Lefu la tsoekere > Mathata a lefu la tsoekere

Lefu la tsoekere ke lefu le holofatsang la methapo ea kutlo e bakoang ke mathata a metabolic a hlahang ka lebaka la lefu la tsoekere. Boloetse bona bo bonahatsoa ke ho hloka kutloelo-bohloko le khatello ea kelello.

Ho buuoa ka lefu la tsoekere ho atile ebile ho fumanoa, ho latela bangoli ba fapaneng, ho bakuli ba 30-50% ba nang le lefu la tsoekere.

Lisosa le Lintho Tse Kotsi

Karolo e ka sehloohong ho methapo ea methapo ea methapo ea lefu la tsoekere ke ea micangiopathies, ke hore, tšenyo methapong e nyane ea mali e matlafatsang mabota a methapo le methapo ea kutlo. Ho haella ha mali ho lithane tsa methapo ho baka mathata a metabolic ho eona mme e thusa ho bokella lihlahisoa tsa khatello ea oxidative. Ka lebaka leo, lithaelese tsa methapo lia ruruha, tsamaiso ea methapo ea motlakase ea mpefala. Qetellong, methapo ea kutlo ea methapo.

Lintho tse eketsang kotsi ea ho ba le lefu la tsoekere:

botsofali
khatello ea kelello ea methapo
hyperglycemia
nako e telele ea lefu la tsoekere,
ho tsuba
botenya.

Mefuta ea lefu lena

Ho latela sebopeho sa topics, ho na le:

autonomic neuropathy. E amana le tlolo ea molao ea ho boloka litho tsa ka hare,
peripheral neuropathy. Bongata ba methapo ea mokokotlo boa ameha.

Tloaelong ea bongaka, mofuta oa syndromic o sebelisoa haholo:

Polyneuropathy e akaretsang. Ho latela sesepa sa methapo ea kutlo kapa ea motor, e arotsoe ka maikutlo le methapo ea methapo, ka ho latellana. Ka tšenyo e tšoanang ka mefuta e 'meli ea methapo ea kutlo, ba bua ka neuropathy e kopaneng.
Autonomic (vegetative) neuropathy. E arotsoe ka mefuta ea sudomotor, pelo, phefumoloho, urogenital le gastrointestinal.
Mulopocal (focal) neuropathy. Ho kenyelletsa demyelinating e sa foleng ea ho ruruha, ho tsitsipanya, cranial neuropathy, plexopathy (radiculoneuropathy), amyotrophy.

Ka linako tse ling ka tsela e arohaneng, neuropathy ea mantlha e khetholoha, e iponahatsang:

likotsi tsa methapo ea pelo e mpe haholo,
encephalomyelopathy
mathata a kelello a hlobaetsang.

Methati ea lefu lena

Mehato e meraro ea lefu la tsoekere e ea khetholoha:

Subclinical.
Kliniki (e se nang bohloko, e bohloko le e sa foleng ea bohloko bo sa foleng).
Mothati oa mathata a morao-rao (lefu la tsoekere, ho holofala ha leoto, joalo-joalo).

Ho buuoa ka lefu la tsoekere ho atile ebile ho fumanoa, ho latela bangoli ba fapaneng, ho bakuli ba 30-50% ba nang le lefu la tsoekere.

Sebopeho sa peropheral neuropathy ea lefu la tsoekere se tšoauoa ke:

maikutlo a ho tepella, ho chesa, letlalo la hlooho (paresthesia),
thole
bohloko ba menoana le menoana, matsoho le maoto,
tahlehelo ea maikutlo a mocheso
sensitivity e eketsehileng ea tactile (hypnothesia),
bofokoli ba mesifa
fokoliseha ho teba ha matla a tendon,
khokahano e senyehileng ea mekhatlo le gait.

Bohloko ba nako e telele bo baka ho hloka boroko, 'me ka mor'a moo khatello e matla ea maikutlo.

Ka mofuta o ikemetseng oa lefu la tsoekere, lesion ea tsamaiso ea methapo ea kutlo e ka hare ea litho tsa ka hare e bonoa, e leng se lebisang ho senyeha ha mesebetsi ea bona. Setšoantšo sa tliliniki sa mofuta ona oa lefu o khethoa ke hore na tsamaiso ea setho se itseng e ba le bothata bo boholo hakae:

Phekolo ea lefu la pelo le methapo. E qala lilemong tsa pele tsa lefu la tsoekere. Tachycardia, orthostatic hypotension (ho fokotseha ha khatello ea mali ha mokuli a ea sebakeng se emeng), le liphetoho tse ling ho electrocardiogram (e leng ho eketsa nako ea QT) ke tšobotsi. Monyetla oa ho ba le mofuta o se nang bohloko oa infarate ea myocardial oa eketseha.
Gastrointestinal diabetesic neuropathy. Ka tlhaho e bonahatsoa ke hypersalivation, gastroparesis (lefu le sa ferekaneng la gastric), pathological gastroesophageal Reflux. Hangata bakuli ba fumanoa ba na le liso tsa ka mpeng le lisele tsa ka mpeng, gallbladder dyskinesia, acid e tlase gouritis, lefu la gallstone, le hepatosis e mafura.
Urogenital diabetesic neuropathy. Ho na le tlolo ea molumo oa methapo ea kutlo le lesapo la mokokotlo, e lebisang ho ho senyeheng ha moroto kapa ho bolokoa ha urine, mme hape ho theha litabatabelo tsa nts'etsopele ea ts'oaetso ea ts'oaetso le ts'oaetso ea ts'ebetso ea "urst" (cystitis, pyelonephritis). Ho banna, neuropathy ea urogenital e ka baka tšenyo ea kutloisiso ea bohloko ba testicles le ho se sebetse hantle ha erectile, 'me ho basali - anorgasmia le ho omella ha mucosa ea botšehali.
Sudomotor diabetesic neuropathy. E tšoauoa ka ho fufuleloa ho eketsehileng ha 'mele oohle (hyperhidrosis e bohareng) ka ho fufuleloa ho fokotsehileng ha matsoho le maoto (ka distal an- kapa hypohydrosis). Pontšo ena ea neuropathy e bonoa ka ho hlaka bosiu le ha o ja.
Karolo ea methapo e amanang le lefu la tsoekere. E tsamaisana le ho fokotseha ha motsoako oa lintho tse ling tse sebelisang phello ea mali, hyperventilation ea matšoafo, liketsahalo tse amanang le ho koaleha moea ka nakoana.

Ho thibela nts'etsopele ea lefu la tsoekere le lefu la tsoekere, hoa hlokahala ho laola boemo ba tsoekere maling, ja hantle le ho phela bophelo bo mafolofolo.

Ts'oaetso

Ho tseba lefu la tsoekere le lefu la tsoekere, haholo-holo mofuta oa limela tsa lefu lena, hangata ho thata. Taba ea mantlha, ho hlahlojoa le setsebi, ebe ho etsoa tlhahlobo e kenyeletsang:

qeto ea khatello ea glucose, insulin, glycosylated hemoglobin, C-peptide serum ea mali,
tekanyo ea khatello ea mali
qeto ea pulsation ea methapo ea kutlo,
tlhahlobo e felletseng ea maoto e le ho khetholla poone, poone, liso tsa fungal, bofokoli.

Ntle le setsebi sa endocrinologist, litsebi tse ling tse nyane (setsebi sa methapo ea mafu, gastroenterologist, ngaka ea methapo ea mafu, gynecologist, andrologist urologist, ophthalmologist, podologist, orthopedist) ba nka karolo ho fumanoeng ha lefu la tsoekere la lefu la tsoekere.

Boteng ba matšoao a bongaka a senya ts'ebetso ea pelo, algorithm ea tlhahlobo ea mantlha e tlatselletsoa ke ECG, echocardiography, liteko tsa pelo (liteko tsa methapo, liteko tsa Valsalva). Teko ea mali e boetse e etsoa bakeng sa litaba tsa lipoprotein le cholesterol.

Tlhahlobo ea methapo bakeng sa neuropathy ea lefu la tsoekere e belaelloang e kenyeletsa:

electroneurography
electromyography
Tlhahlobo ea li-Reflex le mefuta e fapaneng ea maikutlo (maikutlo, tactile, vibrational, mocheso, bohloko).

Ka thuto ea lefu la tsoekere ea lefu la tsoekere, ho ka hlokahala hore u etse tlhahlobo ea letlalo le (kapa) methapo ea namane, ebe ho latela tlhahlobo ea nalane ea lintho tse fumanoeng.

Ka lipontšo tsa lefu la setho sa ka mpeng, ho bontšoa tse latelang:

Liteko tsa Helicobacter
Ultrasound ea mpa ea mpa,
bapisa radiograph ea ka mpeng le mala,
Endoscopy.

Tlhahlobo ea mofuta oa urogenital ea lefu la tsoekere e kenyeletsa:

urinalysis
Teko ea Nechiporenko,
Mohlala oa Zimnitsky,
electromyography ea mesifa ea lesapo la senya,
urravenous urology
cystoscopy
Ultrasound ea liphio le lesapo la mokokotlo ka boikemisetso ba tlatsetso ba palo ea mochini o setseng oa moriti.

Phekolo ea lefu la tsoekere le na le nako e telele ebile e rarahane, e ama mekhoa e mengata ea ts'ebetso ea methapo ea methapo. Hoa hlokahala ho fumana tekanyo e phahameng ka ho fetisisa ea puseletso bakeng sa lefu la tsoekere. Bakeng sa sena, ka ho laola tsoekere e serapeng sa mali, ho khethoa litekanyetso tse hlokahalang tsa lithethefatsi tsa hypoglycemic kapa insulin. Ntle le moo, mokhoa oa ho fetola mekhoa oa bophelo oa hlokahala:

sesebelisoa sa motlakase se nepahetseng (tafole ea. 9 ho ea ka Pevzner),
ikoetlisa khafetsa
taolo ea boima ba 'mele.

Ho ntlafatsa lits'ebetso tsa metabolic, ho fanoa ka livithamini tsa B, li-antioxidants (vithamine E, alpha-lipoic acid), likarolo tsa tekolo (litokisetso tsa zinc le magnesium).

Ka bohloko bo boholo, lithethefatsi tse seng khahlanong le ts'oaetso tsa steroidal li bontšoa, hammoho le li-anticonvulsants.

Mekhoa ea physiotherapeutic e sebelisoa: acupuncture, light light, laser therapy, magnetotherapy, motlakase oa motlakase oa methapo, ho silila.

Tlhokomelo e nepahetseng ea maoto e bohlokoa:

e kolobisang letlalo la maoto ka tranelate e khethehileng,
libate tsa maoto tse tloaelehileng
pedicure ea bongaka
ho roala lieta tse bonolo tse sa qekelletsang leoto 'me u sa li tlotse (ha ho hlokahala, roala lieta tsa orthopedic).

Therapy ea mefuta ea limela ea lefu la tsoekere e lokela ho etsoa ho nahana ka likarolo tsa lefu la tsoekere la kliniki.

Ho ka ba le mathata le litlamorao

Mathata a mantlha a mofuta oa pheriferale ea lefu la tsoekere ke:

ho oa ha leoto la leoto,
hamore ea menoana,
letlalo le nang le mathata a letlalo le tebileng,
lefu la tsoekere la maoto.

Ho opeloa ha nako e telele maotong le matsohong a nang le lefu la tsoekere ho baka ho hloka boroko, 'me ka morao ho moo, khatello e matla ea maikutlo.

Hape, lefu la tsoekere le amanang le lefu la tsoekere le ka lebisa kholisong ea:

asymptomatic hypoglycemia,
tlolo ea thermoregulation,
anemia hemeralopia,
diplopia
mokhathala o tsoelang pele (lefu la tsoekere la "cachexia").

Ka ts'oaetso ea pejana le kalafo e sebetsang ea lefu la tsoekere, ho ka etsahala ho emisa ho tsoela pele ha lefu lena. Phihlello ea mefuta e rarahaneng ea lefu la tsoekere ha e ratehe.

Thibelo

Ho thibela nts'etsopele ea lefu la tsoekere le lefu la tsoekere, o hloka:

taolo ea khatello ea tsoekere maling serum,
lijo tsa phepo
ho ikoetlisa ka tsela e itekanetseng empa e le kamehla
ho latela melao ea kalafo ea "insulin" kapa ho latela lithethefatsi tse theolelang tsoekere tse fanoeng ke ngaka.
kalafo e tlang ka nako ea mafu a kopaneng,
tlhatlhobo e tloaelehileng ea endocrinologist, neurologist le litsebi tse ling tse khothalelitsoeng.

Video ea YouTube e mabapi le sehlooho sa sengoloa:

Thuto: o fumane lengolo Tashkent State Medical Institute ka lengolo la tlhokomelo ea bongaka ka 1991. Khafetsa o ile a nka lithupelo tse tsoetseng pele tsa boikoetliso.

Phihlelo ea mosebetsi: ngaka e thusang ho holisa lihlahisoa tsa bongaka ba toropo, mohoebi oa lefapha la hemodialysis.

Tlhahisoleseling e kopantsoe mme e fanoe molemong oa tlhahisoleseling feela. Bona ngaka ea hau pontsong ea pele ea bokuli. Ho ikoetlisa ho kotsi bophelong!

Peripheral Polyneuropathy

Peripheral Polyneuropathy e tšoauoa ka tšenyo ea methapo ea kutlo e liphula tse holimo le tse tlase. Ho na le maikutlo a tukang, ho tsitsipana, bohloko, haholo bosiu, maikutlo a "ho akheha."

Ho na le bofokoli bo ka bang liphateng, ho tsitsipana ha lesapo, maikutlo a senyehileng matsohong le maotong. Liponahatso tsa mofuta ona oa polyneuropathy hangata ke lisosa tsa lefu la tsoekere la lefu la tsoekere.

Autonomic neuropathy

Lipontšo tsa kliniki tsa neuronomic ea autonomic li fapane, e lebisang ho mathata a bohlokoa a tlhahlobo ea mali.

Sebopeho sa pelo e hlaha ka lebaka la tšenyo ea methapo ea kutlo, e fanang ka polokeho ea tsamaiso ea methapo ea pelo. Ka lebaka la tšenyo mothapong oa vagus, phello e nang le kutloelo-bohloko morerong oa pelo e qala ho ata, ho otla ha pelo ka potlako ho hlaha - tachycardia, e phehellang nakong ea ho ikoetlisa le ho phomola, hypotension ea orthostatic, liketsahalo tsa ho lahleheloa ke kelello - maemo a syncopal a ka hlokomeloa. Autonomic cardiovascular neuropathy ke sesosa se ka sehloohong sa infarction ea myocardial e seng bohloko ho bakuli ba nang le lefu la tsoekere.

Ho sebopeho sa ka mpeng neuropathies e baka mathata a ts'ebetso ea motor le ho tsoa ka mpeng, gastroparesis, gastroesophageal Reflux. Hangata ho na le dyskinesia ea gallbladder, lefu la gallstone, mathata a peristalsis.

Sebopeho sa urogenital e bonahatsoang ke tlolo ea molumo oa bladder le ureters, ho ntša metsi hampe, ho boloka kapa ho hlohlona urinary, ho fokotsehile. Tšoaetso ea pampitšana ea urine hangata e ea kenella. Bakeng sa foromo ea ho phefumoloha mananeo a ho hloleha ho phefumoloha, ho koaleha moea ka bosiu ke tšobotsi.

Pathogeneis le sehlopha

Lintho tse latelang li bapala karolo ea bohlokoa ho pathogenesis ea DPN:

1. Microangiopathy (liphetoho tse sebetsang le / kapa sebopeho ho li-capillaries tse ikarabellang bakeng sa microcirculation ea methapo ea methapo).

Mathata a Metaboliki:

Ho kenngwa tshebetsong ha polyol shunt (tsela e 'ngoe ea metabolism ea tsoekere, eo ho eona e fetoloang ho sorbitol (ho sebelisa enzyme aldose reductase) ebe ho fetoha fructose, ho bokellana ha li-metabolites tsena ho lebisa keketseho ea osmolarity ea sebaka sa "interellular".
Ho fokotseha hoa boemo ba myo-inositol, ho lebisang ho fokotseha ha motsoako oa phosphoinositol (karolo ea likarolo tsa lisele tsa methapo ea kutlo), e qetellang e tlatsetsa ho fokotseheng ha metabolism ea matla le tšusumetso ea methapo ea kutlo.
Glycation ea "non-enzymatic and enzymatic glycation" ea liprotheine (glycation ea myelin le tubulin (likarolo tsa methapo ea kutlo) e lebisa ho demyelination le ho senyeha ha tlhahiso ea methapo ea kutlo, glycation ea liprotheine tsa likarolo tse ka tlase tsa "capillaries" li lebisa tšebetsong ea lona le methapo ea methapo methapong ea methapo.
Khatello e eketsehileng ea oxidative (oxidation e eketsehileng ea tsoekere le lipids, ho fokotseha ha ts'ireletso ea antioxidant ho etsa hore ho bokelloe li-radicals tsa mahala tse nang le phello e tobileng ea cytotoxic).
Ntshetsopele ea li-autoimmune complexes (ho ea ka litlaleho tse ling, li-antibodies ho insulin li thibela kholo ea kholo ea methapo, e lebisang ho atrophy ea methapo ea methapo).

Kamano pakeng tsa lintlha tse fapaneng tsa pathogeneis ea DPN e bonts'itsoe Setšoantšong sa 1.

Classified le lipontšo tsa mantlha tsa kliniki tsa DPN

Psal sensory kapa sensorimotor neuropathy

Ka lesapo le hlahelletseng la likhoele tse nyane:

bohloko bo tukang kapa bo tukang,
hyperalgesia
paresthesia
ho lahleheloa ke bohloko kapa maikutlo a mocheso,
ulc maoto
ho haella ha bohloko ba visceral.

Ka tšenyo e kholo ea likhoele tse kholo:

tahlehelo ea kutlo ea vibration
ho felloa ke matla a ho lemoha lintho ka hloko,
areflexia.

Lithethefatsi tsa lithethefatsi

Anuropathy ea bohloko bo boholo

Lefu la ho ruruha le fokolisang khatello ea methapo

O hlohlorisoa ka mokhoa o ferekanyang kelello.
Mathata a Ts'oenyehang.
Asymptomatic hypoglycemia.
Autonomic gastrointestinal neuropathy:
atony ea mala,
atony of gallbladder,
lefu la tsoekere "(" noarrurnal lets'ollo "),
ho sokela
fecal incinuence.
Autonomic neuropathy ea methapo ea pelo le pelo:
ischemia e se nang bohloko
orthostatic hypotension,
morethetho oa pelo
orthostatic tachycardia,
tachycardia ea phomolo,
sekhahla sa pelo se tsitsitseng
Liphetoho mohatleng oa circadian,
fokotsa mamello.
Autonomic neuropathy ea senya.
Autonomic neuropathy ea mokhoa oa ho ikatisa (dysfunction ea erectile, ho khutla hoa kemolo).

Merobo e tsepamisang mohopolo le ea multifocal

Oculomotor nerve (III).
Mofuta oa methapo (Vuction nerve).
Thibela nerve (IV).

Asymmetric proximal letheka le ka tlase la neuropathy

Asymmetric proximal motor neuropathy.
Bohloko bo ka morao, letheka, mangole.
Bofokoli le mokhabiso oa 'mele oa "fluor", "adductor" le "quadriceps", "
Ho lahleheloa ke Reflex ho tloha Quadriceps tendon.
Liphetoho tse fokolang tsa maikutlo.
Ho fokotsa boima ba 'mele.

Bohloko bo fumaneha ka morao, sefubeng, mpeng.
Re fokotse maikutlo kapa khatello ea kelello.

Khatello (moeli):
- leoto le kaholimo: methapo ea methapo kahareng ea carpal,
- leoto le ka tlase: nko ea tibial, methapo ea kutlo.
E sa qhekelloang.

Phekolo le thibelo ea DPN

Morero oa mantlha oa kalafo le thibelo ea DPN ke ts'ebetso ea taolo ea glycemic. Boithuto bo bongata bo entsoeng lilemong tsa morao tjena bo pakile ka mokhoa o kholisang hore ho fihlella maemo a tsoekere a mali hantle ka nako ea letsatsi le le leng ho thibela nts'etsopele ea lipontšo tsa DPN. Phekolo ea morao-rao le e nang le bokhoni ea neuropathy e ke ke ea sebetsa ntle le puseletso e sa khaotseng ea lefu la tsoekere.

Hoa tsebahala hore ho lefu la tsoekere ho na le khaello ea li-vithamine tse ngata le likarolo tsa trace, leha ho le joalo, bakeng sa kalafo ea DPN, karolo ea bohlokoa ka ho fetisisa e bapaloa ka ho tlosa khaello ea livithamini tsa sehlopha B. Livithamini tsa Neurotropic (sehlopha sa B) ke li-coenzymes tse kenyelletsoeng lits'ebetsong tse fapaneng tsa biochemical, ho ntlafatsa matla a sele ea methapo, le ho thibela ho etsoa ha lihlahisoa tsa qetello. glycation ea liprotheine. Litokisetso tsa livithamini tsena li sebelisitsoe ho phekola DPN ka nako e telele hantle. Leha ho le joalo, tšebeliso e arohaneng ea vithamine ea B e 'ngoe e eketsa liente le litafole tse' maloa kalafong ea bakuli, e leng tšitiso e kholo. Neuromultivitis ea lithethefatsi e qoba ho kenella ha lithethefatsi tse ngata, hobane Letlapa le le leng le koahetsoeng filimi le se le na le:

thiamine hydrochloride (vithamine B1) - 100 mg,
pyridoxine hydrochloride (vithamine B6) - 200 mg,
cyanocobalamin (vithamini B12) - 0,2 mg.

Thiamine (vithamine B1) 'meleng oa motho ka lebaka la ts'ebetso ea phosphorylation e fetoha cocarboxylase, e leng coenzyme e amehang liputsong tse ngata tsa enzyme. Thiamine e bapala karolo ea bohlokoa ho carbohydrate, protheine le mafura metabolism, e kenella ka mafolofolo lits'ebetsong tsa maqhubu a ho thothomela hoa methapo ea kutlo.

Pyridoxine (vithamine B6) e ea hlokahala bakeng sa ts'ebetso e tloaelehileng ea ts'ebetso ea methapo ea methapo e bohareng le e poteletseng. Ka sebopeho sa phosphorylated, ke coenzyme e amehang ho metabolism ea amino acid (decarboxylation, transamination, jj.). E sebetsa joaloka coenzyme ea li-enzyme tsa bohlokoahali tse sebetsang liseleng tsa methapo. E nka karolo ho biosynthesis ea li-neurotransmitters tse ngata, joalo ka dopamine, norepinephrine, adrenaline, histamine le γ-aminobutyric acid.

Cyanocobalamin (vithamine B12) e hlokahala bakeng sa ho thehoa ka mokhoa o tloaelehileng oa mali le erythrocyte, hape e kenella mekhoeng e mengata ea phetoho e netefatsang ts'ebetso ea bohlokoa ea 'mele: phetisong ea lihlopha tsa methyl (le likarolo tse ling tsa khabone e le' ngoe), phetolelong ea li-acid tsa acid, protheine, phapusing ea amino acid, lik'habohaedreite. E na le phello e molemo lits'ebetsong tse teng tsamaisong ea methapo (synthetic of acidic and lipid composition of cerebrosides and phospholipids). Mefuta ea Coenzyme ea cyanocobalamin - methylcobalamin le adenosylcobalamin lia hlokahala bakeng sa ho pheta-pheta ha lisele le kholo.

Boithuto ba boemo ba methapo ea methapo ea kutlo ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 bo bontšitse hore Neuromultivitis e na le phello e ntle boikhatellong ba kutlo ba maoto le maqhubu, hape e fokotsa haholo botebo ba letšoao la bohloko. Sena se bontša ho fokotseha hoa menyetla ea ho ba le liso tsa maoto a trophic le keketseho ea boleng ba bophelo ba bakuli ba nang le distal DPN. Hape ho lokela ho hlokomeloe bonolo ba ho tsamaisa mofuta oa kalafo motheong oa kantle, hobane setlhare ha se hloke tsamaiso ea batsoali.

Alpha lipoic acid ke coenzyme ea li-enzyme tsa bohlokoa tsa potoloho ea Krebs, eu lumellang ho khutlisetsa tekanyo ea matla ea methapo ea methapo, hammoho le antioxidant (e le moemeli oa tlhaho oa oxidizing), e etsang hore ho khonehe ho thibela tšenyo e eketsehileng mehahong ea methapo le ho sireletsa lithane tsa methapo ho tsoa ho li-radicals tsa mahala. Pele, bakeng sa libeke tse 2-5. (Bonyane thupelo - 15, ka nepo - 20) α-lipoic acid e beoa joalo ka ts'ebetso ea letsatsi le letsatsi ea iv drip ea 600 mg / ka letsatsi. Kamora moo, ba fetohela matlapeng a nang le 600 mg ea α-lipoic acid, Letlapa le le 1 / khoeli bakeng sa likhoeli tse 1.5-2.

Bakeng sa kalafo ea mofuta o utloisang bohloko oa DPN, li-analgesics tse bonolo, lithethefatsi tse seng khahlanong le ts'oaetso (acetylsalicylic acid, paracetamol) li ka eketsoa ho lithethefatsi tse kaholimo. Har'a bona, ho bohlokoa ho hlokomela motsoako oa lithethefatsi Neurodiclovit, o nang le livithamini tsa diclofenac le B (B1, B6, B12), e nang le phello e boletsoeng ea hore li-analgesic, anti-inflammatory le antipyretic.

Ts'ebeliso ea lihlopha tse joalo tsa lithethefatsi joalo ka li-antidepressants tsa li-tricyclic (amitriptyline 25-50-100 mg bosiu), gabapentin (lethal dose la pele - 300 mg, keketseho ka 300 mg ka matsatsi a 1-3, tekanyetso e kholo - 3600 mg), pregabalin (tekanyetso ea pele) e bonts'oa - 150 mg, keketseho ho 300 mg ka matsatsi a 3-7, lethal dose e kholo - 600 mg (e arotsoe ka litekanyetso tse 2-3), duloxetine (lethal dose la pele - 60 mg 1 r. / Letsatsi, ka linako tse ling le nyolohela ho 60 mg 2 r. / letsatsi, tekanyo e phahameng ke 120 mg).

Bakeng sa kalafo ea neuronomic ea matsoele ea matsoele e sebelisoa:

ka atony ea ka mpeng: cisapride (5- 40 mg 2 - 4 leq. / letsatsi metsotso e 15 pele ho lijo), metoclopramide (5 - 10 mg, 3 - 4 p. / letsatsi), domperidone (10 mg 3 leq. / letsatsi),
ka enteropathy (lets'ollo): loperamide (lethal dose la pele ke 2 mg, ebe 2 - 2 mg / letsatsi ho ea ho maqhubu a 1ml. / ka letsatsi, empa eseng ho feta 6 mg bakeng sa boima ba mokuli ka mong ka makhetlo a 20).

Bakeng sa kalafo ea "neuronomicuropathy" ea pelo le methapo ea pelo (resta tachycardia), li-blockers tsa pelo, li-blockers tsa calcium calcium (jk. Verapamil, Diltiazem Lannacher) li sebelisoa.

Bakeng sa phekolo ea ho senyeha ha erectile dysfunction, mofuta oa 5 phosphodiesterase inhibitors (haeba ho se na li-contraindication), tsamaiso e bohlale ea alprostadil, prosthetics, tlhabollo ea kelello e sebelisoa.

Bakeng sa thibelo e akaretsang ea hypovitaminosis le mathata, bakuli ba nang le lefu la tsoekere ba boletsoe litokisetso tsa multivitamin. Tabeng ena, tsamaiso ea li-vithamine tsa B ho litekanyetso tsa kalafo (Neuromultivitis) le eona e ea sebetsa.