances, but electrophysiological examination often shows involvement of both motor and sensory nerves. Clinical symptoms are symmetrical pain and sensory abnormalities, with lower extremity symptoms more common than upper extremity. Sensory abnormalities include numbness, ankylosis, insect crawling, fever, electric shock-like sensation, often from the distal toes up to the knee, the patient has a sock and glove-like sensation. Severe cases of sensory disturbance may present with arthrosis and ulcers in the lower extremities. The pain is stabbing, burning, drilling pain, and seems to be deep in the bone marrow, sometimes severe pain such as amputation pain is light day and night. Sometimes there is hypersensitivity to touch, and even the pressure of the quilt is not tolerated, and the quilt must be propped up. When the motor nerve is tired, there is often varying degrees of muscle strength loss, and in the late stage there is dystrophic muscular atrophy. Peripheral neuropathy can be bilateral, unilateral, symmetrical or asymmetrical, but bilateral symmetry is more common.  The signs of diabetic peripheral neuropathy include: (1) weakened or absent Achilles tendon reflex and knee tendon reflex; (2) weakened or absent vibration sensation; (3) weakened or absent position sensation, especially deep sensory loss.  Treatment measures include: Because the etiology and pathogenesis of diabetes and peripheral neuropathy are unknown, there is no specific etiological therapy for diabetic peripheral neuropathy so far. The current treatment measures are: 1. Strict control of blood sugar is the basic principle for the treatment of this disease. In recent years, the use of insulin pumps abroad to strictly control blood glucose on the prevention and treatment of neuropathy has been a good effect.  2, drug treatment. In the past years, a large number of B vitamins, including B1, B2, B6, B12 and vitamin B complex have been tried to be ineffective. In recent years, the following drugs are mostly used: aldose reductase inhibitors, inositol, methyl B12?  3, symptomatic treatment. Including: ① physical therapy. For numbness and pain, warm water bath, warm heat therapy, massage, acupuncture treatment can be used, which can have certain effect. ② Analgesics. Commonly used are aminometrazine, phenytoinamide, fluphenazine, amytalin, etc. ③Antidiarrheal agents. Tannins, bismuth subcarbonate, Chinese herbal medicine to strengthen the spleen and warm the kidneys to stop diarrhea. Acupuncture treatment is more effective for diabetic diarrhea. ④Neurogenic bladder. Suprapubic massage can be tried to encourage automatic urination every 3-4 hours; in more severe cases, tranylcypromine 0.25mg is given by subcutaneous injection, which is effective; if necessary, indwelling catheterization and bladder irrigation should be used. ⑤ Gastrointestinal hypotension can be given Gastrodia 5-10mg, 3-4 times a day. (6) Postural hypotension can be given 9α-fluorocortisone 0.1-0.3mg once a day, which should be given slowly when getting up or standing up. (vii) Impotence. Chorionic gonadotropin or testosterone can be injected intramuscularly, and herbal kidney tonics have certain efficacy.  4. Dietary attention: 1) Comprehensive supplementation of various nutrients.  (2), diabetic neuropathy diet of active control of blood sugar.  3).Actively engage in exercise therapy and figure out the exercise rules.  4), reasonable application of hypoglycemic drugs.  5), efforts to long-term cultivation of good dosage of dietary rules, understand clearly diabetic neuropathy diet note.